Obstetrics/ Maternity Practice Exam 103 Questions with Verified Answers
The nurse is preparing a client with a term pregnancy who is in active labor
... [Show More] for an amniotomy. What equipment should the nurse have available at the client's bedside? (Select all that apply.)
A. litmus paper
B. fetal scalp electrode
C. a sterile glove
D. an amniotic hook
E. sterile vaginal speculum
F. a doppler - CORRECT ANSWER C. A sterile glove
D. An amniotic hook
F. A doppler
A single sterile glove, an amniotic hook , and Doppler are needed to check fetal heart tones are the necessary equipment for performing an amniotomy.
A woman with Type 2 diabetes mellitus becomes pregnant, and her oral hypoglycemic agents are discontinued. Which intervention is most important for the nurse to implement?
A. Describe diet changes that can improve the management of her diabetes.
B. Inform the client that oral hypoglycemic agents are teratogenic during pregnancy.
C. Demonstrate self-administration of insulin.
D. Evaluate the client's ability to do glucose monitoring. - CORRECT ANSWER A. Describe diet changes that can improve the management of her diabetes.
Diet modifications are effective in managing Type 2 diabetes during pregnancy, and describing the necessary diet changes is the most important intervention for the nurse to implement with this client.
After each feeding, a 3-day-old newborn is spitting up large amounts of a non-dairy based Newborn formula. The pediatric healthcare provider changes the neonate's formula to a soy protein isolate based infant formula. What information should the nurse provide to the mother about the newly prescribed formula?
A. The new formula is a coconut milk formula used with babies with impaired fat absorption.
B. The new formula is prescribed for infants with malabsorption syndromes.
C. The new formula is a casein protein source that is low in phenylalanine.
D. The prescribed formula is well tolerated by lactose intolerant infants. - CORRECT ANSWER D. The prescribed formula is well tolerated by lactose intolerant infants.
The nurse should explain that the newborn's feeding intolerance may be related to the lactose found in cow's milk formula and is being replaced with the soy-based formula that contains sucrose, which is well-tolerated in infants with milk allergies and lactose intolerance.
When preparing a class on newborn care for expectant parents, what content should the nurse teach concerning the newborn infant born at term gestation?
A. Milia are red marks made by forceps and will disappear within 7 to 10 days.
B. Meconium is the first stool and is usually yellow gold in color.
C. Vernix is a white, cheesy substance, predominantly located in the skin folds.
D. Pseudostrabismus found in newborns is treated by minor surgery. - CORRECT ANSWER C. Vernix is a white, cheesy substance, predominantly located in the skin folds.
The vernix is found in the folds of the skin, is a characteristic of term infants.
A 23-year-old client who is receiving Medicaid benefits is pregnant with her first child. Based on knowledge of the statistics related to infant mortality, which plan should the nurse implement with this client?
A. Refer the client to a social worker to arrange for home care.
B. Recommend perinatal care from an obstetrician, not a nurse-midwife.
C. Teach the client why keeping prenatal care appointments is important.
D. Advise the client that neonatal intensive care may be needed. - CORRECT ANSWER C. Teach the client why keeping prenatal care appointments is important.
Regular prenatal visits should begin early in pregnancy to monitor health of the mother and development of the fetus.
An off-duty nurse finds a woman in a supermarket parking lot delivering an infant while her husband is screaming for someone to help his wife. Which intervention has the highest priority?
A. Use a thread to tie off the umbilical cord.
B. Provide as much privacy as possible for the woman.
C. Reassure the husband and try to keep him calm.
D. Put the newborn to breast. - CORRECT ANSWER D. Put the newborn to breast.
The most important intervention is placing the newborn to the mother's breast. This action serves two purposes as it will help contract the uterus thus preventing a postpartum hemorrhage and avoid infant "cold-stress" because skin to skin will maintain the infant's thermoregulation.
When explaining "postpartum blues" to a client who is 1 day postpartum, which symptoms should the nurse include in the teaching plan? (Select all that apply.)
