Maternity Test III (Ch. 13, 14, 20, 21, 22)
The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes have ruptured when the result is which of the following? a. 6.5 b. 6.0 c. 5.5 d. 5.0
a. 6.5
The nurse is measuring a contraction from the beginning of the increment to the end of the decrement for the same contraction, documenting this as which of the following? a. Duration b. Peak c. Intensity d. Frequency
a. Duration
A nurse is assisting a pregnant client during pregnancy is to monitor uterine contractions. Which of the following factors should the nurse assess to monitor uterine contraction? (Select all that apply) a. Uterine resting tone b. Frequency of contractions c. Change in temperature d. Change in blood pressure e. Intensity of contractions
a. Uterine resting tone b. Frequency of contractions e. Intensity of contractions
Part of the assessment of the first prenatal visit includes screening for rubella antibodies. The nurse explains which of the following titer results shows evidence of immunity against rubella? a. 1:10 b. 1:6 c. 1:8 d. 1:4
c. 1:8
A pregnant woman is determined to be at high risk for gestational diabetes. At which time would the nurse schedule a rescreening for the client? a. 20 to 24 weeks b. 16 to 20 weeks c. 24 to 28 weeks d. 28 to 32 weeks
c. 24 to 28 weeks
When managing a client's pain during labor, nurses should a. Make sure the agents given do not prolong labor b. Know that all pain relief measures are similar c. Support the client's decisions and requests d. Not recommend nonpharmacologic methods
c. Support the client's decisions and requests
A nurse is caring for a client in labor who is delivering. Which of the following fetal responses should the nurse monitor for in the client's baby? a. Decrease in arterial carbon dioxide pressure b. Increase in fetal breathing movements c. Increase in fetal oxygen pressure d. Decrease in circulation and perfusion to the fetus
d. Decrease in circulation and perfusion to the fetus
A fundal massage is sometimes performed on a postpartum woman. Which of the following is a reason for performing a fundal massage? a. Uterine prolapse b. Uterine atony c. Uterine contraction d. Uterine subinvolution
b. Uterine atony
The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount? a. 300 mL b. 100 mL c. 500 mL d. 250 mL
c. 500 mL
A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection? a. Herpes simplex virus b. Parvovirus B19 c. Cytomegalovirus d. Toxoplasmosis
d. Toxoplasmosis
A nurse is caring for a client who is experiencing acute onset of dyspnea and hypotension. The physician suspects the client has amniotic fluid embolism. What other signs or symptoms should alert the nurse to the presence of this condition in the client? a. Cyanosis b. Arrhythmia c. Hyperglycemia d. Hematuria e. Pulmonary edema
a. Cyanosis e. Pulmonary edema
The nurse would anticipate a cesarean birth for a client who has which active infection present at the onset of labor? a. Hepatitis b. Herpes simplex virus c. Toxoplasmosis d. Human papillomavirus
b. Herpes simplex virus
When assessing the following women, which would the nurse identify as being at the greatest risk for preterm labor? a. Woman who had twins in a previous pregnancy b. Client living in a large city c. Woman working full time as a computer programmer d. Client with a history of a previous preterm birth
d. Client with a history of a previous preterm birth
A 17-year-old nulliparous client presents in active labor. It is discovered that she received no prenatal care. Which of the following would be important to collect first? a. STI status b. HIV status c. Urinalysis d. Coagulation studies
d. Coagulation studies
The nurse is assessing the laboring client to determine fetal oxygenation status. What indirect assessment method will the nurse likely use? a. External electronic fetal monitoring b. Fetal blood pH c. Fetal oxygen saturation d. Fetal position
a. External electronic fetal monitoring
A nurse is caring for an antenatal mother diagnosed with umbilical cord prolapse. Which of the following should the nurse monitor for in a fetus in cases of umbilical cord prolapse? a. Fetal hypoxia b. Preeclampsia c. Coagulation defects d. Placental pathology
a. Fetal hypoxia
A 27-year-old G1, P1 woman arrives in the emergency department accompanied by her husband and new infant, crying, confused, and with possible hallucinations. The nurse recognizes this could possibly be postpartum psychosis as it can appear approximately when? a. Within 3 months of giving birth b. Within 2 months of giving birth c. Within 5 months of giving birth d. Within 4 months of giving birth
a. Within 3 months of giving birth
A nurse caring for a pregnant client utilizes the RAFT screening instrument to assess the possibility of substance abuse. What question does the "R" in RAFT refer to? a. "Do you use drugs as a form of recreation?" b. "Do you drink or take drugs to relax?" c. "Do you have any relatives that abuse drugs?" d. "Do you ever rely on drugs to help you sleep?"
b. "Do you drink or take drugs to relax?"
A woman is to undergo labor induction. The nurse determines that the woman most likely requires cervical ripening if her Bishop score is: a. 5 b. 6 c. 7 d. 8
a. 5
When treating a postpartum woman for hemorrhage, the nurse will prepare the client for a blood transfusion once the estimates of blood loss reach which level? a. 1,000 mL b. 1,500 mL c. 1,750 mL d. 1,250 mL
b. 1,500 mL
A nurse is documenting a dietary plan for a pregnant client with pregestational diabetes. What instructions should the nurse include in the dietary plan for this client? a. Include more dairy products in the diet b. Include complex carbohydrates in the diet c. Eat only two meals per day d. Eat at least one egg per day
b. Include complex carbohydrates in the diet
A pregnant woman with sickle cell anemia comes to the emergency department. Which of the following would indicate the client is in crisis? (Select all that apply.) a. Increased skin turgor b. Joint pain c. Fever d. Fatigue e. Pallor
b. Joint pain c. Fever
As the nurse working in labor and delivery, you understand that the client who is well prepared and has good labor support demonstrates all except which of the following? a. Less likely to need anesthesia b. Less likely to need analgesia c. Need someone to control the situation d. Unlikely to require cesarean birth
c. Need someone to control the situation
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 of the following marks the importance of the pauses between contractions during labor? a. Effacement and dilation of the cervix b. Shortening of the upper uterine segment c. Reduction in length of the cervical canal d. Restoration of blood flow to uterus and placenta
d. Restoration of blood flow to uterus and placenta
When developing a plan of care for a pregnant woman who is HIV-positive, which of the following is essential to be included? a. Preparing the woman for cesarean birth b. Helping her choose a newborn feeding method c. Educating her about family planning d. Using standard precautions
d. Using standard precautions
Nursing care of the pregnant woman often involves the management of medications. When assessing the client history, the nurse should verify that the client is not taking any prescribed medications of which category? a. B b. C c. D d. X
d. X
During the assessment, the nurse explains that certain landmarks are used to determine the progress of the delivery. What are these landmarks? a. Pubic symphysis b. Cervical os c. Ischial tuberosity d. Ischial spine
d. Ischial spine
The nurse is teaching a pregnant woman with iron deficiency anemia about foods high in iron. Which food(s) if selected by the woman indicates a successful teaching program? (Select all that apply.) a. Broccoli b. Raisins c. Yogurt d. Peanut butter e. Potatoes
a. Broccoli b. Raisins d. Peanut butter
A nurse is caring for a pregnant client who works at a daycare center and is in regular contact with children. What instructions should the nurse give this client in order to minimize risk of transmission of cytomegalovirus to the fetus? a. Ensure thorough hand-washing b. Seek consultation for antibiotics c. Avoid interacting with children d. Drink plenty of fluids
a. Ensure thorough hand-washing
A nurse is assigned to conduct an admission assessment on the phone for a pregnant client. Which of the following information should the nurse obtain from the client? (Select all that apply) a. Estimated due date b. History of drug abuse c. Characteristics of contractions d. Appearance of vaginal blood e. History of drug allergy
a. Estimated due date c. Characteristics of contractions d. Appearance of vaginal blood
Two weeks after a vaginal delivery, a client presents with low-grade fever. The client also complains of a loss of appetite and low energy levels. The physician suspects an infection of the episiotomy. Which sign or symptom is most indicative of an episiotomy infection? a. Foul-smelling vaginal discharge b. Sudden onset of shortness of breath c. Pain in the lower leg d. Apprehension and diaphoresis
a. Foul-smelling vaginal discharge
Gestational diabetes increases the risk of various complications in both the mother and infant. Which of the following would not be an example of a neonatal complication? a. Hyperglycemia b. Hypoglycemia c. Birth trauma d. Macrosomia
