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457 Cards in this Set
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A family is visiting two surviving triplets. The third triplet died 2 days ago. What action indicates that the family has begun to grieve for the dead infant?
a) They refer to the two life infants as twins b) They ask about the dead triplets current status c) They bring in play clothes for all three infantsd) They refer to the dead infant in the past tense |
They refer to the dead infant in the past tense
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A family is visiting two surviving triplets. The third triplet died 2 days ago. What action indicates that the family has begun to grieve for the dead infant? a) They refer to the two life infants as twins
b) They ask about the dead triplets current status c) They bring in play clothes for all three infantsd) They refer to the dead infant in the past tense |
They refer to the dead infant in the past tense
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A newborn in the NICU is dying as a result of a massive infection. The parents speak to the neonatologist, who informs them of their son's prognosis. When the father sees his son, he says, "He looks just fine to me. I cant understand what all this is about." The most appropriate response by the nurse is:
a) Didnt the doctor tell you about your sons problems b) This must be a difficult time for you. Tell me how you're doing c) To stand beside him quickly d) You'll have to face up to the fact that he is going to die sooner or later |
This must be a difficult time for you. Tell me how you're doing
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A woman experienced a miscarriage at 10 weeks of gestation and had a dilation and curettage (D&C). She states that she is just fine and wants to go home as soon as possible. While you are assessing her responses to her loss, she tells you that shehad purchased some baby things and had picked out a name. Based on your assessment of her responses, what nursing intervention would you do for her first?a) Ready her for dischargeb) Notify pastoral care to offer her a blessingc) Ask her is she would like to see what was obtained from her D&Cd) Ask her what name she had picked out for her baby
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Ask her what name she had picked out for her baby
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During the initial acute distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. The nurse's role should be to:a) Take over as much as possible to relieve the pressureb) Encourage grandparantes to take overc) Make sure the parents themselves approve the final decisionsd) Leave them alone to work things out
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Make sure the parents themselves approve the final decisions
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A nurse concludes that grieving parents have progressed to the reorganization/recovery phase during a follow-up visit a year later if:a) They say they feel no painb) They are discussing sex and a future pregnancy, even if they have not sorted out their feelings yetc) They have abandoned those moments of bittersweet griefd) Their questions have progressed from "why" to "why us"
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They are discussing sex and a future pregnancy, even if they have not sorted out their feelings yet
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A nurse caring for a family during a loss might notice that survivor guilt is sometimes experienced by the infant's:a) Siblingsb) Motherc) Fatherd) Grandparents
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Grandparents
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When helping the mother, father, and other family members actualize the loss of the infant, nurses should:a) Use the words lose or gone rather than dead or diedb) Make sure the family understands that it is important to name the babyc) If the parents choose to visit with the baby, apply powder and lotion to the baby and wrap the infant in a pretty blankerd) Set a firm for ending the visit with the baby so that the parents know when to let go
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If the parents choose to visit with the baby, apply powder and lotion to the baby and wrap the infant in a pretty blanket
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What is appropriate for a nurse to say to bereaved parents?a) This happened for the bestb) God had a purpose for himc) I know how you feeld) What can I do for you
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What can I do for you
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Many women and their partners, whether infertile or not, will experience perinatal loss. The nurse who cares for these families should understand that those experiencing a "silent" or "hidden" loss will also grieve and require the support of caregivers, family, and friends. A(n) _________________ is not an example of a silent loss.a) Extopic pregnancyb) Stillbirthc) Miscarriaged) Induced abortion
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stillbirth
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The term _____________________ refers to the grief response that occurs with reminders of loss. This typically happens on special anniversary dates of the loss.
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Bittersweet grief
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A married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. Based on the information given, what family form best describes this family?a) Married-blended familyb) Extended familyc) Nuclear familyd) Same-sex family
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Married-blended family
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The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family:a) Rituals and customsb) Values and beliefsc) Boundaries and channelsd) Socialization processes
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Values and beliefs
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The nurse's care of a Hispanic family includes teaching about infant care. When developing a plan of care, the nurse bases interventions on the knowledge that in traditional Hispanic families:a) Breastfeeding is encouraged immediately after birthb) Male infants typically are circumcisedc) The maternal grandmother participates in the care of the mother and her infantd) Special herbs mixed in water are used to stimulate the passage of meconium
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The maternal grandmother participates in the care of the mother and her infant
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Which health care service represents the primary level of prevention?a) Immunizationsb) Breast self-examinationc) Home care for high risk pregnanciesd) Blood pressure screening
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Immunizations
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What is the primary difference between hospital care and home health care?a) Home care is routinely delivered continuously by professional staffb) Home care is delivered on an intermittent basis by professional staffc) Home care is delivered for emergency conditionsd) Home care is not available 24 hours a day
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Home care is delivered on an intermittent basis by professional staff
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To provide competent care to an Asian-American family, the nurse should include the following question during the assessment interview:a) Do you prefer hot or cold beveragesb) Do you want some milk to drinkc) Do you want music playing while you are in labord) Do you have a name selected for the baby
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Do you prefer hot or cold beverages
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The woman's family members are present when the nurse arrives for a postpartum and newborn visit. What should the nurse do?a) Observe the family member's interactions with the newborn and one anotherb) Ask the woman to meet with her and the baby alonec) Do a brief assessment on all family members presentd) Reschedule the visit for another time so that the mother and infant can be assessed privately
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Observe the family's members' interactions with the newborn and one another
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What is a limitation of a home postpartum visit?a) The nurse's ability to teach is limited by many distractionsb) Identified problems cannot be resolved in the home settingc) Necessary items for infant care are not availabled) Home visits to different families may require the nurse to travel a great distance
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Home visits to different families may require the nurse to travel a great distance
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The nurse should be aware that during the childbearing experience, an African-American woman will most likely:a) Seek prenatal care early in her pregnancyb) Avoid self-treatment of pregnancy-related discomfortc) Request liver in the postpartum period to prevent anemiad) Arrive at the hospital in advanced labor
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Arrive at the hospital in advanced labor
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A health care service representing the tertiary level of prevention includes:a) Stress management seminarsb) Childbirth education classes for single parentsc) A breast self-examination (BSE) pamphlet and teachingd) A premenstrual syndrome (PMS) support group
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A PMS support group
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A married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. Based on the information given, what family form best describes this family?a) Married-blended familyb) Extended familyc) Nuclear familyd) Same-sex family
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Married-blended family
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The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family:a) Rituals and customsb) Values and beliefsc) Boundaries and channelsd) Socialization processes
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Values and beliefs
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The nurse's care of a Hispanic family includes teaching about infant care. When developing a plan of care, the nurse bases interventions on the knowledge that in traditional Hispanic families:a) Breastfeeding is encouraged immediately after birthb) Male infants typically are circumcisedc) The maternal grandmother participates in the care of the mother and her infantd) Special herbs mixed in water are used to stimulate the passage of meconium
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The maternal grandmother participates in the care of the mother and her infant
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Which health care service represents the primary level of prevention?a) Immunizationsb) Breast self-examinationc) Home care for high risk pregnanciesd) Blood pressure screening
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Immunizations
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What is the primary difference between hospital care and home health care?a) Home care is routinely delivered continuously by professional staffb) Home care is delivered on an intermittent basis by professional staffc) Home care is delivered for emergency conditionsd) Home care is not available 24 hours a day
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Home care is delivered on an intermittent basis by professional staff
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To provide competent care to an Asian-American family, the nurse should include the following question during the assessment interview:a) Do you prefer hot or cold beveragesb) Do you want some milk to drinkc) Do you want music playing while you are in labord) Do you have a name selected for the baby
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Do you prefer hot or cold beverages
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The woman's family members are present when the nurse arrives for a postpartum and newborn visit. What should the nurse do?a) Observe the family member's interactions with the newborn and one anotherb) Ask the woman to meet with her and the baby alonec) Do a brief assessment on all family members presentd) Reschedule the visit for another time so that the mother and infant can be assessed privately
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Observe the family's members' interactions with the newborn and one another
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What is a limitation of a home postpartum visit?a) The nurse's ability to teach is limited by many distractionsb) Identified problems cannot be resolved in the home settingc) Necessary items for infant care are not availabled) Home visits to different families may require the nurse to travel a great distance
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Home visits to different families may require the nurse to travel a great distance
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The nurse should be aware that during the childbearing experience, an African-American woman will most likely:a) Seek prenatal care early in her pregnancyb) Avoid self-treatment of pregnancy-related discomfortc) Request liver in the postpartum period to prevent anemiad) Arrive at the hospital in advanced labor
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Arrive at the hospital in advanced labor
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A health care service representing the tertiary level of prevention includes:a) Stress management seminarsb) Childbirth education classes for single parentsc) A breast self-examination (BSE) pamphlet and teachingd) A premenstrual syndrome (PMS) support group
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A PMS support group
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When the services of an interpreter are used, it is important for the nurse to:a) Use any family member who can interpretb) Use an interpreter who is certified and document the person's name in the nursing notesc) Speak only to the interpreterd) Use an interpreter only in an emergency
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Use an interpreter who is certified and document the person's name in the nursing notes
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A traditional family structure in which male and female partners and their children live as an independent unit is known as a/an:a) Extended familyb) Binuclear familyc) Nuclear familyd) Blended family
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Nuclear family
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A perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:a) Uterine atonyb) Uterine inversionc) Vaginal hematomad) Vaginal laceration
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Uterine atony
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A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:a) Establish venous accessb) Perform fundal messagec) Prepare the woman for surgical interventiond) Catheterize the bladder
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Perform fundal message
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A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by:a) Subinvolution of the uterusb) Defective vascularity of the deciduac) Cervical lacerationd) Coagulation disorders
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Subinvolution disorders
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Which client is at greatest risk for early postpartum hemorrhage (PPH)?a) A primiparous woman (G2, P1-0-0-1) being prepared for an emergency cesarean birth for fetal distressb) A woman with severe preeclampsia on magnesium sulfate whose labor is being inducedc) A multiparous woman (G3, P2-0-0-2) with an 8 hour labord) A primigravida in spontaneous labor with preterm twins)
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A woman with severe preeclampsia on mag sulfate whose labor is being induced
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When caring for a postpartum woman experiencing hemorrhagic shock, the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:a) Absence of cyanosis in the buccal mucosab) Cool, dry skinc) Diminished restlessnessd) Urinary output of at least 30ml/hr
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Urinary output of at least 30ml/hr
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The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy?a) Large doses of vitamin C during pregnancyb) Prophylactic antibioticsc) Strict aseptic technique, including handwashing, by all health care personneld) Limited protein and fat intake
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Strict aseptic technique, including handwashing, by all health care personnel
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One of the first symptoms of puerperal infection to assess for in the postpartum woman is:a) Fatigue continuing for longer than 1 weekb) Pain with voidingc) Profuse vaginal bleedingd) Temperature of 38 degree C (100.4 F) or higher on 2 successive days starting 24 hours after birth
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Temperature of 38 degree C (100.4 F) or higher on 2 successive days starting 24 hours after birth
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The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:a) Washing the nipples and breasts with mild soap and water once a dayb) Using proper breastfeeding techniquesc) Wearing a nipple shield for the first few days of breastfeedingd) Wearing a supportive bra 24 hours a day
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Using proper breastfeeding techniques
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Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH). For instance:a) PPH is easy to recognize early; after all, the woman is bleedingb) Traditionally, it takes more than 1000ml of blood after vaginal birth and 2500ml after cesarean birth to define the condition as PPHc) If anything, nurses and doctors tend to overestimate the amount of blood lossd) Traditionally, PPH has been classified as early or late with respect to birth
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Traditionally, PPH has been classified as early or late with respect to birth
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Lacerations of the cervix, vagina, or perineum are also causes and incidence of obstetric lacerations of the lower genital tract include all except:a) Operative or precipitate birthb) Adherent retained placentac) Abnormal presentation of the fetusd) Congenital abnormalities of the maternal soft parts
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Adherent retained placenta
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A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. The nurse should suspect __________ and should confirm the diagnosis by _______________.a) Disseminated intravascular coagulation (DIC); asking for laboratory testsb) von Willebrand disease (vWD); noting whether bleeding times have been extendedc) Thrombophlebitis; using real-time and color Doppler ultrasoundd) Thrombocytopenic purpure; drawing blood for laboratory analysis
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Thrombophlebitis; using real-time and color Doppler ultrasound
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It is important for the perinatal nurse to be knowledgeable regaring conditions of abnormal adherence of the placenta. This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta and decidua. Which classification of separation is not recognized as an abnormal adherence pattern?a) Placenta accretab) Placenta incretac) Placenta percretad) Placenta abruptio
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Placenta abruptio
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Medications used to manage postpartum hemorrhage (PPH) include: (choose all that apply)a) Oxytocinb) Metherginec) Terbutalined) Hemabatee) Magnesium sulfate
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Oxytocin, Methergine, Hemabate
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_____________ is the most common postpartum infection
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Endometritis
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A woman gave birth vaginally to a 9lb, 12oz girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath tid, and a stool softener. What information is most closely correlated with these orders?a) The woman is a gravida 2, para 2b) The woman had a vacuum-assisted birthc) The woman received epidural anesthesiad) The woman has an episiotomy
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The woman has an episiotomy
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The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8; hematocrit, 30%. How would the nurse best interpret these data?a) Rubella vaccine should be givenb) A blood transfusion is necessaryc) Rh immune globulin is necessary within 72 hours of birthd) A Kleihauer-Betke test should be performed
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Rubella vaccine should be given
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A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your assessment you notice that both her breasts are swollen, warm, and tender on palpation. The woman should be advised that this condition can best be treated by:a) Running warm water on her breasts during a showerb) Applying ice to the breasts for comfortc) Expressing small amounts of milk from the breasts to relieve pressured) Wearing a loose-fitting bra to prevent nipple irritation
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Applying ice to the breasts for comfort
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A primiparous woman is to be discharged from the hospital tomorrow with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged?a) The woman is disinterested in learning about infant careb) The woman continues to hold and cuddler her infant after she has fed herc) The woman reads a magazine while her infant sleepsd) The woman changes her infants diaper and then shows the nurse the contents of the diaper
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The woman is disinterested in learning about infant care
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Which finding could prevent early discharge of a newborn who is now 12 hours old?a) Birth weight of 3000gb) One meconium stool since birthc) Voided, clear, pale urine three times since birthd) Infant breastfed once with some difficulty with latch and sucking and once with some success for about 5 minutes on each breast
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Infant breastfed once with some difficulty with latch and sucking and once with some success for about 5 minutes on each breast
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What is not a postpartum practice for preventing infections?a) Not letting the mother walk barefoot at the hospitalb) Educating the client to wipe from back to front after voidingc) Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay homed) Instructing the mother to change her perineal pad from front to back each time she voids or defecates
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Educating the client to wip from back to front after voiding
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What is not a reliable indicator of impending shock from early hemorrhage?a) Respirationsb) Blood pressurec) Skin conditiond) Urinary output
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Blood pressure
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Because a full bladder prevents the uterus from contracting normally, nurses intervent to help the woman empty her bladder spontaneously as soon as possible. If all else fails, the last thing the nurse might try is:a) Pouring water from a squeeze bottle over the woman's perineumb) Placing oil of peppermint in a bedpan under the womanc) Asking the physician to prescribe analgesicsd) Inserting a sterile catheter
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Inserting a sterile catheter
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If a woman is at risk for thrombus and is not ready to ambulate, the nurses might intervene by doing all of these interventions except:a) Putting her in antiembolic stockings (TED hose) and/or sequential compression device (SCD) bootsb) Having her flex, extend, and rotate her feet, ankles and legsc) Having her sit in a chaird) Notifying the physician immediately if a positive Homans' sign occurs
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Having her sit in a chair
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With regard to rubella and Rh issues, nurses should be aware that:a) Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virusb) Woman should be warned that the rubella vaccination is teratogenic and they must avoid pregnancy for at least 1 month after vaccinationc) Rh immune globulin is safely administered intravenously because it cannot harm a nursing infantd) Rh immune globulin boosts the immune system and thereby enhances the effectiveness of vaccinations
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Woman should be warned that the rubella vaccination is teratogenic and they must avoid pregnancy for at least 1 month after vaccination
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The ____________________ test is used to detect the amount of fetal blood in the maternal circulation.
