Test Bank for Maternity and Pediatric Nursing 5th Edition Exam Questions & Multiple Choices with Correct Answers 2025/2026

Test Bank for Maternity and Pediatric Nursing 5th Edition Exam Questions & Multiple Choices with Correct Answers 2025/2026 A 14-year-old boy is at the pediatric clinic for a checkup. What physical changes of puberty will the nurse indicate are related to the production of testosterone? a. Stimulation of production of white cells and platelets b. Promotion of growth of small bones c. Increase in muscle mass and strength d. Decrease in production of sebaceous gland secretions - ANS-C The nurse is educating high school students about puberty. What will the nurse indicate regulates the production of sperm and secretion hormones? a. Testes b. Vas deferens c. Ejaculatory ducts d. Prostate gland - ANS-A . The nurse is speaking with a couple trying to conceive a child. What will the nurse remind the couple is a factor that can decrease sperm production? a. Infrequent sexual intercourse b. The man not being circumcised c. The penis and testes being small d. The testes being too warm - ANS-D When describing the female reproductive tract to a pregnant woman, the nurse would explain that which uterine layer is involved in implantation? a. Perimetrium b. Endometrium c. Myometrium d. Internal os - ANS-B A group of nursing students plans to teach a class of sixth-grade girls about menstruation. What correct information will the nursing students teach to the class? a. Menarche usually occurs around 12 years of age. b. Ovulation occurs regularly from the very first cycle. c. A regular cycle is established by the third period. d. Typically, menstrual flow is heavy and lasts up to 10 days. - ANS-A A 10-year-old girl asks the nurse, what is the first sign of puberty? What is the correct nursing response? a. An increase in height b. Breast development c. Appearance of axillary hair d. The first menstrual period - ANS-B A 12-year-old female pediatric patient experienced menarche 3 months ago. Her mother voices concern to the pediatric office nurse regarding the irregularity of her daughter’s menstrual cycle. What is the nurse’s best response? a. Worrying is not the answer. b. I will talk to the pediatrician about a gynecological referral. c. I can only discuss this with your daughter. d. Early cycles are often irregular. - ANS-D Which hormone initiates the maturation of the ovarian follicle? a. Estrogen b. Follicle-stimulating hormone c. Progesterone d. Luteinizing hormone - ANS-B What statement indicates a woman has correct information about oogenesis? a. Women make fewer ova as they age. b. Women have all of their ova at the time they are born. c. Ova production begins at birth and continues until puberty. d. new ova are made every month from puberty to climacteric. - ANS-B A pregnant woman asks the nurse; Will I be able to have a vaginal delivery? The nurse knows that which is the most favorable pelvic type for vaginal birth? a. Gynecoid b. Android c. Anthropoid d. Platypelloid - ANS-A A mother is anxious about her ability to breastfeed after her child is born because of her small breast size. What would be an important point to teach this mother? a. Milk is produced in ducts and lobules regardless of breast size. b. Supplementing breastfeeding with formula allows the infant to receive adequate nutrition. c. Breast size can be increased with exercise. d. Drinking extra milk during pregnancy allows breasts to produce adequate amounts of milk. - ANS-A For what is the decrease in estrogen and progesterone during the menstrual cycle responsible? a. Degeneration of the corpus luteum b. Ovulation c. Follicle maturation d. Shedding of the endometrium - ANS-D The nurse is assisting with pelvic inlet measurements on a pregnant woman. What measurement will NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 15 provide the nurse with information about whether the woman can deliver vaginally? a. Diagonal conjugate b. Obstetric conjugate c. Transverse diameter d. Anteroposterior diameter - ANS-B The nurse has explained menstruation to a 13-year-old girl. What statement indicates the girl needs additional education? a. Periods last about 5 days. b. My cycle should get regular in 6 months. c. I should expect heavy bleeding with clots. d. Periods come about every 4 weeks. - ANS-C A mother asks the nurse, when will I know my child has entered puberty? What will the nurse state based on an understanding of changes associated with puberty? NURSINGTB.COM a. Your daughter will have her first period. b. You’ll recognize puberty by the mood swings. c. The child becomes interested in the opposite sex. d. Secondary sex characteristics, such as pubic hair, appear. - ANS-D A nurse is planning to teach couples about the physiology of the sex act. What correct information will the nurse provide? a. Fertilization of an ovum requires penetration by several sperm. b. An ovum must be fertilized within 24 hours of ovulation. c. It takes 4 to 5 days for sperm to reach the fallopian tubes. d. Sperm live for only 24 hours following ejaculation. - ANS-B A newly married couple tells the nurse they would like to wait a few years before starting a family. Which NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 16 statement made by the man indicates an understanding about sexual activity and pregnancy? a. My wife can’t get pregnant if I withdraw before climax. b. A man can secrete semen before ejaculation. c. If we dont have intercourse very often, my wife won’t get pregnant. d. It is safe to ejaculate outside the vagina. - ANS-B The nurse is aware that the diagonal conjugate is 12 centimeters. What is the measurement in centimeters of the obstetric conjugate? a. 10 to 10.5 b. 11 to 11.5 c. 12.5 to 13 d. 14 to 14.5 - ANS-A The nurse uses a diagram to demonstrate the fimbriae when teaching nursing students about the female anatomy. What is true about fimbriae? a. They form the passageway for the sperm to meet the ovum. NURSINGTB.COM b. They are the site of fertilization. c. They are fingerlike projections that capture the ovum. d. They propel the egg through the fallopian tube. - ANS-C . What will the nurse explain to a 12-year-old patient when describing what characterizes nocturnal emissions? a. A drop in testosterone level b. Sexual stimulation c. Absence of sperm in ejaculate d. Association with violent dreams - ANS-C The nurse is educating a pregnant patient who expects to breastfeed. The nurse knows that when a patient breastfeeds, which portions of the breast secrete milk? NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 17 a. Lactiferous sinuses b. Lobes c. Montgomery’s glands d. Alveoli - ANS-D Where are the secretions responsible for nourishing sperm excreted from? a. Vas deferens b. Epididymis c. Cowpers gland d. Scrotum - ANS-C What signifies the end of puberty for a male? a. Facial hair is evident. b. Erections can be sustained. c. Ejaculate is greater than 5 mL. d. Mature sperm are formed. - ANS-D How long does sperm remain viable in the female reproductive tract? a. 12 hours b. 1 day c. 2 days d. 4 days - ANS-D The nurse encourages the members of a prenatal class to seriously consider breastfeeding. What does breast milk provide in addition to nourishment for the infant? a. Maternal antibodies b. Stimulus for red blood cell production c. Endorphins that soothe the infant d. Hormones that stimulate growth - ANS-A A female patient reports her menstrual cycle consistently occurs every 32 days. What day of her cycle