a. Hyperglycemia
Methylergonovine is ordered for a woman experiencing postpartum hemorrhage. The nurse monitors the woman closely for which of the following adverse effects? a. Seizures b. Uterine hyperstimulation c. Headache d. Flushing
a. Seizures
Every postpartum client has the potential of hemorrhage. While assessing a client's status, the nurse recognizes which of the following would not be used as an indicator of possible hemorrhage? a. Signs of shock b. Uterine tone c. Estimated amount of blood loss d. Vital signs
a. Signs of shock
Massage is an effective nonpharmacologic technique that can help to decrease pain during labor. Which of the following would be a contraindication for massage? a. Skin rash b. Cultural beliefs c. Already given opioids d. Comfort level of woman
a. Skin rash
A laboring woman is admitted to the labor and birth suite at 6-cm dilation. She would be in which phase of the first stage of labor? a. Latent b. Active c. Transition d. Early
b. Active
A nurse is caring for a pregnant client with asthma. Which of the following interventions should the nurse include during physical examination of this client? a. Monitoring temperature frequently b. Assessing for signs of fatigue c. Monitoring frequency of headache d. Assessing for feeling nauseated
b. Assessing for signs of fatigue
While discussing labor with your client and her partner, they ask what the best position is for delivering the baby. You provide them with information that indicates research has shown which of the following to be the best? a. Lying on her back with feet in stirrups b. Position of comfort for the mother c. Squatting d. Semi-Fowler's position
b. Position of comfort for the mother
The shortest but most intense phase of labor is the: a. Latent phase b. Active phase c. Transition phase d. Placental expulsion phase
c. Transition phase
A woman with systemic lupus erythematosus is interested in preconception counseling to discuss her desire to get pregnant. As the nurse, you explain it would be best if she is symptom-free or in remission for how long before getting pregnant? a. 3 months b. 9 months c. 12 months d. 6 months
d. 6 months
During the first hour of the fourth stage of labor, the nurse would assess the woman's fundus how often? a. Every 20 minutes b. Every 10 minutes c. Every 5 minutes d. Every 15 minutes
d. Every 15 minutes
A 35-year-old G2, P2 client presents to her postpartum appointment with vague complaints. The nurse suspects postpartum depression after the client expresses all except which of the following? a. Appears detached from infant b. Change in sleep c. Lack of energy and motivation d. Feels like eating all the time
d. Feels like eating all the time
A 19-year-old woman presents to the emergency department in the late stages of active labor. Assessment reveals she received no prenatal care. As part of her examination, a rapid HIV screen indicates she is HIV positive. To reduce the perinatal transmission to her infant, which intravenous medication should she receive? a. Nevirapine b. Maraviroc c. Tenofovir d. Zidovudine
d. Zidovudine
During an admission assessment of a client in labor, the nurse observes that there is no vaginal bleeding yet. What nursing intervention is appropriate in the absence of vaginal bleeding when the client is in the early stage of labor? a. Monitor vital signs b. Assess amount of cervical dilation c. Obtain urine specimen for urinalysis d. Monitor hydration status
b. Assess amount of cervical dilation
Within the first hour after birth, the nurse would expect to find the woman's fundus: a. Between the umbilicus and symphysis pubis b. At the level of the umbilicus c. 2 cm above the umbilicus d. One fingerbreadth below the umbilicus
b. At the level of the umbilicus
A client is entering her 42nd week of gestation and is being prepared for induction of labor. The nurse recognizes all except which of the following are potential concerns for the infant? a. Macrosomia b. Hydramnios c. Brachial plexus injuries d. Shoulder dystocia
b. Hydramnios
Cytomegalovirus infection can result in different congenital anomalies. It can also be transmitted via different routes. Permanent fetal disability can occur with which type of transmission of CMV? a. With any transmission b. In utero transmission c. During birth transmission d. After birth transmission
b. In utero transmission
A young mother has tested positive for HIV. When discussing the situation with the client, the nurse should advise the mother that she should avoid which of the following? a. Cesarean delivery b. Breast-feeding c. Future pregnancies d. Handling the infant with open sores
b. Breast-feeding
A nurse is caring for a pregnant client who is in the active phase of labor. At what intervals should the nurse monitor the client's vital signs? a. Every 15 to 30 minutes b. Every 30 minutes c. Every 30 to 60 minutes d. Every 4 hours
b. Every 30 minutes
A pregnant client in labor has to undergo a sonogram to confirm the fetal position of a shoulder presentation. The nurse should assess for which of the following conditions associated with shoulder presentation during a vaginal birth? a. Uterine abnormalities b. Fetal anomalies c. Congenital anomalies d. Prematurity
b. Fetal anomalies
Which assessment would indicate that a woman is in true labor? a. Membranes are ruptured and fluid is clear b. Presenting part is engaged and not floating c. Cervix is 4 cm dilated, 90% effaced d. Contractions last 30 seconds, every 5 to 10 minutes
c. Cervix is 4 cm dilated, 90% effaced
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 of the following? a. Restitution b. Crowning c. Descent d. Engagement
b. Crowning
The nurse collects a urine specimen for culture from a postpartum woman with a suspected urinary tract infection. Which organism would the nurse most likely expect the culture to reveal? a. Gardnerella vaginalis b. Escherichia coli c. Staphylococcus aureus d. Klebsiella pneumoniae
b. Escherichia coli
Which of the following instructions would the nurse include in the teaching plan for a postpartum woman with mastitis? a. "You'll need to take this medication to stop the milk from being produced." b. "Try applying warm compresses to your breasts to encourage the milk to be released." c. "Limit the amount of fluid you drink so your breasts don't get much fuller." d. "Stop breastfeeding until the pain and swelling subside."
b. "Try applying warm compresses to your breasts to encourage the milk to be released."
Following the birth, you are responsible for assessing the cord pH. You recognize which of the following would be considered a normal pH? a. 6.8 b. 7.2 c. 7.0 d. 7.4
b. 7.2
A nurse is caring for a client with idiopathic thrombocytopenic purpura. The nurse is correct when performing which intervention? a. Administration of prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) b. Administration of platelet transfusions as ordered c. Avoiding administration of oxytocics d. Continual firm massage of the uterus
b. Administration of platelet transfusions as ordered
Which of the following would be least effective in promoting a positive birth outcome for a woman in labor? a. Promoting the woman's feelings of control b. Allowing the woman time to be alone c. Providing clear information about procedures d. Encouraging the woman to use relaxation techniques
b. Allowing the woman time to be alone
After teaching a class about various methods for cervical ripening, the instructor determines that the teaching was successful when the class identifies which of the following as a surgical method? a. Laminaria b. Amniotomy c. Breast stimulation d. Prostaglandin
b. Amniotomy
When reviewing the history of a woman in labor, the nurse notes that the client has a funnel-shaped pelvis. The nurse would identify this pelvic shape as which of the following? a. Platypelloid b. Android c. Gynecoid d. Anthropoid
b. Android
A client has presented to the birthing center after her membranes ruptured. The primary focus of the nurse should be: a. Assessing for infection b. Assessing FHR c. Assessing maternal comfort d. Assessing fetal position
b. Assessing FHR
Which of the following conditions would most likely cause a pregnant woman with type 1 diabetes the greatest difficulty during her pregnancy? a. Placenta previa b. Hyperemesis gravidarum c. Abruptio placentae d. Rh incompatibility
b. Hyperemesis gravidarum
Which of the following would the nurse include when teaching a pregnant woman about the pathophysiologic mechanisms associated with gestational diabetes? a. Pregnancy fosters the development of carbohydrate cravings b. There is progressive resistance to the effects of insulin c. Hypoinsulinemia develops early in the first trimester d. Glucose levels decrease to accommodate fetal growth
b. There is progressive resistance to the effects of insulin
A woman receiving an oxytocin infusion for labor induction develops contractions that occur every minute and last 75 seconds. Uterine resting tone remains at 20 mm Hg. Which action would be most appropriate? a. Continue to monitor contractions and fetal heart rate. b. Slow the oxytocin infusion to the initial rate. c. Stop the infusion immediately. d. Notify the birth attendant.
c. Stop the infusion immediately.