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Kleihauer-Betke
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A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this womans fundus?a) At the level of the umbilicusb) Two centimeters below the umbilicusc) Midway between the umbilicus and the symphysis pubisd) Nonpalpable abdominally
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At the level of the umbilicus
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To provide optimum care for the postpartum woman, the nurse understands that teh most common causes of subinvolution are:a) Postpartum hemorrhage and infectionb) Multiple gestation and postpartum hemorrhagec) Uterine tetany and overproduction of oxytocind) Retained placental fragments and infection
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Retained placental fragments and infection
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Which woman is most likely to experience strong afterpains?a) A woman who experienced oligohydramniosb) A woman who is a gravida 4, para 4-0-0-4c) A woman who is bottle feeding her infantd) A woman whose infant weighed 5lb, 3 oz
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A woman who is a gravida 4, para 4-0-0-4
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A woman who gave birth to a health infant boy 5 days ago. What type of lochia does the nurse expect to find when assessing this woman?a) Lochia rubrab) Lochia sangrac) Lochia albad) Lochia serosa
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Lochia serosa
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Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?a) Estrogenb) Progesteronec) Prolactind) Human placental lactogen
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Prolactin
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Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period is:a) Elevated temperature caused by postpartum infectionb) Increased basal metabolic rate after giving birthc) Loss of increased blood volume associated with pregnancyd) Increased venous pressure in the lower extremities
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Loss of increased blood volume associated with pregnancy
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A nurse caring for a postpartum woman understands that breast engorgement is caused by:a) Overproduction of colostrumb) Accumulation of milk in the lactiferous ducts and glandsc) Hyperplasia of mammary tissued) Congestion of veins and lymphatics
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Congestion of veins and lymphatics
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A woman gave birth to a 7lb, 6oz infant girl 1 hour age. The birth was vaginal and the estimated blood loss (EBL) was 1500ml. When assessing the woman's vital signs the nurse is concerned to see:a) Temperature 37.9 C, heart rate 120, respirations 20, blood pressure 90/50b) Temperature 37.4 C, heart rate 88, respirations 36, blood pressure 126/68c) Temperature 38 C, heart rate 80, respirations 16, blood pressure 110/80d) Temperature 36.8 C, heart rate 60, respirations 18, blood pressure 140/90
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Temperature 37.9 C, heart rate 120, respirations 20, blood pressure 90/50
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The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is called the:a) Involutionary period because of what happens to the uterusb) Lochia period because of the nature of the vaginal dischargec) Mini-try period because it lasts only 3 to 6 weeksd) Puerperium, or fourth trimester of pregnancy
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Puerperium, or fourth trimester of pregnancy
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The self-destruction of excess hypertrophied tissue in the uterus is called:a) Autolysisb) Subinvolutionc) Afterpaind) Diastasis
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Autolysis
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With regard to the postpartum uterus, nurses should be aware that:a) At the end of the third stage of labor, it weighs approximately 500gb) After 2 weeks postpartum, it should not be palpable abdominallyc) After 2 weeks postpartum, it wighs 100gd) It returns to its original (prepregnancy) size by 6 weeks postpartum
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After 2 weeks postpartum, it should not be palpable abdominally
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With regard to postpartum ovarian function, nurses should be aware that:a) Almost 75% of women who do not breastfeed resume menstruating within a month after birthb) Ovulation occurs slightly earlier for breastfeeding womenc) Because of menstruation/ovulation schedules, contraception considerations can be postponed until after the puerperiumd) The first menstrual flow after childbirth usually is heavier than normal
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The first menstrual flow after childbirth usually is heavier than normal
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Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium?a) Varicosities of the legsb) Carpal tunnel syndromec) Periodic numbness and tingling of the fingersd) Headaches
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Headaches
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The process in which the uterus returns to a nonpregnant state after birth is known as _______________.
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Involution
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True/FalseChanges in the maternal immune system during the postpartum period account for the profuse diaphoresis that new mothers experience.
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False
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True/FalseClotting factors and fibrinogen levels normally are decreased during pregnancy and remain low in the immediate puerperium. This hypercoagulable state increases the risk of thromboembolism, especially after cesarean birth.
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False
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A woman gave birth to a healthy 7lb, 13 oz infant girl. The nurse suggests that the woman place the infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is effective during the first 30 minutes after birth because this is the:a) Transition periodb) first period of reactivityc) Organization staged) Second period of reactivity
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First period of reactivity
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Part of the health assessment of a newborn is observing the infant's breathing pattern. A full-term newborn's breathing pattern is predominantly:a) Abdominal with synchronous chest movementsb) Chest breathing with nasal flaringc) Diaphragmatic with chest retractiond) Deep with a regular rhythm
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Abdominal with synchronous chest movements
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While assessing a newborn, a nurse should be aware that the average expected apical pulse range of a full-term, quiet, alert newborn is:a) 80 to 100 beats/minb) 100 to 120 beats/minc) 120 to 160 beats/mind) 150 to 180 beats/min
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120 to 160 beats/min
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A newborn is placed under a radiant heat warmer. The nurse knows that thermoregulation presents a problem for newborns because:a) Their renal function is not fully developed for newborns becauseb) Their small body surface area favors more rapid heat loss than does an adult's body surface areac) They have a relatively thin layer of subcutaneous fat that provides poor insulationd) Their normal flexed posture favors heat loss through perspiration
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They have a relatively thin layer of subcutaneous fat that provides poor insulation
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An African-American woman noticed some bruises on her newborn girl's buttocks. She asks the nurse who spanked her daughter. The nurse explains that these marks are called:a) Lanugob) Vascular nevic) Nevus flammeusd) Mongolian spots
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Mongolian spots
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While examining a newborn, the nurse notes uneven skin folds on the buttocks and a clunk when performing the Ortolani maneuver. The nurse recognizes these findings as a sign that the newborn probably has:a) Polydactylyb) Clubfootc) Hip dysplasiad) Webbing
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Hip dysplasia
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A new mother states that her infant must be cold because teh baby's hands and feet are blue. The nurse explains that this is a common and temporary condition called:a) Acrocyanosisb) Erythema neonatorumc) Harlequin colord) Vernix caseosa
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Acrocyanosis
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The nurse assessing a newborn knows that the most critical physiologic change required of the newborn is:a) Closure of fetal shunts in the circulatory systemb) Full function of the immune defense system at birthc) Maintenance of a stable temperatured) Initiation and maintenance of respirations
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Initiation and maintenance of respirations
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A primiparous woman is watching her newborn sleep. She wants him to wake up and respond to her. The mother asks the nurse how much he will sleep every day. The nurses best response to her is:a) He will only wake up to be fed, and you should not bother him between feedingsb) The newborn sleeps about 17 hours a day, with periods of wakefulness gradually increasingc) He will probably follow your same sleep and wake patterns, and you can expect him to be awake soond) He is being stubborn by not waking up when you want him to. You should try to keep him awake during the daytime so that he will sleep through the night
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The newborn sleeps about 17 hours a day, with periods of wakefulness gradually increasing
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The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. The nurse responds to the parents by telling them:a) Infants can see very little until about 3 months of ageb) Infants can track their parents eyes and can distinguish patterns; they prefer complex patternsc) The infants eyes must be protected. Infants enjoy looking at brightly colored stripesd) Its important to shield the newborn's eyes. Overhead lights help them see better
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Infants can track their parents eyes and can distinguish patterns; they prefer complex patterns
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While assessing the integument of a 24 hour old newborn, the nurse notes a pink papular rash with vesicles superimposed on the thorax, back, and abdomen. The nurse should:a) Notify the physician immediatelyb) Move the newborn to an isolation nurseryc) Document the finding as erythema toxicumd) Take the newborn's temperature and obtain a culture of one of the vesicles
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Document the finding as erythema toxicum
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A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket. The mother asks why. The nurses best response is:a) Your baby may lose heat by convection, which means that he will lost heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on himb) Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air form blowing on himc) Your baby may lose hear by evaporation, which menas that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on himd) Your baby will get cold stressed easily and needs to be bundled up at all times
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Your baby may lose heat by convection, which means that he will lost heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him
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The transition period between intrauterine and extrauterine existence for the newborn:a) Consists of four phases, two reactive and two of decreased responsesb) Lasts from birth to 28 days of lifec) Applies to full-term births onlyd) Varies by socioeconomic status and the mother's age
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Lasts from birth to 28 days of life
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All of these statements describe the first stage of the transition period except:a) It lasts no longer than 30 minutesb) It is marked by spontaneous tremors, crying, and head movementsc) It includes the passage of meconiumd) It may involve the infant suddenly sleeping briefly
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It may involve the infant suddenly sleeping briefly
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With regard to the newborn's developing and cardiovascular system, nurses should be aware that:a) The heart rate of a crying infant may rise to 120 beats/minb) Heart murmurs heard after the first few hours are cause for concernc) The point of maximal impulse often is visible on the chest walld) Persistent bradycardia may indicate respiratory distress syndrome
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The point of maximal impulse often is visible on the chest wall
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By knowing about variations in infants' blood counts, nurses can explain to their clients that:a) A somewhat lower than expected red blood cell count could be the result of delay in clamping the umbilical cordb) The early high white blood cell cound is normal at birth and should decrease rapidlyc) Platelet counts are higher than in adults for a few monthsd) Even a modest vitamin K deficiency means a problem with the blood's ability to clot properly
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The early high white blood cell count (WBC) is normal at birth and should decrease rapidly
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What infant response to cool environmental conditions is either not effective or not available to them?a) Constriction of peripheral blood vesselsb) Metabolism of brown fatc) Increased respiratory ratesd) Unflexing from the normal position
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Unflexing from the normal position
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With regard to the functioning of the renal system in newborns, nurses should be aware that:a) The pediatrician should be notified if the newborn has not voided in 24 hoursb) Breastfed infants likely will void more often during the first few days after birthc) "Brick dust" or blood on a diaper is always cause to notify the physiciand) Weight loss from fluid loss and other normal factors should be made up in 4 to 7 daus
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The pediatrician should be notified if the newborn has not voided in 24 hours
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All of these statements about physiologic jaundice are true except:a) Neonatal jaundice is common, but kernicterus is rareb) The appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic processc) Because jaundice may not appear before discharge, parents need instruction on how to assess it and when to call for medical helpd) Breastfed babies have a lower incidence of jaundice
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Breastfed babies have a lower incidence of jaundice
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The cheeselike whitish substance that fuses with the epidermis and serves as a protective coating is called _________________.
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Vernix caseosa
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What marks on a baby's skin may indicate an underlying problem that requires notification of a physician?a) Mongolian spots on the backb) Telangiectatic nevi on the nose or nape of the neckc) Petechiae scattered over the infant's bodyd) Erythema toxicum anywhere on the body
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Petechiae scattered over the infants body
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During life in utero, oxygenation of the fetus occurs through transplacental gas exhange. When birth occurs, four factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows. Which is not one of these essential factors?a) Chemicalb) Mechanicalc) Thermald) Psychologic
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Psychologic
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A collection of blood between the skull bone and its periosteum is known as a cephalhematoma. In order to reassure the new parents whose infant develops such a soft bulge, it is important that the nurse is aware that this condition:a) May occur with spontaneous vaginal birthb) Only happens as the result of a forceps or vacuum-assisted deliveryc) Is present immediately after birthd) Will gradually absorb over the first few months of life
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May occur with spontaneous vaginal birth
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The shivering mechanism of heat production is rarely functioning in the newborn. Nonshivering _____________________ is accomplished primarily by metabolism of brown fat, which is unique to the newborn, and by increased metabolic activity in the brain, heart, and liver.
