OB EXAM 2

When caring for a pregnant woman with sickle cell anemia, the nurse is aware that signs and symptoms of sickle cell crisis include: Endometritis. Anemia. Urinary tract infection. Fever and pain.

Fever and pain. Sx include: severe abdominal pain, muscle spasms, leg pains, joint pain, fever, stiff neck, N/V, and seizure

A woman at 15 weeks' gestation asks the nurse what the fetus looks like. Which response by the nurse would be most accurate? Fetus is 15 inches long Vernix caseosa, Fingernails and toenails are present. Rhythmic breathing

Fingernails and toenails are present.

client is in her second trimester, and the health care provider has recommended she undergo an amniocentesis. The nurse explains that the procedure is used to diagnose which conditions? Select all that apply inborn errors of metabolism HIV neural tube defects Rh incompatibility chromosomal abnormalities

ANSWER: inborn errors of metabolism neural tube defects chromosomal abnormalities

A nurse working in the newborn nursery hears an innocent murmur on auscultation of a 24- hour-old infant's chest. The nurse recognizes this as most likely the result of which condition? delayed fetal shunt closure dysfunctional foramen ovale attached umbilical cord stump congenital defect

delayed fetal shunt closure

A pregnant woman at 25 weeks' gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? "The fetus is demonstrating the aural reflex." "Babies respond to sound starting at about 24 weeks of gestation." "That must have been a coincidence; babies can't respond like that." "Let me know if it happens again; we need to report that to your midwife."

"Babies respond to sound starting at about 24 weeks of gestation."

in vitro fertilization-embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. The husband asks the nurse to explain what the procedure entails. The nurse's most appropriate response is: Group of answer choices "IVF-ET is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in the laboratory with your sperm, and transferring the embryo to her uterus." "A donor embryo will be transferred into your wife's uterus." "Don't worry about the technical stuff; that's what we are here for." "Donor sperm will be used to inseminate your wife."

"IVF-ET is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in the laboratory with your sperm, and transferring the embryo to her uterus."

A woman who is 16 weeks pregnant asks the nurse, "Is it possible to tell by ultrasound if the baby is a boy or girl yet?" The best answer is: "The baby has developed enough that we can determine the sex by examining the genitals through ultrasound." "It might be possible to determine your baby's sex, but the external organs look very similar right now." "Boys and girls look alike until about 20 weeks after conception, and then they begin to look different "A baby's sex is determined as soon as conception occurs."

"The baby has developed enough that we can determine the sex by examining the genitals through ultrasound."

A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has PKU. The couple tells the nurse that they are planning to have a second baby. Because their daughter has PKU, they are sure that their next baby won't be affected. What response by the nurse is most accurate? "The ultrasound indicates a boy, and boys are not affected by PKU." "You are both carriers, so each baby has a 25% chance of being affected." "Good planning; you need to take advantage of the odds in your favor." "I think you'd better check with your doctor first."

"You are both carriers, so each baby has a 25% chance of being affected."

A woman asks the nurse, "What protects my baby's umbilical cord from being squashed while the baby's inside of me?" The nurse's best response is: "The umbilical cord is a group of blood vessels that are very well protected by the placenta." "You don't need to worry about things like that." "Your baby's umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby." "Your baby's umbilical floats around in blood anyway

"Your baby's umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby."

A man smokes two packs of cigarettes a day. He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant. The nurse's most appropriate response is: "Smoking can give you lung cancer, even though it has no effect on sperm." "Smoking can reduce the quality of your sperm." "Only marijuana cigarettes affect sperm count." "Your sperm count seems to be okay in the first semen analysis."

ANSWER: "Smoking can reduce the quality of your sperm."

it is important that nurses include a discussion about teratogens in their prenatal discussions to help prevent deformities or abnormalities. Which substances would the nurse include as teratogens? Select all that apply. Alcohol infections certain medications, caustic chemicals

Alcohol certain medications, caustic chemicals

The fetus starts making its own insulin around the _ wk

10 weeks gestation (per powerpoint)

At approximately _____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110 g. 30 weeks 28 weeks 24 weeks 20 weeks

28 weeks

At the first prenatal visit of clients with Diabetes, appropriate blood screenings are obtained. The nurse realizes that a hemoglobin A1c above which level is concerning for diabetes and warrants further testing? ______________________ 5.5% 5.0% 6.0% 6.5%

6.5%

What symptom described by a woman is characteristic of premenstrual syndrome (PMS)? A) "I feel irritable and moody a week before my period is supposed to start."B) "I have lower abdominal pain beginning the third day of my menstrual period."C) "I have nausea and headaches after my period starts, and they last 2 to 3 days."D) "I have abdominal bloating and breast pain after a couple days of my period."

A) "I feel irritable and moody a week before my period is supposed to start." PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses. PMS begins in the luteal phase and resolves as menses occurs. It does not start after menses has begun. This complaint is associated with PMS. However, the timing reflected in this statement is inaccurate. PMS begins in the luteal phase and resolves as menses occurs. It does not start after menses has begun. Abdominal bloating and breast pain are likely to occur a few days prior to menses, not after it has begun.

