Final Exam Flashcards
All except which of the following are important historical questions for a 29-year-old woman in clinic for right-sided weakness?
History of pelvic inflammatory disease
A 19-year-old pregnant patient, at 20 weeks gestation, complains of pain in the right lower quadrant. She is afebrile and denies nausea and vomiting. The most likely diagnosis is
Round ligament pain
It is imperative that the nurse practitioner teach patients taking an oral contraceptive to report any of the danger signs of complications. Which of the following would be of least concern to the nurse practitioner?
Weight gain
Aida, who is 29 weeks pregnant, received a blunt trauma to the abdomen during an argument with her boyfriend. She has no obvious injuries and denies pain. Aida needs to be monitored for the occurrence of
Abruptio placentae
What distinguishes pyelonephritis from cystitis?
The infection has ascended to the kidneys
During nursery rounds, you examine a 12-hour-old newborn. The infant has a yellow tint to the skin and sclera. What lab test will you order to further evaluate this infant?
Direct Coombs’ test
The treatment(s) with demonstrated effectiveness relieving symptoms of dysmenorrhea in women with premenstrual syndrome is (are):
The NSAIDs
What has changed in terms of recommended antibiotic treatment for uncomplicated lower UTIs?
Three-day regimens are now recommended
In evaluating a mother-and-infant breastfeeding situation, signs of an effective latch at the breast are
Infant’s lips flanged out, cheeks full
Heger’s sign, a physiological sign of pregnancy, is
Softness of the uterus and ballottement at the isthmus
Susie, who is 16 weeks pregnant, is having mild cramps with persistent and excessive bleeding. Upon examination, you find that some portion of the products of conception (placental) remain in the uterus, but the fetus has been expelled. What type of abortion is Susie having?
Incomplete
The best way for a pregnant woman to avoid injury to herself and her fetus in the event of a motor vehicle accident (MVA) is to
Use both the lap restraint and shoulder restraint
What is the general goal of surgical treatment for stress UI?
To support and stabilize the urethra
To prevent breast trauma during the breastfeeding, the nurse practitioner should stress the importance of
Positioning of the infant
Optimal weight gain during pregnancy is based on the woman’s prepregnant BMI and:
Age
Samantha, who has genital herpes, just found out that she is pregnant. Although she has not had a recurrence in years, she states that she has heard that genital herpes might cause a spontaneous abortion. You know that genital herpes
Might cause a spontaneous abortion if the primary infection was early in the pregnancy
Nelda is breastfeeding her 6-week-old daughter. She comes today with pain, a lump in her right breast, and flu-like symptoms. You see that the breast is engorged, erythematous, and warm to the touch. Her temperature is 101.8°F. Your diagnosis is:
Mastitis
When evaluating Marge during her first obstetric visit, you assess the shape of her pelvis. While drawing her a picture of her android-type pelvis, you explain that it has:
A wedge-shaped inlet, a narrow forepelvis, a flat posterior segment, and a narrow sacrosciatic notch with the sacrum inclining forward
A 45-year-old patient voices concern about her hot flashes and irregular menstral periods. What diagnostic test would the nurse practitioner order to confirm the beginning of menopause?
Serum follicular stimulating hormone (FSH)
The reason most often cited to explain why women who have had a usual length of stay and normal delivery discontinue breastfeeding before 8 weeks postpartum is:
The perception that the infant isn’t receiving enough milk
Lynn comes to the clinic for her initial prenatal visit. Based on her menstral history, the client is at 9 weeks’ gestation and is scheduled to have an ultrasound for estimation of the gestational age of the fetus. Which fetal measurement is the best indicator of gestational age at this time?
Crown-rump measurement
What is a common cause of leg cramps during pregnancy?
An imbalance of calcium and magnesium
A 15-year-old pregnant patient presents for her first prenatal visit. On physical examination, her uterus is approximately 24-week gestation size. She does not know when her last menstrual period was or when she might have conceived. Gestational age for this patient can most accurately be assessed by:
Ultrasonography
What is the most common disorder leading to hyperthyroidism?