can the woman anticipate ovulation? a. 14 b. 16 c. 18 d. 20 - ANS-C The nurse conducting a sex education class for junior high students describes some cultural rites celebrating the entry to adulthood. What information would the nurse include? (Select all that apply.) a. Bar mitzvah b. Displays of bravery c. Receiving part of their inheritance d. Ritual circumcision e. Displays of self-defense - ANS-A, B, D, E The nurse is reading a pregnant patient’s history and physical. What information does the nurse recognize might indicate the need for a cesarean delivery? (Select all that apply.) a. History of childhood rickets b. Immobile coccyx c. Prepregnant weight of 100 pounds d. Avid horse rider e. Pelvic fracture 3 years ago - ANS-A,B,E What are considered to be functions of the fallopian tubes? (Select all that apply.) NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 19 a. Passage for sperm to meet ova b. Passage for ovum to uterus c. Safe environment for zygote d. Restriction for only one ovum to enter uterus e. Site for fertilization - ANS-A,B,C,E The nurse is providing an in-service to students beginning their obstetric clinical rotation. Using a diagram, the nurse points out parts of the female pelvis. What will the nurse include? (Select all that apply.) a. Two innominates b. Obstetric conjugate c. Sacrum d. Perimetrium e. Coccyx - ANS-A,C,E The nurse explains that testosterone is responsible for males exceeding females in which aspects? (Select all that apply.) a. Strength b. Height c. Mental concentration d. Hematocrit levels e. Agility - ANS-A, B, D . A patient is being seen by her health care provider for a suspected vaginal infection. What will the nurse include when educating this patient on factors that affect the vaginal pH? (Select all that apply.) a. Antibiotic therapy b. Frequent douching c. Exercise d. Jet lag e. Use of vaginal sprays - ANS-A,B,E When the nurse reads in the history and physical of a pregnant patient that she has a platypelloid pelvis, the nurse is aware that this pelvis has a narrow _____________ diameter, making a vaginal birth unlikely. - ANS-anteroposterior In males the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH) from the anterior pituitary stimulate testosterone production in the ________ cells of the testes. - ANS-Leydig The ___________ is a period of years during which the woman’s ability to reproduce gradually declines - ANS-climacteric Where the labia majora and the labia minora meet is known as the fourchette or ___________________ __________ - ANS-obstetrical perineum The nurse outlines the phases of the sexual response. Arrange the phases in order of occurrence. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Nipples become erect. b. Involuntary muscle spasms occur. c. Engorgement resolves. d. Heart rate slows. e. Skin flushes. - ANS-A, E, B, C, D What is the total number of chromosomes contained in a mature sperm or ovum? a. 22 b. 23 c. 44 d. 46 - ANS-B . A pregnant woman states, My husband hopes I will give him a boy because we have three girls. What will the nurse explain to this woman? a. The sex chromosome of the fertilized ovum determines the gender of the child. b. When the sperm and ovum are united, there is a 75% chance the child will be a girl. c. When the pH of the female reproductive tract is acidic, the child will be a girl. d. If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced. - ANS-D . What is the most common site for fertilization? a. Lower segment of the uterus b. Outer third of the fallopian tube near the ovary c. Upper portion of the uterus d. Area of the fallopian tube farthest from the ovary - ANS-B The embryo is termed a fetus at which stage of prenatal development? a. 2 weeks b. 4 weeks c. 9 weeks d. 16 weeks - ANS-ANS: C The fetus (third stage of prenatal development) begins at the ninth week and continues until the 40th week of gestation or until birth. The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus? a. One umbilical vein b. Two umbilical veins c. One umbilical artery d. Two umbilical arteries - ANS-A Where is the usual location for implantation of the zygote? a. Upper section of the posterior uterine wall b. Lower portion of the uterus near the cervical os c. Inner third of the fallopian tube near the uterus d. Lateral aspect of the uterine wall - ANS-A What is the embryonic membrane that contains fingerlike projections on its surface, which attach to the uterine wall? a. Amnion b. Yolk sac c. Chorion d. Decidua basalis - ANS-C Which hormone is responsible for converting the endometrium into decidual cells for implantation? a. Estrogen b. Human chorionic gonadotropin c. Human placental lactogen d. Progesterone - ANS-D A patient asks the nurse when her infant’s heart will begin to pump blood. What will the nurse reply? a. By the end of week 3 b. Beginning in week 8 c. At the end of week 16 d. Beginning in week 24 - ANS-A What organ does the ductus venosus shunt blood away from in fetal circulation? a. Liver b. Heart c. Lungs d. Kidneys - ANS-A What complication can result from untreated respiratory distress in the newborn? a. Esophageal atresia b. Gastric dilation c. Cold stress d. Reopening of the foramen ovale - ANS-D During an ultrasound, two amnions and two placentas are observed. What will be the most likely result of this pregnancy? a. Dizygotic twins b. Monozygotic twins c. Conjoined twins d. High birth-weight twins - ANS-A A woman who is 25 weeks pregnant asks the nurse what her fetus looks like. What does the nurse explain is one physical characteristic present in a 25-week-old fetus? a. Lanugo covering the body b. Constant motion c. Skin that is pink and smooth d. Eyes that are closed - ANS-A At what point in prenatal development do the lungs begin to produce surfactant? a. 17 weeks b. 20 weeks c. 25 weeks d. 30 weeks - ANS-C A woman missed her menstrual period 1 week ago and has come to the doctor’s office for a pregnancy test. Which placental hormone is measured in pregnancy tests? a. Progesterone b. Estrogen c. Human chorionic gonadotropin d. Human placental lactogen - ANS-C When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent? a. Congenital heart defects b. Neural tube defects c. Mental retardation d. Premature birth - ANS-B The nurse is educating a class of expectant parents about fetal development. What is considered fetal age of viability? a. 14 weeks b. 20 weeks c. 25 weeks d. 30 weeks - ANS-B The nurse is presenting a conference on gene dominance. What does the nurse report as the percentage of children carrying the dominant gene if one parent has a dominant gene and the other parent does not? a. 10% b. 25% c. 50% d. 100% - ANS-C The nurse explains that the birth weight of monozygotic twins is frequently below average. What is the most likely cause? a. Inadequate space in the uterus b. Inadequate blood supply c. Inadequate maternal health d. Inadequate placental nutrition - ANS-D The school nurse is counseling a group of adolescent girls. What does the nurse explain about sperm ejaculated near the cervix? a. They are destroyed by the acidic pH of the vagina. b. They survive up to 5 days and can cause pregnancy. c. They lose their motility in about 12 hours after intercourse. d. They are usually pushed out of the vagina by the muscular action of the vaginal wall. - ANS-B What does the nurse explain can affect the survival of the X- and Y-bearing sperm after intercourse? a. Age b. Estrogen level c. Body temperature d. Level of feminine hygiene - ANS-B Of what is the normal umbilical cord comprised? a. 1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetus b. 1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetus c. 