Effective nursing management involves many aspects and being aware of subtle changes in the client. Which of the following should alert the nurse to a potential infection in the client? a. Temperature of 38.5% C or higher after the first 36 hours after childbirth b. Temperature of 39% C or higher after the first 48 hours after childbirth c. Temperature of 38% C or higher after the first 24 hours after childbirth d. Temperature of 37.5% C or higher after the first 12 hours after childbirth
c. Temperature of 38% C or higher after the first 24 hours after childbirth
A client in the third stage of labor has experienced placental separation and expulsion. Why is it necessary for a nurse to massage the woman's uterus briefly until it is firm? a. To reduce boggy nature of the uterus b. To remove pieces left attached to uterine wall c. To constrict the uterine blood vessels d. To lessen the chances of conducting an episiotomy
c. To constrict the uterine blood vessels
A client has arrived to the birthing center in labor, requesting a VBAC. The nurse knows that she would be a good candidate after reading her previous history due to which of the following? a. Had prior classic uterine incision b. Had prior transfundal uterine surgery c. Has contracted pelvis d. Has previous lower abdominal incision
d. Has previous lower abdominal incision
Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes she has a history of asthma. Which of the following medications would be contraindicated in her case? a. Pitocin b. Cytotec c. Methergine d. Hemabate
d. Hemabate
When a client in labor is fully dilated, which instruction would be most effective to assist her in encouraging effective pushing? a. Hold your breath and push through entire contraction b. Use chest-breathing with the contraction c. Pant and blow during each contraction d. Instruct her to wait until she feels the urge to push
d. Instruct her to wait until she feels the urge to push
A physician orders oral tocolytic therapy for a woman with preterm labor. Which agent would the nurse be least likely to administer? a. Terbutaline b. Indomethacin c. Nifedipine d. Magnesium sulfate
d. Magnesium sulfate
A pregnant client has a history of asthma. Which of the following agents would not be appropriate to help her control her asthma during her pregnancy? a. Albuterol b. Budesonide c. Misoprostol d. Salmeterol
c. Misoprostol
When discussing the various risks to the mother and infant, the nurse should include that which of the following is the leading cause of mental retardation in the United States? a. Genetic anomalies b. Pregnancy Category X medications c. Maternal drug addiction d. Fetal alcohol spectrum disorder
d. Fetal alcohol spectrum disorder
When reviewing the medical record of a client, the nurse notes that the woman has a condition in which the fetus cannot physically pass through the maternal pelvis. The nurse interprets this as: a. Cervical insufficiency b. Contracted pelvis c. Maternal disproportion d. Fetopelvic disproportion
d. Fetopelvic disproportion
After teaching a class on ways to decrease the postpartum complication of thrombotic conditions, the nurse recognizes more teaching is needed when one of the participants states: a. "At least, I don't have to give up smoking for this one." b. "Using passive range-of-motion exercises in bed sounds easy enough." c. "He has to do the deep breathing exercises with me." d. "I can drink more, so I don't get dehydrated."
a. "At least, I don't have to give up smoking for this one."
A client is admitted to the unit in preterm labor. In preparing the client for tocolytic therapy, the nurse recognizes this will prolong the pregnancy for which of the following? a. 2 to 7 days b. 4 to 8 days c. 6 to 10 days d. 1 to 5 days
a. 2 to 7 days
What important instruction should the nurse give a pregnant client with tuberculosis? a. Maintain adequate hydration b. Avoid direct sunlight c. Avoid red meat d. Wear light, cotton clothes
a. Maintain adequate hydration
A 19-year-old nulliparous is in early labor with erratic contractions. An assessment notes that she is remaining at 3 cm. There is also a concern that the uterus is not fully relaxing between contractions. Which of the following complications is a concern? a. Reduced oxygen to the fetus b. Cephalopelvic disproportion c. Precipitate labor d. Ruptured uterus
a. Reduced oxygen to the fetus
The assessment of a pregnant client, who is toward the end of her third trimester, reveals that she has increased prostaglandin levels. Which of the following factors should the nurse assess for in the client? (Select all that apply) a. Reduction in cervical resistance b. Myometrial contractions c. Boggy appearance of the uterus d. Softening and thinning of the cervix e. Hypotonic character of the bladder
a. Reduction in cervical resistance b. Myometrial contractions d. Softening and thinning of the cervix
A client in her third trimester of pregnancy arrives at a health care facility complaining of cramping and low back pain; she also notes that she is urinating more frequently and that her breathing has become easier the past few days. Physical examination conducted by the nurse indicates the client has edema of the lower extremities, along with an increase in vaginal discharge. The nurse knows that the client is experiencing which of the following conditions? a. Nesting b. Lightening c. Braxton Hicks contractions d. Bloody show
b. Lightening
Which fetal lie is most conductive to a spontaneous vaginal birth? a. Transverse b. Longitudinal c. Perpendicular d. Oblique
b. Longitudinal
A client has asked that an opioid be kept on standby in case she needs it for pain control. As a precaution, the nurse will also have which of the following readily available to reverse the effects of that opioid? a. Nalbuphine b. Naloxone c. Hydroxyzine d. Midazolam
b. Naloxone
Assessment reveals that a woman's cervix is approximately 1 cm in length. The nurse would document this as: a. 75% effaced b. 100% effaced c. 50% effaced d. 0% effaced
c. 50% effaced
The client is requesting information on the various pain medication management techniques that are available to decide which option she would like to choose for her impending delivery. While gathering together the information, which technique would you indicate that has become very popular and effective? a. Epidural analgesia b. Systemic analgesia c. Neuraxial analgesia/anesthesia d. Spinal analgesia
c. Neuraxial analgesia/anesthesia
A pregnant client has been diagnosed with gestational diabetes. Which of the following are risk factors for developing gestational diabetes? (Select all that apply) a. Maternal age less than 18 years b. Genitourinary tract abnormalities c. Obesity d. Hypertension e. Previous large for gestational age (LGA) infant
c. Obesity d. Hypertension e. Previous large for gestational age (LGA) infant
A nurse is caring for a client who delivered vaginally 2 hours ago. What postpartum complication can the nurse assess within the first few hours following delivery? a. Postpartal infection b. Postpartal blues c. Postpartal hemorrhage d. Postpartum depression
c. Postpartal hemorrhage
During the examination, the health care provider mentions the fetus has a good attitude. You explain to the parents that this means which of the following? a. The fetus is presenting head first. b. Posture of the fetus is with arms at its side and legs straight. c. Posture of the fetus with all joints flexed for delivery d. The fetus is cooperating with the labor.
c. Posture of the fetus with all joints flexed for delivery
A nurse is caring for a 45-year-old pregnant client with a cardiac disorder, who has been instructed by her physician to follow Class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations? a. "You will need to be on bedrest for the remainder of your pregnancy" b. "It is important for you to rest after any physical activity in order to prevent any cardiac complications" c. "It will be beneficial if you plan rest periods throughout your day" d. "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath"
d. "You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath"
A pregnant woman with diabetes is having her glycosylated hemoglobin level evaluated. Which result would require the nurse to revise the client's plan of care? a. 6.5% b. 7.5% c. 5.5% d. 8.5%
d. 8.5%
A nurse is caring for a pregnant client who is HIV-positive. What is a priority issue that the nurse should discuss with the client? a. The client's relationship with the spouse b. The amount of physical contact that should occur with the infant c. The client's plan for future pregnancies d. The need for the client to avoid breastfeeding
d. The need for the client to avoid breastfeeding
A woman in labor is receiving oxytocin. Which of the following would the nurse need to be alert for potentially occurring? a. Hypertension b. Uterine hypotonicity c. Fetal distress d. Water intoxication
d. Water intoxication
A nurse is caring for a client who has been administered an epidural block. Which of the following symptoms must the nurse monitor the client for? a. Respiratory depression b. Accidental intrathecal blockade c. Inadequate or failed block d. Postdural puncture headache
a. Respiratory depression
A nurse is assigned to care for a client who has to undergo a forceps and vacuum-assisted birth. The nurse understands that which of the following factors has contributed to a forceps and vacuum-assisted birth? a. A prolonged second stage of labor b. Oligohydramnios due to placental insufficiency c. Preterm labor with premature rupture of membranes d. Rupture of uterus
a. A prolonged second stage of labor
The nurse is reviewing the uterine contraction pattern and identifies the peak intensity, documenting this as which of the following? a. Decrement b. Diastole c. Acme d. Increment
c. Acme
Which of the following observations would suggest that placental separation is occurring? a. Uterus stops contracting altogether b. Umbilical cord pulsations stop c. Uterine shape changes to globular d. Maternal blood pressure drops
c. Uterine shape changes to globular
The health care provider has determined that the source of dystocia for a woman is related to the fetus size. The nurse would know that macrosomia would indicate the fetus weighs which of the following? a. 4,000 g or more b. 4,500 g or more c. 3,000 g or more d. 3,500 g or more
a. 4,000 g or more
The client is anxious about her prolonged pregnancy. She informs the nurse she has been doing research on the Internet and has read about certain herbs that can help. Which of the following would an appropriate response from the nurse? a. "Please talk to your physician first to ensure it is safe." b. "Why would you do something as stupid as that." c. "Personally, I would use them, but I cannot tell you to." d. "There is no scientific evidence they work. You will just complicate your situation more."
a. "Please talk to your physician first to ensure it is safe."
