Maternity: PrepU Quiz #1
A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" After teaching the woman about possible causes, the nurse determines that the teaching was successful when the woman identifies which condition as a common cause? Vaginal pH of 4.2 Endometriosis History of ovarian tumor Pelvic inflammatory disease Anovulation Chapter 4 Page 130
Endometriosis Pelvic inflammatory disease Anovulation Common causes of female infertility ovarian dysfunction, tubal and pelvic disorders, cervical mucus factors, and vaginal problems. A normal vaginal pH is 4-5.
A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which kind of mucus? Spinnbarkeit mucus Purulent mucus Postovulatory mucus Normal pre-ovulation mucus Chapter 4 Page 140
Spinnbarkeit mucus The client is describing spinnbarkeit mucus, the copious, clear, slippery, smooth, and stretchable mucus that occurs as ovulation approaches. Purulent mucus would be yellow or green and malodorous. Pre-ovulation mucus is clear but not as copious, slippery, and stretchable.
A nurse from the neonatal intensive care unit is called to the birth room for an infant requiring resuscitation. After placing the newborn in the sniffing position what would the nurse do next? Ventilate at a rate of 40 to 60 breaths per minute. Suction the mouth then the nose. Suction the nose then the mouth. Give 3 compressions with 1 breath every 3 seconds. Chapter 23 Page 888
Suction the mouth then the nose. ABCDs of newborn resuscitation include: airway maintenance by placing infant's head in "sniffing" position; suction the mouth, then the nose; suction the trachea if meconium-stained and newborn is NOT vigorous (strong respiratory effort, good muscle tone, and heart rate 100 bpm). Breathing is assisted through the use of positive-pressure ventilation (PPV) for apnea, or pulse 100 bpm. The nurse should ventilate at rate of 40 to 60 breaths/minute. Listen for raising heart rate and audible breath sounds. Look for slight chest movement with each breath. Use carbon dioxide detector after intubation. The nurse should use circulation assistance through compressions if heart rate is 60 after 30 seconds of effective PPV. Give 3 compressions: 1 breath every 2 seconds. Compress one third of the anterior-posterior diameter of the chest.
A nurse is educating a client on the basal body temperature method as a form of contraception. Which statement by the client indicates and understanding of when she can expect to see a rise in her temperature? "My temperature will increase with the start of my menses." "If I am pregnant, I will have a temperature spike." "There will be an increase in my temperature right before I ovulate." "Immediately following ovulation my temperature will increase." Chapter 4 Page 141
"Immediately following ovulation my temperature will increase." The basal body temperature dips immediately prior to ovulation; when ovulation occurs there will be an increase in temperature.
Hormone levels of a woman indicate that the corpus luteum stopped functioning and releasing progesterone after 5 weeks. The nurse would recognize that which scenario is the expected outcome? The pregnancy would continue unaffected. A spontaneous abortion (miscarriage) would occur. There is a higher than normal chance of a multifetal pregnancy. She will need progesterone supplement throughout the pregnancy. Chapter 11 Page 367
A spontaneous abortion (miscarriage) would occur. If the corpus luteum fails to produce progesterone for approximately 6 to 7 weeks, a spontaneous abortion will occur. After 7 weeks, the placenta will produce enough progesterone to sustain the pregnancy. There is no connection between multifetal pregnancies and the corpus luteum not functioning long enough in progesterone production.
Which woman requires the most weight gain during pregnancy? a woman carrying twins and a prepregnant BMI of 23 a woman with a prepregnant BMI of 27 with a single fetus a woman with a prepregnant BMI of less than 19 a woman who is pregnant for the third time in 5 years Chapter 11 Page 381
A woman carrying twins and a prepregnant BMI of 23 Women carrying a twin gestation have additional requirements for weight gain during pregnancy. Women with a low BMI or frequent pregnancies need to be assessed for signs of nutrient deficits; dietary intake should be modified as needed.
A nurse is assessing a client who may be pregnant. The nurse reviews the client's history for presumptive signs. Which signs would the nurse most likely note? Select all that apply. Amenorrhea Nausea Abdominal enlargement Braxton-Hicks contractions Fetal heart sounds Chapter 11 Page 363
Amenorrhea Nausea Presumptive signs include amenorrhea, nausea, breast tenderness, urinary frequency and fatigue. Abdominal enlargement and Braxton-Hicks contractions are probable signs of pregnancy. Fetal heart sounds are a positive sign of pregnancy.