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Thermogenesis
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An infant boy was born a few minutes ago. The nurse is conducting the intial assessment. Part of the assessment includes the Apgar scores. The Apgar assessment is performed:a) Only if the newborn is in obvious distressb) Once by the obstetrician, just after the birthc) At least twice, 1 minute and 5 minutes after birthd) Every 15 minutes during the newborn's first hour after birth
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At least twice, 1 minute and 5 minutes after birth
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A new father wants to know what the medication was put into his infant's eyes and why it is needed. The nurse explains to the father that the purpose of the erythromycin ophthalmic oitment is to:a) Destroy an infectious exudate caused by Staphylococcus that could make the infant blindb) Prevent gonorrheal and chlamydial infection of the infant's eyes potentially acquired from the birth canalc) Prevent potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyesd) Prevent the infant's eyelids from sticking together and help the infant see
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Prevent gonorrheal and chlamydial infection of the infants eyes potentially acquired from the birth canal
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The nurse administers vitamin K to the newborn for what reason?a) Most mothers have a diet deficient in vitamin K, which results in the infant being deficientb) Vitamin K prevents the synthesis of prothrombin in the liver and must be given by injectionc) Bacteria that synthesize vitamin K are not present in the newborns intestinal tractd) The supply of vitamin K is inadequate for at least 3 to 4 months, and the newborn must be supplemented
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Bacteria that synthesize vitamin K are not present in the newborns intestinal tract
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The nurse is using the New Ballard Scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks?a) Flexed postureb) Abundant lanugoc) Smooth, pink skin with visible veinsd) Faint red marks on the soles of the feet
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Flexed posture
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A newborn is jaundiced and is receiving phototherapy via ultraviolet lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method is to:a) Apply an oil-based lotion to the newborn's skin to prevent drying and crackingb) Limit the newborn's intake of milk to prevent nausea, vomiting and diarrheac) Place eye shields over the newborns closed eyesd) Change the newborns position every 4 hours
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Place eye shields over the newborns closed eyes
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Early this morning an infant boy was circumcised using the PlastiBell method. The nurse tells the mother that she and the infant can be discharged after:a) The bleeding stops completelyb) Yellow exudate forms over the glansc) The PlastiBell rim falls offd) The infant voids
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The infant voids
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A mother is changing the diaper of the newborn son. She notices that his scrotum appears large and swollen. She asks the nurse, "What is that?" The best response from the nurse is:a) This is a hydrocele, which is a common findings in newborn males. The swelling usually decreases without interventionb) I dont know, but I'm sure its is nothingc) Your baby might have testicular cancerd) Your baby's urine is backing up into his scrotum
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This is a hydrocele, which is a common finding in newborn males. The swelling usually decreases without intervention
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As part of standard precautions, nurses wear gloves when handing the newborn. The chief reason is:a) To protect the baby from infectionb) It is part of the Apgar scorec) To protect the nurse from contamination by the newbornd) Because the nurse has primary for the baby during the first 2 hours
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To protect the nurse from contamination by the newborn
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At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats/min, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. The nurse calculates an Apgar score of:a) 4b) 5c) 6d) 7
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5
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In the classification of newborns by gestational age and birth weight, the appropriate-for-gestational age (AGA) weight:a) Falls between the 25th and 75th percentiles for the infant's ageb) Depends on the infant's length and the size of the headc) Falls between the 10th and 90th percentiles for the infants aged) Is modified to consider intrauterine growth restriction (IUGR)
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Falls between the 10th and 90th percentiles for the infants age
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During the complete physical examination 24 hours after birth:a) The parents are excused to reduce their normal anxietyb) The nurse can gauge the neonates maturity level by assessing his or her general appearancec) Once often neglected, blood pressure is not routinely checkedd) When the nurse listens to the heart, the S1 and S2 sounds can be heard; the first sound is somewhat higher in pitch and sharper than the second
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The nurse can gauge the neonates maturity level by assessing his or her general appearance
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Nurses can help parents deal with the issue and fact of circumcision if they explain:a) The pros and cons of the procedure during the prenatal periodb) That the american academy of pediatrics recommends that all newborn males be routinely circumcisedc) That circumcision is rarely painful and that any discomforts can be managed without medicationd) That the infant will likely be alert and hungry shortly after the procedure
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The pros and cons of the procedure during the prenatal period
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An assessment tool for pain in newborns uses the acronym CRIES to identify behavioral indicators of pain. In the acronym:a) R stands for requiring more medicationb) I stands for increased vital signsc) E stands for eliminationd) S stands for sleepiness
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I stands for increased vital signs
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Although most blood specimens are drawn by laboratory technicians, nurses may be required to perform heelsticks to obtain blood for glucose monitoring or newborn screening. The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. To prevent this problem the stick should be made:a) At the outer aspect of the heelb) On the walking surface of the heelc) In the ball of the footd) In the area just below the fifth tow
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At the outer aspect of the heel
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The normal term infant has little difficulty clearing its airway after birth. Most secretions are brought up to the oropharynx by the cough reflex. However, if the infant has excess secretions, the mouth and nasal passages can easily be cleared with a bulb syringe. When instructing parents on the correct use of this piece of equipment, it is important that the nurse teach them to:a) Avoid suctioning the naresb) Insert the compressed bulb into the center of the mouthc) Suction the mouth firstd) Remove the bulb syringe from the crib when finished
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Suction the mouth first
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As part of the infant discarge teaching, the nurse is reviewing the use of the infant car safety seat. The nurse is teaching that:a) Infant carriers are fine until an infant car safety seat can be purchasedb) For traveling on airplanes, buses, and trains, infant carriers are satisfactoryc) Infant car safety seats are used for infants only from birth to 15 poundsd) Infant car seats should be rear facing and placed in the back seat of the car
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Infant car seats should be rear facing and placed in the back seat of the car
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Parents lost their first child to sudden infant death syndrome (SIDS). Therefore, you are teaching then infant CPR. You know they are knowledgeable when they demonstrate infant CPR compressions of ______ per minute.a) 50b) 75c) 100d) 125
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100
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A woman has chosen the calendar method of conception control. During the assessment process, it is most important that the nurse:a) Obtain a history of menstrual cycle lengths for the past 6 to 12 monthsb) Determine the client'w weight gain and loss pattern for the previous yearc) Examine skin pigmentation and hair texture for hormonal changesd) Explore the client's previous experiences with conception control
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Obtain a history of menstrual cycle lengths for the past 6 to 12 months
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A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). The nurse's most appropriate reply is:a) They're not very effective, and its very likely you'll get pregnantb) They can be effective for many couples, but they require motivationc) These methods have a few advantages and several health risksd) You would be much safer going on the pill and not having to worry
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They can be effective for many couples, but they require motivation
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A woman who has just undergone a first-trimester abortion will be using oral contraceptives. To protect against pregnancy, she should be advised to:a) Avoid sexual contact for at least 10 days after starting the pillb) Use condoms and foam for the first few weeks as backupc) Use another method of contraception for 1 week after starting the pilld) Begin sexual relations once vaginal bleeding has ended
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Use another method of contraception for 1 week after starting the pill
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A woman currently uses a diaphragm and spermicide for contraception. She asks the nurse what the major differences are between the cervical cap and diaphragm. The nurse's most appropriate response is:a) No spermicide is used with the cervical cap, so its less messyb) The diaphragm can be left in place longer after intercousec) Repeated intercourse with the diaphragm is more convenientd) The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later
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The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide
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An unmarried young woman describes her sex life as "active" and involving "many" partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). The nurse's most appropriate response is:a) The IUD does not interfere with sexb) The risk of pelvic inflammatory disease will be higher for youc) The IUD will protect you from sexuall transmitted infectionsd) Pregnancy rates are high with the IUDs
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The risk of pelvic inflammatory disease will be higher for you
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A woman will be taking oral contraceptives using a 28 day pack. The nurse should advise this woman to protect against pregnancy by:a) Limiting sexual contact for one cycle after starting the pillb) Using condoms and foam instead of the pill for as long as she takes an antibioticc) Taking one pill at the same time every dayd) Thworing away the pack and using a backup method if she misses two pills during week 1 of her cycle
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Taking one pill at the same time every day
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Although reported in small numbers, toxic shock syndrome can occur with the use of a diaphragm. If a client is interested in this form of conception control, the nurse should teach the woman how to reduce her risk of TSS. The nurse might say:a. “You should always remove your diaphragm 6 to 8 hours after intercourse. Don’t use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4º C, hypotension, and a rash.”b. “You should remove your diaphragm right after intercourse to prevent TSS.”c. “It’s okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly first to prevent TSS.”d. “Make sure you don’t leave your diaphragm in for longer than 24 hours, or you may get TSS.” |
You should always remove your diaphragm 6 to 8 hours after intercourse. Don't use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash |
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Which contraceptive method best protects against sexually transmitted infections and HIV?a) Periodic abstinenceb) Barrier methodsc) Hormonal methodsd) They all offer about the same protection
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Barrier methods
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With regard to the use of intrauterine devices (IUDs), nurses should be aware that:a) Return to fertility can take several weeks after the device is removedb) IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercoursec) IUDs offer the same protection against sexually transmitted infections as the diaphragmd) Consent forms are not needed for IUD insertion
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IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse
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Which statement is the most complete and accurate description of medical abortions?a) They are performed only for maternal healthb) They can be achieved through surgical procedures or with drugsc) They are mostly performed in the second trimesterd) They can be either elective or therapeutic
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They can be either elective or therapeutic
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A new mother asks the nurse when the "soft spot" on her son's head will go away. The nurse's answer is based on the knowledge that the anterior fontanel closes after birth by:a) 2 monthsb) 8 monthsc) 12 monthsd) 18 months
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18 months
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When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:a) Lieb) Presentationc) Attituded) Position
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Attitude
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When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, moveable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother's right side close to midline. What is the likely position of the fetus?a) ROAb) LSPc) RSAd) LOA
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RSA
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What position is least effective when gravity is desired to assist in fetal descent?a) Lithotomyb) Kneelingc) Sittingd) Walking
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Lithotomy
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The nurse recognizes that a woman is in true labor when she states:a) I passed some thick, pink mucus when I urinated this morningb) My bag of waters just brokec) The contractions in my uterus are getting stronger and closer togetherd) My baby dropped, and I have to urinate more frequently now
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The contractions in my uterus are getting stronger and closer together
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The nurse has received a report about a woman in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. The nurse's interpretation of this assessment is that:a) The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spinesb) The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spinesc) The cervix is effaced 3 cm, it is dilated 30%, and the presenting parts is 2cm below the ischial spinesd) The cervix is dilated 3cm, it is effaced 30%, and the presenting part is 2cm below the ischial spines
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The cervix is 3cm dilated, it is effaced 30%, and the presenting part is 2cm above the ischial spines
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A pregnant woman is at 38 weeks of gestation. She wants to know is any signs indicate "labor is getting closer to starting." The nurse informs the woman that which of the following is a sign that labor may begin soon?a) Weight gain of 1.5 to 2kg (3-4lb)b) Increase in fundal heightc) Urinary retentiond) Surge of energy
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Surge of energy
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To adequately care for a laboring woman, the nurse should know which stage of labor varies the most in length?a) Firstb) Secondc) Thirdd) Fourth
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First
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The nurse expects which maternal cardiovascular finding during labor?a) Increased cardiac outputb) Decreased pulse ratec) Decreased white blood cell (WBC) countd) Decreased blood pressure
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Increased cardiac output
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The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:a) Passengerb) Passagewayc) Powersd) Pressure
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Pressure
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To provide the necessary assessment of parent education, the nurse must know which bone is not a bone in the fetal skull?a) Parietalb) Temporalc) Fontaneld) Occipital
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Fontanel
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The slight overlapping of cranial bones or shaping of the fetal head during labor is called:a) Lighteningb) Moldingc) Ferguson reflexd) Valsalva maneuver
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Molding
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Regarding how the fetus moves through the birth canal, nurses should be aware that:a) The fetal attitude describes the angle at which the fetus exits the uterusb) Of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the motherc) The normal attitude of the fetus is called general flexiond) The transverse lie is preferred for vaginal birth
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The normal attitude of the fetus is called general flexion
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A woman's position is very important in the progress of labor. While discussing optimal positioning, maternity nurses should be able to tell the client that:a) The supine position commonly used increases blood flowb) The "all fours" position, on her hands and knees, is hard on her backc) Frequent changes in position help relieve her fatigue and increase her comfortd) In a sitting or squatting position her abdominal muscles will have to work harder
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Frequent changes in position help relieve her fatigue and increase her comfort
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Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth. These changes occur naturally during labor and include all except:a) Fetal lung fluid is cleared from the air passages during labor and vaginal birthb) Fetal oxygen pressure decreases (PO2)c) Fetal arterial carbon dioxide increases (PCO2)d) Fetal respiratory movements increase during labor
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Fetal respiratory movements increase during labor
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Which description of the four stages of labor is correct for both definition and duration?a) First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hoursb) Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hoursc) Third stage: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first-timer)d) Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour
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First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
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With regard to the turns and other adjustments of the fetus during the birth process, known as the mechanism of labor, nurses should be aware that:a) The seven critical movements must progress in a more or less orderly sequenceb) Asynclitism sometimes is achieved by means of the Leopold maneuverc) The effects of the forces determining descent are modified by the shape of the woman's pelvis and the size of the fetal headd) At birth the baby is said to achieve "restitution:; that is, a return to the C-shape of the womb
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The effects of the forces determining descent are modified by the shape of the woman's pelvis and the size of the fetal head
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A womans obstetric history indicates that she is pregnant for the fourth time, and all her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?a) 3-1-1-1-3b) 4-1-2-0-4c) 3-0-3-0-3d) 4-2-1-0-3
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4-1-2-0-4
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A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely has:a) Amenorrheab) Positive pregnancy testc) Chadwick signd) Hegar sign
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Amenorrhea
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A woman is at 14 weeks of gestation. The nurse expects to palpate the fundus at which level?a) Not palpable above the symphysis pubis at this timeb) Slightly above the symphysis pubisc) At the level of the umbilicusd) Slightly above the umbilicus
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Slightly above the symphysis pubis
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The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?a) Her center of gravity will shift backwardb) She will have increased lordosisc) She will have increased abdominal muscle toned) She will notice decreased mobility of her pelvic joints
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She will have increased lordosis
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A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:a) This is a normal respiratory change in pregnancy caused by elevated levels of estrogenb) This is an abnormal cardiovascular change and the nosebleeds are an ominous signc) The woman is a victim of domestic violence and is being hit in the face by her partnerd) The woman has been using cocaine intranasally
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This is a normal respiratory change in pregnancy caused by elevated levels of estrogen
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In order to reassure and educate pregnant clients about changes in their breasts, nurses should be aware that:a) The visibility of blood vessels that form an intertwinning blue network indicates full function of Montgomery's tubercles and possibly infection of the tuberclesb) The mammary glands do not develop until 2 weeks before laborc) Lactation is inhibited until the estrogen level declines after birthd) Colostrum is the yellowish oile substance used to lubricate the nipples for breastfeeding
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Lactation is inhibited until the estrogen level declines after birth
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A nurse is caring for a pregnant client must understand that the hormone essential for maintaining pregnancy is:a) Estrogenb) Human chorionic gonadotropin (hCG)c) Oxytocind) Progesterone
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Progesterone
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A nurse providing care to a pregnant woman should know that all are normal gastrointestinal changes in pregnancy except:a) Ptyalismb) Pyrosisc) Picad) Decreased peristalsis
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Pica
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Appendicitis may be difficult to diagnose in pregnancy because the appendix is:a) Displaced upward and laterally, high and to the rightb) Displaced upward and laterally, high and to the leftc) Deep at McBurney's pointd) Displaced downward and laterally, low and to the right
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Displaced upward and laterally, high and to the right
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In order to reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that:a) A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia, requires close medical and obstetric observation no matter how healthy she otherwise may appearb) Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to termc) Palpitations are twice as likely to occur in twin gestationsd) All of the above changes likely will occur
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Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term
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Probable signs of pregnancy are:a) Determined by ultrasoundb) Observed by the health care providerc) Reported by the clientd) Diagnostic tests
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Observed by the health care provider
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Which time-based description of a stage of development in pregnancy is accurate?a) Viability - 22 to 37 weeks since the last menstrual period (assuming a fetal weight greater than 500g)b) Term - pregnancy from the beginning of week 38 of gestation to the end of week 42c) Preterm - pregnancy from 20 to 28 weeksd) Postdate - pregnancy that extends beyond 38 weeks
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Term - pregnancy from the beginning of week 38 of gestation to the end of week 42
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Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and therefore the basis for many tests. A maternity nurse should be aware that:a) hCG can be detected as early as 2.5 weeks after conceptionb) The hCG level increases gradually and uniformly throughout pregnancyc) Much lower than normal increases in the level of hCG may indicate a postdate pregnancyd) A higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome
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A higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome
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In order to reassure and educate pregnant clients about changes in the uterus, nurses should be aware that:a) Lightening occurs near the end of the second trimester as the uterus rises into a different positionb) The woman's increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softeningc) Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercised) The uterine souffle is the movement of the fetus
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The womans increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused nby softening
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The mucous plug that forms in the endocervical canal is called the:a) Operculumb) Leukorrheac) Funic souffled) Ballottement
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Operculum
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Some pregnant clients may complain of changes in their voice and impaired hearing. The nurse can tell these clients that these are common reactions to:a) A decreased estrogen levelb) Displacement of the diaphragm, resulting in thoracic breathingc) Congestion and swelling, which occur because the upper respiratory tract has become more vasculard) Increased blood volume
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Congestion and swelling, which occur because the upper respiratory tract has become more vascular
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In order to reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:a) Increased urinary output makes pregnant women less susceptible to urinary infectionb) Increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost emptyc) Renal (kidney) function is more efficient when the woman assumes a supine positiond) Using diuretics during pregnancy can help keep kidney function regular
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Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even if the bladder is almost empty
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A pregnant woman tells her nurse that she is worried about the blotchy, brownish coloring over the cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal change, commonly called the mask of pregnancy or, scientifically:a) Chloasmab) Linea nigrac) Striae gravidarumd) Palmar erythema
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Chloasma
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Which statement about a condition of pregnancy is accurate?a) Insufficient salivation (ptyalism) is caused by increases in estrogenb) Acid indigestion (pyrosis) begins early but declines throughout pregnancyc) Hyperthyroidism often develops (temporarily) because hormone production increasesd) Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial
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Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial
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A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the client that this type of contraction:a) Is painlessb) Increases with walkingc) Causes cervical dilationd) Impedes oxygen flow to the fetus
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Is painless
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In order to reassure and educate pregnant clients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that:a) Because of a number of changes in the cervix, abnormal Pap tests are much easier to evaluateb) Quickening is a technique of palpating the fetus engage it in passive movementc) the deepening color of the vaginal mucose and cervix (Chadwick sign) usually appears in the second trimester or later as the vagina prepares to stretch during labord) Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester
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Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester
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______________ is when the fetus begins to descend and drop into the pelvis.