After teaching a local woman's group about postpartum affective disorders, which statement by the group indicates that the teaching was successful? a. "Postpartum depression develops gradually, appearing within the first 6 weeks." b. "Postpartum psychosis usually appears soon after the woman comes home." c. "Postpartum blues usually resolves by the fourth or fifth postpartum day." d. "Postpartum psychosis usually involves psychotropic drugs but not hospitalization."
a. "Postpartum depression develops gradually, appearing within the first 6 weeks."
Disseminated intravascular coagulation is a life-threatening condition that the nurse recognizes can occur as a complication secondary to which of the following primary conditions? (Select all that apply.) a. Abruptio placenta b. Severe preeclampsia c. Isoimmunization d. Ectopic pregnancy e. Septicemia
a. Abruptio placenta b. Severe preeclampsia e. Septicemia
In preparing for a class for a group of new parents, the nurse should include that smoking can increase the risk of which of the following complications? (Select all that apply.) a. Abruptio placenta b. Premature rupture of membranes c. Spontaneous abortion d. High birth weight e. Maternal hypertension
a. Abruptio placenta c. Spontaneous abortion e. Maternal hypertension
A refugee from a third world country presents to the clinic to find out if she is pregnant. Which of the following signs and/or symptoms indicate she might have an active case of tuberculosis as well? (Select all that apply.) a. Anorexia b. Hemoptysis c. Weight gain d. Night sweats e. Fatigue
a. Anorexia b. Hemoptysis d. Night sweats e. Fatigue
The client wants to avoid an episiotomy. What other technique would the nurse suggest for the client to try? a. Apply warm compresses to the perineum. b. Deliver the infant while lying on her back. c. Massage the perineum daily during the last trimester. d. Practice Kegel exercises during pregnancy.
a. Apply warm compresses to the perineum.
A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which of the following interventions should the nurse perform to evaluate the efficacy of the drug treatment? (Select all that apply) a. Assess client's uterine tone b. Monitor client's vital signs c. Assess client's skin turgor d. Get a pad count e. Assess deep tendon reflexes
a. Assess client's uterine tone b. Monitor client's vital signs d. Get a pad count
A nurse is caring for a client with CVD who has just delivered. What nursing intervention should the nurse perform when caring for this client? (Select all that apply). a. Assess for shortness of breath b. Assess for a moist cough c. Assess for edema and note any pitting d. Auscultate heart sounds for abnormalities e. Monitor the client's hemoglobin and hematocrit
a. Assess for shortness of breath b. Assess for a moist cough c. Assess for edema and note any pitting d. Auscultate heart sounds for abnormalities
Which of the following postoperative interventions should a nurse perform when caring for a client who has undergone a cesarean section? a. Assess uterine tone to determine fundal firmness b. Delay breastfeeding the newborn for a day c. Ensure that the client does not cough or breathe deeply d. Avoid early ambulation to prevent respiratory problems
a. Assess uterine tone to determine fundal firmness
A client who is in labor presents with shoulder dystocia of the fetus. Which of the following is an important nursing intervention? a. Assist with positioning the woman in squatting position b. Assess for complaints of intense back pain in first stage of labor c. Anticipate possible use of forceps to rotate to anterior position at birth d. Assess for prolonged second stage of labor with arrest of descent
a. Assist with positioning the woman in squatting position
A 19-year-old female presents in advanced labor. Examination reveals the fetus is in frank breech position. You explain to the client this means which of the following? a. Buttocks are presenting first with both legs extended up toward the face. b. Fetus is sitting cross-legged above the cervix. c. One leg is presenting. d. One arm is presenting.
a. Buttocks are presenting first with both legs extended up toward the face.
After conducting a class on possible congenital infections with a group of student nurses, the instructor recognizes the class was successful when the class identifies which of the following as the most common congenital viral infection? a. CMV b. RSV c. HIV d. HPV
a. CMV
The nurse is assessing the woman who has a forceps-assisted birth for complications. Which of the following would be least likely to occur in the mother? a. Caput succedaneum b. Perineal hematoma c. Infection of episiotomy d. Cervical lacerations
a. Caput succedaneum
On examination, the nurse determines the client is at 50% effacement. This means: a. Cervical canal is 1 cm long. b. Cervical canal is 2 cm long. c. Cervical canal is 1.5 cm long. d. Cervical canal is 2.5 cm long.
a. Cervical canal is 1 cm long.
A full-term pregnant client is being assessed for induction of labor. Her bishop score is less than 6. Which of the following does it indicate? a. Cervical ripening method should be used b. A cesarean may be required c. Vaginal birth will be successful d. Labor will occur spontaneously
a. Cervical ripening method should be used
A nurse is caring for obstetric clients. The nurse should be aware of which of the following as an indication for labor induction? a. Chorioamnionitis b. Complete placenta previa c. Abruptio placenta d. Transverse fetal lie
a. Chorioamnionitis
A woman with cardiac disease has come to the office for prenatal counseling. According to the functional classification system developed by the Criteria Committee of the New York Heart Association, which category of women should avoid pregnancy? a. Class IV b. Class III c. Class I d. Class II
a. Class IV
A new dad is alarmed at the shape of his newborn's head. You remind him this is due to: a. Cranial bones overlapping at the suture lines b. Prolonged labor c. A congenital defect d. Extreme pressure in the vaginal vault
a. Cranial bones overlapping at the suture lines
The nurse performing Leopold's maneuvers for a pregnant client explains to the client the purpose of the maneuvers. Which of the following is the purpose of the maneuvers? (Select all that apply) a. Determining the presentation of the fetus b. Determining the position of the fetus c. Determining the lie of the fetus d. Determining the weight of the fetus e. Determining the size of the fetus
a. Determining the presentation of the fetus b. Determining the position of the fetus c. Determining the lie of the fetus
Certain pharmaceuticals can be used to attain cervical ripening in women who need assistance in cervical ripening. They have also often continued into labor without further agents to stimulate uterine contractions. The nurse is aware that the FDA has approved the use of which of the following as a cervical ripening agent? a. Dinoprostone b. Misoprostol c. Oxytocin d. Magnesium sulfate
a. Dinoprostone
The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which of the following instructions should the nurse give this client to prevent toxoplasmosis? (Select all that apply). a. Eat meat cooked to 160 degrees b. Avoid cleaning the cat's litter box c. Keep the cat outdoors at all times d. Avoid contact with children when they have a cold e. Avoid outdoor activities such as gardening
a. Eat meat cooked to 160 degrees b. Avoid cleaning the cat's litter box e. Avoid outdoor activities such as gardening
The nurse encourages a woman in labor to ambulate based on the understanding that it helps with which of the following? (Select all that apply.) a. Enhances the effectiveness of contractions b. Widens one side of the pelvis c. Encourages rotation of the fetus d. Enlists the aid of gravity to move the fetus e. Increases the urge to push during the second stage f. Helps the fetus line up with the angle of the pelvis
a. Enhances the effectiveness of contractions d. Enlists the aid of gravity to move the fetus e. Increases the urge to push during the second stage f. Helps the fetus line up with the angle of the pelvis
A client at 33 weeks' gestation is calling the office with various complaints and is very concerned. The nurse recognizes which of the following as indicating the client is potentially going into preterm labor? (Select all that apply.) a. General sense of discomfort b. Irregular contractions c. GI upset (nausea, vomiting, diarrhea) d. Achiness in the thighs e. Low, dull backache
a. General sense of discomfort c. GI upset (nausea, vomiting, diarrhea) d. Achiness in the thighs e. Low, dull backache
A nurse is caring for a pregnant client during labor. Which of the following methods should the nurse use to provide comfort to the pregnant client? (Select all that apply) a. Hand holding b. Chewing gum c. Massaging d. Acupuncture e. Prescribed pain killers
a. Hand holding c. Massaging d. Acupuncture
A client in her 7th week of postpartum period is experiencing bouts of sadness and insomnia. The nurse suspects that the client may have developed postpartum depression. What signs or symptoms are indicative of postpartum depression? (Select all that apply) a. Inability to concentrate b. Loss of confidence c. Manifestations of mania d. Decreased interest in life e. Bizarre behavior
a. Inability to concentrate b. Loss of confidence d. Decreased interest in life
A nurse is caring for a pregnant client who is in labor. Which of the following maternal physiologic responses should the nurse monitor for in the client as the client progresses through childbirth? (Select all that apply) a. Increase in heart rate b. Increase in blood pressure c. Increase in respiratory rate d. Slight decrease in body temperature e. Increase in gastric emptying and pH
a. Increase in heart rate b. Increase in blood pressure c. Increase in respiratory rate
