ob_exam_1_20170205233115

Question 1

A 28 year old woman is pregnant presently and
had a history of delivering term twins followed
by a spontaneous abortion. What is her GP and
TPAL?

Question 2

Frequency of Visits

How often should a pregnant mother visit her provider when she is up to 28 weeks pregnant?

Answer 2

Every 4 weeks

Question 3

Describe what GP and TPAL mean

Question 4

Frequency of Visits

How often should a pregnant mother visit her provider when she is 37 weeks or later?

Answer 4

Every week

Question 5

A mother is pregnant for the fourth time. At home
she has a child who was born term. Her second
pregnancy ended at 10 weeks gestation. She then gave
birth to twins at 35 weeks and one of the twins died
soon after birth. Write her OB history.

Question 6

The greatest risk to the developing embryo is between ____ and ____ days after conception.

Question 7

A mother is pregnant for the fourth time.
One abortion at 8 weeks, and has a daughter
born at 40 weeks and a son at 34 weeks. What
is her obstetrical history?

Question 8

Frequency of Visits

How often should a pregnant mother visit her provider when she is 29 to 36 weeks?

Answer 8

every 2 weeks

Question 9

A mother is pregnant for the fourth time with a twin pregnancy at present. She lost a pregnancy at 12 weeks gestation, had one preterm birth 4 years ago and a term birth after. What is her G, P, TPAL?

Answer 9

G4P2 T1P1A1L2

Question 10

Uterine enlargement and breast enlargement.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 10

Presumptive (subjective)

what the patient experiences

Question 11

Ultrasound verification of embryo or fetus, fetal movement felt by experienced clinician, and/or auscultation of fetal heart tones via Doppler.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 11

Positive (diagnostic)

confirmation that the fetus is growing in the uterus

Question 12

Amenorrhea.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 12

Presumptive (subjective)

what the patient experiences

Question 13

Braxton Hicks contractions.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 13

Probable (objective)

signs that are detected on physical examination by the health care professional

Question 14

Positive pregnancy test.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 14

Probable (objective)

signs that are detected on physical examination by the health care professional

Question 15

Bluish discoloration of the vaginal mucosa and cervix.

a. ) Chadwick’s Sign
b. ) Goodell’s Sign
c. ) Hegar’s Sign

Answer 15

Chadwick’s Sign

Chadwick’s Sign = Bluish discoloration of the vaginal mucosa and cervix.

Goodell’s Sign = Softening of the cervix.

Hegar’s Sign = Softening of the lower uterine segment or isthmus.

Question 16

What is normal weight gain for pregnant women?

Answer 16

25 to 35 pounds during entire pregnancy

Question 17

Abdominal enlargement.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 17

Probable (objective)

signs that are detected on physical examination by the health care professional

Question 18

Quickening.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 18

Presumptive (subjective)

what the patient experiences

Question 19

Ballotement.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 19

Probable (objective)

signs that are detected on physical examination by the health care professional

Question 20

Softening of the lower uterine segment or isthmus.

a. ) Chadwick’s Sign
b. ) Goodell’s Sign
c. ) Hegar’s Sign

Answer 20

Hegar’s Sign

Chadwick’s Sign = Bluish discoloration of the vaginal mucosa and cervix.

Goodell’s Sign = Softening of the cervix.

Hegar’s Sign = Softening of the lower uterine segment or isthmus.

Question 21

Hyperpigmentation of skin

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 21

Presumptive (subjective)

what the patient experiences

Question 22

Softening of the cervix.

a. ) Chadwick’s Sign
b. ) Goodell’s Sign
c. ) Hegar’s Sign

Answer 22

Goodell’s Sign

Chadwick’s Sign = Bluish discoloration of the vaginal mucosa and cervix.

Goodell’s Sign = Softening of the cervix.

Hegar’s Sign = Softening of the lower uterine segment or isthmus.

Question 23

Goodell’s sign, Chadwick’s sign, and Hegar’s sign.

a. ) Presumptive signs
b. ) Probable signs
c. ) Positive signs

Answer 23

Probable (objective)

signs that are detected on physical examination by the health care professional

Question 24

What factors would change during a pregnancy if the hormone progesterone were reduced or withdrawn?

a. ) The woman’s gums would become red and swollen and would bleed easily.
b. ) The uterus would contract more and peristalsis would increase.
c. ) Morning sickness would increase and would be prolonged.
d. ) The secretion of prolactin by the pituitary gland would be inhibited.

Question 25

Which of the following is a presumptive sign or symptom of pregnancy?

a. ) Restlessness
b. ) Elevated mood
c. ) Urinary frequency
d. ) Low backache

Answer 25

c.) Urinary frequency

Question 26

When obtaining a blood test for pregnancy, which hormone would the nurse expect the test to measure?

a. ) Human chorionic gonadotropin (hCG)
b. ) Human placental lactogen (hPL)
c. ) Follicle-stimulating hormone (FSH)
d. ) Luteinizing hormone (LH)

Answer 26

a.) Human chorionic gonadotropin (hCG)

Question 27

During pregnancy, which of the following should the expectant mother reduce or avoid?

a. ) Raw meat or uncooked shellfish
b. ) Fresh, washed fruits and vegetables
c. ) Whole grains
d. ) Protein and iron from meat sources

Answer 27

a.) Raw meat or uncooked shellfish

Question 28

A feeling expressed by most women upon learning they are pregnant is:

a. ) Acceptance
b. ) Depression
c. ) Jealousy
d. ) Ambivalence

Answer 28

d.) Ambivalence

Question 29

Reva Rubin identified four major tasks that the pregnant woman undertakes to form a mutually gratifying relationship with her infant. What is “binding in”?

a. ) Ensuring safe passage through pregnancy, labor, and birth
b. ) Seeking acceptance of this infant by others
c. ) Seeking acceptance of self as mother to the infant
d. ) Learning to give of oneself on behalf of the infant

Answer 29

c.) Seeking acceptance of self as mother to the infant

Seeking acceptance of self as mother to the infant is the basis for establishing a mutually gradifying relationship between mother and infant. This “binding in” is a process that changes throughout the pregnancy, starting with the mothers acceptance of the pregnancy and then the infant as a separate entity. Ensuring safe passage through pregnancy , labor, and birth focusas on the mother

Question 30

Which of the following biophysical profile findings indicate poor oxygenation to the fetus?

a. ) Two pockets of amniotic dluid
b. ) Well-flexed arms and legs
c. ) Nonreactive fetal heart rate
d. ) Fetal breathing movements noted

Answer 30

c.) Nonreactive fetal heart rate

Question 31

The nurse teaches the pregnant client how to perform Kegel exercises as a way to accomplish which of the following?

a. ) Prevent perineal lacerations
b. ) Stimulate labor contractions
c. ) Increase pelvic muscle tone
d. ) Lose pregnancy weight quickly

Answer 31

c.) Increase pelvic muscle tone

Question 32

During a clinic visit, a pregnant client at 30 weeks’ gestation tells the nurse, “I’ve had some mild cramps that are pretty irregular. What does this mean?” The cramps are probably:

a. ) The beginning of labor in the very early stages
b. ) An ominous nding indicating that the client is about to have a miscarriage
c. ) Related to overhydration of the woman
d. ) Braxton Hicks contractions, which occur throughout pregnancy

Answer 32

d.) Braxton Hicks contractions, which occur throughout pregnancy

Question 33

The nurse is preparing her teaching plan for a woman who has just had her pregnancy confirmed. Which of the following should be included in it? Select all that apply.

a. ) Prevent constipation by taking a daily laxative
b. ) Balance your dietary intake by increasing your calories by 300 to 500 daily
c. ) Continue your daily walking routine just as you did before this pregnancy
d. ) Tetanus, measles, mumps, and rubella vaccines will be given to you now
e. ) Avoid tub baths now that you are pregnant to prevent vaginal infections
f. ) Sexual activity is permitted as long as your membranes are intact
g. ) Increase your consumption of milk to meet your iron needs

Answer 33

b. ) Balance your dietary intake by increasing your calories by 300 to 500 daily
c. ) Continue your daily walking routine just as you did before this pregnancy
f. ) Sexual activity is permitted as long as your membranes are intact

Question 34

A pregnant client’s last normal menstrual period was on August 10. Using Nagele’s rule, the nurse calculates that her estimated date of birth (EDB) will be which of the following?

a. ) June 23
b. ) July 10
c. ) July 30
d. ) May 17

Answer 34

d.) May 17

Question 35

A woman began her last normal menstrual period on March 22, 2016. Using Negele’s rulse, calculate her expected date of birth (EDB).

Answer 35

December 29, 2017

Question 36

A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following would be included? (Select all that apply)

a. ) Montgomery’s glands
b. ) Goodall’s sign
c. ) Ballottement
d. ) Chadwick’s sign
e. ) Quickening

Answer 36

b. ) Goodall’s sign
c. ) Ballottement
d. ) Chadwick’s sign

Question 37

What is a positive sign of pregnancy?

a. ) Hegar’s sign
b. ) fetal movement felt by examiner
c. ) uterine contractions
d. ) positive pregnancy test

Answer 37

b.) fetal movement felt by examiner

Question 38

Amanda is about 16 weeks pregnant and is concerned because she feels her “abdomen” contracting. She calls the primary care provider’s office and speaks to the nurse. What is the nurse’s most appropriate response to Amanda’s concern?

a. ) “What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy.”
b. ) “You need to go to the emergency room right away.”
c. ) “You have nothing to be concerned about. I am sure you are not feeling contractions at this point in your pregnancy.”
d. ) “You need to come to the office to be examined.”

Answer 38

a.) “What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy.”

Question 39

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby’s father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called?

a. ) cretinism
b. ) pregnancy syndrome
c. ) couvade syndrome
d. ) pseudo pregnancy

Answer 39

c.) couvade syndrome

Question 40

As a pregnant woman lies on the examining table, she grows very short of breath and dizzy. This phenomenon probably happens because:

a. ) her cerebral arteries are growing congested with blood.
b. ) the uterus requires more blood in a supine position.
c. ) sympathetic nerve responses cause dyspnea when a woman lies supine.
d. ) blood is trapped in the vena cava in a supine position.

Answer 40

d.) blood is trapped in the vena cava in a supine position.

Question 41

A pregnant woman tells the nurse she often has allergic responses to drugs. She is concerned that she will be allergic to her fetus or her body will reject the pregnancy. The nurse’s reply would be based on which statement?

a. ) The kidneys release a hormone during pregnancy to prevent this from happening.
b. ) Immunologic activity is decreased during pregnancy.
c. ) The level of aldosterone during pregnancy reduces production of IgG antibodies.
d. ) The decreased corticosteroid activity during pregnancy ensures this will not happen.

Answer 41

b.) Immunologic activity is decreased during pregnancy.

Question 42

Which change related to the vital signs is expected in pregnant women?

a. ) Lung space increases.
b. ) Temperature decreases.
c. ) Pulse decreases.
d. ) Blood pressure decreases.

Answer 42

d.) Blood pressure decreases.

Question 43

During a routine antepartal visit, a pregnant woman says, “I’ve noticed my gums bleeding a bit since I’ve become pregnant. Is this normal?” The nurse bases the response on the understanding of which effect of pregnancy?

a. ) effects of regurgitation from relaxation of the cardiac sphincter
b. ) elevated progesterone levels
c. ) increased venous pressure
d. ) influence of estrogen and blood vessel proliferation

Answer 43

d.) influence of estrogen and blood vessel proliferation

Question 44

Before becoming pregnant, a woman’s heart rate averaged 72 beats per minute. The woman is now 15 weeks pregnant. The nurse would expect this woman’s heart rate to be approximately:

a. ) 90 beats per minute.
b. ) 95 beats per minute.
c. ) 100 beats per minute.
d. ) 85 beats per minute.

Answer 44

d.) 85 beats per minute.

Question 45

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

a. ) amenorrhea
b. ) fetal heartbeat
c. ) ultrasound pictures
d. ) morning sickness
e. ) breast changes
f. ) hydatidiform mole

Answer 45

a. ) amenorrhea
d. ) morning sickness
e. ) breast changes

Question 46

Which assessment finding in the pregnant woman at 12 weeks of gestation should the nurse find most concerning? The inability to:

a. ) feel fetal movements.
b. ) palpate the fetal outline.
c. ) detect fetal heart sounds with a Doppler.
d. ) hear the fetal heartbeat with a stethoscope.

Answer 46

c.) detect fetal heart sounds with a Doppler.

Question 47

Many changes occur in the body of a pregnant woman. Some of these are changes in the integumentary system. What is one change in the integumentary system called?

a. ) chloasma
b. ) linea rubria
c. ) ballottement
d. ) Chadwick’s sign

SUBMIT ANSWER

Answer 47

a.) chloasma

Question 48

During a prenatal visit, the nurse inspects the skin of the client’s abdomen. Which would the nurse identify as an abnormal finding?

a. ) striae
b. ) linea nigra
c. ) bruising
d. ) darkening of the umbilicus

Answer 48

c.) bruising

Question 49

A woman in the last trimester of pregnancy reports sleeping poorly. She becomes light-headed and dizzy whenever she sleeps on her back, but she cannot sleep at all if she lies on her side. How would the nurse suggest she try sleeping?

a. ) with a pillow under both hips
b. ) with a pillow under her right hip
c. ) with a pillow under her shoulders
d. ) without a pillow

Answer 49

b.) with a pillow under her right hip

Question 50

Many factors influence how a woman adapts psychologically to pregnancy. What is the psychological adaptation the woman must come to terms with during the second trimester?

a. ) accept the baby
b. ) accept the pregnancy
c. ) prepare for parenthood
d. ) prepare for labor and birth

Answer 50

a.) accept the baby

Question 51

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

a. ) Wait until after two missed menstrual periods.
b. ) Refrain from eating for 4 hours before testing.
c. ) Arrange for prenatal care if the test is positive.
d. ) Use a diluted urine specimen.

SUBMIT ANSWER

Answer 51

c.) Arrange for prenatal care if the test is positive.

Question 52

A woman’s prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week?

a. ) 2/3 lb (.30 kg)
b. ) 1 lb (.45 kg)
c. ) 1.5 lb (.68 kg)
d. ) 2 lb (.90 kg)

Answer 52

b.) 1 lb (.45 kg)

Question 53

The obstetrical nurse knows that a woman’s hormone levels change dramatically during pregnancy. Which hormonal actions accurately represent these changes? Select all that apply.

a. ) maintaining the endometrium so that the embryo can implant
b. ) decreasing the mother’s blood volume and red blood cell mass to increase oxygen
c. ) causing changes in the mother’s metabolism so that nutrients are available for both
d. ) decreasing the blood supply to the gastrointestinal tract and slowing peristaltic waves
e. ) preparing the breasts for lactation, keeping the milk from coming in until birth occurs
f. ) relaxing the ligaments that connect the pelvic bones, allowing them to spread slightly

Answer 53

a. ) maintaining the endometrium so that the embryo can implant
c. ) causing changes in the mother’s metabolism so that nutrients are available for both
e. ) preparing the breasts for lactation, keeping the milk from coming in until birth occurs
f. ) relaxing the ligaments that connect the pelvic bones, allowing them to spread slightly

Question 54

A client who has just given a blood sample for pregnancy testing in the health care provider’s office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

a. ) laboratory test of a urine specimen for hCG
b. ) visualization of the fetus by ultrasound
c. ) laboratory test of a blood serum specimen for hCG
d. ) absence of a period

Answer 54

b.) visualization of the fetus by ultrasound

Question 55

The hormone responsible for the initiation of lactation is what?

a. ) estrogen
b. ) oxytocin
c. ) progesterone
d. ) prolactin

Answer 55

d.) prolactin

Question 56

A pregnant woman asks the nurse, “I’ve heard that I should avoid eating certain types of fish. So what fish can I eat?” Which type of fish would the nurse recommend? Select all that apply.

a. ) tilefish
b. ) shrimp
c. ) catfish
d. ) shark
e. ) salmon

Answer 56

b. ) shrimp
c. ) catfish
e. ) salmon

Question 57

Early in pregnancy, frequent urination results mainly from which cause?

a. ) addition of fetal urine to maternal urine
b. ) pressure on the bladder from the uterus
c. ) decreased glomerular selectivity
d. ) increased concentration of urine

Answer 57

b.) pressure on the bladder from the uterus

Question 58

Pregnancy tests (both urine and blood) measure levels of which hormone to validate the existence of pregnancy?

a. ) estrogen
b. ) human chorionic gonadotropin (hCG)
c. ) progesterone
d. ) aldosterone

Answer 58

b.) human chorionic gonadotropin (hCG)

Question 59

Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy?

a. ) finding of hCG in the blood
b. ) visualization of the gestational sac or fetus
c. ) finding hCG in the urine
d. ) positive home pregnancy test

Answer 59

b.) visualization of the gestational sac or fetus

Question 60

Labor Station

Baby’s head is entering the pelvis and pressure on baby’s head will push it back up.

a. ) Floating
b. ) Ballotable
c. ) Engagement

Answer 60

Ballotable

Question 61

What is quickening?

