RNC Test 171 Questions with Verified Answers,100% CORRECT

RNC Test 171 Questions with Verified Answers b - CORRECT ANSWER The insulin requirements for most diabetic breastfeeding mom's is: a. increased b. decreased c. same b - CORRECT ANSWER In a normal pregnancy, there is usually a physiologic drop in blood pressure to its lowest point in the a. first trimester b. 2nd trimester c. 3rd trimester a - CORRECT ANSWER Which statement best describes the relationship between maternal and fetal hemoglobin levels? a. Fetal hemoglobin is higher than maternal hemoglobin b. Maternal hemoglobin is higher than fetal hemoglobin c. Maternal and fetal hemoglobin are the same b - CORRECT ANSWER The cardiac output during pregnancy a. decreases by 23% b. Increases by 30-50% c. remains the same a - CORRECT ANSWER What class of antihypertensive medication is recommended in pregnancy since it has been shown not to increase the chance of new onset diabetes by improving sensitivity to insulin glycemic control? a. Ace inhibitors b. Beta Blockers c. Calcium Channel Blockers a - CORRECT ANSWER An antihypertensive that Is contraindicated during the second and third trimester of pregnancy is a. Ace inhibitors (Ex: captopril, enalapril, ramipril) b. Calcium channel blockers (Nifedipine) c. Combined alpha - beta blockers (Labetolol) c - CORRECT ANSWER The primary indication for the use of magnesium sulfate in preeclampsia is a. lowering the blood pressure b. prevention of HELLP c. seizure prophylaxis b - CORRECT ANSWER A pregnant woman on a continuous infusion of Magnesium Sulfate for preeclampsia exhibits the following: Respiratory rare: 14 per minute, Deep tendon reflexes: decreased with clonus, absent mental status: awake and alert . The most appropriate nursing action is to a. decrease the infusion rate b. discontinue the infusion rate c. maintain the infusion rate b - CORRECT ANSWER Compared to the general population, woman with pregestational diabetes are how likely to deliver a baby with a major congenital anomaly? a. 1-2 times more likely b. 3-4 times more likely c. 5-6 times more likely c - CORRECT ANSWER The tocolytic that is contraindicated in the diabetic woman is a. Magnesium Sulfate b. Nifedipine (Procardia) Terbutaline (Beta - mimetics) a - CORRECT ANSWER Compared to the first trimester, the insulin requirements for the diabetic mother in the third trimester are a. greater b. less c. the same c - CORRECT ANSWER A Type I (pregestational) diabetic woman at 32 weeks gestation is admitted with complaints of abdominal pain, nausea and vomiting over the last 48 hours. she states she omitted her insulin last evening and this morning since she could not eat. Her vital signs are 138/86 T-99 P-120 R 32. Her arterial blood gas ph is 7.02. These findings indicate a. eugylcemia b. insulin shock c. ketoacidoses a - CORRECT ANSWER A Type I (pregestational) diabetic woman at 32 weeks gestation is admitted with complaints of abdominal pain, nause and vomiting over the last 48 hours. she states she omitted her insulin last evening and this morning since she could not eat. Her vital signs are 138/86 T-99 P-120 R 32. Her arterial blood gas ph is 7.02. The appropriate treatment is a. aggressive IV hydration and IV insulin b. fluid restriction and Iv glucose c. hyperalimentation and subcutaneous insulin a - CORRECT ANSWER A previously normotensive woman is 34 weeks gestation develops hypertension and proteinuria. Her diagnosis would be a. gestational hypertension b. preeclampsia c. pregnancy induced hypertension (PIH) c - CORRECT ANSWER The goal of treatment of gestational diabetes is to decrease the likelihood of fetal a. congenital anomalies b. growth restriction c. macrosomia b - CORRECT ANSWER The customary recommendation for the timing of laboratory screening to detect gestational diabetes in the low risk woman is a. 12-16 weeks b. 24-28 weeks c. 32-36 weeks b - CORRECT ANSWER Woman with gestational diabetes are at a higher risk for developing a. gestational trophoblastic disease b. hypertension c. placenta previa c - CORRECT ANSWER Which one of the cardiac conditions listed below has the highest rate of maternal mortality a. atrial septal defect b. mitral stenosis c. pulmonary hypertension c - CORRECT ANSWER The time during labor and birth that is of greatest risk for woman with a cardiac condition is a. active