NU 402 Exam 1 2 OB complete solutions with all questions and answers graded A

NU 402 Exam 1 2 OB complete solutions with all questions and answers graded A Exam 1 OB 1 A woman’s position is an important component of the labor progress. Which guidance is important for the nurse to provide to the laboring client? The supine position, which is commonly used in the United States, increases blood flow. , Not Selected The laboring client positioned on her hands and knees (“all fours” position) is hard on the woman’s back. , Not Selected Correct answer: Frequent changes in position help relieve fatigue and increase the comfort of the laboring client. D. In a sitting or squatting position, abdominal muscles of the laboring client will have to work harder. , Not Selected Results for item 2. 2 0 / 2.5 points You are taking the history of a gravida 2 para 1 patient. Which findings in the patient’s history warrant further investigation? Select all that apply. Correct answer: Anemia Correct answer: Severe hemorrhage Correct answer: Infections Incorrect answer: Malnutrition Missed Option - Incorrect Correct answer: Eclampsia Results for item 3. 3 2.5 / 2.5 points Many pregnant women have questions regarding work and travel during pregnancy. Which education is a priority for the nurse to provide? Women should sit for as long as possible and cross their legs at the knees from time to time for exercise. , Not Selected Women should avoid seat belts and shoulder restraints in the car because they press on the fetus. , Not Selected Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times. , Not Selected Correct answer: While working or traveling in a car or on an airplane, women should arrange to walk around at least every hour or so. Results for item 4. 4 0 / 2.5 points A nurse caring for a woman in labor should understand that absent or minimal variability is classified as either abnormal or indeterminate. Which condition related to decreased variability is considered benign? Periodic fetal sleep state , Not Selected Extreme prematurity , Not Selected Fetal hypoxemia , Not Selected Preexisting neurologic injury , Not Selected Incorrect answer:(no answer) Correct Answer: Periodic fetal sleep state Results for item 5. 5 2.5 / 2.5 points A woman in labor has just received an epidural block. What is the most important nursing intervention at this time? Limit parenteral fluids. , Not Selected Monitor the fetus for possible tachycardia. , Not Selected Correct answer: Monitor the maternal blood pressure for possible hypotension. Monitor the maternal pulse for possible bradycardia. , Not Selected Results for item 6. 6 2.5 / 2.5 points Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)? Correct answer: All women, regardless of risk factors Women who have had more than one sexual partner , Not Selected Women who have had a sexually transmitted infection (STI) , Not Selected Woman who are monogamous with one partner , Not Selected Results for item 7. 7 2.5 / 2.5 points A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive? “Discontinue all contraception now.” , Not Selected “Lose weight so that you can gain more during pregnancy.” , Not Selected “You may take any medications you have been regularly taking.” , Not Selected Correct answer: “Make sure you include adequate folic acid in your diet.” Results for item 8. 8 2.5 / 2.5 points What is the minimum level of practice that a reasonably prudent nurse is expected to provide? Correct answer: Standard of care Risk management , Not Selected Sentinel event , Not Selected Failure to rescue , Not Selected Results for item 9. 9 2.5 / 2.5 points What measures should the nurse implement to provide intrauterine resuscitation? Answer, Call the provider, reposition the mother, and perform a vaginal examination. Correct answer: Turn the client onto her side, provide oxygen (O2) via face mask, and increase intravenous (IV) fluids. Answer, Administer O2 to the mother, increase IV fluids, and notify the health care provider. Answer, Perform a vaginal examination, reposition the mother, and provide O2 via face mask. Results for item 10. 10 2.5 / 2.5 points Which client would not be a suitable candidate for an internal electronic fetal monitor (EFM)? Correct answer: Client who still has intact membranes Woman whose fetus is well engaged in the pelvis , Not Selected Pregnant woman who has a comorbidity of obesity , Not Selected Client whose cervix is dilated to 4 to 5 cm , Not Selected Results for item 11. 11 2.5 / 2.5 points Which signs and symptoms should a woman immediately report to her health care provider? (Select all that apply.) Correct answer: Vaginal bleeding Correct answer: Rupture of membranes Correct answer: Heartburn accompanied by severe headache Answer, Decreased libido Answer, Urinary frequency Results for item 12. 12 2.5 / 2.5 points A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has the condition. The couple tells the nurse that they are having a second baby. Because their daughter has PKU, they are certain that this baby will not be affected. Which response by the nurse is the most accurate? “Good planning. You need to take advantage of the odds that are in your favor.” , Not Selected “I think you’d better first check with your physician.” , Not Selected Correct answer: “You are both carriers; therefore, each baby has a 25% chance of being affected.” “The ultrasound indicates a boy, and boys are not affected by PKU." , Not Selected Results for item 13. 13 2.5 / 2.5 points Which factors influence cervical dilation? (Select all that apply.) Correct answer: Strong uterine contractions Correct answer: Force of the presenting fetal part against the cervix Answer, Size of the woman Correct answer: Pressure applied by the amniotic sac Correct answer: Scarring of the cervix Results for item 14. 14 2.5 / 2.5 points A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. Which guidance should the nurse provide? Since you’re in your second trimester, there’s no problem with having one drink with dinner.” , Not Selected “One drink every night is too much. One drink three times a week should be fine.” , Not Selected “Since you’re in your second trimester, you can drink as much as you like.” , Not Selected Correct answer: “Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy.” Results for item 15. 