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Lightening
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Which nutrient's recommended dietary allowance (RDA) is higher during lactation than during energy?a) Energyb) Ironc) Vitamin Ad) Folic acid
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Energy
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A pregnant woman's diet consists almost entirely of whole grain breads and cereals fruits, and vegetables. The nurse is most concerned about this woman's intake of:a) Calciumb) Proteinc) Vitamin B12d) Folic acid
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Vitamin B12
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Which statement made by a lactating woman leads the nurse to believe that the woman might have lactose intolerance?a) I always have heartburn after I drink milkb) If I drink more than a cup of milk, I usually have abdominal cramps and bloatingc) Drinking milk usually makes me break out in hivesd) Sometimes I notice that I have bad breath after I drink a cup of milk
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If I drink more than a cup of milk, I usually have abdominal cramps and bloating
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A pregnant woman's diet history indicates that she likes the following. The nurse encourages this woman to consume more of which food in order to increase her calcium intake?a) Fresh apricotsb) Canned clamsc) Spaghetti with meat sauced) Canned sardines
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Canned sardines
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A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She can expect the following advice: a) Discontinue all contraception nowb) Lose weight so that you can gain more during pregnancyc) You may take any medications you have been taking regularlyd) Make sure you include adequate folic acid in your diet
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Make sure you include adequate folic acid in your diet
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To prevent gastrointestinal (GI) upset, clients should be instructed to take iron supplements:a) On a full stomachb) At bedtimec) After eating a meald) With milk
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At bedtime
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After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so that you can assess her understanding of the instructions given. Which statement indicates that she understands the role of protein in her pregnancy?a) Protein will help my baby growb) Eating protein will prevent me from becoming anemixc) Eating protein will make my baby have strong teeth after he is bornd) Eating protein will prevent me from being diabetic
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Protein will help my baby grow
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Pregnant adolescents are at high risk for ______________ due to lower body mass indexes (BMI) and fad dieting.a) Obesityb) Gestational diabetesc) Low-birth-weight babiesd) High-birth weight babies
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Low-birth-weight babies
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Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy because:a) It is very difficult to adjust because of people's ingrained eating habitsb) It is am important preventive measure for a variety of problemsc) Women love obsessing about their weight and dietsd) A woman's preconception weight becomes irrelevant
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It is an important preventive measure for a variety of problems
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With regard to weight gain during pregnancy, maternity nurses should know that:a) In this case, the woman`s height is not a factor in determining her target weightb) Obese women may have their health concerns, but their risk of giving birth to a child with major congenital defects is the same as with normal-weight womenc) Women with inadequate weight gain have an increased risk of delivering an infant with IUGRd) Greater than expected weight gain during pregnancy is almost always due to old-fashioned overeating
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Women with inadequate weight gain have an increased risk of delivering an infant with IUGR
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Which nutritional recommendation about fluids is accurate?a) A woman's daily intake should be six to eight glasses of water, milk, and/or juiceb) Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worryc) Of the articifial sweeteners, only aspartame has not been associated with any maternity health concernsd) Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay
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A womans daily intake should be six to eight glasses of water, milk, and/or juice
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Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet?a) Fat-soluble vitamins A and Db) Water-soluble vitamins C and B6c) Iron and folated) Calcium and zinc
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Iron and folate
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Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother?a) Zincb) Vitamin Dc) Folic acidd) Vitamin A
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Vitamin A
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While taking a diet history the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. This represents a nutritional problem known as:a) Preeclampsiab) Pyrosisc) Picad) Purging
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Pica
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Assessment of a woman's nutritional status includes a diet history, medication regimen, physical examination, and relevant laboratory tests. A maternity nurse performing such an assessment should be aware that:a) Oral contraceptive use may interfere with the absorption of ironb) Illnesses that have created nutritional deficits, such as phenylketonuria (PKU), may require nutritional care before conceptionc) The woman's socioeconomic status and educational level are not relevant to her examination; they are the province of the social workerd) The only nutrition-related laboratory test most pregnant women need is testing for diabetes
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Illnesses that have created nutritional deficits, such as phenylketonuria (PKU), may require nutritional care before conception
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To help a woman reduce the severity of nausea caused by morning sickness, the nurse might suggest that she:a) Try a tart food or drink, such as lemonade, or salty foods, such as potato chipsb) Drink plenty of fluids early in the dayc) Brush her teeth immediately after eatingd) Never snack before bedtime
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Try a tart food, or drink, such as lemonade, or salty foods, such as potato chips
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A nurse caring for a newly pregnant woman advises her tha ideally prenatal care should begin:a) Before the first missed menstrual periodb) After the first missed menstrual periodc) After the second missed menstrual periodd) After the third missed menstrual period
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after the first missed menstrual period
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A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was Feb 14th, 2011. Her expected date of birth (EDB) is:a) September 17th, 2011b) November 7th, 2011c) November 21st, 2011d) December 17, 2011
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November 21st 2011
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Prenatal testing for the human immunodeficiency virus (HIV) is recommended for which women?a) All women, regardless of risk factorsb) A woman who has had more than one sexual partnerc) A woman who has had a sexually transmitted infectiond) A woman who is monogamous with her partner
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All women, regardless of risk factors
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Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider?a) Nausea with occasional vomitingb) Fatiguec) Urinary frequencyd) Vaginal bleeding
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Vaginal bleeding
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A nurse should advise which women about continued condom use during pregnancy?a) Unmarried pregnant womenb) Women at risk for acquiring or transmitting sexually transmitted infections (STIs)c) All pregnant womend) Women at risk for candidiasis
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Women at risk for acquiring or transmitting sexually transmitted infections (STIs)
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A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild to moderate intensity. The nurse recommends that she:a) Do Kegel exercisesb) Do pelvic rock exercisesc) Use a softer mattressd) Stay in bed for 24 hours
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Do pelvic rock exercises
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For what reason is breastfeeding contraindicated?a) Hepatitis Bb) Everted nipplesc) History of breast cancer 3 years agod) HIV positive
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HIV positive
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A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she doesn't know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate?a) Don't worry about it; you'll feel better in a month or sob) Have you talked to your husband about how you feelc) Perhaps you really dont want to be pregnantd) Hormone changes during pregnancy commonly result in mood swings
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Homone changes during pregnancy commonly result in mood swings
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A nurse should be aware that a partner's main role in pregnancy is:a) To provide financial supportb) To protect the pregnant woman from "old wives tales"c) To support and nurture the pregnant womand) To make sure the pregnant woman keeps prenatal appointments
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To support and nurture the pregnant woman
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During the first trimester a woman can expect which of the following changes in her sexual desire?a) An increase, because of enlarging breastsb) A decrease, because of nausea and vomitingc) No changed) An increase, because of increased levels of female hormones
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A decrease, because of nausea and vomiting
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In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have on purpose in common. Which statement best describes that purpose?a) To promote family unityb) To ward off the "evil eye"c) To appease the gods of fetilityd) To protect the mother and fetus during pregnancy
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To protect the mother and fetus during pregnancy
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Which statement about pregnancy is accurate?a) A normal pregnancy lasts about 10 lunar monthsb) A trimester is one third of a yearc) The prenatal period extends from fertilization to conceptiond) The estimated date of confinement is how long the mother will have to be bedridden after birth
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A normal pregnancy lasts about 10 lunar months
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With regard to a woman's reordering of personal relationships during pregnancy, the maternity nurse should be aware that:a) Because of the special motherhood bond, a woman's relationship with her mother is even more important than with the father of the childb) Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each otherc) Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the fatherd) The woman's sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier
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Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father
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With regard to the initial physical exam of a woman beginning prenatal care, maternity nurses should be aware that:a) Only women who show physical signs or meet the sociologic profile should be assessed for physical abuseb) The woman should empty her bladder before the pelvic examinationc) The distribution, amount, and quality of body hair are of no particular importanced) The size of the uterus is discounted in the initial examination because it is just going to get bigger soon
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The woman should empty her bladder before the pelvic examination
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A woman who is 16 weeks pregnant has come in for a follow-up visit with her significant other. In order to reassure the client regarding fetal well-being it is best for the nurse to:a) Assess the fetal heart tones with a Doppler stethoscopeb) Measure the girth of the woman's abdomenc) Complete an ultrasound examination (sonogram)d) Offer then woman and her family the opportunity to listen to the fetal heart tones
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Offer then woman and her family the opportunity to listen to the fetal heart tones
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When instructing a pregnant client regarding personal hygiene, it is important for a maternity nurse to be aware that:a) Tub bathing is permitted even in late pregnancy unless membranes have rupturedb) The perineum should be wiped from back to frontc) Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bathd) Expectant mothers should use specially treated soap to cleanse the nipples
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Tub bathing is permitted even in late pregnancy unless membranes have ruptured
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The nurse should be aware that the "pinch" test is used to:a) Check the sensitivity of the nipplesb) Determine whether the nipple is everted or invertedc) Calculate the adipose buildup in the abdomend) See whether the fetus has become inactive
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Determine whether the nipple is everted or inverted
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Many pregnant women have questions regarding work and travel during pregnancy. Nurses should instruct clients that:a) Women should sit for as long as possible and cross their legs at the knees from time to time for exerciseb) Women should avoid seat belts and shoulder restraints in the car because they press on the fetusc) Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of timesd) While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so
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While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so
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True/FalsePregnant women who become ill with seasonal respiratory influenza (flu) are more likely than other persons to develop serious complications, such as pneumonia.
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True
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True/FalseAn obese woman who has become pregnant is at the same risk for delivering an infant with congenital anomalies as a woman who is not obese.
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False
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An 18 year old pregnant woman, gravida 1, is admitted to the labor and birth unit whith moderate contractions every 5 minutes that last 40 seconds. The woman states, "My contractions are so strong, I don't know what to do." The nurse should:a) Assess for fetal well-beingb) Encourage the woman to lie on her sidec) Disturb the woman as little as possibled) Recognize that pain is personalized for each individual
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Recognize that pain is personalized for each individual
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A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively; she states that she did not attend childbirth classes. The most important nursing action is to:a) Notify the woman's health care providerb) Administer the prescribed narcotic analgesicc) Assure her that her labor will be over soond) Assist her with simple breathing and relaxation instructions
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Assist her with simple breathing and relaxation techniques
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Nursing care measures are commonly offered to women in labor. Which nursing measure reflects application of the gate-control theory?a) Massage the woman's backb) Change the woman's positionc) Give the prescribed medicationd) Encourage the woman to rest between contractions
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Massage the woman's back
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Breathing patterns are taught to laboring women. Which breathing pattern would the nurse support for the woman and her coach during the latent phase of the first stage of labor if the couple had attended Lamaze classesa) Slow-paced breathingb) Deep abdominal breathingc) Modified-paced breathingd) Patterned-paced breathing
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Slow-paced breathing
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If an opioid antagonist is administered to a laboring woman, she should be told:a) Her pain will decreaseb) Her pain will returnc) She will feel less anxiousd) She will no longer feel the urge to push
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Her pain will return
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A woman has requested an epidural for her pain. She is 5cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Prior to initiation of the epidural the woman should be informed regarding the disadvantages of an epidural block. They include all except:a) Ability to move freely is limitedb) Orthostatic hypotension and dizzinessc) Gastric emptying is not delayedd) Higher rate of fever
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Gastric emptying is not delayed
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Your client is in early labor, and you are discussing the pain relief options she is considering. She states that she wants an epidural "no matter what!" Your best response is:a) Ill make sure you get your epiduralb) You may only have an epidural if your doctor allows itc) You may only have any epidural if you are going to deliver vaginallyd) The type of analgesia or anesthesia used is determined in part by the stage of your labor and the method of birth
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The type of analgesia or anesthesia used to determined in part by the stage of your labor and the method of birth
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The role of the nurse with regard to informed consent is to:a) Inform the client about the procedure and have her sign the consent formb) Act as a client advocate and help clarify the procedure and the optionsc) Call the physician to see the clientd) Witness the signing of the consent form
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Act as a client advocate and help clarify the procedure and the options
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A first-time mother is concerned about the type of medications she will receive during labor. She is in a fair amount of pain and is nauseated. Additionally she appears to be very anxious. You explain that opioid analgesics often are used with sedatives because:a) The two together work the best for you and your babyb) Sedatives help the opioid work better, and they will help relax you and relieve your nauseac) They work better together so you can sleep until you have the babyd) This is what the doctor has ordered for you
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Sedatives help the opioid work better, and they will help relax you and relieve your nausea
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In order to help clients manage discomfort and pain during labor, nurses should be aware that:a) The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomenb) Referred pain is the extreme discomfort between contractionsc) The somatic pain of the second stage of labor is more generalized and related to fatigued) Pain during the third stage is a somewhat milder version of the second stage
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The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen
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With regard to a pregnant woman's anxiety and pain experience, nurses should be aware that:a) Even mild anxiety must be treatedb) Severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety, and so onc) Anxiety may increase the perception of pain, but it does not affect the mechanism of labord) Women who have had a painful labor will have learned from the experience and have less anxiety the second time because of increased familiarity
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Severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety, and so on
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Nurses should be aware that all reputable childbirth methods attempt to meet all these goals except;a) Increase the woman's sense of controlb) Prepare a support person to help in laborc) Guarantee a pain-free childbirthd) Learn distraction techniques
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Guarantee a pain-free childbirth
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A woman in labor is breathing into a mouthpiece just before the start of her regular contractions. As she inhales, a valce opens and gas is released. She continues to inhale the gas slowly and deeply until the contraction starts to subside. When the inhalation stops, the valve closes. This procedure is:a) Not used much anymoreb) Likely to be used in the second stage of labor but not in the first stagec) An application of nitrous oxided) A prelude to cesarean birth
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An application of nitrous oxide
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During anesthetic management of the morbidly obese woman in labor, the nurse must remain alert for complications specific to this type of client. Which is not a concern for the L&D nurse?a) Failed epidural placementb) Accidental dural puncturec) Inadequate pain reliefd) Difficult intubation
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Inadequate pain relief
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Todays pregnant woman has a number of nonpharmacologic measures available to assist with pain relief in labor. One such measures involves the application of heat, cold, or pressure to specific areas of the body and is known as _________________.
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Acupressure
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A nurse is caring for a laboring woman is cognizant that early decelerations are caused by:a) Altered fetal cerebral blood flowb) Umbilical cord compressionc) Uteroplacental insufficiencyd) Spontaneous rupture of membranes
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Altered fetal cerebral blood flow
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Fetal tachycardia is most common during:a) Maternal feverb) Umbilical cord prolapsec) Regional anesthesiad) Magnesium sulfate administration
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Maternal fever
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While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The nurse's first priority is to:a) Change the womans positionb) Notify the health care providerc) Assist with amnioinfusiond) Insert a scalp electrode
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Change the woman's position
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The nurse providing care for the laboring woman understands that variable fetal heart rate (FHR) decelerations are cause by:a) Altered fetal cerebral blood flowb) Umbilical cord compressionc) Uteroplacental insufficiencyd) Fetal hypoxemia
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Umbilical cord compression
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The nurse providing care for a high risk laboring woman is alert for late fetal heart rate (FHR) decelerations. These late decelerations may be caused by:a) Altered cerebral blood flowb) Umbilical cord compressionc) Uteroplacental insufficiencyd) Meconium fluid
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Uteroplacental insufficiency
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A nurse providing care for a laboring woman understands that amnioinfusion is used to treat:a) Variable decelerationsb) Late decelerationsc) Fetal bradycardiad) Fetal tachycardia
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Variable decelerations
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Which fetal heart rate (FHR) finding concerns the nurse during labor?a) Accelerations with fetal movementb) Early decelerationsc) An average FHR of 126 beats/mind) Late decelerations
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Late decelerations
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What three measures should the nurse implement to provide intrauterine resuscitation? Select the best response that indicates the priority of actions that should be taken, starting with the most important.a) Call the provider, reposition the mother, and perform a vaginal examb) Provide oxygen via face mask, reposition the mother, and increase IV fluidsc) Administer oxygen to the mother, increase IV fluid, and notifty the health care providerd) Perform a vaginal examination, reposition the mother, and provide oxygen via face mask
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Provide oxygen via face mask, reposition the mother, and increase IV fluid
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A nurse caring for a woman in labor understands that maternal hypertension can result in: a) Early decelerationb) Fetal arrhythmiasc) Uteroplacental insufficiencyd) Spontaneous rupture of membranes
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Uteroplacental insufficiency
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Perinatal nurses are legally responsible for:a) Correctly interpreting fetal heart rate (FHR) patterns, initiating appropriate nursing interventions, and documenting the outcomesb) Greeting the client on arrival, assessing her, and starting an IV linec) Applying the external fetal monitor and notifying the health care providerd) Making sure the woman is comfortable
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Correctly interpreting fetal heart rate (FHR) patterns, initiating appropriate nursing interventions, and documenting the outcomes
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As a perinatal nurse, you realize that a fetal heart rate (FHR) that is tachycardic, bradycardic, has safe decelerations, or loss of variability is nonreassuring and is associated with:a) Hypotensionb) Cord compressionc) Maternal drug used) Hypoxemia
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Hypoxemia
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A normal uterine activity pattern in labor is characterized by:a) Contractions every 2 to 5 minutesb) Contractions lasting about 2 minutesc) Contractions about 1 minute apartd) A contraction intensity of about 500mm Hg with relaxation at 50mm Hg
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Contractions every 2 to 5 minutes
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When usint intermittent auscultation (IA) for a fetal heart rate, nurses should be aware that:a) They can be expected to cover only two or three clients when IA is the primary method of fetal assessmentb) The best course is to use the descriptive terms associated with electronic fetal monitoring when documenting resultsc) If the heartbeat cannot be found immediately, a shift must be made to electronic monitoringd) Ultrasound can be used to find the FHR and reassure the mother if initial difficulty was a factor
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Ultrasound can be used to find the FHR and reassure the mother if initial difficulty was a factor
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What is an advantage of external electronic fetal monitoring?a) The ultrasound transducer can accurately measure short-term variability and beat-to-beat changes in the fetal heart rateb) The tocotransducer can measure and record the frequency, regularity, intensity, and approximate duration of uterine contractions (UCs)c) The tocotransducer is especially valuable for measuring uterine activity during the first stage of labord) Once correctly applied by the nurse, the transducer need not be repositioned even when the woman changes positions
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The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor
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When assessing the relative advantages of internal fetal monitoring (EFM), nurses should be cognizant of which of the following clients is not an appropriate choice for this type of fetal surveillance?a) A client who still has intact membranesb) A woman whose fetus is well engaged in the fetusc) A pregnant woman who has a comorbidity of obesityd) A client whose cervix is dilated to 4 to 5 cm
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A client who still has intact membranes
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During labor a fetus with an average fetal heart rate of 135 beats/min over a 10-minute period is considered to have:a) Bradycardiab) A normal baseline heart ratec) Tachycardiad) Hypoxia
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A normal baseline heart rate
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A nurse caring for a woman in labor should understand that absent or minimal variability is classified as either abnormal or indeterminate. Which condition related to decreased variability is considered benign?a) A periodic fetal sleep stateb) Extreme prematurityc) Fetal hypoxemiad) Preexisting neurologic injury
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A periodic fetal sleep state
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Nurses should be aware that accelerations in the fetal heart rate:a) Are indications of fetal well-being when they are periodicb) Are greater and longer in preterm gestationsc) Are usually seen with breech presentations when they are episodicd) Are a visually apparent abrupt peak
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Are a visually apparent abrupt peak
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Which deceleration of the fetal heart rate does not require the nurse to change the maternal position?a) Early decelerationsb) Late decelerationsc) Variable decelerationsd) It is always a good idrea to change the woman's position
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Early decelerations
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Which characteristic correctly matches the type of deceleration with its likely cause?a) Early deceleration - umbilical cord compressionb) Late deceleration - uteroplacental insufficiencyc) Variable deceleration - head compressiond) Prolonged deceleration - cause unknown
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Late deceleration - uteroplacental insufficiency
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The nurse caring for a woman in labor understands that prolonged decelerations:a) Are a continuing pattern of benign decelerations that do not require interventionb) Constitute a baseline change when they last longer than 5 minutesc) Are caused by a disruption to the fetal O2 supplyd) Require the usual fetal monitoring by the nurse
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Are caused by a disruption to the fetal O2 supply
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A nurse might be callsed on to stimulate the fetal scalp:a) As part of fetal scalp blood samplingb) In response to tocolysisc) In preparation for fetal oxygen saturation monitoringd) To elicit an acceleration in the fetal heart rate
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To elicit an acceleration in the fetal heart rate
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In assisting with the two factors that have an effect on fetal status, namely pushing and positioning, nurses should:a) Encourage the woman's cooperation in avoiding the supine positionb) Advise the woman to avoid the semi-Fowler positionc) Encourage the woman to hold her breath and tighten her abdominal muscles to produce a vaginal responsed) Instruct the woman to open her mouth and close her glottis, letting air escape after the push
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Encourage the woman's cooperation in avoiding the supine position
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A therapy often used in labor to promote relaxation of the uterus is referred to as _________________.