Graves disease
Margie, who has been breastfeeding for 4 weeks, has mastitis in her right breast and is taking Dixcloxacillin. She asks you what she needs to do about feeding the baby. You respond
There is no need to stop breastfeeding, but start with your left side.”
What is the minimum number of cafe-au-lait spot that should be of concern?
More than 5
An autosomal recessive disorder such as cystic fibrosis is expressed in the offspring when:
Both parents carry the gene
Glenda gave birth to Jack 4 weeks ago. Her postpartum course was complicated by an intrauterine infection that was successfully treated with antibiotics. Today Glenda calls the office because Jack has white patches on his tongue and gums. She is concerned that her milk has become “sour” and is causing the white patches in Jack’s mouth. Based on these data, what diagnosis do you expect for Jack?
Oral candidiasis
Sandra, who is 5 months pregnant and of average height and weight, asks you how many extra calories she should be adding to her diet per day. You tell her to add:
300 calories
What do current theories suggest as to how cranberry products can reduce UTIs?
The fructose keeps E. coli bacteria from adhering to bladder cell walls.
When is round ligament pain most likely to occur in pregnant women?
16-20 wks gestation
Kim states that she has heard many old wives’ tales of harmful things during pregnancy. Which of the following is harmful late in pregnancy?
Douching
NSAID use during pregnancy has been linked to which condition in newborns?
Pulmonary HTN
Carbohydrate intolerance and increased insulin resistance first recognized in pregnancy is known as:
Gestational Diabetes
What is considered to be a common trigger of psoriasis?
Stress
The drug of choice for the pregnant woman with diabetes is
Insulin
Screening for hyperlipidemia is recommended to begin at what age for women with no risk factors?
45
Any woman with a complicated cystitis or symptoms of upper tract disease needs a urine culture and:
Sensitivity test
What is a possible cause of abdominal pain during pregnancy?
Round ligament pain
All except which of the following are important historical questions for a 29-year-old woman in clinic for right-sided weakness?
History of pelvic inflammatory disease
What do current theories suggest as to how cranberry products can reduce UTIs?
The fructose keeps E. coli bacteria from adhering to bladder cell walls.
How does the third stage of labor end?
With the delivery of the placenta
What is the term for the craving and purposeful consumption of nonfood items for more than one month?
Pica
In order to maintain continence bladder pressure must be
lower than urethral pressure.
What is the general goal of surgical treatment for stress UI?
To support and stabilize the urethra
What is the leading cause of first-trimester maternal death?
Ectopic pregnancy
What is more likely to occur in women with female genital cutting?
Birth-related complications
What is a contributor to the increased incidence of heartburn during pregnancy?
The pregnancy hormone relaxin, which softens the lower esophageal sphincter
What distinguishes pyelonephritis from cystitis?
The infection has ascended to the kidneys.
What is the most typical schedule of prenatal care in the first 28 weeks of pregnancy?
Visits scheduled every 4 weeks
After how many weeks’ gestation is a pregnancy loss considered a fetal death or stillbirth?
20wks
What is an indication of the second stage of labor?
complete dilation of cervix
How can hormonal influences during pregnancy cause backache?
They loosen ligaments and joints.
Carbohydrate intolerance and increased insulin resistance first recognized in pregnancy is known as:
Gestational diabetes
Where does edema tend to occur in the pregnant woman’s body?
Feet
What is important to consider when vaginal bleeding occurs during the first trimester?
Ectopic pregnancy
The primary endocrine disorders affecting women are diabetes mellitus and:
Thyroid conditions
What is the potential danger of a fetus born through meconium-stained amniotic fluid?
The infant can breathe meconium into the lungs.
What tends to cause acne in adolescence?
An increase in testosterone
What is the term for a postpartum disorder in which bacteria ascend from the lower genital tract and infect the uterus?
Postpartum endometritis
What step can a clinician take to learn more about any chemicals used in a woman’s workplace?