A client in labor is administered lorazepam to help her relax enough so that she can participate effectively during her labor process rather than fighting against it. Which of the following is an adverse effect of the drug that the nurse should monitor for? a. Increased sedation b. Newborn respiratory depression c. Nervous system depression d. Decreased alertness
a. Increased sedation
A nurse is assessing the cause of multiple gestations in clients. Which of the following factors should the nurse assess as contributors to increased probability of multiple gestations? a. Infertility treatment b. Medications c. Advanced maternal age d. Adolescent pregnancies
a. Infertility treatment
A pregnant client has opted for hydrotherapy for pain management during labor. Which of the following should the nurse consider when assisting the client during the birthing process? a. Initiate the technique only when the client is in active labor b. Do not allow the client to stay in the bath for long c. Ensure that the water temperature exceeds body temperature d. Allow the client into the water only if her membranes have ruptured
a. Initiate the technique only when the client is in active labor
The health care provider is evaluating a high-risk woman for a continuous internal monitor. Which of the following would not be a criterion to make this decision? a. Insertion of spiral electrode by any staff b. The presenting fetal part is visible c. Rupture of membranes d. Cervical dilation of at least 2 cm
a. Insertion of spiral electrode by any staff
After a vaginal examination, the nurse determines that the client's fetus is in an occiput posterior position. The nurse would anticipate that the client will have: a. Intense back pain b. Frequent leg cramps c. Nausea and vomiting d. A precipitous birth
a. Intense back pain
A client is in the transitional phase of labor. Which of the following would the nurse most likely find? (Select all that apply.) a. Irritability with restlessness b. Apprehension mixed with excitement c. Strong desire to push d. Cervical dilation of 6 cm e. Contractions occurring every 3 minutes
a. Irritability with restlessness c. Strong desire to push
When assisting the parents in the grieving process after the death of their infant, which of the following is the most important for the nurse to do? a. Keep the communication lines open b. Remove the infant quickly c. Contact a grief counselor d. Leave the parents alone
a. Keep the communication lines open
A woman presents to her first postpartum visit with complaining she does not feel well. Which of the following would lead the nurse to suspect that she has developed metritis? (Select all that apply.) a. Leukocytosis b. Hematuria c. Foul-smelling lochia d. Flank pain e. Pain on both sides of the abdomen
a. Leukocytosis c. Foul-smelling lochia e. Pain on both sides of the abdomen
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, you explain this is probably due to: a. Lightening b. Start of labor c. Placenta previa d. Rupture of the membranes
a. Lightening
A client has had a forceps delivery which resulted in lacerations and bleeding. How can a nurse identify if the bleeding is due to laceration? a. Look for a contracted uterus with vaginal bleeding b. Look for a subinvoluted uterus with vaginal bleeding c. Look for a boggy uterus with vaginal bleeding d. Look for an inverted uterus with vaginal bleeding
a. Look for a contracted uterus with vaginal bleeding
A nurse is caring for a client who is in the first stage of labor. The client is experiencing extreme pain due to the labor. The nurse understands that which of the following is causing the extreme pain in the client? (Select all that apply) a. Lower uterine segment distention b. Fetus moving along the birth canal c. Stretching and tearing of structures d. Spontaneous placental expulsion e. Dilation of the cervix
a. Lower uterine segment distention c. Stretching and tearing of structures e. Dilation of the cervix
Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client: week 16 : 124/86; week 20 : 138/90; week 24 : 140/92; and week 28 : 142/94. Which of the following would be the correct classification of her blood pressure? a. Mild hypertensive b. Prehypertensive c. Severe hypertensive d. Normotensive
a. Mild hypertensive
After conducting a childbirth class, you recognize that students understand what was presented after correctly choosing which of the following factors that can affect the labor process? (Select all that apply.) a. Powers b. Place c. Participation d. Passenger e. Patience
a. Powers d. Passenger e. Patience
A 26-year-old female, G1,P0, presents to the emergency department with complaints of regular uterine contractions. Since she is in her 36th week of gestation, the nurse recognizes which of the following is potentially occurring? a. Preterm labor b. Dystocia c. Precipitate labor d. Normal labor
a. Preterm labor
A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What assessment finding will the nurse expect to find in the client? a. Prolonged bleeding time b. A fever of 100.4 F after the first 24 hours following childbirth c. Foul-smelling vaginal discharge d. Postpartum fundal height that is higher than expected
a. Prolonged bleeding time
A nurse is assigned the task of educating a pregnant client about childbirth. Which of the following nursing interventions should the nurse perform as a part of prenatal education for the client to ensure a positive childbirth experience? (Select all that apply) a. Provide the client clear information on procedures involved b. Encourage the client to have a sense of mastery and self-control c. Encourage the client to have a positive reaction to pregnancy d. Instruct the client to spend some time alone each day e. Instruct the client to begin changing the home environment
a. Provide the client clear information on procedures involved b. Encourage the client to have a sense of mastery and self-control c. Encourage the client to have a positive reaction to pregnancy
A woman is experiencing dystocia that appears related to psyche problems. Which intervention would be most appropriate for the nurse initiate? a. Providing a comfortable environment with dim lighting b. Administering oxytocin c. Preparing the woman for an amniotomy d. Encouraging the woman to assume a hands-and-knees position
a. Providing a comfortable environment with dim lighting
A postpartum woman reports hearing voices and says, "The voices are telling me to do bad things to my baby." The clinic nurse interprets these findings as suggesting postpartum: a. Psychosis b. Anxiety disorder c. Depression d. Blues
a. Psychosis
During the assessment of a pregnant client, the nurse learns that the client has CVD. Which of the following should the nurse identify as a major risk that can be faced by the newborn of this client? a. Respiratory distress syndrome b. Congenital varicella syndrome c. SIDS d. Prune belly syndrome
a. Respiratory distress syndrome
A nurse is caring for a newborn with fetal alcohol spectrum disorder. What characteristic of the fetal alcohol spectrum disorder should the nurse assess for in the newborn? a. Small head circumference b. Decreased blood glucose level c. Poor breathing pattern d. Wide eyes
a. Small head circumference
A pregnant client requires administration of an epidural block for management of pain during labor. Which of the following conditions should the nurse check for in the client before administering the epidural block? (Select all that apply) a. Spinal abnormality b. Hypovolemia c. Varicose veins d. Coagulation defects e. Skin rashes or bruises
a. Spinal abnormality b. Hypovolemia d. Coagulation defects
When determining the frequency of contractions, the nurse would measure which of the following? a. Start of one contraction to the start of the next contraction b. Beginning of one contraction to the end of the same contraction c. Peak of one contraction to the peak of the next contraction d. End of one contraction to the beginning of the next contraction
a. Start of one contraction to the start of the next contraction
A pregnant woman has just presented to the emergency department with various complaints and in distress. Which of the following would lead the nurse to suspect that she is experiencing an amniotic fluid embolism? (Select all that apply.) a. Sudden onset of respiratory distress b. Hypotension c. Acute, continuous abdominal pain d. Tachycardia e. Sudden onset of fetal distress
a. Sudden onset of respiratory distress b. Hypotension d. Tachycardia
The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which of the following should the nurse recognize as a symptom of cardiac decompensation with this client? a. Swelling of the face b. Dry, rasping cough c. Slow, labored respiration d. Elevated temperature
a. Swelling of the face
A nurse is caring for a pregnant client with sickle cell anemia. What should the nursing care for the client include? (Select all that apply) a. Teach the client meticulous hand-washing b. Assess serum electrolyte levels of the client at each visit c. Instruct client to consume protein-rich foods d. Assess hydration status of the client at each visit e. Urge the client to drink 8 to 10 glasses of fluid daily
a. Teach the client meticulous hand-washing d. Assess hydration status of the client at each visit e. Urge the client to drink 8 to 10 glasses of fluid daily
A nurse is caring for a client who is scheduled to undergo amnioinfusion. The nurse knows that the client will not be able to have this procedure if which condition is present? a. The client has uterine hypertonicity b. The client has an active genital herpes infection c. The client has signs of abruptio placentae d. The client has invasive cervical cancer
a. The client has uterine hypertonicity
A client experiencing contractions presents at a health care facility. Assessment conducted by the nurse reveals that the client has been experiencing Braxton Hicks contractions. The nurse has to educate the client on the usefulness of Braxton Hicks contractions. Which of the following is the role of Braxton Hicks contractions in aiding labor? a. These contractions help in softening and ripening the cervix b. These contractions increase the release of prostaglandins c. These contractions increase oxytocin sensitivity d. These contractions make maternal breathing easier