A nurse is reviewing the obstetric history of a pregnant woman who has come to the clinic for a visit. The history reveals that the woman is "gravida 3, para 2". Which interpretation by the nurse would be appropriate? Three previous pregnancies and two children born at term Two previous pregnancies, two children born at term, and currently pregnant Two previous preterm births and three miscarriages Three previous pregnancies and two preterm births Chapter 12 Page 405
Two previous pregnancies, two children born at term, and currently pregnant A woman who has had two previous pregnancies, given birth to two term children, and is pregnant again is gravida 3, para 2.
A female client who has chosen the cervical cap as her method of contraception states that she knows how to use it. Which statement by the client would indicate to the nurse that the client does understand this method of contraception? "I will remove the cap immediately after every intercourse and reinsert it later." "This method will help protect me from getting sexually transmitted infections." "I do not need any follow-up procedures for this method." "I do not have any spermicidal allergies, so this method is OK for me." Chapter 4 Page 146
"I do not have any spermicidal allergies, so this method is OK for me." Spermicidal allergies are contraindications for the cervical cap. The client should leave the cervical cap in place for at least six hours after intercourse. The cervical cap does not protect against sexually transmitted infections. The woman should have a follow-up Papanicolaou test 3 months after beginning to use the cap.
A nurse is conducting a class for nursing students on genetic inheritance and is focusing specifically on X-linked recessive disorders. Which statement by a nursing student would indicate appropriate learning has occurred? "Males cannot be carriers if they do not have the disorder." "If the female is the carrier, the daughter can be too." "If the male does not have it, the children will not either." "If the female is the carrier, the sons may have the disorder." Chapter 10 Page 344
"If the female is the carrier, the daughter can be too." Because females have two X chromosomes, if they receive an X-linked recessive disorder from the mother, they can be a carrier of the disorder just like the mother.
A nurse is teaching a pregnant woman how to perform fetal kick counts. The nurse determines that the teaching was successful when the client states that she will call her healthcare provider if it takes longer than what time frame to reach 10 kicks? 1 hour 2 hours 3 hours 4 hours Chapter 12 Page 411
2 hours The most common method of kick counting is "Count to 10," whereby a woman focuses her attention on her fetus's movement and records how long it takes to document 10 movements. If it takes longer than 2 hours, the woman should contact her health care provider for further evaluation.
After assessing a client, a nurse determines that an IUD as a method of contraceptive would be contraindicated based on a history of which finding? Smoking Hypertension Abnormal uterine shape Thromboembolic disease Chapter 4 Page 151
Abnormal uterine shape Use of an IUD may be contraindicated for a woman whose uterus is distorted in shape (the device might perforate the uterine wall). The copper IUD use also is not advised for a woman with severe dysmenorrhea (painful menstruation) or menorrhagia (heavy bleeding) because use may increase the incidence of these conditions. Because use of a copper IUD can cause heavier than usual menstrual flow, a woman with anemia also may not be considered a good candidate for a copper IUD. The other findings are not contraindications.
A nurse is developing a plan of care with a client and significant other who has been diagnosed as being sterile. Which outcome should receive priority in the plan? Client states understanding of procedures to increase probability of conception. Client demonstrates ability to maintain medication adherence. Client states they are well equipped to manage reproductive changes. Client states they are taking steps to remain close in light of stress. Chapter 4 Page 131
Client states they are taking steps to remain close in light of stress. News of a sterile diagnosis is one that comes with a grieving process. The nurse should assess to see if the client is developing coping mechanisms to overcoming the stress of the diagnosis.
The nursing student is preparing a presentation which will depict the pre-embryonic stage. The instructor determines the student has correctly illustrated the process by putting the stages in which order? Use all the options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 formation of the zygote 2 cleavage 3 formation of the morula 4 formation of blastocyst 5 implantation Chapter 10 Page 336
Formation of the zygote Cleavage Formation of the morula Formation of blastocyst Implantation The pre-embryonic stage begins with fertilization and the formation of a zygote. Mitosis or cleavage occurs. After four cleavages, the 16 cells appear as a solid ball of cells or morula. With additional cell division, the morula divides into specialized cells, the blastocyst and trophoblast. The trophoblast attaches itself to the surface of the endometrium, and implantation occurs.