15 2.5 / 2.5 points Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion? Correct answer: Variable decelerations Late decelerations , Not Selected Fetal bradycardia , Not Selected Fetal tachycardia , Not Selected Results for item 16. 16 2.5 / 2.5 points Which statement by the client will assist the nurse in determining whether she is in true labor as opposed to false labor? “I passed some thick, pink mucus when I urinated this morning.” , Not Selected “My bag of waters just broke.” , Not Selected Correct answer: “The contractions in my uterus are getting stronger and closer together.” “My baby dropped, and I have to urinate more frequently now.” , Not Selected Results for item 17. 17 2.5 / 2.5 points The musculoskeletal system adapts to the changes that occur throughout the pregnancy. Which musculoskeletal alteration should the client expect? Her center of gravity will shift backward. , Not Selected Correct answer: She will have increased lordosis. She will have increased abdominal muscle tone. , Not Selected She will notice decreased mobility of her pelvic joints. , Not Selected Results for item 18. 18 2.5 / 2.5 points Intervention for the sexual abuse survivor by a maternity and woman’s health nurse can be very sensitive issue due to the concern about increasing the distress of women and their lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman’s care? Correct answer: Listening and encouraging therapeutic communication skills. Initiating a referral to an expert counselor. , Not Selected Setting limits on what the client discloses. , Not Selected Acknowledging the nurse’s discomfort to the client and expression of empathy. , Not Selected Results for item 19. 19 2.5 / 2.5 points A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she does not know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate? “Don’t worry about it; you’ll feel better in a month or so.” , Not Selected “Have you talked to your husband about how you feel?” , Not Selected “Perhaps you really don’t want to be pregnant.” , Not Selected Correct answer: “Hormone changes during pregnancy commonly result in mood swings.” Results for item 20. 20 0 / 2.5 points The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply.) Correct answer: Identification of fetal heartbeat Incorrect answer: Palpation of fetal outline Missed Option - Incorrect Correct answer: Visualization of the fetus Correct answer: Verification of fetal movement Answer, Positive hCG test Results for item 21. 21 2.5 / 2.5 points Emergency conditions during labor that would require immediate nursing intervention can arise with startling speed. Which situations are examples of such an emergency? (Select all that apply.) Correct answer: Nonreassuring or abnormal FHR pattern Correct answer: Inadequate uterine relaxation Correct answer: Bright red vaginal bleeding Answer, Prolonged second stage Correct answer: Prolapse of the cord Results for item 22. 22 2.5 / 2.5 points Which clinical finding in a primiparous client at 32 weeks of gestation might be an indication of anemia? Ptyalism , Not Selected Pyrosis , Not Selected Correct answer: Pica Decreased peristalsis , Not Selected Results for item 23. 23 2.5 / 2.5 points A laboring woman has received meperidine (Demerol) intravenously (IV), 90 minutes before giving birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate? Fentanyl (Sublimaze) , Not Selected Promethazine (Phenergan) , Not Selected Correct answer: Naloxone (Narcan) Nalbuphine (Nubain) , Not Selected Results for item 24. 24 2.5 / 2.5 points Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could the nurse use to increase the client’s blood pressure? (Select all that apply.) Answer, Place the woman in a supine position. Correct answer: Place the woman in a lateral position. Correct answer: Increase IV fluids. Correct answer: Administer oxygen. Answer, Perform a vaginal examination. Results for item 25. 25 2.5 / 2.5 points A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding? Correct answer: Chloasma Linea nigra , Not Selected Striae gravidarum , Not Selected Palmar erythema , Not Selected Results for item 26. 26 2.5 / 2.5 points During labor a fetus displays an average FHR of 135 beats per minute over a 10-minute period. Which statement best describes the status of this fetus? Bradycardia , Not Selected Correct answer: Normal baseline heart rate Tachycardia , Not Selected Hypoxia , Not Selected Results for item 27. 27 2.5 / 2.5 points A client is experiencing back labor and complains of intense pain in her lower back. Which measure would best support this woman in labor? Correct answer: Counterpressure against the sacrum Pant-blow (breaths and puffs) breathing techniques , Not Selected Effleurage , Not Selected Conscious relaxation or guided imagery , Not Selected Results for item 28. 28 2.5 / 2.5 points A woman asks the nurse, “What protects my baby’s umbilical cord from being squashed while the baby’s inside of me?” What is the nurse’s best response? Correct answer: “Your baby’s umbilical cord is surrounded by connective tissue called Wharton’s jelly, which prevents compression of the blood vessels.” “Your baby’s umbilical cord floats around in blood and amniotic fluid.” , Not Selected “You don’t need to be worrying about things like that.” , Not Selected “The umbilical cord is a group of blood vessels that are very well protected by the placenta.” , Not Selected Results for item 29. 29 0 / 2.5 points The nurse providing care for a high-risk laboring woman is alert for late FHR decelerations. Which clinical finding might be the cause for these late decelerations? Incorrect answer: Altered cerebral blood flow Correct Answer: Uteroplacental insufficiency Umbilical cord compression , Not Selected Uteroplacental insufficiency , Not Selected Meconium fluid , Not Selected Results for item 30. 30 2.5 / 2.5 points At least five factors affect the process of labor and birth. These are easily remembered as the five Ps. Which factors are included in this process? (Select all that apply.) Correct answer: Passenger Correct answer: Passageway Correct answer: Powers Answer, Pressure Correct answer: Psychologic response Results for item 31. 