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus d. 2 arteries carrying blood to the fetus and 2 veins carrying blood away from the fetus - ANS-C What part of the fetal body derives from the mesoderm? a. Nails b. Oil glands c. Muscles d. Lining of the bladder - ANS-C A couple just learned they are expecting their first child and are curious if they are having a boy or a girl. At what point of development can the couple first expect to see the sex of their child on ultrasound? a. 4 weeks gestational age b. 6 weeks gestational age c. 10 weeks gestational age d. 16 weeks gestational age - ANS-C A nurse is teaching a lesson on fetal development to a class of high school students and explains the primary germ layers. What are the germ layers? (Select all that apply.) a. Ectoderm b. Endoderm c. Mesoderm d. Blastoderm e. Blastoderm - ANS-A,B,C What are the functions of amniotic fluid? (Select all that apply.) a. Maintaining an even temperature b. Impeding excessive fetal movement c. Lubricating fetal skin d. Acting as a reservoir for nutrients e. Acting as a cushion for the fetus - ANS-A,E A patient at the obstetric office has just learned she is pregnant with dizygotic twins. What facts will the nurse include when educating this patient? (Select all that apply.) a. Dizygotic twins are the same sex. b. Dizygotic twins share a placenta. c. Dizygotic pregnancies tend to repeat in families. d. Dizygotic twins have separate chorions. e. Dizygotic twin incidence decreases with maternal age. - ANS-C,D The nurse explains that prior to fertilization each cell is reduced from 46 chromosomes to 23 chromosomes. This is referred to as the __________ number. - ANS-haploid The component of development that programs the genetic code into the nucleus of the cell is ____________. - ANS-DNA . The vessels comprising the umbilical cord are cushioned and protected by a substance called ___________ _____________. - ANS-Whartons jelly The normal volume of amniotic fluid is approximately _______________ mL at 37 weeks' gestation. - ANS-1000 . Organize the developmental stages in the correct order. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Fetus b. Zygote c. Embryo d. Blastocyst e. Morula - ANS-B, E, D, C, A Put the embryonic/fetal characteristics in the correct order of occurrence from week 3 to week 36 of gestation. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Subcutaneous fat is present. b. Bone marrow forms blood cells. c. Spinal cord and brain appear. d. Skull and jaw ossify. e. Neural tube closes. - ANS-C, E, D, B, A A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old son and had one previous spontaneous abortion. How would the nurse document the patient’s obstetric history using the TPALM system? a. Gravida 2, para 20120 b. Gravida 3, para 10011 c. Gravida 3, para 10110 d. Gravida 2, para 11110 - ANS-C A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy. How frequently will the nurse assist the patient to schedule these appointments? a. Every 3 weeks until the 6th month, then every 2 weeks until delivery b. Every 4 weeks until the 7th month, after which appointments will become more frequent c. Monthly until the 8th month d. Every 2 to 3 weeks for the entire pregnancy - ANS-B During the physical examination for the first prenatal visit, it is noted that Chadwicks sign is present. What is Chadwicks sign? a. bluish or purplish discoloration of the vulva, vagina, and cervix b. Presence of early fetal movements c. Darkening of the areola and breast tenderness d. Palpation of the fetal outline - ANS-A After the examination is completed, the patient asks the nurse why Chadwicks sign occurs during pregnancy. What would the nurse explain as the cause of Chadwicks sign? a. Enlargement of the uterus b. Progesterone action on the breasts c. Increasing activity of the fetus d. Vascular congestion in the pelvic area - ANS-D The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that the woman understands the information? a. Blood pressure goes up toward the end of pregnancy. b. My breathing will get deeper and a little faster. c. Ill notice a decreased pigmentation in my skin. d. There will be a curvature in the upper spine area. - ANS-B A woman reports that her last normal menstrual period began on August 5, 2013. What is this woman’s expected delivery date using Angeles rule? a. April 30, 2014 b. May 5, 2014 c. May 12, 2014 d. May 26, 2014 - ANS-C During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler device. How early might fetal heart tones be detected with an electronic Doppler device? a. 4 weeks b. 8 weeks c. 10 weeks d. 14 weeks - ANS-C In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. What are the nurses first action? a. Ask if the patient has taken a sedative. b. Notify the physician. c. Turn the patient to her right side. d. Record the rate as a normal finding. - ANS-D A woman’s prepregnant weight is determined to be average for her height. What will the nurse advise the woman regarding recommended weight gain during pregnancy? a. 10 to 20 pounds b. 15 to 25 pounds c. 25 to 35 pounds d. 28 to 40 pounds - ANS-C When the nurse tells a pregnant woman that she needs 1200 mg of calcium daily during pregnancy, the woman responds, I don’t like milk. What dietary adjustments could the nurse recommend? a. Increase intake of organ meats. b. Eat more green leafy vegetables. c. Choose more fresh fruits, particularly citrus fruits. d. Include molasses and whole-grain breads in the diet. - ANS-B A pregnant woman is experiencing nausea in the early morning. What recommendations would the nurse offer to alleviate this symptom? a. Eat three well-balanced meals per day and limit snacks. b. Drink a full glass of fluid at the beginning of each meal. c. Have crackers handy at the bedside, and eat a few before getting out of bed. d. Eat a bland diet and avoid concentrated sweets. - ANS-C The patient who is 28 weeks pregnant shows a 10-pound weight gain from 2 weeks ago. What are the nurses initial action? a. Assess food intake. b. Weigh the patient again. c. Take the blood pressure. d. Notify the physician. - ANS-C The patient remarks that she has heard some foods will enhance brain development of the fetus. The nurse replies that foods high in docosahexaenoic acid (DHA) are thought to enhance brain development. What food can the nurse recommend? a. Fried fish b. Olive oil c. red meat d. Leafy green vegetables - ANS-C The nurse encourages adequate intake of folic acid for women of childbearing age before and during pregnancy. What is folic acid thought to decrease the incidence of in fetal development? a. Structural heart defects b. Craniofacial deformities c. Limb deformities d. Neural tube defects - ANS-D A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy? a. Amenorrhea b. Uterine enlargement c. HCG detected in the urine d. Fetal heartbeat - ANS-D At her initial prenatal visit, a woman asks, when can I hear the baby’s heartbeat? At what gestational age can the fetal heartbeat be auscultated with a specially adapted stethoscope or fetoscope? a. 4 weeks NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 35 b. 12 weeks c. 18 weeks d. 24 weeks - ANS-C A woman pregnant for the first time asks the nurse, when will I begin to feel the baby move? What is the nurse’s best response? a. You may notice the baby moving around the 4th or 5th