a. These contractions help in softening and ripening the cervix
It is the nurse's first meeting with a pregnant client. What is the first point that the nurse needs to ascertain as part of the admission assessment to check whether the client needs to be admitted? a. Whether the client is in true or false labor b. Whether the client is pregnant for the first time c. Whether the client is addicted to drugs d. Whether the client has a history of drug allergy
a. Whether the client is in true or false labor
A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her infant should be vaccinated with an initial HBV vaccine dose at which of the following? a. Within 12 hours of birth b. Within 36 hours of birth c. Within 24 hours of birth d. Within 48 hours of birth
a. Within 12 hours of birth
A woman with diabetes is in labor. The nurse monitors her blood glucose level closely with the goal to maintaining her glucose level at which of the following to reduce the likelihood of neonatal hypoglycemia? a. Below 115 mg/dL b. Below 110 mg/dL c. Below 120 mg/dL d. Below 105 mg/dL
b. Below 110 mg/dL
When assessing the effectiveness of the obstetrical regional analgesia received by a client, you recognize it is successful by the complete loss of pain sensation at which level of the spinal cord? a. Below T7 level b. Below T8 level c .Below T5 level d. Below T6 level
b. Below T8 level
A nurse is caring for a client who has had an intrauterine fetal death with prolonged retention of the fetus. Which of the following signs and symptoms should the nurse watch for in a client to assess for an increased risk of disseminated intravascular coagulation? (Select all that apply) a. Hypertension b. Bleeding gums c. Tachycardia d. Acute renal failure e. Lochia less than usual
b. Bleeding gums c. Tachycardia d. Acute renal failure
A fetus is in the LST position. The nurse interprets this as indicating which of the following as the presenting part? a. Chin b. Buttocks c. Fetal head d. Shoulder
b. Buttocks
A woman received meperidine during labor to help with pain control. Which of the following would the nurse need to monitor the newborn for after delivery? a. Increased agitation b. Decreased alertness c. Low Apgars d. Increased crying
b. Decreased alertness
When explaining to a pregnant woman about HIV infection and transmission, which of the following would the nurse include? a. It primarily occurs when there is a large viral load in the blood b. HIV is most commonly transmitted via sexual contact c. It affects the majority of infants of mothers with HIV infections d. Nurses are most frequently affected due to needlesticks
b. HIV is most commonly transmitted via sexual contact
In preparing for a class in teaching women and their partners, which of the following would be the most important to emphasize as helping to prevent postpartum complications? a. Adequate follow-up with their health care provider b. Handwashing c. Limiting contact with outsiders for the first week d. Ensure proper hydration
b. Handwashing
A nurse is caring for a pregnant client. The initial interview reveals that the client is accustomed to drinking coffee at regular intervals. What possible effect of maternal coffee consumption during pregnancy should the nurse make the client aware of? a. Increased risk of heart disease b. Increased risk of anemia c. Increased risk of rickets d. Increased risk of scurvy
b. Increased risk of anemia
A nurse is teaching a couple about patterned breathing during their childbirth education. Which of the following techniques should the nurse suggest for slow-paced breathing? a. Inhale and exhale through the mouth at a rate of 4 breaths every 5 seconds b. Inhale slowly through nose and exhale through pursed lips c. Punctuated breathing by a forceful exhalation through pursed lips every few breaths d. Hold breath for 5 seconds after every 3 breaths
b. Inhale slowly through nose and exhale through pursed lips
A woman in labor who is receiving an opioid for pain relief is to receive promethazine. The nurse determines that this drug is effective when the woman demonstrates which of the following? a. Increased feelings of control b. Less anxiety c. Decreased sedation d. Increased cervical dilation
b. Less anxiety
A postpartum client who has discharged home returns to the primary health care facility within 2 weeks with complaints of fever and pain in the breast. The client is diagnosed with mastitis. What education should the nurse give to the client for managing and preventing mastitis? a. Discontinue breastfeeding to allow time for healing b. Perform hand-washing before and after breastfeeding c. Avoid hot or cold compresses on the breast d. Discourage manual compression of breast for expressing milk
b. Perform hand-washing before and after breastfeeding
A nurse is caring for a pregnant client. The nurse learns from the report that the client is diabetic. Which of the following should the nurse identify as the effect of insulin resistance in the client? a. Hypertension b. Postprandial hyperglycemia c. Hypercholesterolemia d. Myocardial infarction
b. Postprandial hyperglycemia
As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is: a. Discomfort level is greater with false labor b. Progressive cervical changes occur in true labor c. There is a feeling of nausea with false labor d. There is more fetal movement in true labor
b. Progressive cervical changes occur in true labor
A client administered combined spinal-epidural analgesia is showing signs of hypotension and associated FHR changes. What interventions should the nurse perform to manage the changes? a. Assist client to a supine position b. Provide supplemental oxygen c. Discontinue IV fluid d. Turn client on her left side
b. Provide supplemental oxygen
A couple has just experienced intrauterine fetal demise. Which action by the nurse would be least effective in assisting them? a. Give the parents a lock of the infant's hair. b. Refrain from discussing the situation with the couple. c. Allow the couple to spend as much time as they want with their stillborn infant. d. Assist the family in making arrangements for their stillborn infant.
b. Refrain from discussing the situation with the couple.
What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? a. Stressing the avoidance of dairy products b. Stressing the positive benefits of a healthy lifestyle c. Stressing the increased use of Vitamin D supplements d. Stressing regular walks and exercise
b. Stressing the positive benefits of a healthy lifestyle
Quickly determining the cause of postpartum hemorrhaging enables effective treatment. A nurse using the 5T's tool will recognize which of the following as being a potential cause of postpartum hemorrhage? (Select all that apply.) a. Time b. Tissue c. Thrombin d. Tone e. Technique of delivery
b. Tissue c. Thrombin d. Tone
During the fourth stage of labor, the nurse assess the woman at frequent intervals after giving childbirth. What assessment data would cause the nurse the most concern? a. Moderate amount of dark red lochia drainage on peripad b. Uterine fundus palpated to the right of the umbilicus c. An oral temperature reading of 100.6 F d. Perineal area bruised and edematous beneath her ice pack
b. Uterine fundus palpated to the right of the umbilicus
A nurse is caring for a client administered general anesthesia for an emergency cesarean birth. What complications associated with general anesthesia should the nurse monitor for? a. Pruritis b. Uterine relaxation c. Inadequate or failed block d. Maternal hypotension
b. Uterine relaxation
Which of the following would the nurse expect to include in the plan of care for a woman with mastitis who is receiving antibiotic therapy? a. Stop breastfeeding and apply lanolin b. Administer analgesics and bind both breasts c. Apply warm or cold compresses and administer analgesics d. Remove the nursing bra and expose the breast to fresh air
c. Apply warm or cold compresses and administer analgesics
A postpartum mother appears very pale and states she is bleeding heavily. The nurse should first: a. Call the client's health care provider immediately b. Immediately set up an intravenous infusion of magnesium sulfate c. Assess the fundus and ask her about her voiding status d. Reassure the mother that this is a normal finding after childbirth
c. Assess the fundus and ask her about her voiding status
A nurse is caring for a postpartum client. What instruction should the nurse provide to the client as precautionary measures to prevent thromboembolic complications? a. Avoiding performing any deep-breathing exercises b. Try to relax with pillows under knees c. Avoid sitting in one position for long periods of time d. Refrain from elevating legs above heart level
c. Avoid sitting in one position for long periods of time
A nurse is caring for a postpartum client who has a history of thrombosis during pregnancy and is at high risk of developing a pulmonary embolism. For which sign or symptom should the nurse monitor the client to prevent the occurrence of pulmonary embolism? a. Sudden change in mental status b. Difficulty in breathing c. Calf swelling d. Sudden chest pain
c. Calf swelling
Women who drink alcohol during pregnancy: a. Often produce more alcohol dehydrogenase b. Usually become intoxicated faster than before c. Can give birth to an infant with fetal alcohol spectrum disorder d. Gain fewer pounder throughout the gestation
c. Can give birth to an infant with fetal alcohol spectrum disorder
When explaining to a class why labor begins, the nurse will include the fact that there are several theories that have been proposed to explain why labor begins, although none have been proven scientifically. Which of the following is one of those theories? a. Number of oxytocin receptors decrease. b. The level of estrogen decreases. c. Change in estrogen-to-progesterone ratio d. Prostaglandins decrease, leading to myometrium contractions.