When does it usually occur?

Question 62

Labor Station

Presents at 0 station (top of head reaches ischial spine).

a. ) Floating
b. ) Ballotable
c. ) Engagement

Answer 62

Engagement

Question 63

Labor Station

Will just see the baby’s head.

a. ) Floating
b. ) Ballotable
c. ) Engagement

Answer 63

Floating

Question 64

When determining the frequency of contractions, the nurse would measure which of the following?

a. ) Start of one contraction to the start of the next contraction
b. ) Beginning of one contraction to the end of the same contraction
c. ) Peak of one contraction to the peak of the next contraction
d. ) End of one contraction to the beginning of the next contraction

Answer 64

a.) Start of one contraction to the start of the next contraction

Frequency is measured from the start of one contraction to the start of the next contraction. The duration of a contraction is measured from the beginning of one contraction to the end of that same contraction.

The intensity of two contractions is measured by comparing the peak of one contraction with the peak of the next contraction.

The resting interval is measured from the end of one contraction to the beginning of the next contraction.

Question 65

Which fetal lie is most conducive to a spontaneous vaginal birth?

a. ) Transverse
b. ) Longitudinal
c. ) Perpendicular
d. ) Oblique

Answer 65

b.) Longitudinal

A longitudinal lie places the fetus in a vertical position, which would be the most conducive for a spontaneous vaginal birth.

A transverse lie does not allow for a vaginal birth because the fetus is lying perpendicular to the maternal spine.

A perpendicular lie describes the transverse lie, which would not be conducive for a spontaneous birth.

An oblique lie would not allow for a spontaneous vaginal birth because the fetus would not fit through the maternal pelvis in this side-lying position.

Question 66

Which of the following observations would suggest that placental separation is occurring?

a. ) Uterus stops contracting altogether.
b. ) Umbilical cord pulsations stop.
c. ) Uterine shape changes to globular.
d. ) Maternal blood pressure drops.

Answer 66

c.) Uterine shape changes to globular.

After the placenta separates from the uterine wall, the shape of the uterus changes from discoid to globular. The uterus continues to contract throughout the placental separation process and the umbilical cord continues to pulsate for several minutes after placental separation occurs. Maternal blood pressure is not affected by placental separation because the maternal blood volume has increased dramatically during pregnancy to compensate for blood loss during birth.

Question 67

As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is:

a. ) Discomfort level is greater with false labor.
b. ) Progressive cervical changes occur in true labor.
c. ) There is a feeling of nausea with false labor.
d. ) There is more fetal movement with true labor.

Answer 67

b.) Progressive cervical changes occur in true labor.

Progressive cervical changes occur in true labor. This is not the case with false labor.

Question 68

The shortest but most intense phase of labor is the:

a. ) Latent phase
b. ) Active phase
c. ) Transition phase
d. ) Placental expulsion phase

Answer 68

c.) Transition phase

The transition phase of the first stage of labor occurs when the contractions are 1 to 2 minutes apart and the final dilation is taking place. The transition phase is the most difficult and, fortunately, the shortest phase for the woman, lasting approximately 1 hour in the first birth and perhaps 15 to 30 minutes in successive births. Many women are not able to cope well with the intensity of this short period, become restless, and request pain medications.

During the latent phase, contractions are mild. The woman is in early labor and able to cope with the infrequent contractions. This phase can last hours.

The active phase involves moderate contractions that allow for a brief rest period in between, helping the woman to be able to cope with the next contraction. This phase can last hours.

The placental expulsion phase occurs during the third stage of labor. After separation of the placenta from the uterine wall, continued uterine contractions cause the placenta to be expelled. Although this phase can last 5 to 30 minutes, the contraction intensity is less than that of the transition phase.

Question 69

A laboring woman is admitted to the labor and birth suite at 6-cm dilation. She would be in which phase of the first stage of labor?

a. ) Latent
b. ) Active
c. ) Transition
d. ) Early

Answer 69

b.) Active

Cervical dilation of 6 cm indicates that the woman is in the active phase of the first stage of labor. In this phase, the cervix dilates from 3 to 7 cm with 40% to 80% effacement occurring.

During the latent phase, the cervix dilates from 0 to 3 cm. During the transition phase, the cervix dilates from 8 to 10 cm.

The first stage of labor is divided into three phases: latent, active, and transition. There is no early phase.

Question 70

Which assessment would indicate that a woman is in true labor?

a. ) Membranes are ruptured and uid is clear.
b. ) Presenting part is engaged and not oating.
c. ) Cervix is 4 cm dilated, 90% effaced.
d. ) Contractions last 30 seconds, every 5 to 10 minutes.

Answer 70

True labor is characterized by contractions occurring at regular intervals that increase in frequency, duration, and intensity. These contractions bring about progressive cervical dilation and effacement. Thus, a cervix dilated to 4 cm and 90% effaced indicates true labor.

Rupture of membranes may occur before the onset of labor, at the onset of labor, or at any time during labor and thus is not indicative of true labor.
Engagement occurs when the presenting part reaches 0 station; it typically occurs 2 weeks before term in primigravidas and several weeks before the onset of labor or at the beginning of labor for multiparas.

Contractions of true labor typically last 30 to 60 seconds and occur approximately every 4 to 6 minutes.

Question 71

When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive assessment that uterine contractions are effective would be:

a. ) dilatation of cervix.
b. ) rupture of amniotic membranes.
c. ) bloody show.
d. ) engagement of fetus.

Answer 71

a.) dilatation of cervix.

Question 72

A woman in labor at the hospital has just received an epidural block. Which intervention is a priority before and during epidural placement?

a. ) Monitor temperature every four hours, and give acetaminophen if 100.4 degrees or higher.
b. ) Monitor the maternal apical pulse for bradycardia.
c. ) Increase oral fluids every hour to prevent dehydration.
d. ) Provide adequate IV fluids to maintain her blood pressure.

Answer 72

d.) Provide adequate IV fluids to maintain her blood pressure.

Question 73

When assessing fetal heart rate patterns, which finding would alert the nurse to a possible problem?

a. ) early decelerations
b. ) accelerations
c. ) variable decelerations
d. ) prolonged decelerations

Answer 73

d.) prolonged decelerations

Question 74

The nurse assesses her client and notes that the fetus is at +1 station. The nurse interprets +1 station as indicating that the fetal presenting part is at:

a. ) 1 cm below the symphysis pubis.
b. ) 1 cm below the ischial spine.
c. ) 1 cm above the symphysis pubis.
d. ) 1 cm above the ischial spine.

SUBMIT ANSWER

Answer 74

b.) 1 cm below the ischial spine.

Question 75

The student nurse is preparing to assess the fetal heart rate (FHR). She has determined that the fetal back is located toward the client’s left side, the small parts toward the right side, and there is a vertex (occiput) presentation. The nurse should initially begin auscultation of the fetal heart rate in the mother’s:

a. ) left upper quadrant.
b. ) right lower quadrant.
c. ) left lower quadrant.
d. ) right upper quadrant.

Answer 75

c.) left lower quadrant.

Question 76

To assess the frequency of a woman’s labor contractions, the nurse would time:

a. ) the beginning of one contraction to the beginning of the next.
b. ) how many contractions occur in 5 minutes.
c. ) the end of one contraction to the beginning of the next.
d. ) the interval between the acme of two consecutive contractions.

Answer 76

a.) the beginning of one contraction to the beginning of the next.

Question 77

The nurse is reviewing the uterine contraction pattern and identifies the peak intensity, documenting this as which phase of the contraction?

a. ) decrement
b. ) increment
c. ) diastole
d. ) acme

Answer 77

d.) acme

Question 78

What is a nursing intervention that helps prevent the most frequent side effect from epidural anesthesia in a pregnant client?

a. ) administrating IV naloxone
b. ) administrating IV ephedrine
c. ) starting an IV and hanging IV fluids
d. ) maintaining the client in a supine position

Answer 78

c.) starting an IV and hanging IV fluids

Question 79

A nurse is caring for a pregnant client who is in the active phase of labor. At what interval should the nurse monitor the client’s vital signs?

a. ) every 45 minutes
b. ) every 15 minutes
c. ) every 1 hour
d. ) every 30 minutes

Answer 79

d.) every 30 minutes

Question 80

A client is a gravida 1, in the active phase of stage 1 labor. The fetal position is LOA. When the client’s membranes rupture, the nurse should expect to see a:

a. ) very large amount of blood.
b. ) moderate amount of clear to straw-colored fluid.
c. ) small segment of the umbilical cord.
d. ) small amount of greenish fluid.

Answer 80

b.) moderate amount of clear to straw-colored fluid.

Question 81

Which signs signify that the second stage of labor has begun?

a. ) The urge to push occurs.
b. ) Frequency of contractions are 5–6 minutes.
c. ) Fetus is a –1 station.
d. ) Emotions are calm and happy.

Answer 81

a.) The urge to push occurs.

Question 82

The nurse is assessing the laboring client to determine fetal oxygenation status. What indirect assessment method will the nurse likely use?

a. ) fetal oxygen saturation
b. ) external electronic fetal monitoring
c. ) fetal position
d. ) fetal blood pH

SUBMIT ANSWER

Answer 82

b.) external electronic fetal monitoring

Question 83

The nurse explains Leopold’s maneuvers to a pregnant client. For which purposes are these maneuvers performed? Select all that apply.

a. ) determining the size of the fetus
b. ) determining the weight of the fetus
c. ) determining the position of the fetus
d. ) determining the presentation of the fetus
e. ) determining the lie of the fetus

Answer 83

c. ) determining the position of the fetus
d. ) determining the presentation of the fetus
e. ) determining the lie of the fetus

Question 84

A multigravida is admitted to the hospital in active labor. The client’s and the fetus’s condition have been good since admission. The client calls out to the nurse, “the baby is coming!” What is the first action of the nurse?

a. ) Inspect the perineum.
b. ) Auscultate the fetal heart tones.
c. ) Time the contractions.
d. ) Contact the primary care provider.

Answer 84

a.) Inspect the perineum.

Question 85

As a woman enters the second stage of labor, her membranes spontaneously rupture. When this occurs, what would the nurse do next?

a. ) Ask her to bear down with the next contraction.
b. ) Test a sample of amniotic fluid for protein.
c. ) Assess fetal heart rate for fetal safety.
d. ) Elevate her hips to prevent cord prolapse.

Answer 85

c.) Assess fetal heart rate for fetal safety.

Question 86

After administration of epidural anesthesia during labor, the client develops a temperature of 100.2°F (37.9°C). The client’s husband is asking if she is “getting sick”. How should the nurse respond to the client and her husband?

a. ) “We will have to take her temperature every 30 minutes and might start antibiotics.”
b. ) “This elevation in temperature is a possible side effect of the anesthesia. We will notify the provider and assess temperature again in an hour.”
c. ) “Due to the length of your labor, you might be dehydrated and that may cause your temperature to rise; let’s get you something to drink.”
d. ) “Can you tell me if you have been exposed to any illnesses you might be developing?”

Answer 86

b.) “This elevation in temperature is a possible side effect of the anesthesia. We will notify the provider and assess temperature again in an hour.”

Question 87

A nurse is required to obtain the fetal heart rate (FHR) for a pregnant client. If the presentation is cephalic, which maternal site should the nurse monitor to hear the FHR clearly?

a. ) just below the maternal umbilicus
b. ) above the level of the maternal umbilicus
c. ) at the level of the maternal umbilicus
d. ) lower quadrant of the maternal abdomen

Answer 87

d.) lower quadrant of the maternal abdomen

Question 88

Maternal Psychological Adaptation

Partner’s psychological adaptation.

a. ) Taking-in phase
b. ) Taking-hold phase
c. ) Letting-go phase
d. ) Degrossment

Answer 88

Degrossment

Question 89

Maternal Psychological Adaptation

Time immediately after birth when the client needs others to meet her needs and relives the birth process.

a. ) Taking-in phase
b. ) Taking-hold phase
c. ) Letting-go phase
d. ) Degrossment

Answer 89

Taking-in Phase

Question 90

Maternal Psychological Adaptation

The woman reestablishes relationships with others.

a. ) Taking-in phase
b. ) Taking-hold phase
c. ) Letting-go phase
d. ) Degrossment

Answer 90

Letting-go phase

Question 91

Maternal Psychological Adaptation

Characterized by dependent and independent maternal behavior.

a. ) Taking-in phase
b. ) Taking-hold phase
c. ) Letting-go phase
d. ) Degrossment

Answer 91

Taking-hold phase

Question 92

A postpartal woman has a history of thrombophlebitis. Which action would help the nurse determine if she is developing this postpartally?

a. ) Assess for calf redness and edema.
b. ) Take her temperature every 4 hours.
c. ) Palpate her feet for tingling or numbness.
d. ) Ask her if she feels any warmth in her legs.

Answer 92

a.) Assess for calf redness and edema.

Question 93

Review of a woman’s labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this laceration as which type?

a. ) fourth-degree laceration
b. ) second-degree laceration
c. ) third-degree laceration
d. ) first-degree laceration

Answer 93

c.) third-degree laceration

Question 94

A postpartum client who had a cesarean birth reports right calf pain to the nurse. The nurse observes that the client has nonpitting edema from her right knee to her foot. The nurse knows to prepare the client for which test first?

a. ) noninvasive arterial studies of the right leg
b. ) venogram of the right leg
c. ) venous duplex ultrasound of the right leg
d. ) transthoracic echocardiogram

Answer 94

c.) venous duplex ultrasound of the right leg

Question 95

Elevation of a client’s temperature is a crucial first sign of infection. However, when is elevated temperature not a warning sign of impending infection?

a. ) after any period of decreased intake
b. ) when the white blood cell count is less than 10,000/mm³
c. ) during the first 24 hours after birth owing to dehydration from exertion
d. ) when the elevated temperature exceeds 100.4° F (38° C)

Answer 95

c.) during the first 24 hours after birth owing to dehydration from exertion

Question 96

A client gave birth 2 days ago and is preparing for discharge. The nurse assesses respirations to be 26 rpm and labored, and the client was short of breath ambulating from the bathroom this morning. Lung sounds are clear. The nurse alerts the primary care provider and the nurse-midwife to her concern that the client may be experiencing:

a. ) mitral valve collapse.
b. ) pulmonary embolism.
c. ) thrombophlebitis.
d. ) upper respiratory infection.

Answer 96

b.) pulmonary embolism.

Question 97

Many clients experience a slight fever after birth especially during the first 24 hours. To what should the nurse attribute this elevated temperature?

a. ) infection
b. ) fluid volume overload
c. ) change in the temperature from the birth room
d. ) dehydration

Answer 97

d.) dehydration

Question 98

A nurse assessing a postpartum client notices excessive bleeding. What should be the nurse’s first action?

a. ) Massage the boggy fundus until it is firm.
b. ) Call the primary care provider.
c. ) Document the findings.
d. ) Nothing—excessive postpartum blood loss is normal.

