FINAL EXAM OB practice 101 Questions with Verified Answers
A 23-year-old African-American woman is pregnant with her first child. On the basis of the
... [Show More] statistics for infant mortality, which plan is most important for the nurse to implement?
Perform a nutrition assessment.
Refer the woman to a social worker.
Advise the woman to see an obstetrician, not a midwife.
Explain to the woman the importance of keeping her prenatal care appointments. -CORRECT ANSWER Explain to the woman the importance of keeping her prenatal care appointments.
A 38-year-old maternity patient receives information based on genetic testing that her fetus has a deformity and decides to terminate the pregnancy. There is a family history of genetic abnormalities. Following the termination of pregnancy, the pathology report indicates that the fetus had no structural abnormalities. This finding suggests that:
The patient should have asked for a second opinion from a perinatal specialist.
The genetic test results provided indicated a false-negative finding.
Genetic testing results vary with patient demographics and information provided.
Results indicated a false-positive finding leading to an adverse outcome. -CORRECT ANSWER Results indicated a false-positive finding leading to an adverse outcome.
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?
Biophysical profile
Amniocentesis
Maternal serum alpha-fetoprotein (MSAFP)
Transvaginal ultrasound -CORRECT ANSWER Transvaginal ultrasound
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 coming to see the women's health nurse practitioner for her visit. To facilitate a positive health care experience, the nurse should:
Remind the woman that she is long overdue for her examination and that she should come in annually.
Listen carefully and allow extra time for this woman's health history interview.
Reassure the woman that a nurse practitioner is just as good as her old doctor.
Encourage the woman to talk about the death of her husband and her fears about her own death. -CORRECT ANSWER Listen carefully and allow extra time for this woman's health history interview.
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 behavior is most likely a reflection of:
Delayed attachment.
Embarrassment.
Disappointment in the sex of the baby.
A belief that babies should not be fed colostrum. -CORRECT ANSWER A belief that babies should not be fed colostrum.
A couple has been counseled for genetic anomalies. They ask you, "What is karyotyping?" Your best response is:
"Karyotyping will reveal whether the baby's lungs are mature."
"Karyotyping will reveal whether your baby will develop normally."
"Karyotyping will provide information about the gender of the baby and the number and structure of the baby's chromosomes."
"Karyotyping will detect any physical deformities the baby has." -CORRECT ANSWER "Karyotyping will provide information about the gender of the baby and the number and structure of the baby's chromosomes."
A mother's household consists of her husband, his mother, and another child. She is living in a/an:
Extended family.
Single-parent family.
Married-blended family.
Trinuclear family. -CORRECT ANSWER Extended family.
A nurse is advising a pregnant patient who has a substance abuse problem about a contingency management program. Which statement identifies an aspect of this type of program?
Pregnant woman are confined to an inpatient treatment method during their pregnancy.
Pregnant woman are given biofeedback modalities as stimulus responses to control their addiction.
Pregnant woman are given motivational incentives as a primary approach to stop their drug abuse problem.
Pregnant woman must follow a strict medication nutritional program during the course of pregnancy. -CORRECT ANSWER Pregnant woman are given motivational incentives as a primary approach to stop their drug abuse problem.
A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should:
Tell the couple they need to have an abortion within 2 to 3 weeks.
Explain that the fetus has a 50% chance of having the disorder.
Discuss options with the couple, including amniocentesis to determine whether the fetus is affected.
Refer the couple to a psychologist for emotional support. -CORRECT ANSWER Discuss options with the couple, including amniocentesis to determine whether the fetus is affected.
A nurse is providing instruction for an obstetrical patient to perform a daily fetal movement count (DFMC). Which instructions could be included in the plan of care? (Select all that apply.)
The fetal alarm signal is reached when there are no fetal movements noted for 5 hours.
The patient can monitor fetal activity once daily for a 60-minute period and note activity.
Monitor fetal activity two times a day either after meals or before bed for a period of 2 hours or until 10 fetal movements are noted.
