practice questions for maternity test 2

The test used to screen for gestational diabetes is called: A Glucose challenge test B Glycosylated hemoglobin test C Fasting postprandial test D Jelly bean test

A Glucose challenge test

Intrapartum nursing care for a woman who has sickle cell disease focuses on which priority? A Maintaining oxygenation and hydration B Avoiding excessive movement C Preventing external stimulation like visitors D Increasing calorie intake

A Maintaining oxygenation and hydration

When caring for a woman who has had a molar pregnancy and gestational trophoblastic tissue evacuated, the clinic nurse's priority intervention is to: A Reinforce the need to delay a new pregnancy for 1 year. B Ask the woman whether she has any cramping of bleeding. C Observe return of her blood pressure to normal. D Observe return of her blood pressure to normal.

A Reinforce the need to delay a new pregnancy for 1 year. -dont want them to get pregnant because molar pregnancy can cause cancer

the clinic nurse is performing a psychosocial assessment of a client who has been told that she is pregnant. which assessment finding indicates to the nurse that the client is at risk for contracting HIV? A. a client who has a history of IV drug use B. a client who has significant other who is heterosexual C. a client who has a history of sexually transmitted infections D. a client who has had one sexual partners for the past 10 years

A. a client who has a history of IV drug use

a non stress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. the health care provider prescribes a contraction stress test, and results are documented as negative. how should the nurse document this finding? A. a normla test result B. an abnormal test result C. a high risk for fetal demise D. the need for cesarean delivery

A. a normal test result

a non-stress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. the health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? A. a normal test result B. an abnormal test result C. a high risk for fetal demise D. the need for c-section

A. a normal test result

an ultrasound is performed on a client at term gestation who is experiencing moderate vaginal bleeding. the results of the ultrasound indicate the abruptio placentae is present on the basis of these findings, the nurse should prepare the client for which anticipated prescription? A. delivery of the fetus B. strict monitoring of intake and output C. complete bed rest for the remainder of the pregnancy D. the need for weekly monitor for coagulation studies until the time of delivery

A. delivery of the fetus

the nurse is monitoring a client who is in the active stage of labor. the client has been experiencing contractions that are short, irregular, and weak. the nurse documents that the client is experiencing which type of labor dystocia? A. hypotonic B. precipitous C. hypertonic D. preterm labor

A. hypotonic

the nurse is assessing a pregnant client with type I diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. the nurse determines that further teaching is needed if the client makes which statement? A. i will need to increase my insulin dosage during the first 3 months of pregnancy B. my insulin dose will likely need to be increased during the second and third trimester C. episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy D. my insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding

A. i will need to increase my insulin dosage during the first 3 months of pregnancy insulin needs decrease in the first trimester of pregnancy because of increased insulin production by the pancreas and increased peripheral sensitive to insulin

the nurse has performed a non stress test on a pregnant client and is reviewing the fetal monitor strip. the nurse interprets the test as reactive. how should the nurse document this finding? A. normal B. abnormal C. the need for further evaluation D. that findings were difficult to interpret

A. normal

the home care nurse is monitoring a pregnant client with gestational hypertension who is at risk for preeclampsia. at each home care visit the nurse assesses the clientt for which classic signs of pre-eclampsia? select all that apply A. proteinuria B. hypertension C. low-grade fever D. generalized edema E. increased pulse rate F. increased respiratory rate

A. proteinuria B. hypertension D. generalized edema

the nurse in a labor room is preparing to care for a client with hypertonic uterine contractions. the nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. what is the priority nursing action? A. provide pain relief measures B. prepare the client for an amniotomy C. promote ambulation every 30 minutes D. monitor the oxytocin infusion closely

A. provide pain relief measures

the nurse in a maternity unit is providing emotional support to a client and her husband about preparing to be discharged from the hospital after the birth of a dead fetus. which statement made by the client indicates a component of the normal grieving process? A. we want to attend a support group B. we never want to try to have a baby again C. we are going to try to adopt a child immediately D. we are okay and we are going to try to have another baby immediately