A. Mood swings.
B. Panic attacks.
C. Tearfulness.
D. Decreased need for sleep.
E. Disinterest in the infant. - CORRECT ANSWER A. Mood swings
C. Tearfulness.
"Postpartum blues" is a common emotional response related to the rapid decrease in placental hormones after delivery and include mood swings, tearfulness, feeling low, emotional, and fatigued.
The nurse identifies crepitus when examining the chest of a newborn who was delivered vaginally. Which further assessment should the nurse perform?
Elicit a positive scarf sign on the affected side.
Observe for an asymmetrical Moro (startle) reflex.
Watch for swelling of fingers on the affected side.
Note paralysis of affected extremity and muscles. - CORRECT ANSWER Observe for an asymmetrical Moro (startle) reflex.
The most common neonatal birth trauma due to a vaginal delivery is fracture of the clavicle. Although an infant may be asymptomatic, a fractured clavicle should be suspected if an infant has limited use of the affected arm, malposition of the arm, an asymmetric Moro reflex, crepitus over the clavicle, focal swelling or tenderness, or cries when the arm is moved.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension (PIH). The healthcare provide prescribed magnesium sulfate is to control the symptoms. Which assessment finding would indicate that therapeutic drug level has been achieved?
4+ reflexes.
Urinary output of 50 ml per hour.
A decrease in respiratory rate from 24 to 16.
A decreased body temperature. - CORRECT ANSWER A decrease in respiratory rate from 24 to 16.
Magnesium sulfate is a CNS depressant that helps prevent seizures. A decreased respiratory rate indicates that the drug is effective. (Respiratory rate below 12 indicates toxic effects.) The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6 mg/dl.
What action should the nurse implement to decrease the client's risk for hemorrhage after a cesarean section?
Monitor urinary output via an indwelling catheter.
Assess the abdominal dressings for drainage.
Give the Ringer's Lactated infusion at 125 ml/hr.
Check the firmness of the uterus every 15 minutes. - CORRECT ANSWER Check the firmness of the uterus every 15 minutes.
A client's risk of postpartal hemorrhage is decreased when the uterus is firm after delivery of the infant. Assessment of fundus consistency q15 minutes provides frequent intervals to stimulate the fundus to contract and prevent bleeding.
One hour after giving birth to an 8-pound infant, a client's lochia rubra has increased from small to large and her fundus is boggy despite massage. The client's pulse is 84 beats/minute and blood pressure is 156/96. The healthcare provider prescribes Methergine 0.2 mg IM X 1. What action should the nurse take immediately?
A. Give the medication as prescribed and monitor for efficacy.
B. Encourage the client to breastfeed rather than bottle term-8feed.
C. Have the client empty her bladder and massage the fundus.
D. Call the healthcare provider to question the prescription. - CORRECT ANSWER D. Call the healthcare provider to question the prescription.
Methergine is used to treat postpartum hemorrhage, but is contraindicated for clients with elevated blood pressure, so the nurse should contact the healthcare provider and question the prescription because the client's elevated blood pressure.
A 4-week-old premature infant has been receiving epoetin alfa (Epogen) for the last three weeks. Which assessment finding indicates to the nurse that the drug is effective?
Slowly increasing urinary output over the last week.
Respiratory rate changes from the 40s to the 60s.
Changes in apical heart rate from the 180s to the 140s.
Change in indirect bilirubin from 12 mg/dl to 8 mg/dl. - CORRECT ANSWER Changes in apical heart rate from the 180s to the 140s.
Epogen, given to prevent or treat anemia, stimulates erythropoietin production, resulting in an increase in RBCs. Since the body has not had to compensate for anemia with an increased heart rate, changes in heart rate from high to normal is one indicator that Epogen is effective.
When assessing a client who is at 12-weeks gestation, the nurse recommends that she and her husband consider attending childbirth preparation classes. When is the best time for the couple to attend these classes?
At 16-weeks gestation.
At 20-weeks gestation.
At 24-weeks gestation.
At 30-weeks gestation. - CORRECT ANSWER At 30-weeks gestation.
Learning is facilitated by an interested pupil. The couple is most interested in childbirth toward the end of the pregnancy when they are psychologically ready for the termination of the pregnancy, and the birth of their child is an immediate concern.