Count all fetal movements in a 12-hour period daily until 10 fetal movements are noted. -CORRECT ANSWER The patient can monitor fetal activity once daily for a 60-minute period and note activity.
Monitor fetal activity two times a day either after meals or before bed for a period of 2 hours or until 10 fetal movements are noted.
Count all fetal movements in a 12-hour period daily until 10 fetal movements are noted.
A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:
A positive pregnancy test result.
Fetal movement palpated by the nurse-midwife.
Braxton Hicks contractions.
Quickening. -CORRECT ANSWER Fetal movement palpated by the nurse-midwife.
A patient has undergone an amniocentesis for evaluation of fetal well-being. Which intervention would be included in the nurse s plan of care after the procedure? (Select all that apply.)
Perform ultrasound to determine fetal positioning.
Observe the patient for possible uterine contractions.
Administer RhoGAM to the patient if she is Rh negative.
Perform a minicatheterization to obtain a urine specimen to assess for bleeding. -CORRECT ANSWER Observe the patient for possible uterine contractions.
Administer RhoGAM to the patient if she is Rh negative.
A pregnant patient is experiencing some integumentary changes and is concerned that they may represent abnormal findings. The nurse provides information to the patient that the following findings would be considered "normal abnormal" findings during pregnancy so that she should not be alarmed. (Select all that apply.)
Facial edema
Melasma
Linea nigra
Superficial thrombophlebitis
Vascular spiders
Allodynia -CORRECT ANSWER Melasma
Linea nigra
Vascular spiders
woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity according to the GTPAL system?
2-0-0-1-1
2-1-0-1-0
3-1-0-1-0
3-0-1-1-0 -CORRECT ANSWER 3-1-0-1-0
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
Primipara
Primigravida
Multipara
Nulligravida -CORRECT ANSWER Primipara
A woman who is at 36 weeks of gestation is having a nonstress test. Which statement indicates her correct understanding of the test?
"I will need to have a full bladder for the test to be done accurately."
"I should have my husband drive me home after the test because I may be nauseated."
"This test will help to determine whether the baby has Down syndrome or a neural tube defect."
"This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."
1 points -CORRECT ANSWER "This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
Less audible heart sounds (S1, S2)
Increased pulse rate
Increased blood pressure
Decreased red blood cell (RBC) production -CORRECT ANSWER Increased pulse rate
From the nurse's perspective, what measure should be the focus of the health care system in order to reduce the rate of infant mortality further?
Implementing programs to ensure women's early participation in ongoing prenatal care
Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days
Expanding the number of neonatal intensive care units (NICUs)
Mandating that all pregnant women receive care from an obstetrician -CORRECT ANSWER Implementing programs to ensure women's early participation in ongoing prenatal care
In caring for a mother who has abused (or is abusing) alcohol and for her infant, nurses should be aware that:
The pattern of growth restriction of the fetus begun in prenatal life is halted after birth, and normal growth takes over.
Two thirds of newborns with fetal alcohol syndrome (FAS) are boys.
Alcohol-related neurodevelopmental disorders (ARNDs) not sufficient to meet FAS criteria (learning disabilities, speech and language problems) are often not detected until the child goes to school.
Both the distinctive facial features of the FAS infant and the diminished mental capacities tend toward normal over time. -CORRECT ANSWER Alcohol-related neurodevelopmental disorders (ARNDs) not sufficient to meet FAS criteria (learning disabilities, speech and language problems) are often not detected until the child goes to school.
In the past, factors to determine whether a woman was likely to have 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. Which of the options listed here is not included as a category?
Biophysical
Psychosocial
Geographic
Environmental -CORRECT ANSWER Geographic
In which culture is the father more likely to be expected to participate in the labor and delivery?
Asian-American
African-American
European-American
Hispanic -CORRECT ANSWER European-American
Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?
Radioimmunoassay
Radioreceptor assay
Latex agglutination test
Enzyme-linked immunosorbent assay (ELISA) -CORRECT ANSWER Enzyme-linked immunosorbent assay (ELISA)
The hormone responsible for maturation of mammary gland tissue is:
Estrogen.