A. we want to attend a support group

the nurse is preparing a list of self care instructions for postpartum client who was diagnosed with mastitis. which instructions should be included on the list? select all that apply A. wear a supportive bra B. rest during acute phase C. maintain a fluid intake of at least 3000 mL D. continue to breast feed if the breasts are not too sore E. take the prescribed antibiotics until the soreness subsides F. avoid decompression of the breasts by breastfeeding or breast pump

A. wear a supportive bra B. rest during acute phase C. maintain a fluid intake of at least 3000 mL D. continue to breast feed if the breasts are not too sore

a stillborn baby was delivered in the birthing suite a few hours ago. After the delivery the family remained together, holding and touching the baby. Which statement by the nurse would further assist the family in their initial period of grief? A. what can i do for you ?? B. now you have an angel in heaven C. don't worry there is nothing you could have done D. we will see to it that you have an early discharge

A. what can i do for you ??

the nurse is providing instructions to a pregnant client with HIV infection regarding care to the newborn after delivery. the client asks the nurses about the feeding options that are available. which response should the nurse make to the client? A. you will need to bottle feed your newborn B. you will need to feed your newborn by nasogastric tube feeding C. you will be bale to breast feed for 6 months D. you will be able to breast feed for 9 months and then will need to switch to bottle feeding

A. you will need to bottle feed your newborn

The best way for the nurse to evaluate the quality of a pregnant adolescent's diet is to: A Ask her, in a nonthreatening way, how well she eats. B Ask her to describe what she ate the day before. C Assume that it is inadequate and give her advice. D Have her record everything she eats for one week.

B Ask her to describe what she ate the day before.

A laboring woman is on magnesium sulfate for preeclampsia. In addition to the fetal heart rate, the essential nursing assessments are: A Determining uterine contraction intensity and frequency. B Monitoring maternal vital signs, heart and lung sounds. C Performing vaginal exams to assess for cervical change. D Validating her perception of fetal movement with contractions.

B Monitoring maternal vital signs, heart and lung sounds.

A laboring woman is frustrated by the slowness of the labor due to hypotonic contractions. Which of the following nursing interventions is best? A Start oxytocin at a low rate. B Offer her to walk and shower. C Reassure her that this problem is common. D Do not allow any oral intake.

B Offer her to walk and shower. -because hypotonic contractions are just getting her started in labor -for A to be right it would have to have the words "as ordered" -walking and showering helps move pelvis, moving baby along, also water falling on the breast is nipple stimulation

The feature that distinguishes preeclampsia from eclampsia is the: A Elevation of blood pressure B Presence of seizure. C Greater amount of proteinuria. D Marked edema of face and hands.

B Presence of seizure.

When providing intrapartum care for the woman with severe preeclampsia, priority nursing care is to: A Maintain the ordered rate of anticonvulsant medications. B Promote placental blood flow and prevent maternal injury. C Give intravenous fluids and observe urine output. D Reduce maternal blood pressure to the prepregnancy level.

B Promote placental blood flow and prevent maternal injury. -this is the PRIORITY ANSWER D is not correct because the body becomes use to functioning at the high blood pressure level

the nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. the nurse reviews the plan of care and prepares to monitor the client for which risk associated with placenta previa? A. infection B. hemorrhage C. chronic hypertension D. DIC

B. hemorrhage

the nurse in a health care clinic is instructing a pregnant client how to perform "kick counts" which statement by the client indicates a need for further instructions? A. i will record the number of movement or kicks B. i need to lie flat on my back to perform the procedure C. if i count fewer than 10 kicks in a 2 hour period I should count the kicks again over the next 2 hours D. i should place my hands on the largest part of my abdomen and contrite on th fetal moment to count the kicks

B. i need to lie flat on my back to perform the procedure

the nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." which statement by the client indicates a need for further instructions? A. i wil record the number of movements or kicks B. i need to lie flat on my back to perform the procedure C. if i count fewer than 10 kicks in a 2 hour period i should count the kicks again over the next 2 hours D. i should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks

B. i need to lie flat on my back to perform the procedure -the client should sit or lie quietly on her side to perform kick counts. -lying flat on the back is not necessary to perform this procedure, it can cause discomfort and presents a risk of vena cava syndrome: *supine hypotension*

a client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. a threatened abortion is suspected and the nurse instructs the client regarding management of care. which statement made by the client indicates a need for further instruction? A. i will watch for the evidence of the passage of tissue B. i will maintain strict bed rest throughout the remainder of the pregnancy C. i will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad D. i will avoid sexual intercourse until the bleeding has stopped and for 2 weeks following the last evidence of bleeding