month. b. Quickening varies with every woman. c. You’ll feel something by the end of the first trimester. d. The baby will be big enough for you to feel in your 8th month. - ANS-A A pregnant woman inquiry about exercising during pregnancy. What information should the nurse include when planning to educate this woman? a. Exercise elevates the mother’s temperature and improves fetal circulation. NURSINGTB.COM b. Exercise increases catecholamines, which can prevent preterm labor. c. A regular schedule of moderate exercise during pregnancy is beneficial. d. Pregnant women should limit water intake during exercise. - ANS-C An ultrasound confirms that a 16-year-old girl is pregnant. How does the need for prenatal care and counseling for adolescents different from other age populations? a. A pregnant adolescent is experiencing two major life transitions at the same time. b. Adolescents who get pregnant are more likely to have other chronic health problems. c. Adolescents are at greater risk for multifetal pregnancies. d. At this age, a pregnant adolescent will accept the nurse’s advice. - ANS-A At what age is a woman who becomes pregnant for the first time described as an elderly primip? NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 36 a. After 25 years old b. After 28 years old c. After 30 years old d. After 35 years old - ANS-D The nurse explains that the softening of the cervix and vagina is a probable sign of pregnancy. What is the appropriate term for this sign? a. Chadwick’s b. Hegars c. McDonalds d. Goodells - ANS-D When obtaining a prenatal history on a pregnant patient the nurse notes a family history of sickle cell disease. Given this information, what lab test can the nurse anticipate the physician will order? a. Endovaginal ultrasound b. Pap test c. Complete blood count d. Hemoglobin electrophoresis - ANS-D A pregnant woman is attending her second postpartum visit. Prenatal lab work indicates she is not immune to the rubella virus. What is the most appropriate nursing intervention? a. Provide the rubella vaccine as ordered by the physician immediately. b. Inform the woman she should receive the vaccine in the hospital after delivery. c. Hold all immunizations until 1 month postpartum. d. Encourage the patient to decide whether or not to get the rubella vaccine prenatally. - ANS-B A woman who is 37 weeks pregnant reports feeling dizzy when lying on her back. What does the nurse NURSINGTB.COM NURSINGTB.COM INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 37 explain as the most likely cause of this symptom? a. Supine hypotension syndrome b. Gestational diabetes c. Pregnancy-induced hypertension d. Malnutrition - ANS-A A woman who is 36 weeks pregnant tells the nurse she plans to take a 12-hour flight to Hawaii. What would the nurse recommend that the patient does during the flight? (Select all that apply.) a. Wear tight-fitting clothing to promote venous return. b. Eat a large meal before boarding the flight. c. Request a seat with greater leg room. d. Drink at least 4 ounces of water every hour. e. Get up and walk around the plane frequently. - ANS-C,D,E . The nurse cautions the patient that, because of hormonal changes in late pregnancy, the pelvic joints relax. What does this result in? (Select all that apply.) a. Waddling gait b. Joint instability c. Urinary frequency d. Back pain e. Aching in cervical spine - ANS-A,B The nurse assesses the progress from the announcement stage of fatherhood to the acceptance stage when the patient reports which actions by the father? (Select all that apply.) a. Goes fishing every afternoon b. Has revised his financial plan c. Spends leisure time with his friends d. Traded his sports car for a sedan e. Helped select a crib - ANS-B,D,E What nursing interventions are appropriate for the prenatal patient in terms of prenatal care? (Select all that apply.) a. Offer nutritional counseling. b. Reinforce responsibility of parenthood. c. Reduce risk factors. d. Improve health practices. e. Make financial arrangements for delivery. - ANS-A,B,C,D The nurse recognizes which behavior characteristic(s) of women in their first trimester of pregnancy? (Select all that apply.) a. Showing off her sonogram photos b. Ambivalence about pregnancy c. Emotional and labile mood d. Focusing on her infant e. Fatigue - ANS-A,B,C,E The number of years between menarche and the date of conception is known as ___________________ age. - ANS-gynecological The patient confesses to eating crushed ice 10 or 12 times daily. The nurse assesses this behavior as __________. - ANS-Pica The nurse is aware that ______________ maneuver can assess the position and presentation of the fetus. - ANS-Leopolds Fathers go through phases similar to the expectant mother. Place the following phases in order from first to last. a. Focus phase b. Announcement phase c. Adjustment phase - ANS-B, C, A A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness? a. Hyperemesis gravidarum usually lasts for the duration of the pregnancy. b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances. c. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum. d. The woman with hyperemesis gravidarum will have persistent vomiting without weight loss. - ANS-B A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping. She reports passing some tissue. Cervical dilation is noted on examination. What is the most likely cause of these symptoms? a. Inevitable abortion b. Incomplete abortion c. Complete abortion d. Missed abortion - ANS-B The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for a missed abortion. What is the most appropriate statement by the nurse? a. There is usually something wrong with the fetus when this happens early in pregnancy. b. Now there. You can try to conceive on your next cycle. c. I’m here if you need to talk. d. You are young and strong. I know you can have a healthy pregnancy - ANS-C . A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. Which statement indicates that the woman understands the explanation of an ectopic pregnancy? a. The chorionic villi develop vesicles within the uterus. b. The placenta develops in the lower part of the uterus. c. The fetus dies in the uterus during the first half of the pregnancy. d. The embryo is implanted in the fallopian tube. - ANS-D An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. What does the nurse understand best describes this condition? a. Low-lying placenta b. Marginal placenta previa c. Partial placenta previa d. Total placenta previa - ANS-D What symptom presented by a pregnant woman is indicative of abruptio placentae? a. Painless vaginal bleeding b. Uterine irritability with contractions c. Vaginal bleeding and back pain d. Premature rupture of membranes - ANS-C What situation would concern the nurse about the presence of Rh incompatibility? a. Rh-negative mother, Rh-positive fetus b. Rh-positive mother, Rh-negative fetus c. Rh-negative mother, Rh-negative fetus d. Rh-positive mother, Rh-positive fetus - ANS-A A primigravida in her first trimester is Rh negative. What will this woman receive to prevent anti-Rh antibodies from forming? a. Rh immune globulin during labor b. Intrauterine transfusions with O-negative blood c. Rh immune globulin at 28 weeks and within 72 hours after the birth of a Rh-positive infant d. Rh immune globulin now and again in the last trimester - ANS-C A woman seeking prenatal care relates a history of macrosomic infants, two stillbirths, and polyhydramnios with each pregnancy. What does the nurse recognize