Testosterone.
Prolactin.
Progesterone. -CORRECT ANSWER Progesterone.
The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping:
In a side-lying position.
On her back with a pillow under her knees.
With the head of the bed elevated.
On her abdomen. -CORRECT ANSWER In a side-lying position.
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?
Doppler blood flow analysis
Contraction stress test (CST)
Amniocentesis
Daily fetal movement counts -CORRECT ANSWER Doppler blood flow analysis
visually apparent gradual decrease in FHR in which onset to lowest point is greater than 30 seconds -CORRECT ANSWER late decelerations
A visually apparent abrupt increase in fetal heart rate above the baseline rate. -CORRECT ANSWER acceleration
What uses external transducers placed on the maternal abdomen to assess FHR and pattern and uterine activity -CORRECT ANSWER external fetal monitoring
Irregular fluctuations in the baseline fetal heart rate of two cycles per minute or greater. -CORRECT ANSWER variability
the time from the beginning of one contraction to the beginning of the next contraction -CORRECT ANSWER contraction frequency
Please choose all that are true of a fetal heart rate that is abnormal (hypoxic fetus) and require intervention
Baseline fetal heart rate of 110-160
Recurrent variable decelerations
Recurrent late decelerations
Early decelerations either present or absent
Baseline variability absent -CORRECT ANSWER Recurrent variable decelerations
Recurrent late decelerations
Baseline variability absent
Choose all that are true of a reassuring (normal) fetal heart rate pattern
recurrent late decelerations
accelerations either present or absent
Bradycardia
Baseline rate of 110-160
variability moderate -CORRECT ANSWER accelerations either present or absent
Baseline rate of 110-160
variability moderate
A nurse caring for a laboring woman is cognizant that early decelerations are caused by:
Compression on the fetal head
Umbilical cord compression
Uteroplacental insufficiency
Spontaneous rupture of membranes -CORRECT ANSWER Compression on the fetal head
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.
Call the provider, reposition the mother, and perform a vaginal exam.
Provide oxygen via face mask, reposition the mother, and increase IV fluid.
Administer oxygen to the mother, increase IV fluid, and notify the health care provider.
Perform a vaginal examination, reposition the mother, and provide oxygen via face mask. -CORRECT ANSWER Provide oxygen via face mask, reposition the mother, and increase IV fluid.
Which fetal heart rate (FHR) finding concerns the nurse during labor?
Accelerations with fetal movement
Early decelerations
An average FHR of 126 beats/min
Late decelerations -CORRECT ANSWER Late decelerations
When electronic fetal monitoring (EFM) made its debut for clinical use in the early 1970s, the expectation was that its use would result in fewer cases of cerebral palsy and be more sensitive than auscultation in predicting fetal compromise. Was this prediction correct?
True
False -CORRECT ANSWER False
According to the National Institute of Child Health and Human Development (NICHD) Three-Tier System of Fetal Heart Rate Classification, category III tracings include all fetal heart rate (FHR) tracings not categorized as category I or II. Which characteristics of the fetal heart rate belong in category III?
Baseline rate of 110 to 160 beats/min
Tachycardia
Absent baseline variability not accompanied by recurrent decelerations
Variable decelerations with other characteristics such as shoulders or overshoots
Absent baseline variability with recurrent variable decelerations
Bradycardia -CORRECT ANSWER Absent baseline variability with recurrent variable decelerations
Bradycardia
A 25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge. As the nurse prepares her for discharge, she begins to cry. The nurse's next action should be what?
Assess her for pain.
Point out how lucky she is to have a healthy baby.
Explain that she is experiencing postpartum blues.
Allow her time to express her feelings. -CORRECT ANSWER Allow her time to express her feelings.
A new mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues rather than waiting until the baby is frantically crying. Which feeding cue would indicate that the baby is ready to eat?