The nurse should teach a pregnant woman that which substances are teratogens? (Select all that apply) A. Cigarette smoke Correct B. Isotretinoin (Retin A) Correct C. Vitamin C D. Salicylic acid E. Rubella

A. Cigarette smoke B. Isotretinoin (Retin A) (Chemical) E. Rubella Vitamin C and salicylic acid are not known teratogens. ionizing radiation Organic mercury Lead exposure Toxoplasma Syphilis bacteria Rubella virus Cytomegalovirus Varicella zoster Herpes virus Maternal conditions—obesity, diabetes, hypothyroidism, hyperthyroidism, and phenylketonuria (PKU). Drugs—include thalidomide (limb malformations); alcohol (fetal alcohol spectrum disorder); angiotensin-converting enzyme (ACE) inhibitors (antihypertensive agents) (prematurity, intrauterine growth restriction [IUGR]); cocaine (placental abruption, prematurity, microcephaly); and tetracycline (yellow-brown teeth discoloration) (Norwitz et al., 2019).

As relates to dysfunctional uterine bleeding (DUB), the nurse should be aware that: a. It is most commonly caused by anovulation. b. It most often occurs in middle age. c. The diagnosis of DUB should be the first considered for abnormal menstrual bleeding. d. The most effective medical treatment is steroids

ANS: A Anovulation may occur because of hypothalamic dysfunction or polycystic ovary syndrome. DUB most often occurs when the menstrual cycle is being established or when it draws to a close at menopause. A diagnosis of DUB is made only after all other causes of abnormal menstrual bleeding have been ruled out. The most effective medical treatment is oral or intravenous estrogen

A woman has a thick, white, lumpy, cottage cheeselike discharge, with patches on her labia and in her vagina. She complains of intense pruritus. The nurse practitioner would order which preparation for treatment? a. Fluconazole c. Clindamycin b. Tetracycline d. Acyclovir

ANS: A Fluconazole, metronidazole, and clotrimazole are the drugs of choice to treat candidiasis. Tetracycline is used to treat syphilis. Clindamycin is used to treat bacterial vaginosis. Acyclovir is used to treat genital herpes

On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish white vaginal discharge with a fishy odor; complaint of pruritus. On the basis of these findings, the nurse suspects that this woman has: a. Bacterial vaginosis (BV). c. Trichomoniasis. b. Candidiasis. d. Gonorrhea

ANS: A Most women with BV complain of a characteristic fishy odor. The discharge usually is profuse; thin; and white, gray, or milky in color. Some women also may have mild irritation or pruritus. The discharge associated with candidiasis is thick, white, and lumpy and resembles cottage cheese. Trichomoniasis may be asymptomatic, but women commonly have a characteristic yellowish-to-greenish, frothy, mucopurulent, copious, and malodorous discharge. Women with gonorrhea are often asymptomatic. They may have a purulent endocervical discharge, but discharge usually is minimal or absent.

Which symptom described by a patient is characteristic of premenstrual syndrome (PMS)? a. I feel irritable and moody a week before my period is supposed to start. b. I have lower abdominal pain beginning the third day of my menstrual period. c. I have nausea and headaches after my period starts, and they last 2 to 3 days. d. I have abdominal bloating and breast pain after a couple days of my period.

ANS: A PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses. Complaints of lower abdominal pain, nausea and headaches, and abdominal bloating all are associated with PMS. However, the timing reflected is inaccurate.

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to: a. Endometriosis. c. Primary dysmenorrhea. b. PMS. d. Secondary dysmenorrhea

ANS: A Symptoms of endometriosis can change over time and may not reflect the extent of the disease. Major symptoms include dysmenorrhea and deep pelvic dyspareunia (painful intercourse). Impaired fertility may result from adhesions caused by endometriosis. Although endometriosis may be associated with secondary dysmenorrhea, it is not a cause of primary dysmenorrhea or PMS. In addition, this woman is complaining of dyspareunia and infertility, which are associated with endometriosis, not with PMS or primary or secondary dysmenorrhea.

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? a. Herpes simplex virus (HSV)-2 b. Human papillomavirus (HPV) c. Human immunodeficiency virus (HIV) d. Cytomegalovirus (CMV)

ANS: A The initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of HSV infection commonly have only local symptoms that usually are less severe than the symptoms of the initial infection. With HPV infection, lesions are a chronic problem. HIV is a retrovirus. Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered the body. Severe depression of the cellular immune system associated with HIV infection characterizes acquired immunodeficiency syndrome (AIDS). AIDS has no cure. In most adults, the onset of CMV infection is uncertain and asymptomatic. However, the disease may become a chronic, persistent infection.

An essential component of counseling women regarding safe sex practices includes discussion regarding avoiding the exchange of body fluids. The physical barrier promoted for the prevention of sexually transmitted infections and human immunodeficiency virus is the condom. Nurses can help motivate clients to use condoms by initiating a discussion related to a number of aspects of condom use. The most important of these is: a. Strategies to enhance condom use. b. Choice of colors and special features. c. Leaving the decision up to the male partner. d. Places to carry condoms safely

ANS: A When the nurse opens discussion on safe sex practices, it gives the woman permission to clear up any concerns or misapprehensions that she may have regarding condom use. The nurse can also suggest ways that the woman can enhance her condom negotiation and communications skills. These include role-playing, rehearsal, cultural barriers, and situations that put the client at risk. Although women can be taught the differences among condoms, such as size ranges, where to purchase, and price, this is not as important as negotiating the use of safe sex practices. Women must address the issue of condom use with every sexual contact. Some men need time to think about this. If they appear reluctant, the woman may want to reconsider the relationship. Although not ideal, women may safely choose to carry condoms in shoes, wallets, or inside their bra. They should be taught to keep the condom away from heat. This information is important; however, it is not germane if the woman cannot even discuss strategies on how to enhance condom use

Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include (Select all that apply): a. Fellatio. b. Unprotected anal intercourse. c. Multiple sex partners. d. Dry kissing. e. Abstinence.

