Maternity Exam 1
Which of the following recommendations should the nurse make to the patient with diabetes who is interested in becoming pregnant? A. "Achieving excellent glycemic control now will help ensure positive pregnancy outcomes" B. "Because of your diabetes, you will not be able to deliver vaginally" C. "Pregnancy risks for diabetic mothers are caused by macrocosmic infants" D. "You will need to make sure to have good control of your blood sugars as soon as you find out you are pregnant"
A. "Achieving excellent glycemic control now will help ensure positive pregnancy outcomes"
The nurse is caring for a primipara with PROM who appears extremely anxious and reveals that she is scared her birthing process will be extremely painful because it will be "dry". Which is the best response from the nurse? A. "No birth is ever really dry, because amniotic fluid continues to be manufactured." B. "This is true but you can receive pain medication to help relieve this." C. "Don't think so far ahead; concentrate on the problem at hand." D. "Although the birth will be dry, it won't be painful."
A. "No birth is ever really dry, because amniotic fluid continues to be manufactured."
A woman refuses to have an epidural block because she does not want to have a spinal headache after birth. What would be the nurse's best response? A. "Spinal headache is not a usual complication of epidural blocks." B. "Your health care provider knows what is best for you." C. "The pain relief offered will compensate for the discomfort afterward." D. "The anesthesiologist will do her best to avoid this."
A. "Spinal headache is not a usual complication of epidural blocks."
A low-risk client is in the active phase of labor. The nurse evaluates the fetal monitor strip at 10:00 a.m. and notes the following: moderate variability, FHR in the 130s, occasional accelerations, and no decelerations. At what time should the nurse reevaluate the FHR? A. 10:30 a.m. B. 11:15 a.m. C. 10:05 a.m. D. 11:30 a.m.
A. 10:30 a.m.
A client comes to the clinic for her usual prenatal check up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation? A. 24 weeks B. 20 weeks C. 28 weeks D. 32 weeks
A. 24 weeks
A client presents to the health care clinic for her first prenatal visit. The client's current nonpregnant weight is normal for her height. What recommendation for proper weight gain should the nurse discuss with the client? A. 25 to 35 pounds B. 35 to 40 pounds C. 40 to 45 pounds D. 15 to 25 pounds
A. 25 to 35 pounds
Which of the following would a provider diagnose with infertility? A. A 37-year-old women trying to get pregnant for 7 months B. A 24-year-old woman trying to get pregnant for 11 months C. A 30-year-old woman trying to get pregnant for 6 months D. None of the above
A. A 37-year-old women trying to get pregnant for 7 months Infertility is diagnosed after one year of well-timed intercourse for women under 35 years old. Infertility is diagnosed after 6 months for women over 35.
A client has opted to receive epidural anesthesia during labor. Which of the following interventions should the nurse implement to reduce the risk of a significant complication associated with this type of pain management? A. Administration of 500 mL of IV Ringer's lactate B. Administration of aspirin C. Move the woman into a supine position D. Administration of 1000 mL of IV glucose solution
A. Administration of 500 mL of IV Ringer's lactate
During the active stage of labor, a patient's membranes spontaneously rupture. Which action should the nurse do first after this occurs? A. Assess fetal heart rate for fetal safety. B. Instruct to bear down with the next contraction. C. Test a sample of amniotic fluid for protein. D. Turn the patient onto the left side.
A. Assess fetal heart rate for fetal safety.
The nurse has just applied a sterile pressure dressing to an epidural site after removing the epidural catheter in a client who is now recovering from a standard delivery. Which action should the nurse now prioritize? A. Assess return of sensory and motor functions to the lower extremities. B. Let the client rest and recover while keeping her legs slightly elevated. C. Make sure the client receives plenty of fluids. D. Help the client get up and walk around immediately.
A. Assess return of sensory and motor functions to the lower extremities.
A patient in labor is prescribed transcutaneous electrical nerve stimulation (TENS) to help with pain relief during labor. How should the nurse explain the process of pain relief with this method? A. Counterirritation stimulation blocks pain from traveling to the spinal cord. B. Small injections of sterile saline reduce are used to reduce the amount of back pain. C. A machine is used to measure the patient's ability to relax during contractions. D. Needles are inserted along meridians to release endorphins and control pain.
A. Counterirritation stimulation blocks pain from traveling to the spinal cord.
The nurse identifies from a client's prenatal record that she has a documented gynecoid pelvis. Upon the client entering the labor and delivery department, which nursing action is best? A. Take no extra measures; prepare for a standard labor. B. Prepare for vital signs and fetal monitoring hourly. C. Notify the client's support person that the labor is typically long. D. Anticipate this client is a one-to-one registered nursing assignment.
A. Take no extra measures; prepare for a standard labor.
Rebecca had a category III fetal heart rate tracing. What does this likely mean? A. There was poor perfusion to her placenta from the abruption and the result was late decelerations B. The fetus was likely experiencing head compression and the result was early decelerations C. There was poor perfusion to her placenta from the abruption and the result was variable decelerations D. There were likely no decelerations, moderate variability, and a baseline of 130
A. There was poor perfusion to her placenta from the abruption and the result was late decelerations Category III tracings are non reassuring and require expedited interventions
At what time is the laboring client encouraged to push? A. When the cervix is fully dilated B. When the health care provider has arrived C. When she feels the urge to push D. When the fetal head can be seen
A. When the cervix is fully dilated
The nurse caring for a client in preterm labor observes abnormal fetal heart rate (FHR) patterns. Which nursing intervention should the nurse perform next? A. administration of oxygen by mask B. application of vibroacoustic stimulation C. tactile stimulation D. fetal scalp stimulation
A. administration of oxygen by mask
A patient complains of breast tenderness and about not getting her period, which was due 2 days ago. She states the pregnancy test she took this morning was negative. What is the best response by the nurse? A. "If the pregnancy test was negative, you are not pregnant" B. "You should come to the clinic to get an early trimester ultrasound" C. "If you don't get your period, take another pregnancy test in three days" D. "You should come to the hospital to rule out an ectopic pregnancy"
C. "If you don't get your period, take another pregnancy test in three days" If she still thinks she may be pregnant after a negative pregnancy tests, she should take another test in 3-7 days because her first test may have been a false negative. She does not need an ultrasound at this time. it is too early to determine if she has an ectopic pregnancy. Signs of an ectopic pregnancy include unilateral abdominal pain and vaginal bleeding.
When collecting data to devise a labor plan for a multiparous woman, which question best allows the nurse to develop individualized strategies? A. "How do you want the health care team to plan your care?" B. "Who do you want to be with you when you are in labor?" C. "Tell me how you handled labor pain in your past deliveries." D. "Picking from these options, what options do you feel is best?"