phase of labor b. second stage of birth c. immediately after birth c - CORRECT ANSWER The medication that is contraindicated in women with a cardia condition a. hydralazine (apresoline) b. oxytocin c. terbutaline a - CORRECT ANSWER Which one of the following infections does not cross the placenta? a. Neisseria gonorrhea b. HIV c. Syphyllis c - CORRECT ANSWER Physiologic anemia of pregnancy occurs due to a. decreased iron stores due to an inadequate diet rich in iron foods b. inadequate intake of folic acid preconceptionally c. proportionately greater increase in plasma that red cell volume c - CORRECT ANSWER At 32 weeks, an African American prenatal patient has a hemoglobin of gms/dl. She reports no problems and her assessment at this visit is normal. She most likely would have what type of anemia? a Folic acid deficiency b. Iron deficiency anemia c. physiologic anemia of pregnancy c - CORRECT ANSWER The maternal anemia that results in an increased viscosity of the blood a. folic acid anemia b. iron deficiency anemia c. sickle cell anemia b - CORRECT ANSWER A prenatal patient with a negative prenatal RH antibody screen should receive immune globulin (RhoGam) 300 mcg at what stage of her pregnancy a. 24-26 weeks b. 28-32 weeks c. 34-36 weeks c - CORRECT ANSWER A woman with a history of a pregnancy that was anencephalic should be advised to supplement her diet with what dosage of folic acid? a. 0.04 mg b. 0.4 mg c. 4.0 mg c - CORRECT ANSWER A risk factor for prenatal toxoplasmosis is a. charbroiled meat b. processed lunch meat c. sushi a - CORRECT ANSWER A 21 year old, 32 week gestation, gravida 4m para 0 with no prenatal care is admitted with complaints of unremitting abdominal pain and bright red vaginal bleeding. Her abdomen palpates board-like and rigid. This history is suspicious of the use of a. cocaine b. heroine c. marijuana a - CORRECT ANSWER A woman at 31 weeks gestation is admitted to labor and delivery in possible labor. On examination, the nurse notices bruises on the patient's breast and abdomen. When asked about the bruises she reluctantly admits that her partner threw her against the door when she was trying to leave him due to repeated abusive episodes. The nurse recognizes that the most urgent priority is the woman's a. physical safety b. risk for fetal loss c. social support c - CORRECT ANSWER A pregnant woman who has outdoor cats is at increased risk to acquire a. cytomegalovirus b. rubella c. toxoplasmosis a - CORRECT ANSWER An umbilical cord blood gas (artery) reveals the following: ph 7.29; po2: 22 mm/hg;PCO2: 47 mm/gh; HCO3: 23 mEq/L; This represents a. normal value b. metabolic acidosis c. respiratory acidosis c - CORRECT ANSWER In the prenatal period, when should screening for Group B streptococcus be performed? a. 22-24 weeks b. 26-28 weeks c. 35-37 weeks a - CORRECT ANSWER The relation of the fetal body parts to one another is called fetal a. attitude b. lie c. presentation a - CORRECT ANSWER The most accurate dating of a pregnancy by ultrasound is a. 1st trimester evaluation of the crown-rump length b. 2nd trimester of the bi-parietal (BPD) , femur length and and abdominal circumference c. 3rd trimester biophysical profile a - CORRECT ANSWER Failure to elicit a reactive pattern with a nonstress test after 40 minutes of fetal monitoring warrants a. further evaluation b. increased testing time c. retest after giving orange juice b - CORRECT ANSWER In a 30 week GA fetus who has never had a NST before, the test is considered reactive when a. accelerations accompany the marks made by the mother noted in a 20 minute period b. accelerations peak at 10 bpm above the baseline with a duration of 10 seconds within 20 minutes c. at least 2 fetal heart accelerations occur in 20 minutes b - CORRECT ANSWER A negative contraction stress test is characterized by a. accelerations with onset of contractions b. no late or significant variable decelerations c. presence of moderate variability in between contractions b - CORRECT ANSWER At 32 weeks, a prenatal patient reported decreased fetal movement. A non-stress test is reported as non reactive. Which of the following is appropriate for this patient? a. admission to the labor unit for an expedited delivery b. Biophysical profile c. keeping a fetal movement record and return in 24 hours a - CORRECT ANSWER A low level of alpha