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Tocolysis
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The nurse recognizes that a woman is in true labor when she states:a) I passed some thick, pink mucus when I urinated this morningb) My bag of waters just brokec) The contractions in my uterus are getting stronger and closer togetherd) My baby dropped, and I have to urinate more frequently noe
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The contractions in my uterus are getting stronger and closer together
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What a nulliparous woman telephones the hospital to report that she is in labor, the nurse initially should:a) Tell the woman to stay home until her membranes ruptureb) Emphasize that food and fluid intake should stopc) Arrange for the woman to come to the hospital for labor evaluationd) Ask the woman to describe why she believes she is in labor
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Ask the woman to describe why she believes she is in labor
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When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman's risk for _________________ has increased.a) Intrauterine infectionb) Hemorrhagec) Precipitous labord) Supine hypotension
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Intrauterine infection
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The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter. The nurse notes that the intrauterine pressure at the peak of the contraction ranges from 65 to 70mm Hg, and the resting tone range is 6-10mm Hg. The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. Based on this information, the nurse should:a) Notify the woman's primary health care provider immediatelyb) Prepare to administer an oxytocic to stimulate uterine activityc) Document the findings because they reflect the expected contraction pattern for the active phase of labord) Prepare the woman for the onset of the second stage of labor
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Document the findings because they reflect the expected contraction pattern for the active phase of labor
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Which action is correct when palpation is used to assess the characteristics and pattern of uterine contractions?a) Place the hand on the abdomen below the umbilicus and palpate uterine tone with the fingertipsb) Determine the frequency by timing from the end of one contraction to the end of the next contractionc) Evaluate the intensity by pressing the fingertips into the uterine fundusd) Assess uterine contractions every 30 minutes throughout the first stage of labor
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Evaluate the intensity by pressing the fingertips into the uterine fundus
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When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective is:a) Dilation of the cervixb) Descent of the fetusc) Rupture of the amniotic membranesd) Increase in blood show
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Dilation of the cervix
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A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. The nurse's initial response is to:a) Prepare the woman for imminent birthb) Notify the woman's primary health care providerc) Document the characteristics of the fluidd) Assess the fetal heart rate and pattern
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Assess the fetal heart rate and pattern
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A nulliparous woman who has just begun the second stage of her labor most likely:a) Experiences a strong urge to bear downb) Shows perineal bulgingc) Feels tired yet relieved that the worst is overd) Shows an increase in bright red bloody show
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Feel tired yet relieved that the worst is over
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The nurse knows that the second stage of labor, the descent phase, has begun when:a) The amniotic membranes ruptureb) The cervix cannot be felt during a vaginal examinationc) The woman experiences a strong urge to bear downd) The presenting part is below the ischial spines
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The woman experiences a strong urge to bear down
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Through vaginal examination, the nurse determines that a woman is 4cm dilated, and the external fetal monitor shows uterine contractions every 3.5 to 4 minutes. The nurse reports this as:a) First stage, latent phaseb) First stage, active phasec) First sage, transition phased) Second stage, latent phase
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First stage, active phase
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The most critical nursing action in caring for the newborn immediately after birth is:a) Keeping the airway clearb) fostering parent-newborn attachmentc) Drying the newborn and wrapping the infant in a blanketd) Administering eye drops and vitamin K
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Keeping the airway clear
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The nurse expects to administer an oxytocic (e.g., Pitocin, methergine) to a woman after expulsion of her placenta to:a) Relieve painb) Stimulate uterine contractionsc) Prevent infectiond) Facilitate rest and relaxation
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Stimulate uterine contractions
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Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?a) Latent: mild, regular contractions; no dilation; bloody showb) Active: moderate, regular contractions; 4 to 7 cm dilationc) Lull: no contractions; dilation stabled) Transition: very strong but irregular contractions; 8 to 10 cm dilation
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Active: moderate, regular contractions; 4 to 7 cm dilation
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As part of the physical examination component of assessments, Leopold maneuvers are used to help identify all of the following except:a) The gender of the fetusb) The number of fetusesc) The fetal lie and attituded) The degree of the presenting part's descent into the pelvis
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The gender of the fetus
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Nurses alert to signs of the onset of the second stage of labor can be certain that stage has begun when:a) The woman has a sudden episode of vomitingb) The nurse is unable to feel the cervix during a vaginal examinationc) Bloody show increasesd) The woman involuntary tries to bear down
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The nurse is unable to feel the cervix during a vaginal examination
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A means of controlling the birth of the fetal head with a vertex presentation is:a) The Ritgen maneuverb) Fundal pressurec) The lithotomy positiond) The De Lee apparatus
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The Ritgen maneuver
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A 25 year old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9lb, 7oz boy after augmentation of labor with oxytocin (Pitocin). She puts on her call light and asks for her nurse right away, stating "Im bleeding a lot." The most likely cause of postpartum hemorrhage in this woman is:a) Retained placental fragmentsb) Unrepaired vaginal lacerationsc) Uterine atonyd) Puerperal infection
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Uterine atony
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In the recovery room, if a woman is asked either to raise her legs (knees extended) off the bed or to flex her knees, place her feet flat on the bed, and raise her buttocks well off the bed, most likely she is being tested to see whether she:a) Has recovered from epidural or spinal anesthesiab) Has hidden bleeding underneath herc) Has regained some flexibilityd) Is a candidate to go home after 6 hours
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Has recovered from epidural or spinal anesthesia
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A __________________-degree perineal laceration continues through the anal sphincter muscles.
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Third
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The period encompassing the first 1 to 2 hours after birth often is referred to as the _______________stage of labor.
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Fourth
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A newly married couple plans to use natural fertility planning. It is important for them to know how long an ovum can live after ovulation. The nurse knows that teaching is effective when the couple responds that an ovum is considered fertile for:a) 6-8 hoursb) 24 hoursc) 2 to 3 daysd) 1 week
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24 hours
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The volume of amniotic fluid is an important factor in assessing fetal well-being. Oligohydramnios (an amniotic fluid volume of less than 300 mL) is associated with what kind of fetal anomalies?a) Renalb) Cardiacc) Gastrointestinald) Neurologic
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renal
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A pregnant woman at 25 weeks of 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?a) That must have been a coincidence; babies can'r respond like thatb) The fetus is demonstrating the aural reflexc) Babies respond to sound starting at about 24 weeks of gestationd) Let me know if it happens again; we need to report that to your midwife
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Babies respond to sound starting at about 24 weeks of gestation
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At approximately _____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27cm crown to rump and weighs approximately 1110g.a) 20b) 24c) 28d) 30
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28
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It is important for the nurse to understand that the placenta:a) Produces nutrients for fetal nutritionb) Secretes both estrogen and progesteronec) Forms a protective impenetrable barrier to microorganisms such as bacteria and virusesd) Excretes prolactin and insulin
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Secretes both estrogen and progesterone
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A nurse caring for a laboring woman should know that meconium is produced by:a) Fetal intestinesb) Fetal kidneysc) Amniotic fluidd) The placenta
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Fetal intestines
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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:a) 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 babyb) Your baby's umbilical floats around in blood anywayc) You dont need to be worrying about things like thatd) The umbilical cord is a group of blood vessels that are very well protected by the placenta
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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
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The ____________ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream.a) Decidua basalisb) Blastocystc) Germ layerd) Chorionic villi
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Chorionic villi
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A woman who is 8 months pregnant asks the nurse, "Does my baby have any antibodies to fight infection?" The most appropriate response by the nurse is:a) Your baby has all the immunoglobulins necessary: IgG, IgM, and IgAb) Your baby wont receive any antibodies until he is born and you breastfeed himc) Your baby does not have any antibodies to fight infectiond) Your baby has IgG and IgM immunoglobulins
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Your baby has IgG and IgM immunoglobulins
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The measurement of lecithin in relation to sphingomyelin (L/S ratio) is used to determine fetal lung maturity. Which ratio reflects maturity of the lungs?a) 1.4:1b) 1.8:1c) 2:1d) 1:1
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2:1
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Sally comes in for her first prenatal examination. This is her first child. She asks you (the nurse), "how does my baby get air inside my uterus?" The correct response is:a) The baby's lungs work in utero to exchange oxygen and carbon dioxideb) The baby absorbs oxygen from your blood streamc) The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstreamd) The placenta delivers oxygen-rich blood through the umbilical artery to the baby's abdomen
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The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream
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The most basic information a maternity nurse should have concerning conception is:a) Ova are considered fertile 48 to 72 hours after ovulationb) Sperm ramain viable in the woman's reproductive system for an average of 12 to 24 hoursc) Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovumd) Implantation in the endometrium occurs 6 to 10 days after conception
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Implantation in the endometrium occurs 6 to 10 days after conception
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The various systems and organs develop at different stages. Which statement is accurate?a) The cardiovascular system is the first organ system to function in the developing humanb) Hematopoiesis originating in the yol sac begins in the liver at 10 weeksc) The body changes from straight to C-shaped at 8 weeksd) The gastrointestinal system is mature at 32 weeks
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The cardiovascular system is teh first organ system to function in the developing human
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Which statement concerning neurologic and sensory development is accurate?a) Brain waves have been recorded on an EEG as early as the end of the first trimester (12 weeks)b) Fetuses respond to sound by 24 weeks and can be soothed by the sound of the mother's voicec) Eyes are first receptive to light at 34 to 36 weeksd) At term, the fetal brain is at least one third the size of an adult brain
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Fetuses respond to sound by 24 weeks and can be soothed by the sound of the mothers voice
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______________ twins is another term for fraternal twins. These twins may be the same or different sexes and genetically are no more alike than siblings born at different times.
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Dizygotic
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The ability of the fetus to survive outside the uterus is called _______________.
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Viability
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Very fine hairs, called ______________, appear first at 12 weeks of gestational age on the fetus's eyebrows and upper lip. By 20 weeks they cover the entire body. By 28 weeks, the scalp hair is longer than these fine hairs, which thin and disappear by term gestation.
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Lanugo
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True/FalseThe fetal concentration of glucose is lower than the glucose level in the maternal blood because of its rapid metabolism by the fetus.