Waves her arms in the air
Makes sucking motions
Has the hiccups
Stretches out her legs straight -CORRECT ANSWER Makes sucking motions
A nurse caring for a postpartum woman understands that breast engorgement is caused by:
Overproduction of colostrum
Accumulation of milk in the lactiferous ducts and glands
Hyperplasia of mammary tissue
Congestion of veins and lymphatics -CORRECT ANSWER Congestion of veins and lymphatics
A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. Which findings should the nurse include in the discussion? (Select all that apply.)
Breast tenderness
Warmth in the breast
Area of redness on the breast often resembling the shape of a pie wedge
Small white blister on the tip of the nipple
Fever and flulike symptoms -CORRECT ANSWER Breast tenderness
Warmth in the breast
Area of redness on the breast often resembling the shape of a pie wedge
Fever and flulike symptoms
A nurse providing couplet care should understand the issue of nipple confusion. In which situation might this condition occur?
Breastfeeding babies receive supplementary bottle feedings.
Baby is too abruptly weaned.
Pacifiers are used before breastfeeding is established.
Twins are breastfed together.
1 points -CORRECT ANSWER Breastfeeding babies receive supplementary bottle feedings.
A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment after childbirth. Recognizing the needs of women during this stage, how should the nurse respond?
Foster an active role in the baby's care.
Provide time for the mother to reflect on the events of her labor and delivery.
Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital.
Promote maternal independence by encouraging her to meet her own hygiene and comfort needs. -CORRECT ANSWER Provide time for the mother to reflect on the events of her labor and delivery.
A primiparous woman is to be discharged from the hospital the following day with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged?
The woman is disinterested in learning about infant care.
The woman continues to hold and cuddle her infant after she has fed her.
The woman reads a magazine while her infant sleeps.
The woman changes her infant's diaper and then shows the nurse the contents of the diaper. -CORRECT ANSWER The woman is disinterested in learning about infant care.
A woman gave birth to a 7-lb, 6-oz infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When assessing the woman's vital signs, the nurse is concerned to see:
Temperature 37.9° C, heart rate 120, respirations 20, blood pressure 90/50
Temperature 37.4° C, heart rate 88, respirations 36, blood pressure 126/68
Temperature 38° C, heart rate 80, respirations 16, blood pressure 110/80
Temperature 36.8° C, heart rate 60, respirations 18, blood pressure 140/90 -CORRECT ANSWER Temperature 37.9° C, heart rate 120, respirations 20, blood pressure 90/50
Hearing loss is one of the genetic disorders included in the universal screening program. Auditory screening of all newborns within the first month of life is recommended by the AAP. What is the rationale for having this testing performed? (Select all that apply.)
Prevents or reduces developmental delays
Reassures concerned new parents
Provides early identification and treatment
Helps the child communicate better
Is recommended by the Joint Committee on Infant Hearing -CORRECT ANSWER Prevents or reduces developmental delays
Provides early identification and treatment
Helps the child communicate better
Is recommended by the Joint Committee on Infant Hearing
In assisting the breastfeeding mother to position the baby, which information regarding positioning is important for the nurse to keep in mind?
The cradle position is usually preferred by mothers who had a cesarean birth.
Women with perineal pain and swelling prefer the modified cradle position.
Whatever the position used, the infant is belly to belly with the mother.
While supporting the head, the mother should push gently on the occiput. -CORRECT ANSWER Whatever the position used, the infant is belly to belly with the mother.
Many first-time parents do not plan on having their parents' help immediately after the newborn arrives. Which statement by the nurse is the most appropriate when counseling new parents regarding the involvement of grandparents?
"You should tell your parents to leave you alone."
"Grandparents can help you with parenting skills."
"Grandparent involvement can be very disruptive to the family."
"They are getting old. You should let them be involved while they can." -CORRECT ANSWER "Grandparents can help you with parenting skills."
Many new mothers experience some type of nipple pain during the first weeks of initiating breastfeeding. Should this pain be severe or persistent, it may discourage or inhibit breastfeeding altogether. Which factors might contribute to this pain? (Select all that apply.)
Improper feeding position
Large-for-gestational age infant
Fair skin
Progesterone deficiency
Flat or retracted nipples -CORRECT ANSWER Improper feeding position
Fair skin
Flat or retracted nipples
The nurse observes that a first-time mother appears to ignore her newborn. Which strategy should the nurse use to facilitate mother-infant attachment?