fetoprotein is indicative of a. Down syndrome b. maternal fetal hemorrhage c. neural tube defects c - CORRECT ANSWER A woman, who is a gravida 4 para 1212 has had 4 pregnancies with one a. two term, one preterm, and 2 living children b. two abortions, one living child and two preterm c. two preterm, one abortion and two living children b - CORRECT ANSWER A potential fetal complication that occurs with cordocentesis (percutaneous umbilical blood sampling) 2% of the time is a. cardiac dysrhythmias b. fetal loss c. profound persistent bradycardia a - CORRECT ANSWER A patient who does not want chromosome testing but would like to know the risk of her delivering a newborn with a neural tube defect (NTD), should have what test ordered that is specific for NTD? a. Maternal serum alpha fetal protein (MSAFP) b. Nuchal translucency c. Triple Screen c - CORRECT ANSWER Quad screening compared to alphafetoprotein testing can better detect a. metabolic disorders b. open neural tube defects c. trisomies c - CORRECT ANSWER A fetal heart rate change that can be seen after administration of butorphanol (stadol) is a. bradycardia b. marked variability c. Sinusoidal - appearing c - CORRECT ANSWER A woman at term is in labor and exhibits significant variable decelerations on an electronic fetal monitor. An amnioinfusion is ordered with the goal of a. improving placental circulation b. maximizing fetal oxygenation c. relieving umbilical cord compression c - CORRECT ANSWER A baroreceptor response is seen in what type of deceleration? a. early b. late c. early b - CORRECT ANSWER Decelerations are determined to be prolonged based on their a. amplitude b. duration c. etiology a - CORRECT ANSWER Baroreceptors respond mainly to changes in a. blood pressure b. hormonal changes c. oxygen and carbon dioxide levels a - CORRECT ANSWER A woman is 7 cm dilated and on the electronic fetal monitor. Fetal heart rate activity mirrors the contraction intensity and begins and ends in concert with the contraction. This is consistent with a/n a. early b. late deceleration c. variable deceleration b - CORRECT ANSWER Stimulation of the sympathetic nervous system causes the fetal heart rate to a. decrease b. increase c. remain the same c - CORRECT ANSWER Which statement describes normal uterine activity? a. Frequency of 1 1/2 to 2 minutes b. Intensity of 90 mmHg early in labor c. Resting tone less than 20-25 mmHg c - CORRECT ANSWER using the NICHD definitions, spontaneous occurrence of greater than 5 contractions in 10 minutes, averaged over a 30 minute window is called a. hyperstimulation b. hypertonus c. tachysystole c - CORRECT ANSWER The most common side effect of prostaglandin administration is a. Maternal fever b. Nausea and vomiting c. Tachysystole a - CORRECT ANSWER When fetal heart tones are heard above the umbilicus abd the fetal head is palpated in the upper part of the uterus, this is consistent with a. breech presentation b. brow presentation c. occiput posterior position b - CORRECT ANSWER Palpate the uterus is best performed by using the a. back of the hand b. fingertips c. palm c - CORRECT ANSWER At a prenatal visit, a woman's uterus is palpated at the xyphoid process. This would be normally found at what week gestation? a. 32 b. 34 c. 36 a - CORRECT ANSWER The first Leopold's maneuver assists in identifying the fetal a. attitude b. cephalic prominence c. presentation b - CORRECT ANSWER A fetal scalp blood sample reveals a ph 7.21. Based on the finding, the nurse is prepared to a. assist repeat testing in 30 minutes b. recognize the ph is normal c. transfer the patient to the OR for delivery b - CORRECT ANSWER Umbilical blood gas values are used to a. direct initial steps of neonatal resuscitation b. establish the state of fetal oxygenation c. predict adverse neurological outcomes b - CORRECT ANSWER An advantage of vibroacoustic testing is that is a. can be used effectively at any gestational age b. can decrease nonstress testing time c. can be used for 3 seconds each time, up to 5 times a - CORRECT ANSWER A fetal response to asphyxia is a. decreased PCO2 b. increased lactate level c. increased PO2 c - CORRECT ANSWER a negative fetal fibronectin test at 30 weeks indicates a. a need for further testing b. increased risk for delivery c. risk of delivery is low for the next 7-14 days a - CORRECT ANSWER The Montevideo