Answer 98

a.) Massage the boggy fundus until it is firm.

Question 99

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration?

a. ) third degree
b. ) second degree
c. ) first degree
d. ) fourth degree

Answer 99

d.) fourth degree

Question 100

Upon assessment, a nurse notes the client has a pulse of 90 bpm, moderate lochia, and a boggy uterus. What should the nurse do next?

a. ) Change the client’s peri-pad.
b. ) Assess the client’s blood pressure.
c. ) Notify the healthcare provider.
d. ) Massage the client’s fundus.

Answer 100

d.) Massage the client’s fundus.

Question 101

When completing the morning postpartum data collection, the nurse notices the client’s perineal pad is completely saturated. Which action should be the nurse’s first response?

a. ) Have the charge nurse review the assessment.
b. ) Immediately call the primary care provider.
c. ) Ask the client when she last changed her perineal pad.
d. ) Vigorously massage the fundus.

Answer 101

c.) Ask the client when she last changed her perineal pad.

Question 102

A woman who had a cesarean birth of twins 6 hours ago reports shortness of breath and pain in her right calf. What complication should the nurse expect?

a. ) pulmonary emboli
b. ) infection
c. ) hemorrhage
d. ) fluid volume overload

Answer 102

c.) hemorrhage

Question 103

A client who gave birth vaginally 16 hours ago states she does not need to void at this time. The nurse reviews the documentation and finds that the client has not voided for 7 hours. Which response by the nurse is indicated?

a. ) “I’ll check on you in a few hours.”
b. ) “I’ll contact your primary care provider.”
c. ) “It’s not uncommon after birth for you to have a full bladder even though you can’t sense the fullness.”
d. ) “If you don’t attempt to void, I’ll need to catheterize you.”

Answer 103

c.) “It’s not uncommon after birth for you to have a full bladder even though you can’t sense the fullness.”

Question 104

A nurse helps a postpartum woman out of bed for the first time postpartally and notices that she has a very heavy lochia flow. Which assessment finding would best help the nurse decide that the flow is within normal limits?

a. ) The color of the flow is red.
b. ) The flow contains large clots.
c. ) Her uterus is soft to your touch.
d. ) The flow is over 500 mL.

Answer 104

a.) The color of the flow is red.

Question 105

When palpating for fundal height on a postpartal woman, which technique is preferable?

a. ) placing one hand on the fundus, one on the perineum
b. ) placing one hand at the base of the uterus, one on the fundus
c. ) resting both hands on the fundus
d. ) palpating the fundus with only fingertip pressure

Answer 105

b.) placing one hand at the base of the uterus, one on the fundus

Question 106

A nurse is assessing a woman who gave birth vaginally approximately 24 hours ago. Which finding would the nurse report to the primary care provider immediately?

a. ) pulse rate 75 beats per minute
b. ) respiratory rate 16 breaths/minute
c. ) oral temperature 100.8° F (38.2° C)
d. ) uterine fundus 1 cm below umbilicus

SUBMIT ANSWER

Answer 106

c.) oral temperature 100.8° F (38.2° C)

Question 107

Does the APGAR score dictate resuscitation?

Question 108

A full-term baby has hypertonic flexion, elbow at the midline, plantar creases, larger raised breast tissue, an ear that has form to it, descended testes/large amount of rugae (boys) and larger labia (girls).

A pre-term baby has more extended extremities, an elbow that moves way passed the midline, no resistance for heel-to-ear, smooth soles (foot), smaller/non-raised breast buds, ears that fold over/press together, and testes not descended/little rugae (boys) and labia minora that protrudes beyond the labia majora (girls).

Answer 108

A full-term baby has hypertonic flexion, elbow at the midline, plantar creases, larger raised breast tissue, an ear that has form to it, descended testes/large amount of rugae (boys) and larger labia (girls).

A pre-term baby has more extended extremities, an elbow that moves way passed the midline, no resistance for heel-to-ear, smooth soles (foot), smaller/non-raised breast buds, ears that fold over/press together, and testes not descended/little rugae (boys) and labia minora that protrudes beyond the labia majora (girls).

Question 109

What are the normal vital signs for a newborn?

Question 110

Name 3 signs of respiratory distress for a newborn

Answer 110

Respiratory Distress

1. grunting
2. retractions
3. nasal flaring
4. cyanosis
5. rapid respirations
6. asymmetric chest expansion

Question 111

True or False:

Lung rales on auscultation can be normal during the first few hours of newborn transition.

Answer 111

True

Question 112

How much larger is the head circumference than the chest circumference?

Answer 112

Newborn head is 2-3 cm larger than chest

Head = 1/4 of the body

Question 113

What is the significance of circumoral cyanosis?

If baby is active - ?

If baby is crying - ?

Answer 113

If baby is not active – stimulate baby and this should disappear.

If baby is crying and this happens it could be a cardiovascular (CV) abnormality

Question 114

What is meconium and when is it usually noted?

Answer 114

The first stool, usually dark and stick.

Baby should have meconium within 24 hrs of life.

Question 115

On a newborns head, this is a collection of blood that does not cross the suture line.

a. ) Caput Succedaneum
b. ) Cephalhematoma
c. ) Molding

Answer 115

Cephalhematoma

collection of blood that does NOT cross the suture line​

Question 116

What is pseudomenstruation?

Answer 116

White/red discharge in female diaper.

Caused by hormones from mother.

Reassure the parents that this is normal, as it can be scary for them.

Teach them about this prior to going home so they can anticipate it (often happens).

Question 117

On a newborns head, this is a collection of serous fluid that crosses the suture line.

a. ) Caput Succedaneum
b. ) Cephalhematoma
c. ) Molding

Answer 117

Caput Succedaneum

collection of serous fluid that crosses the suture line

Question 118

Look like little white heads. Almost all babies have these.

a. ) Facial Milia b.) Stork Bites
c. ) Erythema Toxicum d.) Mongolian Spots
e. ) Port Wine Stains f.) Strawberry Masks

Answer 118

Facial Milia

Question 119

Also known as nevus vasculosus. Rare and mostly is seen in pre-term infants at 2 weeks of age or later. Usually resolves by 3 years of age without tx.

a. ) Facial Milia b.) Stork Bites
c. ) Erythema Toxicum d.) Mongolian Spots
e. ) Port Wine Stains f.) Strawberry Masks

Answer 119

Strawberry Masks

nevus vasculosus​

Question 120

Red rash all over the body that usually disappers within the first several weeks.

a. ) Facial Milia b.) Stork Bites
c. ) Erythema Toxicum d.) Mongolian Spots
e. ) Port Wine Stains f.) Strawberry Masks

Answer 120

Erythema Toxicum

Question 121

Also known as nevus flammeus. Rare and can be associated with childhood cancer. This has to be removed/lessened by laser and these children must be monitored for cancer and other malformations.

a. ) Facial Milia b.) Stork Bites
c. ) Erythema Toxicum d.) Mongolian Spots
e. ) Port Wine Stains f.) Strawberry Masks

Answer 121

Port Wine Stains

nevus flammeus

Question 122

A red area often at nape of neck. These disappear usually by one year of age, and they can pop out or become brighter red when baby cries.

a. ) Facial Milia b.) Stork Bites
c. ) Erythema Toxicum d.) Mongolian Spots
e. ) Port Wine Stains f.) Strawberry Masks

Answer 122

Stork Bites

Question 123

Elongated shape of infant’s head due to overlapping cranial bones caused by passing through birth canal in vertex position.

a. ) Caput Succedaneum
b. ) Cephalhematoma
c. ) Molding

Answer 123

Molding

Question 124

Blue or purple and can look like brusies. Sometimes seen on Black, Asian, and/or Indian babies. It is important to point these out to parents and tell them not to worry about them and that they usually disappear by 1 year of age.

a. ) Facial Milia b.) Stork Bites
c. ) Erythema Toxicum d.) Mongolian Spots
e. ) Port Wine Stains f.) Strawberry Masks

Answer 124

Mongolian Spots

Question 125

The infant’s temperature is 97.2° F (36.2° C) axillary an hour after birth. Which intervention is appropriate for the nurse?

a. ) Place the infant under a radiant warmer or in a heated isolette.
b. ) Place a second stockinette on the baby’s head.
c. ) Administer a warm bath with temperature slightly higher than usual.
d. ) Take the infant to the mother for bonding.

Answer 125

a.) Place the infant under a radiant warmer or in a heated isolette.

Question 126

What are small unopened or plugged sebaceous glands that occur in a newborn’s mouth and gums?

a. ) Mongolian spots
b. ) stork bites
c. ) Epstein’s pearls
d. ) milia

Answer 126

c.) Epstein’s pearls

Question 127

As a part of the newborn assessment, the nurse examines the infant’s skin. Which nursing observation would warrant further investigation?

a. ) bright red, raised bumpy area noted above the right eye
b. ) fine red rash noted over the chest and back
c. ) small pink or red patches on the baby’s eyelids and back of the neck
d. ) blue or purplish splotches on buttocks

Answer 127

a.) bright red, raised bumpy area noted above the right eye

Question 128

A nurse determines that a newborn has a 1-minute Apgar score of 5 points. What conclusion would the nurse make from this finding?

a. ) The infant is adjusting well to extrauterine life.
b. ) The infant is experiencing moderate difficulty in adjusting to extrauterine life.
c. ) The infant probably has either a congenital heart defect or an immature respiratory system.
d. ) The infant requires immediate and aggressive interventions for survival.

Answer 128

b.) The infant is experiencing moderate difficulty in adjusting to extrauterine life.

Question 129

The AGPAR score is based on which 5 parameters?

a. ) heart rate, breaths per minute, irritability, tone, and color
b. ) heart rate, respiratory effort, temperature, tone, and color
c. ) heart rate, muscle tone, reflex irritability, respiratory effort, and color
d. ) heart rate, breaths per minute, irritability, reflexes, and color

Answer 129

c.) heart rate, muscle tone, reflex irritability, respiratory effort, and color

Question 130

A nurse is observing respiratory effort in a newborn as part of Apgar scoring. Which method should the nurse use to do this?

a. ) Observe chest movement.
b. ) Observe response to a suction catheter in the nostrils.
c. ) Observe resistance to any effort to extend the newborn’s extremities.
d. ) Observing and count the pulsations of the umbilical cord.

Answer 130

a.) Observe chest movement.

Question 131

The nurse notices while holding him upright that a day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the physician. What does this finding most likely indicate?

a. ) Vernix caseosa
b. ) Dehydration
c. ) Increased intracranial pressure
d. ) Cyanosis

Answer 131

b.) Dehydration

Question 132

A newborn is 7 minutes old. Her heart rate is 92 bpm, her cry is weak, her muscles are limp and flaccid, she makes a face when she is stimulated, and her body and extremities are pink. What would the nurse assign as her Apgar score?

a. ) 4
b. ) 3
c. ) 6
d. ) 5

Answer 132

d.) 5

Question 133

The nurse is assessing the abdomen of the neonate. When inspecting the umbilical cord area of a newborn, the nurse would expect which finding?

a. ) three arteries and no veins
b. ) one artery and two veins
c. ) two arteries and two veins
d. ) two arteries and one vein

Answer 133

d.) two arteries and one vein

Question 134

The Ballard scoring system evaluates newborns on which two factors?

a. ) physical maturity and neuromuscular maturity
b. ) body maturity and cranial nerve maturity
c. ) tone maturity and extremities maturity
d. ) skin maturity and reflex maturity

Answer 134

a.) physical maturity and neuromuscular maturity

Question 135

A nurse is performing a detailed assessment of a female newborn. Which observations indicate normal findings? Select all that apply.

a. ) Mongolian spots
b. ) enlarged fontanelles
c. ) short, creased neck
d. ) low-set ears
e. ) swollen genitals

Answer 135

a. ) Mongolian spots
c. ) short, creased neck
e. ) swollen genitals

Question 136

A new mother is nervous about sudden infant death syndrome (SIDS) and asks the nurse how to prevent it when the newborn is ready to sleep. Beside placing the infant on a firm sleep surface, what should the nurse tell the mother to do? Select all that apply.

a. ) Let the newborn sleep in the same bed as the parents.
b. ) Provide a pacifier when putting the infant to sleep.
c. ) Not allow anyone to smoke around the infant.
d. ) Place the infant on his or her back.
e. ) Keep the infant dressed warmly at night.

Answer 136

c. ) Not allow anyone to smoke around the infant.
d. ) Place the infant on his or her back.

Question 137

Which measurements were most likely obtained from a normal newborn born at 38 weeks to a healthy mother with no maternal complications?

a. ) weight = 2000 g, length = 17 inches (43 cm), head circumference = 32 cm, and chest circumference = 30
b. ) weight = 2500 g, length = 18 inches (46 cm), head circumference = 32 cm, and chest circumference = 30 cm
c. ) weight = 3500 g, length = 20 inches (51 cm), head circumference = 34 cm, and chest circumference = 32 cm
d. ) weight = 4500 g, length = 22 inches (56 cm), head circumference = 36 cm, and chest circumference = 34 cm

Answer 137

c.) weight = 3500 g, length = 20 inches (51 cm), head circumference = 34 cm, and chest circumference = 32 cm

Question 138

A newborn has a heart rate of 90 beats per minute, a regular respiratory rate of 40 breaths per minute, tight flexion of the extremities, a grimace when stimulated, and acrocyanosis. The nurse assigns an Apgar score of:

a. ) 6.
b. ) 8.
c. ) 5.
d. ) 7.

Answer 138

d.) 7.

Question 139

Which is the best place to perform a heel stick on a newborn?

a. ) the calcaneus
b. ) the fat pads on the lateral aspects of the foot
c. ) the vascularized flat surface of the foot
d. ) the front of the heel (the outer arch)

Answer 139

b.) the fat pads on the lateral aspects of the foot

Question 140

The nurse is orienting a student to the nursery. The nurse understands that teaching has been effective when the student states that the signs of neonate respiratory distress include which findings? Select all that apply.

a. ) nasal flaring
b. ) respiratory rate greater than 60 breaths per minute
c. ) blue hands and feet
d. ) retractions
e. ) heart rate greater than 100 beats per minute

Answer 140

a. ) nasal flaring
b. ) respiratory rate greater than 60 breaths per minute
d. ) retractions
e. ) heart rate greater than 100 beats per minute

Question 141

One minute after birth, the neonate’s heart rate is 98 beats per minute (bpm), respirations are slow and irregular, arms are flexed, hips are extended, the neonate has no grimace, and the hands/feet are acrocyanotic. What Apgar score should the nurse assign to the neonate?

a. ) 4
b. ) 6
c. ) 5
d. ) 7

Answer 141

a.) 4

Question 142

When assessing a newborn’s gestational age, the nurse evaluates which parameter to indicate physical maturity? Select all that apply.

a. ) scarf sign
b. ) posture
c. ) arm recoil
d. ) genitals
e. ) lanugo

Answer 142

d. ) genitals
e. ) lanugo

Question 143

A nurse is performing Apgar scoring on a newborn. The newborn demonstrates the following: a heart rate of 110 bpm; a good, strong cry; muscles of the extremities well flexed; a grimace in response to a slap to the sole of the foot; and normal pigment in most of the body, with blue at the extremities. Which score would be the total Apgar score for this newborn?

a. ) 9
b. ) 6
c. ) 7
d. ) 8

Answer 143

d.) 8

Question 144

The nurse receives report and enters the room to do the initial shift assessment and finds the laboring mother supine and EFM is not picking up the FHTs well. What is the priority action?

a. ) Notify the physician using SBAR and ask him/her to come in to verify FHTs.
b. ) Ask the resident to bring the US machine in and do the assessment.
c) Reposition the mother so she is sitting up in bed, then readjust the US and toco.
d. ) Check the maternal pulse to see if the machine is picking up maternal pulse instead.

