Abnormal skin lesions on a newborn can result from exposure to the following maternal infections (select all that apply): - CORRECT ANS-Herpes Simplex Virus (HSV) -Varicella - Cytomegalovirus (CMV) -Rubella During a prenatal intake interview, the nurse i

Abnormal skin lesions on a newborn can result from exposure to the following maternal infections (select all that apply): - CORRECT ANS-Herpes Simplex Virus (HSV) -Varicella - Cytomegalovirus (CMV) -Rubella During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is the most important for the nurse to perform? - CORRECT ANSAssess whether the client understands the discussion A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection and she has been using an over the counter cream for the past two days to treat it. How should the nurse initially respond? - CORRECT ANSAsk the woman to describe the symptoms that indicate to her she has a vaginal infection. A woman is menstruating. If hormonal studies were done at this time, which of the following hormone levels would the nurse expect? - CORRECT ANSBoth estrogen and progesterone are low. The Clinical Nurse Leader has been asked to plan health promotion activity for women in their 50's for a community event. The main focus should be on prevention of: - CORRECT ANSCancer A couple arrives at their first appointment at an infertility center. Which of the following is a noninvasive test performed during the initial diagnostic phase of testing? - CORRECT ANSSemen analysis Based on the Affordable Care Act 0f 2012, HIV counseling and screening for sexually active women should be covered: - CORRECT ANSAnnually Injectable progestins (DMPA, Depo-Provera) are a good contraceptive choice for women who: - CORRECT ANSHave difficulty remembering to take oral contraceptives daily. A non-pregnant, non-sexually-active client reports a thin, white, watery vaginal discharge with a foul odor. The most likely diagnosis is: - CORRECT ANSBacterial Vaginosis Health behaviors and lifestyle choices can affect fertility. Which of the following practices could enhance a couple's ability to conceive? - CORRECT ANSUse balanced nutrition and exercise to achieve a normal BMI Which statement best exemplifies contemporary maternity nursing? - CORRECT ANSFamily-centered care In developing a culture of safety, which of the following actions would be considered "proactive?" - CORRECT ANSTeam STEPPS safety training An example of a positive adoption language statement made by the nurse is: - CORRECT ANS"The couple is in the process of making an adoption plan." The maternity nurse's best defense against an accusation of malpractice or negligence is that the nurse: - CORRECT ANSmet the standards of care for the area in which they practice. An effective relief measure for Primary Dysmenorrhea would be: - CORRECT ANSNon-steroidal anti-inflammatories (NSAID's) According to the Davidson model of grief, the initial stage of grief is characterized by: - CORRECT ANSshock & numbness Women who identify themselves as lesbian and bisexual women are more likely to experience intimate partner violence than women who identify themselves as heterosexual. - CORRECT ANSTrue Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasing hormone (GnRH) and follicle-stimulating hormone (FSH)? - CORRECT ANSFollicular Phase You are providing a postpartum patient with information about contraception. She asks you "Is breastfeeding an effective method of birth control?" Which of the following is the most accurate response? - CORRECT ANS"You will need another form of contraception once you start menstruating or at 6 months postpartum - whichever is sooner." You are the nurse caring for Arnold and Cecile, a couple in their early 30s who have been trying to get pregnant for the last 18 months. A thorough health and sexual history reveals that Cecile had chlamydia and gonorrhea twice in her twenties. This history put the couple at risk for infertility related to: - CORRECT ANSFallopian tube obstruction Which of the following methods of contraception is most likely to result in an unwanted pregnancy? - CORRECT ANSCondoms In a normal 28 day menstrual cycle when would you expect the luteinizing hormone (LH) surge to occur? - CORRECT ANSDays 13-15 A nurse is teaching a group of peer health care workers about sexually transmitted infections. You know your teaching is effective when one participant states: - CORRECT ANS"Chlamydia rates have steadily increased over the last two decades." You are teaching your patient about her menstrual cycle and fertility awareness. Which of the following sign or symptom is associated with ovulation : - CORRECT ANSIncrease in Basal Body Temperature A woman gave birth to twin girls, one of whom was stillborn. Which nursing action would be least helpful in supporting the woman as she copes with her loss? - CORRECT ANSRemind her that that one daughter survived and is healthy. The RN should be familiar with the use of the 5P's tool for evaluating risk behaviors for sexually transmitted infections. Which components would the nurse include when utilizing the 5 's assessment tool (select all that apply) - CORRECT ANS-Number of partners -Prevention of pregnancy -Protection from STI's -Past History of STI's A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? - CORRECT ANSExplain to the woman the importance of keeping her prenatal care appointments. A client tells the nurse one week after the death of their newborn, "Ever since the baby's funeral, my husband won't talk about the baby. He just goes to work and acts like nothing happened." The husband's behavior most likely represents: - CORRECT ANSInhibited or absent grieving The pregnant woman who becomes infected with chickenpox should be taught to promptly report: - CORRECT ANSCough and/or dyspnea A patient is scheduled for a repeat cesarean. In regards to informed consent, the RN's legal obligation is to: - CORRECT ANSWitness and document that the patient