Tell the mother she must pay attention to her infant.
Show the mother how the infant initiates interaction and attends to her.
Demonstrate for the mother different positions for holding her infant while feeding.
Arrange for the mother to watch a video on parent-infant interaction. -CORRECT ANSWER Show the mother how the infant initiates interaction and attends to her.
The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?
The postpartum woman talks and coos to her son.
She seldom makes eye contact with her son.
The mother cuddles her son close to her.
She tells visitors how well her son is feeding. -CORRECT ANSWER She seldom makes eye contact with her son.
Screening for critical congenital heart disease (CCHD) was added to the uniform screening panel in 2011. The nurse has explained this testing to the new mother. Which action by the nurse related to this test is correct?
Screening is performed when the infant is 12 hours of age.
Testing is performed with an electrocardiogram.
Oxygen (O2) is measured in both hands and in the right foot.
A passing result is an O2 saturation of ≥95%. -CORRECT ANSWER A passing result is an O2 saturation of ≥95%.
Rh o immune globulin will be ordered postpartum if which situation occurs?
Mother Rh-, baby Rh+
Mother Rh-, baby Rh-
Mother Rh+, baby Rh+
Mother Rh+, baby Rh- -CORRECT ANSWER Mother Rh-, baby Rh+
Postpartum overdistention of the bladder and urinary retention can lead to which complications?
Postpartum hemorrhage and eclampsia
Fever and increased blood pressure
Postpartum hemorrhage and urinary tract infection
Urinary tract infection and uterine rupture -CORRECT ANSWER Postpartum hemorrhage and urinary tract infection
Which actions are examples of appropriate techniques to wake a sleepy infant for breastfeeding? (Select all that apply.)
Unwrapping the infant
Changing the diaper
Talking to the infant
Slapping the infant s hands and feet
Applying a cold towel to the infant s abdomen -CORRECT ANSWER Unwrapping the infant
Changing the diaper
Talking to the infant
When should discharge instruction, or the teaching plan that tells the woman what she needs to know to care for herself and her newborn, officially begin?
At the time of admission to the nurse's unit
When the infant is presented to the mother at birth
During the first visit with the physician in the unit
When the take-home information packet is given to the couple -CORRECT ANSWER At the time of admission to the nurse's unit
When caring for a newly delivered woman, what is the best measure to prevent abdominal distention after a cesarean birth?
Rectal suppositories
Early and frequent ambulation
Tightening and relaxing abdominal muscles
Carbonated beverages -CORRECT ANSWER Early and frequent ambulation
What information should the nurse understand fully regarding rubella and Rh status?
Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus.
Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination.
Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant.
Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations. -CORRECT ANSWER Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination.
The process in which the uterus returns to a nonpregnant state after birth is known as ____________________. -CORRECT ANSWER involution
The postpartum woman continually repeats the story of her labor, delivery, and recovery experience. What is this new mother attempting to achieve with this behavior?
Providing others with her knowledge of events
Making the birth experience real
Taking hold of the events leading up to her labor and delivery
Accepting her response to labor and delivery -CORRECT ANSWER Making the birth experience real
Which explanation will assist the parents in their decision on whether they should circumcise their son?
The circumcision procedure has pros and cons during the prenatal period.
American Academy of Pediatrics (AAP) recommends that all male newborns be routinely circumcised.
Circumcision is rarely painful, and any discomfort can be managed without medication.
The infant will likely be alert and hungry shortly after the procedure. -CORRECT ANSWER The circumcision procedure has pros and cons during the prenatal period.
Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
Estrogen
Progesterone
Prolactin
Human placental lactogen -CORRECT ANSWER Prolactin
Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?
Notify the physician of an impending hemorrhage.
Assess the blood pressure and pulse.
Evaluate the lochia.
Assist the client in emptying her bladder. -CORRECT ANSWER Assist the client in emptying her bladder.