Answer 144

c) Reposition the mother so she is sitting up in bed, then readjust the US and toco.

Question 145

The fetal monitor has shown late decelerations over the last three contractions. This pattern indicates the fetus is experiencing:

a. ) head compression
b. ) utero placental insufficiency
c. ) umbilical cord compression
d. ) maternal hypertension

Answer 145

b.) utero placental insufficiency

Question 146

The fetal monitor has shown several late decelerations over the past 10 minutes. What does this pattern indicate?

a. ) Umbilical cord compression
b. ) Head compression
c. ) Fetal hypoxia
d. ) Maternal fever

Answer 146

c.) Fetal hypoxia

Question 147

A nurse is analyzing a maternal client’s fetal heart rate (FHR) strip monitor and notes that some early decelerations are present. The nurse explains to the client that early decelerations are most often related to:

a. ) umbilical cord compression
b. ) uteroplacental insufficiency
c. ) fetal hypoxia
d. ) fetal head compression

Answer 147

d.) fetal head compression

Question 148

The labor nurse is caring for a G2P1 who is a 39 5/7 weeks gestation. The woman is in the active phase of labor at 6 cm. She calls on the light to say her water just broke. What is the nurse’s initial action?

a. ) Observe the EFM strip for accelerations
b. ) Note the FHTs to verify there is no prolapsed cord
c. ) Turn the patient on her side
d. ) Apply oxygen mask at 10 L/min

Answer 148

b.) Note the FHTs to verify there is no prolapsed cord

Question 149

You are caring for a multigravida who is being induced and is in the active phase of labor. You notice early decels on the EFM tracing. What is your nursing priority now?

a. ) Continue routine assessment and monitoring
b. ) Notify the physician/certified midwife
c. ) Turn the patient on left side and give O₂ by mask
d. ) Turn off the pitocin and increase IV fluids

Answer 149

a.) Continue routine assessment and monitoring

Question 150

After several hours of labor, the EFM strip shows repetitive variable decelerations on the fetal strip. You would interpret the decelerations to be consistent with:

a. ) umbilical cord compression
b. ) breech presentation
c. ) compression of the fetal head
d. ) uteroplacental insufficiency

Answer 150

a.) umbilical cord compression

Question 151

The OB nurse is monitoring a pregnant client at 32 weeks gestation who is 6 cm, and being induced due to a diagnosis of pre-eclampsia with severe features. The nurse notes persistent late decelerations despite doing POISE. What is the next step in caring for the client?

a. ) Continue pitocin
b. ) Turn the patient on the left side
c. ) Start the amnio-infusion with normal saline
d. ) Anticipate a emergent cesarean section

Answer 151

d.) Anticipate a emergent cesarean section

Question 152

You are caring for a laboring woman whose water suddenly broke. You note it is clear, with a large amount on the blue pad. The FHTs are in the 80s and stay there. What is your primary action to this event?

a. ) React with POISE
b. ) Call the physician to come to a stat c/section
c. ) Put the patient in Trendelenburg position
d. ) Call the team leader to come help

Answer 152

a.) React with POISE​

Question 153

What is the physiology of blood flow to the fetus during a contraction?

a. ) Blood flow increases
b. ) Blood flow stops/ceases
c. ) Blood flow decreases
d. ) Blood flow is not affected

Answer 153

b.) Blood flow stops/ceases

Question 154

The nurse observes variable decelerations on the EFM. What is the appropriate FIRST action to treat this pattern?

a. ) Stop the Pitocin
b. ) Turn the patient on one side, then another to see if it will relieve the decelerations
c. ) Give oxygen by mask at 10 L/min
d. ) Notify the care provider to get a prescription for amnio-infusion

Answer 154

b.) Turn the patient on one side, then another to see if it will relieve the decelerations

Question 155

It has been six hours since the patient gave birth. Upon doing the next assessment, you palpate the patient’s abdomen and it is soft. Your next move:

a. ) Do nothing, this is considered normal
b. ) Call the physician and state there is a problem
c. ) React with POISE
d. ) Massage the woman’s uterus

Answer 155

d.) Massage the woman’s uterus

Question 156

Recovery.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 156

4^th stage of labor

Primary task: stop the bleeding

Question 157

You need to calculate the woman’s due date. She states that her last menstrual period was September 1^st

a. ) June 8^th
b. ) July 7^th
c. ) August 1^st
d. ) August 7^th

Answer 157

a.) June 8^th

Question 158

_____ is presenting part of the fetal head at 0 station.

a. ) Quickening
b. ) Braxton-Hicks
c. ) Lightening
d. ) Engagement

Answer 158

Engagement is presenting part of the fetal head at 0 station.

Question 159

Normal fetal heart rate is ____.

Answer 159

Normal fetal heart rate is 110 to 160

Question 160

10cm to birth.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 160

2^nd stage of labor

Primary task: get the baby out

Question 161

True or false:

After birth, the cervix does not return to its pre-pregnant shape

Answer 161

true

Question 162

_____ is the time when the expectant mother first feels fetal movement.

a. ) Quickening
b. ) Braxton-Hicks
c. ) Lightening
d. ) Engagement

Answer 162

Quickening is the time when the expectant mother first feels fetal movement.

Question 163

Primary task is to get the baby out.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 163

2^nd stage of labor

Primary task: get the baby out

Question 164

_____ force is pushing during the second stage of labor.

a. ) Primary
b. ) Secondary

Answer 164

b.) Secondary

• Primary force is uterine muscular contractions.*
• Secondary force is pushing during the second stage of labor.*

Question 165

_____ is the fetal head entering the maternal pelvis.

a. ) Quickening
b. ) Braxton-Hicks
c. ) Lightening
d. ) Engagement

Answer 165

Lightening is the fetal head entering the maternal pelvis.

Question 166

Normal maternal weight gain during pregnancy is _____ pounds.

Answer 166

Normal maternal weight gain during pregnancy is:

25 to 35 pounds.

Question 167

A woman comes in complaining of vaginal bleeding, as a nurse, your first step would be:

a. ) Assess the woman by performing a vaginal exam
b. ) Perform ultrasound and use a speculum to assess the woman
c. ) Call the physician as this is an emergency
d. ) Tell her that she is entering the first stage of labor

Answer 167

b.) Perform ultrasound and use a speculum to assess the woman

Question 168

True or false:

Ambivalence is a normal response during the first trimester of pregnancy

Answer 168

true

Question 169

Fundal height = weeks gestation until ____ weeks

Answer 169

Fundal height = weeks gestation until 36 weeks

Question 170

_____ force is pushing during the second stage of labor.

a. ) Primary
b. ) Secondary

Answer 170

a.) Primary

• Primary force is uterine muscular contractions.*
• Secondary force is pushing during the second stage of labor.*

Question 171

Upon measuring, you find that the fundal height is greater than weeks gestation. The possible cause of such finding could be to: (select all that apply)

a. ) Hydramnios
b. ) Multiple gestation
c. ) IUGR
d. ) Uterine fibroids
e. ) The patient is overweight

Answer 171

a. ) Hydramnios
b. ) Multiple gestation
d. ) Uterine fibroids

Question 172

Labor to dilation.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 172

1^st stage of labor

Primary task: dilate the cervix

Question 173

A woman comes in for a prenatal visit during pregnancy and asks when she should feel the fetal movement. You answer her question by saying:

a. ) By 2 months into the pregnancy, you should be able to feel the baby move.
b. ) This usually happens between 16 and 20 weeks into the pregnancy.
c. ) If you do not feel the movement now, then we need to check your baby’s heart rate.
d. ) This usually happens between 20 and 30 weeks into the pregnancy.

Answer 173

b.) This usually happens between 16 and 20 weeks into the pregnancy.

Question 174

False contractions are also called _____.

a. ) Quickening
b. ) Braxton-Hicks
c. ) Lightening
d. ) Engagement

Answer 174

False contractions are also called Braxton-Hicks

Question 175

Primary task is to get the placenta out.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 175

3^rd stage of labor

Primary task: get the placenta out

Question 176

The best way to measure the fundal height is to:

a. ) measure in centimeters with a tape measure while the woman is lying flat on her back with knees slightly flexed.
b. ) measure in inches with a tape measure while the woman is lying flat on her back with stretched out legs.
c. ) measure in centimeters with a tape measure while the woman is lying on her side with knees slightly flexed.

Answer 176

a.) measure in centimeters with a tape measure while the woman is lying flat on her back with knees slightly flexed.

Question 177

Sources of folic acid include:

a. ) tomatoes, lentils, and quinoa
b. ) dark green vegetables, bananas, and walnuts
c. ) all fruits and vegetables
d. ) broccoli, citrus fruits, peanuts, and liver

Answer 177

d.) broccoli, citrus fruits, peanuts, and liver

Question 178

The greatest risk to the developing embryo is between ___ and ___ days.

Answer 178

The greatest risk to the developing embryo is between 17 and 56 days.

Question 179

Blood loss average:

Vaginal birth = ?

Cesarean birth = ?

Answer 179

Blood loss average:

Vaginal birth = 500 mL

Cesarean birth = 1,000 mL

Question 180

A woman complains of lightheadedness, fainting spells, and frequent palpitations. As a nurse, you know that she is experiencing vena caval syndrome and recommend her to:

a. ) come in to the hospital as soon as possible.
b. ) switch to a side-lying position.
c. ) empty bladder frequently
d. ) stop taking BP medications

Answer 180

b.) switch to a side-lying position.

Question 181

A woman is pregnant for the fourth time. She has had one miscarriage at 9 weeks, and has a son born at 41 weeks and another son at 36 weeks. What is her obstetrical history?

Answer 181

G₄ P₂ T₁ P₁ A₁ L₂

Question 182

Primary task is to stop the bleeding.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 182

4^th stage of labor

Primary task: stop the bleeding

Question 183

What are the 5 factors affecting the labor process?

(5 P’s)

Answer 183

Passageway

Passenger

Position

Power

Psychosocial

Question 184

When ROM (SROM or AROM) thou shalt:

Answer 184

When ROM (SROM or AROM) thou shalt check fetal heart tones for cord prolapse

Question 185

True or false:

You know the woman is in true labor because she has contractions at regular intervals, progressive effacement, and dilation of the cervix.

Answer 185

true

You know the woman is in true labor because she has contractions at regular intervals, progressive effacement, and dilation of the cervix.

Question 186

Primary task is to dilate the cervix.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 186

1^st stage of labor

Primary task: dilate the cervix

Question 187

Birth of placenta.

a. ) 1^st stage of labor
b. ) 2^nd stage of labor
c. ) 3^rd stage of labor
d. ) 4^th stage of labor

Answer 187

3^rd stage of labor

Primary task: get the placenta out

Question 188

As a nurse, you would perform two tests to confirm that the membrane ruptured. What are they?

Answer 188

Nitrazene

Ferning

Question 189

Late decelerations.

a. ) Cord compression
b. ) Head compression
c. ) Uteroplacental insufficiency

Answer 189

Uteroplacental insufficiency

Question 190

Caused by head compression.

a. ) Early decelerations
b. ) Variable decelerations
c. ) Late decelerations

Answer 190

Early decelerations

Question 191

Caused by cord compression.

a. ) Early decelerations
b. ) Variable decelerations
c. ) Late decelerations

Answer 191

Variable decelerations

Question 192

Peak minus resting tone.

a. ) Duration
b. ) Frequency
c. ) Resting
d. ) Intensity

Answer 192

Intensity

only accurate with IUPC

Question 193

Interventions include changing position and amnioinfusion if the membrane has ruptured.

a. ) Early decelerations
b. ) Variable decelerations
c. ) Late decelerations

Answer 193

Variable decelerations

Question 194

Tone at rest between UC’s.

a. ) Duration
b. ) Frequency
c. ) Resting
d. ) Intensity

Answer 194

Resting

only accurate with IUPC

Question 195

Variable decelerations.

a. ) Cord compression
b. ) Head compression
c. ) Uteroplacental insufficiency

Answer 195

Cord compression

Question 196

No intervention necessary.

a. ) Early decelerations
b. ) Variable decelerations
c. ) Late decelerations

Answer 196

Early decelerations

Question 197

If lochia goes back to rubra color = ?

Answer 197

If lochia goes back to rubra color = hemorrhage

Question 198

Caused by uteroplacental insufficiency.

a. ) Early decelerations
b. ) Variable decelerations
c. ) Late decelerations

Answer 198

Late decelerations

Question 199

Early decelerations.

a. ) Cord compression
b. ) Head compression
c. ) Uteroplacental insufficiency

Answer 199

Head compression

Question 200

Interventions include POISE.

a. ) Early decelerations
b. ) Variable decelerations
c. ) Late decelerations

Answer 200

Late decelerations

Question 201

Beginning of UC until end of UC.

a. ) Duration
b. ) Frequency
c. ) Resting
d. ) Intensity

Answer 201

Duration

seconds

Question 202

In order to locate the FHR in LOA position, you would put the sono in which area?

a. ) Place sono at the the umbilicus region
b. ) Place sono in right epigastric area
c. ) Place sono at the LLQ of the abdomen
d. ) Place sono at the LUQ of the abdomen

Answer 202

c.) Place sono at the LLQ of the abdomen

Question 203

Beginning of one UC until the beginning of the next UC.

a. ) Duration
b. ) Frequency
c. ) Resting
d. ) Intensity

Answer 203

Frequency

minutes

Question 204

______ = partner psychological adaptation

Answer 204

Engrossment = partner psychological adaptation

Question 205

The tests that require Rhogam for RH negative moms after procedure are _____ and _____.

Answer 205

The tests that require Rhogam for RH negative moms after procedure are:

amniocentesis and chorionic-villi sampling.

Question 206

Commandment

What is the difference between variability and variable decelerations?

Answer 206

Variability = oxygenation

Variable decelerations = U/V/W & cord compression

Question 207

Commandment

When ROM (SROM or AROM) occurs, what do you immediately check?

Answer 207

Immediately check FHT’s for cord prolapse.

If the FHT’s become bradycardic, then do a vag exam to assess for prolapsed cord.

Push that head up and rush to a c/s

Question 208

Commandment

OB nurses always intervene first, THEN call the physician.

There are however 2 exceptions, what are they?

Answer 208

1. ) There is abruption
2. ) Uterine rupture

Question 209

Commandment

Any type of nipple stimulation (e.g., rubbing, baby sucking, hot shower water, intercourse, etc.) will cause the uterus to _______.

Answer 209

Any type of nipple stimulation (e.g., rubbing, baby sucking, hot shower water, intercourse, etc.) will cause the uterus to contract (during ante, intra, and postpartum).

Question 210

Commandment

What are the 2 reasons you perform an amnioinfusion?

Answer 210

Reasons for Amnioinfusion

1. To flush meconium poop out of lungs
2. To cushion the cord when variable decelerations are present

Question 211

Commandment

Never perform a vaginal exam on any pregnant woman complaining of ______.

What do you do instead?

Answer 211

Never perform a vaginal exam on any pregnant woman complaining of vaginal bleeding.

Do speculum and ultrasound instead.

Question 212

Commandment

If a mother complains of sore nipples, what two things do you need to assess?

Answer 212

1. ) Positioning
2. ) Latch-on techniques
   * These are usually the problem*

Question 213

Commandment

What are the 4 H’s you need to assess for all new babies?

Answer 213

Hypoxia

Hypothermia

Hypoglycemia

Hyperbilirubinemia

Question 214

Commandment

1. ) Fundal height = weeks of gestation until _____.
2. ) If fundal height > weeks of gestation, _____ may be present.
3. ) If fundal height < weeks of gestation, _____ may be present.

Answer 214

1. ) Fundal height = weeks of gestation until 36 weeks.
2. ) If fundal height > weeks of gestation, polyhydramnios, multiple gestation, or uterine fibroids may exist.
3. ) If fundal height < weeks of gestation, IUGR may be present.