has signed the consent. A client who recently was diagnosed with diabetes verbalizes symptoms of intense itching and white patches on her labia and in her vagina. The nurse anticipates that the APRN will prescribe which of the following medications? - CORRECT ANSFluconazole A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to: - CORRECT ANSEndometriosis A nurse is assessing a newborn born to a mother who used heroin throughout her pregnancy. The nurse knows that the following are signs or symptoms of withdrawal in infants: (Select all that apply) - CORRECT ANS-Irritability -High Pitched Cry -Weight loss or failure to gain weight When assessing women, it is important for a nurse to keep in mind the possibility that they are victims of violence. The nurse should: - CORRECT ANSuse an abuse assessment screen at every encounter. The nurse at the family planning clinic has done some teaching on combined oral contraceptives (COCs) with a client who is 36 years old. The nurse knows that the teaching has been effective when the client responds: - CORRECT ANS"I need to stop smoking before I start taking this type of birth control because I have an increased risk of having a heart attack if I continue". An important teaching point for patients with polycystic ovary syndrome (PCOS) is their increased risk for: - CORRECT ANSType 2 diabetes Which term is an accurate description of the process by which people retain some of their own culture while adopting the practices of the dominant society? - CORRECT ANSAcculturation A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that her best chance is when: - CORRECT ANSLuteinizing hormone is high. Which statement regarding emergency contraception is most correct? - CORRECT ANSEmergency contraceptive pills do not cause an abortion and do not work if the patient is already pregnant. A 30-week pregnant woman presents to OB triage with bright red vaginal bleeding. She reports substance use. Placental abruption is suspected. Which is the most likely etiology? - CORRECT ANSCocaine The nurse in the outpatient clinic has been asked to discuss "the combination pill" with a 17-year old female. Which of the following must be taught to this teen? (select all that apply): - CORRECT ANS-Take one pill at the same time everyday whether you have sex or not. -Call the health care provider right away if you have a severe headache, chest pain, or leg swelling. -The use of "the pill" does not protect you or your partner from sexually transmitted infections. The nurse explains to the clients that clomiphene citrate's (Clomid) action is to: - CORRECT ANSstimulate ovulation. After an initial loading dose of penicillin, the physician writes an order for the laboring woman to receive the medication every four hours until delivery. The rationale for this order is because the laboring woman had the following lab value. - CORRECT ANSGroup B Streptococcus (GBS) positive A 36-year-old woman has been diagnosed with having uterine fibroids. When planning care for this client, the nurse should know that: - CORRECT ANSMenorrhagia is a common finding. With regard to the assessment of female, male and couple infertility, the nurse should be aware of what information? - CORRECT ANSThe investigation will take several months and can be very costly. According to Rubin's Theory of maternal adjustment, the postpartum woman who continually repeats the story of her labor and delivery experience is: - CORRECT ANSTaking-in and focusing on herself. A nurse in labor and delivery receives a call from the emergency department informing her that they are sending up a stable pregnant patient at 32 week gestation who fell down the stairs. The nurse knows that this patient is at highest risk for which of the following: - CORRECT ANSPlacental abruption How does the nurse document results of a Non-Stress Test during with two or more FHR accelerations of at least 15 beats per minute occurring with fetal movement in a 20-minute period? - CORRECT ANSReactive A patient who delivered 2 days ago reports a heavy, foul-smelling lochia with strong uterine contractions persisting after birth and unrelieved with Motrin. Her temperature has been elevated ranging from 100.6 F to 101.3F, for the past 2 days. Her uterus is firm at 3 fingerbreadths above the umbilicus and very tender. The nurse would suspect: - CORRECT ANSEndometritis On the first postpartum day, a patient reports perineal pressure and pain that was unrelieved by ibuprofen 600 mg given just 2 hours ago. The assessment reveals a firm fundus at U/U and only small lochia rubra. The nurse would assess for which of the following: - CORRECT ANSPerineal hematoma Which of the following data on a client's health history would most likely place her at highest risk for an ectopic pregnancy? - CORRECT ANSRecurrent pelvic infections An amniotic fluid embolism is likely to lead to immediate respiratory distress, cyanosis and/or cardiac arrest. - CORRECT ANSTrue 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. Her fetus is at the greatest risk for which condition? - CORRECT ANSMacrosomia A patient is undergoing induction of labor and is currently in the transition phase of labor. While evaluating the external fetal monitor tracing, the nurse notes the fetal heart rate (FHR) tracing below. What is the priority independent nursing intervention the nurse should implement: -Normal HR -Early Decels - CORRECT ANSDocument the finding in the client's record. After delivery of the head, a client develops shoulder dystocia. The nurse can assist the health care provider by performing which of the following interventions? - CORRECT ANSApply suprapubic pressure to maneuver the anterior shoulder under the pubic bone A woman telephones the labor unit and says she has been having increasingly worse back discomfort that "comes and goes" all day and is unrelieved with rest, hydration and urination. She is at 32 weeks gestation. The nurse should