ANS: A, B, C Engaging in these sexual activities increases the exposure risk and the possibility of acquiring an STI. Dry kissing and abstinence are considered safe sexual practices

There is little consensus on the management of premenstrual dysphoric disorder (PMDD). However, nurses can advise women on several self-help modalities that often improve symptoms. The nurse knows that health teaching has been effective when the client reports that she has adopted a number of lifestyle changes, including (Select all that apply): a. Regular exercise. b. Improved nutrition. c. A daily glass of wine. d. Smoking cessation. e. Oil of evening primrose

ANS: A, B, D, E These modalities may provide significant symptom relief in 1 to 2 months. If there is no improvement after these changes have been made, the patient may need to begin pharmacologic therapy. Women should decrease both their alcohol and caffeinated beverage consumption if they have PMDD.

Care management of a woman diagnosed with acute pelvic inflammatory disease (PID) most likely would include: a. Oral antiviral therapy. b. Bed rest in a semi-Fowler position. c. Antibiotic regimen continued until symptoms subside. d. Frequent pelvic examination to monitor the progress of healing

ANS: B A woman with acute PID should be on bed rest in a semi-Fowler position. Broad-spectrum antibiotics are used. Antibiotics must be taken as prescribed, even if symptoms subside. Few pelvic examinations should be conducted during the acute phase of the disease.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that HPV be treated with clientapplied: a. Miconazole ointment. b. Topical podofilox 0.5% solution or gel. c. Penicillin given intramuscularly for two doses. d. Metronidazole by mouth

ANS: B Available treatments are imiquimod, podophyllin, and podofilox. Miconazole ointment is used to treat athletes foot. Intramuscular penicillin is used to treat syphilis. Metronidazole is used to treat bacterial vaginosis.

Which of the following statements about the various forms of hepatitis is accurate? a. A vaccine exists for hepatitis C but not for hepatitis B. b. Hepatitis A is acquired by eating contaminated food or drinking polluted water. c. Hepatitis B is less contagious than human immunodeficiency virus (HIV). d. The incidence of hepatitis C is decreasing.

ANS: B Contaminated milk and shellfish are common sources of infection with hepatitis A. A vaccine exists for hepatitis B but not for hepatitis C. Hepatitis B is more contagious than HIV. The incidence of hepatitis C is increasing.

During her gynecologic checkup, a 17-year-old girl states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse would document this complaint as: a. Amenorrhea. c. Dyspareunia. b. Dysmenorrhea. d. Premenstrual syndrome (PMS).

ANS: B Dysmenorrhea is pain during or shortly before menstruation. Amenorrhea is the absence of menstrual flow. Dyspareunia is pain during intercourse. PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses

The viral sexually transmitted infection (STI) that affects most people in the United States today is: a. Herpes simplex virus type 2 (HSV-2). b. Human papillomavirus (HPV). Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 50 c. Human immunodeficiency virus (HIV). d. Cytomegalovirus (CMV).

ANS: B HPV infection is the most prevalent viral STI seen in ambulatory health care settings. HSV-2, HIV, and CMV all are viral STIs but are not the most prevalent viral STIs.

A 25-year-old single woman comes to the gynecologists office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the patient has human papillomavirus (HPV). The client asks, What is that? Can you get rid of it? Your best response is: a. Its just a little lump on your cervix. We can freeze it off. b. HPV stands for human papillomavirus. It is a sexually transmitted infection (STI) that may lead to cervical cancer. c. HPV is a type of early human immunodeficiency virus (HIV). You will die from this. d. You probably caught this from your current boyfriend. He should get tested for this.

ANS: B It is important to inform the patient about STIs and the risks involved with HPV. The health care team has a duty to provide proper information to the patient, including information related to STIs. HPV and HIV are both viruses that can be transmitted sexually, but they are not the same virus. The onset of HPV can be insidious. Often STIs go unnoticed. Abnormal bleeding frequently is the initial symptom. The client may have had HPV before her current boyfriend. You cannot make any deductions from this limited information

While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the clients recent menstrual cycles. The nurse should collect additional information with which statement? a. The woman says her menstrual flow lasts 5 to 6 days. b. She describes her flow as very heavy. c. She reports that she has had a small amount of spotting midway between her periods for the past 2 months. d. She says the length of her menstrual cycle varies from 26 to 29 days

ANS: B Menorrhagia is defined as excessive menstrual bleeding, in either duration or amount. Heavy bleeding can have many causes. The amount of bleeding and its effect on daily activities should be evaluated. A menstrual flow lasting 5 to 6 days is a normal finding. Mittlestaining, a small amount of bleeding or spotting that occurs at the time of ovulation (14 days before onset of the next menses), is considered normal. During her reproductive years, a woman may have physiologic variations in her menstrual cycle. Variations in the length of a menstrual cycle are considered normal

To detect human immunodeficiency virus (HIV), most laboratory tests focus on the: a. virus. c. CD4 counts. b. HIV antibodies. d. CD8 counts.

ANS: B The screening tool used to detect HIV is the enzyme immunoassay, which tests for the presence of antibodies to the virus. CD4 counts are associated with the incidence of acquired immunodeficiency syndrome (AIDS) in HIV-infected individuals.

Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be aware that the optimal pharmacologic therapy for pain relief is: a. Acetaminophen. b. Oral contraceptives (OCPs). c. Nonsteroidal antiinflammatory drugs (NSAIDs). d. Aspirin

ANS: C NSAIDs are prostaglandin inhibitors and show the strongest research results for pain relief. Often if one NSAID is not effective, another one can provide relief. Approximately 80% of women find relief from NSAIDs. Preparations containing acetaminophen are less effective for dysmenorrhea because they lack the antiprostaglandin properties of NSAIDs. OCPs are a reasonable choice for women who also want birth control. The benefit of OCPs is the reduction of menstrual flow and irregularities. OCPs may be contraindicated for some women and have numerous potential side effects. NSAIDs are the drug of choice. If a woman is taking a NSAID, she should avoid taking aspirin

When evaluating a patient whose primary complaint is amenorrhea, the nurse must be aware that lack of menstruation is most often the result of: a. Stress. c. Pregnancy. b. Excessive exercise. d. Eating disorders

ANS: C Amenorrhea, or the absence of menstrual flow, is most often a result of pregnancy. Although stress, excessive exercise, and eating disorders all may be contributing factors, none is the most common factor associated with amenorrhea.

The drug of choice for treatment of gonorrhea is: a. Penicillin G. c. Ceftriaxone. b. Tetracycline. d. Acyclovir.

ANS: C Ceftriaxone is effective for treatment of all gonococcal infections. Penicillin is used to treat syphilis. Tetracycline is prescribed for chlamydial infections. Acyclovir is used to treat herpes genitalis

When evaluating a patient for sexually transmitted infections (STIs), the nurse should be aware that the most common bacterial STI is: a. Gonorrhea. c. Chlamydia. b. Syphilis. d. Candidiasis

ANS: C Chlamydia is the most common and fastest spreading STI among American women, with an estimated 3 million new cases each year. Gonorrhea and syphilis are bacterial STIs, but they are not the most common ones among American women. Candidiasis is caused by a fungus, not by bacteria

When assessing a patient for amenorrhea, the nurse should be aware that this is unlikely to be caused by: a. Anatomic abnormalities. c. Lack of exercise. b. Type 1 diabetes mellitus. d. Hysterectomy

ANS: C Lack of exercise is not a cause of amenorrhea. Strenuous exercise may cause amenorrhea. Anatomic abnormalities, type 1 diabetes mellitus, and hysterectomy all are possible causes of amenorrhea

Which statement concerning cyclic perimenstrual pain and discomfort (CPPD) is accurate? a. Premenstrual dysphoric disorder (PMDD) is a milder form of premenstrual syndrome (PMS) and more common in younger women. b. Secondary dysmenorrhea is more intense and medically significant than primary dysmenorrhea. c. Premenstrual syndrome is a complex, poorly understood condition that may include any of a hundred symptoms. d. The causes of PMS have been well established.

ANS: C PMS may manifest with one or more of a hundred or so physical and psychologic symptoms. PMDD is a more severe variant of PMS. Secondary dysmenorrhea is characterized by more muted pain than that seen in primary dysmenorrhea; the medical treatment is much the same. The cause of PMS is unknown. It may be a collection of different problems

The nurse should know that once human immunodeficiency virus (HIV) enters the body, seroconversion to HIV positivity usually occurs within: a. 6 to 10 days. c. 6 to 8 weeks. b. 2 to 4 weeks. d. 6 months

ANS: C Seroconversion to HIV positivity usually occurs within 6 to 8 weeks after the virus has entered the body.

A 36-year-old woman has been given a diagnosis of uterine fibroids. When planning care for this patient, the nurse should know that: a. Fibroids are malignant tumors of the uterus that require radiation or chemotherapy. b. Fibroids increase in size during the perimenopausal period. c. Menorrhagia is a common finding. d. The woman is unlikely to become pregnant as long as the fibroids are in her uterus

ANS: C The major symptoms associated with fibroids are menorrhagia and the physical effects produced by large myomas. Fibroids are benign tumors of the smooth muscle of the uterus, and their etiology is unknown. Fibroids are estrogen sensitive and shrink as levels of estrogen decline. Fibroids occur in 25% of women of reproductive age and are seen in 2% of pregnant women.

The two primary areas of risk for sexually transmitted infections (STIs) are: a. Sexual orientation and socioeconomic status. b. Age and educational level. c. Large number of sexual partners and race. d. Risky sexual behaviors and inadequate preventive health behaviors

ANS: D Risky sexual behaviors and inadequate preventive health behaviors put a person at risk for acquiring or transmitting an STI. Although low socioeconomic status may be a factor in avoiding purchasing barrier protection, sexual orientation does not put one at higher risk. Younger individuals and individuals with less education may be unaware of proper prevention techniques; however, these are not the primary areas of risk for STIs. Having a large number of sexual partners is a risk-taking behavior, but race does not increase the risk for STIs

When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended? a. Increasing the intake of red meat and simple carbohydrates b. Reducing the intake of diuretic foods such as peaches and asparagus c. Temporarily substituting physical activity for a sedentary lifestyle d. Using a heating pad on the abdomen to relieve cramping

ANS: D Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing uterine ischemia. Dietary changes such as eating less red meat may be recommended for women experiencing dysmenorrhea. Increasing the intake of diuretics, including natural diuretics such as asparagus, cranberry juice, peaches, parsley, and watermelon, may help ease the symptoms associated with dysmenorrhea. Exercise has been found to help relieve menstrual discomfort through increased vasodilation and subsequent decreased ischemia.