these factors highly suggest? a. Toxoplasmosis b. Abruptio placentae c. Hydatidiform mole d. Diabetes mellitus - ANS-D A nurse is providing prenatal education. The nurse will explain that pregnancy affects glucose metabolism in what way? a. Placental hormones increase the resistance of cells to insulin. b. Insulin cells cannot meet the body’s demands as the woman’s weight increases. c. There is a decreased production of insulin during pregnancy. d. The speed of insulin breakdown is decreased during pregnancy. - ANS-A Why does the woman taking oral hypoglycemic agents to control diabetes mellitus need to take insulin during pregnancy? a. Insulin can cross the placental barrier to the fetus. b. Insulin does not cross the placental barrier to the fetus. c. Oral agents do not cross the placenta. d. Oral agents are not sufficient to meet maternal insulin needs. - ANS-B A pregnant woman comes to the clinic stating that she has been exposed to hepatitis B. She is afraid that her infant will also contract hepatitis B. What will the nurse explain to this woman? a. The infant will be given a single dose of hepatitis immune globulin after birth. b. The infant will be able to use the antibodies from the immunizations given to the patient before delivery. c. The infant will not have hepatitis B because the virus does not pass through the placental barrier. d. The infant will be immune to hepatitis B because of the mother’s infection. - ANS-A What will the nurse begin with when asking a patient about drug use during a prenatal history? a. Do you smoke, drink alcohol, or use drugs? b. Do you ever use prescription or street drugs? c. What over-the-counter and prescription drugs have you taken in the past 3 months? d. We need to know if you take drugs so we can help your baby. - ANS-C The nurse assesses a pregnant woman for pregnancy-induced hypertension. What is the first sign of fluid retention suggestive of this complication? a. Abdominal enlargement b. Facial swelling c. Sudden weight gain d. Swelling of the feet and ankles - ANS-C . A patient with gestational hypertension is exhibiting all of the signs below. What should the nurse report immediately? a. Diarrhea b. Urticaria c. Blurred vision d. Backache - ANS-C A patient who is 28 weeks pregnant presents with consistent hypertension. What need would the home health nurse make the first priority? a. Activity restriction b. Balanced nutrition c. Increased fluid intake to ensure adequate hydration d. Instruction about the effect of diuretics - ANS-A The nurse is caring for a pregnant woman diagnosed with preeclampsia. What will the nurse explain is the objective of magnesium sulfate therapy for this patient? a. To prevent convulsions b. To promote diaphoresis c. To increase reflex irritability d. To act as a saline cathartic - ANS-A The nurse is caring for a pregnant woman receiving an intravenous infusion with magnesium sulfate. What is the most appropriate nursing intervention? a. Count respirations and report a rate of less than 12 breaths/min. b. Count respirations and report a rate of more than 20 breaths/min. c. Check blood pressure and report a rate of less than 100/60 mm Hg. d. Monitor urinary output and report a rate of less than 100 mL/hr. - ANS-A What drug will the nurse plan to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient? a. Ergonovine maleate (Ergotrate) b. Oxytocin c. Calcium gluconate d. Hydralazine (Apresoline - ANS-C A woman who is 35 weeks pregnant has a total placenta previa. She asks the nurse; Will I be able to deliver vaginally? What explanation by the nurse is the most appropriate? a. Yes, you can deliver vaginally until 36 weeks. b. A vaginal delivery can be attempted, but if bleeding occurs, a cesarean section will be done. c. A cesarean section is performed when the mother has a total placenta previa. d. There is no reason why you cannot have a vaginal delivery. - ANS-C The nurse teaches a woman who is 8 weeks pregnant about how rubella can affect the developing fetus. What can result from maternal rubella during pregnancy? a. Facial abnormalities b. Mental retardation c. Liver failure d. Limb deformities - ANS-B What symptom reported by a pregnant patient would lead the nurse to suspect pyelonephritis? a. Frequency and urgency of urination b. Nausea and weight loss c. Burning sensation when voiding d. Tenderness in the flank area - ANS-D The nurse is caring for a prenatal patient diagnosed with a placenta previa. What is the best position for this patient? a. Flat on her back with knees flexed to help prevent hemorrhage b. On her side to prevent supine hypotension c. In the semi-Fowlers position to prevent supine hypotension d. In the knee-chest position to reduce pressure on the placenta - ANS-B The young prenatal patient with gestational diabetes mellitus (GDM) says, I am frightened that I will have to deal with insulin injections for the rest of my life. What is the best response by the nurse? a. After delivery your doctor will prescribe oral hypoglycemic medication to control your disease. Pills are so much simpler than insulin injections. b. Have you considered an insulin pump? c. After a while those insulin injections won’t seem so bad. d. It will most likely resolve 6 weeks or so after the baby is born. - ANS-D The nurse is preparing a pregnant patient for an abdominal ultrasound at 8 weeks gestation. What intervention will the nurse implement before this diagnostic test? a. Instruct the patient to take nothing by mouth after midnight the night before the test. b. Initiate an IV. c. Encourage the patient to drink 1 to 2 quarts of water before the test. d. Instruct the patient to remove all jewelry. - ANS-C The nurse is caring for a macrosomic newborn of a diabetic patient. What complications will the nurse assess for in the newborn? (Select all that apply.) a. Meconium ileus b. Diarrhea c. Hypoglycemia d. Muscle tremors e. Urine retention - ANS-C The nurse educates prenatal patients about the threat of TORCH infections. Which infections are included in this classification? (Select all that apply.) a. Toxoplasmosis b. Toxemia c. Cytomegalovirus d. Rubella e. Herpes simplex - ANS-A,C,D,E The nurse emphasizes to a patient with a high-risk pregnancy that the impact of such a pregnancy might result in which problems? (Select all that apply.) a. Disruption of family roles b. financial pressures c. Excessive attachment to infant d. Frustration with activity restriction e. Alteration in child care practices - ANS-A,B,D,E A patient who is 30 weeks pregnant delivers a stillborn child in the emergency department (ED). What should the ED nurse offer the patient? (Select all that apply.) a. Privacy b. An opportunity to hold the infant c. Materials about support groups d. A memento (footprint or lock of hair) e. A warm beverage - ANS-A,B,C,D What would the nurse include in a teaching plan for the pregnant patient who has iron deficiency anemia and has been placed on iron supplements? (Select all that apply.) a. Citrus fruits enhance absorption of iron. b. Bran products support iron deficiency. c. Milk will disguise the taste of the iron. d. The iron therapy will continue for about 3 months. e. Tea should be avoided while taking iron. - ANS-A,D,E The nurse takes into consideration that the patient with placenta previa is at risk for postpartum infection for what reasons? (Select all that apply.) a. Vaginal organisms can invade the placenta. b. The undernourished placenta becomes necrotic. c. The amniotic fluid can become infected. d. The