C. "Tell me how you handled labor pain in your past deliveries."
A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? A. Specific gravity of 1.010 B. Trace of glucose C. 2+ Protein in urine D. Straw-like color
C. 2+ Protein in urine
Is the following statement true or false: Often preconception care involves assessing and treating preexisting conditions and can have a positive impact on pregnancy outcomes.
True
Is the following statement true or false: It is important to monitor infant feedings and output while under phototherapy lights.
True Because adequate input helps with the excretion of excess bilirubin
Is the following statement true or false: A nutrition assessment can be used to assess for deficiencies, eating disorders, and areas of concern.
True Nutritional assessments are useful for many reasons including providing patient education, determining risk, and addressing concerns
Is the following statement true or false: A nurse expects a patient's hemoglobin and hematocrit to be lower at the end of pregnancy than they were at her initial prenatal visit.
True Proportionally, the volume of plasma increases more than the increase in red blood cells during pregnancy. The net result is an expected decrease in hemoglobin and hematocrit from the beginning to the end of pregnancy. This change is called physiologic anemia, or pseudoanemia, of pregnancy
A labor and delivery nurse knows that when assessing a woman's contraction pattern, it is important to include which of the following? Select all that apply. A. intensity B. frequency C. activity of fetus D. status of membranes E. duration
A. intensity B. frequency E. duration
A client in her third trimester of pregnancy visits the health care center and asks why she is constipated. The nurse would include which most likely cause when responding to the client? A. pressure on intestine by the growing fetus B. relaxation of cardioesophageal sphincter C. engorgement of veins by the weight of the uterus D. pressure of fetal head on the bladder
A. pressure on intestine by the growing fetus
A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor? A. restoration of blood flow to uterus and placenta B. shortening of the upper uterine segment C. effacement and dilation of the cervix D. reduction in length of the cervical canal
A. restoration of blood flow to uterus and placenta
A pregnant client is to receive fentanyl IV for pain control during labor. The nurse would assess the client for which possible effect? A. slowing of labor B. hypertension C. depression D. tachypnea
A. slowing of labor
A nurse is providing care to a woman during the third stage of labor. Which finding would alert the nurse that the placenta is separating? A. sudden gush of dark blood from the vagina B. boggy, soft uterus C. uterus becoming discoid shaped D. shortening of the umbilical cord
A. sudden gush of dark blood from the vagina
The nurse is assisting a primigravid on calculating the due date of her baby using Naegele's rule. The most important information provided by the mother is: A. the first day of the last menstrual period. B. the last day of her menstrual period. C. the date that intercourse occurred. D. the ovulation date between her periods.
A. the first day of the last menstrual period.
During the second stage of labor, a woman is generally: A. turning inward to concentrate on body sensations. B. very aware of activities immediately around her. C. no longer in need of a support person. D. anxious to have people around her.
A. turning inward to concentrate on body sensations.
The client is being rushed into the labor and delivery unit. At which station would the nurse document the fetus immediately prior to birth? A. -5 B. +4 C. +1 D. 0
B. +4
Four hours ago, a patient with preeclampsia on magnesium sulfate had hyper reflexes and clonus present in both legs. She is now slurring her words, moving slowly, and has no reflexes or clonus. What should you do first? A. Obtain a set of vital signs B. Turn off the magnesium sulfate C. Administer calcium gluconate D. Call the provider to notify about the patient's changes
B. Turn off the magnesium sulfate
A nurse is providing care to a woman in labor. After asssessment of the fetus, the nurse documents the fetal lie. Which term would the nurse use? A. cephalic B. longitudinal C. flexion D. extension
B. longitudinal
What anatomic area should be examined when assessing Montgomery tubercles? A. abdomen B. thorax C. breasts D. perineum
C. breasts
The nurse is caring for a client in active labor who has had a fetal blood sampling to check for fetal hypoxia. The nurse determines that the fetus has acidosis when the pH is: A. 7.21. B. 7.20. C. 7.25 or more. D. 7.15 or less.
D. 7.15 or less.
Gestational diabetes is managed by which of the following? A. Home glucose monitoring B. Diet only C. Exercise D. Insulin only E. A & C
E. A & C Gestational diabetes is managed by a combination of home glucose monitoring, diet, exercise, and potentially medications.
Is the following statement true or false: In a placental abruption, the nurse would always see vaginal bleeding.
False Bleeding may or may not be visible depending on the location of the abruption
The client in active labor overhears the nurse state the fetus is ROA. The nurse should explain this refers to which component when the client becomes concerned? A. fetal position B. fetal attitude C. fetal size D. fetal station
A. fetal position
A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which movements would the nurse include? Select all that apply. A. flexion B. abduction C. descent D. internal rotation E. pronation
A. flexion C. descent D. internal rotation
A woman in her 15th week of pregnancy is about to undergo amniocentesis. Which nursing intervention should be made first? A. Observe the fetal heart rate monitor. B. Obtain a signed consent form. C. Place the client in supine position. D. Have the client void.
B. Obtain a signed consent form.
A woman is in the fourth stage of labor. During the first hour of this stage, the nurse would assess the woman's fundus at which frequency? A. every 5 minutes B. every 15 minutes C. every 20 minutes D. every 10 minutes
A. every 5 minutes
A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor? A. effacement and dilation of the cervix B. restoration of blood flow to uterus and placenta C. reduction in length of the cervical canal D. shortening of the upper uterine segment
B. restoration of blood flow to uterus and placenta
Risk of amniotic fluid volume disorders include which of the following? A. Preterm delivery B. Umbilical cord prolapse C. Variable decelerations in the fetal heart rate D. All of the above
D. All of the above
A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as: A. crowning B. -2 station C. 0 station D. +2 station
B. -2 station
The nurse determines a client is 7 cm dilated. What is the best response when asked by the client's partner how long will she be in labor? A. "She is in active labor; she is progressing at this point and we will keep you posted." B. "She is still in early latent labor and has much too long to go to tell when she will give birth." C. "She is in the transition phase of labor, and it will be within 2 to 3 hours, though it might be sooner." D. "She is doing well and is in the second stage; it could be anytime now."
A. "She is in active labor; she is progressing at this point and we will keep you posted."
The nurse is reviewing the structure and function of various organs in the female reproductive system. Which information should the nurse include about the ovum in the review with the client? A. All the ova a female will ever have are present at birth. B. It contains a small nucleus, within which is a nucleolus called the germinal spot. C. It consists of protoplasm enclosed within a three-layered cell wall. D. The ovum is smaller than the sperm cell.
A. All the ova a female will ever have are present at birth.
Which statement is true regarding analgesia versus anesthesia? A. Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area. B. Hypotension is the most common side effect when systemic analgesia is used. C. Decreased FHR variability is a common side effect when regional anesthesia is used. D. Regional anesthesia should be given with caution close to the time of birth because it crosses the placenta and can cause respiratory depression in the newborn.
A. Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area.
A nurse caring for a pregnant client in labor observes that the fetal heart rate (FHR) is below 110 beats per minute. Which interventions should the nurse perform? Select all that apply. A. Assess client for underlying causes. B. Ignore questions from the client. C. Administer oxygen by mask. D. Turn the client on her left side. E. Reduce intravenous (IV) fluid rate.
A. Assess client for underlying causes C. Administer oxygen by mask D. Turn the client on her left side
A patient with gestational diabetes just delivered a macrocosmic infant. What can the nurse do to prevent hypoglycemia in the infant? A. Assist the patient with breastfeeding as soon as possible B. Obtain infant's blood glucose according to hospital policy C. Assist the patient with skin to skin contact with the infant D. Frequently observe the infant for signs and symptoms of hypoglycemia
A. Assist the patient with breastfeeding as soon as possible Assisting with breastfeeding can help maintain the infant's blood sugar above 50 mg/dL. Monitoring blood glucose, assisting with skin to skin contact, and observing infant for signs and symptoms of hypoglycemia are important but do not prevent hypoglycemia.
A nurse is working with a client who has just begun labor and who has given birth vaginally five previous times. Which of the following interventions will the nurse most likely need to implement to meet the needs of this particular client? A. Convert the birthing room to birth readiness before full dilatation is obtained B. Prepare the client for cesarean birth C. Darken the room lights D. Prepare to administer oxytocin
A. Convert the birthing room to birth readiness before full dilatation is obtained
A mother complains of nipple pain when breastfeeding. A crescent-shaped bruise is noted on top of her nipple. What should the nurse do next? A. Discuss components of a good latch and ask to be present at the next feeding B. Encourage the patient to formula-feed the infant until the bruise has healed C. Administer pain medication and reassure the patient that her experience is normal D. Evaluate the infant's mouth for signs of early teeth or other anomalies
A. Discuss components of a good latch and ask to be present at the next feeding
Which fetal adaptation is anticipated in a vaginal birth? Select all that apply. A. Excretion of respiratory tract mucus B. Circumoral cyanosis after birth C. Decreased intracranial pressure D. Decreasing pH throughout labor E. Changing heart rate during contractions
A. Excretion of respiratory tract mucus D. Decreasing pH throughout labor E. Changing heart rate during contractions
A nurse explains to a pregnant woman the importance of consuming adequate iodine in her diet. Which of the following conditions can a deficiency in iodine lead to? A. Goiter B. Anemia C. Hypercholesterolemia D. Diminished bone density
A. Goiter
Which is the most important nursing assessment of the mother during the fourth stage of labor? A. Hemorrhage B. The mother's psyche C. Blood pressure D. Heart rate
A. Hemorrhage
In providing culturally competent care to a laboring woman, which is a priority? A. Identify how the client expresses labor pain. B. Identify the decision maker within the family. C. Identify any cultural foods used prior to labor. D. Identify who is the support person during the labor.
A. Identify how the client expresses labor pain.
A nurse counsels a pregnant woman regarding her recommended daily allowance of calories. She advises her to obtain her carbohydrate calories from complex carbohydrates rather than simple carbohydrates. What is the best rationale for this guidance? A. More consistent regulation of glucose and insulin B. Provision of a greater amount of calories per gram C. Greater fatty acid content D. Faster digestion of complex than simple carbohydrates
A. More consistent regulation of glucose and insulin
Which nursing action prevents a complication associated with the lithotomy position for the birth of the fetus? A. Placing a wedge under the hips B. Providing a paper bag C. Massaging the client's lower back D. Rubbing the client's legs
A. Placing a wedge under the hips
The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence? A. Quickening B. Placenta previa C. Lightening D. Linea nigra
A. Quickening
Which changes in the female body occur to allow the passage of the fetus down the birth canal? Select all that apply. A. The cervix softens B. Round ligaments contract C. The cervix dilates to 10 cm D. Vaginal rugae stretch and smooth out E. Effacement is noted as 0%
A. The cervix softens C. The cervix dilates to 10 cm D. Vaginal rugae stretch and smooth out
A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as: A. effleurage B. acupressure C. therapeutic touch D. patterned breathing
A. effleurage
Which intervention would be least effective in caring for a woman who is in the transition phase of labor? A. encouraging the woman to ambulate B. urging her to focus on one contraction at a time C. providing one-to-one support D. having the client breathe with contractions
A. encouraging the woman to ambulate
A nurse is interviewing the family members of a pregnant client to obtain a genetic history. While asking questions, which information would be most important? A. if couples are related to each other or have blood ties B. socioeconomic status of the family members C. avoidance of questions on race or ethnic background D. specific physical characteristics of family members
A. if couples are related to each other or have blood ties
A client who requested "no drugs" in labor asks the nurse what other options are available for pain relief. The nurse reviews several options for nonpharmacologic pain relief, and the client thinks effleurage may help her manage the pain. This indicates that the nurse will: A. instruct the client or her partner to perform light fingertip repetitive abdominal massage. B. instruct the client to perform controlled chest breathing with a slow inhale and a quick exhale. C. lead the client through a series of visualizations to aid in relaxation. D. press down firmly with her index finger and forefinger on key trigger points on the client's ankle or wrist.
A. instruct the client or her partner to perform light fingertip repetitive abdominal massage.
A nurse is caring for a client who has been administered an epidural block. Which should the nurse assess next? A. respiratory rate B. temperature C. uterine contractions D. pulse
A. respiratory rate
A nurse is caring for a client who has been administered an epidural block. Which should the nurse assess next? A. respiratory rate B. uterine contractions C. pulse D. temperature
A. respiratory rate
Leticia is correct when she says, "I am getting RhoGAM now..." A. "...because I can become sick if my baby was Rh positive." B. "...because I could make antibodies that could harm my next baby." C."...to ensure my miscarriage is complete." D. "...because my baby was for sure Rh positive."
B. "...because I could make antibodies that could harm my next baby." Fetus had unknown blood type and she is Rh negative
A client asks why she should learn breathing patterns for labor. After instruction is given, the nurse determines teaching has been effective when the client states: A. "Breathing patterns help a woman concentrate on pain." B. "Breathing patterns are distraction techniques taught to decrease pain in labor." C. "Breathing patterns cannot be taught while in labor." D. "Breathing patterns must be used with a coach."
B. "Breathing patterns are distraction techniques taught to decrease pain in labor."
A nurse is conducting a class geared toward changes in early pregnancy and self-care items like perineal hygiene. A woman shares that she douches at least once a day since she has "so much discharge" from her vagina. Which response by the nurse is most appropriate at this time? A. "Douching will definitely keep your vagina clean." B. "During pregnancy, you should not douche because it can cause fluid to enter the cervix resulting in an infection." C. "If you prepare your own douching solution, be sure to boil the water to kill bacteria." D. "Let's discuss this with your health care provider before you continue douching."