Which physiologic factors are reliable indicators of impending shock from postpartum hemorrhage? (Select all that apply.)
Respirations
Skin condition
Blood pressure
Level of consciousness
Urinary output -CORRECT ANSWER Respirations
Skin condition
Level of consciousness
Urinary output
With regard to the postpartum uterus, nurses should be aware that:
At the end of the third stage of labor, it weighs approximately 500 g
After 2 weeks postpartum, it should not be palpable abdominally
After 2 weeks postpartum, it weighs 100 g
It returns to its original (prepregnancy) size by 6 weeks postpartum -CORRECT ANSWER After 2 weeks postpartum, it should not be palpable abdominally
A married couple is discussing male and female sterilization with the nurse. Which statement is most appropriate for the nurse to make?
"Male and female sterilization methods are 100% effective."
"A vasectomy may have a slight effect on sexual performance."
"Tubal ligation can be easily reversed if you change your mind in the future."
"Major complications after sterilization are rare." -CORRECT ANSWER "Major complications after sterilization are rare."
A woman taking an oral contraceptive pill (OCP) as her birth control method of choice should notify her health care provider immediately if she notes:
Breast tenderness and swelling
Weight gain
Swelling and pain in one of her legs
Mood swings -CORRECT ANSWER Swelling and pain in one of her legs
With regard to emergency contraception pills, nurses should be aware that:
The pills should be readily available during the initial learning phase when a woman is using a new method of contraception.
The pills must be taken no later than 48 hours after unprotected intercourse or birth control mishap.
The pills protect the woman against pregnancy even if she engages in unprotected intercourse in the days after treatment.
Emergency contraception has no medical contraindications. -CORRECT ANSWER The pills should be readily available during the initial learning phase when a woman is using a new method of contraception.
Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:
Uses soap and warm water to wash the vulva and perineum.
Washes from symphysis pubis back to the episiotomy.
Changes her perineal pad every 2 to 3 hours.
Uses the peribottle to rinse upward into her vagina. -CORRECT ANSWER Uses the peribottle to rinse upward into her vagina.
Following a vaginal delivery, the patient tells the nurse that she intends to breastfeed her infant but she is very concerned about returning to her prepregnancy weight. On the basis of this interaction, the nurse would advise the patient that: (Select all that apply.)
She should join Weight Watchers as soon as possible to ensure adequate weight loss.
Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period.
Weight loss diets are not recommended for women who breastfeed.
If breastfeeding, she should regulate her fluid consumption in response to her thirst level.
If she decreases her calorie intake by 100-200 calories a day she will lose weight more quickly. -CORRECT ANSWER Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period.
Weight loss diets are not recommended for women who breastfeed.
If breastfeeding, she should regulate her fluid consumption in response to her thirst level.
Which of the following would be considered to be an intrapartum risk factor for neonatal sepsis?
Mechanical ventilation
Chorioamnionitis
Galactosemia
Meconium aspiration -CORRECT ANSWER Chorioamnionitis
Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. Some generalized signs are:
Hypertonia, tachycardia, and metabolic alkalosis.
Abdominal distention, temperature instability, and grossly bloody stools.
Hypertension, absence of apnea, and ruddy skin color.
Scaphoid abdomen, no residual with feedings, and increased urinary output. -CORRECT ANSWER Abdominal distention, temperature instability, and grossly bloody stools.
In which situations would the use of Methergine or prostaglandin be contraindicated even if the patient was experiencing a postpartum significant bleed? (Select all that apply.)
Patient has delivered twin pregnancies.
Patient's blood pressure postpartum is 180/90.
Patient has a history of asthma.
Patient has a mitral valve prolapse.
Patient is a grand multip. -CORRECT ANSWER Patient's blood pressure postpartum is 180/90.
Patient has a history of asthma.
Patient has a mitral valve prolapse.
To provide adequate postpartum care, the nurse should be aware that postpartum depression (PPD) with psychotic features:
Is more likely to occur in women with more than two children.
Is rarely delusional and is usually about someone trying to harm her (the mother).
Although serious, is not likely to need psychiatric hospitalization.
