Maternal & Child Practice Exam 1

Maternal & Child Practice Exam 1 Which of the following would the nurse assess in a client experiencing abruptio placenta? A) Palpable fetal outline B Concealed or external dark red bleeding C) Bright red, painless vaginal bleeding D) Soft and nontender abdomen A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain. The uterus is typically firm to boardlike, and the fetal presenting part may be engaged. Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa. Which of the following is the primary predisposing factor related to mastitis? A Breast injury caused by overdistention, stasis, and cracking of the nipples B Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts C Temporary urinary retention due to decreased perception of the urge to avoid D Endemic infection occurring randomly and localizing in the periglandular connective tissue With mastitis, injury to the breast, such as overdistention, stasis, and cracking of the nipples, is the primary predisposing factor. Epidemic and endemic infections are probable sources of infection for mastitis. Temporary urinary retention due to decreased perception of the urge to void is a contributory factor to the development of urinary tract infection, not mastitis. Heartburn and flatulence, common in the second trimester, are most likely the result of which of the following? A) Decreased intestinal motility B) Increased plasma HCG levels C) Decreased gastric acidity D) Elevated estrogen levels During the second trimester, the reduction in gastric acidity in conjunction with pressure from the growing uterus and smooth muscle relaxation, can cause heartburn and flatulence. HCG levels increase in the first, not the second, trimester. Decrease intestinal motility would most likely be the cause of constipation and bloating. Estrogen levels decrease in the second trimester. Which of the following would be disadvantage of breast feeding? A) The father may resent the infant's demands on the mother's body B) The incidence of allergies increases due to maternal antibodies C) There is a greater chance for error during preparation D) Involution occurs more rapidly With breast feeding, the father's body is not capable of providing the milk for the newborn, which may interfere with feeding the newborn, providing fewer chances for bonding, or he may be jealous of the infant's demands on his wife's time and body. Breast feeding is advantageous because uterine involution occurs more rapidly, thus minimizing blood loss. The presence of maternal antibodies in breast milk helps decrease the incidence of allergies in the newborn. A greater chance for error is associated with bottle feeding. No preparation is required for breast Which of the following would the nurse identify as a classic sign of PIH? A Early morning headache B Weight gain of 1 lb/week C Edema of the hands and face D Edema of the feet and ankles Edema of the hands and face is a classic sign of PIH. Many healthy pregnant woman experience foot and ankle edema. A weight gain of 2 lb or more per week indicates a problem. Early morning headache is not a classic sign of PIH. Before birth, which of the following structures connects the right and left auricles of the heart? A Umbilical vein B Ductus arteriosus C Ductus venosus D Foramen ovale The foramen ovale is an opening between the right and left auricles (atria) that should close shortly after birth so the newborn will not have a murmur or mixed blood traveling through the vascular system. The umbilical vein, ductus arteriosus, and ductus venosus are obliterated at birth. Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester? A Incontinence B Dysuria Frequency D Burning Pressure and irritation of the bladder by the growing uterus during the first trimester is responsible for causing urinary frequency. Dysuria, incontinence, and burning are symptoms associated with urinary tract infections. Which of the following is the nurse's initial action when umbilical cord prolapse occurs? A) Notify the physician and prepare the client for delivery B) Begin monitoring maternal vital signs and FHR C) Apply a sterile warm saline dressing to the exposed cord D) Place the client in a knee-chest position in bed The immediate priority is to minimize pressure on the cord. Thus the nurse's initial action involves placing the client on bed rest and then placing the client in a knee-chest position or lowering the head of the bed, and elevating the maternal hips on a pillow to minimize the pressure on the cord. Monitoring maternal vital signs and FHR, notifying the physician and preparing the client for delivery, and wrapping the cord with sterile saline soaked warm gauze are important. But these actions have no effect on minimizing the pressure on the cord. Which of the following may happen if the uterus becomes overstimulated by oxytocin during the induction of labor? A) Tetanic contractions prolonged to more than 90 seconds B) Increased restlessness and anxiety C) Weak contraction prolonged to more than 70 seconds D) Increased pain with bright red vaginal bleeding Hyperstimulation of the uterus such as with oxytocin during the induction of labor may result in tetanic contractions prolonged to more than 90seconds, which could lead to such complications as fetal distress, abruptio placentae, amniotic fluid embolism, laceration of the cervix, and uterine rupture. Weak contractions would not occur. Pain, bright red vaginal bleeding, and increased restlessness and anxiety are not associated with hyperstimulation. ...............