units (MVU's) for a woman in the active phase of labor is 225 a. adequate contraction activity for labor progression b. Hypertonic labor c. Inadequate contraction activity for progress b - CORRECT ANSWER The term used to describe the fetus settling down into the pelvic inlet (engagement) during pregnancy is a. Chadwick's sign b. lightening c. quickening b - CORRECT ANSWER The pelvic type is favorable for a vaginal birth is a. android b. gynecoid c. platypelloid a - CORRECT ANSWER One theory of labor initiation is an increase in a. corticotrophin- releasing-hormone (CRH) b. progesterone c. prostacylin a - CORRECT ANSWER When differentiating false labor from true labor, a finding that would suggest a woman is in true labor is if after 1-2 hours of walking which of the following occurs? a. Back pain radiating to the abdomen b. Cervix is soft and closed c. Contractions lesson some with walking c - CORRECT ANSWER The umbilical vein carries a. carbon dioxide from the fetus back to the placenta b. deoxygenated blood from the fetus to the placenta c. oxygenated blood from the placenta to the fetus a - CORRECT ANSWER Maternal supine hypotension is caused mainly by compression of the a. inferior vena cava b. spiral arteries c. uterine vessels b - CORRECT ANSWER During labor and delivery, cardiac output is at its highest in the a. first stage b. second stage c. immediate period after delivery b - CORRECT ANSWER The Ferguson reflex is the result of a. cytokine release b. pressure on the cervix c. prostaglandin release from the membranes a - CORRECT ANSWER Compared to non-pregnant values, the maternal arterial carbon dioxide (pCO2) during pregnancy is a. decreased b. increased c. the same b - CORRECT ANSWER Compared to non-pregnant values, the maternal arterial ph during pregnancy is a. slightly decreased b. slightly increased c. the same b - CORRECT ANSWER The metabolic states of pregnancy is described as a chronic a. respiratory acidosis b. respiratory alkalosis c. mixed acidosis b - CORRECT ANSWER During pregnancy cardiac output increases by what percent? a. 20-30 % b. 40-50 % c. 60-70% a - CORRECT ANSWER The color of nitrazine paper most indicative of ruptured membranes is a. blue b. green c. yellow c - CORRECT ANSWER During labor, a woman in pain complains of dizziness, light-headedness, and numbness and tingling in her lips. The most likely cause of these symptoms is a. carbon dioxide retention b. excessive anxiety c. hyperventilation c - CORRECT ANSWER The fetal heart tones of a baby in the ROP position, would best be heard over the mother's a. left lower abdomen closer to her side b. left upper abdomen toward the midline c. right lower abdomen a - CORRECT ANSWER In the low risk patient who is in the active stage of labor, the fetal heart should be assessed every a. 15 minutes b. 30 minutes c. 60 minutes b - CORRECT ANSWER According to the ACOG guidelines for continuous electronic monitoring, a patient without complications in the active phase of labor should have the fetal heart rate assessed every a. 15 minutes b. 30 minutes c. 60 minutes c - CORRECT ANSWER During labor and delivery, the cardinal movement of restitution describes a. flexion of the fetal head b. internal rotation of the fetal head c. rotation of the fetal head 45 degrees after head delivery a - CORRECT ANSWER In the second stage of labor, the high risk patient should be assessed every a. 5 minutes b. 10 minutes c. 15 minutes b - CORRECT ANSWER The phase of labor that distraction techniques are most likely to be effective is a. active b. latent c. transition c - CORRECT ANSWER A prolonged second stage in a primigravida with regional anesthesia is defined as a lack of continuous progress and a second stage duration of greater than a. 1 hour b. 2 hours c. 3 hours a - CORRECT ANSWER Internal rotation of the head generally occurs in a. mid pelvis b. pelvic entry c posterior pelvis c - CORRECT ANSWER The transition phase of labor is characterized by maternal a. alertness and seriousness b. excitement and anticipation c. panic and fear b - CORRECT ANSWER One sign that suggests placental separation is a. downward movement of the uterus in the abdomen b. lengthening of the umbilical cord c. uterus changes shape from a glob to a disk a - CORRECT ANSWER A woman in labor is having contractions about every 2-3 minutes. She is 7-8 cm