B. "During pregnancy, you should not douche because it can cause fluid to enter the cervix resulting in an infection."
A nurse is explaining the fetus's position to a female client whose baby is in the frank breech position. Which statement by the client would indicate that the teaching was understood? A. "My baby's hips and the knees are flexed." B. "My baby's hips are flexed, and the knees are extended." C. "My baby's hips are extended, and the knees are flexed." D. "My baby's hips and knees are extended."
B. "My baby's hips are flexed, and the knees are extended."
A client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse? A. "You don't want to harm the baby by taking medications now, do you?" B. "The safest medication to take for your headaches during your pregnancy would be acetaminophen." C. "Wait until you reach your third trimester. You can take something to relieve headaches then." D. "The safest medication to take for your headaches during your pregnancy would be ibuprofen."
B. "The safest medication to take for your headaches during your pregnancy would be acetaminophen."
A nurse is performing an assessment on a client in early labor who is discouraged about the seemingly slow progress of her labor. Which response should the nurse prioritize for this client after noting the effacement is progressing even though the cervix is still only 2 cm for the past 2 hours? A. Don't mention anything to the client yet; wait for further dilatation to occur. B. "You are still 2 cm dilated, but the cervix is thinning out nicely." C. "There has been no further dilatation; effacement is progressing." D. "You haven't dilated any further, but hang in there; it will happen eventually."
B. "You are still 2 cm dilated, but the cervix is thinning out nicely."
A pregnant woman with an asthma exacerbation tells the nurse she stopped taking her medication because she didn't want it to affect her baby. What is the best response by the nurse? A. "You are right to stop taking any medications while you are pregnant" B. "You should still take your asthma medication while you are pregnant to help control your asthma" C. "You should only take your asthma medications when you have an exacerbation" D. "You probably won't need your medication because asthma always improves with pregnancy"
B. "You should still take your asthma medication while you are pregnant to help control your asthma"
A client in labor has requested the administration of narcotics to reduce pain. At 2 cm cervical dilatation, she says that she is managing the pain well at this point but does not want it to get ahead of her. What should the nurse do? A. Explain to the client that narcotics should only be administered an hour or less before birth. B. Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor. C. Agree with the client, and administer the drug immediately to keep the pain manageable. D. Refuse to administer narcotics because they can develop dependency in the client and the fetus.
B. Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor.
The nurse discovers a new prescription for RhoGAM for a client who is about to undergo a diagnostic procedure. The nurse will administer the RhoGAM after which procedure? A. Contraction stress test B. Amniocentesis C. Biophysical profile D. Nonstress test
B. Amniocentesis
A primigravida client has just arrived in early labor and is showing signs of extreme anxiety over the birthing process. Why should the nurse prioritize helping the client relax? A. Decreased anxiety will increase trust in the nurse. B. Anxiety can slow down labor and decrease oxygen to the fetus. C. Anxiety will increase blood pressure, increasing risk with an epidural. D. Increased anxiety will increase the risk for needing anesthesia.
B. Anxiety can slow down labor and decrease oxygen to the fetus.
The nurse is documenting the length of time in the second stage of labor. Which data will the nurse use to complete the documentation? A. Admission time and time of fetal birth B. Complete cervical dilation and time of fetal birth C. Time of mucous plug expulsion and full cervical dilation D. Effacement time and time when contractions are regular
B. Complete cervical dilation and time of fetal birth
The nurse is assisting a client through labor, monitoring her closely now that she has received an epidural. Which finding should the nurse prioritize to the anesthesiologist? A. Urinary retention B. Inability to push C. Dry, cracked lips D. Rapid progress of labor
B. Inability to push
A multigravida client admitted in active labor has progressed well and the client ane fetus have remained in good condition. Which action should the nurse prioritize if the client suddenly shouts out, "The baby is coming!"? A. Contact the primary care provider. B. Inspect the perineum. C. Time the contractions. D. Auscultate the fetal heart tones.
B. Inspect the perineum.
The nurse is caring for a client whose fetus is noted to be in the position shown. For which fetal lie would the nurse provide client teaching? A. Transverse B. Longitudinal C. Obtuse D. Oblique
B. Longitudinal
When the membranes of a pregnant patient rupture during labor, the nurse determines that the patient and fetus are in danger. What did the nurse assess at the time of membrane rupture? A. Maternal pulse of 90 to 95 beats/min B. Meconium-stained amniotic fluid C. Blood-tinged vaginal discharge at full dilation D. Fetus presenting in an LOA position
B. Meconium-stained amniotic fluid
The nurse provides instructions to a patient with hyperemesis gravidarum. Which outcome indicates that teaching has been effective? A. Patient has vomiting episodes only in the morning. B. Patient is able to ingest a regular diet after progressing through clear liquids and soft foods. C. Patient is able to tolerate soft foods after episodes of vomiting. D. Patient is able to ingest clear liquids between episodes of vomiting.
B. Patient is able to ingest a regular diet after progressing through clear liquids and soft foods.
A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition? A. Keep the head of the client's bed slightly elevated. B. Place the client in the left lateral position. C. Place the client in an orthopneic position. D. Keep the client's legs slightly elevated.
B. Place the client in the left lateral position.
The nurse is educating the client at 12 weeks' gestation regarding the best types of exercise throughout pregnancy. Which activities should the nurse encourage? A. High impact movements enabling less time in the activity B. Stretching and breathing exercises such as yoga C. All activities that the client does in a prepregnant state D. Relaxing activities such as those including hot baths and jacuzzis
B. Stretching and breathing exercises such as yoga
When planning a labor experience for a primigravid, understanding which characteristic of labor pain is most helpful? A. Women innately know how to deal with labor pain. B. The characteristics of labor pain follow a pattern. C. If the woman is in too much pain, a cesarean section is an option. D. All pain is the same.
B. The characteristics of labor pain follow a pattern.
When developing a labor plan with the client, which outcome is the priority? A. The client will attend all prenatal classes prior to delivery. B. The client will direct her pain management techniques. C. The client will be pain-free during the labor process. D. The client will deliver the fetus vaginally.
B. The client will direct her pain management techniques.
During labor, a pregnant patient's doula uses therapeutic touch and massage. Which outcome indicates that these approaches have been effective? A. The patient asks for a cold compress at the end of a contraction. B. The patient is not requesting pain medication. C. The patient is not complaining of leg cramps. D. The patient is focusing on a painting during contractions.