B. i will maintain strict bed rest throughout the remainder of the pregnancy

the nurse has developed a plan of care for a client experiencing dystocia and includes several nursing actions in the plan of care. what is the priority nursing action? A. providing comfort measure B. monitoring the fetal heart rate C. changing the clients position frequently D. keeping the significant other informed of the progress of the labor

B. monitoring the fetal heart rate

the maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has suspected diagnosis of placenta previa. the nurse reviews the health care provider's prescriptions and should question which prescription? A. prepare the client for an ultrasound B. obtain equipment for a manual pelvic examination C. prepare to draw hemoglobin and hematocrit blood sample D. obtain equipment for external electronic fetal heart rate monitoring

B. obtain equipment for a manual pelvic examination

the nurse in a labor room is performing a vaginal assessment on a pregnant client in labor. the nurse notes the presence of the umbilical cord protruding from the vagina. what is the first nursing action with this finding? A. gently push the cord into the vagina B. place the client in trendelenburg C. find the closest telephone and page the health care provider stat D. call the delivery room to notify the staff that the client will be transported immediately

B. place the client in trendelenburg

after a precipitous delivery the nurse notes that the new mother is a passive and only touches her newborn infant briefly with her fingertips. what should the nurse do to help the woman process the delivery? A. encourage the mother to breast feed soon after birth B. support the mother in her reaction to the newborn infant C. tell the mother that it is important to hold the newborn infant D. document a complete account of the mothers reaction on the birth record

B. support the mother in her reaction to the newborn infant -the precipitous labor that lasts 3 hours or less home who have experienced precipitous labor often describe feelings of disbelief that their labor progresses so rapidly. to assist the client to process what has happened, the best option is to support the client in her reaction to the newborn infant

the nurse is performing an initial assessment on a client who has just been told that a pregnancy test is positive. which assessment findings indicates that the client is at risk for preterm labor? A. the client is a 35 yr old primigravida B. the client has a history of cardiac disease C. the clients hemoglobin level is 13.5 D. the client is a 20 yr old primigravida of average weight and height

B. the client has a history of cardiac disease

the nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. which assessment finding should the nurse expect to note if this condition is present? A. soft abdomen B. uterine tenderness C. absence of abdominal pain D. painless, bright red vaginal bleeding

B. uterine tenderness

A woman presents at 9 cms in rapid labor with her fourth child. Which nursing measure is the most appropriate to help her manage pain? A Offer her narcotic medication. B Prepare her for an epidural. C Coach her in breathing techniques. D Keep her in an upright position.

C Coach her in breathing techniques.

A woman tells you she has been teary for most of the 2 weeks since the birth of her baby. Although the infant appears to be cared for appropriately, the mother states that she feels too tired to spend as much time with him as she should. She has lost her appetite and cannot sleep at night. She has been too ashamed to tell anyone before now. The nurse's best response is to: A Tell her that this is normal postpartum blues and she will get over it in a few days. B Suggest that she get some help to care for the baby and that with more rest she will feel fine. C Listen to her feelings carefully and then acknowledge that something is wrong. D Suggest that she spend time away from the baby to rest from the constant infant care.

C Listen to her feelings carefully and then acknowledge that something is wrong.

A breastfeeding mother who complains of pain is reluctant to take a prescribed analgesic because she does not want to pass it to the baby. The nurse should tell her that: A Formula feeding as long as she needs analgesics may be best for the baby. B It is important to avoid all nonessential medications during nursing, including analgesics. C Medications prescribed for postpartum discomfort are safe for use in lactation. D She should feed less often so that she can limit transfer of medication to the baby.