Ask the woman to obtain her workplace MSDs (material safety data sheets).
What can be used as a space-filling device, replacing normal pressure on the vaginal walls when levator ani support is unreliable?
Tampons
A common prenatal care model in which women have their first visit with one provider and then subsequent visits in a group setting is called:
Centering Pregnancy
What is the most common cause of medical complications in pregnancy?
Hypertension
Fever associated with pyelonephritis will usually resolve within how many hours of treatment with antibiotics?
72 hours
What is significant about cytomegalovirus (CMV)?
It can remain dormant within the body for life.
How does women’s anatomy make them more susceptible to UTIs?
Their urethras are shorter.
What has changed in terms of recommended antibiotic treatment for uncomplicated lower UTIs?
Three-day regimens are now recommended.
Screening for hyperlipidemia is recommended to begin at what age for women with no risk factors?
45
What is the term for stimulation of the uterus by an external agent to enhance uterine contractions after labor has started?
Augmentation
At what time during pregnancy does nausea typically occur?
6-8 weeks gestation
Gender differences in heart disease can be found in:
All of the above
What is the most common cause of death in women in the United States?
Cardiovascular disease
When can relief from pregnancy induces nausea and vomiting be expected?
12-14wks gestation
What is a common cause of leg cramps during pregnancy?
An imbalance of calcium and magnesium
In the formula to estimate gestational age, woman are considered pregnant from: ___________________________
The first day of the last menstrual period
How are pregnancy-related DHA (docosahexaenoic acid) needs best met?
By consuming 2 servings of fatty low-mercury-content fish per week
Sarah, who just found out she is pregnant, is taking prenatal vitamins with extra daily supplements of iron. She may be a candidate for
Premature delivery
Margie, who has been breastfeeding for 4 weeks, has mastitis in her right breast and is taking Dixcloxacillin. She asks you what she needs to do about feeding the baby. You respond
“There is no need to stop breastfeeding, but start with your left side.”
A 25-year-old obese female has a history of frequent candida vaginal infections in the past year. She is in a monogamous sexual relationship and uses and intrauterine device (IUD) for contraception. Of the following, which is the most likely underlying condition predisposing her to recurring candida vaginitis?
Diabetes mellitus
Qualitative urine testing for hCG (human chorionic gonadotropin) can be done reliably ________ days after implantation of the blastocyst (fertilized egg).
7-9 days
Karen is taking oral contraceptive pills for fertility control. Karen calls the clinic and reports the presence of chest pain and shortness of breath. You instruct Karen to:
Go to the nearest emergency room immediately to be evaluated.
A new mother asks, “Is it true that breast milk will prevent my baby from catching colds and other infections?” You should give which of the following replies based on current research findings:
“Your baby will have increased resistance to illness caused by bacteria and viruses, but he may still contract infections.”
What is a contributor to the increased incidence of heartburn during pregnancy?
The pregnancy hormone relaxin, which softens the lower esophageal sphincter
Lynn comes to the clinic for her initial prenatal visit. Based on her menstral history, the client is at 9 weeks’ gestation and is scheduled to have an ultrasound for estimation of the gestational age of the fetus. Which fetal measurement is the best indicator of gestational age at this time?
crown-rump measurment
A 28-year-old pregnant patient, at 18 weeks gestation, complains of feeling lightheaded when standing. which of the following is an appropriate response by the nurse practitioner?
Blood pressure normally decreases during pregnancy and can cause this symptom.
In order to maintain continence bladder pressure must be
lower than urethral pressure
Which of the following drugs should be used with extreme caution in breastfeeding mothers?
Phenobarbital
How can hormonal influences during pregnancy cause backache?
They loosen ligaments and joints.
According to Naegele’s rule, if a woman’s last normal menstral period (LNMP) was September 23, what is her estimated date of delivery?