One of the alterations in cyclic bleeding that occurs between periods is called: a. Oligomenorrhea. c. Leiomyoma. b. Menorrhagia. d. Metrorrhagia

ANS: D Metrorrhagia is bleeding between periods. It can be caused by progestin injections and implants. Oligomenorrhea is infrequent or scanty menstruation. Menorrhagia is excessive menstruation. Leiomyoma is a common cause of excessive bleeding

With regard to dysmenorrhea, nurses should be aware that: a. It is more common in older women. b. It is more common in leaner women who exercise strenuously. c. Symptoms can begin at any point in the ovulatory cycle. d. Pain usually occurs in the suprapubic area or lower abdomen

ANS: D Pain is described as sharp and cramping or sometimes as a dull ache. It may radiate to the lower back or upper thighs. Dysmenorrhea is more common in women 17 to 24 years old, women who smoke, and women who are obese. Symptoms begin with menstruation or sometimes a few hours before the onset of flow.

The recommended treatment for the prevention of human immunodeficiency virus (HIV) transmission to the fetus during pregnancy is: a. Acyclovir. c. Podophyllin. b. Ofloxacin. d. Zidovudine

ANS: D Perinatal transmission of HIV has decreased significantly in the past decade as a result of prophylactic administration of the antiretroviral drug zidovudine to pregnant women in the prenatal and perinatal periods. Acyclovir is an antiviral treatment for HSV. Ofloxacin is an antibacterial treatment for gonorrhea. Podophyllin is a solution used in the treatment of human papillomavirus.

The nurse providing care in a womens health care setting must be aware regarding which sexually transmitted infection that can be successfully treated and cured? a. Herpes b. Acquired immunodeficiency syndrome (AIDS) c. Venereal warts d. Chlamydia

ANS: D The usual treatment for infection by the bacterium Chlamydia is doxycycline or azithromycin. Concurrent treatment of all sexual partners is needed to prevent recurrence. There is no known cure for herpes, and treatment focuses on pain relief and preventing secondary infections. Because there is no known cure for AIDS, prevention and early detection are the primary focus of care management. Condylomata acuminata are caused by human papillomavirus. No treatment eradicates the virus

The clinic nurse is performing a prenatal assessment on a pregnant client at risk for preeclampsia. Which clinical signs are included as symptoms of preeclampsia? Select all that apply Edema Hypertension Glucosuria Proteinuria

ANSWER: Edema Hypertension Proteinuria

A pregnant client has been diagnosed with gestational diabetes. Which of the following are risk factors for developing gestational diabetes? Select all that apply Hypertension Previous small for gestational age infant. Obesity maternal age less than 18 years Genitourinary tract abnormalities previous large for gestational age

ANSWER: Hypertension Obesity previous large for gestational age

here is little consensus on the management of premenstrual dysphoric disorder (PMDD). However, nurses can advise women on several self-help modalities that often improve symptoms. The nurse knows that health teaching has been effective when the client reports that she has adopted a number of lifestyle changes, including (Select all that apply): Improved nutrition Oil of evening primrose. Smoking cessation. Regular exercise. A daily glass of wine.

ANSWER: Improved nutrition Oil of evening primrose. Smoking cessation. Regular exercise.

Substances and their effects on pregnancy.

Alcohol- growth deficiencies,facial abnormalities, CNS impairment, behavioral disorders, and abnormal intellectual development Caffeine- Decrease iron absorption; increased risk of anemia Nicotine- Reduced uteroplacental blood flow, decreased birth weight, abortion, prematurity, abruptio placenta Cocaine- Vasoconstriction, tachycardia, hypertension, abruptio placenta, abortion, prune belly syndrome, IUGR Narcotics- Neonatal abstinence syndrome, preterm labor, intrauterine growth restriction (IUGR) and preeclampsia Sedatives- Respiratory problems, feeding difficulties, disturbed sleep

With regard to the diagnosis and management of amenorrhea, nurses should be aware that :A) it probably is the result of a hormone deficiency that can be treated with medication. B) it may be caused by stress or excessive exercise or both. C) it likely will require the client to eat less and exercise more. D) it often goes away on its own.

B) it may be caused by stress or excessive exercise or both. Amenorrhea may be the result of a decrease in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This is usually caused by stress, body fat to lean ratio, and in rare occurrences a pituitary tumor. It cannot be treated by medication. Amenorrhea usually is the result of stress and/or an inappropriate ratio of body fat to lean tissue, possibly as a result of excessive exercise. Management includes counseling and education about the causes and possible lifestyle changes. In most cases a client will need to decrease her amount of exercise and increase her body weight in order to resume menstruation. Management of stress and eating disorders is usually necessary to manage this condition.

What best describes the pattern of genetic transmission known as autosomal recessive inheritance? A. Disorders in which the abnormal gene for the trait is expressed even when the other member of the pair is normal B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed C. Disorders in which a single gene controls the particular trait D. Disorders in which the abnormal gene is carried on the X chromosome

B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed Autosomal dominant inheritance occurs when the abnormal gene for the trait is expressed, even when the other member of the pair is normal, such as Huntington disease or Marfan syndrome. An autosomal recessive inheritance disorder occurs when both genes of the pair are abnormal, such as phenylketonuria or sickle cell anemia. Disorders in which a single gene controls the particular trait describe the unifactorial inheritance. X-linked recessive inheritance occurs when the abnormal gene is carried on the X chromosome, such as hemophilia or Duchenne muscular dystrophy

With regard to abnormalities of chromosomes, nurses should be aware that: A. they occur in approximately 10% of newborns. B. abnormalities of number are the leading cause of pregnancy loss. C. down syndrome is a result of an abnormal chromosomal structure. D. unbalanced translocation results in a mild abnormality that the child will outgrow

B. abnormalities of number are the leading cause of pregnancy loss. Chromosomal abnormalities occur in less than 1% of newborns. Aneuploidy is an abnormality of number that also is the leading genetic cause of mental retardation. Down syndrome is the most common form of trisomal abnormality, an abnormality of chromosome number (47 chromosomes). Unbalanced translocation is an abnormality of chromosome structure that often has serious clinical effects.

