review ex 1 Flashcards
A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of: Eclamptic seizure. Rupture of the uterus Placenta previa. Placental abruption.
Placental abruption.
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old at 28 weeks gestation; delivered a daughter, now 5 years old, at 39 weeks gestation; had a miscarriage 3 years ago; and had a first trimester abortion 2 years ago. She is currently pregnant. Which of the following correctly portrays her GTPAL?
G5P1122 OR G5P11A2L2
The nurse is caring for a client in the transition phase of labor and notes that the fetal monitor tracing shows average short-term and long-term variability with a baseline of 142 beats per minute. What actions should the nurse take in this situation?
Provide caring labor support
A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:
This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor?
Restoration of blood flow to uterus and placenta
Immediately prior to amniotomy, the external fetal heart monitor tracing shows 145 bpm with early decelerations. Immediately following the procedure, an internal tracing shows a fetal heart rate of 120 with variable decelerations. A moderate amount of clear amniotic fluid is seen on the bed linens. The nurse concludes that which of the following has occurred?
Prolapsed cord
An Rh(-) mother is given RhoGam during the 2nd trimester. Why is this injection given?
Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten when she delivered to her Rh(+) baby
A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first day of her last menstrual period was September 19th, 2018. Using Naegele’s rule, the nurse determines the estimated date of confinement as:
June 26, 2019
pregnant woman’s diet may not meet her need for folate. A good source of this nutrient is?
Green leafy vegetables
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity according to the GTPAL system?
3-1-0-1-0
A patient who Is beginning preterm labor was diagnosed with complete separation of placenta. What would be the priority nursing intervention to ensure the safety of the patient and the fetus at this time?
Immediate delivery
A 26-year old multigravida is 14 weeks’ pregnant and is scheduled for an alpha-fetoprotein test. She asks the nurse, “What does the alpha-fetoprotein test indicate?” The nurse bases a response on the knowledge that this test can detect what?
Neural tube defects
A multigravida presents to the clinic at 24 weeks gestation. the sonogram revealed this below the nurse should suspect what disorder?
Hydatidiform Mole
The nurse is teaching 16-year-old how to correctly do a breast self-examination. the nurse correctly explains that breast self-examination is best done by the woman on herself every month when?
Right after the menstrual period so that the breast is not being affected by the increase in the hormones particularly estrogen
The nurse explains to a 20 year old primigravida diagnosed with GDM at 28 weeks that women with gestational diabetes are visually managed by which of the following therapies?
Exercise
The patient receiving magnesium sulfate c/o difficulty breathing. The patient has decreased reflexes and has urine output is less than 30 ml/hr. The nurse should anticipate that the MD will order what medication?
Calcium Gluconate
The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?
She will have increased lordosis
A maternity nurse is caring for a client with abruptio placenta and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation?
Swelling of the labia majora
Petechiae and oozing of blood from the skin
Hematuria
Increased platelet count
Prolonged clotting time
Swelling of the labia majora
Increased platelet count
Which of the following sexually transmitted infections is characterized by a foul- smelling, yellow-green discharge that is often accompanied by vaginal pain and dyspareunia?
Trichomoniasis
Diabetes in pregnancy puts the fetus at risk in several ways. What should the nurse be aware of about fetuses of patients with gestational diabetes?
The most important cause of perinatal loss in diabetic pregnancy is congenital malformations
A maternity nurse should be aware of which fact about the amniotic fluid?
It serves as a source of oral fluid and as a repository for waste from the fetus
The nurse is educating a group of adolescent women regarding sexually transmitted infections (STIs). The nurse knows that learning was achieved when a group member states that the most common signs/symptom of sexually transmitted infections is which of the following?
Lack of signs or symptoms
The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa)?
Intense abdominal pain
On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish white vaginal discharge with a fishy odor; complaint of pruritus. On the basis of these findings, the nurse suspects that this woman has what?
Bacterial vaginosis (BV)
A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview you discover that she has not had any immunizations. Which immunizations should she receive at this point in her pregnancy? Select all that apply. Tetanus Diphtheria Chickenpox Rubella Hepatitis B
Tetanus
Diphtheria
Hepatitis B
What does the maternity nurse understand that vascular volume increases 40% to 60% during pregnancy?