dilated, 100% effaced, and a +1 station. These findings are most consistent with what stage of labor? a. First b. Second c. Third c - CORRECT ANSWER The pushing technique that a woman in second stage should be encouraged to use is a. Alternating between open and closed glottis pushing b. Closed glottis pushing while holding her breath to the count of 10 c. Open-glottis pushing for 6-8 seconds with 3-4 pushes per contraction c - CORRECT ANSWER In the multigravida with no maternal or fetal contraindications, pushing efforts may be delayed up to a. 30 minutes b. 1 hour c. 2 hours c - CORRECT ANSWER The second stage position that can increase the pelvic diameter as much as 28-30 % is a. knee-chest b. semi-fowlers c. squatting b - CORRECT ANSWER The frequency of fetal heart rate assessments for a low risk woman in active labor on Pitocin is every a. 5 minutes b. 15 minutes c. 30 minutes b - CORRECT ANSWER After the last dose of misoprostol (cytotec) , oxytocin administration should be delayed for at least a. 30-60 minutes b. 4 hours c. 6-12 hours b - CORRECT ANSWER The current recommendation regarding timing of prophylactic antibiotics for a cesarean section is a. after placenta delivery b. immediately after cord clamping c. within 60 minutes prior to the start of the cesarean section c - CORRECT ANSWER A bishop score of 4 indicates a. a favorable cervix b. and intermediate cervix c. an unfavorable cervix a - CORRECT ANSWER The likelihood of a successful labor induction with a Bishop score of 8 is a. high b. low c. moderate a - CORRECT ANSWER A patient is admitted to labor and delivery for induction of labor. Her cervical assessment is: Cervix closed, firm and posterior; 60-70 % effaced; -2 station. her bishop score is a. 3 b. 5 c. 7 b - CORRECT ANSWER The half-life of Pitocin is a. 5-7 minutes b. 10-12 minutes c. 13-15 minutes c - CORRECT ANSWER In order to prevent water intoxication during Pitocin administration, the Pitocin should be mixed in an intravenous fluid that is a. hypertonic b. hypotonic c. isotonic a - CORRECT ANSWER Pitocin dosages during labor should be documented in a. mU/per minute b. ml/min c. cc/hr c - CORRECT ANSWER A patient is being induced and is at an oxytocin level of 20 mU/min. she reports nausea and vomiting, feels her heart beating rapidly, feeling faint and has a headache. She most likely is experiencing a. an infectious process b. anxiety from labor c. water intoxication a - CORRECT ANSWER The recommended initial intravaginal dose of misoprostol (cytotec) for cervical ripening is a. 25 mcg b. 50 mcg c. 100 mcg a - CORRECT ANSWER When cervidyl (Prepdil) is used for induction of labor, at what point can oxytocin be initiated after insertion of the Cervidyl? a. 30 minutes after removal b. 4 hrs after insertion c. 6 hrs after insertion b - CORRECT ANSWER An advantage of prostaglandin E2 over low dose oxytocin is a. fewer cesarean deliveries b. labors are shortened c. less morbidity b - CORRECT ANSWER When active labor is achieved during a Pitocin induction or augmentation, the Pitocin dosage can be a. discontinued b. incrementally decreased c. incrementally increased a - CORRECT ANSWER The frequency of fetal heart rate assessments for a low risk woman in second stage on Pitocin is every a. 5 minutes b. 15 minutes c. 30 minutes b - CORRECT ANSWER When a pattern of coupling and tripling of contractions is occurring the oxytocin dose should be a. decreased b. discontinued c. maintained a - CORRECT ANSWER According to the gate control theory relieving pain with massage, heat, and cold acts by a. blocking the capacity of nerve pathways to transmit pain b. diverting the pathways to areas of spinal cord decreasing sensation c. limiting the amount of nerve sensation across the pathway c - CORRECT ANSWER Therapeutic touch is based on the theory that a. application of pressure to extremities will direct the body b. natural endorphin release will be induced by massaging body c. well-being can be promoted by uniting the energy fields of the care giver and the patient a - CORRECT ANSWER Fentanyl requires more frequent dosing for management of labor pain because a. it has a shorter duration of action b. multiple smaller doses over time decrease the incidence of side effects c. the peak effect time lengthens with subsequent doses a - CORRECT ANSWER Cholestasis is a condition that