31 0 / 2.5 points An infertile couple voices concern to the nurse about assisted reproductive technologies (ART). The nurse agrees that ART has created many ethical dilemmas. Which potential questions does the nurse discuss with the couple? Select all that apply. Correct answer: Which partner has ownership over the embryos? Correct answer: Should a child be told about donors or surrogates? Correct answer: Are there parental rights for sperm donors? Incorrect answer: Does a fertility donor have a financial obligation? Missed Option - Incorrect Correct answer: What happens to any surplus embryos? Results for item 32. 32 2.5 / 2.5 points A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2015. What is the client’s expected date of birth (EDB)? September 17, 2015 , Not Selected November 7, 2015 , Not Selected Correct answer: November 21, 2015 December 17, 2015 , Not Selected Results for item 33. 33 2.5 / 2.5 points Which minerals and vitamins are usually recommended as a supplement in a pregnant client’s diet? Fat-soluble vitamins A and D , Not Selected Water-soluble vitamins C and B6 , Not Selected Correct answer: Iron and folic acid Calcium and zinc , Not Selected Results for item 34. 34 2.5 / 2.5 points Which statement regarding the probable signs of pregnancy is most accurate? Determined by ultrasound , Not Selected Correct answer: Observed by the health care provider Reported by the client , Not Selected Confirmed by diagnostic tests , Not Selected Results for item 35. 35 2.5 / 2.5 points The nurse is performing an initial assessment of a client in labor. What is the appropriate terminology for the relationship of the fetal body parts to one another? Lie , Not Selected Presentation , Not Selected Correct answer: Attitude Position , Not Selected Results for item 36. 36 2.5 / 2.5 points Pregnant adolescents are at greater risk for Obesity , Not Selected Gestational diabetes , Not Selected Correct answer: Low-birth-weight babies High-birth-weight babies , Not Selected Results for item 37. 37 2.5 / 2.5 points You are the nurse counseling a patient about her third pregnancy. The patient tells you that her first two pregnancies ended in the second trimester for an undetermined reason. She is very anxious about this current pregnancy. Which initial advice would you provide for the patient? Consider adoption , Not Selected Correct answer: Seek genetic studies Plan for fertility tests , Not Selected Attend grief counseling , Not Selected Results for item 38. 38 2.5 / 2.5 points A client has arrived for her first prenatal appointment. She asked the nurse to explain exactly how long the pregnancy will be. What is the nurse’s best response? Correct answer: Normal pregnancy is 10 lunar months. Pregnancy is made up of four trimesters. , Not Selected Pregnancy is considered term at 36 weeks. , Not Selected Pregnancy is 260 days long. , Not Selected Results for item 39. 39 2.5 / 2.5 points A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The FHR has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. What disposition would the nurse anticipate? Admitted and prepared for a cesarean birth , Not Selected Admitted for extended observation , Not Selected Discharged home with a sedative , Not Selected Correct answer: Discharged home to await the onset of true labor Results for item 40. 40 2.5 / 2.5 points Which time-based description of a stage of development in pregnancy is correct? Viability—22 to 37 weeks of gestation since the last menstrual period (assuming a fetal weight greater than 500 g) , Not Selected Correct answer: Term—pregnancy from the beginning of 38 weeks of gestation to the end of 42 weeks of gestation Preterm—pregnancy from 20 to 28 weeks of gestation , Not Selected Postdate—pregnancy that extends beyond 38 weeks of gestation , Not Selected Results for item 41. 41 2.5 / 2.5 points Which FHR decelerations would require the nurse to change the maternal position? (Select all that apply.) Answer, Early decelerations Correct answer: Late decelerations Correct answer: Variable decelerations Answer, Moderate decelerations Correct answer: Prolonged decelerations Results for item 42. 42 0 / 2.5 points What is the name of this breech position? Incorrect answer: Frank Correct Answer: Complete Footling , Not Selected Fred , Not Selected Complete , Not Selected Cannonball , Not Selected Results for item 43. 43 2.5 / 2.5 points A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? Calcium , Not Selected Protein , Not Selected Correct answer: Vitamin B12 Folic acid , Not Selected Results for item 44. 44 2.5 / 2.5 points A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. Which statement best describes why this may be happening to this client? Correct answer: This respiratory change is normal in pregnancy and caused by an elevated level of estrogen. This cardiovascular change is abnormal, and the nosebleeds are an ominous sign. , Not Selected The woman is a victim of domestic violence and is being hit in the face by her partner. , Not Selected The woman has been intranasally using cocaine. , Not Selected Results for item 45. 45 2.5 / 2.5 points A tiered system of categorizing FHR has been recommended by professional organizations. Nurses, midwives, and physicians who care for women in labor must have a working knowledge of fetal monitoring standards and understand the significance of each category. What is the correct nomenclature for these categories? (Select all that apply.) Answer, Reassuring Correct answer: Category I Correct answer: Category II Answer, Nonreassuring Correct answer: Category III Results for item 46. 46 2.5 / 2.5 points Sarah is coming into the labor and delivery unit for an induction of labor at 42 weeks gestation. What are some of the medications that could be used for an induction of labor? Select all that apply. Answer, Betamethasone Correct answer: Cervidil Answer, Terbutaline Correct answer: Oxytocin Correct answer: Misoprostol Correct answer: Cytotec Results for item 47. 47 2.5 / 2.5 points The nurse has received a report regarding a client in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment? Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines. , Not Selected Correct answer: Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines. , Not Selected Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines. , Not Selected Results for item 48. 48 2.5 / 2.5 points Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur? Correct answer: Maternal fever Umbilical cord prolapse , Not Selected Regional anesthesia , Not Selected Magnesium sulfate administration , Not Selected Results for item 49. 49 2.5 / 2.5 points The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman replies, “I have special undergarments that I do not remove for religious reasons.” Which is the most appropriate response from the nurse? “You can’t have an examination without removing all your clothes.” , Not Selected “I’ll ask the physician to modify the examination.” , Not Selected Correct answer: “Tell me about your undergarments. I’ll explain the examination procedure, and then we can discuss how you can comfortably have your examination.” “I have no idea how we can accommodate your beliefs." , Not Selected Results for item 50. 50 0 / 2.5 points A complete abuse screening should be conducted on all clients entering the health care setting. The screenings should include: (Mark all that apply) Correct answer: Asking the client if she has ever been slapped, kicked, punched, or physically hurt by her partner. Incorrect answer: Asking the client is she is afraid of her partner. Missed Option - Incorrect Correct answer: Asking the client if she has ever been forced to perform sexual acts. Correct answer: Diagraming the client’s current injuries on a body map. Incorrect answer: Asking the client what she thinks she did wrong to elicit the abuse. Selected Answer - Incorrect Results for item 51. 51 2.5 / 2.5 points A pregnant woman’s diet may not meet her increased need for folates. Which food is a rich source of this nutrient? Chicken , Not Selected Cheese , Not Selected Potatoes , Not Selected Correct answer: Green leafy vegetables Results for item 52. 52 2.5 / 2.5 points A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman’s IV fluid for a preprocedural bolus. The nurse reviews her laboratory values and notes that the woman’s hemoglobin is 12 g/dl, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for this woman? She is too far dilated. , Not Selected She is anemic. , Not Selected Correct answer: She has thrombocytopenia. She is septic. , Not Selected Results for item 53. 53 2.5 / 2.5 points What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern? Correct answer: Altered fetal cerebral blood flow Umbilical cord compression , Not Selected Uteroplacental insufficiency , Not Selected Spontaneous rupture of membranes , Not Selected Results for item 54. 54 2.5 / 2.5 points What is the most likely cause for variable FHR decelerations? Altered fetal cerebral blood flow , Not Selected Correct answer: Umbilical cord compression Uteroplacental insufficiency , Not Selected Fetal hypoxemia , Not Selected Results for item 55. 55 2.5 / 2.5 points Proper documentation of the abuse as reported by the victim is a crucial role of the nurse. Evaluate the following data, which include information from the victim and choose the best documentation by the nurse Correct answer: Client is a 34 year-old Caucasian female. Presents with periorbital ecchymosis on the right side. Laceration of the left parietal area, three cm long with tissue bridging. Approximately one cm deep. The client states that “My boyfriend threw a brick from ten feet away, aiming at my head. The corner of the brick hit the left side of my head”. She reports that he also “hit me in the eye”. Client indicates that she “was hit with her boyfriend’s closed fist”. Client is a 34 year old Caucasian female who alleges that her “boyfriend beat me up”. She has bruising that she reports were from her boyfriend on the right side. Laceration on left parietal area, three cm long, with tissue bridging. Approximately one cm deep. , Not Selected The client is a white 34 year old female. Presents with periorbital ecchymosis on the right side. Alleges that her “boyfriend hit her in the eye and the head”. A bruise noted on the right side of the head and bleeding noted from alleged dispute. She has a laceration on the head that is about one inch deep. , Not Selected Client is a white 34 year old female who presents with a black eye and a cut on the left side of her head. She reports “my boyfriend abused me”. She claims that he also “hit me in the eye”. Client indicates that she “was hit with her boyfriends closed fist”. , Not Selected Results for item 56. 56 2.5 / 2.5 points A woman’s obstetric history indicates that she is pregnant for the fourth time, and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system? 3-1-1-1-3 , Not Selected Correct answer: 4-1-2-0-4 3-0-3-0-3 , Not Selected 4-2-1-0-3 , Not Selected Results for item 57. 57 2.5 / 2.5 points A woman in the 34th week of pregnancy reports that she is very uncomfortable because of heartburn. Which recommendation would be appropriate for this client? Substitute other calcium sources for milk in her diet. , Not Selected Lie down after each meal. , Not Selected Reduce the amount of fiber she consumes. , Not Selected Correct answer: Eat five small meals daily. Results for item 58. 58 2.5 / 2.5 points A woman has requested an epidural block for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman’s IV fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be informed regarding the disadvantages of an epidural block. Which concerns should the nurse share with this client? (Select all that apply.) Correct answer: Ability to move freely is limited. Correct answer: Orthostatic hypotension and dizziness may occur. Answer, Gastric emptying is not delayed. Correct answer: Higher body temperature may occur. Answer, Blood loss is not excessive. Results for item 59. 59 2.5 / 2.5 points Which FHR finding is the most concerning to the nurse who is providing care to a laboring client? Accelerations with fetal movement , Not Selected Early decelerations , Not Selected Average FHR of 126 beats per minute , Not Selected Correct answer: Late decelerations Results for item 60. 