Provide adequate perfusion of the placenta
Which symptom in a woman who is using oral contraceptives should be reported to the physician immediately?
Leg Pain
A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period was September 10, 2013 her expected date of birth would be?
06/17/2014
A nurse is caring for a client who states that she is a lesbian. Which of the following
should the nurse consider when caring for this client?
Lesbian women are at higher risk for bacterial vaginosis than are straight women.
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
Increased pulse rate
. A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have?
Amenorrhea
for men who have sex with men (MSM) a red handkerchief means that the wearer is willing to have what type of sex?
Fisting
A pregnant woman wants to know why her diagnosis is marginal placental previa. what answer should the nurse give to the patient?
Placenta is nest in, but not covering the cervical os
.A woman is menstruating. If hormonal studies were to be completed at this time, which of the following hormonal levels would the nurse expect to see?
Both estrogen and progesterone are low.
physician prescribes clomiphene citrate (Clomid, Serophene) for a woman experiencing infertility. She is very concerned about the risk of multiple births. The nurse’s most appropriate response is:
This is a legitimate concern. Would you like to discuss this further before your treatment begins?”
The vagina is at risk for infection because of its location and because it opens to the outside of the body. What is a protective mechanism of the vagina to keep from becoming infected?
Normal vaginal pH is acidic (4 to 5), which protects from infection
A nurse is conducting a class on preterm labor. A client asks the nurse about strategies to prevent preterm labor. The nurse is aware the client needs further instructions if she states which of the following about prevention of preterm labor?
Changing to filter cigarettes is helpful during pregnancy
Th MD wrote “+oligohydramnios. +nuchal cord x2. +thick meconium. category 2 tracing.” What procedures should the nurse expect MD to order and why?
Amnioinfusion. To facilitate true labor
A patient at 24 weeks of gestation contacts the nurse at her obstetric provider’s office to complain that she has cravings for dirt and gravel. The nurse is aware that this condition is known as ________ and may indicate anemia.
Pica
.The nurse is listening to the fetal heart tones of a client at 37 weeks’ gestation while the client is in a supine position. The client states, “I’m getting lightheaded and dizzy.” What is the nurse’s best action?
Help the client turn onto her left side
Enlargement and softening of the uterus
Piskacek Sign
Ease in flexing the body of the uterus against cervix is called-
McDonalds Sign
Hyperpigmentation (brown patches) seen on the forehead, cheeks, and bridge of nose. Known as the “mask of pregnancy”
Chloasma
Darkened vertical midline between the fundus and the symphysis pubis on the abdomen-
Linea Nigra
Stretch marks on the abdomen, thighs, and breasts that occur during pregnancy
Stria Gravidarum
A fully matured endometrium that has reached the thickness of heavy, soft velvet describes the ____ phase of the endometrial cycle
Secretory
A patient came in with complaints of excessive bleeding greater than 7 days or blood loss. Saturation of pad less than hour. The nurse should document the findings as what?
Menorrhagia
A patient with a normal pre-pregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy?
Up to 40 pounds for an underweight woman
A breast-feeding client informs the nurse that she is unable to maintain her milk supply. What instructions should the nurse give to the client to improve milk supply?
Empty the breasts frequently
Following removal of the epidural, the patient develops a severe headache when she sits up in bed. The physician has instructed the patient that she will need a blood patch. Which best describes this procedure?
Removing blood from a vein in the patient and injecting it into the epidural space in the back
A nurse is caring for a newborn with hypoglycemia. what symptoms of hypoglycemia the nurse monitor the newborn for?
lethargy
cyanosis
jitteriness
A 2-day old neonate received a vitamin K injection at birth. Which of the following signs/ symptoms in the bay would indicate that the treatment was effective?
Blood clots after heel stick
A client who has a breast-feeding newborn complains of sore nipples. Which of the following interventions can the nurse suggest to alleviate the client’s condition?
Offer suggestions based on observation to correct positioning or latching.
One hour following a normal vaginal delivery, a newborn infant boy’s axillary temperature is 96° F, his lower lip is shaking and, when the nurse assesses for a Moro reflex, the boy’s hands shake. Which intervention should the nurse implement first?