occurs in pregnancy and is caused by elevated a. bile acid b. bilirubin c. liver enzymes a - CORRECT ANSWER A patient has an IUPC inserted for an amnioinfusion. There is no leaking of fluid in the vagina. The appropriate action is a. discontinue the procedure and notify the physician b. reposition the catheter c. take no action and continue to monitor the patient b - CORRECT ANSWER The NICHD definitionof uterine tachysystole is a contraction frequency averaged over 30 minutes of greater than a. 4 contractions in 10 minutes b. 5 contractions in 10 minutes c. 6 contractions in 10 minutes a - CORRECT ANSWER When a fetus is in the occiput posterior position, the position that is most helpful in facilitating rotation is a. hands and knees b. lithotomy c. semi-fowlers b - CORRECT ANSWER A woman with a history for gestational diabetes is about to deliver. The nurse should be prepared to a. apply fundal pressure b. apply suprapubic pressure c. laterally displace the uterus b - CORRECT ANSWER In the event of a prolapsed cord, the nurse should a. cover the cord with dry gauze to prevent exposure to air b. place the woman into a knee/chest position c. re-insert the cord into the uterus b - CORRECT ANSWER A woman with hydramnious is experiencing abdominal pain and dyspnea. Treatment with indomethacin will a. decrease fetal lung liquid absorption b. decrease fetal urine production c. promote diuresis a - CORRECT ANSWER A 32 week gestation woman is delivered by emergency c/s for a placental abruption. She begins to exhibit oozing from her IV site and petechiae under the blood pressure cuff. This is suggestive of a. disseminated intravascular coagulation b. preeclampsia c. sickle cell crisis a - CORRECT ANSWER A woman is admitted to labor and delivery with moderate uterine pain without bleeding. On examination, the uterus is high tonicity and the uterine contraction tracing shows increased restinf tone. The most likely a. placental abruption b. placenta previa c. uterine rupture c - CORRECT ANSWER A patient with a placenta previa is scheduled for a cesarean birth. The nurse can anticipate what type of incision is to be made? a. Classical vertical incision b. Low segment transverse c. low segment vertical c - CORRECT ANSWER Following premature rupture of membranes, a woman at 33 weeks gestation is placed on a fetal heart rate monitor. The fetal heart rate is persistently 175 bpm. This is most likely consistent with a. immature fetal CNS integrity b. maternal anxiety c. uterine infection a - CORRECT ANSWER Betamethasone given to the mother can transiently affect the fetal heart rate by a. decreasing the variability b. increasing the variability c. lowering the baseline b - CORRECT ANSWER Benefits of corticosteroids are most beneficial if what number of hours have lapsed between the time the dose is administered and birth a. 24 b. 48 c. 72 c - CORRECT ANSWER When dexamethasone (Decadrone) 6 mg is administered to a patient with preterm labor, which of the following should be administered to follow the dose? a. Betamethasone 12 mg in 24 hrs b. Betamethasone Sodium Phosphate 6 mg in 10 hours c. Dexamethasone 6 mg every 12 hours for 4 doses c - CORRECT ANSWER The tocolytic that places a woman at risk to develop diabetic ketoacidosis is a. Magnesium Sulfate b. Nifedipine c. Terbutaline b - CORRECT ANSWER Magnesium sulfate is mainly excreted through the a. intestines b. kidneys c. liver a - CORRECT ANSWER A woman is pregnant with twins and had an ultrasound diagnosis of monochorionicity. Compared to dichorioicity, risk of perinatal mortality is a. higher b. lower c. similar b - CORRECT ANSWER Nifedipine (Procardia) for tocolyisis in preterm labor should not be given with which other drug? a. Indocin b. Magnesium Sulfate c. Terbutaline c - CORRECT ANSWER A woman has a diagnosis of monozygotic twins. compared to a patient with dizygotic twins, the risk of discordant growth and malformation is a. higher b. lower c. the same b - CORRECT ANSWER A predisposing factor to a breech presentation is a. grand multiparity b. multifetal pregnancy c. previous breech presentation c - CORRECT ANSWER In twin to twin transfusion, the complication that occurs in the recipient twin is a. macrosomia b. oliguria c. plethora c - CORRECT ANSWER Neurologic injury in a twin who survivies the intrauterine death of the co-twin is most