60 2.5 / 2.5 points All pregnant women should be instructed to recognize and report potential complications for each trimester of pregnancy. Match the sign or symptom with a possible cause. Correct answer: Kidney infection or stones Severe backache and flank pain Correct answer: Gestational diabetes Glycosuria Correct answer: Hyperemesis gravidarum Severe vomiting early in pregnancy Correct answer: Fetal jeopardy or intrauterine fetal death Decreased fetal movement Correct answer: Hypertension, preeclampsia Epigastric pain in late pregnancy Exam 2 OB 2.5 / 2.5 points As recently as 2005, the AAP revised safe sleep practices to assist in the prevention of Sudden Infant Death Syndrome (SIDS). The nurse should model these practices in the hospital and incorporate this information into the teaching plan for new parents. Which practices are ideal for role modeling? (Select all that apply.) Correct answer: Fully supine position for all sleep Answer, Side-sleeping position as an acceptable alternative Correct answer: “Tummy time” for play Correct answer: Infant sleep sacks or swaddlers Answer, Soft mattress Results for item 2. 2 2.5 / 2.5 points Which statements concerning the benefits or limitations of breastfeeding are accurate? (Select all that apply.) Correct answer: Breast milk changes over time to meet the changing needs as infants grow. Answer, Breastfeeding increases the risk of childhood obesity. Correct answer: Breast milk and breastfeeding may enhance cognitive development. Correct answer: Long-term studies have shown that the benefits of breast milk continue after the infant is weaned. Correct answer: Benefits to the infant include a reduced incidence of SIDS. Results for item 3. 3 2.5 / 2.5 points A mother expresses fear about changing her infant’s diaper after he had a Gomco circumcision. What does the client need to be taught to care for her newborn son? Cleanse the penis with prepackaged diaper wipes every three to four hours. , Not Selected Apply constant, firm pressure by squeezing the penis with the fingers for at least five minutes if bleeding occurs. , Not Selected Correct answer: Gently cleanse the penis with water and apply petroleum jelly around the glans after each diaper change. Wash off the yellow exudate that forms on the glans at least once every day to prevent infection. , Not Selected Results for item 4. 4 2.5 / 2.5 points The nurse is assigned a homecare visit of a five-day-old infant for the treatment of jaundice. A thorough assessment is completed, and health history is obtained. Which signs or symptoms will the newborn display prior to the onset of encephalopathy? High-pitched cry , Not Selected Severe muscle spasms (opisthosomas) , Not Selected Fever and seizures , Not Selected Correct answer: Hypotonia, lethargy, and poor suck Results for item 5. 5 2.5 / 2.5 points During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. Which statement by the client reassures the nurse that teaching has been effective? “I will need to eat 600 more calories per day because I am pregnant.” , Not Selected “I can continue with the same diet as before pregnancy as long as it is well balanced.” , Not Selected Correct answer: “Diet and insulin needs change during pregnancy.” “I will plan my diet based on the results of urine glucose testing.” , Not Selected Results for item 6. 6 2.5 / 2.5 points The above fetal heart tracing would be categorized as: Correct answer: Category I Category II , Not Selected Category III , Not Selected Category IV , Not Selected Results for item 7. 7 0 / 2.5 points What are the complications and risks associated with caring for women who have had a cesarean delivery? (Select all that apply) Correct answer: Pulmonary edema Correct answer: Wound dehiscence Correct answer: Hemorrhage Correct answer: Urinary tract infections Incorrect answer: Fetal injuries Missed option - incorrect Results for item 8. 8 2.5 / 2.5 points Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium? Varicosities of the legs , Not Selected Carpal tunnel syndrome , Not Selected Periodic numbness and tingling of the fingers , Not Selected Correct answer: Headaches Results for item 9. 9 2.5 / 2.5 points The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman’s latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate amino transaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition? Eclampsia , Not Selected Disseminated intravascular coagulation (DIC) syndrome , Not Selected Correct answer: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome Idiopathic thrombocytopenia , Not Selected Results for item 10. 10 2.5 / 2.5 points What is the primary purpose for magnesium sulfate administration for clients with preeclampsia and eclampsia? To improve patellar reflexes and increase respiratory efficiency , Not Selected To shorten the duration of labor , Not Selected Correct answer: To treat and prevent seizures To prevent a boggy uterus and lessen lochia flow , Not Selected Results for item 11. 11 0 / 2.5 points A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. Which findings should the nurse include in the discussion? (Select all that apply.) Correct answer: Breast tenderness Correct answer: Warmth in the breast Correct answer: Area of redness on the breast often resembling the shape of a pie wedge Incorrect answer: Small white blister on the tip of the nipple Selected Answer - Incorrect Incorrect answer: Fever and flu like symptoms Missed option - incorrect Results for item 12. 12 2.5 / 2.5 points Which actions are examples of appropriate techniques to wake a sleepy infant for breastfeeding? (Select all that apply.) Correct answer: Unwrapping the infant Correct answer: Changing the diaper Correct answer: Talking to the infant Answer, Slapping the infant’s hands and feet Answer, Applying a cold towel to the infant’s abdomen Results for item 13. 13 2.5 / 2.5 points Which adverse prenatal outcomes are associated with the HELLP syndrome? (Select all that apply.) Correct answer: Placental abruption Answer, Placenta previa Correct answer: Renal failure Answer, Cirrhosis Correct answer: Maternal and fetal death Results for item 14. 