C Medications prescribed for postpartum discomfort are safe for use in lactation.

the nurse in maternity unit is reviewing the clients records. which client would the nurse identity ad being at the most risk for developing disseminated intravascular coagulation (DIC)? A. a primigravida with mild pre-eclampsia B. a primigravida who delivered a 10 lb infant 3 hours ago C. a gravida II who has just been diagnosed with dead fetus syndrome D. a gravid who delivered 8 hours ago and has lost 500mL of blood

C. a gravida II who has just been diagnosed with dead fetus syndrome

the nurse is providing instruction to a pregnant client who is schedule for an amniocentesis. what instruction should the nurse provide? A. strict bed rest is required after the procedure B. hospitalization is necessary for 24 hours after the procedure C. an informed consent needs to be signed before the procedure D. a fever is expected after the procedure because of the trauma to the abdomen

C. an informed consent needs to be signed before the procedure

the nurse is providing instructions to pregnant client who is scheduled for an amniocentesis. what instruction should the nurse provide? A. strict bed rest is required after the procedure B. hospitalization is necessary for 24 hours after the procedure C. an informed consent needs to be signed before the procedure D. a fever is expected after the procedure because of the trauma to the abdomen

C. an informed consent needs to be signed before the procedure

which assessment finding following an amniotomy should be conducted first? A. cervical dilation B. bladder distention C. fetal heart rate pattern D. maternal blood pressure

C. fetal heart rate pattern

the nurse is performing an assessment of primigravida who is being evaluated in a clinic during her second trimester of pregnancy. which finding concerns the nurse and indicates the need for follow up? A. quickening B. braxton hicks C. fetal hert rate of 180 BPM D. consistent increase in fundal height

C. fetal hert rate of 180 BPM

the nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching? A. i should stay on the diabetic diet B. i should perform glucose monitoring at home C. i should avoid exercise because of the negative effects on insulin production D. i should be aware of any infections and report signs of infection immediately

C. i should avoid exercise because of the negative effects on insulin production

a client arrives at a birthing center in active labor. her membranes are still intact, and the health care provider prepares to perform an amniotomy what will the nurse really to the client as the most likely outcome of the amniotomy? A. less pressure on her cervix B. decreased number of contractions C. increased efficiency of contractions D. the need for increased maternal blood pressure monitoring

C. increased efficiency of contractions

the nurse is reviewing the health care provider prescriptions for a client admitted for premature rupture of the membranes. gestational age of the fetus is determined to be 37 weeks. which prescription should the nurse question? A. monitor fetal heart rate continuously B. monitor maternal vital signs frequently C. perform a vaginal examination every shift D. administer ampicillin 1g as an IV piggyback

C. perform a vaginal examination every shift

A few minutes after a laboring woman's membranes rupture the fetal heart rate drops from its baseline of 145 bpm to 80 bpm. What is the priority nursing action? A Notify the provider immediately. B Assess maternal vital signs. C Insert an indwelling catheter. D Examine for a prolapsed cord

D Examine for a prolapsed cord -usually do something before notifying the provider

While admitting a baby to the nursery, the nurse is informed a shoulder dystocia occurred at the birth. What is a priority nursing assessment? A Assess for inward turning of the feet. B Check for limited abduction of the hips. C Inspect for head swelling that does not extend beyond the suture. D Palpate the clavicles for movement, listen for creaking.

D Palpate the clavicles for movement, listen for creaking.

Twelve hours after birth, a mother lies in bed resting. Although she has only one more day in the hospital, she does not ask about her baby or provide any care. What is the probable reason for her behavior? A She may be dissatisfied with some aspect of the newborn. B She is still affected by medications given during labor. C She shows behaviors that may lead to postpartum depression. D She is still in the taking-in phase of maternal adaptation.

D She is still in the taking-in phase of maternal adaptation. "taking-in phase" starting to give up one self for baby "letting-go phase" someone who is stuck in this phase is bringing the baby to the bar

a client in postpartum units complains of sudden sharp chest pain and dyspnea. the nurse notes that the client is tachycardia and the respiratory rate is elevated. the nurse suspects a pulmonary embolism. which should be the initial nursing action? A. inmate an IV line B. assess the clients blood pressure C. prepare to administer morphine sulfate D. administer oxygen 8-10

D. administer oxygen 8-10

fetal distress is occurring with a laboring client. As the nurse prepares the client for a c section brith what is the most important nursing action? A. slow the IV flow rate B. place the client in a high fowlers position C. continue the oxytocin D. administer oxygen 8-10 L/minute via face mask