B. The patient is not requesting pain medication.
If a woman with AB+ blood and her partner with B- blood have a baby, what is the likelihood the infant will have an Rh-negative blood type? A. There is no chance the infant will have Rh-negative blood B. There is a 50-100% chance the infant will have Rh-negative blood C. There is a 25-75% chance the infant will have Rh-negative blood D. There is not enough information to determine the infant's blood type
B. There is a 50-100% chance the infant will have Rh-negative blood
The client is requesting information on the various pain medication management techniques that are available so she can decide which option she would like to choose for her impending birth. While gathering together the information, the nurse would indicate which technique as becoming very popular and effective? A. spinal analgesia B. systemic analgesia C. epidural analgesia D. neuraxial analgesia/anesthesia
D. neuraxial analgesia/anesthesia
A patient is 37 weeks pregnant and exposed to a teratogen that can impede neural tube fusion. The nurse understands that: A. There is little risk because the pregnancy is now in the embryonic stage B. There is little risk because neural tube fusion is complete in the embryonic stage C. There is little risk to any pregnancy when the mother is exposed to a teratogen D. The pregnancy is at risk because the neural tube fuses during the fetal stage of development
B. There is little risk because neural tube fusion is complete in the embryonic stage Pregnant women should avoid teratogens during their pregnancy because they can cause harm. However, neural tube fusion is complete in the embryonic stage of development and the patient is in the fetal stage of development
The nurse teaches a sedentary pregnant client with a BMI of 35 about the importance of healthy lifestyle during pregnancy. Which goal would be appropriate for this client? A. Participate in a daily aerobic dance program. B. Walk for 30 minutes 5 days a week. C. Adhere to a weight reduction diet. D. Begin lifting weights for 30 minutes per day.
B. Walk for 30 minutes 5 days a week.
Which of the following is true about Pap testing? A. As a rule, women over age 65 should be screened more frequently than women who are under age 25 B. Women should receive their first Pap test at age 21 regardless of sexual history C. A Pap test evaluates cervical cells for the presence of sexually transmitted infections D. Pap testing should be done annually until age 29
B. Women should receive their first Pap test at age 21 regardless of sexual history
The nurse explains Leopold's maneuvers to a pregnant client. For which purposes are these maneuvers performed? Select all that apply. A. determining the weight of the fetus B. determining the lie of the fetus C. determining the size of the fetus D. determining the position of the fetus E. determining the presentation of the fetus
B. determining the lie of the fetus D. determining the position of the fetus E. determining the presentation of the fetus
If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? A. fetal baseline rate increasing at least 5 mm Hg with contractions B. fetal heart rate declining late with contractions and remaining depressed C. a shallow deceleration occurring with the beginning of contractions D. variable decelerations, too unpredictable to count
B. fetal heart rate declining late with contractions and remaining depressed
Early in labor, a pregnant client asks why contractions hurt so much. Which answer should the nurse provide? A. distraction of the brain cortex by other stimuli B. lack of oxygen to the muscle fibers of the uterus due to compression of blood vessels C. blocking of nerve transmission via mechanical irritation of nerve fibers D. release of endorphins in response to contractions
B. lack of oxygen to the muscle fibers of the uterus due to compression of blood vessels
A nurse is explaining to a pregnant client about the changes occurring in the body in preparation for labor. Which hormone would the nurse include in the explanation as being responsible for causing the pelvic connective tissue to become more relaxed and elastic? A. prolactin B. relaxin C. progesterone D. oxytocin
B. relaxin
A nurse practitioner working in a high-risk pregnancy clinic is mentoring a new graduate nurse. The new nurst asks if there are any ways to diagnose Down syndrome prior to birth other than an amniocentesis. The nurse tells the new nurse that another test that can diagnose the disorder prior to birth. Which test would the nurse practitioner most likely include? A. blood test B. ultrasound C. X-ray D. Doppler study
B. ultrasound
An obviously pregnant woman appears for her first prenatal visit. She reports a headache and generalized abdominal pain which has persisted over the past couple months. Which question should the nurse prioritize after determining the client is approximately 24 weeks' gestation, appears nervous, and is reluctant to have a full physical assessment? A. "Have you been taking a prenatal vitamin?" B. "Do you have a family history of thyroid disease?" C. "Do you feel safe at home?" D. "How much activity have you been able to fit into your schedule?"
C. "Do you feel safe at home?"
A patient is interested in emergency contraception due to unprotected intercourse that occurred 1 week ago. What is the best response by the nurse? A. "Emergency contraception may include a progestin intrauterine device" B. "Emergency contraception is only available after a sexual assault" C. "Emergency contraception should be taken within 72-120 hours to be effective" D. "A copper intrauterine device may be inserted at this time for emergency contraception"
C. "Emergency contraception should be taken within 72-120 hours to be effective" Emergency contraception may include medications or a copper IUD. Emergency contraception should be obtained before 120 hours to be effective. Emergency contraception is not limited to sexual assault. Progestin intrauterine devices are not used for emergency contraception.
After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, the nurse understands that which client statement indicates the need for additional teaching? A. "I'll stay away from foods like cabbage and brussels sprouts." B. "I'll increase my time spent on walking each day." C. "I'll switch to chewing gum instead of using mints." D. "I'll try to drink more fluids to help move things along."
C. "I'll switch to chewing gum instead of using mints."
A client comes to the emergency department reporting strong contractions that have lasted for the past 2 hours. Which assessment will indicate to the nurse that the client is in true labor? A. increased fetal activity B. pink show C. 1:5 uterine contractions D. progressive cervical dilatation and effacement
D. progressive cervical dilatation and effacement
A nurse is performing a vaginal examination of a woman in the early stages of labor. The woman has been at 2 cm dilated for the past 2 hours, but effacement has progressed steadily. Which statement by the nurse would best encourage the client regarding her progress? A. Don't mention anything to the client yet; wait for further dilatation to occur. B. "There has been no further dilatation; effacement is progressing." C. "You are still 2 cm dilated, but the cervix is thinning out nicely." D. "You haven't dilated any further, but hang in there; it will happen eventually."
C. "You are still 2 cm dilated, but the cervix is thinning out nicely."
A student nurse is concerned about learning enough about different cultures to deliver competent care. The preceptor responds by saying: A. "Responding effectively to different cultures means always using an interpreter to communicate" B. "You will never know everything so focus on cultural sensitivity for people born in other countries" C. "You will never know everything but keeping an open mind and communicating effectively will help" D. "You only need to be concerned about knowing about the main cultures in our community"
C. "You will never know everything but keeping an open mind and communicating effectively will help"
A student nurse is concerned about learning enough about different cultures to deliver competent care. The preceptor responds by saying: A. "Responding effectively to different cultures means always using an interpreter to communicate." B. "You will never know everything so focus on cultural sensitivity for people born in other countries." C. "You will never know everything but keeping an open mind and communicating will effectively help." D. "You only need to be concerned about knowing about the main cultures in our community."