41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus? Ultrasound for fetal anomalies Maternal serum alpha-fetoprotein (MSAFP) screening Biophysical profile (BPP) Percutaneous umbilical blood sampling (PUBS)

Biophysical profile (BPP) (per ppt BPP if NST non-reactive)

All pregnant women should be instructed to recognize and report potential complications for each trimester of pregnancy. The following combine the sign or symptom with a possible cause. Fetal jeopardy or intrauterine fetal death- Decreased fetal movement Kidney infection or stones- Severe backache and flank pain Gestational diabetes- Glycosuria Hyperemesis gravidarum- Severe vomiting in early pregnancy Hypertension, preeclampsia- Epigastric pain late in pregnancy

Fetal jeopardy or intrauterine fetal death- Decreased fetal movement Kidney infection or stones- Severe backache and flank pain Gestational diabetes- Glycosuria Hyperemesis gravidarum- Severe vomiting in early pregnancy Hypertension, preeclampsia- Epigastric pain late in pregnancy

A couple has been counseled for genetic anomalies. They ask you, "What is karyotyping?" Your best response is: A. "Karyotyping will reveal if the baby's lungs are mature." B. "Karyotyping will reveal if your baby will develop normally." C. "Karyotyping will provide information about the gender of the baby, and the number and structure of the chromosomes." D. "Karyotyping will detect any physical deformities the baby has."

C. "Karyotyping will provide information about the gender of the baby, and the number and structure of the chromosomes." The lecithin/sphingomyelin ratio, not karyotyping, reveals lung maturity. Although karyotyping can detect genetic anomalies, the range of normal is nondescriptive. Karyotyping provides genetic information, such as gender and chromosomal structure. Although karyotyping can detect genetic anomalies, not all such anomalies display obvious physical deformities. The term deformities is a nondescriptive word. Furthermore, physical anomalies may be present that are not detected by genetic studies (e.g., cardiac malformations).

A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? A. "We don't really know when such defects occur." B. "It depends on what caused the defect." C. "They occur between the third and fifth weeks of development." D. "They usually occur in the first 2 weeks of development

C. "They occur between the third and fifth weeks of development." This is an accurate statement. Regardless of the cause, the heart is vulnerable during its period of development, the third to fifth weeks. The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week. This is an accurate statement

The student nurse is giving a presentation about milestones in embryonic development. Which information should he or she include? A. At 8 weeks of gestation, primary lung and urethral buds appear. B. At 12 weeks of gestation, the vagina is open or the testes are in position for descent into the scrotum. C. At 20 weeks of age, the vernix caseosa and lanugo appear. D. At 24 weeks of age, the skin is smooth, and subcutaneous fat is beginning to collect.

C. At 20 weeks of age, the vernix caseosa and lanugo appear The primary lung and urethral buds appear at 6 weeks of gestation. The vagina is open or the testes are in position for descent into the scrotum at 16 weeks. Two milestones that occur at 20 weeks are the appearance of the vernix caseosa and lanugo. The appearance of smooth skin occurs at 28 weeks, and subcutaneous fat begins to collect at 30 to 31 weeks.

A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should: A. tell the couple they need to have an abortion within 2 to 3 weeks. B. explain that the fetus has a 50% chance of having the disorder. C. discuss options with the couple, including amniocentesis to determine whether the fetus is affected. D. refer the couple to a psychologist for emotional support

C. discuss options with the couple, including amniocentesis to determine whether the fetus is affected. The couple should be given information about the likelihood of having another baby with this disorder so that they can make an informed decision. A genetic counselor is the best source for determining genetic probability ratios. Genetic testing, including amniocentesis, would need to be performed to determine whether the fetus is affected. The couple eventually may need emotional support, but the status of the pregnancy must be determined first.

A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates: A. the fetus is at risk for Down syndrome. B. the woman is at high risk for developing preterm labor. C. lung maturity. D. meconium is present in the amniotic fluid.

C. lung maturity.The presence of surface-active phospholipids is not an indication of Down syndrome. This result reveals the fetal lungs are mature and in no way indicates risk for preterm labor. The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation. Meconium should not be present in the amniotic fluid.

Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with: Hyperemesis gravidarum. Frequent episodes of maternal hypoglycemia. Congenital anomalies in the fetus. Polyhydramnios

Congenital anomalies in the fetus.

With regard to the estimation and interpretation of the recurrence of risks for genetic disorders, nurses should be aware that: A. with a dominant disorder, the likelihood of the second child also having the condition is 100%. B. an autosomal recessive disease carries a one in eight risk of the second child also having the disorder. C. disorders involving maternal ingestion of drugs carry a one in four chance of being repeated in the second child. D. the risk factor remains the same no matter how many affected children are already in the family.

D. the risk factor remains the same no matter how many affected children are already in the family. In a dominant disorder, the likelihood of recurrence in subsequent children is 50% (one in two). An autosomal recessive disease carries a one in four chance of recurrence. Subsequent children would be at risk only if the mother continued to use drugs; the rate of risk would be difficult to calculate. Each pregnancy is an independent event. The risk factor (e.g., one in two, one in four) remains the same for each child, no matter how many children are born to the family.

n planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: Degree of glycemic control during pregnancy. Amount of insulin required prenatally Number of years since diabetes was diagnosed. Mother's age. Degree of glycemic control during pregnancy.

Degree of glycemic control during pregnancy.