placenta is an excellent growth medium. e. The misplaced placenta weakens the uterine wall. - ANS-A,D The nurse is obtaining history and physical information on a new patient attending her first prenatal visit. After recording current height, weight, and BMI, it is determined that the patient is obese. What complications related to obesity will the nurse assess this patient for during pregnancy? (Select all that apply.) a. Gestational diabetes b. RH Incompatibility c. Hypertension d. Pre-eclampsia e. Infection - ANS-A,C,D A woman, gravida 3, para 2, is attending her fourth prenatal visit and confides in the nurse that she is battered by her husband. She is assessed to have multiple bruises at various stages of healing. What nursing actions are appropriate for the nurse to implement? (Select all that apply.) a. Tell the husband that authorities will be notified immediately. b. Provide privacy for the assessment. c. Determine if children are being hurt. d. Communicate in a non-judgmental way. e. Determine factors that increase the risk of injury. - ANS-B,C,D,E The nurse cautions that the consumption of as few as ________ alcoholic drink(s) during pregnancy can lead to the loss of fetal brain cells. - ANS-2 The nurse explains that ___________ is a procedure in which an incompetent cervix is sutured closed to prevent its opening when the fetus presses against it. - ANS-cerclage _______________________ ________________________ is the leading cause of perinatal infections that have a high mortality rate. - ANS-Group B streptococcus (GBS) A(n) _________________________________ consists of a group of five fetal assessments: fetal heart rate and reactivity (the NST), fetal breathing movements, fetal body movements, fetal tone (closure of the hand), and volume of amniotic fluid. - ANS-biophysical profile What does the nurse note when measuring the frequency of a laboring woman’s contractions? a. How long the patient states the contractions last b. The time between the end of one contraction and the beginning of the next c. The time between the beginning and the end of one contraction d. The time between the beginning of one contraction and the beginning of the next - ANS-D Why is the relaxation phase between contractions important? a. The laboring woman needs to rest. b. The uterine muscles fatigue without relaxation. c. The contractions can interfere with fetal oxygenation. d. The infant progresses toward delivery at these times. - ANS-C What contraction duration and interval do the nurse recognize could result in fetal compromise? a. Duration shorter than 30 seconds, interval longer than 75 seconds b. Duration shorter than 90 seconds, interval longer than 120 seconds c. Duration longer than 90 seconds, interval shorter than 60 seconds d. Duration longer than 60 seconds, interval shorter than 90 seconds - ANS-C Vaginal examination reveals the presenting part is the infants head, which is well flexed on the chest. What is this presentation? a. Vertex b. Military c. Brow d. Face - ANS-A What does meconium-stained amniotic fluid indicate when the infant is in a vertex presentation? a. Fetal distress b. Fetal maturity c. Intact gastrointestinal tract d. Dehydration in the mother - ANS-A It is determined that the presenting part of the fetus is the buttocks. At delivery the fetus hips are flexed and the knees are extended. How would the nurse record this presentation? a. Complete breech b. Frank breech c. Double footling d. Buttocks presentation - ANS-B At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse knows that what indicates the beginning of true labor? a. Contractions that are relieved by walking b. Discomfort in the abdomen and groin c. A decrease in vaginal discharge d. Regular contractions becoming more frequent and intense - ANS-D While discussing labor and delivery during a prenatal visit, a primigravida asks the nurse when she should go to the hospital. What are the nurses most informative response? a. When you feel increased fetal movement b. When contractions are 10 minutes apart c. When membranes have ruptured d. When abdominal or groin discomfort occurs - ANS-C The nurse is caring for a woman in the first stage of labor. What will the nurse remind the patient about contractions during this stage of labor? a. They get the infant positioned for delivery. b. They push the infant into the vagina. c. They dilate and efface the cervix. d. They get the mother prepared for true labor. - ANS-C A woman is 7 cm dilated, and her contractions are 3 minutes apart. When she begins cursing at her birthing coach and the nurse, what does the nurse assess as the most likely explanation for the woman’s change in behavior? a. Labor has progressed to the transition phase. b. She lacked adequate preparation for the labor experience. c. The woman would benefit from a different form of analgesia. d. The contractions have increased from mild to moderate intensity. - ANS-A What is the function of contractions during the second stage of labor? a. Align the infant into the proper position for delivery b. Dilate and efface the cervix c. Push the infant out of the mother’s body d. Separate the placenta from the uterine wall - ANS-C What marks the end of the third stage of labor? a. Full cervical dilation b. Expulsion of the placenta and membranes c. Birth of the infant d. Engagement of the head - ANS-B Why should the nurse encourage the mother to void during the fourth stage of labor? a. A full bladder could interfere with cervical dilation. b. A full bladder could obstruct progress of the infant through the birth canal. c. A full bladder could obstruct the passage of the placenta. d. A full bladder could predispose the mother to uterine hemorrhage. - ANS-D The nurse observes the patient bearing down with contractions and crying out, the baby is coming! What is the best nursing intervention? a. Find the physician. b. Stay with the woman and use the call bell to get help. c. Send the woman’s partner to locate a registered nurse. d. Assist with deep breathing to slow the labor process. - ANS-B The nurse observes on the fetal monitor a pattern of a 15-beat increase in the fetal heart rate that lasts 15 to 20 seconds. What does this pattern indicate? a. A well-oxygenated fetus b. Compression of the umbilical cord c. Compression of the fetal head d. Uteroplacental insufficiency - ANS-A What is the most appropriate statement from the nurse when coaching the laboring woman with a fully dilated cervix to push? a. At the beginning of a contraction, hold your breath and push for 10 seconds. b. Take a deep breath and push between contractions. c. Begin pushing when a contraction starts and continue for the duration of the contraction. d. At the beginning of a contraction, take two deep breaths and push with the second exhalation. - ANS-D What is the most important nursing intervention during the fourth stage of labor? a. Monitor the frequency and intensity of contractions. b. Provide comfort measures. c. Assess for hemorrhage. d. Promote bonding. - ANS-C One-hour postdelivery the nurse notes the new mother has saturated three perineal pads. What is the most appropriate nursing action? a. Check the fundus for position and firmness. b. Report to the doctor immediately. c. Change the pads and chart the time. d. Time how long it takes to soak one pad. - ANS-A While caring for a laboring woman, the nurse notices a pattern of variable decelerations in fetal heart rate with uterine contractions. What is the nurse’s initial action? a. Stop