A couple has been trying to conceive for nine months without success. Which information obtained from the clients is most likely to have an impact on the couple's ability to conceive a child?
Exercise regimen of both partners includes running four miles each morning.
History of having sexual intercourse 2 to 3 times per week.
The woman's menstrual period occurs every 35 days.
They use lubricants with each sexual encounter to decrease friction. - CORRECT ANSWER They use lubricants with each sexual encounter to decrease friction.
The use of lubricants has the potential to affect fertility because some lubricants interfere with sperm motility.
Just after delivery, a new mother tells the nurse, "I was unsuccessful breastfeeding my first child, but I would like to try with this baby." Which intervention is best for the nurse to implement first?
Assess the husband's feelings about his wife's decision to breastfeed their baby.
Ask the client to describe why she was unsuccessful with breastfeeding her last child.
Encourage the client to develop a positive attitude about breastfeeding to help ensure success.
Provide assistance to the mother to begin breastfeeding as soon as possible after delivery. - CORRECT ANSWER Provide assistance to the mother to begin breastfeeding as soon as possible after delivery.
Infants respond to breastfeeding best when feeding is initiated in the active phase soon after delivery.
A primigravida at 40-weeks gestation is receiving oxytocin (Pitocin) to augment labor. Which adverse effect should the nurse monitor for during the infusion of Pitocin?
Dehydration.
Hyperstimulation.
Galactorrhea.
Fetal tachycardia. - CORRECT ANSWER Hyperstimulation.
Pitocin causes the uterine myofibril to contract, so unless the infusion is closely monitored, the client is at risk for hyperstimulation which can lead to tetanic contractions, uterine rupture, and fetal distress or demise.
The nurse is counseling a client who wants to become pregnant. The client tells the nurse that she has a 36-day menstrual cycle and the first day of her last menstrual period was January 8. Which date accurately reflects the calculation of the client's next fertile period?
January 14-15.
January 22-23.
January 30-31.
February 6-7. - CORRECT ANSWER January 30-31.
This client can expect her next period to begin 36 days from the first day of her last menstrual period. A menstrual cycle begins at the first day of the cycle and continues to the first day of the next cycle, therefore if January 8 was the first day on her last menstrual cycle, her next period would begin on February 13. Ovulation occurs 14 days before the first day of the menstrual period so this client would be ovulating on January 30- 31.
A full-term infant is transferred to the nursery from labor and delivery. Which information is most important for the nurse to receive when planning immediate care for the newborn?
The length of labor and method of delivery.
The infant's condition at birth and treatment received.
The feeding method chosen by the parents.
The history of drugs given to the mother during labor. - CORRECT ANSWER The infant's condition at birth and treatment received.
Immediate care is most dependent on the infant's current status (i.e., Apgar scores at 1 and 5 minutes) and any treatment or resuscitation that was indicated.
A new mother is afraid to touch her baby's head for fear of hurting the "large soft spot." Which explanation should the nurse give to this anxious client?
"Some care is required when touching the large soft area on top of your baby's head until the bones fuse together."
"That's just an 'old wives' tale' so don't worry, you can't harm your baby's head by touching the soft spot."
"The soft spot will disappear within 6 weeks and is very unlikely to cause any problems for your baby."
"There's a strong, tough membrane there to protect the baby so you need not be afraid to wash or comb his/her hair." - CORRECT ANSWER "There's a strong, tough membrane there to protect the baby so you need not be afraid to wash or comb his/her hair."
The anterior fontanel or "large soft spot" has a strong epidermal membrane present, which can be touched. The posterior fontanel closes at 8-12 weeks. Providing this information to the client will alleviate her anxiety related to knowledge deficit
In developing a teaching plan for expectant parents, the nurse plans to include information about when the parents can expect the infant's fontanels to close. The nurse bases the explanation on knowledge that for the normal newborn, the
anterior fontanel closes at 2 to 4 months and the posterior by the end of the first week.
anterior fontanel closes at 5 to 7 months and the posterior by the end of the second week.
anterior fontanel closes at 8 to 11 months and the posterior by the end of the first month.
anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month. - CORRECT ANSWER anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month.