Obtain a serum glucose level
After a laboring clients membrane rupture spontaneously, the nurse observes the umbilical cord protruding from the vagina. What is the priority nursing intervention after putting the patient in a knee-chest position?
assess fetal heart rate?
The mother has delivered the placenta. You note that the shiny surface of the placenta was delivered first. What delivery mechanism is this known as AND is this the maternal or baby’s surface of the placenta?
Schultze mechanism, baby
Immediately following administration of an epidural anesthesia, the nurse must monitor the mother for which of the following?
Hypotension OR Drop in blood pressure headache
A laboring woman, G4 P3003, who was 6 cm dilated 1 hour ago cries, “Hurry. I have to go to the bathroom to have a bowel movement.” The nurse notes that there is an increase in bloody show. Which of the following actions by the nurse is appropriate?
Assess cervical dilation
A nurse is advising the parents of a newborn regarding when they should call their pediatrician. Which of the following responses show that the teaching was effective?
If the baby has no tears when he cries
Your laboring patient has transitioned to stage 2 of labor. What changes in the perineum indicate the birth of the baby is imminent?
Bulging perineum and rectum with an increase in bloody show
A client in labor informs the nurse that she is concerned about the amount of blood loss associated with giving birth. The nurse advises the client that the amount of blood loss during childbirth is usually tolerated by the patient because of what?
increased blood volume
A lactation nurse is teaching a class on breastfeeding to a group of newly delivered mothers. What should the nurse include in her teaching about removing the baby from the breast?
Break the sucking by placing a finger in the baby’s mouth
. The nurse is assisting in developing a care plan for a client with an episiotomy. Which interventions would be included for the nursing diagnosis Acute pain related to perineal sutures?
Use Sitz bath
Wash from front to back after each void and bowel movement
The nurse in the obstetric clinic received a telephone call from a bottle-feeding mother of a 3- day old baby girl. The client stated that her breasts are firm, red, and very shiny. Which of the following is the best action for the nurse to advise the client to perform?
Intermittently apply ice packs to the axillae and breast regions
. The nurse places a warmed blanket on the scale when weighing a newborn to minimize heat loss via which mechanism?
Conduction
. A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature 37.3° C, pulse rate 88 beats per minute, respiratory rate 10 breaths per minute, BP 148/90 mm Hg, absent deep tendon reflexes (DTRs), and no ankle clonus. The client complains, “I’m so thirsty and warm.” What is the nurse’s immediate action?
To discontinue the magnesium sulfate infusion
. A patient informs the nurse that she is very constipated. Which of the following foods would be best for the nurse to recommend to the client?
Celery
A nurse is caring for a client who has had a vaginal birth. The nurse understands that pelvic relaxation can occur in any woman experiencing a vaginal birth. Which of the following should the nurse recommend to the client to improve pelvic floor tone?
Kegel Exercise
Given below, in random, are the phases of labor. Arrange them in order of their occurrence.
Latent stage Active stage Transition stage Second stage Third stage
A baby girl was delivered at 38 weeks gestation and is having difficulty maintaining normal body temperature. What nursing intervention would best prevent cold stress in a term neonate at delivery?
Put the baby on skin-to-skin contact with the mother
A nurse is educating a pregnant woman regarding the moves a fetus makes. During the birthing process. Please place the following cardinal moments of labor in the order the nurse should inform the client that the fetus will make.
Descent, Internal Rotation, Extension, External Rotation, Expulsion
As part of their teaching function at discharge, nurses should educate parents regarding safe sleep. Based on the most recent evidence, which information is incorrect and should be discussed with parents?
Place the infant on his or her abdomen to sleep
A newborn infant is assessed for cephalohematoma and caput succedaneum when making this assessment the nurse include that the difference between caput succedaneum and cephalohematoma is what?
Edema crosses the suture line
A neonate is admitted to a hospital’s central nursery. The neonate’s vital signs are temperature = 96.5 degrees F., heart rate = 120 bpm, and respirations = 40/minute. The infant is pink with slight acrocyanosis. The priority nursing diagnosis for the neonate is…
Ineffective thermoregulation related to fluctuating environmental temperatures.