Is typified by auditory or visual hallucinations. -CORRECT ANSWER Is typified by auditory or visual hallucinations.
What important aspects do all the fertility awareness-based (FAB) methods have in common?
They all require a woman to be able to touch her genitals to assess cervical mucus.
They all involve abstinence at some point.
They all rely on measurement of body temperature.
They all require the cooperation of the woman's partner. -CORRECT ANSWER They all require the cooperation of the woman's partner.
Excessive blood loss after childbirth can have several causes; however, the most common is:
Vaginal or vulvar hematomas.
Unrepaired lacerations of the vagina or cervix.
Failure of the uterine muscle to contract firmly.
Retained placental fragments. -CORRECT ANSWER Failure of the uterine muscle to contract firmly.
Parents can facilitate the adjustment of their other children to a new baby by:
Having children at home choose or make a gift to give the new baby on his or her arrival home.
Emphasizing activities that keep the new baby and other children together.
Having the mother carry the new baby into the home so she can show the other children the baby.
Reducing stress on the other children by limiting their involvement and care of the new baby. -CORRECT ANSWER Having children at home choose or make a gift to give the new baby on his or her arrival home.
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 a 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?
PPD symptoms are consistently severe.
This syndrome affects only new mothers.
PPD can easily go undetected.
Only mental health professionals should teach new parents about this condition. -CORRECT ANSWER PPD can easily go undetected.
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:
Bladder distention
Uterine atony
Constipation
Hematoma formation -CORRECT ANSWER Hematoma formation
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication?
Urinary output of 20 mL per hour
Respiratory rate of 10 breaths/minute
Deep tendons reflexes 2+
Difficulty in arousing -CORRECT ANSWER Deep tendons reflexes 2+
The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which of the following because of the woman's increased risk?
Oligohydramnios
Preeclampsia
Pre term labor
Chorioamnionitis -CORRECT ANSWER Preeclampsia
Pre term labor
The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome?
Hyperglycemia
Elevated platelet count
Leukocytosis
Elevated liver enzymes -CORRECT ANSWER Elevated platelet count
Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?
Calcium gluconate
Potassium chloride
Calcium carbonate
Ferrous sulfate -CORRECT ANSWER Calcium gluconate
A nurse is teaching a pregnant woman with preterm premature rupture of membranes about caring for herself. Which statement by the woman indicates a need for additional teaching?
"I need to keep a close eye on how active my baby is each day."
"I need to call my doctor if my temperature increases."
"It's okay for my husband and me to have sexual intercourse."
"I can shower but I shouldn't take a tub bath." -CORRECT ANSWER "It's okay for my husband and me to have sexual intercourse."
A nursing student is reviewing an article about preterm labor. Which of the following would the student expect to find as factor placing a woman at high risk for this condition? (Select all that apply.)
Low BMI
Urinary tract infection
Single gestation
Smoking -CORRECT ANSWER Low BMI
Urinary tract infection
Smoking
A woman with gestational hypertension experiences a seizure. Which of the following would be the priority?
Delivery of the fetus
Oxygenation
Fluid replacement
Control of hypertension -CORRECT ANSWER Oxygenation
A 21 y.o. client, 6 weeks pregnant, is diagnosed with hyperemesis gravidum. This excessive vomiting during pregnancy will often result in which of the following?
bowel perforation
electrolyte imbalance
miscarriage
PIH -CORRECT ANSWER electrolyte imbalance
A 17 y.o. primpigravida with severe PIH has been receiving mag sulfate IV for 3 hours. The latest assessment reveals DTR of +1, BP 150/100 mmgHg, pulse 92 bpm, respiratory rate 10bpm and urine output 20ml/hr. Which of the following actions would be most appropriate?