With regard to the association of maternal diabetes and other risk situations affecting mother and fetus, nurses should be aware that: Infections occur about as often and are considered about as serious in diabetic and nondiabetic pregnancies Hydramnios occurs approximately twice as often in diabetic pregnancies. Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy. Even mild to moderate hypoglycemic episodes can have significant effects on fetal well-being.

Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment the nurse finds the following vital signs: temperature of 37.3° C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure (BP) of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The client complains, "I'm so thirsty and warm." The nurse: Calls for a stat magnesium sulfate level. Administers oxygen. Discontinues the magnesium sulfate infusion. Prepares to administer hydralazine.

Discontinues the magnesium sulfate infusion.

When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cardiac decompensation, which include: Dyspnea; crackles; and an irregular, weak pulse A regular heart rate and hypertension. An increased urinary output, tachycardia, and dry cough. Shortness of breath, bradycardia, and hypertension.

Dyspnea; crackles; and an irregular, weak pulse

A woman has been diagnosed with a high-risk pregnancy. She and her husband come into the office in a very anxious state. She seems to be coping by withdrawing from the discussion, showing declining interest. The nurse can best help the couple by: Telling her that the physician will isolate the problem with more tests. Encouraging her and urging her to continue with childbirth classes. Becoming assertive and laying out the decisions the couple needs to make. Downplaying her risks by citing success rate studies.

Encouraging her and urging her to continue with childbirth classes.

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine "several times" during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high-risk category? Blood pressure, age, BMI Family history, blood pressure, BMI Drug/alcohol use, age, family history Family history, BMI, drug/alcohol abus Family history, BMI, drug/alcohol abus

Family history, BMI, drug/alcohol abuse

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit. The nurse notifies the physician because the laboratory results are indicative of: HELLP syndrome. Eclampsia Disseminated intravascular coagulation (DIC). Idiopathic thrombocytopenia.

HELLP syndrome. Hemolysis (evident on peripheral smear), Elevated Liver Enzymes, Low Platelets

the nurse in a health clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instructions? I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks. I need to lie flat on my back to perform the procedure I will record the number of movements or kicks If I count fewer than 10 kicks in a 2-hour period, I should count the kicks again over the next 2 hours

I need to lie flat on my back to perform the procedure

With regard to small for gestational age (SGA) infants and intrauterine growth restrictions (IUGR), nurses should be aware that: In asymmetric IUGR weight is slightly more than SGA, whereas length and head circumference are somewhat less than SGA. Infants with asymmetric IUGR have the potential for normal growth and development Symmetric IUGR occurs in the later stages of pregnancy. In the first trimester diseases or abnormalities result in asymmetric IUGR.

In asymmetric IUGR weight is slightly more than SGA, whereas length and head circumference are somewhat less than SGA.

hile providing care in an obstetric setting, the nurse should understand that postpartum care of the woman with cardiac disease: Includes ambulating frequently, alternating with active range of motion. Includes rest, stool softeners, and monitoring of the effect of activity. Is the same as that for any pregnant woman. Includes limiting visits with the infant to once per day.

Includes rest, stool softeners, and monitoring of the effect of activity.

he use of methamphetamine (meth) has been described as a significant drug problem in the United States. In order to provide adequate nursing care to this client population, the nurse must be cognizant that methamphetamine: Is a stimulant with vasoconstrictive characteristics Is similar to opiates. Should not be discontinued during pregnancy. Is associated with a low rate of relapse.

Is a stimulant with vasoconstrictive characteristics -per book side effects few done indicate an increased risk for preterm births, low birth weight, placental abruption, fetal growth restriction, and congenital anomalies

Nurses should be aware that the biophysical profile (BPP): Is a compilation of health risk factors of the mother during the later stages of pregnancy. Is an accurate indicator of impending fetal death. Involves an invasive form of ultrasound examination. Consists of a Doppler blood flow analysis and an amniotic fluid index

Is an accurate indicator of impending fetal death.

As related to the care of the patient with anemia, the nurse should be aware that: It is the most common medical disorder of pregnancy. Thalassemia is a European version of sickle cell anemia. The most common form of anemia is caused by folate deficiency. It can trigger reflex brachycardia

It is the most common medical disorder of pregnancy.

creening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for: Low birth weight Congenital anomalies of the central nervous system. Preterm birth. Macrosomia.

Macrosomia.

A pregnant woman presents in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. On the basis of her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy? Alcohol Heroin Marijuana Cocaine

alcohol

With regard to the development of the respiratory system, maternity nurses should understand that: Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. The respiratory system does not begin developing until after the embryonic stage The infant's lungs are considered mature when the lecithin/sphingomyelin (L/S) ratio is 1:1, at about 32 weeks. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks.

Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity.

With regard to prenatal genetic testing, nurses should be aware that: Group of answer choices Presymptomatic testing is used to predict the likelihood of breast cancer. Predisposition testing predicts with near certainty that symptoms will appear. Carrier screening tests look for gene mutations of people already showing symptoms of a disease. Maternal serum screening can determine whether a pregnant woman is at risk of carrying a fetus with Down syndrome.

Maternal serum screening can determine whether a pregnant woman is at risk of carrying a fetus with Down syndrome.

Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be aware that the optimal pharmacologic therapy for pain relief is: _________________________________.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A new mother with which of these thyroid disorders would be strongly discouraged from breastfeeding? Thyroid storm Hypothyroidism Phenylketonuria (PKU) Hyperthyroidism

Phenylketonuria (PKU)

Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring client with diabetes mellitus, the nurse is aware that she is at a greater risk for: Postterm pregnancy. Oligohydramnios. Chromosomal abnormalities. Polyhydramnios.