c. Change in estrogen-to-progesterone ratio
While preparing a young couple for the upcoming birth of their child, the mother expresses concern for needing pain medications and the effects on the fetus. You explain that with your experience and recent research, which of the following helps contribute to the decreased 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 d. A quick epidural can replace the need for pain medication.
c. Continuous support through the labor process
A postpartum client had a difficult labor. Which assessment finding will alert the nurse that the client is most likely hemorrhaging? a. Decreased heart rate b. Increased urinary output c. Decreased blood pressure d. Increased body temperature
c. Decreased blood pressure
A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as: a. Acupressure b. Patterned breathing c. Effleurage d. Therapeutic touch
c. Effleurage
A client who was in active labor and whose cervix had dilated to 4 cm experiences a weakening in the intensity and frequency of her contractions and exhibits no further progress in labor. The nurse interprets this as a sign of: a. Hypertonic labor b. Precipitate labor c. Hypotonic labor d. Dysfunctional labor
c. Hypotonic labor
As the client gets closer to her due date, it is important to stress that the woman seek assessment after spontaneous rupture of the membranes due to: a. Potential rapid delivery of fetus b. Potential placenta previa c. Increased risk of infection d. Increased risk of breech presentation
c. Increased risk of infection
The nurse is teaching a group of students about factors that place a pregnant woman at risk for infection in the postpartum period. Which of the following would the nurse be least likely to include? a. Prolonged labor with multiple vaginal examinations to evaluate progress b. Retained placental fragments c. Increased vaginal acidity leading to growth of bacteria d. Loss of protection with premature rupture of membranes
c. Increased vaginal acidity leading to growth of bacteria
A nurse is caring for a client who has been diagnosed with precipitous labor. For which of the following potential fetal complications should the nurse monitor as a result of precipitous labor? a. Facial nerve injury b. Cephalhematoma c. Intracranial hemorrhage d. Facial lacerations
c. Intracranial hemorrhage
While assessing a postpartum woman, the nurse palpates a contracted uterus. Perineal inspection reveals a steady stream of bright-red blood trickling out of the vagina. The woman reports mild perineal pain. She just voided 200 mL of clear yellow urine. Which of the following would the nurse suspect? a. Uterine inversion b. Uterine atony c. Laceration d. Hematoma
c. Laceration
The health care provider is recommending induction of labor for a 42-week nulliparous client. All except which of the following will be important to assess before induction? a. Fetal dating b. Amniotic fluid studies c. Leopold position d. Bishop scoring
c. Leopold position
A pregnant client is admitted to a maternity clinic for childbirth. Which assessment finding indicates that the client's fetus is in the transverse lie position? a. Long axis of fetus is at 60 degrees to that of client b. Long axis of fetus is parallel to that of the client c. Long axis of fetus is perpendicular to that of client d. Long axis of fetus is at 45 degrees to that of client
c. Long axis of fetus is perpendicular to that of client
While assessing a postpartum multiparous woman, the nurse detects a boggy uterus midline 2 cm above the umbilicus. Which intervention would be priority? a. Assessing vital signs immediately b. Measuring her next urinary output c. Massaging her fundus d. Notifying the woman's obstetrician
c. Massaging her fundus
A pregnant client is admitted with vaginal bleeding. The nurse performs a nitrazine test to confirm that the membranes have ruptured. The nitrazine tape remains yellow to olive green, with pH between 5 and 6. What does this indicate? a. Membranes have ruptured b. Presence of amniotic fluid c. Presence of vaginal fluid d. Presence of excess blood
c. Presence of vaginal fluid
Which of the following should the nurse identify as a risk associated with anemia during pregnancy? a. Newborn with heart problems b. Fetal asphyxia c. Preterm birth d. Newborn with enlarged liver
c. Preterm birth
A nurse is newly posted to the obstetric unit of the health care facility. Which of the following are the causes of intrauterine fetal demise in late pregnancy that the nurse should be aware of? (Select all that apply) a. Hydramnios b. Multifetal gestation c. Prolonged pregnancy d. Malpresentation e. Hypertension
c. Prolonged pregnancy e. Hypertension
You have been asked to present information to a group of civic leaders concerning women's health issues. In preparing your information, you include what goals from Healthy People 2020? a. Ensure all couples receive preconceptional counseling b. Ensure prenatal care includes immunizations c. Reduce the rate of cesarean births among low-risk births d. Encourage women with previous cesareans to always have a cesarean
c. Reduce the rate of cesarean births among low-risk births
A young couple are anxious for the birth of their child. When discussing the options, you explain that elective induction of labor in nulliparous is associated with all of the following except: a. Neonatal resuscitation b. Postpartum hemorrhage c. Shorter hospitalizations d. Increased rates of cesarean sections
c. Shorter hospitalizations
A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already delivered once and is pregnant a second time. What explanation should the nurse offer the client? a. Braxton Hicks contractions are not strong enough during first pregnancy b. Contractions are stronger during the first pregnancy than the second c. The cervix takes around 12 to 16 hours to dilate during first pregnancy d. Spontaneous rupture of membranes occurs during first pregnancy
c. The cervix takes around 12 to 16 hours to dilate during first pregnancy
The nurse recognizes that any client may develop postpartum hemorrhage and frequent assessments are conducted to ensure this is not happening. Which of the following is the most common cause of postpartum hemorrhage? a. Distended bladder b. Placenta previa c. Uterine atony d. Uterine lacerations
c. Uterine atony
Which of the following would the nurse use to monitor the effectiveness of intravenous anticoagulant therapy for a postpartum woman with deep vein thrombosis? a. PT b. Fibrinogen level c. aPTT d. INR
c. aPTT
On examination, the nurse determines the fetus is at -1 station. He explains this means the fetus is: a. 1 cm above the pubic bone b. 1 cm below the pubic bone c. 1 cm below the ischial spines d. 1 cm above the ischial spines
d. 1 cm above the ischial spines
The nurse plays a major role in assessing the progress of labor. Which of the following is a simple rule that the nurse will use to monitor the progress? a. 1 cm per hour for fetal descent b. 2 cm per hour for fetal descent c. 2 cm per hour for cervical dilation d. 1 cm per hour for cervical dilation
d. 1 cm per hour for cervical dilation
A G3,P2 woman arrives at the birthing center stating that she has been in labor for the past 18 hours. To rule out a potential protracted disorder the nurse is aware that which of the following criteria for cervical dilation is used? a. 1.75 cm per hour b. 1.25 cm per hour c. 1.0 cm per hour d. 1.5 cm per hour
d. 1.5 cm per hour
When teaching a group of students about the structures of the fetal skull, the nurse describes the anterior fontanelle. Which of the following would the nurse include? a. Closes 8 to 12 weeks after birth b. Located at the back of the fetal head c. Triangular shape d. Approximately 2 to 3 cm in size
d. Approximately 2 to 3 cm in size
A nurse is caring for a pregnant client with heart disease in a labor unit. Which of the following is the most important intervention for this client in the first 48 hours postpartum? a. Limiting sodium intake b. Inspecting the extremities for edema c. Ensuring that the client consumes a high-fiber diet d. Assessing for cardiac decompensation
d. Assessing for cardiac decompensation
A nurse is caring for a client who has been treated for a deep vein thrombosis. Which teaching point should the nurse stress when discharging the client? a. Avoid using compression stockings b. Plan long rest periods throughout the day c. Avoid using products containing aspirin d. Avoid use of oral contraceptives
d. Avoid use of oral contraceptives