C. "You will never know everything but keeping an open mind and communicating will effectively help."
A couple plans to try for a baby after they get married in 3 months. Based on their situation, what method of birth control might be best for them? A. A progestin intrauterine device B. A Depo Provera injection C. Condoms D. None of the above
C. Condoms Progestin intrauterine devices are long-acting reversible contraception likely not cost effective if removed in 3 months. It may take several months for women who use Depo Provera to become fertile and therefore, not a good choice for this couple. Condoms are a barrier method of birth control and likely the best choice for their situation.
The nurse is preparing a young couple for the upcoming birth of their child, and the mother expresses concern for needing pain medications and the effects on the fetus. When counseling the couple about pain relief, the nurse would incorporate which information in the teaching about measures to help to decrease the requests for pain medication? A. Sitting in a hot tub helps decrease the need for pain medication. B. Lying on an ice pack can help decrease the need for pain medication. C. Continuous support through the labor process helps decrease the need for pain medication. D. A quick epidural can replace the need for pain medication.
C. Continuous support through the labor process helps decrease the need for pain medication.
The nurse is monitoring a client in the first stage of labor. The nurse determines the client's uterine contractions are effective and progressing well based on which finding? A. Rupture of amniotic membranes B. Engagement of fetus C. Dilation of cervix D. Bloody show
C. Dilation of cervix
Heat loss is best minimized by the nurse in the delivery room when the infant is: A. Dried, dressed in a onesie, and swaddled in a warm blanket B. Dried and passed to family members for assessment and bonding C. Dried, placed on the mother's chest, and covered in a warm blanket D. Wrapped in a blanket and placed in the prewarmed warmer
C. Dried, placed on the mother's chest, and covered in a warm blanket
The nurse is admitting a client who is in early labor. After determining that the birth is not imminent, which assessment should the nurse perform next? A. Maternal status B. Maternal obstetrical history C. Fetal status D. Risk factors
C. Fetal status
All of the following are physical signs of protein deficiency in pregnancy EXCEPT: A. Pale or brittle fingernails B. Poor muscle tone or diminished reflexes C. Fissures at the corner of the mouth or pale mucous membranes D. Dull, brittle, and lifeless hair
C. Fissures at the corner of the mouth or pale mucous membranes
A nurse observes a breastfeeding mother sleeping while a family member is holding the newborn infant. The nurse notices the infant smacking her lips, turning her head, and making sucking motions. What should the nurse do? A. Allow the mother to continue napping B. Provide a bottle of formula for the infant C. Gently wake the mother and encourage her to breastfeed D. Offer to take the infant to the nursery so the family can rest
C. Gently wake the mother and encourage her to breastfeed
Which nursing action is required before a client in labor receives an epidural? A. Checking for maternal pupil dilation B. Observing maternal gait C. Giving a fluid bolus of 500 ml D. Testing maternal reflexes
C. Giving a fluid bolus of 500 ml
A pregnant client has opted for hydrotherapy for pain management during labor. Which measure should the nurse consider when assisting the client during the birthing process? A. Ensure that the water temperature exceeds body temperature. B. Do not allow the client to stay in the bath for long. C. Initiate the technique only when the client is in active labor. D. Allow the client into the water only if her membranes have ruptured.
C. Initiate the technique only when the client is in active labor.
A pregnant patient nearing her due date expresses anxiety over the labor and delivery process. Which outcome should the nurse select as appropriate for the patient during the delivery process? A. Patient tolerates the use of sanitary napkins to absorb vaginal secretions during labor. B. Patient requests pain medication throughout the labor process. C. Patient uses breathing techniques to control anxiety and pain during labor. D. Patient refuses complementary and alternative techniques to control pain during labor.
C. Patient uses breathing techniques to control anxiety and pain during labor.
A woman in her third trimester complains to the nurse of significant back pain. The nurse questions the client carefully and records a detailed account of her back symptoms. What is the best rationale for the nurse evaluating the client's back symptoms with such care? A. Back pain could be a result of a soft mattress B. Back pain could be a result of improper lifting C. Back pain could be a sign of degenerated discs D. Back pain could be a sign of bladder or kidney infection
D. Back pain could be a sign of bladder or kidney infection
A patient's amniotic sack is broken at 39 weeks but she is not contracting. What is the best response by the nurse? A. Tell the patient to go home and come back when contractions are less than 5 minutes apart B. Call the health care provider for an immediate delivery C. Prepare for hospital admission D. None of the above
C. Prepare for hospital admission Once the amniotic fluid sack is ruptured, the patient is at risk for infection, variable decelerations in the fetal heart rate, and umbilical cord prolapse. The patient should be monitored by health care professionals and should not be discharged home. There is nothing in the question to indicate imminent birth. The best response by the nurse is to prepare for a hospital admission.
A provider artificially ruptures a patient's bag of water and then states, "I feel a cord." The first reaction by the nurse is to: A. Change the wet peripad for a dry peripad B. Put on a sterile glove so the nurse can replace the provider by holding up the fetal presenting part C. Press the staff emergency call button to get help D. Document the provider's statement in the computer
C. Press the staff emergency call button to get help A prolapsed cord is an obstetric emergency
During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next? A. Advise the woman about the need to culture the discharge. B. Notify the healthcare provider of a possible infection. C. Tell the woman that this is entirely normal. D. Check the discharge for evidence of ruptured membranes.
C. Tell the woman that this is entirely normal.
What assessment finding would suggest to the care team that the pregnant client has completed the first stage of labor? A. The infant is born. B. The client experiences her first full contraction. C. The client's cervix is fully dilated. D. The client has contractions once every two minutes.
C. The client's cervix is fully dilated.
A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse prepares the client for this monitoring based on the understanding that which criterion must be present? A. a neonatologist to insert the electrode B. floating presenting fetal part C. cervical dilation of 2 cm or more D. intact membranes
C. cervical dilation of 2 cm or more
The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows: A. descent, flexion, external rotation, extension, internal rotation, expulsion. B. internal rotation, flexion, descent, extension, external rotation, expulsion. C. descent, flexion, internal rotation, extension, external rotation, expulsion. D. internal rotation, flexion, descent, extension, external rotation, expulsion.