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True
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With regard to primary and secondary powers, the maternity nurse should understand that:a) Primary powers are responsible for effacement and dilation of the cervixb) Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnanciesc) Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilationd) Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs
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Primary powers are responsible for effacement and dilation of the cervix
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With regard to primary and secondary powers, the maternity nurse should understand that:a) Primary powers are responsible for effacement and dilation of the cervixb) Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnanciesc) Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilationd) Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs
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Primary powers are responsible for effacement and dilation of the cervix
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With regard to primary and secondary powers, the maternity nurse should understand that:a) Primary powers are responsible for effacement and dilation of the cervixb) Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnanciesc) Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilationd) Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs
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Primary powers are responsible for effacement and dilation of the cervix
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Nurses can advise their clients that all are signs that precede labor except:a) A return of urinary frequency as a result of increased bladder pressureb) Persistent low backache from relaxed pelvic jointsc) Stronger and more frequent uterine (Braxton Hicks) contractionsd) A decline in energy, as the body stores up for labor
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A decline in energy, as the body stores up for labor
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In order to accurately assess the health of the mother accurately during labor, the nurse should be aware that:a) The woman's blood pressure increases during contractions and falls back to prelabor normal between contractionsb) Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxiac) Having the woman point her toes reduces leg crampsd) The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation
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The endogenous endorphins released during labor raise the womans pain threshold and produce sedation
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The nurse knows that the second stage of labor, the descent phase, has begun when:a) The amniotic membranes ruptureb) The cervix cannot be felt during a vaginal examinationc) The woman experiences a strong urge to bear downd) The presenting part is below the ischial spines
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The woman experiences a strong urge to bear down
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All statements about normal labor are true except:a) A single fetus presents by vertexb) It is completed within 8 hoursc) A regular progression of contractions, effacement, dilation, and descent occursd) No complications are involved
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It is completed within 8 hours
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Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?a) Latent: milk, regular contractions; no dilation; blood show; duration of 2 to 4 hoursb) Active: moderate, regular contractions; 4 to 7cm dilation; duration of 3 to 6 hoursc) Lull: no contractions; dilation stable; duration of 20 to 60 minutesd) Transition: very strong but irregular contractions; 8 to 10cm dilation; duration of 1 to 2 hours
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Active: moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hours
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Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased?a) Semirecumbentb) Sittingc) Squattingd) Side-lying
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Squatting
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Fetal circulation can be affected by many factors during labor. Accurate assessment of the laboring woman and fetus requires knowledge of these expected adaptations. Which factor will not affect fetal circulation during labor?a) Fetal positionb) Uterine contractionsc) Blood pressured) Umbilical cord blood flow
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Fetal position
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Concerning the third stage of labor, nurses should be aware that:a) The placenta eventually detaches itself from a flaccid uterusb) The duration of the third stage may be as short as 3 to 5 minutesc) It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surfaced) The major risk for women during the third stage is a rapid heart rate
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The duration of the third stage may be as short as 3 to 5 minutes
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A woman in active labor receives an opioid agonist analgesic. Which medication relieves severe, persistent, or recurrent pain, creates a sense of well-being, overcomes inhibitory factors, and may even relax the cervix but should be used cautiously in women with cardiac disease?a) Meperidine (Demerol)b) Promethazine (phenergan)c) Butorphanol tartrate (Stadol)d) Nalbuphine (Nubain)
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Meperidine (Demerol)
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A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:a) Notify the woman's physicianb) Tell the woman to slow the pace of her breathingc) Administer oxygen via mask or nasal canulad) Help her breathe into a paper bag
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Help her breathe into a paper bag
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A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure is to use:a) Counterpressure against the sacrumb) Pant-blow (breaths and puffs) breathing techniquesc) Effleuraged) Biofeedback
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Counterpressure against the sacrum
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Nurses should be aware of the difference experience can make in labor pain, such as:a) Sensory pain for nulliparous women often is greater than for multiparous women during early laborb) Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of laborc) Women with a history of substance abuse experience more pain during labord) Multiparous women have more fatigue from labor and therefore experience more pain
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Sensory pain for nulliparous women often is greater than for multiparous women during early labor
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With regard to breathing during labor, maternity nurses should be aware that:a) Breathing techniques in the first stage of labor is designed to increase the size of the abdominal cavity to reduce frictionb) By the time labor has begun, it is too late for instruction in breathing and relaxationc) Controlled breathing techniques are most difficult near the end of the second stage of labord) The patterned-paced breathing technique can help prevent hyperventilation
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Breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction
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With regard to what might be called the tactile approaches to comfort management, nurses should be aware that:a) Either hot or cold applications may provide relief, but they should never be used together in the same treatmentb) Acupuncture can be performed by a skilled nurse with just a little trainingc) Hand and foot massage may be especially relaxing in advanced labor when a womans tolerance for touch is limitedd) Therapeutic touch uses handheld electronic stimulators that produce sympathetic vibrations
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Hand and foot massage may be especially relaxing in advanced labor when a womans tolerance for touch is limited
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With regard to systemic analgesics administered during labor, nurses should be aware that:a) Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrierb) Effects on the fetus and newborn can include decreased alertness and delayed suckingc) IM administration is preferred over IV administrationd) IV patient-controlled analgesia (PCA) results in increased use of an analgesic
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Effects on the fetus and newborn can include decreased alertness and delayed sucking
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With regard to spinal and epidural (block) anesthesia, nurses should know that:a) This type of anesthesia is commonly used for cesarean births but it not suitable for vaginal birthsb) A high incidence of postbirth headache is seen with spinal blocksc) Epidural blocks allow the woman to move freelyd) Spinal and epidural blocks are never used together
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A high incidence of postbirth headache is seen with spinal blocks
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After change of shift report the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, buttocks, and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is:a) Visceralb) Referredc) Somaticd) Afterpain
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Referred
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Fetal bradycardia is most common during:a) Maternal hyperthyroidismb) Fetal anemiac) Viral infectiond) Tocolytic treatment using ritodrine
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Fetal anemia
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The nurse providing care for the laboring woman understands that accelerations with fetal movement:a) Are reassuringb) Are caused by umbilical cord compressionc) Warrant close observationd) Are caused by uteroplacental insufficiency
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Are reassuring
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The most common cause of decreased variability in the FHR that lasts 30 minutes or less is:a) Altered cerebral blood flowb) Fetal hypoxemiac) Umbilical cord compressiond) Fetal sleep cycles
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Fetal sleep cycles
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You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase IV fluid, and perform a vaginal exam. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should you take?a) Call for helpb) Insert a foley catheterc) Start oxytocin (Pitocin)d) Notify the primary health care provider immediately
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Notify the primary health care provider immediately
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When using intermittent auscultation to assess uterine activity, nurses should be aware that:a) The examiner's hand should be placed over the fundus before, during, and after contractionsb) The frequency and duration of contractions are measured in seconds for consistencyc) Contraction intensity is given a judgment number of 1 to 7 by the nurse and client togetherd) The resting tone between contractions is described as either placid or turbulent
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The examiner's hand should be placed over the fundus before, during, and after contractions
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A nurse caring for a woman in labor understands that increased variability of the fetal heart rate might be caused by:a) Narcoticsb) Barbituratesc) Methamphetaminesd) Tranquilizers
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Methamphetamines
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In documenting labor experiences, nurses should know that a uterine contraction is described according to all of these characteristics except:a) Frequency (how often contractions occur)b) Intensity (the strength of the contraction at its peak)c) Resting tone (The tension in the uterine muscle)d) Appearance (shape and height)
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appearance (shape and height)
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The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by:a) Change in positionb) Oxytocin administrationc) Regional anesthesiad) Intravenous analgesic
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change in position
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Fetal well-being during labor is assessed by:a) The response of the fetal heart rate (FHR) to uterine contractions (UCs)b) Maternal pain controlc) Accelerations in the FHRd) An FHR greater than 110 beats/min
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The response of the fetal heart rate (FHR) to uterine contractions (UCs)
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A group of fetal monitoring experts (National Institute of Child Health and Human Development, 2008) recommends that fetal heart rate (FHR) tracings demonstrate certain characteristics to be described as reassuring or normal (category I). This includes:a) Bradycardia not accompanied by baseline variabilityb) Early decelerations, either present or absentc) Sinusoidal patternd) Tachycardia
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Early decelerations, either present or absent
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A nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates her understanding of the instructions when the woman states:a) True labor contractions will subside when I walked aroundb) True labor contractions will cause discomfort over the top of my uterusc) True labor contractions will continue and get stronger even if I relax and take a showerd) True labor contractions will remain irregular but become stronger
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True labor contractions will continue and get stronger even if I relax and take a shower
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Vaginal examinations should be performed by the nurse under all these circumstances except:a) An admission to the hospital at the start of laborb) When accelerations of the fetal heart rate (FHR) are notedc) On maternal perception of perineal pressure or the urge to bear downd) When membranes ruptured
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When accelerations of the fetal heart rate are noted
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When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include:a) Encouraging the woman to try various upright positions, including squatting and standingb) Telling the woman to start pushing as soon as her cervix is fully dilatedc) Continuing on epidural anesthetic so that pain is reduced and the woman can relaxd) Coaching the woman to use sustained 10 to 15 second, closed-glottis bearing-down efforts with each contraction
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Encouraging the woman to try various upright positions, including squatting and standing
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Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period?a) The healthy newborn should be taken to the nursery for a complete assessmentb) After drying, the infant should be given to the mother wrapped in a receiving blankerc) Encourage skin-to-skin contact of mother and babyd) The father or support persons should be encouraged to hold the infant while awaiting delivery of the placenta
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Encourage skin-to-skin contact of mother and baby
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Which description of the pases of the second stage of labor is accurate?a) Latent phase: feels sleepy, fetal station is 2+ to 4+, duration is 30 to 45 minutesb) Active phase: overwhelmingly strong contractions, Ferguson reflex activated, duration is 5 to 15 minutesc) Descent phase: significant increase in contractions, Ferguson reflex activated, average duration variesd) Transitional phase: woman "laboring down," fetal station is 0, duration is 15 minutes
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Descent phase: significant increase in contractions, Ferguson reflex activated, average duration varies
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When performing a vaginal examinations on laboring women, the nurse should be guided by what principle?a) Cleanse the vulva and perineum before and after the examination as neededb) Wear a clean glove lubricated with tap water and reduce discomfortc) Perform the examination every hour during the active phase of the first stage of labord) Perform an examination immediately if active bleeding is present
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Cleanse the vulva and perineum before and after the examination as needed
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Which test is performed to determine if membranes are ruptured?a) Urine analysisb) Fern testc) Leopold maneuversd) AROM
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Fern test
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When assessing a multiparous woman who has just given birth to an 8 pound boy, the nurse notes that the woman's fundus is firm and has become globular. A gush of dark red blood comes from her vagina. The nurse concludes that:a) The placenta has separatedb) A cervical tear occurred during the birthc) The woman is beginning to hemorrhaged) Clots have formed in the upper uterine segment
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The placenta has separated
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A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is:a) Dont worry about it. You'll do fineb) Its normal to be anxious about labor. Let's discuss what makes you afraidc) Labor is scary to think about, but the actual experience isn'td) You may have an epidural. You won't feel anything
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It's normal to be anxious about labor. Let's discuss what makes you afraid
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For the labor nurse, care of the expectant mother begins with any or all of these situations except:a) The onset of progressive, regular contractionsb) The bloody, or pink, showc) The spontaneous rupture of membranesd) formulation of the woman's plan of care for labor
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Formulation of the woman's plan of care for labor
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If a woman complains of back labor pain, the nurse might best suggest that she:a) Lie on her back for a while with her knees bentb) Do less walking aroundc) Take some deep, cleansing breathsd) Lean over a birth ball with her knees on the floor
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Lean over a birth ball with her knees on the floor
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In a variation of rooming-in, called couplet care, the mother and infant share a room and the mother shares the care of the infant with:a) The father of the infantb) Her mother (the infant's grandmother)c) Her eldest daughter (the infant's sister)d) the nurse
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The nurse
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A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. What finding indicates the preterm labor is occurring?a) Estriol is not found in maternal salivab) Irregular, mild uterine contractions are occurring every 12 to 15 minutesc) Fetal fibronectin is present in vaginal secretionsd) The cervix is effacing and dilated to 2 cm
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The cervix is effacing and dilated to 2 cm
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In planning for an expected cesarean birth for a woman who has given birth by cesarean previously and who has a fetus in the transverse presentation, the nurse includes which information?a) Because this is a repeat procedure, you are at the lowest risk for complicationsb) Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative proceduresc) Because this is your second cesarean birth, you will recover fasterd) You will not need preoperative teaching because this is your second cesarean birth
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Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures
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For a woman at 42 weeks of gestation, which finding requires more assessment by the nruse?a) Fetal heart rate of 116 beats/minb) Cervix dilated 2cm and 50% effacedc) Score of 8 on the biophysical profiled) One fetal movement noted in 1 hour of assessment by the mother
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One fetal movement noted in 1 hour of assessment by the mother
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A pregnant woman's amniotic membranes rupture. Prolapsed cord is suspected. Which intervention is the nurse's top priority?a) Place the woman in the knee-chest positionb) Cover the cord in a sterile towel saturated with warm normal salinec) Prepare the woman for a cesarean birthd) Start oxygen by face mask
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Place the woman in the knee-chest position
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A nurse is caring for a client whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of:a) Uterine contractions occuring every 8 to 10 minutesb) A fetal heart rate (FHR) of 180 with absence of variabilityc) The client needing to voidd) Rupture of the clients amniotic membranes
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A fetal heart rate (FHR) of 180 with absence of variability
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With regard to the use of tocolytic therapy to suppress uterine actvity, nurses should be aware that:a) The drugs can be given efficaciously up to the designated beginning of term at 37 weeksb) There are no important maternal (as opposed to fetal) contraindicationsc) Its most important function is to afford the opportunity to administer antenatal glucocorticoidsd) If the client develops pulmonary edem whil on tocolytics, IV fluids should be given
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Its most important function is to afford the opportunity to administer antenatal glucocorticoids
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With regards to dysfunctional labor, nurses should be aware that:a) Women who are underweight are more at riskb) Women experiencing precipitous labor are about the only dysfunctionals not to be exhaustedc) Hypertonic uterine dysfunction is more common than hypotonic dysfunctiond) Abnormal labor patterns are most common in older women
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Women experiencing precipitous labor are about the only dysfunctionals not to be exhausted
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A nurse providing care to a woman in labor should be aware that cesarean birth:a) Is declining in frequency in the United Statesb) Is more likely to be done for the poor in public hospitals who do not get the nurse counseling that wealthier clients doc) Is performed primarily for the benefit of the fetusd) Can be either elected or refused by women as their absolute legal right
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Is performed primarily for the benefit of the fetus
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Which statement is most likely to be associated with a breech presentation?a) Least common malpresentationb) Descent is rapidc) Diagnosis by ultrasound onlyd) High rate of neuromuscular disorders
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High rate of neuromuscular disorders
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The breasts of a bottle-feeding woman are engorged. The nurse should instruct her to:a) Wear a snug, supportive brab) Allow warm water to soothe the breasts during a showerc) Express milk from breasts occasionally to relieve discomfortd) Place absorbent pads with plastic liners into her bra to absorb leakage
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Wear a snug, supportive bra
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A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is:a) Urinary tract infectionb) Excessive uterine bleedingc) A ruptured bladderd) Bladder wall atony
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Excessive uterine bleeding
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What statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth?a) My first menstrual cycle will be lighter than normal and then will get heavier every month thereafterb) My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cyclesc) I will not have a menstrual cycle for 6 months after childbirthd) My first menstrual cycle will be heavier than normal and then will be light for several months after
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My first cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles
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With regard to afterbirth pains, nurses should be aware that these pains are:a) Caused my mild, continual contractions for the duration of the postpartum periodb) More common in first-time mothersc) More noticeable in births in which the uterus was overdistendedd) Alleviated somewhat when the mother breastfeeds
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More noticeable in births in which the uterus was overdistended
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Postbirth uterine/vaginal discharge, called lochia:a) Is similar to a light menstrual period for the first 6 to 12 hoursb) Is usually greater after cesarean birthsc) Will usually decrease with ambulation and breastfeedingd) Should smell like normal menstrual flow unless an infection is present
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Should smell like normal menstrual flow unless an infection is present
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Which description of postpartum restoration or healing times is accurate?a) The cervix shortens, becomes firm, and returns to form within a month postpartumb) Rugae reappear within 3 to 4 weeksc) Most episiotomies healh within a weekd) Hermorrhoids usually decrease in size within 2 weeks of childbirth
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Rugae reappear within 3 to 4 weeks
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With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that:a) Kidney function returns to normal a few days after birthb) Diastasis recti abdominis is a common condition that alters the voiding reflexc) Fluid loss through perspiration and increased urinary output accoun for a weight loss of more than 2kg during the puerperiumd) With adequate emptying of the bladder, bladder tone usually is restored 2 to 3 weeks after childbirth
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Fluid loss through perspiration and increased urinary output account for a weight loss of more than 2kg during the puerperium
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As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is 1 day postpartum. An expected finding is:a) Little if any changeb) Leakage of milk at let-downc) Swollen, warm and tender on palpationd) A few blisters and a bruise on each areola
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Little if any change
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Perineal care is an important infection control measure. When evaluation a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:a) Uses soap and warm water to wash the vulva and perineumb) Washes from symphysis pubis back to the episiotomyc) Changes her perineal pad every 2 to 3 hoursd) Uses the peribottle to rinse upward into her vagina