A 32-year-old multigravida returns to the clinic for a routine prenatal visit at 36 weeks’ gestation. The assessments during this visit include: blood pressure 140/90 mm Hg; pulse 80 beats/min; respiratory rate 16 breaths/min. What further information should the nurse obtain to determine if this client is becoming preeclamptic?
Proteinuria
A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor?
Restoration of blood flow to uterus and placenta
A client is worried that her newborn’s stools are greenish, with an unpleasant odor. The newborn is being formula-fed. What instruction should the nurse give this client?
Greenish stools with an unpleasant odor are normal
A new mother received epidural anesthesia during labor and had a forceps delivery after pushing 2 hours. At 6 hours PP, her systolic blood pressure has dropped 20 points, her diastolic BP has dropped 10 points, and her pulse is 120 beats per minute. The client is anxious and restless. On further assessment, a vulvar hematoma is verified. After notifying the health care provider, the nurse immediately plans to?
Prepare for surgery.
internal hemorrhage with shock setting in
When examining the insides of a newborn’s mouth the nurse notes small raised white bumps that do not bleed when touched. What is the most likely diagnosis?
Epstein’s Pearl
The patient asks the nurse “What does the alpha-fetoprotein test indicate?” The nurse explains to the patient that this prenatal assessment is performed as early at 14 weeks to detect what?
a. Neural Tube defects
b. Cardiac defects
c. Urinary defects
d. Kidney defects
Neural Tube defects
A woman is experiencing preterm labor. The patient asks why she is on betamethasone (Celestone). The best response by the nurse would be “This medication:
a. “Is an antibiotic that will treat your urinary tract infection, which caused preterm labor.”
b. “Will relax the smooth muscles in the infant’s lungs so the baby can breathe.” c. “Will halt the labor process until the baby is more mature.”
d. “Is effective in stimulating lung development in the preterm infant.”
d. “Is effective in stimulating lung development in the preterm infant.
A nurse caring for a 16 year old g1p0 with s/s of early labor and ruptured membranes. Her blood pressure is 170/112mm/hg. She has 3+ protein in her urine and her hands and face are swollen. What initial medication should the nurse expect to be prescribed for this patient?
c. Magnesium sulfate.
A client dilated to 5 cm has just received an epidural for pain. She complains of feeling lightheaded and dizzy within 10 minutes after the procedure. In addition to the bolus of fluids she has been given, the MD orders Ephedrine. What is the therapeutic effect of this medication?
a. Stop the patient from having a seizure
b. Stops the contractions
c. Increase the blood pressure
d. Increase the fetal heart rate
c. Increase the blood pressure
A nurse understands that a definitive diagnosis of bacterial meningitis is based on:
a. Clinical manifestations and history of exposure
b. Blood cultures
c. Cerebrospinal fluid cultures
d. White blood cell count
. Cerebrospinal fluid cultures
The nurse is administering the prescribe NPH insulin to a diabetic patient. The nurse should assign highest priority 30 minutes after administering the insulin to which of the following?
a. Testing the patient’s urine for glucose
b. Observing the patient for an allergic reaction c. Checking the injection site for bleeding
d. Instructing the patient to eat a meal
d. Instructing the patient to eat a meal
The nurse noted the fetal heart rate below. Based on the findings, the nurse will document what type of deceleration?
a. Early deceleration
b. Late deceleration
c. Variable deceleration
d. Prolonged deceleration
a. Early deceleration
The nurse receives a phone call from a patient who claims she is pregnant. The patient reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was October 17, 2017. What would the patient’s estimated date of delivery (EDD) be?
b. July 24, 2018
A type 1 diabetic who is at 32 weeks’ gestation is having a non-stress test for fetal well-being because she has been having problems with glucose control. Which of the following meets the criteria for her test to be considered reactive?
a. Fetal heart rate baseline of 140 with one acceleration to 160 for 15 seconds within 30 minutes
b. Fetal heart rate baseline of 130 with two accelerations to 140 for 15 seconds within 20 minutes
c. Fetal heart rate baseline of 140 with two accelerations to 155 for 15 seconds within 20 minutes
d. Fetal heart rate baseline of 150 with two accelerations to 160 for 10 seconds within 20 minutes
c. Fetal heart rate baseline of 140 with two accelerations to 155 for 15 seconds within 20 minutes