In the normal infant the anterior fontanel closes at 12 to 18 months of age and the posterior fontanel by the end of the second month .
The nurse observes a new mother is rooming-in and caring for her newborn infant. Which observation indicates the need for further teaching?
Cuddles the baby close to her.
Rocks and soothes the infant in her arms.
Places the infant prone in the bassinet.
Wraps the baby in a warm blanket after bathing. - CORRECT ANSWER Places the infant prone in the bassinet.
The mother should be instructed to avoid placing the infant prone which is associated with an increased incidence of sudden infant death syndrome (SIDS).
When assisting a client to relieve postpaturm uterine contractions, which nursing intervention would be most helpful for the nurse to take?"
Lying client prone with a pillow on the abdomen.
Asking the client to express milk via breast pump.
Massaging the client's abdomen.
Giving oxytocic medications. - CORRECT ANSWER Lying client prone with a pillow on the abdomen.
Lying prone keeps the fundus contracted and is especially useful with multiparas, who commonly experience afterpains due to lack of uterine tone.
A client in active labor complains of cramps in her leg. What intervention should the nurse implement?
Ask if she takes a daily calcium tablet.
Extend the leg and dorsiflex the foot.
Lower the leg off the side of the bed.
Elevate the leg above the heart. - CORRECT ANSWER Extend the leg and dorsiflex the foot.
Dorsiflexing the foot by pushing the sole of the foot forward or by standing (if the client is capable) (B), and putting the heel of the foot on the floor is the best means of relieving leg cramps. (A) is not related to leg cramps caused by reduced circulation to the foot. (C) is not likely to be helpful. (D) is used to promote venous return, but is not indicated for leg cramps.
A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the nurse to ask this client?
"Which symptom did you experience first?"
"Are you eating large amounts of salty foods?"
"Have you visited a foreign country recently?"
"Do you have a history of rheumatic fever?" - CORRECT ANSWER "Do you have a history of rheumatic fever?"
Obtaining a client's health history is a priority because clients with a history of rheumatic fever may develop mitral valve prolapse, which increases the risk for cardiac decompensation due to the increased blood volume that occurs during pregnancy.
A client who gave birth to a healthy 8 pound infant 3 hours ago is admitted to the postpartum unit. Which nursing plan is best in assisting this mother to bond with her newborn infant?
Encourage the mother to provide total care for her infant.
Provide privacy so the mother can develop a relationship with the infant.
Encourage the father to provide most of the infant's care during hospitalization.
Meet the mother's physical needs and demonstrate warmth toward the infant. - CORRECT ANSWER Meet the mother's physical needs and demonstrate warmth toward the infant.
It is most important to meet the mother's requirement for attention to her needs so that she can begin infant care-taking. Nurse theorist Reva Rubin describes the initial postpartal period as the "taking-in phase," which is characterized by maternal reliance on others to satisfy the needs for comfort, rest, nourishment, and closeness to families and the newborn.
The nurse is preparing a client with a term pregnancy who is in active labor for an amniotomy. What equipment should the nurse have available at the client's bedside? (Select all that apply.)
Select all that apply
Some correct answers were not selected
Litmus paper.
Fetal scalp electrode.
A sterile glove.
An amnihook.
Sterile vaginal speculum.
Lubricant. - CORRECT ANSWER A single sterile glove
An amniotic Hook
Lubricant
A single sterile glove, an amnihook, and lubricant are the necessary equipment for performing an amniotomy.
A client who is in the second trimester of pregnancy tells the nurse that she wants to use herbal therapy. Which response is best for the nurse to provide?
"Herbs are a cornerstone of good health to include in your treatment."
"Touch is also therapeutic in relieving discomfort and anxiety."
"Your healthcare provider should direct treatment options for herbal therapy."
"It is important that you want to take part in your care." - CORRECT ANSWER "It is important that you want to take part in your care."
Clients need to be viewed holistically. By acknowledging the emphasis the client made to alternative and complementary therapies, such as herbal therapy, the client is empowered as an integral member of the healthcare team.