14 0.5 / 2.5 points Biophysical risks include factors that originate with either the mother or the fetus and affect the functioning of either one or both. The nurse who provides prenatal care should have an understanding of these risk factors. Match the specific pregnancy problem with the related risk factor. Select each answer only one time. Premature rupture of membranes Incorrect answer: Chromosomal abnormalities Correct Answer:Polyhydramnios Advanced maternal age Incorrect answer: Polyhydramnios Correct Answer:Chromosomal abnormalities Fetal congenital anomalies Incorrect answer: IUGR (fetoplacental cause) Correct Answer:Oligohydramnios Abnormal placenta development Incorrect answer: IUGR (maternal cause) Correct Answer:IUGR (fetoplacental cause) Smoking, alcohol, and illicit drug use Correct answer: IUGR (maternal cause) Results for item 15. 15 2.5 / 2.5 points A perinatal nurse is caring for a woman in the immediate post-birth period. Assessment reveals that the client is experiencing profuse bleeding. What is the most likely cause for this bleeding? Correct answer: Uterine atony Uterine inversion , Not Selected Vaginal hematoma , Not Selected Vaginal laceration , Not Selected Results for item 16. 16 2.5 / 2.5 points While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms, his fingers fan out and form a C with the thumb and forefinger, and he has a slight tremor. The nurse would document this finding as a positive reflex. tonic neck , Not Selected glabellar (Myerson) , Not Selected Babinski , Not Selected Correct answer: Moro Results for item 17. 17 2.5 / 2.5 points What is this fetal position? Correct answer: ROP ROA , Not Selected LOP , Not Selected LOA , Not Selected Results for item 18. 18 2.5 / 2.5 points Which client is most likely to experience strong and uncomfortable after pains? A woman who experienced oligohydramnios , Not Selected Correct answer: A woman who is a gravida 4, para 4-0-0-4 A woman who is bottle-feeding her infant , Not Selected A woman whose infant weighed 5 pounds, 3 ounces , Not Selected Results for item 19. 19 2.5 / 2.5 points Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus? Notify the physician of an impending hemorrhage. , Not Selected Assess the blood pressure and pulse. , Not Selected Evaluate the lochia. , Not Selected Correct answer: Assist the client in emptying her bladder. Results for item 20. 20 0 / 2.5 points Which of the following statements apply to this fetal heart tracing? (Mark all that apply) Answer, Absent variability Correct answer: Moderate variability Correct answer: Accelerations present Incorrect answer: Accelerations absent Selected Answer - Incorrect Answer, Early decelerations Incorrect answer: Late decelerations Selected Answer - Incorrect Answer, Variable decelerations Results for item 21. 21 2.5 / 2.5 points Which statement is the best rationale for recommending formula over breastfeeding? Correct answer: Mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk. Mother lacks confidence in her ability to breastfeed. , Not Selected Other family members or care providers also need to feed the baby. , Not Selected Mother sees bottle feeding as more convenient. , Not Selected Results for item 22. 22 2.5 / 2.5 points The nurse is planning the care for a laboring client with diabetes mellitus. This client is at greater risk for which clinical finding? Oligohydramnios , Not Selected Correct answer: Polyhydramnios Post-term pregnancy , Not Selected Chromosomal abnormalities , Not Selected Results for item 23. 23 2.5 / 2.5 points What is the most common reason for late postpartum hemorrhage (PPH)? Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress , Not Selected Correct answer: Woman with severe preeclampsia on magnesium sulfate whose labor is being induced Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor , Not Selected Primagravida in spontaneous labor with preterm twins , Not Selected Results for item 24. 24 0 / 2.5 points Which statements regarding physiologic jaundice are accurate? (Select all that apply.) Correct answer: Neonatal jaundice is common; however, kernicterus is rare. Incorrect answer: Appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process. Selected Answer - Incorrect Correct answer: Because jaundice may not appear before discharge, parents need instruction on how to assess for jaundice and when to call for medical help. Answer, Jaundice is caused by reduced levels of serum bilirubin. Answer, Breastfed babies have a lower incidence of jaundice. Results for item 25. 25 2.5 / 2.5 points Misoprostol has been ordered for a pregnant woman at 43 weeks of gestation. What is the primary purpose of Misoprostol administration? To enhance Uteroplacental perfusion in an aging placenta , Not Selected To increase amniotic fluid volume , Not Selected Correct answer: To ripen the cervix in preparation for labor induction To stimulate the amniotic membranes to rupture , Not Selected Results for item 26. 26 2.5 / 2.5 points The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis? Absence of cyanosis in the buccal mucosa , Not Selected Cool, dry skin , Not Selected Calm mental status , Not Selected Correct answer: Urinary output is less than 30 ml/hr Results for item 27. 27 2.5 / 2.5 points Nurses need to understand the basic definitions and incidence data regarding PPH. Which statement regarding this condition is most accurate? PPH is easy to recognize early; after all, the woman is bleeding. , Not Selected Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH. , Not Selected If anything, nurses and physicians tend to overestimate the amount of blood loss. , Not Selected Correct answer: Traditionally, PPH has been classified as early PPH or late PPH with respect to birth. Results for item 28. 28 2.5 / 2.5 points Which assessments are included in the fetal Biophysical profile (BPP)? (Select all that apply.) Correct answer: Fetal movement Correct answer: Fetal tone Correct answer: Fetal heart rate Correct answer: Amniotic Fluid Index (AFI) Answer, Placental grade Results for item 29. 29 2.5 / 2.5 points The exact cause of preterm labor is unknown but believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Which type of infection has not been linked to preterm birth? Correct answer: Viral Periodontal , Not Selected Cervical , Not Selected Urinary tract , Not Selected Results for item 30. 