A nurse assessing the laboratory results of a pregnant client in her second trimester notes that she has a hemoglobin level of 11 gm/dL. What will the nurse interpret this finding to most likely indicate? iron-deficiency anemia a multiple gestation pregnancy greater-than-expected weight gain hemodilution of pregnancy Chapter 11 Page 369
Hemodilution of pregnancy During pregnancy, the red blood cell count increases along with an increase in plasma volume. However, there is a greater increase in the plasma volume as a result of hormonal factors and sodium and water retention. Thus, the plasma increase exceeds the increase in RBCs, resulting in hemodilution of pregnancy, which is also called physiologic anemia of pregnancy. Changes in maternal iron levels would be more indicative of an iron-deficiency anemia. Although anemia may be present with a multiple gestation, an ultrasound would be a more reliable method of identifying it. Weight gain does not correlate with hemoglobin levels.
A client reports prolonged nausea, vomiting every morning for the past week, and no appetite. The pregnancy test comes back positive. What recommendation should the nurse give this client? Select all that apply. Take small amounts of liquids between, not with meals. Eat a saltine cracker before getting out of bed in the morning. Delay eating breakfast until the nausea and vomiting has passed. Eat a low-fat diet and eliminate all caffeine. Eat a high-protein, low-carb snack during the night. Chapter 12 Page 422
Take small amounts of liquids between, not with meals. Eat a saltine cracker before getting out of bed in the morning. Delay eating breakfast until the nausea and vomiting has passed. Eating a saltine cracker before getting out of bed, delaying breakfast, and taking small amount of liquids between meals are all appropriate interventions to cope with morning sickness. Morning sickness is related to hormone levels. The fat, protein, or carbohydrate content of the diet is not the causative factor.
A client who is 15 weeks' gestation is attending prenatal classes and asks the nurse, "What changes in development has my baby made?" Which statements would the nurse include in the response? Select all that apply. "Soft hair covers your baby's head." "Your baby makes sucking motions now with its mouth." "You will be able to detect quickening." "The increase in weight of your baby has stopped now." "Your baby's lungs are ready for life outside the uterus." Chapter 10 Page 340
"Soft hair covers your baby's head." "Your baby makes sucking motions now with its mouth." "You will be able to detect quickening." During weeks 13 through 16, a fine hair called lanugo develops on the head. The fetus makes active movement, sucking motions are made with the mouth, weight quadruples, and fetal movement (also known as quickening) is detected by mother. Alveoli of the lungs have not developed, and thus lungs are not ready for life outside the womb.
A nurse is counseling a couple who report that they are both carriers for a condition. The medical history reveals neither of them have have symptoms of the condition. In the event this couple conceives a child, what is the likelihood they will have a child who will have the disorder? 25% 50% 75% 100% Chapter 10 Page 350
25% When an individual is a carrier for a disorder they have one normal gene and one abnormal gene. They do not demonstrate the symptoms of the disorder. In the event they reproduce with an individual with the same pattern they will have a 25% chance of conceiving a child with the disorder. There is a 50% chance they will conceive a child who like them is a carrier for the disorder.
A nurse is providing nutritional counseling to a pregnant woman and gives her suggestions about consuming foods that are high in folic acid. As part of the plan of care, the client is to keep a food diary that the client and nurse will review at the next visit. When reviewing the client's diary, which meals would indicate to the nurse that the client is increasing her intake of folic acid? Select all that apply. Chicken breast with baked potato and broccoli Cheeseburger with spinach and baked beans Pork chop with mashed potatoes and green beans Strawberry walnut salad with romaine lettuce Fried chicken sandwich with mayonnaise and avocado Chapter 11 Page 379
Chicken breast with baked potato and broccoli Cheeseburger with spinach and baked beans Strawberry walnut salad with romaine lettuce Good food sources of folic acid include dark green vegetables, such as broccoli, romaine lettuce, and spinach; baked beans; black-eyed peas; citrus fruits; peanuts; and liver. So the meals containing chicken breast with baked potato and broccoli, cheeseburger with spinach and baked beans, and the strawberry walnut salad with romaine lettuce demonstrate an intake of foods high in folic acid.
Which interventions would a pregnant client be taught regarding dietary restrictions during pregnancy? Select all that apply. Discard foods that have been left out at room temperature for two hours. Wash raw fruits and vegetables with hot water and a mild soap. Eat only soft cheeses such as feta or brie. Limit beef intake to 10-12 ounces per week. Don't drink raw or unpasteurized milk. Chapter 11 Page 381
Discard foods that have been left out at room temperature for two hours. Don't drink raw or unpasteurized milk. While pregnant, women must adhere to certain rules regarding food preparation and storage. If food is left out at room temperature for more than two hours, the food needs to be discarded. Pregnant women should avoid intake of raw milk. None of the other restrictions are a problem.