Question 215

Commandment

When a patient presents with any infection (anywhere in the body), what do you assess for?

Answer 215

When a patient presents with any infection (anywhere in the body), you should assess for preterm labor.

When a patient presents with preterm labor, you should assess for infection.

infection and preterm labor are highly related

Question 216

Commandment

When a patient presents with preterm labor, you should assess for ______.

Answer 216

When a patient presents with any infection (anywhere in the body), you should assess for preterm labor.

When a patient presents with preterm labor, you should assess for infection.

infection and preterm labor are highly related

Question 217

Commandment

The physiologic reason for inducing labor by AROM is to allow the release of _______ from the membrane lining the bag (the amnion) and the lining of the uterus (the decidua).

The hard skull also puts more pressure on the cx so dilation is faster.

Answer 217

The physiologic reason for inducing labor by AROM is to allow the release of prostaglandins from the membrane lining the bag (the amnion) and the lining of the uterus (the decidua).

The hard skull also puts more pressure on the cx so dilation is faster.

Question 218

After performing a CVS (Chorionic Villi Sampling), mothers who are RH negative need to receive _______.

Answer 218

After performing a CVS (Chorionic Villi Sampling), mothers who are RH negative need to receive Rhogam.

Question 219

In _____ pregnancy, ultrasound is more accurate to determine gestational age compared to performing ultrasound later in pregnancy.

Answer 219

In early pregnancy, ultrasound is more accurate to determine gestational age compared to performing ultrasound later in pregnancy.

Question 220

Quad marker screening tests screen for neural tube defects (NTD’s) and/or chromosome anomalies. Which of the following conditions can happen when the AFP is elevated? (select all that apply)

a. ) NTD’s (e.g. spina bifida)
b. ) Multiple gestation
c. ) fetal demise
d. ) T21 (Trisomy 21, Down Syndrome)

Question 221

Which test detects genetic and/or chromosomal abnormalities and produces definitive results?

Answer 221

Amniocentesis

Question 222

Quad marker screening tests screen for neural tube defects (NTD’s) and/or chromosome anomalies. Which of the following conditions can happen when the AFP is low, uE3 is low, inhibin A is low, and HCG is high? (select all that apply)

a. ) NTD’s (e.g. spina bifida)
b. ) Multiple gestation
c. ) fetal demise
d. ) T21 (Trisomy 21, Down Syndrome)

Question 223

Attempting to compensate for _______ results in hypoxia, hypoglycemia, and hyperbilirubinemia.

Answer 223

Attempting to compensate for cold stress / hypothermia results in hypoxia, hypoglycemia, and hyperbilirubinemia.

Question 224

Flow of heat from body surface to cooler surrounding air or to air circulating over a body surface.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 224

Convection

Question 225

Having the air conditioning on.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 225

Convection

Question 226

Loss of body heat to cooler, solid surfaces in close proximity, but not in direct contact.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 226

Radiation

Question 227

Cold walls of room or open incubator door.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 227

Radiation

Question 228

Heat is lost when liquid or moisture from the skin and respiratory tract converts to vapor.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 228

Evaporation

Question 229

Wet baby from amniotic fluid or bath.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 229

Evaporation

Question 230

Transfer of heat from object to object when the two objects are in direct contact with each other.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 230

Conduction

Question 231

Cold hands, cold scales, cold stethoscopes.

a. ) Convection
b. ) Radiation
c. ) Evaporation
d. ) Conduction

Answer 231

Conduction

Question 232

Cessation of breathing during a newborn’s respiratory cycle that lasts less than 15 seconds.

a. ) Physiologic Apnea
b. ) Pathologic Apnea

Answer 232

Physiologic Apnea

Question 233

Cessation of breathing that lasts more than 15 seconds.

a. ) Physiologic Apnea
b. ) Pathologic Apnea

Answer 233

Pathologic Apnea

Question 234

A newborn’s temperature falls by ___ to ___ degrees C after birth due to evaporative losses. This triggers cold-induced metabolic responses and heat production.

Question 235

Hypoglycemia is a blood glucose level of less than ___ mg/dL or a plasma concentration less than ___ mg/dL in the first 72 hours of life.

Question 236

Normal newborn blood sugar = ____ mg/dL

Answer 236

40-60 mg/dL

Question 237

The first ___ hours of life, high risk babies are at the greatest risk of developing hypoglycemia.

Answer 237

The first 12 hours of life, high risk babies are at the greatest risk of developing hypoglycemia.

Question 238

High levels of bilirubin results in ______.

Answer 238

jaundice / icterus

Question 239

Never present on the first 24 hours of life. Considered normal for newborns occuring 2 to 3 days of life due to imbalance between production and elimination of bilirubin and an immature liver system.

a. ) Physiologic Jaundice
b. ) Pathologic Jaundice

Answer 239

Physiologic Jaundice

Question 240

When jaundice occurs before 24 hours of life in a term infant.

a. ) Physiologic Jaundice
b. ) Pathologic Jaundice

Answer 240

Pathologic Jaundice

Question 241

Caused by conditions that cause excessive destruction of RBCs (i.e., biliary obstruction, biliary atresia, etc.).

a. ) Physiologic Jaundice
b. ) Pathologic Jaundice

Answer 241

Pathologic Jaundice

Question 242

For babies with the following conditions are in the nursery. Which one is going to be high risk for physiologic jaundice?

a. ) Cephalhematoma
b. ) Caput succedaneum
c. ) Harlequin coloring
d. ) Mongolian spotting

Answer 242

Cephalhematoma

Question 243

Cephalhematomas, bruises to the face and scapula, forceps mark, and vacuum delivery can all cause jaundice because they result in destruction of RBCs from the trauma. What are 2 other conditions that can cause jaundice?

Question 244

Hydration and frequent stooling helps to promote the elimination of bilirubin. What is another method that is used to treat hyperbilirubinemia?

Answer 244

Phototherapy

Question 245

At birth there are multiple changes in the cardiac and respiratory systems. What is one of the changes to occur at birth in the cardiovascular system?

a. ) Oxygen is exchanged in the lungs.
b. ) Fluid is removed from the alveoli and replaced with air.
c. ) Pressure changes occur and result in closure of the ductus arteriosus.
d. ) The oxygen in the blood decreases.

Answer 245

c.) Pressure changes occur and result in closure of the ductus arteriosus.

The ductus arteriosus is one of the openings through which there was fetal circulation. At birth, or within the first few days, this closes and the heart becomes the source of movement of blood to and from the lungs.

The exchange of oxygen in the lungs is not a function of the cardiovascular system; it is a function of the respiratory system. Again, the removal of fluid from the alveoli is not a function of the cardiovascular system. The oxygen content of the blood increases; it does not decrease.

Question 246

The nurse describes the changes in stool that a new mother would see when feeding her newborn formula. Which description best indicates what the mother would observe after several days?

a. ) greenish, tarry, thick black stool
b. ) yellow-green, pasty, unpleasant-smelling stool
c. ) sour-smelling, yellowish-gold stool
d. ) thin, yellowish, seedy brown stool

Answer 246

b.) yellow-green, pasty, unpleasant-smelling stool

The stool of formula-fed newborns varies depending on the type of formula ingested, but it typically is yellow, yellow-green, or greenish, loose, pasty, or formed with an unpleasant odor. Greenish-black tarry stool denotes meconium.

Thin, yellowish, seedy brown stool characterizes the transitional stool that occurs after meconium.

Sour-smelling yellowish-gold stool that is loose and stringy to pasty in consistency is typical of a breastfed newborn stool.

Question 247

A nurse is assessing a newborn during the first 24 hours after birth. Which findings would the nurse recognize as normal?

a. ) body temperature of 97.9° to 99.7° F (36.5° to 37.5° C)
b. ) positive Ortolani sign
c. ) rounded, symmetrical abdomen
d. ) enlarged labia with pseudomenstruation
e. ) heart rate of 90 to 100 bpm

Answer 247

a.) body temperature of 97.9° to 99.7° F (36.5° to 37.5° C)

On average, a newborn’s temperature ranges from 97.9° to 99.7° F (36.5° to 37.5° C).

Question 248

A nurse needs to monitor the blood glucose levels of a newborn under observation at a health care facility. When should the nurse check the newborn’s initial glucose level?

a. ) 24 hours after admission to the nursery
b. ) after the newborn has received the initial feeding
c. ) on admission to the nursery
d. ) 4 hours after admission to the nursery

Answer 248

c.) on admission to the nursery

Typically, a newborn’s blood glucose levels are assessed with use of a heel stick sample of blood on admission to the nursery, not 4 or 24 hours after admission to the nursery. It is also not necessary or even reasonable to check the glucose level only after the newborn has been fed.

Question 249

What should the nurse expect for a full-term newborn’s weight during the first few days of life?

a. ) There is a loss of 5% to 10% of the birth weight in the first few days in breastfed infants only.
b. ) There is a loss of 5% to 10% of birth weight in formula-fed and breastfed newborns.
c. ) There is an increase in 3% to 5% of birth weight by day 3 in formula-fed babies.
d. ) A formula-fed newborn should gain 3% to 5% of the initial birth weight in the first 48 hours, but a breastfed newborn may lose up to 3%.

Answer 249

b.) There is a loss of 5% to 10% of birth weight in formula-fed and breastfed newborns.

The nurse should expect the newborn who is breastfed or formula-fed to lose 5% to 10% of birth weight in the first few days of life.

Question 250

Which newborn neuromuscular system adaptation would the nurse NOT expect to find?

a. ) A plantar grasp reflex at 7 months of age
b. ) A positive Babinski reflex at 2 months of age
c. ) A Moro reflex at 3 months of age
d. ) An extrusion reflux at 9 months of age

Answer 250

d.) An extrusion reflux at 9 months of age

An extrusion reflux usually disappears around 4 months of age.

A positive Babinski reflex can be seen until 3 months of age.

The plantar grasp disappears around 8 to 9 months of age.

The Moro reflex disappears around 4 to 5 months of age.

Question 251

At what point should the nurse expect a healthy newborn to pass meconium?

a. ) by 12 to 18 hours of life
b. ) before birth
c. ) within 1 to 2 hours of birth
d. ) within 24 hours after birth

Answer 251

d.) within 24 hours after birth

The healthy newborn should pass meconium within 24 hours of life.

Question 252

A nurse is caring for an infant with an elevated bilirubin level who is under phototherapy. What evaluation data would best indicate that the newborn’s jaundice is improving?

a. ) Reticulocyte count is 6%.
b. ) Skin looks less jaundiced.
c. ) Hematocrit is 38.
d. ) Bilirubin level went from 15 to 11.

Answer 252

d.) Bilirubin level went from 15 to 11.

The newborn has physiologic jaundice, which is related to decreased bilirubin conjugation. Newborns have relatively immature livers and cannot conjugate (break down) bilirubin as fast as needed.

Bilirubin overproduction is responsible for causing jaundice. A serum bilirubin is the best way to determine whether the jaundice is improving. The other listed methods will not address the needed information.

Question 253

A nurse is teaching a new mother about what to expect for bowel elimination in her newborn. Because the mother is breastfeeding, what should the nurse tell her about the newborn’s stools?

a. ) Stools should be greenish and formed in consistency.
b. ) Stools should be yellow-green and loose.
c. ) Stools should be brown and loose.
d. ) Stools should be yellow-gold, loose, and stringy to pasty.

Answer 253

d.) Stools should be yellow-gold, loose, and stringy to pasty.

The stools of a breast-fed newborn are yellow-gold, loose, and stringy to pasty in consistency.

The stools of the formula-fed newborn vary depending on the type of formula ingested. They may be yellow, yellow-green, or greenish and loose, pasty, or formed in consistency, and they have an unpleasant odor.

Question 254

The nurse is assessing the stools of a 36-hour-old neonate who is being breastfed. The nurse determines that the stools are within normal parameters based on which finding?

a. ) yellowy mustard color with seedy appearance
b. ) greenish black with a tarry consistency
c. ) brownish black with a mucus-like appearance
d. ) tan in color with a firm consistency

Answer 254

a.) yellowy mustard color with seedy appearance

The evolution of a stool pattern begins with a newborn’s first stool, which is meconium. Meconium is composed of amniotic fluid, shed mucosal cells, intestinal secretions, and blood. It is greenish black, has a tarry consistency, and is usually passed within 12 to 24 hours of birth.

The first meconium stool passed is semi-sterile, but this changes rapidly with ingestion of bacteria through feedings. After feedings are initiated, a transitional stool develops, which is greenish brown to yellowish brown, thinner in consistency, and seedy in appearance. If breastfed, the stools will resemble light mustard with seed-like particles. If formula-fed, the stools will be tan or yellow in color and firmer. The neonate’s stool should not appear brownish-black and mucous-like.

Question 255

Upon assessing the newborn’s respirations, which finding would cause the nurse to notify the primary care provider?

a. ) a respiratory rate of 45 breaths per minute with acrocyanosis
b. ) short periods of apnea that last 10 seconds in a pink newborn
c. ) coughing and sneezing in the newborn
d. ) a respiratory rate of 15 breaths per minute with nasal flaring

Answer 255

d.) a respiratory rate of 15 breaths per minute with nasal flaring

Coughing and sneezing are normal reflexes present in the newborn. The respiratory rate of a newborn should be between 30 and 60 breaths per minute. Acrocyanosis can be a normal finding in a newborn and does not indicate respiratory distress. Short periods of apnea that last longer than 15 seconds in the absence of cyanosis can be normal. Nasal flaring is a sign of respiratory distress.

Question 256

A nurse is teaching newborn care to students. The nurse correctly identifies which mechanism as the predominant form of heat loss in the newborn?

a. ) radiation, convection, and conduction
b. ) lack of brown adipose tissue
c. ) nonshivering thermogenesis
d. ) sweating and peripheral vasoconstriction

Answer 256

a.) radiation, convection, and conduction

Heat loss in the newborn occurs primarily through radiation, convection, and conduction because of the newborn’s large ratio of body surface to weight and because of the marked difference between core and skin temperatures. Nonshivering thermogenesis is a mechanism of heat production in the newborn. Lack of brown adipose tissue contributes to heat loss, particularly in premature infants, but it is not the predominant form of heat loss. Peripheral vasoconstriction is a method to increase heat production.

Question 257

A nurse is caring for a 3-hour-old newborn boy. The nurse makes the initial assessment and finds the following: respiratory rate 30 bpm, BP 60/40 mm/Hg, heart rate 155 bpm, axillary temperature 98.2° F (36.8° C). The nurse assesses that the newborn is in a state of quiet alert. What should the nurse do?

a. ) Stimulate the newborn.
b. ) Document the data.
c. ) Call the primary care provider.
d. ) Inform the charge nurse.

Question 258

A 2-month-old infant is admitted to a local health care facility with an axillary temperature of 96.8° F (36° C). Which observed manifestation would confirm the occurrence of cold stress in this client?

a. ) hyperglycemia
b. ) lethargy and hypotonia
c. ) increased appetite
d. ) increase in the body temperature

Answer 258

b.) lethargy and hypotonia

The nurse should look for signs of lethargy and hypotonia in the newborn in order to confirm the occurrence of cold stress.

Cold stress leads to a decrease, not increase, in the newborn’s body temperature, blood glucose, and appetite.

Question 259

All the options are signs of respiratory distress in the newborn except:

a. ) coughing.
b. ) chest retractions.
c. ) nasal flaring.
d. ) central cyanosis.
e. ) respiratory rate >50 breaths/minute.
f. ) grunting.

Answer 259

e.) respiratory rate >50 breaths/minute.

Coughing and sneezing are normal reflexes present in newborns. The expected respiratory rate of newborn is 30 to 60 breaths per minute.

Question 260

A preterm infant is experiencing cold stress after birth. For which symptom should the nurse assess to best validate the problem?

a. ) metabolic alkalosis
b. ) hyperglycemia
c. ) apnea
d. ) shivering

Answer 260

c.) apnea

Preterm newborns are at a greater risk for cold stress than term or postterm newborns. Cold stress can cause hypoglycemia, increased respiratory distress and apnea, and metabolic acidosis. Preterm infants lack the ability to shiver in response to cold stress.