C. descent, flexion, internal rotation, extension, external rotation, expulsion.
A nurse is caring for a pregnant client in labor in a health care facility. The nurse knows that which sign marks the termination of the first stage of labor in the client? A. rupturing of fetal membranes B. diffuse abdominal cramping C. dilation of cervix diameter to 10 cm D. start of regular contractions
C. dilation of cervix diameter to 10 cm
A nurse palpates a woman's fundus to determine contraction intensity. What would be most appropriate for the nurse to use for palpation? A. finger tips B. palm of the hand C. finger pads D. back of the hand
C. finger pads
A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A. complete B. full C. frank D. footing
C. frank
A client calls the clinic asking to come in to be evaluated. She states that when she went to bed last night the fetus was high in the abdomen, but this morning the fetus feels like it has dropped down. After asking several questions, the nurse explains this is probably due to: A. rupture of the membranes B. start of labor C. lightening D. placenta previa
C. lightening
When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem? A. short neck B. slanting of the palpebral fissure C. low-set ears D. bowed legs
C. low-set ears
An 18-year-old pregnant woman asks why she has to have a routine alpha-fetoprotein serum level drawn. You explain that this A. is a screening test for placental function. B. tests the ability of her heart to accommodate the pregnancy. C. may reveal chromosomal abnormalities. D. measures the fetal liver function.
C. may reveal chromosomal abnormalities.
A pregnant woman at 37 weeks gestation calls the clinic to say she thinks that she is in labor. The nurse instructs the woman to go to the health care facility based on the client's report of contractions that are: A. occurring in the abdomen and groin. B. relieved by walking. C. occurring about every 5 minutes. D. lasting about 30 seconds.
C. occurring about every 5 minutes.
When assessing fetal heart rate patterns, which finding would alert the nurse to a possible problem? A. variable decelerations B. accelerations C. prolonged decelerations D. early decelerations
C. prolonged decelerations
When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage? A. Regular contractions B. Fetal movement through the birth canal C. Placental separation D. Cervical dilation
D. Cervical dilation
Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? A. Tay-Sachs disease B. Marfan syndrome C. hemophilia D. sickle cell anemia
D. sickle cell anemia
A nurse has just finished teaching a patient about preeclampsia symptoms that should be reported to the provider. The nurse knows teaching has been effective when the patient states: "I should report..." A. "...leaking of fluid, contractions, and increased fetal movement." B. "...increased need to urinate, fatigue, and shortness of breath." C. "...epigastric pain, shortness of breath, and weight gain of 1 pound per week." D. "...severe headache, vision changes, and decreased fetal movement."
D. "...severe headache, vision changes, and decreased fetal movement."
Which statement by the pregnant woman shows an understanding that she should avoid teratogens in the first trimester? A. "It's okay for me to continue taking my tetracycline for my acne." B. "I am going to have an X-ray this week. My neck is bothering me." C. "One or two glasses of wine at night won't hurt. Wine helps relax me." D. "I have to call my doctor to switch me from lithium to another drug for my bipolar disorder."
D. "I have to call my doctor to switch me from lithium to another drug for my bipolar disorder."
Which statement made by a patient requires further education by the nurse? A. "Because I have no risk factors for breast cancer, I do not need a mammogram until I am at least 40" B. "It is important for me to have awareness of what is normal for my breasts" C. "Since I am 52, I should schedule a mammogram every 1-2 years" D. "I should do monthly self breast examinations"
D. "I should do monthly self breast examinations" Monthly breast self-examinations are no longer recommended.
A primigravidia client at 38 weeks' gestation calls the clinic and reports, "My baby is lower and it is more difficult to walk." Which response should the nurse prioritize? A. "The baby moved down into the pelvis; this means you will be in labor within 24 hours, so wait for contractions then come to the hospital." B. "This is not normal unless you are in active labor; come to the hospital and be checked." C. "That is something we expect with a second or third baby, but because it is your first, you need to be checked." D. "The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."
D. "The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."
The nurse is caring for several families enrolled in Medicaid in the prenatal setting. Which statement by an expectant mother would alert the nurse to assess the family further? A. "My sister-in-law is due to have her baby the same month as our baby is due." B. "In my culture, we have family help us care for the baby in our home for several months." C. "I plan to give birth in a hospital setting with my family at my side." D. "We just moved here from another state and I am still getting used to the new town."
D. "We just moved here from another state and I am still getting used to the new town."
The nurse is analyzing the readout on the EFM and determines the FHR pattern is reassuring based on which recording? A. Increase in variability by 27 bpm B. Decrease in variability for 15 seconds C. Deceleration followed by acceleration of 15 bpm D. Acceleration of at least 15 bpm for 15 seconds
D. Acceleration of at least 15 bpm for 15 seconds
Which of the following patients is a priority for sexually transmitted infection screening? A. A woman 6 weeks pregnant during her initial prenatal visit B. A 17-year-old sexually active male C. A 24-year-old woman being seen for an annual gynecologic exam D. All of the above
D. All of the above Pregnant women should be screened for STIs during their initial prenatal care appointments. All sexually active adolescents should be screened for HIV. Sexually active women less than 25 should be screened annually.
Why is prenatal care important for pregnant women? A. It allows health care providers to identify risk factors for pregnancy B. It allows the health care provider to diagnose problems C. It allows time for the health care provider to teach about healthy behaviors D. All of the above
D. All of the above Prenatal care allows providers the opportunity to diagnose and treat health problems, recognize and mitigate risk factors, and provide information to optimize health for the mother and fetus
A client in the latent phase of the first stage of labor is noted to be uncomfortable with intact membranes and mild contractions on assessment. The nurse should encourage the client to pursue which action? A. Bathroom privileges B. Complete bed rest C. Up in chair TID D. Ambulation ad lib
D. Ambulation ad lib
A client at 16 weeks' gestation is scheduled for prenatal testing. Which of the following would the nurse anticipate as the most likely screening test for congenital anomalies based on the current age of this pregnancy? A. Nuchal translucency testing. B. Cardiocentesis. C. Chorionic villi sampling. D. Amniocentesis.
D. Amniocentesis.
The nurse is preparing to assess the nutritional status of a patient who is 8 weeks pregnant. What is the most effective way for the nurse to assess the patient's food intake thus far in the pregnancy? A. Ask the patient to describe total intake for a week. B. Assess skin status for hydration and color. C. Assess a list that the patient describes as a good diet. D. Ask the patient to describe intake for the last 24 hours.