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Uses the peribottle to rinse upward into her vagina
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On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:a) Begin an IV infusion of Ringer's lactate solutionb) Assess the woman's vital signsc) Call the woman's primary health care providerd) Message the woman's fundus
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Massage the woman's fundus
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Excessive blood loss after childbirth can have several causes; however, the most common is:a) Vaginal or vulvar hematomasb) Unrepaired lacerations of the vagina or cervixc) Failure of the uterine muscle to contract firmlyd) Retained placental fragments
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Failure of the uterine muscle to contract firmly
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Baby-friendly hospitals mandate their infants be put to breast within the first _______ after birth.a) 1 hourb) 30 minutesc) 2 hoursd) 4 hours
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1 hour
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Which finding would be a source of concern if noted during the assessment of a woman who is 12 hours' postpartum?a) Postural hypotensionb) Temperature of 38 Cc) Bradycardia- pulse rate of 55 beats/mind) Pain in left calf with dorsiflexion of left foot
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Pain in left calf with dorsiflexion of left foot
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The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action is to:a) Place her on a bedpan to empty her bladderb) Massage her fundusc) Call the physiciand) Administer methylergonovine (Methergine), 0.2mg IM, which has been ordered prn
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Massage her fundus
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Two hours after giving birth a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse suspects:a) Bladder distentionb) Uterine atonyc) Constipationd) Hematoma formation
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Hematoma formation
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The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?a) Talks and coos to her sonb) Seldom makes eye contact with her sonc) Cuddles her son close to herd) Tell visitors how well her son is feeding
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Seldom makes eye contact with her son
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When the infant's behavior and characteristics call forth a corresponding set of maternal behaviors and characteristics, this is called:a) Mutualityb) Bondingc) Claimingd) Acquaintance
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Mutuality
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In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviours that can either facilitate or inhibit attachment. What is a facilitating behavior?a) The parents have difficulty naming the infantb) The parents hover around the infant, directing attention to and pointment at the infantc) The parents make no effort to interpret the actions or needs of the infantd) The parents do not move from fingertip touch to palmar contact and holding
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The parents hover around the infant, directing attention to and pointing at the infant
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When working with parents who have some form of sensory impairment, nurses should realize that all of these statements are true except:a) One of the major difficulties visually impaired parents experience is the skepticism of health care professionalsb) Visually impaired mothers cannot overcome the infant's need for eye-to-eye contactc) The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilitiesd) Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information
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Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact
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Health care providers demonstrate a variety of reactions to lesbian couples including failure to acknowledge the "other mother's" role in pregnancy, birth, and parenting. Integration of the non-childbearing partner into care includes offering the same opportunities afforded male partners of heterosexual women. These include all except:a) Labor supportb) Cutting the cordc) Rooming in during hospitalizationd) Breastfeeding the infant
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Breastfeeding the infant
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While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically:a) Express a strong need to review the events and her behavior during the process of labor and birthb) Exhibit a reduced attention span, limiting readiness to learnc) Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newbornd) Have reestablished her role as a spouse or partner
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Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn
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Parents can facilitate the adjustment of their other children to a new baby by:a) Having children at home choose or make a gift to give the new baby on his or her arrival homeb) Emphasizing activities that keep the new baby and other children togetherc) Having the mother carry the new baby into the home so she can show the other children the babyd) Reducing stress on the other children by limiting their involvement and care of the new baby
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Having children at home choose or make a gift to give the new baby on his or her arrival home
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The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about one-half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?a) PPD symptoms are consistently severeb) This syndrome affects only new membersc) PPD can easily go undetectedd) Only mental health professionals should teach new parents about this condition
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PPD can easily go undetected
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The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to:a) Call the woman's primary health care providerb) Administer the standing order for an oxytocicc) Palpate the uterus and massage it if it is boggyd) Assess maternal blood pressure and pulse for signs of hypovolemic shock
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Palpate the uterus and massage it if it is boggy
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Which PPH conditions are considered medical emergencies that require immediate treatment?a) Inversion of the uterus and hypovolemic shockb) Hypotonic uterus and coagulopathiesc) Subinvolution of the uterus and idiopathic thrombocytopenic purpurad) Uterine atony and disseminated intravascular coagulation (DIC)
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Inversion of the uterus and hypovolemic shock
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Which postpartum infection is most often contracted by first-time mothers who are breastfeeding?a) Endometritisb) Wound infectionsc) Mastitisd) Urinary tract infections (UTIs)
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Mastitis
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Despite popular belief, there is a rare type of hemophilia that affects women of childbearing age. von Willebrand disease is the most common of the hereditary bleeding disorders and can affect males and females alike. It results from a factor VIII deficiency and platelet dysfunction. Although factor VIII levels increase naturally during pregnancy, there is an increased risk for postpartum hemorrhage from birth until 4 weeks postpartum as levels of von Willebrand factor (vWf) and factor VIII decrease. The treatment that should be considered first for the client with von Willebrand disease who experiences a postpartum hemorrhage is:a) Cryoprecipitateb) Factor VIII and vWFc) Desmopressind) Hemabate
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Desmopressin
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Herbal remedies have been used with some success to control PPH after initial management. Some herbs have homeostatic actions, whereas others work as oxytocic agents to contract the uterus. ________________ is a commonly used oxytocic herbal remedy.a) Witch hazelb) Lady's mantelc) Blue cohoshd) Yarrow
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Blue cohosh
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A thrombosis results from the formation of a blood clot or clots inside a blood vessel and is caused by inflammation or partial obstruction of the vessel. Three thromboembolic conditions are of concern during the postpartum period and include all except:a) Amniotic fluid embolism (AFE)b) Superficial venous thrombosisc) Deep vein thrombosisd) Pulmonary embolism
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Amniotic fluid embolism
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Perineal care is an important infection control measure. When evaluation a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:a) Uses soap and warm water to wash the vulva and perineumb) Washes from symphysis pubis back to the episiotomyc) Changes her perineal pad every 2 to 3 hoursd) Uses the peribottle to rinse upward into her vagina
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Uses the peribottle to rinse upward into her vagina
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On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:a) Begin an IV infusion of Ringer's lactate solutionb) Assess the woman's vital signsc) Call the woman's primary health care providerd) Message the woman's fundus
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Massage the woman's fundus
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Excessive blood loss after childbirth can have several causes; however, the most common is:a) Vaginal or vulvar hematomasb) Unrepaired lacerations of the vagina or cervixc) Failure of the uterine muscle to contract firmlyd) Retained placental fragments
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Failure of the uterine muscle to contract firmly
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Baby-friendly hospitals mandate their infants be put to breast within the first _______ after birth.a) 1 hourb) 30 minutesc) 2 hoursd) 4 hours
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1 hour
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Which finding would be a source of concern if noted during the assessment of a woman who is 12 hours' postpartum?a) Postural hypotensionb) Temperature of 38 Cc) Bradycardia- pulse rate of 55 beats/mind) Pain in left calf with dorsiflexion of left foot
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Pain in left calf with dorsiflexion of left foot
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The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action is to:a) Place her on a bedpan to empty her bladderb) Massage her fundusc) Call the physiciand) Administer methylergonovine (Methergine), 0.2mg IM, which has been ordered prn
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Massage her fundus
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Two hours after giving birth a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse suspects:a) Bladder distentionb) Uterine atonyc) Constipationd) Hematoma formation
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Hematoma formation
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All of these statements indicate the effect of breastfeeding on the family or society at large except:a) Breastfeeding requires fewer supplies and less cumbersome equipmentb) Breastfeeding saves families moneyc) Breastfeeding costs employers in terms of time lost from workd) Breastfeeding benefits the environment
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Breastfeeding costs employers in terms of time lost from work
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In helping the breastfeeding mother position the baby, nurses should keep in mind that:a) The cradle position is usually preferred by mothers who had a cesarean birthb) Women with perineal pain and swelling prefer the modified cradle positionc) Whatever the position used, the infant is "belly to belly" with the motherd) While supporting the head, the mother should push gently on the occuput
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Whatever the position used, the infant is "belly to belly" with the mother
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The maternity nurse must be cognizant that cultural practices have significant influence on infant feeding methods. Many regional and ethnic cultures can be found within the United States. One cannot assume generalized obervations about any cultural group will hold for all members of the group. Which statement related to cultural practices influencing infant feeding practice is correct?a) A common practice among Mexian women is known as los dosb) Muslim cultures do not encourage breastfeeding due to modesty concernsc) Latino women born in the United States are more likely to be breastfeedd) East Indian and Arab women believe that cold foods are best for a new mother
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A common practice among Mexican women is known as los dos
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The birth weight of a breastfed newborn was 8lb, 4oz. One the third day the newborn's weight was 7lb, 12 oz. On the basis of this finding, the nurse should:a) Encourage the mother to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needsb) Suggest that the mother switch to bottle feeding because breastfeeding is ineffective in meeting newborn needs for fluid and nutrientsc) Notify the physician because the newborn is being poorly nourishedd) Refer the mother to a lactation consultant to improve her breastfeeding technique
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Encourage the mother to continue breastfeeding because it is effective in meeting the newborns nutrient and fluid needs
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Which action of a breastfeeding mother indicates the need for further instruction?a) Holds breast with four fingers along bottom and thumb at topb) Leans forward to bring breast toward the babyc) Stimulates the rooting reflex and then inserts nipple and areola into newborn's open mouthd) Puts her finger into newborn's mouth before removing breast
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Leans forward to bring breast toward the baby
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The nurse taught new parents the guidelines to follow regarding the bottle feeding of their newborn. They will be using formula from a can of concentrate. The parents would demonstrate an understanding of the nurse's instructions is they:a) Wash the top of can and can opener with soap and water before opening the canb) Adjust the amount of water added according to weight gain pattern of the newbornc) Add some honey to sweeten the formula and make it more appealing to a fussy newbornd) Warm formula in a microwave oven for a couple of minutes prior to feeding
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Wash the top of a can and can opener with soap and water before opening the can
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The breastfeeding infant can become fussy for a number of reasons. These include all except:a) Gastrointestinal (GI) distressb) An occasional feeding of formulac) Ear infections, sore throat, or thrushd) Something the mother ate
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Ear infections, sore throat, or thrush
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Which statement regarding infant weaning is correct?a) Weaning should proceed from breast to bottle to cupb) The feeding of most interest should be eliminated firstc) Abrupt weaning is easier than gradual weaningd) Weaning can be mother or infant initiated
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Weaning can be mother or infant initiated
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With regard to the long-term consequences of infant feeding practices, the nurse should instruct the obese client that the best strategy to decrease the risk for childhood obesity for her infant is:a) An on-demand feeding scheduleb) Breastfeedingc) Lower-calorie infant formulad) Smaller, more frequent feedings
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Breastfeeding
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When providing an infant with a gavage feeding, what should be documented each time?a) The infant's abdominal circumference after the feedingb) The infant's heart rate and respirationsc) The infant's suck and swallow coordinationd) The infant's response to the feeding
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The infants response to the feeding
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A male infant at 26 weeks of gestation arrives from the delivery room intubated. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturations of 80%. The prescribed saturations are 92%. The nurse's most appropriate action is to:a) Listen to breath sounds and ensure the patency of the endotracheal tube, increase oxygen, and notify a physicianb) Continue to observe and make no changes until the saturations are 75%c) Continue with the admission process to ensure that a thorough assessment is completedd) Notify the parents that their infant is not doing well
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Listen to breath sounds and ensure the patency of the endotracheal tube, increase oxygen, and notify a physician
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Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. Some generalized signs include:a) Hypertonia, tachycardia, and metabolic alkalosisb) Abdominal distention, temperature instability, and grossly bloody stoolsc) Hypertension, absence of apnea, and ruddy skin colord) Scaphoid abdomen, no residual with feedings, and increased urinary output
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Abdominal distention, temperature instability, and grossly bloody stools
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For diagnostic and treatment purposes, nurses should know the birth weight classifications of high risk infants. For example, extremely low birth weight is the designation for an infant whose weight is:a) Less than 1500gb) Less than 1000gc) Less than 2000gd) Dependent on the gestational age
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Less than 1000g
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Premature infants who exhibit 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration are:a) Suffering from sleep or wakeful apneab) Experiencing severe swings in blood pressurec) Trying to maintain a neutral thermal environmentd) Breathing in a respiratory pattern common to premature infants
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Breathing in a respiratory pattern cmmon to premature infants
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A nurse providing care to preterm infants should understand that nasogastric and orogastric tubes are used to:a) Help maintain body temperatureb) Provide oxygen and ventilationc) Replace surfactantsd) Feed the infant
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Feed the infant
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With regard to small-for-gestational age infants and intrauterine growth restriction (IUGR), nurses should be aware that:a) In the first trimester, diseases or abnormalities result in asymmetric IUGRb) Infants with asymmetric IUGR have the potential for normal growth and developmentc) In asymmetric IUGR, weight is slightly more than SGA, whereas length and head circumference are somewhat less than SGAd) Symmetric IUGR occurs in the later stages of pregnancy
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Infants with asymmetric IUGR have the potential for normal growth and development
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The uterus is a muscular pear-shaped organ that is responsible for:a) Cyclic menstruationb) Sex hormone productionc) Fertilizationd) Sexual arousal
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Cyclic menstruation
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The hormone responsible for maturation of mammary gland tissue is:a) Testosteroneb) Estrogenc) Prolactind) Progesterone
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Progesterone
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Which statement about female sexual response is not accurate?a) Women and men are more alike than different in their physiologic response to sexual arousal and orgasmb) Vasocongestion is the congestion of blood vesselsc) The orgasmic phase is the final state of the sexual response cycled) Facial grimacse and spasms of hands and feet are often part of arousal
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The orgasmic phase is the final state of the sexual response cycle
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The nurse who provides preconception care understands that it:a) Is designed for women who have never been pregnantb) Includes risk factors assessments for potential medical and psychologic problems but by law cannotc) Avoids teaching about safe sex to avoid political controversyd) Could include interventions to reduce substance use and abuse
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Could include interventions to reduce substance use and abuse
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A 62 year old woman has not been to the clinic for an annual examination for 5 years. The recent death of her husband reminded her that she should come for a visit. Her family doctor has retired, and she is going to see the women's health nurse practitioner for her visit. To facilitate a positive health care experience, the nurse should:a) Remind the woman that she is long overdue for her examination and that she should come in annuallyb) Listen carefully and allow extra time for this woman's health history interviewc) Reassure the woman that a nurse practitioner is just as good as her old doctord) Encourage the woman to talk about her death of her husband and her fears about her own death
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Listen carefully and allow extra time for this woman's health history interview
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During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response would be to:a) Reassure the woman that the examination will not reveal any problemsb) Explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examinationc) Reassure teh woman that "bumps" can be treatedd) Reassure her that most women have "bumps" on their labia
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Explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination
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Which is correct concerning the performance of a Papanicolaou (Pap) test?a) The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the testb) It should be performed once a year beginning with the onset of pubertyc) A lubricant such as Vaseline should be used to ease speculum insertiond) The specimen for the Pap test should be obtained after specimens are collected for cervical infection
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The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test
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The nurse-midwife is teaching a group of women who are pregnant, including instruction on Kegel exercises. Which statement by a participant would indicate a correct understanding of the instruction?a) I will only see results if I perform 100 Kegel exercises each dayb) I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercisesc) I should only perform Kegel exercises in the sitting positiond) I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results
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I should hold the Kegel exercises in the sitting position
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A woman inquires about herbal alternative methods for improving fertility. Which statement by the nurse is the most appropriate when instructing the woman in which herbal preparations to avoid while trying to conceive?a) You should avoid nettle leaf, dong quai, and vitamin E while you are trying to get pregnantb) You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceivec) You should not take anything with vitamin E, calcium, or magnesium. They will make you infertiled) Herbs have no bearing on fertility
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You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive
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Semen analysis is a common diagnostic procedure related to infertility. In instructing a male client regarding this test, the nurse would tell him to:a) Ejaculate into a sterile containerb) Obtain the specimen after a period of abstinence from ejaculation of 2 to 5 daysc) Transport specimen with container packed in iced) Ensure that the specimen arrives at the laboratory within 30 minutes of ejaculation
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Obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days
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Nurses should be aware that infertility:a) Is perceived differently by women and menb) Has a relatively stable prevalence among the overall population and throughout a womens potential reproductive yearsc) Is more likely the result of a physical flaw in the woman than in her male partnerd) Is the same thing as sterility
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Is perceived differently by women and men
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Although remarkable developments have occurred in reproductive medicine, assisted reproductive therapies are associated with a number of legal and ethical issues. Nurses can provide accurate information about the risks and benefits of treatment alternatives so couples can make informed decisions about their choice of treatment. Which issue would not need to be addressed by an infertile couple before treatment?a) Risk of multiple gestationb) Whether or how to disclose the facts of conception to offspringc) Freezing embryos for later used) Financial ability to cover the cost of treatment
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Financial ability to cover the cost of treatment
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A couple presents for their first appointment at an infertility center. A noninvasive test done during initial diagnostic testing is:a) Hysterosalpingogramb) Endometrial biopsyc) Sperm analysisd) Laparoscopy
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Sperm analysis
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An infertile woman is about to begin pharmacologic treatment. As part of the regimen, she will take purified follicle-stimulating hormone (FSH) (urofollitropin/ Metrodin). The nurse instructs her that his medication is administered in the form of a/an:a) Intranasal sprayb) Vaginal suppositoryc) Intramuscular injectiond) Tablet
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Intramuscular injection
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The rate of fertility declines dramatically after the age of 35. While explaining the cause of this rapid decline in fertility to the client, the nurse is aware that the primary reason for this is related to:a) Endometriosisb) Abnormalities of oocytesc) Infectiond) Metabolic disease
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Abnormalities of oocytes