The nurse is calculating the estimated date of confinement (EDC) using Ngele's rule for a client whose last menstrual period started on December 1. Which date is most accurate?
August 1.
August 10.
September 3.
September 8. - CORRECT ANSWER September 8.
Calculation of a client's EDC provides baseline data to monitor fetal gestation. N gele's rule uses the formula: subtract 3 months and add 7 days to the first day of the last normal menstrual period, so December 1 minus 3 months + 7 days is September 8.
A full term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms are this newborn likely to exhibit?
Choking, coughing, and cyanosis.
Projectile vomiting and cyanosis.
Apneic spells and grunting.
Scaphoid abdomen and anorexia. - CORRECT ANSWER Choking, coughing, and cyanosis.
The "3 Cs" of esophageal atresia are coughing, chocking and cyanosis. They are caused by the overflow of secretions into the trachea.
A client receiving epidural anesthesia begins to experience nausea and becomes pale and clammy. What intervention should the nurse implement first?
Raise the foot of the bed.
Assess for vaginal bleeding.
Evaluate the fetal heart rate.
Take the client's blood pressure. - CORRECT ANSWER Raise the foot of the bed.
These symptoms are suggestive of hypotension which is a side effect of epidural anesthesia. Raising the foot of the bed will increase venous return and provide blood to the vital areas.
A new mother asks the nurse, "How do I know that my daughter is getting enough breast milk?" Which response is best for the nurse provide?
"Weigh the baby daily, and if she is gaining weight, she is eating enough."
"Your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day."
"Offer the baby extra bottle milk after her feeding, and see if she is still hungry."
"If you're concerned, you might consider bottle feeding so that you can monitor her intake." - CORRECT ANSWER "Your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day."
An infant is hydrated when the urine is dilute (straw-colored) and frequency of voiding is >6 to 10 times/day. Infants feed 8-12 times in a 24 hour period.
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action will the nurse take?
Notify the healthcare provider or anesthesiologist immediately.
Continue to assess the blood pressure q5 minutes.
Place the woman in a lateral position.
Turn off the continuous epidural. - CORRECT ANSWER Place the woman in a lateral position.
The nurse should immediately turn the woman to a lateral position, place a pillow or wedge under the right hip to deflect the uterus, increase the rate of the main line IV infusion, and administer oxygen by face mask at 10-12 L/min. If the blood pressure remains low, especially if it further decreases, the anesthesiologist/healthcare provider should be notified immediately.
A client at 28-weeks gestation calls the antepartal clinic and states that she is experiencing a small amount of vaginal bleeding which she describes as bright red. She further states that she is not experiencing any uterine contractions or abdominal pain. What instruction should the nurse provide?
Come to the clinic today for an ultrasound.
Go immediately to the emergency room.
Lie on your left side for about one hour and see if the bleeding stops.
Bring a urine specimen to the lab tomorrow to determine if you have a urinary tract infection. - CORRECT ANSWER Come to the clinic today for an ultrasound.
Third trimester painless bleeding is characteristic of a placenta previa. Bright red bleeding may be intermittent, occur in gushes, or be continuous. Rarely is the first incidence life-threatening, nor cause for hypovolemic shock. Diagnosis is confirmed by transabdominal ultrasound.
A client is admitted with the diagnosis of total placenta previa. Which finding is most important for the nurse to report to the healthcare provider immediately?
Heart rate of 100 beats/minute.
Variable fetal heart rate.
Onset of uterine contractions.
Burning on urination. - CORRECT ANSWER Onset of uterine contractions.
Total (complete) placenta previa involves the placenta covering the entire cervical os (opening). The onset of uterine contractions places the client at risk for dilation and placental separation, which causes painless hemorrhaging. The risk of hemorrhage is the priority.
A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the nurse implement first?
Provide oral hydration.
Have a complete blood count (CBC) drawn.
Obtain a specimen for urine analysis.
Place the client on strict bedrest. - CORRECT ANSWER Obtain a specimen for urine analysis.