During the initial assessment of a preterm infant, it is noted that the infant has a heart murmur. Which shunt from fetal life most likely remains open? Foramen ovale Ductus arteriosus Umbilical vein Ductus venosus Chapter 10 Page 344
Ductus Arteriosis There are three shunts in the fetal circulation: the foramen ovale, the ductus venosus and the ductus arteriosus. Additionally, there are two umbilical arteries and one umbilical vein, which close following birth and form ligaments. In a preterm infant, there is a higher likelihood of the ductus arteriosus remaining open, so a murmur heard in a preterm infant shortly after birth would be suspected to be ductal murmur.
A nurse is visiting with a couple who has recently completed subfertility assessments and are awaiting the results. Throughout the conversation the wife intermittently begins to cry. What would be the most appropriate nursing diagnosis for this couple? Hopelessness related to perception of no viable alternative to usual conception Anticipatory grieving related to failure to conceive or sustain a pregnancy Situational low self-esteem related to the apparent inability to conceive Fear related to possible outcome of subfertility studies Chapter 4 Page 131
Fear related to possible outcome of subfertility studies The nurse should recognize that the client may be expressing fear related to the possible outcomes of the testing. The nurse should address those fears with the client and answer any questions to help reduce fears.
A client asks the nurse to describe the difference between menstruation and implantation bleeding. Which statements should the nurse include in the description? Select all that apply. Menstruation occurs during the follicular phase. Implantation bleeding occurs when the graafian follicle produces estrogen. Menstruation occurs when the ovum is not fertilized. Implantation bleeding occurs when the blastocyst burrows into the endometrium. Menstruation occurs 14 days after ovulation. Implantation bleeding occurs 7 to 10 days after fertilization. Menstruation occurs every 8 days, but varies from 1 to 14 days. Implantation bleeding is not usually mistaken for a menstrual period. Chapter 10 Page 338
Menstruation occurs when the ovum is not fertilized. Implantation bleeding occurs when the blastocyst burrows into the endometrium. Menstruation occurs 14 days after ovulation. Implantation bleeding occurs 7 to 10 days after fertilization. Menstruation is a cyclic bleeding that occurs when the ovum is not fertilized and begins about 14 days after ovulation. Implantation bleeding occurs 7 to 10 days after fertilization when the blastocyst burrows into the endometrium. Menstruation occurs in the ischemic phase, not the follicular phase of the uterine cycle. Menstruation occurs every 29 days, not every 8 days and varies from 21 to 35 days, not 1 to 14 days. Implantation bleeding is not as heavy as a menstrual period.
The nurse is assessing a pregnant woman and noticing behavior changes that indicate she is beginning to accomplish the maternal tasks of becoming mother. The client is in her third trimester. Which behavior would the nurse most likely assess? Accepting the pregnancy but not yet the fetus Identifying what must be given up to assume new role Acknowledging fetus as a separate entity Questioning of ability to become a good mother Chapter 11 Page 387
Questioning of ability to become a good mother During the third trimester, the woman often questions her ability to become a mother. Accepting the pregnancy but not the fetus as yet and identifying what must be given up to assume new role are characteristic of the first trimester. Learning how to delay own desires and acknowledging the fetus as a separate entity are characteristic of the second trimester.
A pregnant woman reports her last child was born by cesarean birth. She questions if she will be required to have a cesarean birth for this current pregnancy. What information should be provided? Select all that apply. The reason for the previous cesarean birth will aid in determining if a repeated cesarean birth will be performed. It is safe for women who have had a cesarean birth to have a vaginal birth if that is what she chooses. The type of incision into the uterus in the previous cesarean birth will be a factor for consideration. If the previous cesarean birth was due to fetal distress a repeated cesarean birth will be needed. If the cesarean birth was due to pelvic size a repeated cesarean birth is likely indicated. Chapter 12 Page 822
The reason for the previous cesarean birth will aid in determining if a repeated cesarean birth will be performed. The type of incision into the uterus in the previous cesarean birth will be a factor for consideration. If the cesarean birth was due to pelvic size a repeated cesarean birth is likely indicated. A woman who gives birth by cesarean may be a candidate for a future birth vaginally. The determination about the method of birth for a future birth will be based upon a series of factors. The underlying reason for the cesarean birth has a large impact. If the woman had an operative birth due to small pelvic size, structural deformities or contractures, a repeated cesarean birth will likely be indicated. This is because the problems will still be present in the next pregnancy. The type of incision on the uterus is also an important factor. If the uterine incision was a classical incision, a repeated cesarean is indicated. The classic incision places the uterus at a high risk for rupture. If the cesarean birth was due to fetal distress, the woman may be a candidate for a vaginal birth after cesarean birth.