The nurse is explaining to a client that there are several laboratory and diagnostic tests that can be conducted to evaluate her preterm labor risk. The nurse will mention all except which of the following as a potential test the physician may use? a. Fetal fibronectin testing b. Salivary estriol levels c. Transvaginal ultrasound d. Blood chemistry levels
d. Blood chemistry levels
Methergine has been ordered for a postpartum woman because of excessive bleeding. The nurse should question this order if which of the following is present? a. Mild abdominal cramping b. Tender inflamed breasts c. Pulse rate of 68 beats per minute d. Blood pressure of 158/69 mm Hg
d. Blood pressure of 158/69 mm Hg
A nurse is assigned to care for a 38-year-old overweight client scheduled to undergo a cesarean section. The client is at an increased risk of thromboembolic complications. During assessment, what factor will help the nurse in the diagnosis of deep vein thrombosis of the leg? a. Sudden chest pain b. Dyspnea c. Tachypnea d. Calf tenderness
d. Calf tenderness
When monitoring a woman in labor, which of the following is not expected to occur? a. Respiratory rate to increase b. Heart rate increase by 10 to 20 beats per minute c. Blood pressure to increase up to 35 mmHg d. Cardiac output increase by 50% during the first stage
d. Cardiac output increase by 50% during the first stage
A client is admitted to the health care facility with a gestational age of 42 weeks. The client is to undergo a cesarean section. Which of the following would be the fetal risk associated with postterm pregnancy? a. Underdeveloped suck reflex b. Congenital heart defects c. Intraventricular hemorrhage d. Cephalopelvic disproportion
d. Cephalopelvic disproportion
After assessing the processing labor of a client, the nurse suspects the fetus is in a persistent occiput posterior position. Which of the following findings would lead the nurse to suspect that? a. Contractions most forceful in the middle of uterus rather than the fundus b. Lack of cervical dilation past 2 cm c. Fetal buttocks as the presenting part d. Complaints of severe back pain
d. Complaints of severe back pain
When providing nutritional counseling to a pregnant woman with diabetes, the nurse would urge the client to obtain most of her calories from which of the following? a. Saturated fats b. Unsaturated fats c. Protein sources d. Complex carbohydrates
d. Complex carbohydrates
A pregnant woman comes to the emergency department because she thinks she is in labor. The nurse determines that the client is in true labor when assessment of contractions reveals which of the following? a. Contractions occur in an irregular pattern. b. Contractions last about 20 to 30 seconds. c. Contractions slow when the woman changes position. d. Contractions radiate to the front of the abdomen from the back.
d. Contractions radiate to the front of the abdomen from the back.
A client has been admitted to the unit for tocolytic therapy. The nurse recognizes all except which of the following tocolytics may be used in this woman's care plan? a. Magnesium sulfate b. Terbutaline c. Indomethacin d. Corticosteroids
d. Corticosteroids
In reviewing the postpartum G3, P3 woman's history the nurse notes it is positive for obesity and smoking. The nurse recognizes this client is at risk for which of the following complications? a. Postpartum hemorrhage b. Uterine atony c. Metritis d. Deep Vein Thrombosis
d. Deep Vein Thrombosis
A nurse is caring for a pregnant client in labor in a health care facility. The nurse knows that which of the following marks the termination of the first stage of labor in the client? a. Diffuse abdominal cramping b. Rupturing of fetal membranes c. Start of regular contractions d. Dilation of cervix diameter to 10 cm
d. Dilation of cervix diameter to 10 cm
The nurse recognizes that the postpartum period is a time of rapid changes for each client. Which of the following is believed to be the cause of postpartum affective disorders? a. Preexisting conditions in the client b. Medications used during labor and delivery c. Lack of social support from family or friends d. Drop in estrogen and progesterone levels after birth
d. Drop in estrogen and progesterone levels after birth
When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do? a. Explain that she should avoid steroid during her pregnancy b. Demonstrate how to assess her blood glucose levels c. Teach correct administration of subcutaneous bronchodilators d. Ensure she seeks treatment for any acute exacerbation
d. Ensure she seeks treatment for any acute exacerbation
The nurse is assisting a client in completing the Postpartum Depression Screening Scale tool to assess for postpartum depression. Which of the following is least likely to be screened with this tool? a. Guilt b. Emotional liability c. Cognitive impairment d. Family and social support system
d. Family and social support system
A pregnant client with a history of spinal injury is being prepared for a cesarean birth. Which of the following methods of anesthesia is to be administered to the client? a. Local infiltration b. Epidural block c. Regional anesthesia d. General anesthesia
d. General anesthesia
A nurse is assigned to care for a client who has been diagnosed with placental abruption. The nurse knows that which of the following could have led to placental abruption in the client? a. Obesity or excess weight gain b. CVD c. Gestational diabetes d. Gestational hypertension
d. Gestational hypertension
A pregnant client is admitted to a maternity clinic for childbirth. The client wishes to adopt the kneeling position during labor. The nurse knows that which of the following is the advantage of adopting a kneeling position during labor? a. It helps the woman in labor to save energy b. It facilitates vaginal examinations c. It facilitates external belt adjustment d. It helps to rotate fetus in a posterior position
d. It helps to rotate fetus in a posterior position
A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which of the following is an important area that the nurse should address during assessment of the client? a. Sexual development of the client b. Whether sex was consensual c. Options for birth control in the future d. Knowledge of child development
d. Knowledge of child development
A nurse finds that a client is bleeding excessively after a vaginal delivery. Which assessment findings would indicate retained placental fragments as a cause of bleeding? a. Soft and boggy uterus that deviates from the midline b. Firm uterus with trickle of bright-red blood in perineum c. Firm uterus with a steady stream of bright-red blood d. Large uterus with painless dark-red blood mixed with clots
d. Large uterus with painless dark-red blood mixed with clots
A pregnant woman with chronic hypertension presents challenges in controlling the hypertension and preventing additional complications. Which hypertensive medication is prescribed due to its safety record during pregnancy? a. Labetalol b. Atenolol c. Nifedipine d. Methyldopa
d. Methyldopa
A client is experiencing shoulder dystocia during delivery. Which of the following should the nurse identify as risks to the fetus in such a condition? a. Extensive lacerations b. Bladder injury c. Infection d. Nerve damage
d. Nerve damage
A client with full-term pregnancy who is not in active labor has been ordered oxytocin intravenously. Which of the following is a contraindication for oxytocin administration a. Dysfunctional labor pattern b. Postterm status c. Prolonged ruptured membranes d. Overdistended uterus
d. Overdistended uterus
When implementing the plan of care for a postpartum woman who gave birth just a few hours ago, the nurse vigilantly monitors the client for which complication? a. Deep vein thrombosis b. Postpartum psychosis c. Uterine infection d. Postpartum hemorrhage
d. Postpartum hemorrhage
Which of the following hormones would the nurse expect to cause the pelvic connective tissue to become more relaxed and elastic in preparation for labor? a. Oxytocin b. Prolactin c. Progesterone d. Relaxin
d. Relaxin
When dealing with a pregnant adolescent, the nurse assists the client to integrate the tasks of pregnancy while at the same time fostering development of which of the following? a. Dependence b. Trust c. Autonomy d. Self-identity
d. Self-identity
A young mother is suspected of abusing heroin. Which of the following would the nurse expect to find in her newborn? a. Hypotonicity b. Easy consolability c. Vigorous sucking d. Sneezing
d. Sneezing
The rationale for using a prostaglandin gel for a client prior to the induction of labor is to: a. Stimulate uterine contractions b. Numb cervical pain receptors c. Prevent cervical lacerations d. Soften and efface the cervix
d. Soften and efface the cervix