Obtaining a urine analysis should be done first because preterm clients with uterine irritability and contractions are often suffering from a urinary tract infection thus it should be ruled out first.
A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness?
Wear a cotton bra.
Increase nursing time gradually.
Correctly place the infant on the breast.
Manually express a small amount of milk before nursing. - CORRECT ANSWER Correctly place the infant on the breast.
The most common cause of nipple soreness is incorrect positioning of the infant on the breast, e. g., grasping too little of the areola or grasping only the nipple.
A 38-week primigravida who works as a secretary and sits at a computer 8 hours each day tells the nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling of blood in the lower extremities?
Wear support stockings.
Reduce salt in her diet.
Move about every hour.
Avoid constrictive clothing. - CORRECT ANSWER Move about every hour.
Pooling of blood in the lower extremities results from the enlarged uterus exerting pressure on the pelvic veins. Moving about every hour will straighten out the pelvic veins and increase venous return.
The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to complain of tingling fingers and dizziness. What action should the nurse take?
Administer oxygen by face mask.
Notify the healthcare provider of the client's symptoms.
Have the client breathe into her cupped hands.
Check the client's blood pressure and fetal heart rate. - CORRECT ANSWER Have the client breathe into her cupped hands.
Tingling fingers and dizziness are signs of hyperventilation (blowing off too much carbon dioxide). Hyperventilation is treated by retaining carbon dioxide. This can be facilitated by breathing into a paper bag or cupped hand.
In evaluating the respiratory effort of a one-hour-old infant using the Silverman-Anderson Index, the nurse determines the infant has synchronized chest and abdominal movement, just visible lower chest retractions, just visible xiphoid retractions, minimal and transient nasal flaring, and an expiratory grunt heard only on auscultation. What Silverman-Anderson score should the nurse assign to this infant? (Enter numeral value only.) - CORRECT ANSWER 4
A Silverman-Anderson Index has five categories with scores of 0, 1, or 2. The total score ranges from 0 to 10. Four of the these assessment findings should receive a score of 1, and the 5th finding (synchronized chest and abdominal movement) receives a score of 0. Therefore, the total score is 4. A total score of 0 means the infant has no dyspnea, a total score of 10 indicates maximum respiratory distress.
The nurse is performing a gestational age assessment on a full-term newborn during the first hour of transition using the Ballard (Dubowitz) scale. Based on this assessment, the nurse determines that the neonate has a maturity rating of 40-weeks. What findings should the nurse identify to determine if the neonate is small for gestational age (SGA)? (Select all that apply.)
Select all that apply
Some correct answers were not selected
Admission weight of 4 pounds, 15 ounces ( 2244 grams).
Head to heel length of 17 inches (42.5 cm).
Frontal occipital circumference of 12.5 inches (31.25 cm).
Skin smooth with visible veins and abundant vernix.
Anterior plantar crease and smooth heel surfaces.
Full flexion of all extremities in resting supine position. - CORRECT ANSWER Admission weight of 4 pounds, 15 ounces (2244 grams)
Head to heel length of 17 inches (42.5 cm)
Frontal occipital circumference of 12.5 inches (31.25 cm)
The normal full-term, appropriate for gestational age (AGA) newborn should fall between the measurement ranges of weight, 6-9 pounds (2700-4000 grams); length, 19-21 inches (48-53 cm); FOC, 13-14 inches (33-35 cm).
On admission to the prenatal clinic, a 23-year-old woman tells the nurse that her last menstrual period began on February 15, and that previously her periods were regular. Her pregnancy test is positive. This client's expected date of delivery (EDD) would be
November 22.
November 8.
December 22.
October 22. - CORRECT ANSWER November 22.
November 22 is the answer. The RN correctly applied N gele's rule for estimating the due date by counting back 3 months from the first day of the last menstrual period (January, December, November) and adding 7 days (15+7=22).
During a prenatal visit, the client is concerned about the effects smoking can have on the fetus. Which response by the nurse is most accurate regarding infants of mothers who smoke during pregnancy?
these infants have lower Apgar scores when born.
These infants have lower birth weights.
Respiratory distress is seen initially.
a higher rate of congenital anomalies. - CORRECT ANSWER These infants have lower birth weights.