30 2.5 / 2.5 points A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine “several times” during the past year and occasionally drinks alcohol. Her blood pressure is 108/70 mm Hg. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics places this client in a high-risk category? Blood pressure, age, BMI , Not Selected Drug and alcohol use, age, family history , Not Selected Family history, blood pressure (BP), BMI , Not Selected Correct answer: Family history, BMI, drug and alcohol use Results for item 31. 31 2.5 / 2.5 points Women who are obese are at risk for several complications during pregnancy and birth. Which of these would the nurse anticipate with an obese client? (Select all that apply.) Correct answer: Thromboembolism Correct answer: Cesarean birth Correct answer: Wound infection Answer, Breech presentation Correct answer: Hypertension Results for item 32. 32 2.5 / 2.5 points Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. This fetus is at the greatest risk for which condition? Correct answer: Macrosomia Congenital anomalies of the central nervous system , Not Selected Preterm birth , Not Selected Low birth weight , Not Selected Results for item 33. 33 2.5 / 2.5 points The client is being induced in response to worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active, despite several hours of oxytocin administration. She asks the nurse, “Why is this taking so long?” What is the nurse’s most appropriate response? Correct answer: “The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.” “I don’t know why it is taking so long.” , Not Selected “The length of labor varies for different women.” , Not Selected “Your baby is just being stubborn.” , Not Selected Results for item 34. 34 2.5 / 2.5 points Which statement related to cephalopelvic disproportion (CPD) is the least accurate? CPD can be related to either fetal size or fetal position. , Not Selected The fetus cannot be born vaginally. , Not Selected Correct answer: CPD can be accurately predicted Causes of CPD may have maternal or fetal origins. , Not Selected Results for item 35. 35 2.5 / 2.5 points A primagravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse? Blood pressure (BP) increase to 138/86 mm Hg , Not Selected Weight gain of 0.5 kg during the past two weeks , Not Selected Correct answer: Dipstick value of 3+ for protein in her urine Pitting pedal edema at the end of the day , Not Selected Results for item 36. 36 2.5 / 2.5 points Which newborn reflex is elicited by stroking the lateral sole of the infant’s foot from the heel to the ball of the foot? Correct answer: Babinski Tonic neck , Not Selected Stepping , Not Selected Plantar grasp , Not Selected Results for item 37. 37 2.5 / 2.5 points Which neonatal complications are associated with hypertension in the mother? Correct answer: Intrauterine growth restriction (IUGR) and prematurity Seizures and cerebral hemorrhage , Not Selected Hepatic or renal dysfunction , Not Selected Placental abruption and DIC , Not Selected Results for item 38. 38 2.5 / 2.5 points The following breech position is: Correct answer: Frank Fred , Not Selected Complete , Not Selected Cannon ball , Not Selected Footling , Not Selected Results for item 39. 39 2.5 / 2.5 points Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral cues that indicate pain, then measures should be taken to manage the pain. Which interventions are examples of non-pharmacologic pain management techniques? (Select all that apply.) Correct answer: Swaddling Correct answer: Nonnutritive sucking Correct answer: Skin-to-skin contact with the mother Correct answer: Sucrose Answer, Acetaminophen Results for item 40. 40 2.5 / 2.5 points Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.) Correct answer: Operative and precipitate births Answer, Adherent retained placenta Correct answer: Abnormal presentation of the fetus Correct answer: Congenital abnormalities of the maternal soft tissue Correct answer: Previous scarring from infection Results for item 41. 41 0 / 2.5 points Which medications are used to manage PPH? (Select all that apply.) Incorrect answer: Misoprostol Missed option - incorrect Correct answer: Methergine Answer, Terbutaline Correct answer: Hemabate Answer, Magnesium sulfate Results for item 42. 42 2.5 / 2.5 points What are the most common causes for sub involution of the uterus? Postpartum hemorrhage and infection , Not Selected Multiple gestation and postpartum hemorrhage , Not Selected Uterine tetany and overproduction of oxytocin , Not Selected Correct answer: Retained placental fragments and infection Results for item 43. 43 2.5 / 2.5 points Which intervention is most important when planning care for a client with severe gestational hypertension? Correct answer: Induction of labor is likely, as near term as possible. If at home, the woman should be confined to her bed, even with mild gestational hypertension. , Not Selected Special diet low in protein and salt should be initiated. , Not Selected Vaginal birth is still an option, even in severe cases. , Not Selected Results for item 44. 44 2.5 / 2.5 points Most congenital anomalies of the Central Nervous System (CNS) result from defects in the closure of the neural tube during fetal development. Which factor has the greatest impact on this process? Maternal diabetes , Not Selected Correct answer: Maternal folic acid deficiency Socioeconomic status , Not Selected Maternal use of anticonvulsant , Not Selected Results for item 45. 45 2.5 / 2.5 points The American College of Obstetricians and Gynecologists (ACOG) has developed a comprehensive list of risk factors associated with the development of preeclampsia. Which client exhibits the greatest number of these risk factors? 30-year-old obese Caucasian with her third pregnancy , Not Selected 41-year-old Caucasian Primagravida , Not Selected Correct answer: 19-year-old African American who is pregnant with twins 25-year-old Asian American whose pregnancy is the result of donor insemination , Not Selected Results for item 46. 