Polyhydramnios

Which factor is known to increase the risk of gestational diabetes mellitus? Previous diagnosis of type 2 diabetes mellitus Maternal age younger than 25 years Underweight before pregnancy Previous birth of large infant

Previous birth of large infant

infants of mothers with diabetes (IDMs) are at higher risk for developing: Respiratory distress syndrome. Hyponatremia Sepsis. Anemia.

Respiratory distress syndrome.

Intrauterine growth restriction (IUGR) is associated with numerous pregnancy-related risk factors (Select all that apply). Smoking Maternal collagen disease Poor nutrition Premature rupture of membranes Gestational hypertension

Smoking Maternal collagen disease Poor nutrition Gestational hypertension

When nurses help their expectant mothers assess the daily fetal movement counts, they should be aware that: "Kick counts" should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off. Alcohol or cigarette smoke can irritate the fetus into greater activity. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. Obese mothers familiar with their bodies can assess fetal movement as well as average-size women.

The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.

Maternal phenylketonuria (PKU) is an important health concern during pregnancy because: It is a recognized cause of preterm labor. Women with PKU are usually retarded and should not reproduce. A pregnant woman is more likely to die without dietary control. The fetus may develop neurologic problems.

The fetus may develop neurologic problems.

With regard to amniocentesis, nurses should be aware that: Despite the use of ultrasound, complications still occur in the mother or infant in 5% to 10% of cases. Because of new imaging techniques, amniocentesis is now possible in the first trimester. The shake test, or bubble stability test, is a quick means of determining fetal maturity. The presence of meconium in the amniotic fluid is always cause for concern.

The shake test, or bubble stability test, is a quick means of determining fetal maturity.

A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time? Group of answer choices Ultrasound examination Amniocentesis Maternal serum alpha-fetoprotein (MSAFP) screening Nonstress test (NST)

Ultrasound examination

Maternal serum alpha-fetoprotein (MSAFP) screening indicates an elevated level. MSAFP screening is repeated and again is reported as higher than normal. What would be the next step in the assessment sequence to determine the well-being of the fetus? Biophysical profile (BPP) for fetal well-being Ultrasound for fetal anomalies Amniocentesis for genetic anomalies Percutaneous umbilical blood sampling (PUBS)

Ultrasound for fetal anomalies

Nursing intervention for the pregnant diabetic patient is based on the knowledge that the need for insulin: Varies depending on the stage of gestation Decreases throughout pregnancy and the postpartum period Should not change because the fetus produces its own insulin. Increases throughout pregnancy and the postpartum period.

Varies depending on the stage of gestation

While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the client's recent menstrual cycles. The nurse should collect additional information with which statement? a. The woman says her menstrual flow lasts 5 to 6 days. b. She describes her flow as very heavy. c. She reports that she has had a small amount of spotting midway between her periods for the past 2 months. d. She says the length of her menstrual cycle varies from 26 to 29 days.

b. She describes her flow as very heavy.

At 35 weeks of pregnancy a woman experiences preterm labor. Tocolytics are administered and she is placed on bed rest, but she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time? a. Percutaneous umbilical blood sampling (PUBS) b. Ultrasound for fetal size c. Amniocentesis for fetal lung maturity d. Nonstress test (NST)

c. Amniocentesis for fetal lung maturity

A client at 32 weeks' gestation has been admitted to the labor and birth unit with preterm labor. Which medication would the nurse be likely to administer to reduce the risk of complications in the preterm newborn? corticosteroids magnesium sulfate nifedipine indomethacin

corticosteroids Corticosteroids are given to help reduce or prevent the frequency and severity of respiratory distress syndrome in preterm infants delivered between 24 and 34 weeks' gestation. Medications most commonly used for tocolysis include magnesium sulfate, indomethacin, and nifedipine.

A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize? depressed deep tendon reflexes tachypnea bradycardia elevated blood glucose

depressed deep tendon reflexes The nurse should assess the woman at least once hourly and report any dyspnea (not tachypnea), tachycardia (not bradycardia), productive cough, adventitious breath sounds, and absent or decreased deep tendon reflexes in a client receiving magnesium sulfate; these are all signs of possible magnesium toxicity. Elevated blood glucose is a potential adverse reaction if the woman is receiving terbutaline.

A client at 38 weeks' gestation has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? external cephalic version trial laborforceps birth vacuum extraction

external cephalic version External cephalic version is the turning of a fetus from a breech to a cephalic position before birth. It may be done as early as 34 to 35 weeks, although the usual time is 37 to 38 weeks of pregnancy. A trial birth is performed when a woman has a borderline (just adequate) inlet measurement and the fetal lie and position are good and involves allowing labor to take its normal course as long as descent of the presenting part and dilation (dilatation) of the cervix continue to occur. Forceps, which are not commonly used anymore, and vacuum extraction are used to facilitate birth when other complications are present, but they would be less likely to be used with a fetus in breech position.

A nursing instructor is teaching students about fetal presentations during birth. The most common cause for increased incidence of shoulder dystocia is: poor quality of prenatal care .longer length of labor. increased number of overall pregnancies .increasing birth weight.

increasing birth weight. Shoulder dystocia is the obstruction of fetal descent and birth by the axis of the fetal shoulders after the fetal head has emerged. The incidence of shoulder dystocia is increasing because of increasing birth weights, with reports of it in as many as 2% of vaginal births.

safe vaccines during pregnancy

tetanus, diphtheria, (Tdap) influenza Meningococcal, pneumococcal, TD High Risk- Hep A. Hep B