Question 261

The nurse is providing teaching to a new mother who is breastfeeding. The mother demonstrates understanding of teaching when she identifies which characteristics as being true of the stool of breastfed newborns? Select all that apply.

a. ) formed in consistency
b. ) firm in shape
c. ) yellowish gold color
d. ) completely odorless
e. ) stringy to pasty consistency

Answer 261

c.) yellowish gold color

e.) stringy to pasty consistency

The stools of a breastfed newborn are yellowish gold in color. They are not firm in shape or solid. The smell is usually sour. A formula-fed infant’s stools are formed in consistency, whereas a breastfed infant’s stools are stringy to pasty in consistency.

Question 262

Forces of contractions, mild asphyxia, increased intracranial pressure, and cold stress all play a role in the newborn transition by releasing which critical component?

a. ) norepinephrine
b. ) catecholamines
c. ) epinephrine
d. ) cortisol

Answer 262

b.) catecholamines

The physical forces of contractions at labor, mild asphyxia, increased intracranial pressure, and cold stress immediately experienced after birth lead to an increased release of catecholamines, which is critical for the changes involved in the transition to extrauterine life.

Question 263

Baby Dina had a birth weight of 8 pounds and 4 ounces (3742 grams). On the fourth day of life baby weighed 7 pounds and 6 ounces (3345 grams). How much is the percentage of weight loss by the fourth day and should you be concerned?

Answer 263

10.6% weight loss

Yes, you should be concerned because infant is only 4 days old and has already more than 10 percent weight loss

Question 264

The birth weight was 6 lbs and 5 ounces. The current weight is 5 lbs and 7 ounces. What is the weight loss percentage? Should you be concerned?

Answer 264

1 pound = 454 grams

1 ounce = 28 grams

Question 265

Initiate breastfeeding.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 265

1^st Period of Reactivity

Question 266

Baby is awake and alert. Appears hungry with rooting and strong suck reflex.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 266

1^st Period of Reactivity

Question 267

Requires close monitoring by the nurse because gagging, choking, and regurgitation may occur and require immediate intervention.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 267

2^nd Period of Reactivity

Question 268

Optimal period for bonding and interaction.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 268

1^st Period of Reactivity

Question 269

Baby has random bursts of movement (moro reflex).

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 269

1^st Period of Reactivity

Question 270

Baby has rapid respiration, flaring of nose, rapid and irregular heart rate, and bowel sounds may be absent.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 270

1^st Period of Reactivity

Question 271

If you did not feed the infant, watch for S/S of hypoglycemia.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 271

1^st Period of Reactivity

Question 272

Increase in motor and muscle tone, and an increase in peristalsis (may pass first meconium).

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 272

2^nd Period of Reactivity

Question 273

Ideal time to give a bath, weigh, and do newborn hearing test because the baby will not wake up or suck.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 273

1^st Period of Reactivity

Question 274

Increase in heart rate and respiratory rate.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 274

2^nd Period of Reactivity

Question 275

Newborn awakens from sleep, shows interest in environmental stimuli.

a. ) 1^st Period of Reactivity
b. ) 2^nd Period of Reactivity

Answer 275

2^nd Period of Reactivity

Question 276

What are the 6 infant states of consciousness?

Rank them in order from least intense to most intense.

Answer 276

QAD QAC

Question 277

Telling caregivers when they want to interact.

a. ) Engagement Cues
b. ) Disengagement Cues

Answer 277

Engagement Cues

Question 278

Telling caregivers when they need to take a break or do something different.

a. ) Engagement Cues
b. ) Disengagement Cues

Answer 278

Disengagement Cues

Question 279

Overstimulation.

a. ) Engagement Cues
b. ) Disengagement Cues

Answer 279

Disengagement Cues

Question 280

Right after delivery in the golden hour (and beyond).

a. ) Crawl
b. ) Side-lying
c. ) Cradle, Cross-Cradle
d. ) Football hold , Cross-Cradle

Answer 280

Crawl

Question 281

Post C/S mom, mom with H/A.

a. ) Crawl
b. ) Side-lying
c. ) Cradle, Cross-Cradle
d. ) Football hold , Cross-Cradle

Answer 281

Side-lying

Question 282

Sore nipples.

a. ) Crawl
b. ) Side-lying
c. ) Cradle, Cross-Cradle
d. ) Football hold , Cross-Cradle

Answer 282

Cradle, Cross-Cradle

you could even use football hold

Question 283

Twins.

a. ) Crawl
b. ) Side-lying
c. ) Cradle, Cross-Cradle
d. ) Football hold , Cross-Cradle

Answer 283

Football hold , Cross-Cradle

Question 284

What is the length of time recommended for exclusive breastfeeding, according to Healthy People 2020?

a. ) 3 months
b. ) 6 months (please don’t memorize the %age, I just want you to know the time frame!)
c. ) 18 months
d. ) 24 months

Answer 284

b.) 6 months (please don’t memorize the %age, I just want you to know the time frame!)

Question 285

Which statement is true?

a. ) Prolactin is the “milk-making” hormone that is stimulated while the mother is resting.
b. ) Oxytocin is the “let-down” hormone that can be inhibited by maternal pain and fatigue.

Answer 285

b.) Oxytocin is the “let-down” hormone that can be inhibited by maternal pain and fatigue. (You can remember this, because oxytocin creates let-down, as well as the uterus to contract. Remember the “Ouch” on the Concept Map)

Question 286

Colostrum is (select the true answer)

a. ) 90 % water
b. ) high in fat and calories
c. ) high in protein & immunoglobulins

Answer 286

c.) high in protein & immunoglobulins (you can remember this, because the baby needs immunoglobulins to keep well especially in the first week of life. And remember it coats the gut, not allowing large pathogens to enter the gut)

Question 287

How many calories should a breastfeeding mother have over pre-pregnancy?

a. ) 100
b. ) 200
c. ) 500
d. ) 1000

Answer 287

c.) 500

500 calories for a breast feeding mother over pre-pregnancy

Question 288

How many calories should a breastfeeding mother have over pregnancy?

a. ) 100
b. ) 200
c. ) 300
d. ) 500

Answer 288

b.) 200

200 calories for a breastfeeding mother over pregnancy

Question 289

How much formula is needed for a newborn baby?

a. ) 30-40 kcal/lb/day
b. ) 45-52 kcal/lb/day
c. ) 55-60 kcal/lb/day

Answer 289

a.) 30-40 kcal/lb/day

Question 290

Describe the difference in pain between incorrect LATCH and thrush.

a. ) Pain with LATCH is in the middle of the feeding only
b. ) Both have increased soreness at beginning & end of feeding

c,) Thrush has continual pain and burning

Answer 290

c,) Thrush has continual pain and burning

Question 291

A bottle feeding mother should…

a. ) wear a comfortable bra
b. ) wear a tight sports bra
c. ) wear a tight ace bandage

Answer 291

b.) wear a tight sports bra

Question 292

It is better for a mother who smokes to bottle feed her baby.

a. ) FALSE. Encourage mom to breastfeed and decrease her tobacco use and get help.
b. ) TRUE. Moms who use tobacco should never breastfeed.

Answer 292

a.) FALSE. Encourage mom to breastfeed and decrease her tobacco use and get help.

Question 293

Select the conditions when mom should NOT breastfeed.

a. ) Active/infected TB
b. ) Current cancer treatment
c. ) Active Herpes/Shingles on breast (not covered)
d. ) Hepatitis C
e. ) HIV
f. ) Covered active Herpes on breast
g. ) CMV
h. ) A, B, C & E
i. ) A, B, C, D & G
j. ) All of the above

Answer 293

h.) A, B, C & E

a. ) Active/infected TB
b. ) Current cancer treatment
c. ) Active Herpes/Shingles on breast (not covered)
e. ) HIV

Question 294

If mom has a low milk supply…

a. ) Add formula between feedings
b. ) Breastfeed frequently
c. ) Add breast pumping between feedings
d. ) A, B & C
e. ) B & C

Answer 294

e.) B & C

b. ) Breastfeed frequently
c. ) Add breast pumping between feedings

Question 295

Select the true statement (3 are false).

a. ) Breastmilk should always be stored in glass bottles
b. ) Breastmilk can remain in the freezer 5 months
c. ) Breastmilk can remain in the refrigerator 8 weeks
d. ) Breastmilk should be thawed by running hot water over the bottle/bag

Answer 295

b.) Breastmilk can remain in the freezer 5 months

Question 296

Classic bleeding sign is brownish vaginal bleeding (prune juice like).

Question 297

Types of Spontaneous Abortion

Heavy vaginal bleeding, intense cramping, cervical dilation, placenta remains but no fetus.

a. ) threatened
b. ) inevitable
c. ) incomplete

Question 298

In regards to monitoring Gestational Trophoblastic Disease, how long does the client need to be monitored for? Describe the process…

Question 299

Which of the following conditions are associated with early bleeding (first half) of pregnancy?

Question 300

Commonly due to fetal genetic abnormalities.

a. ) 1^st trimester spontaneous abortion
b. ) 2^nd trimester spontaneous abortion

Answer 300

1^st trimester spontaneous abortion

Question 301

Which of the following conditions are associated with late bleeding (second half) of pregnancy?

Question 302

Any pregnancy in which the fertilized ovum implants outside the uterine cavity.

Question 303

Types of Spontaneous Abortion

Bleeding, rupture of membranes, cervix dilated, strong cramping, possible passage of products.

a. ) threatened
b. ) inevitable
c. ) incomplete

Question 304

If a client asks you information on what is the major cause of first trimester miscarriages, you would answer by saying:

a. ) nausea and vomiting
b. ) perinatal stress
c. ) chromosomal abnormalities
d. ) umbilical cord accidents

Answer 304

c.) chromosomal abnormalities

Fetal genetic or chromosomal abnormalities are the most common cause of 1^st trimester abortions

Question 305

More likely related to maternal conditions.

a. ) 1^st trimester spontaneous abortion
b. ) 2^nd trimester spontaneous abortion

Answer 305

2^nd trimester spontaneous abortion

Question 306

Types of Spontaneous Abortion

Cervix is closed, placenta attached, some bleeding, no passage of fetal tissue.

a. ) threatened
b. ) inevitable
c. ) incomplete

Question 307

Amniotic fluid <500 mL.

a. ) Hydramnios (or polyhydramnios)
b. ) Oligohydramnios

Answer 307

Oligohydramnios

Question 308

Premature dilation of the cervix with painless contractions, minimal bleeding may be present.

Answer 308

Cervical Insufficiency

Question 309

Has a sudden onset.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 309

Abruptio Placenta

Question 310

Bleeding condition that occurs during the last two trimesters of pregnancy because the placenta implants over the cervical os.

Answer 310

Placenta Previa

Question 311

Bleeding is always visible, slightly more than profuse.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 311

Placenta Previa

Question 312

Uterus tone is firm to rigid.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 312

Abruptio Placenta

Question 313

Treatment includes indomethacin.

a. ) Hydramnios (or polyhydramnios)
b. ) Oligohydramnios

Answer 313

Hydramnios (or polyhydramnios)

Question 314

Constant, uterine tenderness on palpation.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 314

Abruptio Placenta

Question 315

Placenta attaches itself too deeply into the wall of the uterus, but does not penetrate the uterine muscle.

Answer 315

Placenta Accreta

Question 316

Painless.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 316

Placenta Previa

Question 317

Bleeding can be concealed or visible.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 317

Abruptio Placenta

Question 318

Uterus tone is soft and relaxed.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 318

Placenta Previa

Question 319

Onset is insidious.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 319

Placenta Previa

Question 320

Comprises spectrum of disorders that originate in the placenta. The cells that become the placenta proliferate making chorionic villi edematous and become grapelike clusters of a molar pregnancy.

Answer 320

Gestational Trophoblastic Disease

Question 321

Any pregnancy in which the fertilzed ovum implants outside the uterine cavity.

Answer 321

Ectopic Pregnancy

Question 322

Amniotic fluid >2,000 mL.

a. ) Hydramnios (or polyhydramnios)
b. ) Oligohydramnios

Answer 322

Hydramnios (or polyhydramnios)

Question 323

Dark red bleeding.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 323

Abruptio Placenta

Question 324

Separation of normally located placenta after 20^th week of gestation leading to hemorrhage and compromised fetal blood supply. Has a high mortality rate.

Answer 324

Abruptio Placenta

Question 325

Blood is bright red.

a. ) Placenta Previa
b. ) Abruptio Placenta

Answer 325

Placenta Previa

Question 326

A woman is admitted with a diagnosis of ectopic pregnancy. For which action would the nurse anticipate beginning preparation?

a. ) bed rest for the next 4 weeks
b. ) intravenous administration of a tocolytic
c. ) immediate surgery
d. ) internal uterine monitoring

SUBMIT ANSWER

Answer 326

c.) immediate surgery

Ectopic pregnancy means an embryo has implanted outside the uterus, usually in the fallopian tube. Surgery is usually necessary to remove the growing structure before the tube ruptures or repair the tube if rupture has already occurred.

Bed rest will not correct the problem of an ectopic pregnancy. Administering a tocolytic is not indicated, nor is internal uterine monitoring.

Question 327

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?

a. ) assessing uterine contractions by an internal pressure gauge
b. ) assessing fetal heart tones by use of an external monitor
c. ) performing a vaginal examination to assess the extent of bleeding
d. ) helping the woman remain ambulatory to reduce bleeding

Answer 327

b.) assessing fetal heart tones by use of an external monitor

Not disrupting the placenta is a prime responsibility. An internal monitor, a vaginal examination, and remaining ambulatory could all do this and thus are contraindicated.

Question 328

What would be the physiologic basis for a placenta previa?

a. ) low placental implantation
b. ) a placenta with multiple lobes
c. ) a uterus with a midseptum
d. ) a loose placental implantation

Answer 328

a.) low placental implantation

The cause of placenta previa is usually unknown, but for some reason the placenta is implanted low instead of high on the uterus.

Question 329

A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, “Why am I getting this drug?” The nurse responds to the client, integrating understanding that this drug achieves which effect?

a. ) ensures passage of all the products of conception
b. ) alleviates strong uterine cramping
c. ) suppresses the immune response to prevent isoimmunization
d. ) halts the progression of the abortion

Answer 329

a.) ensures passage of all the products of conception

Misoprostol is used to stimulate uterine contractions and evacuate the uterus after an abortion to ensure passage of all the products of conception.

Rh (D) immunoglobulin is used to suppress the immune response and prevent isoimmunization.

Question 330

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy?

a. ) ondansetron
b. ) promethazine
c. ) oxytocin
d. ) methotrexate

Answer 330

d.) methotrexate

Methotrexate, a folic acid antagonist that inhibits cell division in the developing embryo, is most commonly used to treat ectopic pregnancy.

Oxytocin is used to stimulate uterine contractions and would be inappropriate for use with an ectopic pregnancy.

Promethazine and ondansetron are antiemetics that may be used to treat hyperemesis gravidarum.

Question 331

A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first?

a. ) Provide emotional support to the client and significant other.
b. ) Administer oxygen to the client.
c. ) Obtain a surgical consent from the client.
d. ) Assess the client’s vital signs.

Answer 331

d.) Assess the client’s vital signs.

A suspected ectopic pregnancy can put the client at risk for hypovolemic shock. The assessment of vital signs should be performed first, followed by any procedures to maintain the ABCs.

Providing emotional support would also occur, as would obtaining a surgical consent, if needed, but these are not first steps.

Question 332

A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective?

a. ) “Purse-string sutures are placed in the cervix to prevent it from dilating.”
b. ) “A cervical cap is placed so no amniotic fluid can escape.”
c. ) “The cervix is glued shut so no amniotic fluid can escape.”
d. ) “Staples are put in the cervix to prevent it from dilating.”