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What is not a trend in the delivery of health care in the United States?a) Greater emphasis has been placed on curing disease and disability than on preventing themb) Hospital stays for many conditions have been shortenedc) Acute care increasingly is provided through home-based servicesd) Hospital-based nurses are increasingly involved in follow-up care after discharge
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Greater emphasis has been places on curing disease and disability than on preventing them
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A 23 year old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement?a) Perform a nutrition assessmentb) Refer the woman to a social workerc) Advise the woman to see an obstetrician, not a midwifed) Explain to the woman the importance of keeping the prenatal care appointments
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Explain to the woman the importance of keeping her prenatal care appointments
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When a nurse is unsure about how to perform a client care procedure, the best action would be to:a) Ask another nurseb) Discuss the procedure with the client's physicianc) Look up the procedure in a nursing textbookd) Consult the agency procedure manual and follow the guidelines for the procedure
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Consult the agency procedure manual and follow the guidelines for the procedure
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When caring for pregnant women, the nurse should keep in mind that violence during pregnancy:a) Affects more than 25% of pregnant women in the United Statesb) Increases a pregnant woman's risk for gestational hypertensionc) May be associated with substance abuse by both the pregnant woman and her partnerd) Has decreased in incidence as a result of better assessment techniques and record keeping
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May be associated with substance abuse by both the pregnant woman and her partner
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The following conditions have contributed to the increase in maternity-related health care costs except:a) Early postpartum dischargesb) Maternal medical risk factors, such as diabetesc) The use of high-tech equipmentd) The cost of care for low-birth-weight (LBW)
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Early postpartum discharges
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From the nurses's perspective, what measure should be the focus of the health care system in order to reduce the rate of infant mortality further?a) Implementing programs to ensure women's early participation in ongoing prenatal careb) Increasing the length of stay in a hospital after vaginal birth from 2 to 3 daysc) Expanding the number of neonatal intensive care units (NICUs)d) Mandating that all pregnant women receive care from an obstetrician
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Implementing program's to ensure women's early participation in ongoing prenatal care
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The term used to describe legal and professional responsibility for practice for maternity nurses is:a) Collegialityb) Ethicsc) Evaluationd) Accountability
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Accountability
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The two most frequently reported maternal medical risk factors are:a) Hypertension associated with pregnancy and diabetesb) Drug use and alcohol abusec) Homelessness and lack of insuranced) Behaviors and lifestyles
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Hypertension associated with pregnancy and diabetes
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Which statement made by the nurse would indicate that he or she is practicing appropriate family-centered care techniques?a) The nurse encourages the mother and father to make choices whenever possibleb) The nurse updates the family about what is going to happen but instructs the clients sister that she cannot be present in the room during the birthc) The nurse believes that he or she is acting in the best interest of the client and commands her what to do throughout labord) The father is discouraged from accompanying his wife during a cesarean birth
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The nurse encourages the mother and father to make choices whenever possible
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Providing treatment and rehabilitation for people who have developed disease is part of:a) Primary preventive careb) Secondary preventive carec)Tertiary preventive cared) Primordial preventive care
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Teritary care
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The perinatal continuum of care begins with:a) The diagnosis of pregnancyb) The interval just before birthc) Identification of a pregnant woman as high riskd) Family planning and preconception care
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Family planning and preconception care
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What would a breastfeeding mother who is concerned that her baby is not getting enough to eat find most helpful and most cost-effective on the day after discharge?a) Visiting a pediatric screening clinic at the hospitalb) Placing a call to the hospital nursery "warm line"c) Calling the pediatrician for a lactation consult referrald) Requesting a home visit
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Placing a call to the hospital nursery"warm line"
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Which personal safety precaution should guide the nurse working in home care?a) Do not carry personal items, such as extra car keys or a cellular phoneb) Avoid making a visit with another nursec) Schedule visits during daylight hoursd) Never wear a name tag
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Schedule visits during daylight hours
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When providing health education to the client, the nurse understands that an example of the secondary level of prevention is:a) Approved infant car seatsb) Breast self-examinationc) Immunizationsd) Support groups for parents of children with Down syndrome
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Breast self examination
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A mother's househole consists of her husband, his mother, and another child. She is living in a/an:a) Extended familyb) Single-parent familyc) Married-blended familyd) Trinuclear family
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Extended family
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The process by which people retain some of their own culture while adopting the practices of the dominant society is known as:a) Acculturationb) Assimilationc) Ethnocentrismd) Cultural relativism
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Acculturation
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In which culture is the father more likely to be expected to participate in the labor and delivery?a) Asian-Americanb) African-Americanc) European-Americand) Hispanic
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European-American
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The nurse understands the importance of a walking survey because this tool:a) Determines how much exercise expectant mothers have been getting, to help inform client care decisionsb) Usually takes place on the maternity ward but can be expanded to other areas of the hospitalc) Is a method of observing the resources and health-related environment of the communityd) Is performed by government census takers as part of their canvas
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Is a method of observing the resources and health-related environment of the community
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Practices such as providing recommended immunizations, infant car seats, and school health education are part of:a) Primary preventive careb) Secondary preventive carec) Tertiary preventive cared) Primordial preventive care
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Primary preventive care
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A Native-American woman gave birth to a baby girl 12 hours ago. The nurse notes that the woman keeps her baby in the bassinet except for bottle feeding and states that she will wait until she gets home to begin breastfeeding. The nurse recognizes that this behaviour is most likely a reflection of:a) Delayed attachmentb) Embarrassmentc) Disappointment in the sex of the babyd) A belief that babies should not be fed colostrum
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A belief that babies should not be fed colostrum
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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 startb) I have lower abdominal pain beginning the third day of my menstrual periodc) I have nausea and headaches after my period starts, and they last 2 to 3 daysd) I have abdominal bloating and breast pain after a couple days of my period
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I feel irritable and moody a week before my period is supposed to start
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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 medicationb) It may be caused by stress or excessive exercise or bothc) It likely will require the client to eat less and exercise mored) It often goes away on its own
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It may be caused by stress or excessive exercise or both
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A nurse counseling a client with endometriosis understands which statement regarding the management of endometriosis is not accurate?a) Bone loss from hypoestrogenism is not reversibleb) Side effects from the steroid danaxol include masculinizing traitsc) Surgical intervention is often needed for severe or acute symptomsd) Women without pain and who do not want to become pregnant need to treatment
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Bone loss from hypoestrogenism is not reversible
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With regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that:a) It is most commonly caused by anovulationb) It most osten occurs in middle agec) The diagnosis of DUB should be the first considered for abnormal menstrual bleedingd) The most effective medical treatment involves steroids
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It is most commonly caused by anovulation
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An effective relief measure for primary dysmenorrhea is to:a) Reduce physical activity level until menstruation ceasesb) Begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flowc) Decrease intake of salt and refined sugar about 1 week before menstruation is about to occurd) Use barrier methods rather than the oral contraceptive pill (OCP) for birth control
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Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur
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Several noted health risks are associated with menopause. These risks include all except:a) Osteoporosisb) Coronary heart diseasec) Breast cancerd) Obesity
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Breast cancer
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A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her:a) You dont need to modify your exercising any time during your pregnancyb) Stop exercising, because it will harm the fetusc) You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh monthd) Jogging is too hard on your joints; switch to walking now
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You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month
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A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be:a) Constipationb) Alteration in the pattern of fetal movementc) Heart palpitationsd) Edema in the ankles and feet at the end of the day
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Alteration in the pattern of fetal movement
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A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse tells her:a) Because you're in your second trimester, there's no problem with having one drink with dinnerb) One drink every night is too much. One drink three times a week should be finec) Because you're in your second trimester, you can drink as much as you liked) Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy
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Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout pregnancy
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Which behavior indicates that a woman is "seeking safe passage" for herself and her infant?a) She keeps all prenatal appointmentsb) She "eats for two"c) She drives her car slowlyd) She wears only low-heeled shoes
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She keeps are prenatal appointments
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What type of cultural concern is the most likely deterrent to many women seeking prenatal care?a) Religionb) Modestyc) Ignoranced) Belief that physicians are evil
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Modesty
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In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that:a) Nonacceptance of the pregnancy very often equates to rejection of the childb) Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changesc) Ambivalent feelings during pregnancy usually are seen only in emotionally immature or very young mothersd) Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth
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Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changes
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With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:a) The father goes through three phases of acceptance of his ownb) The fathers attachment to the fetus cannot be as strong as that of the mother because it does not start until after birthc) In the last 2 months of pregnancy, most expentant fathers suddenly get very protective of their established lifestyle and resist making changes to the homed) Typically men remain ambivalent about fatherhood right up to the birth of their child
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The father goes through three phases of acceptance of his own
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With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that:a) Prescription and over-the-counter drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetusb) The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimesterc) Killed-virus vaccines (e.g., tetanus) should not be given during pregnancy, but live-virus vaccines (e.g., measles) are permissibled) No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus
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Prescription and over-the-counter drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus
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Which statement about multifetal pregnancy is not accurate?a) The expectant mother often develops anemia because the fetuses have a greater demand for ironb) Twin pregnancies come to term with the same frequency as single pregnanciesc) The mother should be counseled to increase her nutritional intake and gain more weightd) Backache and varicose veins are often more pronounces
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Twin pregnancies come to term with the same frequency as single pregnancies
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The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that:a) She will have to give birth at homeb) She must see an obstetrician as well as the midwife during pregnancyc) She will not be able to have epidural analgesia for labor paind) She must be having a low-risk pregnancy
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She must be having a low-risk pregnancy
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An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that:a) Intercourse should be avoided if any spotting from the vagina occurs afterwardb) Intercourse is safe until the third trimesterc) Safer-sex practices should be used once the membranes ruptured) Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present
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Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present
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A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps is she:a) Wiggles and points her toes during the crampb) Applies cold compresses to the affected legc) Extends her leg and dorsiflexes her foot during the crampd) Avoids weight bearing on the affected leg during the cramp
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Extends her leg and dorsiflexes her foot during the cramp
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An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's best response is:a) This is normal behaviour and should begin to subside by the second trimesterb) She may be having difficulty adjusting to pregnancy; I will refer her to a counselor I knowc) This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnantd) You seem impatient with her. Perhaps this is precipitating her behaviour
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This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant
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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 weeksb) Explain that the fetus has a 50% chance of having the disorderc) Discuss options with the couple, including amniocentesis to determine whether the fetus is affectedd) Refer the couple to a psychologist for emotional support
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Discuss options with the couple, including amniocentesis to determine whether the fetus is affected
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You are a maternal-newborn nurse caring for a mother who just delivered a baby born with Down syndrome. What nursing diagnosis would be the most essential in caring for the mother of this infant?a) Disturbed body imageb) Interrupted family processesc) Anxietyd) Risk for injury
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Interrupted family processes
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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 matureb) Karyotyping will reveal if your baby will develop normallyc) Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomesd) Karyotyping will detect any physical deformities and chromosomal structure
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Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes.
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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 disorderc) Disorders involving maternal ingestion of drugs carry a one in four chance of being repeated in the secong childd) The risk factor remains the same no matter how many affected children are already in the family
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The risk factor remains the same no matter how many affected children are already in the family
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With regard to abnormalities of chromosomes, nurses should be aware that:a) They occur in approximately 10% of newbornsb) Abnormalities of number are the leading cause of pregnancy lossc) Down syndrome is a result of an abnormal chromosomal structured) Unbalanced translocation results in a milk abnormality that the child will outgrow
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Abnormalities of number are the leading cause of pregnancy loss
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A key finding from the Human Genome Project is:a) Approximately 20,000 to 25,000 genes make up the genomeb) All human beings are 80.99 identical at the DNA levelc) Human genes produce only one protein per gene; other mammals produce three proteins per gened) Single-gene testing will become a standardized test for all pregnant women in the future
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Approximately 20,000 to 25,000 genes make up the genome
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Most of the genetic tests now offered in clinical practice are tests for:a) Single-gene disordersb) Carrier screeningc) Predictive valuesd) Predispositional testing
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Single-gene disorders
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Which suggestion about weight gain is not an accurate recommendation?a) Underweight women should gain 12.5 to 18kgb) Obese women should gain at least 7kgc) Adolescents are encouraged to strive for weight gains at the upper end of the recommended scaled) In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled
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In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled
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A pregnant woman experiencing nausea and vomiting should:a) Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morningb) Eat small, frequent meals (every 2 to 3 hours)c) Increase her intake of high-fat foods to keep the stomach full and coatedd) Limit fluid intake throughout the day
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Eat small, frequent meals (every 2 to 3 hours)
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A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important?a) Several glasses of fluidb) Extra protein sources, such as peanut butterc) Salty foods to replace sodiumd) Easily digested sources of carbohydrates
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Extra protein sources, such as peanut butter
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Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:a) Spina bifidab) Intrauterine growth restrictionc) Diabetes mellitusd) Down syndrome
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Intrauterine growth restriction
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Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet?a) Fat soluble vitamins A and Db) Water-soluble vitamins C and B6c) Iron and folated) Calcium and zinc
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Iron and folate
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With regard to nutritional needs during lactation, a maternity nurse should be aware that:a) The mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancyb) Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakefulc) Critical iron and folic acid levels must be maintainedd) Lactating women can go back to their prepregnant calorie intake
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Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful
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When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:a) Milk, coffee, and tea iron absorption if consumed at the same time as ironb) Iron absorption is inhibited by a diet rich in vitamin Cc) Iron supplements are permissible for children in small dosesesd) Constipation is common with iron supplements
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constipation is common with iron supplements
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A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lb) since conception. How would the nurse interpret this?a) This weight gain indicates possible gestational hypertensionb) This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR)c) This weight gain cannot be evaluated until the woman has been observed for several more weeksd) The woman's weight gain is appropriate for this stage of pregnancy
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The woman's weight gain is appropriate for this stage of pregnancy
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With regard to protein in the diet of pregnant women, nurses should be aware that:a) Many protein-rich foods are also good sources of calcium, iron, and B vitaminsb) Many women need to increase their protein intake during pregnancyc) As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the dietd) High-protein supplements can be used without risk by women on macrobiotic diets
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Many protein-rich foods are also good sources of calcium, iron, and B vitamins
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A 40 year old woman with a high body mass index (BMI) is 10 weeks pregnant. Which diagnostic tool is appropriate to suggest to her at this time?a) Biophysical profileb) Amniocentesisc) Maternal serum alpha-fetoprotein (MSAFP)d) Transvaginal ultrasound
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Transvaginal ultrasound
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A nurse providing care for antepartum woman should understand that the contraction stress test (CST):a) Sometimes use vibroacoustic stimulationb) Is an invasive test; however, contractions are stimulatedc) Is considered negative if no late decelerations are observed with the contractionsd) Is more effective than nonstress test (NST) if the membranes have already been ruptured
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Is considered negative if no late decelerations are observed with the contractions
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In the past, factors to determine whether a woman was likely to develop a high risk pregnancy were evaluated primarily from a medical point of view. A broader more comprehensive approach to high risk pregnancy has been adopted. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. These categories include all of these except:a) Biophysicalb) Psychosocialc) Geographicd) Environmental
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Geographic
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A woman who is at 36 weeks of gestation is having a nonstress test. Which statement indicates her correct understanding of the test?a) I will need to have a full bladder for the test to be done accuratelyb) I should have my husband drive me home after the test because I may be nauseatedc) This test will help determine if the baby has Down syndrome or a neural tube defectd) This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby
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This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby
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What is an appropriate indicator for performing a contraction stress test?a) Increased fetal movement and small for gestational ageb) Maternal diabetes mellitus and postmaturityc) Adolescent pregnancy and poor prenatal cared) History of preterm labor and intrauterine growth restriction
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Maternal diabetes mellitus and postmaturity
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The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis?a) Doppler blood flow analysisb) Contraction stress test (CST)c) Amniocentesisd) Daily fetal movement counts
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Doppler blood flow analysis
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Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that:a) Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosisb) Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defectsc) Percutaneous umbilical blood sampling (PUBS) is one of the quad-screen tests for Down syndromed) MSAFP is a screening tool only; it identifies candidates for more definitive procedures
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MSAFP is a screening tool only; it identifies candidates for more definitive procedures
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