the oxytocin infusion. b. Increase the intravenous flow rate. c. Reposition the woman on her side. d. Start oxygen via nasal cannula. - ANS-C . How should the nurse intervene to relieve perineal bruising and edema following delivery? a. Place an ice pack on the area for 12 hours. b. Place a warm pack on the perineal area for 24 hours. c. Administer aspirin to relieve inflammation. d. Change the perineal pad frequently. - ANS-A At 1 and 5 minutes of life, a newborns Apgar score is 9. What does the nurse understand that a score of 9 indicates? a. The newborn will require resuscitation. b. The newborn may have physical disabilities. c. The newborn will have above average intelligence. d. The newborn is in stable condition. - ANS-D The husband of a woman in labor asks, what does it mean when the baby is at minus 1 station? After giving an explanation, what statement by the husband indicates that teaching was effective? a. Fetal head is above the ischial spines. b. Fetal head is below the ischial spines. c. Fetal head is engaged in the mother’s pelvis. d. Fetal head is visible at the perineum. - ANS-A The nurse formulates a nursing diagnosis for a woman in the fourth stage of labor. What is the most appropriate nursing diagnosis? a. Pain related to increasing frequency and intensity of contractions. b. Fear related to the probable need for cesarean delivery. c. Dysuria related to prolonged labor and decreased intake. d. Risk for injury related to hemorrhage. - ANS-D The nurse is caring for a patient who is not certain if she is in true labor. How might the nurse attempt to stimulate cervical effacement and intensify contractions in the patient? a. By offering the patient warm fluids to drink b. By helping the patient to ambulate in the room c. By seating the patient upright in a straight-back chair d. By positioning the patient on her right side - ANS-B What is the best nursing action to implement when late decelerations occur? a. Reposition the patient to supine b. Decrease flow of intravenous (IV) fluids c. Increase oxygen to 10 L/minute d. Prepare to increase oxytocin drip - ANS-C What is the nurse primarily concerned about maintaining in the initial care of the newborn? a. Fluid intake b. Feeding schedule c. Thermoregulation d. Parental bonding - ANS-C A pregnant woman, gravida 2, para 1, tells the nurse she desires a VBAC (vaginal birth after cesarean section) with this pregnancy. What is the primary concern regarding complications for this patient during labor and birth? a. Eclampsia b. Placental abruption c. Congestive heart failure d. Uterine rupture - ANS-D The physician performs an amniotomy on a laboring woman. What will be the nurse’s priority assessment immediately following this procedure? a. Fetal heart rate b. Fluid amount c. Maternal blood pressure d. Deep tendon reflexes - ANS-A While caring for an Arab woman in labor, the nurse should provide cultural sensitivity through which interventions? (Select all that apply.) a. Provide for extreme modesty. b. Assign a male caregiver. c. Arrange for the husband/partner to participate in labor. d. Provide adequate pain control. e. Respect protective amulets. - ANS-A,D,E What are the advantages of a freestanding birth center? (Select all that apply.) a. Home-like setting b. Designed for high-risk pregnancies c. Lower costs d. Attended by certified obstetricians e. Immediate emergency access - ANS-A,C . What do late decelerations indicate? (Select all that apply.) a. A nonreassuring pattern b. Uteroplacental insufficiency c. Fetal heart depression d. Cord compression e. Head compression - ANS-A,B,C A pregnant woman arrives at the emergency department (ED) and reports she is in labor. After a thorough examination and diagnostic testing, it is determined to be false (prodromal) labor. What signs and symptoms would lead the nurse to suspect false (prodromal) labor? (Select all that apply.) a. Leaking of vaginal fluid b. Contractions intensify with ambulation c. pink spotting d. Painless tightening of abdominal muscles e. Cervix thick and not effaced - ANS-D,E After the pregnant woman is admitted to the labor suite, the nurse assesses the position of the infant as ROA; this means that the infants head is _________ __________ _________. - ANS-Right occiput anterior The nurse explains that the four Ps of the birth process are __________, __________, __________, and __________. - ANS-powers, passenger, passage, psyche After the membranes have ruptured, the nurse should assess the fetal heart rate (FHR) for ________ minute(s). - ANS-1 The nurse may assist the health care provider in determining the fetal position and presentation by abdominal palpations called _____________________________ _____________________________. - ANS-Leopolds maneuver A nursing student is observing prenatal exams in the office setting. The health care provider informs the student that the fetal position is LSA. The student interprets this as a ____________________ presentation. - ANS-Breech Using a diagram, the nurse demonstrates the sequence of the mechanisms of labor. Place the seven mechanisms of labor in sequential order. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Extension b. Engagement c. Descent d. Flexion e. Expulsion f. Internal rotation g. External rotation - ANS-C, B, D, F, A, G, E A nurse is teaching a childbirth preparation class. The group is discussing individual expression of labor pain. What statement is accurate about a patient’s expression of pain? a. It reduces the patient’s perception of pain. b. It is intensified by the vertex position of the fetus. c. It is influenced by culture. d. It can be completely controlled by nonpharmacological techniques. - ANS-C What chemical substance(s) produced in the body acts as a natural pain reliever? a. Endorphins b. Morphine c. Codeine d. Atropine - ANS-A A nurse instructs a woman’s labor coach to comfort her by firmly pressing on her lower back. What is this technique? a. Sacral pressure b. Distraction c. Effleurage d. Conscious relaxation - ANS-A A woman who is 6 cm dilated has the urge to push. What will the nurse instruct the woman to do during the contraction? a. Use slow-paced breathing. b. Hold her breath and push. c. Blow in short breaths. d. Use rapid-paced breathing. - ANS-C Several hours into labor, a woman complains of dizziness, numbness, and tingling of her hands and mouth. What does the nurse recognize these symptoms signify? a. Hypertension b. Anxiety c. Anoxia d. Hyperventilation - ANS-D What is the most appropriate nursing action to take when a laboring woman hyperventilates? a. Help her breathe into her cupped hands. b. Place her flat on her back. c. Initiate oxygen at 2 liters via mask. d. Notify the doctor. - ANS-A A woman in the transition phase of labor requests a narcotic analgesic medication for pain relief. What should the nurse explain regarding giving a narcotic analgesic medication at this stage of labor? a. It can cause medication given at later stages to be ineffective. b. It will have no complications for the mother or infant. c. It may result in respiratory depression to the newborn. d. It will speed up labor and increase pain. - ANS-C What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions? a. Offer warm liquids to the patient. b. Encourage the patient to pant. c. Engage the patient in conversation. d. Assist the patient to the knee-chest position. - ANS-B A woman in labor will receive general anesthesia prior to cesarean section. The nurse reminds the patient that food