46 2.5 / 2.5 points A number of methods can be used for inducing labor. Which cervical ripening method falls under the category of mechanical or physical? Prostaglandins are used to soften and thin the cervix. , Not Selected Correct answer: Labor can sometimes be induced with balloon catheters or Laminaria tents. Oxytocin is less expensive and more effective than prostaglandins but creates greater health risks. , Not Selected Cervidil can be used to make the cervix more favorable for labor. , Not Selected Results for item 47. 47 2.5 / 2.5 points The condition, hypospadias, encompasses a wide range of penile abnormalities. Which information should the nurse provide to the anxious parents of an affected newborn? Correct answer: Mild cases involve a single surgical procedure. Infant should be circumcised. , Not Selected Repair is performed as soon as possible after birth. , Not Selected No correlation exists between hypospadias and testicular cancer. , Not Selected Results for item 48. 48 2.5 / 2.5 points A new mother wants to be sure that she is meeting her daughter’s needs while feeding the baby commercially prepared infant formula. The nurse should evaluate the mother’s knowledge about appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place? “Since reaching two weeks of age, I add rice cereal to my daughter’s formula to ensure adequate nutrition.” , Not Selected “I warm the bottle in my microwave oven.” , Not Selected Correct answer: “I burp my daughter during and after the feeding as needed.” “I refrigerate any leftover formula for the next feeding.” , Not Selected Results for item 49. 49 2.5 / 2.5 points Rho immune globulin will be ordered postpartum if which situation occurs? Correct answer: Mother Rh–, baby Rh+ Mother Rh–, baby Rh– , Not Selected Mother Rh+, baby Rh+ , Not Selected Mother Rh+, baby Rh– , Not Selected Results for item 50. 50 2.5 / 2.5 points A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurse’s plan of care? Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own. , Not Selected Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar. , Not Selected Correct answer: During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus. Maternal insulin requirements steadily decline during pregnancy. , Not Selected Results for item 51. 51 2.5 / 2.5 points Which statement most accurately describes the HELLP syndrome? Mild form of preeclampsia , Not Selected Diagnosed by a nurse alert to its symptoms , Not Selected Correct answer: Characterized by hemolysis, elevated liver enzymes, and low platelets Associated with preterm labor but not perinatal mortality , Not Selected Results for item 52. 52 2.5 / 2.5 points On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the nurse’s highest priority at this time? Beginning an intravenous (IV) infusion of Ringer’s lactate solution , Not Selected Assessing the woman’s vital signs , Not Selected Calling the woman’s primary health care provider , Not Selected Correct answer: Massaging the woman’s fundus Results for item 53. 53 2.5 / 2.5 points Preconception counseling is critical in the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy? Frequent episodes of maternal hypoglycemia , Not Selected Correct answer: Congenital anomalies in the fetus Hydramnios , Not Selected Hyperemesis Gravidarum , Not Selected Results for item 54. 54 2.5 / 2.5 points A pregnant woman has been receiving a magnesium sulfate infusion for treatment of late-onset preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature 37.3° C, pulse rate 88 beats per minute, respiratory rate 10 breaths per minute, BP 148/90 mm Hg, absent deep tendon reflexes (DTRs), and no ankle clonus. The client complains, "I'm so thirsty and warm." What is the nurse's immediate action? To call for an immediate magnesium sulfate level , Not Selected To administer oxygen , Not Selected Correct answer: To discontinue the magnesium sulfate infusion To prepare to administer hydralazine , Not Selected Results for item 55. 55 2.5 / 2.5 points A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of Betamethasone. What is the purpose of this pharmacologic intervention? Correct answer: To stimulate fetal surfactant production To reduce maternal and fetal tachycardia associated with Ritodrine administration , Not Selected To suppress uterine contractions , Not Selected To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy , Not Selected Results for item 56. 56 2.5 / 2.5 points What is the nurse’s initial action while caring for an infant with a slightly decreased temperature? Immediately notify the physician. , Not Selected Correct answer: Place a cap on the infant’s head, and have the mother perform skin to skin Tell the mother that the infant must be kept in the nursery and observed for the next four hours. , Not Selected Change the formula; a decreased body temperature is a sign of formula intolerance. , Not Selected Results for item 57. 57 2.5 / 2.5 points Which preexisting factor is known to increase the risk of GDM? Underweight before pregnancy , Not Selected Maternal age younger than 25 years , Not Selected Correct answer: Previous birth of large infant Previous diagnosis of type 2 diabetes mellitus , Not Selected Results for item 58. 58 2.5 / 2.5 points Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother? Correct answer: Hypoglycemia Hypercalcemia , Not Selected Hypo bilirubinemia , Not Selected Hyperinsulinemia , Not Selected Results for item 59. 59 2.5 / 2.5 points Which client is at greatest risk for early PPH? Primiparous woman (G 2, P 1-0-0-1) being prepared for an emergency cesarean birth for fetal distress , Not Selected Correct answer: Woman with severe preeclampsia on magnesium sulfate whose labor is being induced Multiparous woman (G 3, P 2-0-0-2) with an 8-hour labor , Not Selected Primagravida in spontaneous labor with preterm twins , Not Selected Results for item 60. 60 2.5 / 2.5 points A woman gave birth to a 7-pound, 6-ounce infant girl one hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman’s vital signs, which finding would be of greatest concern to the nurse? Correct answer: Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg Temperature 37.4° C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg , Not Selected Temperature 38° C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg , Not Selected Temperature 36.8° C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg