OB FINAL EXAM New Material [Ch 3 + 17}

A patient who is at 41 weeks gestation is concerned when the primary care provider decides to induce labor. Which reason does the nurse explain as the most important need for this procedure? a. Increasing size of the neonate b. Ability to deliver vaginally c. Risk for placental dysfunction d. Likelihood of meconium aspiration

c. Risk for placental dysfunction

The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy. For which reason does the nurse emphasize the first 8 weeks of gestation? a. Pregnancies often abort before or at this time of development. b. Lack of size and movement prevents confirmation of pregnancy. c. All organ systems are developing during this period. d. Factors that can interrupt the pregnancy are no longer a concern.

c. All organ systems are developing during this period.

The nurse works in a urologist's office. A male patient is scheduled for routine fertility testing. For which test does the nurse refrain from making preparation? a. STI screening b. Hormonal levels c. Sexual functioning d. Ejaculate analysis

c. Sexual functioning

A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility? a. The patient works as a ballroom dance instructor. b. The patient is turning 37 years old this year. c. The patient has hot flashes and mood swings. d. The patient was treated for a pelvic inflammatory disease while in college.

c. The patient has hot flashes and mood swings.

The nurse in NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse's greatest concern? a. Absent or weak reflexes b. Presence of a heart murmur c. Apnea 20 seconds or longer d. Low hemoglobin lab level

c. Apnea 20 seconds or longer

The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize? a. Close connections with extended family b. Strong intimate relationship with her partner c. Difficulty accepting pregnancy if it does occur d. Greater focus on career and job opportunities

c. Difficulty accepting pregnancy if it does occur

The nurse is present in the delivery room when a mother is told her neonate was stillborn. The mother begins to wail loudly and pull at her hair. Which action does the nurse take? a. Allow the mother to express grief in her own way. b. Attempt to calm the mother and prevent self-harm. c. Ask for a sedative to calm the mother's reaction. d. Ask a family member to comfort the mother.

a. Allow the mother to express grief in her own way.

The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy? a. Determine whether termination is still a consideration. b. Explain they will experience grief, which is normal. c. Provide additional information about the disorder. d. Refer them to a disorder-specific support group.

a. Determine whether termination is still a consideration.

The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, "I don't believe this is happening to us. We were so careful during pregnancy." The nurse associates the parents' comments with which stage of grief? a. Disbelief b. Depression c. Denial of reality d. Anger with each other

a. Disbelief

The postnatal nurse is providing care for a neonate being treated with phototherapy for hyperbilirubinemia. For which side effects of phototherapy will the nurse contact the neonatal care provider? Select all that apply. a. Hyperthermia b. Lethargy c. Hypocalcemia d. Thrombocytopenia e. Bronze baby syndrome

a. Hyperthermia c. Hypocalcemia d. Thrombocytopenia

The nurse is providing care for a neonate born to a mother with preexisting diabetes mellitus. Which neonatal assessment findings do the nurse expect? Select all that apply. a. Macrosomia b. Hyperglycemia c. Hypocalcemia d. Jaundice e. Dyspnea

a. Macrosomia c. Hypocalcemia d. Jaundice e. Dyspnea

The nurse is counseling a female patient diagnosed with anovulation as a cause of infertility. Which information does the nurse provide to the patient? Select all that apply. a. Methods for dietary planning b. Consultation for myomectomy c. Refrain from unprotected sex d. Surgical correction of fallopian tubes e. Instructions for clomiphene citrate

a. Methods for dietary planning e. Instructions for clomiphene citrate

A patient at 34 weeks gestation is undergoing an ultrasound. The nurse notes that the amniotic fluid is estimated at between 500 and 600 mL. Which deduction does the nurse make from this finding? a. Oligohydramnios is present. b. Fluid is normal for gestation age. c. Polyhydramnios has formed. d. Follow-up ultrasound is warranted.

a. Oligohydramnios is present.

The nurse is providing care for a premature neonate born at 28 weeks gestation who is experiencing respiratory distress syndrome (RDS). Which assessment finding indicates to the nurse that the neonate's respiratory status is deteriorating? a. Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen. b. Respiratory rate is 58 breaths per minute. c. Breath sounds on auscultation are decreased. d. Heart rate is 162 beats per minute.

a. Pao2 is 48 and Paco2 is 55 mm Hg on 90% oxygen.

The nurse is preparing for the discharge of a neonate diagnosed with a congenital breathing disorder. Which health team members does the nurse include in discharge planning? Select all that apply. a. Respiratory therapist b. Community agency manager c. Social worker d. Home health agency nurse e. Case manager

a. Respiratory therapist c. Social worker d. Home health agency nurse e. Case manager

Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of the individual's clinical care. Which example does the nurse associate with genomic medicine? a. Screening of neonates for inherited, treatable genetic diseases b. Creating drugs specifically for the treatment of cancer c. Conducting trial studies to determine how drugs effect individuals d. Tracing and gaining knowledge about how genetic mutations occur

a. Screening of neonates for inherited, treatable genetic diseases

A patient at 37 weeks gestation arrives at the labor and delivery unit and reports a rupture of her membranes. Which factor causes the nurse to anticipate the HCP will prescribe a medical method of labor induction? a. The fetus is viable and the barrier for a sterile uterine environment is breached. b. The fetus is at risk for "drying out" and causing the mother to have a dry birth. c. The mother must be maintained on complete bedrest until contractions begin. d. The mother is at risk for developing an infection and passing it to the fetus.

a. The fetus is viable and the barrier for a sterile uterine environment is breached.

A female patient with a history of infertility is scheduled to have a hysterosalpingogram. Which findings can be detected with this procedure? Select all that apply. a. Tubal occlusions b. Uterine fibroids c. Cervical irritation d. Bicornate uterus e. Vaginal infection

a. Tubal occlusions b. Uterine fibroids d. Bicornate uterus

The premature neonate is more susceptible to skin breakdown than a term neonate. Which skin care interventions will the nurse implement for the premature neonate? Select all that apply. a. Use a neutral pH cleanser and sterile water for bathing. b. Gently apply emollients to avoid unnecessary friction. c. Perform daily skin assessment to identify problems early. d. Use water, air, or gel mattresses. e. Provide a full bath every other day.

a. Use a neutral pH cleanser and sterile water for bathing. b. Gently apply emollients to avoid unnecessary friction. d. Use water, air, or gel mattresses.

An infertile couple voices concern to the nurse about assisted reproductive technologies (ART). The nurse agrees that ART has created numerous dilemmas. Which potential questions does the nurse discuss with the couple? Select all that apply. a. Which partner has ownership of the embryos? b. Should a child be told about donors or surrogates? c. Are there parental rights for sperm donors? d. Does a fertility donor have financial obligations? e. What happens to any surplus embryos?

a. Which partner has ownership of the embryos? b. Should a child be told about donors or surrogates? c. Are there parental rights for sperm donors? e. What happens to any surplus embryos?

A male patient is diagnosed with low sperm count as the cause of infertility. Which interventions will the nurse recommend to improve the patient's sperm count? Select all that apply. a. Yoga or relaxation techniques b. Surgical repair of an inguinal hernia c. Switch to underwear made from cotton d. Avoidance of showers with hot water temperature e. Consultation to change hypertension drugs

a. Yoga or relaxation techniques b. Surgical repair of an inguinal hernia e. Consultation to change hypertension drugs

The nurse notices that a neonate being treated for hyperbilirubinemia with phototherapy has had a daily increase of total bilirubin serum levels greater than 5 mg/dL for the past 2 days. The neonatal care provider prescribes an exchange transfusion. Which knowledge does the nurse apply to the procedure? a. The bilirubin indicates a severe hemolytic disease. b. Approximately 85% of the neonate's RBCs are replaced. c. Donor RBCs are obtained from the neonate's mother. d. The procedure is exclusive to pathological jaundice.

b. Approximately 85% of the neonate's RBCs are replaced.

The nurse is providing support to parents of a premature neonate in NICU. Which actions by the nurse will best provide psychosocial support to the parents? Select all that apply. a. Assess the parents' ability to care for their neonate. b. Ask the parents how they are coping with the experience. c. Provide equipment for breast pumping and storage of milk. d. Encourage parents to take photos to share with family and friends. e. Praise parents for their involvement in the care of their neonate.

b. Ask the parents how they are coping with the experience. d. Encourage parents to take photos to share with family and friends. e. Praise parents for their involvement in the care of their neonate.

The nurse is counseling a patient regarding pregnancy. The patient lost her first two pregnancies in the second trimester of gestation for undetermined reasons. Which initial advice does the nurse provide for this patient? a. Consider adoption. b. Seek genetic studies. c. Plan for fertility tests. d. Attend grief counseling.

b. Seek genetic studies.

A mother of a premature neonate in NICU asks the nurse when her baby will begin getting oral feedings. The nurse is aware that multiple conditions are desired. Which condition is most essential? a. The neonate demonstrates proper feeding actions. b. The neonate exhibits cardiorespiratory regulation. c. The neonate is able to demonstrate hunger cues. d. The neonate is able to maintain a quiet alert state.

b. The neonate exhibits cardiorespiratory regulation.