June 30
A poorly defined, flat, blue-black macule, present at birth and usually on the trunk and buttocks, is a
Mongolian spot
Without treatment shortly after birth, as many as 90 percent of infants born to hepatitis B–infected mothers will:
Become infected
A 28-year-old pregnant patient gives a history of smoking 1 pack of cigarettes per day (1 PPD). The nurse practitioner is accurate when she tells the patient that cigarette smoking is associated with:
Intrauterine growth restriction
Which of the following does not increase a woman’s risk for developing cervical cancer?
Nulliparity
What is the best description of Bishop’s score?
It is an assessment of the cervix’s readiness for elective induction.
Sandra, who is 5 months pregnant and of average height and weight, asks you how many extra calories she should be adding to her diet per day. You tell her to add:
300 calories
What components make up the biophysical profile?
Fetal tone, breathing, motion, amniotic fluid volume, and nonstress test.
What is the leading cause of first-trimester maternal death?
Ectopic pregnancy
A newborn delivered by a mother with no prenatal care exhibits the following: dysmorphic facial features including short palpebral fissures, a thin upper lip, an elongated and flattened philtrum, and a flattened midface region. You suspect that the mother engaged in what behavior during pregnancy?
Excessive alcohol intake
What is the simplest and safest method of suppressing lactation after it has started?
Gradually weaning the baby to a bottle or cup over a 3-week period
Uncomplicated acute bacterial cystitis occurs in women who:
Have no signs of upper tract infection
Which of the following diseases is not acquired transplancentally?
Tuberculosis
Carrie is due to deliver her second baby. During your work-up, you note that she hemorrhaged after delivering her first baby 2 years ago, has always had menorrhagia, and bruises easily. Her lab work reveals a normal blood work-up, including a normal prothrombin time and activated partial thromboplastin time. What do you suspect?
Von Willibrand’s disease
Which of the following recommendations should you provide to parents about reducing the risk of sudden infant death syndrome (SIDS)?
A bare crib with firm sleep surface; no soft objects, wedges, or ruffles.
What is the recommended timing for gestational diabetes screening?
24-28 wks gestation
What is an indication of the second stage of labor?
Complete dilation of cervix
Liza is 34 weeks pregnant and has mild hypertension. You are performing a nonstress test (NST). What is the criterion for a reactive NST?
At least two fetal heart rate accelerations in response to fetal movement in a 20-minute test period.
You see G5P4015 on a client’s history form. You surmise that
The woman has five living children, including a set of twins, and she has had one abortion.
A 30-year-old female patient is seeking advice from the nurse practitioner about becoming pregnant. She is currently taking an oral contraceptive. She gives a history of having a hydatidiform molar pregnancy 2 years ago. The appropriate plan of care for this patient should include:
discontinuing the OCP
A woman with hyperemesis gravidarum would most likely benefit from a plan of care designed to address which of the following nursing diagnosis?
Anxiety, related to effects of hyperemesis on fetal well-being
All except which of the following are important historical questions for a 29-year-old woman in clinic for right-sided weakness?
Hx of PID
The onset of labor is indicated by regular uterine contractions and:
Progressive cervical change
An example of an X-linked recessive condition or trait is
Hemophilia
The majority of early pregnancy losses are due to:
Unknown causes
Any woman with a complicated cystitis or symptoms of upper tract disease needs a urine culture and:
Sensitivity test
How are pregnancy-related DHA (docosahexaenoic acid) needs best met?
By consuming 2 servings of fatty low-mercury-content fish per week
What is more likely to occur in women with female genital cutting?
birth-related complications
Which of the following is a predictor of impending preterm birth?
Positive fetal fibronectin testing
What was the reason that prenatal care began in the early 1900s?
Screen for preeclampsia
What do current theories suggest as to how cranberry products can reduce UTIs?
The fructose keeps E. coli bacteria from adhering to bladder cell walls.
After how many weeks’ gestation is a pregnancy loss considered a fetal death or stillbirth?
20 weeks
What significantly increases the risk of hypertension in women?
Onset of menopause
What should be addressed during late postpartum maternal evaluation (weeks 2–6)?
The need for birth control information or supplies
Where does edema tend to occur in the pregnant woman’s body?
Feet