D. Ask the patient to describe intake for the last 24 hours.
The practical nursing is evaluating the tracings on the fetal heart monitor. The nurse is concerned that there is a change in the tracings. What should the practical nurse do first? A. Wait 2 minutes to review another tracing B. Notify the health care provider C. Notify the registered nurse D. Assess and reposition the woman
D. Assess and reposition the woman
A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture? A. Bloody fluid B. Cloudy white fluid C. Greenish fluid D. Clear to straw-colored fluid
D. Clear to straw-colored fluid
A nurse is caring for a client who has just been told that her unborn baby carries a genetic disorder associated with significant health related issues. The client asks, "Should I kill the baby?" What is the most appropriate nursing diagnosis for this client? A. Deficient knowledge related to inheritance pattern B. Fear related to birth of a baby C. Situational low self-esteem D. Decisional conflict related to continuation of pregnancy
D. Decisional conflict related to continuation of pregnancy
Which cardinal movement of delivery is the nurse correct to document by station? A. Flexion B. Internal rotation C. Extension D. Descent
D. Descent
Which of the following signs and symptoms are most likely due to a pulmonary embolism in a postpartum patient? A. Feeling that something isn't right and shortness of breath B. Fever and wheezing C. Unilateral leg swelling, redness, and tenderness D. Dyspnea and tachypnea
D. Dyspnea and tachypnea Dyspnea and tachypnea are the most common signs and symptoms of a pulmonary embolism. Feeling that something isn't right, hypotension, fever, and wheezing are all possible symptoms of a pulmonary embolism, but are less common and may be related to something else. Unilateral leg swelling, redness, and tenderness are symptoms of a deep vein thrombosis, which may lead to a pulmonary embolism.
A patient who is 10 weeks pregnant complains of nausea, vomiting, fatigue, and breast tenderness. Recommendations by the nurse should include: A. Looking for over-the-counter medications to help with nausea and fatigue during pregnancy B. Notifying the provider if the patient experiences severe headache or vision changes such as blurred or double vision after 20 weeks C. Letting the doctor know if the patient is unable to keep any food down, experiences weight loss, and is dehydrated D. Eating small, frequent meals; napping frequently; and wearing a supportive, well-fitting
D. Eating small, frequent meals; napping frequently; and wearing a supportive, well-fitting To minimize the discomforts of nausea, vomiting, fatigue, and breast tenderness, the nurse should recommend small frequent meals, naps, and a supportive bra.
A client presents to the birthing center in labor. The client's membranes have just ruptured. Which assessment is the nurse's priority? A. maternal comfort level B. fetal position C. signs of infection D. FHR
D. FHR
A pregnant client is admitted to a maternity clinic for birth. Which assessment finding indicates that the client's fetus is in the transverse lie position? A. Long axis of fetus is parallel to that of client. B. Long axis of fetus is at 45° to that of client. C. Long axis of fetus is at 60° to that of client. D. Long axis of fetus is perpendicular to that of client.
D. Long axis of fetus is perpendicular to that of client.
A nurse is educating a group of nursing students about the etiology of labor. Which of the following should the nurse explain as the hormone produced by the posterior pituitary? A. Relaxin B. Estrogen C. Progesterone D. Oxytocin
D. Oxytocin
The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client? A. Nulligravida B. Primipara C. Multipara D. Primigravida
D. Primigravida
The nurse providing care to patients in the labor and delivery suite desires to support the 2020 National Health Goals to reduce maternal and infant mortality after labor and birth. Which action should the nurse perform to support these goals? A. Apply specific infection control practices during the labor and birthing processes. B. Recommend the use of epidural and spinal anesthesia to aid in the labor process. C. Encourage laboring patients to use analgesia to control painful contractions. D. Support laboring patients through the use of controlled breathing techniques.
D. Support laboring patients through the use of controlled breathing techniques.
The nurse is caring for four clients within the labor and delivery unit. Which client does the nurse anticipate will be sent home? A. The multiparous who is effaced with dilation of 4 cm. B. The multiparous who just experienced lightening and is having contractions 7 minutes apart. C. The primigravid who is effaced, having intense contractions but at irregular intervals and dilation is 6 cm D. The primigravid who has a thinning cervix and a dilation of 3 cm
D. The primigravid who has a thinning cervix and a dilation of 3 cm
A patient diagnosed with preeclampsia had a severe headache, 2+ protein in the urine, hyperreflexes, and was started on magnesium sulfate. Current assessment findings include a severe headache, slurred speech, and hypo reflexes. What should the nurse do next? A. Reassess the patient in 1 hour B. Notify the charge nurse immediately C. Document current assessment findings D. Turn off the magnesium sulfate infusion
D. Turn off the magnesium sulfate infusion
A woman you care for in a prenatal clinic tells you that her pregnancy was unplanned and unwanted. At what point in pregnancy does the average woman change her mind about an unwanted pregnancy? A. After lightening happens B. Around the third month C. After the seventh month D. When quickening occurs
D. When quickening occurs
The coach of a client in labor is holding the client's hand and appears to be intentionally applying pressure to the space between the first finger and thumb on the back of the hand. The nurse recognizes this as which form of therapy? A. biofeedback B. effleurage C. acupuncture D. acupressure
D. acupressure
The nurse notes that the fetal head is at the vaginal opening and does not regress between contractions. The nurse interprets this finding as which process? A. descent B. engagement C. restitution D. crowning
D. crowning
When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation? A. effacement B. molding C. crowning D. dilation
D. dilation
To give birth to her infant, a woman is asked to push with contractions. Which pushing technique is the most effective and safest? A. lying on side, arms grasped on abdomen B. squatting while holding her breath C. lying supine with legs in lithotomy stirrups D. head elevated, grasping knees, breathing out
D. head elevated, grasping knees, breathing out
A nurse is caring for a pregnant client in her second trimester of pregnancy. The nurse educates the client to look for which danger sign of pregnancy needing immediate attention by the primary care provider? A. lower abdominal and shoulder pain B. painful urination C. severe, persistent vomiting D. vaginal bleeding
D. vaginal bleeding
Is the following statement true or false: The purpose of obtaining a health history during pregnancy is to understand a patient's physical ailments
False A health history includes physical ailments, obstetric history, sexual history, family history, lifestyle assessment, questions about eating and sleeping, demographic information, allergies, and exposure to environmental habits
Is the following statement true or false: A high Apgar score is indicative of higher cognitive ability in the neonate.
False An Apgar score is an assessment of the infant's immediate status after birth and is not associated with higher cognitive ability
Is the following statement true or false: Health outcomes improve with the amount on money spent on care.
False Health outcomes are not associated with higher costs. Funding programs aimed at health promotion or social services may be a cost-effective strategy to improve population health
Is the following statement true or false: In monozygotic twinning, the earlier an ovum is cleaved, the higher the risk.
False In monozygotic twinning, the earlier an ovum is cleaved, the less likely the twins will share any structures.
Is the following statement true or false: Preeclampsia progresses from mild to severe before eclampsia begins.
False Preeclampsia is a hypertensive disease that progresses at different rates in different women.
Is the following statement true or false: The purpose of obtaining a health history during pregnancy is to understand a patient's physical ailments.
False A health history includes physical ailments, obstetric history, sexual history, family history, lifestyle assessment, questions about eating and sleeping, demographic information, allergies, and exposure to environmental habits
Is the following statement true or false: Health outcomes improve with the amount of money spent on care.
False Health outcomes are not associated with higher costs. Funding programs aimed at health promotion or social services may be a cost-effective strategy to improve population health