D. administer oxygen 8-10 L/minute via face mask

the nurse is performing an assessment on a client diagnosed with placenta previa. which of these assessment findings would the nurse expect to note? select all that apply A. uterine rigidity B. uterine abdomina tenderness C. severe abdominal pain D. bright red vaignal bleeding E. soft, relaxed, non tender uterus F. fundal height may be greater than expected for gestational age

D. bright red vaignal bleeding E. soft, relaxed, non tender uterus F. fundal height may be greater than expected for gestational age

the nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus. which instruction should the nurse provide to the client? A. total abstinence from sexual intercourse B. sitz bath C. daily administration of anti-viral D. c-section will be necessary if vaginal lesion are present

D. c-section will be necessary if vaginal lesion are present

the nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. then nurse notes the presence of episodic accelerations on the electronic fetal monitoring tracing. which action is most appropriate? A. notify the ehatlh care provider B. reposition the mother and check the monitor for changes in the fetal tracing C. take the mothers vital signs and tell the mother that bed rest is required to conserve oxygen D. document the findings and tell the mother that the pattern on the monitor indicates fetal well being

D. document the findings and tell the mother that the pattern on the monitor indicates fetal well being

the nurse is performing an assessment on a pregnant client with a diagnosis of severe preeclampsia. the nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis? A. enlargement of the breasts B. complaints of feeling hot when the room is cool C. periods of fetal movement followed by a quiet period D. evidence of bleeding such as in the gums, petechiae, and purpura

D. evidence of bleeding such as in the gums, petechiae, and purpura

the nurse is providing instruction to a maternity client with a history of cardiac disease regarding appropriate dietary measures. Which statement if made by the client indicates an understanding of the info provided by the nurse? A. i should increase my sodium intake during pregnancy B. i should lower my blood volume by limiting my fluids C. i should maintain a low calorie diet to prevent any weight gain D. i should drink adequate fluids and increase my intake of high fiber foods

D. i should drink adequate fluids and increase my intake of high fiber foods

the nurse is providing instructions about measures to prevent postpartum mastitis to a client who is breast feeding her newborn. which client statement would indicate a need for further instruction? A. i should breast feed every 2 to 3 hours B. i should change the breast pads frequently C. i should wash my hands well before breast feeding D. i should wash my nipples daily with soap ad water

D. i should wash my nipples daily with soap ad water soap should not be used because it is drying leading to cracking of the nipples

a pregnant client reports to a health care clinic complaining of loss of appetites, weight loss, and fatigue. After assessment of the client tuberculosis is suspected. a sputum culture is obtained and identifies mycobacterium tuberculosis. which instruction should the nurses include in the clients teaching plan? A. therapeutic abortion is required B. she will have to stay at home until treatment is completed C. medications wil not be started until after delivery of the fetus D. isoniazid plus rifampin will be required for 9 months

D. isoniazid plus rifampin will be required for 9 months

the nurse in a labor room is monitoring a client with dysfunctional labor of rings of fetal or maternal compromise. which assessment finding would alert the nurse to a compromise? A. maternal fatigue B. coordinated uterine contractions C. progressive changes in the cervix D. persistent non reassuring fetal heart rate

D. persistent non reassuring fetal heart rate

the home care nurse visits a pregnant client who has a diagnosis of mild pre-eclampsia. which assessment findings indicate a worsening of the pre-eclampsia and the need to notify the health care provider? A. urinary output has increased B. dependent edema has resolved C. blood pressure reading is at the prenatal baseline D. the client complains of a headache and blurred vision

D. the client complains of a headache and blurred vision

the nurse evaluates the ability of a hep B positive mother to provide safe bottle-feeding to her newborn during postpartum hospitalization. which maternal action best exemplifies the mother knowledge of potential disease transmission to the newborn? A. the mother requests that the window be closed before feeding B. the mother holds the newborn properly during feeding and burping C. the mother tests the temperature of the formula before initiating feeding D. the mother washes and dries her hands before and after self-care of the perineum and asks for a pari of gloves before feeding

D. the mother washes and dries her hands before and after self-care of the perineum and asks for a pari of gloves before feeding

the nurse is is monitoring a client in labor. the nurse suspect umbilical cord compression if which is noted on the sternal monitor tracing during a contraction? A. variability B. accelerations C. early deceleration D. variable decelerations

D. variable decelerations