Smoking is associated with low-birth-weight infants, therefore mothers are encouraged not to smoke during pregnancy.
A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when she could use a home pregnancy test to diagnose pregnancy. Which response is appropriate?
"A home pregnancy test can be used right after your first missed period."
"These tests are most accurate after you have missed your second period."
"Home pregnancy tests often give false positives and should not be trusted."
"The test can provide accurate information when used right after ovulation. - CORRECT ANSWER "A home pregnancy test can be used right after your first missed period."
Home urine tests are based on the chemical detection of human chorionic gonadotrophin, which begins to increase 6 to 8 days after conception, and is best detected at 2 weeks gestation or immediately after the first missed period.
A client who is attending antepartum classes asks the nurse why her healthcare provider has prescribed iron tablets. The nurse's response is based on what knowledge?
Supplementary iron is more efficiently utilized during pregnancy.
It is difficult to consume 18 mg of additional iron by diet alone.
Iron absorption is decreased in the GI tract during pregnancy.
Iron is needed to prevent megaloblastic anemia in the last trimester. - CORRECT ANSWER It is difficult to consume 18 mg of additional iron by diet alone.
Consuming enough iron-containing foods to facilitate adequate fetal storage of iron and to meet the demands of pregnancy is difficult so iron supplements are often recommended.
The nurse is planning preconception care for a new female client. Which information should the nurse provide the client?
Discuss various contraceptive methods to use until pregnancy is desired.
Provide written or verbal information about prenatal care.
Ask the client about risk factors associated with complications of pregnancy.
Encourage healthy lifestyles for families desiring pregnancy. - CORRECT ANSWER Encourage healthy lifestyles for families desiring pregnancy.
Preconception care has an overall goal to prepare the client for a healthy pregnancy. It begins with encouraging healthy lifestyle choices in the family and should focus on measures to assist the client in reducing lifestyle variables that may increase the risk for problems in pregnancy.
Which assessment finding should the nursery nurse report to the pediatric healthcare provider?
Blood glucose level of 45 mg/dl.
Blood pressure of 82/45 mmHg.
Non-bulging anterior fontanel.
Central cyanosis when crying. - CORRECT ANSWER Central cyanosis when crying.
An infant who demonstrates central cyanosis when crying is manifesting poor adaptation to extrauterine life which should be reported to the healthcare provider for determination of a possible underlying cardiovascular problem. The other options are expected findings in newborn.
A 40-week gestation primigravida client is being induced with an oxytocin (Pitocin) secondary infusion and complains of pain in her lower back. Which intervention should the nurse implement?
Discontinue the oxytocin (Pitocin) infusion.
Place the client in a semi-Fowler's position.
Inform the healthcare provider.
Apply firm pressure to sacral area. - CORRECT ANSWER Apply firm pressure to sacral area.
The discomfort of "back labor" can be minimized by the application of firm pressure to the sacral area.
A healthcare provider informs the charge nurse of a labor and delivery unit that a client is coming to the unit with suspected abruptio placentae. What findings should the charge nurse expect the client to demonstrate? (Select all that apply.)
Dark, red vaginal bleeding.
Lower back pain.
Premature rupture of membranes.
Increased uterine irritability.
Bilateral pitting edema.
A rigid abdomen. - CORRECT ANSWER Dark, red vaginal bleeding.
Increased uterine irritability.
A rigid abdomen.
The symptoms of abruptio placentae include dark red vaginal bleeding (A), increased uterine irritability (D), and a rigid abdomen (F). (B, C, and E) are findings not associated with abruptio placentae.
While breastfeeding, a new mother strokes the top of her baby's head and asks the nurse about the baby's swollen scalp. The nurse responds that the swelling is caput succedaneum. Which additional information should the nurse provide this new mother?
The infant should be positioned to reduce the swelling.
The swelling is a subperiosteal collection of blood.
The pediatrician will aspirate the blood if it gets larger.
The scalp edema will subside in a few days after birth. - CORRECT ANSWER The scalp edema will subside in a few days after birth. [Show Less]