The nurse works in an infertility clinic and is interviewing a male patient whose partner has been unable to conceive. Which finding obtained during a health history will cause the nurse greatest concern? a. The patient is a passionate gardener. b. The patient had a vasectomy reversed. c. The patient rides a bicycle daily to work. d. The patient is concerned about infertility.

b. The patient had a vasectomy reversed.

After counseling with an obstetrician about infertility, a couple is advised to undergo testicular sperm aspiration. The nurse is aware that the procedure may be recommended for which infertility? a. Blocked fallopian tubes b. Unsuccessful vasectomy reversal c. Poor cervical mucus production d. Diminished sperm motility

b. Unsuccessful vasectomy reversal

The nurse is preparing for the discharge of a premature neonate to home with the parents. The nurse explains the neonate must be able to pass the infant car seat challenge before discharge. For which reason would the neonate be considered unsafe in a car seat? a. Inability to remain at a 45-degree angle for a period of 1 hour b. Reluctance of parents to use the car seat because of the small size of the baby c. Inability to maintain adequate oxygenation, heart rate, and respiratory rate during trial d. Inability to continue prescribed oxygen therapy for the neonate while in a car seat

c. Inability to maintain adequate oxygenation, heart rate, and respiratory rate during trial

The nurse is providing care for a premature neonate in the NICU nursery. The neonate is diagnosed with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Which specific intervention does the nurse expect for this neonate? a. Monitor of hemoglobin and hematocrit levels. b. Obtain blood glucose levels. c. Maintain fluid restrictions. d. Administer enteral feedings.

c. Maintain fluid restrictions.

The nurse is providing support to a mother whose newborn is diagnosed with a life-threatening defect. The mother states, "I just want to go home and never come back." Which reaction by the mother does the nurse recognize? a. Guilty feelings by the mother b. Delay of attachment process c. Maternal emotional distancing d. Disruption of family life

c. Maternal emotional distancing

A female carries one positive genetic marker for Huntington's disease. Her partner does not have any markers for the disease. For which reason is it so important for this family to identify persons with the genetic marker? a. The Huntington gene is recessive. b. All of the couple's offspring will have the disease. c. Symptoms do not manifest until 30 to 50 years of age. d. The expression of the disease is varied by individual.

c. Symptoms do not manifest until 30 to 50 years of age.

The nurse is discussing genetically linked diseases with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Which information from the nurse is correct? a. Any offspring will have the disease. b. Only male children will have the disease. c. The male partner needs genetic testing. d. The couple should not become pregnant.

c. The male partner needs genetic testing.

The NICU nurse encourages the mother of a premature neonate to bring breast milk to the unit for enteral feedings to her baby. For which reason does the nurse make this suggestion? a. The baby will be more likely to breastfeed later. b. The mother will feel more involved with the baby. c. The neonate will gain weight faster on breast milk. d. Breast milk helps prevent necrotizing enterocolitis.

d. Breast milk helps prevent necrotizing enterocolitis.

A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse's greatest concern? a. The carbamazepine may be discontinued. b. The pregnancy is likely to end with fetal demise. c. The fetus will experience loss of vision and hearing. d. Carbamazepine is teratogenic and causes neural and facial defects.

d. Carbamazepine is teratogenic and causes neural and facial defects.

A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother? a. Fetal waste products and CO2 pass through the placenta to the mother. b. The placenta is a special organ developed to create nutrients and oxygen. c. The mother's blood and fetus's blood mix for an exchange of nutrients. d. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.

d. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.

The nurses in a NICU are concerned about the appropriate levels of oxygen therapy during the care of premature neonates. The nurses referenced an article by Newman (2014) titled, "Oxygen Saturation Limits and Evidence supporting the Targets." On which evidence-based conclusion will the nurses develop guidelines? a. Oxygen saturation limits of 85% to 89% are effective. b. Oxygen saturation rates of 91% to 95% are effective. c. Infants are within saturation limits about 75% of the time. d. Oxygen saturation limits need to be between 87% to 94%.

d. Oxygen saturation limits need to be between 87% to 94%.

The labor and delivery nurse is present for the delivery of a premature neonate. Which action by the nurse is most important? a. Stabilize and transfer neonate to NICU. b. Review pregnancy history for risk factors. c. Maintain fluid and electrolyte balance. d. Provide a neutral temperature environment.

d. Provide a neutral temperature environment.

An infertile couple learns that the female is unable to produce viable eggs. The male partner suggests the use of a surrogate as a means of having a child. The female states, "I don't want your baby with another woman!" The nurse is aware of which psychosocial issue with this couple? a. The male blames the female for the infertility. b. The female is jealous of the surrogate's fertility. c. The male needs to have a child with his genes. d. The female is experiencing self-esteem issues.

d. The female is experiencing self-esteem issues.