likely due to a. DIC due to transfer of thromboplastic material b. Rh isoimmunization c. significant hypotension at the time of the demise c - CORRECT ANSWER A pregnancy is classified as postterm beginning at a. 40 weeks and 1 day b. 41 weeks and 6 days c. 42 weeks and 0 days c - CORRECT ANSWER Afterpains are due to a. hormonal shifts that affect the muscles b. physiologic stress from the birth process c. uterine contractions during involution a - CORRECT ANSWER On postpartum day two, a postpartum woman who is afebrile has a white blood count of 20,000. this indicates a. a normal physiologic response b. an infection c. hemoconcentration a - CORRECT ANSWER Uterine involution occurs through the process of a. autolysis b. a decrease in the number of myometrial cells c. exfolitation c - CORRECT ANSWER At the end of the 3rd stage of labor, the fundus is located a. at the umbilicus b. one fingerbreadth above the umbilicus c. 2 cms below the level of the umbilicus b - CORRECT ANSWER Four hours after delivery, a woman's fundus is three fingers above the umbilicus and deviated to the left. Her fundus is boggy but firms with massage. she has moderate lochia rubra. The most appropriate action is to a. administer Pitocin to promote uterine contractions b. assist the woman to the bathroom to void c. perform continued fundal massage to express clots c - CORRECT ANSWER Which of the following women is most likely to experience the strongest afterbirth pains? a. breastfeeding mom after her 1st baby b. bottlefeeding mom after her 2nd baby c. breastfeeding mom after her 3rd baby c - CORRECT ANSWER The lochia that is pink or brown in color and occurs between 3 and 10 days postpartum is a. alba b. rubra c. serosa a - CORRECT ANSWER The nurse understands that there are many differences in how various cultural belief systems are involved in the birth process and postpartum periods. To ensure the best approach for each culture the nurse should a. ask the patient about her preferences and wishes b. consult the unit policy on a specific culture c. look up specific information on the internet c - CORRECT ANSWER The phase of maternal adjustment that typically starts the 2nd to the 3rd day postpartum where the mother focuses on the care of the baby while still needing nurturing herself is known as a. letting go b. taking hold c. taking in b - CORRECT ANSWER The process where families engage in identification of the new baby to other family members is a. acquaintance b. claiming c. mutuality c - CORRECT ANSWER Breastfeeding in the woman with diabetes is a. contraindicated b. dependent on the type of diabetes c. recommended b - CORRECT ANSWER The milk ejection reflex (let-down) occurs when there is a release of oxytocin from the a. oxytocin from the anterior pituitary b. oxytocin from the posterior pituitary c. prolactin from the posterior pituitary b - CORRECT ANSWER The most important skill to teach the breastfeeding mother in the hospital is how to a. care for the nipples before and after feedings b. latch-on and position the baby on the breast c. pump her breast and store the milk c - CORRECT ANSWER The best way to determine if milk transfer is occurring during breast feeding is a. ask the mother if the baby sleeps after the feedings b. the baby nurses 8-10 times in 24 hours c. the presence of frequent audible swallowing c - CORRECT ANSWER The most common cause of the sore nipples in the immediate postpartum period is a. feeding the baby too long during feedings b. frequent feedings c. improper latch- on and positioning a - CORRECT ANSWER Most persistent fevers after childbirths are cause by a. genital tract infection b. mastitis c. urinary tract infection a - CORRECT ANSWER A woman with a history of asthma, is 12 hours postpartum and has uterine atony. the patient's virtal signs are BP 150/90; Pulse 100; Respirations 14; Temperature 99.4 F (37.4 C). The nurse would expect and order for which medication a. hemabate b. methergine c. oxytocin c - CORRECT ANSWER A postpartum woman is nursing has not had a tdap (tetanus, dyptheria, pertussis) vaccine. What is the appropriate time for administration. a. after she completes nursing b. at her postpartum visit c. before discharge a - CORRECT ANSWER At type I (pregestational) diabetic woman at 32 gestation is admitted with complaints of abdominal pain, nausea, vomiting over the last 48 hours. she states she omitted her insulin doses last evening and this morning since she could not eat. her vital signs are 138/86, T 99, pulse 120, R 32. Her arterial blood gas is 7.02. after delivery, the insulin requirements in the diabetic woman a. decrease rapidly b. increase over 23 hours c. remain the same c - CORRECT ANSWER A woman 4 hours postpartum reports increasing, excruciating vulvar pain and severe rectal pressure. The patient is likely exhibiting symptoms of a a. Bartholin gland cyst b. vulvar edema c. vulvar hematoma b - CORRECT ANSWER A postpartum woman is being given Rh immune globulin (RhoGAM) at two days postpartum. The nurse should alert the woman to what possible side effects a. increased lochia for a few hours following administration b. Soreness at the injection site c. Temporary decrease in milk supply c - CORRECT ANSWER A patient who is breastfeeding inquires as to if she will be able to take her annual flu shot this year. The nurse should inform her that breastfeeding will have which of the following effect on the flu vaccine. a. decrease the efficacy of the vaccine slightly b. decrease the milk production for a few days c. There is no effect on the vaccine or the milk production a - CORRECT ANSWER Vitamin K injection is necessary because of which of the following states present in the first few days of life? a. Absence of normal flora in the gut for synthesis of Vitamin K b. Coagulation factors are unstable c. The newborn liver does not have complete physiologic function b - CORRECT ANSWER To assess the fontanelles , the newborn should be in what position? a. lying flat on the back b. sitting upright c. turned to ones side a - CORRECT ANSWER A normal breathing pattern for a two hour old neonate may include a. periodic breathing b. seesaw breathing c. tachypnea b - CORRECT ANSWER A woman with diabetes delivers a male at 36 6/7 weeks weighing 3300 grams. Her newborn is a. preterm appropriate for gestational age b. preterm large for gestational age c. term small for gestational age b - CORRECT ANSWER During a gestational age assessment, the square window is at 90 degrees. This indicates that the newborn is a. postterm b. preterm c. term a - CORRECT ANSWER The fetus of a mother who has systemic lupus erythematosus is at increased risk for a. congenital heart block b. limb abnormalities c. microcephaly b - CORRECT ANSWER During the initial assessment of a newborn, the nurse palpates the femoral pulses and notes that they are decreased bilaterally. The nurse knows that this indicates a. normal finding s for the first few hours of life b. coarctation of the aorta and requires follow-up c. stenosis of the aorta and requires follow-up b - CORRECT ANSWER The nurse tells the mother of a 36 hour old neonate that her newborn has breastfeeding jaundice. The nurse should recommend to the mother to a. discontinue breastfeeding for 24 hours b. encourage breastfeeding every 2-3 hours c. offer water between breastfeeding c - CORRECT ANSWER The neonate whose mother is infected with varicella virus (chicken pox) within 5 days of the onset of labor should receive a. acyclovir b. sulfadiazine c. Varicella Zoster immune globulin (Vzig) a - CORRECT ANSWER A complication of a neonate who is born with chlamydia is a. conjunctivitis b. skin rash c. respiratory distress a - CORRECT ANSWER When a newborn is born to a mother with HIV, the appropriate test to perform is a/an a. DNA PCR test before 48 hours of age b. Elisa testing at birth with cord blood c. Western blot test before discharge a - CORRECT ANSWER When bottle feeding a newborn, which type of formula is recommended by the AAP and ACOG? a. iron fortified b. iron free c. low iron fortified b - CORRECT ANSWER In the event a nurse engages in touching a patient without consent, the legal charge would be a. assault b. battery c. trespassing c - CORRECT ANSWER The means of insuring enforcement of the nurse practice act is through the a. employer b. state legislature c. state board of nursing c - CORRECT ANSWER When a research finding is determined not likely to occurred by the chance alone, this is termed a. a best practice b. evidence - based c. statistically significant c - CORRECT ANSWER Most medical and nursing errors occur because of a. lack of education b. non-adherence to standard of care c. system failures