Answer 332

a.) “Purse-string sutures are placed in the cervix to prevent it from dilating.”

The cerclage, or purse string suture is inserted into the cervix to prevent preterm cervical dilatation and pregnancy loss. Staples, glue, or a cervical cap will not prevent the cervix from dilating.

Question 333

A 16-year-old client gave birth to a 12 weeks’ gestation fetus last week. The client has come to the office for follow-up and while waiting in an examination room notices that on the schedule is written her name and “follow-up of spontaneous abortion.” The client is upset about what is written on the schedule. How can the nurse best explain this terminology?

a. ) “Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy.”
b. ) “Oh, that just means it was a miscarriage.”
c. ) “Abortion is a medical term for any interruption of pregnancy before a fetus is viable.”
d. ) “Spontaneous abortion is the medical name for a miscarriage.”

Answer 333

a.) “Spontaneous abortion is a more specific term used to describe a spontaneous miscarriage, which is a loss of pregnancy before 20 weeks. This term does not imply that you did anything to affect the pregnancy.”

Abortion is a medical term for any interruption of a pregnancy before a fetus is viable, but it is better to speak of these early pregnancy losses as spontaneous abortions to avoid confusion with intentional terminations of pregnancies. The other responses are correct, but they do not provide the client with the most complete and reassuring answer.

Question 334

A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion?

a. ) no passage of fetal tissue
b. ) closed cervical os
c. ) strong abdominal cramping
d. ) slight vaginal bleeding

Answer 334

c.) strong abdominal cramping

Strong abdominal cramping is associated with an inevitable spontaneous abortion.

Slight vaginal bleeding early in pregnancy and a closed cervical os are associated with a threatened abortion.

With an inevitable abortion, passage of the products of conception may occur.

No fetal tissue is passed with a threatened abortion.

Question 335

A pregnant woman is diagnosed with abruptio placentae. When reviewing the woman’s physical assessment in her medical record, which finding would the nurse expect?

a. ) bright red vaginal bleeding
b. ) firm, rigid uterus on palpation
c. ) fetal heart rate within normal range
d. ) absence of pain

Answer 335

b.) firm, rigid uterus on palpation

The uterus is firm-to-rigid to the touch with abruptio placentae. It is soft and relaxed with placenta previa. Bleeding associated with abruptio placentae occurs suddenly and is usually dark in color. Bleeding also may not be visible. Bright red vaginal bleeding is associated with placenta previa. Fetal distress or absent fetal heart rate may be noted with abruptio placentae. The woman with abruptio placentae usually experiences constant uterine tenderness on palpation.

Question 336

A client with preeclampsia is receiving magnesium sulfate. Which nursing assessment should be ongoing while the medication is being administered?

a. ) urine protein
b. ) ability to sleep
c. ) hemoglobin
d. ) respiratory rate

Answer 336

d.) respiratory rate

Question 337

A client is admitted to labor and birth for management of severe preeclampsia. An IV infusion of magnesium sulfate is started. What is the primary goal for magnesium sulfate therapy?

a. ) reverse edema
b. ) decrease protein in urine
c. ) decrease blood pressure
d. ) prevent maternal seizures

Question 338

A nurse has been assigned to assess a pregnant client for abruptio placenta. For which classic manifestation of this condition should the nurse assess?

a. ) painless bright red vaginal bleeding
b. ) generalized vasospasm
c. ) increased fetal movement
d. ) “knife-like” abdominal pain with vaginal bleeding

Answer 338

d.) “knife-like” abdominal pain with vaginal bleeding

The classic manifestations of abruption placenta are painful dark red vaginal bleeding, “knife-like” abdominal pain, uterine tenderness, contractions, and decreased fetal movement. Painless bright red vaginal bleeding is the clinical manifestation of placenta previa. Generalized vasospasm is the clinical manifestation of preeclampsia and not of abruptio placenta.

Question 339

A pregnant client has been admitted with reports of brownish vaginal bleeding. On examination there is an elevated hCG level, absent fetal heart sounds, and a discrepancy between the uterine size and the gestational age. The nurse interprets these findings to suggest which condition?

a. ) ectopic pregnancy
b. ) placenta previa
c. ) gestational trophoblastic disease
d. ) abruption of placenta

Answer 339

c.) gestational trophoblastic disease

The client is most likely experiencing gestational trophoblastic disease or a molar pregnancy. In gestational trophoblastic disease or molar pregnancy, there is an abnormal proliferation and eventual degeneration of the trophoblastic villi. The signs and symptoms of molar pregnancy include brownish vaginal bleeding, elevated hCG levels, discrepancy between the uterine size and the gestational age, and absent fetal heart sounds. Abruption of placenta is characterized by premature separation of the placenta. Ectopic pregnancy is a condition where there is implantation of the blastocyst outside the uterus. In placenta previa the placental attachment is at the lower uterine segment.

Question 340

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placenta and placenta previa. Which statement should the nurse include in the teaching?

a. ) “Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placenta is associated with bright red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”
b. ) “Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placenta is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”
c. ) “Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placenta is associated with right red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”
d. ) “Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placenta is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

Answer 340

b.) “Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placenta is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

Placenta previa is a condition of pregnancy in which the placenta is implanted abnormally in the lower part of the uterus and is the most common cause of painless bright red bleeding in the third trimester. Abruptio placenta is the premature separation of a normally implanted placenta that pulls away from the wall of the uterus either during pregnancy or before the end of labor.

Question 341

A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate?

a. ) infection
b. ) central nervous system (CNS) involvement
c. ) fetal distress related to hypoxia
d. ) cord compression

SUBMIT ANSWER

Answer 341

c.) fetal distress related to hypoxia

When meconium is present in the amniotic fluid, it typically indicates fetal distress related to hypoxia. Meconium stains the fluid yellow to greenish brown, depending on the amount present.

A decreased amount of amniotic fluid reduces the cushioning effect, thereby making cord compression a possibility.

A foul odor of amniotic fluid indicates infection.

Meconium in the amniotic fluid does not indicate CNS involvement.

Question 342

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding?

a. ) strong abdominal cramping
b. ) cervical dilation
c. ) passage of fetal tissue
d. ) slight vaginal bleeding

SUBMIT ANSWER

Answer 342

d.) slight vaginal bleeding

Question 343

Your patient just had Dinoprostone (Cervidil) vaginal insert placed int the posterior fornix of the vaginal vault. What is the reason for doing this?

a. ) To make the cervix softer
b. ) To prevent bacteria from entering
c. ) To stop preterm labor
d. ) To augment labor

Answer 343

a.) To make the cervix softer

Question 344

You are caring for a pregnant client on Magnesium Sulfate drip. Your assessment reveals her blood levels are reaching toxic levels. What IV med do you give her to reverse the effects?

a. ) Terbutaline
b. ) Oxytocin
c. ) Calcium
d. ) Brethine

Answer 344

c.) Calcium

Question 345

A mother just received an epidural and is experiencing hypotension. Which drug would you administer to counteract the effect?

a. ) Methylergonovine (Methergine)
b. ) Naloxone (Narcan)
c. ) Ephedrine
d. ) Hydralazine (Apresoline)

Answer 345

c.) Ephedrine

Question 346

Hemabate is used in emergency situations. What is the drug composed of?

a. ) Multiple vasoconstrictors
b. ) Powerful oxytocic
c. ) Rapid acting sympathomimetics
d. ) Specific type of prostaglandin

Answer 346

d.) Specific type of prostaglandin

Question 347

You are recovering a woman who recently delivered twins who had severe pre-eclampsia. Her lochia is too heavy. Based on the patient data, which drug listed below is the appropriate measure to stop uterine hemorrhage (not prevent it) before taking her in to do an emergency hysterectomy?

a. ) Methylergonomive Maleate (Methergine)
b. ) Oxytocin (Pitocin)
c. ) Terbutaline (Brethine)
d. ) Hemabate (Prostaglandin F₂ or Prostaglandin M)

Answer 347

d.) Hemabate (Prostaglandin F₂ or Prostaglandin M)

Question 348

You are caring for a pregnant client and the physician prescribes Betamethasone (Celestone). Why did s/he order it for the client?

a. ) Inhibits prostaglandin secretion, thus decreasing UC’s
b. ) Stimulates surfactant production in the fetal lung tissue
c. ) Decreases the quantity of acetylcholine, blocking neuromuscular transmission
d. ) Increases the production of prolactin, to produce milk

Next

Answer 348

b.) Stimulates surfactant production in the fetal lung tissue

Question 349

You are on the high risk antepartal unit and taking care of a patient who was just admitted in preterm labor. Which drug below could be ordered for her to stop her contractions?

a. ) Narcan
b. ) Methylergonovine (Methergin)
c. ) Betamethasone (Celestone)
d. ) Nifedipine (Procardia)

Answer 349

d.) Nifedipine (Procardia)

Procardia (Nifedipine) is a calcium channel blocker. You need calcium to contract–this drug blocks it so calcium cannot get into smooth muscle –ergo no UC’s!

Question 350

What blood type incompatibilities would necessitate Rhogam be given to an antepartum or postpartum patient?

a. ) Mother is Rh positive and baby is Rh positive
b. ) Mother is Rh positive and baby is Rh negative
c. ) Mother is Rh negative and baby is Rh positive
d. ) Mother is Rh negative and baby is Rh negative

Answer 350

c.) Mother is Rh negative and baby is Rh positive

Question 351

You just gave your client the prescribed dose of Methylergonovine (Methergine). Which period of the childbearing cycle do we use Methergine when doing secondary interventions?

a. ) Postpartal period
b. ) Intrapartal period
c. ) Antepartal period
d. ) Pre-conceptual period

Answer 351

a.) Postpartal period

Question 352

You are taking care of a pregant patient on a Magnesium sulfate (MgSO₄) drip. Why is your patient on this medication?

a. ) To augment labor
b. ) To stop labor
c. ) To mature the baby’s lungs
d. ) To decrease pain sensation during labor

Answer 352

b.) To stop labor

Question 353

A patient has just delivered and is bleeding a little more than you would like to see. You turn up the Pitocin in her LR bag, but the bleeding continues. Her VS are 99.0 F, 82, 16, 118/78, Pain=5. Which drug would you next need to give to control heavy postpartum bleeding?

a. ) Narcan IV
b. ) Cytotec P.V.
c. ) Methergine IM
d. ) Pitocin P.O.

Answer 353

c.) Methergine IM

Question 354

You are caring for a gravida 1, age 38, diagnosed with Pre-eclampsia (previously called PIH). Her blood pressure is 168/105. What medication would you administer to get her BP under control so that she doesn’t have a stroke?

a. ) Magnesium Sulfate
b. ) Prostaglandin
c. ) Hydralazine (Apresoline)
d. ) Ephedrine

Answer 354

c.) Hydralazine (Apresoline)

Question 355

Oxytocin (Pitocin) is a medication we also use in the clinic for the postpartum mother in the form of a nasal spray. Why would a mother need it postpartally?

a. ) Helps prevent coagulation problems associated with postpartum.
b. ) Helps decrease edema due to its vasopressor and diuretic effects
c. ) Helps sitmulate the milk ejection reflex in breastfeeding mothers
d. ) Inhibits the mother from making milk when she chooses to bottlefeed.

Answer 355

c.) Helps sitmulate the milk ejection reflex in breastfeeding mothers

Question 356

Magnesium sulfate drip is given during pregnancy to treat PIH. What is the physiological action of Magnesium Sulfate?

a. ) Prevent seizures
b. ) Eliminate facial edema
c. ) Decrease blood pressure
d. ) Improve kidney functioning

Answer 356

a.) Prevent seizures

Question 357

A patient in labor was requesting pain medicine and you give her Nubain IVP. Unfortunately you forgot to do a vag exam prior to giving the medication, and she delivered a baby boy 45 minutes later. Now the baby is depressed. What medication intervention will you need to do to counteract the depression?

a. ) Terbutaline (Brethine)
b. ) Betamethasone (Celestone)
c. ) Neonatal Narcan
d. ) Epinephrine (Adrenalin)

Answer 357

c.) Neonatal Narcan

Question 358

The baby has just been delivered vaginally 10 minutes ago. Erythromycin eye ointment (Ilotycin) has been ordered. Why is this medication ordered for newborns?

a. ) To prevent vaginal normal flora from getting into the eyes
b. ) To coat the eye with lubricant so they won’t dry out
c. ) To prevent blindness caused by chlamydia
d. ) To help the baby’s eyes to focus from a distance

Answer 358

c.) To prevent blindness caused by chlamydia

Question 359

A patient has Colace ordered during her postpartum stay in the hospital. What is the mechanism of action for Colace?

a. ) Adds cellulose to make it blander
b. ) Irritates mucosal lining to stimulate peristalsis
c. ) Produces more bulk to stimulate peristalsis
d. ) Draws water into the stool to make it softer

Answer 359

d.) Draws water into the stool to make it softer

Question 360

You are admitting a G1P0 at 30 weeks gestation who is in apparent preterm labor. Which of the following medications would the nurse administer in order to stop preterm labor?

a. ) Cervidil (Prostaglandin E)
b. ) Betamethasone (Celeston Solupan)
c. ) Hydralazine (Apresoline)
d. ) Magnesium Sulfate (MgSO₄)

Answer 360

d.) Magnesium Sulfate (MgSO₄)

Question 361

For pre-eclamptic patients, Magnesium sufate (MgSO₄) drip is given primarily to:

a. ) Increase renal perfusion
b. ) Decrease peripheral edema
c. ) Prevent seizures
d. ) Decrease blood pressure

Answer 361

c.) Prevent seizures

Question 362

You need to give a baby the Vit K shot. Which drug below is the generic name for Vit K?

a. ) Phytonadione
b. ) Ilotycin
c. ) Promethazine
d. ) Meperidine

Answer 362

a.) Phytonadione

Question 363

What is the primary action of Terbutaline (Brethine) when given to an OB patient?

a. ) Lower the risk of eclampsia
b. ) Cause fetal lung maturity
c. ) Quiet the myometrium of the uterus
d. ) Increase ranal GFR to reduce fluid retention

Answer 363

• not b.) Cause fetal lung maturity*
• not a.) Lower the risk of eclampsia​*

Question 364

Terbutaline (Brethine) is a sympatho-mimetic (it mimics the sympathetic branch of CNS). Brethine is used during pregnancy to cause which action?

a. ) Hypotonic contractions
b. ) anti-Hypertensive
c. ) anti-hemolysis
d. ) Tocolysis

Answer 364

d.) Tocolysis

Question 365

You are caring for a postpartum patient who still shows signs of pre-eclampsia with severe features (previously called severe PIH). The physician prescribed routine Methergine 0.2 mg p.o. q 8 hours. What is the appropriate nursing action?

a. ) Administer pain medication in tandem with Methergine
b. ) Administer the medication
c. ) Discontinue the medication and notify pharmacy
d. ) Hold the medication and notify the physician

Answer 365

d.) Hold the medication and notify the physician

Question 366

After administering Dinoprostone (Cervidil) to an induction candidate, the nurse should do which of the following?

a. ) Instruct the patient to rub one nipple at a time to help w/ contractions
b. ) Perform AROM to stimulate contractions
c. ) Monitor UC’s and FHR for one hour after insertion
d. ) Have patient ambulate around the unit

Answer 366

c.) Monitor UC’s and FHR for one hour after insertion

Question 367

The nurse is administering oxytocin to a client in labor. During oxytocin infusion, why must the nurse monitor I&O closely?

a. ) Because oxytocin causes water intoxication
b. ) Because oxytocin has a diuretic effect
c. ) Because oxytocin can be toxic to the kidneys.
d. ) Because oxytocin causes excessive thirst

Answer 367

a.) Because oxytocin causes water intoxication

Question 368

Prior to delivery, a client is treated with Magnesium Sulfate for pre-eclampsia. Her respiratory rate is 12 and DTRs are 0. Which of the following interventions would be most appropriate next?

a. ) Monitor the blood pressure, urinary output, and the change in amount of sacral edema
b. ) Put client in Left lateral position and bring the emergency box into her room.
c. ) Notify the doctor and the operating room staff to prepare for c/s
d. ) Turn off Magnesium, run a stat Mg level

Answer 368

d.) Turn off Magnesium, run a stat Mg level

Question 369

You have just given a postpartum patient a Rubella vaccination. What must you counsel the patient about before she is discharged?

a. ) If she developes a fever, she should wear a mask around her newborn
b. ) She may experience headaches for about 2 days
c. ) The best site for injection is the fat pads on the hip
d. ) She must not get pregnant for 3 months

Answer 369

d.) She must not get pregnant for 3 months

Question 370

You are taking care of a patient on MgSO₄ drip. What is the most serious side effect to monitor for when administering this drug?

a. ) Cerebral edema
b. ) Hypotonic reflexes
c. ) Bradycardia
d. ) Hypotension

Next

Answer 370

b.) Hypotonic reflexes

Question 371

Demerol, Stadol, and Nubain are three narcotic analgesics that are given to alleviate pain during the first stage of labor. What is the most important thing a nurse needs to assess when these drugs are given?

a. ) How close the mother is to delivery
b. ) When was the last time the bladder was emptied
c. ) Change in the mother’s LOC
d. ) Fetal heart rate stability

Answer 371

a.) How close the mother is to delivery

Question 372

You are caring for a diabetic patient experiencing preterm labor. She has been on Mag Sulfate for two days. This am she is contracting 2 in 10 minutes. The physician prescribes nifedipine to arrest UCs. What would you do with the prescription?

a. ) Administer the med and document on MAR
b. ) Withold it and notify the physician of the additive affect.
c. ) Turn down the mag, wait one hour and administer the med
d. ) Leave the magnesium the same, and give half the nifedipine now and half in 1 hour

Answer 372

b.) Withold it and notify the physician of the additive affect.

