Maternity Final Practice Questions

The nurse in the prenatal clinic is taking a nutritional history from a 16 year old pregnant adolescent. Which statement by the adolescent alerts the nurse to a potential psychosocial problem?

"I have to watch my weight. I don't want to gain too much". Rationale: Adolescents are often concerned about their body image. If weight is a major focus for the adolescent, the adolescent is more likely to restrict calories to avoid weight gain.

The nurse is reinforcing instructions to a postpartum client regarding postpartum exercises. Which statement by the client indicates an understanding of the exercises?

"I should alternately contract and relax the muscles in the perineal area". Rationale: Kegel exercises are extremely important to strengthen the muscle tone of the perineal area and can be done soon after birth.

The nurse reinforces teaching to a pregnant client about Kegel exercises and tells the woman that the purpose of these exercises is to help prevent which complication?

Loss of pelvic floor muscle tone. Rationale: Kegel exercises are movements that strengthen the pubococcygeal muscle, which surrounds the vagina and urinary meatus.

The nurse is caring for a client who is at risk for preterm labor. Which findings indicate that preterm labor may be occurring? Select all that apply.

Low back pain. Pelvic pressure. Uterine contractions. Change in amount of discharge. Rationale: Signs of impending preterm labor include low back pain; pelvic pressure; uterine contractions; a change in the amount of discharge and abdominal cramping.

The nurse is caring for a client with dystocia. The nurse understands that which factors are causes of this disorder?

Malpositoned fetus. Excessively large fetus. Abnormal presentation of the fetus. Rationale: Dystocia is difficult labor that is prolonged or more painful. Causes of dystocia include a malpositioned fetus, an excessively large fetus, and abnormal presentation of the fetus.

The nurse is caring for a postpartum client with diabetes mellitus. The nurse should include which interventions in the plan of care for this client? Select all that apply.

Monitor for a hypoglycemic reaction. Re-regulate insulin needs as prescribed. Monitor for signs of infection or hemorrhage. Assess dietary needs based on insulin requirements. Rationale: Nursing interventions for the postpartum client with diabetes mellitus include monitoring for a hupoglycemic reaction; re regulating insulin needs as prescribed; monitoring for signs of infection or hemorrage, and assessing dietary needs based on insulin requirements.

The nurse is caring for a client in the postpartum period following cesarean delivery. The nurse includes which interventions in the plan of care for this client?

Monitor urine output Monitor bowel sounds Encourage frequent voiding Assess incision and dressing frequently. Rationale: Following cesarean delivery, nursing interventions include encouraging frequent ambulation; monitoring urine output; monitoring bowel sounds; encouraging frequent voiding; and assessing the incision and dressing frequently, once per shift or as otherwise prescribed.

A pregnany client just underwent a lumbar epidural block. The nurse should prioritize monitoring of which parameter frequently?

Respirations. Rationale: The nurse should monitor the pregnany client with a lumbar epidural block for respiratory distress, nausea, and vomiting, pruritus, hypotension, bladder distention, and a prolonged second stage of labor.

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data, if noted on the client's record, should alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy?

The client's history of chronic hypertension. Rationale: Known risk factors that increase the risk of developing gestational diabetes include chronic hypertension, obesity (more than 198lb), previous birth of a large infant (more than 4000g), family history of type 2 diabetes mellitus, and gestational diabetes during a previous pregnancy.

The nurse is preparing to measure the fundal height of a prenatal client. In order to make an accurate measurement, the nurse begins by placing the tape at which anatomical location?

The level of the symphysis pubis. Rationale: When performing a fundal assessment, the nurse begins by placing the tape at the level of the symphysis pubis while the client is lying in a supine position.

Which statement best describes the taking hold phase in a postpartum client according to Rubin's phases of regeneration?

The mother is independent. Rationale:

A pregnant client is diagnosed with syphilis. The nurse is aware that the client is most at risk for which complication of pregnancy?

Spontaneous abortion. Rationale: Maternal infections such as syphilis, toxoplasmosis, and rubella are causes of spontaneous abortion.

The nurse is reinforcing teaching to a pregnant woman about the physiological effects and hormone changes that occur in pregnancy and provides the woman with which information about the purpose of estrogen?

Suppresses the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Stimulates uterine development to provide an environment for the fetus and to stimulate the breasts to prepare for lactation. Rationale: Estrogen suppresses the secretion of FSH and LH. It also stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.

The nurse is monitoring the fetal patterns of a client in active labor and notes a late deceleration on the monitor strip. Which nursing actions are most appropriate?

Turn the client on her side. Administer oxygen via face mask. Rationale: Late decelerations are due to uteroplacental insufficiency as the result of decreased blood flow and oxygen to the fetus during the uterine contractions. This causes hypoxemia; therefore, oxygen is necessary. The client should be turned onto her side to displace pressure of the gravid uterus on the inferior vena cava.

The nurse is preparing to apply a tocotransducer to a woman in labor to monitor uterine activity. The nurse plans to place the transducer at which best location?

Upper uterus. Rationale: Uterine activity is best detected where it is strongest and where the fetus lies close to the uterine wall. This location is usually over the upper uterus.

The nurse is caring for a pregnant client who is to undergo general anesthesia. The nurse understands that which are adverse effects of this therapy?

Aspiration. Respiratory depression. Rationale: Adverse effects of general anesthesia for any client include aspiration and respiratory depression. Headache, sleepiness, and lowered blood pressure may occur, but these are not adverse effects but rather side effects of general anesthesia.

The nurse working on the labor and delivery unit is monitoring a pregnant client and determining her readiness for labor. The nurse notes the following: cervix is dilated 2cm, cervix is effaced 50%, cervix is of medium consistency and is in midposition, and the station of the presenting part is at -2. The nurse assigns which Bishop score to this client?

Bishop score of 1. Rationale: The bishop score is used to determine maternal readiness for labor, and cervical status and fetal position.

An ultrasound is performed on a client, at term gestation, who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that a placental abruption is present. What should the nurse prepare the client for on the basis of these findings?

Delivery of the fetus. Rationale: The goal of management in abruptio placentae is to control the hemorrhage and deliver the fetus as soon as possible. Delivery is the treatment of choice if the fetus is at term gestation or if the bleeding is moderate to severe and the mother or fetus is in jeopardy.

The nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse should monitor the client closely for the risk of uterine rupture if which event occurs?

Forceps delivery. Rationale: Excessive fundal pressure, forceps delivery, violent bearing-down efforts, tumultuous labor, and shoulder dystocia can place a woman at risk for traumatic uterine rupture.

A client calls the health care provider's office to schedule an appointment because a home pregnancy test was performed and the results were positive. The nurse determines that the home pregnancy test identified the presence of human chorionic gonadotropin (hCG) in the urine. The nurse understands this indicates which finding?

Probable sign of pregnancy. Rationale: The presence of hCG in the urine is a probable sign of pregnancy. Other signs include uterine enlargement, Hegar's Sign, Gooddell's sign, Chadwick's sign, ballottement; and Braxton's Hick's contractions.

The nurse is caring for the postpartum client who has had an episiotomy. Which prescription should the nurse question if noted in the medical record?

Provide warm packs during the first 24 hours. Rationale: When caring for a client who has had an episiotomy, the nurse should question a prescription that states to provide warm packs during the first 24 hours. Ice packs should be provided during this tie to assist with decreasing pain and inflammation.

Data are collected on a pregnant client in labor, and the nurse notes that the client's hemoglobin and hematocrit levels are low, indicating anemia. The nurse should be most concerned about which finding?

Signs of infection. Rationale: Anemic women have a greater likelihood of cardiac failure during labor, postpartum infection, and/or poor wound healing.