Continue monitoring per standards of care
Decrease magnesium sulfate infusion per provider orders
Increase magnesium sulfate infusion per provider orders
Stop the magnesium sulfate infusion -CORRECT ANSWER Stop the magnesium sulfate infusion
After reviewing the client's maternal history of magnesium sulfate during labor, which condition would the nurse anticipate as a potential problem in the neonate?
hypoglycemia
jitteriness
tachycardia
respiratory depression -CORRECT ANSWER respiratory depression
Which of the following are considered risk factors for developing gestation diabetes? (Select all that apply)
Obesity
Previous delivery of a LGA baby
Gestational age greater than 35 weeks
Family history of diabetes -CORRECT ANSWER Obesity
Previous delivery of a LGA baby
Family history of diabetes
The nurse is preforming an initial assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding indicates that the client is at risk for preterm labor?
The client is a 25 year old primigravida
The client has a history of chronic hypertension
The client's hemoglobin level is 13.5 g/dL
The client is a 20 year old primigravida with BMI of 20.5 -CORRECT ANSWER The client's hemoglobin level is 13.5 g/dL
A client in preterm labor (32 weeks) who is dilated to 5cm has been given magnesium sulfate and the contractions have stopped. If the labor can be delayed for the next 2 days, which of the following medication does the nurse expect that will be prescribed?
Fentanyl
Sufentanil
Betamethasone
Butorphanol tartrate -CORRECT ANSWER Betamethasone
What are the typical lab results that can be expected with a 28 week client experiencing HELLP syndrome?
Decreased hemoglobin and hematocrit
Elevated platelets
Elevated liver enzymes
Decreased white blood cell count -CORRECT ANSWER Decreased hemoglobin and hematocrit
Elevated liver enzymes
The nurse is assisting in developing a teaching plan for a client who's about to enter the third trimester of pregnancy. The teaching plan should include identification of which danger sign that must be reported immediately?
Blurred vision
Feeling tired
Weight gain of 1 lb per week
Lower extremity edema -CORRECT ANSWER Blurred vision
A nurse cares for a client diagnosed with preeclampsia. The nurse prepares to administer magnesium sulfate as prescribed. Which assessment data is important prior to initiation of the magnesium sulfate?
Urinary output
Deep tendon reflexes
Bowel function
Blood pressure -CORRECT ANSWER Urinary output
Deep tendon reflexes
Blood pressure
A client with premature rupture of membranes (PROM) at 33 weeks' gestation is to be given betamethasone to increase fetal lung maturity. The nurse checks the client's record to ensure that the client does not have what disorder that could be affected by this drug?
Diabetes Mellitus
History of alcohol abuse
Incompetent cervix
Intrauterine growth restriction (IUGR) -CORRECT ANSWER Diabetes Mellitus
After PROM, if the latent period is longer than 24 hours, the client is predisposed to:
Hemorrhage
Gestational HTN
Amniotic fluid embolism
Chorioamnionitis -CORRECT ANSWER Chorioamnionitis
A nurse is assisting with the evaluation of a client who is 34 weeks gestation for PPROM. Which findings indication PPROM has occurred?
Fernlike pattern seen under microscope when vaginal fluid is placed on a glass slide and allowed to dry
Acidic pH of the vaginal fluid sample
Alkaline of the vaginal fluid when tested
Cervical dilation of 6 cm -CORRECT ANSWER Fernlike pattern seen under microscope when vaginal fluid is placed on a glass slide and allowed to dry
Alkaline of the vaginal fluid when tested
The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes. Which statement if made by the client indicates a need for further education?
I will need to avoid exercise because of the negative effects of insulin production.
I will perform glucose monitoring at home.
I will need to stay on the diabetic diet.
I need to be aware of any infections and report signs of infection immediately to my health care provider. -CORRECT ANSWER I will need to avoid exercise because of the negative effects of insulin production.
Clients with gestational diabetes are usually managed by which of the following therapies?
Oral hypoglycemic
Diet
Long acting insulin before bed
No management is necessary because it will resolve after delivery of the baby -CORRECT ANSWER Diet
Which of the following complications can be potentially life threatening and can occur in a client receiving a tocolytic agent?
Sickle cell anemia
Hyperemesis gravidarum
Pulmonary edema
Diabetic Ketoacidocis -CORRECT ANSWER Pulmonary edema [Show Less]