Question 373

You are administering Hydralazine (Apresoline) to a severely preeclamptic patient. The appropriate blood pressure evaluations should be done every how many minutes after giving the medication?

a. ) q 5 minutes til stable
b. ) q 10 minute X 3
c. ) q 20 minutes, may repeat X1
d. ) q 20 minutes until stable

Answer 373

a.) q 5 minutes til stable

Question 374

Mrs. Smith was admitted to L&D yesterday in preterm labor. She is 32 weeks gestation, and has been on 2 gms MgSO4 drip since admission. This morning she exhibits lethargy, DTR = 0. What will you anticipate giving as the antidote for Mag toxicity?

a. ) Vitamin K
b. ) Naloxone Hydrochloride
c. ) Calcium Gluconate
d. ) Epinephrine

Answer 374

c.) Calcium Gluconate

Question 375

The Rubella Vaccine is a live virus vaccine. When administering the vaccine, the most important teaching factor to address is to:

a. ) Suspend breastfeeding for 3 days, but to continue pumping
b. ) Avoid pregnancy for 3 months after the injection.
c. ) inform the client that the vaccine will stimulate active immunity
d. ) determine if there is an allergy to neomycin

Answer 375

b.) Avoid pregnancy for 3 months after the injection.

Question 376

A patient at term has been scheduled for induction at 0700. You admit her and begin the induction with pitocin. After two hours, you notice UC’s q 2-3 minutes but they are mild in intensity. What should you do?

a. ) Slow down the rate of infusion of the Pitocin drip
b. ) Continue to increase Pitocin until UC’s are stronger
c. ) Perform AROM to make contractions stronger
d. ) Discontinue the IV Pitocin–wait 30 minutes and restart it

Answer 376

b.) Continue to increase Pitocin until UC’s are stronger

Question 377

A mother gave birth to a baby boy this morning, and she is Rh neg. Which of the following would be a nursing judgement when administering Rhogam?

a. ) Rhogam is given by sub-q injection in the arm
b. ) Administer it because baby is Rh negative
c. ) Rhogam must be given within 72 hrs of birth
d. ) Do not administer unless mother is Rh positive

Answer 377

c.) Rhogam must be given within 72 hrs of birth

Question 378

The CNM has ordered Methergine to be given p.o. q 6 hours to a postpartum client. What common side effect might the new mother experience?

a. ) Severe afterpains
b. ) nausea and gas
c. ) Priapism
d. ) Breast engorgement

Answer 378

a.) Severe afterpains

So you may want to bring a pain pill at the same time!

Question 379

No body movement, rhythmic breathing, bursts of sucking.

a. ) Drowsy
b. ) Active Alert
c. ) Quiet Alert
d. ) Quiet Sleep
e. ) Active Sleep

Answer 379

d.) Quiet Sleep

Question 380

Body activity, irregular breathing, easy to wake,

a. ) Drowsy
b. ) Active Alert
c. ) Quiet Alert
d. ) Quiet Sleep
e. ) Active Sleep

Answer 380

e.) Active Sleep

Question 381

Variable movement, irregular breathing, opens and closes eyes.

a. ) Drowsy
b. ) Active Alert
c. ) Quiet Alert
d. ) Quiet Sleep
e. ) Active Sleep

Answer 381

a.) Drowsy

Question 382

Little body movement, eyes open and bright, steady regular breathing.

a. ) Drowsy
b. ) Active Alert
c. ) Quiet Alert
d. ) Quiet Sleep
e. ) Active Sleep

Answer 382

c.) Quiet Alert

Question 383

Fussy, lots of body and facial movement. Common before feeding.

a. ) Drowsy
b. ) Active Alert
c. ) Quiet Alert
d. ) Quiet Sleep
e. ) Active Sleep

Answer 383

b.) Active Alert

Question 384

Cessation of breathing lasting more than 15 seconds.

a. ) Pathologic Apnea
b. ) Physiologic Apnea
c. ) Periodic Breathing

Answer 384

Pathologic Apnea

Question 385

Cessation of breathing during a newborn’s respiratory cycle lasting less than 15 seconds.

a. ) Pathologic Apnea
b. ) Physiologic Apnea
c. ) Periodic Breathing

Answer 385

Physiologic Apnea​

Question 386

Pauses in respiratory movements lasting up to 15 seconds during breathing cycle.

a. ) Pathologic Apnea
b. ) Physiologic Apnea
c. ) Periodic Breathing

Answer 386

Periodic Breathing

Question 387

Cold scales, cold stethoscope.

a. ) Conduction
b. ) Radiation
c. ) Convection
d. ) Evaporation

Answer 387

Conduction

Question 388

Cold hands.

a. ) Conduction
b. ) Radiation
c. ) Convection
d. ) Evaporation

Answer 388

Conduction

Question 389

Cold wall of room.

a. ) Conduction
b. ) Radiation
c. ) Convection
d. ) Evaporation

Answer 389

Radiation

Question 390

Air conditioner is on.

a. ) Conduction
b. ) Radiation
c. ) Convection
d. ) Evaporation

Answer 390

Convection

Question 391

Wet baby following bath.

a. ) Conduction
b. ) Radiation
c. ) Convection
d. ) Evaporation

Answer 391

Evaporation

Question 392

Open incubator door.

a. ) Conduction
b. ) Radiation
c. ) Convection
d. ) Evaporation

Answer 392

Radiation

Question 393

Dark red bleeding, visible or concealed.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 393

Placenta Abruptio

• Dark red bleeding, visible or concealed*
• Uterus firm to rigid*
• Fetal distress*

Question 394

Placenta attaches itself to uterine wall.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 394

Placenta Accreta

Placenta attaches itself to uterine wall

Question 395

Fetal distress.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 395

Placenta Abruptio

• Dark red bleeding, visible or concealed*
• Uterus firm to rigid*
• Fetal distress*

Question 396

Uterus is soft and relaxed.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 396

Placenta Previa

• Red bleeding, visible*
• Uterus is soft and relaxed*

Question 397

Red bleeding, visible.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 397

Placenta Previa

• Red bleeding, visible.*
• Uterus is soft and relaxed*

Question 398

Premature dilation of cervix with painless contractions.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 398

Cervical Insufficiency

Question 399

Uterus firm to rigid.

a. ) Placenta Accreta
b. ) Placenta Previa
c. ) Placenta Abruptio
d. ) Cervical Insufficiency

Answer 399

Placenta Abruptio

• Dark red bleeding, visible or concealed*
• Uterus firm to rigid*
• Fetal distress*

Question 400

Type of Thalassemia with mild persistent anemia.

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 400

Thalassemia Anemia Alpha

Type of Thalassemia with mild persistent anemia

Question 401

Hereditary autosomal recessive disorder

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 401

Thalassemia Anemia

Hereditary autosomal recessive disorder​

Question 402

Maternal risk: fatigue, weakness, malaise, anorexia, susceptibility to infection.

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 402

Iron Deficiency Anemia

Maternal risk: fatigue, weakness, malaise, anorexia, susceptibility to infection.​

Question 403

Fetal neural tube defects, spina bifida, anencephaly.

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 403

Folic Acid Deficiency

Fetal neural tube defects, spina bifida, anencephaly.​

Question 404

Maternal risks include: PTL, pre-eclampsia, eclampsia, and placenta abruption.

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 404

Sickle Cell Anemia

• Autosomal recessive disease*
• Maternal risks:*
• PTL
• Pre-Eclampsia
• Eclampsia
• Placenta abruption

Question 405

Type of Thassalemia causing severe maternal hemolysis, anemia, and premature death.

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 405

Thalassemia Anemia Beta

Type of Thassalemia causing severe maternal hemolysis, anemia, and premature death​

Question 406

Autosomal recessive disease.

a. ) Sickle Cell Anemia
b. ) Thalassemia Anemia
c. ) Folic Acid Deficiency
d. ) Thalassemia Anemia Alpha
e. ) Thalassemia Anemia Beta
f. ) Iron Deficiency Anemia

Answer 406

Sickle Cell Anemia

• Autosomal recessive disease*
• Maternal risks:*
• PTL
• Pre-Eclampsia
• Eclampsia
• Placenta abruption

Question 407

Hypertension without proteinuria.

a. ) Gestational Hypertension
b. ) Preeclampsia
c. ) Eclampsia

Answer 407

Gestational Hypertension

Question 408

Hypertension with proteinuria.

a. ) Gestational Hypertension
b. ) Preeclampsia
c. ) Eclampsia

Answer 408

Preeclampsia

Question 409

Seizures present.

a. ) Gestational Hypertension
b. ) Preeclampsia
c. ) Eclampsia

Answer 409

Eclampsia

Question 410

Blood pressure > 140/90.

a. ) Mild Preeclampsia
b. ) Severe Preeclampsia

Answer 410

Mild Preeclampsia

Question 411

S/S include mild facial/hand edema and weight gain.

a. ) Mild Preeclampsia
b. ) Severe Preeclampsia

Answer 411

Mild Preeclampsia

Question 412

Blood pressure > 160/110.

a. ) Mild Preeclampsia
b. ) Severe Preeclampsia

Answer 412

Severe Preeclampsia

Question 413

S/S include epigastric/RUQ pain, blurred vision, H/A, hyperreflexia.

a. ) Mild Preeclampsia
b. ) Severe Preeclampsia

Answer 413

Severe Preeclampsia

Question 414

What is HELLP syndrome?

Question 415

What medication is given for mag toxicity?

Which med do you not want to give with mag sulfate?

Question 416

When will a mother recieve Rhogam?

Question 417

A woman is hospitalized with severe preeclampsia. The nurse is meal-planning with the patient and encourages a diet that is high in:

a. ) Fruit
b. ) Sodium
c. ) Protein
d. ) Carbohydrates

Answer 417

c.) Protein

Question 418

The nurse is assessing a client who has severe preeclampsia. The assessment finding that should be reported to the physician is:

a. ) Proteinuria
b. ) Platelet count of 60,000
c. ) Urine output of 50 mL per hour
d. ) DTR’s 2+

Answer 418

b.) Platelet count of 60,000

Question 419

A pregnant woman is being treated with magnesium sulfate. The nurse is concerned that the patient is experiencing early drug toxicity. What assessment finding by the nurse indicates early magnesium sulfate toxicity?

a. ) Respiratory rate of 16
b. ) Fetal heart rate 120
c. ) Complaints by the patient of feeling flushed and warm
d. ) Patellar reflexes are weak or absent

Answer 419

d.) Patellar reflexes are weak or absent

Question 420

A patient has preeclampsia. She is 36 weeks pregnant, and comes to the high-risk screening center for a non-stress test (NST). The nurse should explain to the patient that the NST is being done to determine:

a. ) What effect her hypertension has had on the fetus
b. ) Whether the fetus will be able to tolerate labor
c. ) Whether fetal movement increases with braxton-hicks contractions
d. ) What effect sitting position will have on her blood pressure

Answer 420

a.) What effect her hypertension has had on the fetus

Question 421

The nurse identifies the following assessment findings on a client with preeclampsia: blood pressure 156/100; urinary output 50 mL/hour; lungs clear to auscultation; urine protein 1+ on dipstick; and edema of the hands, ankles, and feet. On the next hourly assessment, which new assessment finding would be an indication of worsening of the preeclampsia?

a. ) Blood pressure 158/104
b. ) Urinary output 20 mL/hour
c. ) Reflexes 2+
d. ) Platelets 110,000

Answer 421

b.) Urinary output 20 mL/hour

Question 422

A patient is being admitted to the labor area with the diagnosis of eclampsia. Which actions by the nurse are appropriate at this time? Select all that apply.

a. ) Tape a tongue blade to the edge of the bed
b. ) Pad the siderails and head of the bed
c. ) Provide the patient with needed stimulation
d. ) Provide the patient with grief counseling
e. ) Pull the blinds and provide a dark, quiet environment

Answer 422

b. ) Pad the siderails and head of the bed
e. ) Pull the blinds and provide a dark, quiet environment

Question 423

A G1P0 client comes to the OB clinic for her first prenatal checkup. Her obstetrician determines she is 10 weeks gestation and orders a lab draw to determine blood type and Rh. Lab tests reveal mother’s blood type is O neg. Four weeks later she experiences a miscarriage. What should be the follow-up plan?

a. ) No sex for two months
b. ) RhoGAM injection
c. ) No pregnancy for one year
d. ) Genetic testing on the product of conceptus

Answer 423

b.) RhoGAM injection

Question 424

Identify all the events where a pregnant client requires a RhoGAM injection. Select all that apply.

a. ) Mother’s blood type O positive, Baby A neg
b. ) Mother O neg, experiences a car accident
c. ) Mother B neg, father O neg
d. ) Mother O neg, gets amniocentesis at 20 weeks
e. ) Mother A neg, Baby O neg
f. ) Mother AB neg, Baby AB pos
g. ) Mother A neg, Indirect Coomb’s test +

Answer 424

b. ) Mother O neg, experiences a car accident
d. ) Mother O neg, gets amniocentesis at 20 weeks
f. ) Mother AB neg, Baby AB pos

Question 425

A patient is diagnosed with severe pre-eclampsia and has a blood pressure of 190/100. What is the appropriate medication to give her to normalize the blood pressure?

a. ) Magnesium Sulfate
b. ) Terbutaline
c. ) Labetelol
d. ) Betamethesone

Answer 425

c.) Labetelol

Question 426

The rationale for Magnesium Sulfate is to

a. ) Provide minerals
b. ) Prevent seizures
c. ) Decrease BP
d. ) Augment labor

Answer 426

b.) Prevent seizures

Question 427

Which finding indicates HELLP syndrome in a pregnant woman?

a. ) Increased edema
b. ) Marked elevated blood pressure
c. ) Thrombocytopenia
d. ) Seizures

Answer 427

c.) Thrombocytopenia

Question 428

The best treatment for eclampsia is to

a. ) Deliver the baby
b. ) Initiate Magnesium Sulfate
c. ) Turn mom to the left lateral side
d. ) Give BP meds

Answer 428

a.) Deliver the baby