and fluids need to be restricted for several hours prior to delivery. What will this prevent? a. Nausea and vomiting b. Vomiting and aspiration c. Abdominal cramping d. Intestinal obstruction - ANS-B What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman? a. Bladder for distention b. Blood pressure c. Sensation in the lower extremities d. Intravenous fluid flow rate - ANS-B A woman in labor has had an epidural block for pain relief. The nurse will be assessing carefully for what associated side effect of this type of regional anesthesia? a. Reduced fetal heart rate b. Long, intense contractions c. Sudden leg cramps d. Bladder distention - ANS-D Which narcotic antagonist is used to reverse narcotic-induced respiratory depression? a. Hydroxyzine (Vistaril) b. Phenobarbital c. Naloxone (Narcan) d. Nitrous oxide - ANS-C The nurse is preparing a teaching plan for a woman receiving a subarachnoid block before delivery. What nursing action will be included in this plan to prevent the associated side effect of this type of anesthesia? a. Restrict oral fluids. b. Keep legs flexed. c. Walk with assistance as soon as possible. d. Lie flat for several hours. - ANS-D A woman requests a pudendal block to manage her labor pain. What statement by the woman indicates a need for further explanation about the pudendal block? a. I’m having a contraction. Can I get the pudendal block now? b. I’ll get the pudendal block right before I deliver. c. The nurse midwife will insert the needles into my vagina. d. It takes a few minutes after the medicine is administered to make me feel numb. - ANS-A An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She received little prenatal care and had no childbirth preparation. She is crying loudly and shouting, please give me something for the pain. I can’t take the pain! What is the priority nursing diagnosis? a. Pain related to uterine contractions b. Knowledge deficit related to the birth experience c. Ineffective coping related to inadequate preparation for labor d. Risk for injury related to lack of prenatal care - ANS-A The nurse who encourages the gate control theory of pain control would advise a woman in labor and her partner to use which nonpharmacological method of pain management? a. Slow abdominal breathing b. Guided relaxation c. Listening to music d. Massage - ANS-D When a pregnant woman arrives at the labor suite, she tells the nurse that she wants to have an epidural for delivery. What is a contraindication to an epidural block? a. Abnormal clotting b. Previous cesarean delivery c. History of migraine headaches d. History of diabetes mellitus - ANS-A The nurse coaches the primigravida not to bear down until the cervix is completely dilated. What may premature bearing down cause? a. Increased use of oxygen b. Cervical laceration c. Uterine rupture d. Compression of the cord - ANS-B What is the Dick-Read method of childbirth preparation based on? a. Mild sedation throughout labor b. Relaxation techniques c. Skin stimulation d. Deep massage - ANS-B The nurse is instructing a Lamaze class on abdominal breathing and tells a patient that her baseline respiratory rate is 22 breaths per minute. What should be the patient’s rate while performing slow breathing? a. 9 b. 11 c. 15 d. 20 - ANS-B What is the least amount of sensation that one perceives as pain? a. Tolerance b. Threshold c. Level d. Abatement - ANS-B The nurse is caring for a laboring patient who is not reporting pain. What sign would alert the nurse of the need for pain relief? a. Frequently asking for ice chips b. Facial grimacing c. Changing positions in bed d. Covering her face with her hands - ANS-B A patient who received an epidural block asks why her blood pressure is taken so often. What is the nurses best response to explain the frequent blood pressure assessments? a. They ensure that unsafe levels of hypertension do not occur. b. They help assess for the need for further pain relief. c. They monitor the progress of labor. d. They ensure adequate placental perfusion. - ANS-D A laboring patient requests hot and cold applications be applied to her abdomen for pain control. How will this intervention act to control pain? a. By increasing endorphin production b. By facilitating effacement and dilation c. By producing increasing pain tolerance d. By stimulation of large nerve fibers - ANS-D When caring for the laboring patient, the nurse determines that the fetus is located in the right occiput posterior (ROA). What will the nurse anticipate? a. Urinary retention b. Severe lower back pain c. A shorter labor process d. Nausea - ANS-B What typical types of classes are available to help expectant parents prepare for parenthood? (Select all that apply.) a. Infant care b. Breastfeeding c. Gestational diabetes d. Sources of financial aid e. Yoga - ANS-A,B,C What breathing techniques would the nurse teach the prenatal patient to help her focus during labor in order to reduce pain? (Select all that apply.) a. First stage breathing b. Abdominal breathing c. Fourth stage breathing d. Modified pace breathing e. Patterned paced breathing - ANS-A,B,D,E How does the pain of childbirth differ from other types of pain? (Select all that apply.) a. Childbirth pain is part of a normal process. b. Childbirth pain seldom needs narcotic relief. c. Position changes relieve pain and facilitate delivery. d. Childbirth pain declines following birth. e. Childbirth pain is self-limited. - ANS-A, C, D,E . Which are nonpharmacological forms of pain relief? (Select all that apply.) a. Skin stimulation b. Diversion and distraction c. Breathing techniques d. Exercise e. Yoga - ANS-A,B,C Which position(s) and exercise(s) will the nurse teach as beneficial in combating discomfort in the later stages of pregnancy? (Select all that apply.) a. Leg lifts b. Pelvic rock c. Tailor sitting d. Sit-ups e. Shoulder curling - ANS-B, C, E The nurse is providing a conference on nonpharmacological pain control methods. What major advantages of nonpharmacological pain control methods will the nurse include in the presentation? (Select all that apply.) a. They sedate the mother. b. They do not slow labor. c. They do not dull the excitement of the birth experience. d. They do not have the potential to cause allergic reactions. e. They do not have to be delayed until labor is well established. - ANS-B, C, D.E The nurse is caring for a woman with epidural anesthesia for pain control during a vaginal delivery. A risk for injury related to epidural anesthesia has been identified by the nursing staff. What interventions are appropriate for the nurse to implement related to this diagnosis? (Select all that apply.) a. Assess leg movement and sensation before ambulating. b. Administer antibiotic as ordered. c. Observe for signs of impending birth. d. Provide sacral pressure as needed. e. Assess fetal position frequently. - ANS-A, C The physician has ordered Fentanyl (Sublimaze) for a woman in labor and has asked the nurse to provide patient education. What will the nurse include in the educational plan? (Select all that apply.) a. Onset is slow. b. Duration is short. c. Administration is by mouth. d. No known side effects. e. It is not the same drug as sufentanil. - ANS-B, E The amount of pain a person is willing to endure is referred to as ______________ ______________. - ANS-pain tolerance The massage technique that stimulates the large-diameter fibers in order to block impulses from the small- diameter fibers is ____________________. - ANS-Effleurage • Continues...