tell the woman that she: - CORRECT ANSShould come to the hospital for further evaluation Which of the following observations may indicate compromise of fetal well-being? - CORRECT ANSA positive contraction stress test The major advantage of chorionic villus sampling over amniocentesis is that it : - CORRECT ANSCan be performed earlier in gestation. A nurse has assessed a woman who gave birth vaginally 12 hours ago with small lochia rubra. Which of the following findings would require further assessment? - CORRECT ANSSeparation of the longitudinal abdominal wall muscles A pregnant woman is 28 weeks pregnant when she experiences vaginal bleeding. Upon her arrival at the hospital, what would be an expected procedure? - CORRECT ANSUltrasound for placental location A woman with pre-eclampsia is being treated with bed rest and intravenous magnesium sulfate. The indication for this medication is to act as a(n): - CORRECT ANSAnticonvulsant A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant via cesarean section following a pregnancy with placenta previa. The nurse reviews the plan of care and knows that the highest risk associated with this diagnosis is: - CORRECT ANSHemorrhage A woman 24 hours postpartum complains of profuse diaphoresis. She has no other complaints. Which of the following actions by the nurse is appropriate? - CORRECT ANSReassure the women that this is normal. A woman is having an eclamptic seizure. What is the nurse's highest priority during a seizure? - CORRECT ANSTo stay with the client and call for help A client is scheduled for an external cephalic version for breech position. The nurse would expect to prepare which of the following medications to be administered prior to the procedure. - CORRECT ANSTerbutaline (Brethine) Which newborn complication is commonly seen with a vacuum assisted delivery? - CORRECT ANSHyperbilirubinemia You are assessing the midline episiotomy of a postpartum patient. Which of the following findings would you expect to see? - CORRECT ANSWell-approximated edges Based on the fetal heart rate and contraction pattern below of a patient being augmented during her labor, which priority nursing action is indicated? -normal rate -looks like late decels idk wtf the deal is - CORRECT ANS. Continue to provide routine labor support and document. Which of the following documentation entries in the client's medical record on postpartum day 10 indicates normal postpartum adaptation? - CORRECT ANSFundus below the symphysis and not palpable The prenatal clinic nurse assesses a 30-year-old primigravid woman at 16 weeks' gestation. The patient's blood pressure, measured twice at intervals 24 hour apart, is 146/86 mmHg & 142/96 mmHg. This Hypertension in Pregnancy finding is best described as: - CORRECT ANSChronic hypertension A woman gave birth to a healthy infant five days ago. What type of lochia does the nurse expect to find when evaluating this client? - CORRECT ANSLochia serosa The fetal heart rate is monitored during labor of a full term fetus. Components of a Category I tracing must include: (Select all that apply) - CORRECT ANS-Fetal heart rate baseline from 110- 160 beats per minute -Moderate baseline variability -Absence or presence of fetal heart rate accelerations Cytotec (misoprostol) has been ordered for a pregnant woman at 41 weeks gestation. The nurse recognizes that this medication will be administered to - CORRECT ANSRipen the cervix in preparation for labor induction Which statement best describes postpartum depression? - CORRECT ANSSigns include ambivalence toward newborn, weight loss, and sleeplessness that may last up to one year after delivery. The RN is assigned to a patient whose labor is being induced with an IV oxytocin (Pitocin) infusion. Which of the following adverse effects of this medication will the nurse need to monitor for? Select all that apply - CORRECT ANS-Uterine rupture -Fetal hypoxia -Water intoxication -Uterine tachysystole The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve: - CORRECT ANSIV therapy to correct fluid and electrolyte imbalances. A woman, who is 8 weeks pregnant, is diagnosed as having an inevitable abortion. All of the following symptoms may be present with spontaneous abortions. In order to be classified as an inevitable abortion, which of these symptoms must be present? - CORRECT ANS. Cervical dilation A woman is in active labor. During artificial rupture of her membranes, the nurse notices variable decelerations of the fetal heart rate, followed by fetal bradycardia. Upon on further assessment, a small section of the umbilical cord is seen protruding from the vagina. What should be done do next? - CORRECT ANSPlace patient in Trendelenburg or knee-chest position In planning for the care of a 30-year-old woman with pre-gestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: - CORRECT ANSDegree of glycemic control during pregnancy A postpartum client calls the office where you are a nurse and complains of a unilateral, reddened, swollen, and tender breast 12 days after delivery. Based on this finding, the nurse would advise the client that: - CORRECT ANSThese symptoms suggest an inflammatory or infectious process and she needs to be seen by her provider for follow-up. A patient at 39 weeks gestation is admitted for induction. Which of the following are contraindications for induction of labor? (Select all that apply): - CORRECT ANS-Placenta previa -Active maternal genital herpes infection -Breech presentation -Placenta previa A pregnant woman's BPP score is 8. She asks the nurse to explain the results. How should the nurse respond at this time? - CORRECT ANS"The test results are within normal limits." The nurse observes that a mother who is 3 days postpartum seems to ignore her newborn. A strategy that the nurse can use to facilitate mother-infant attachment in this mother is to: - CORRECT ANSshow the mother how the baby initiates and reciprocates during interactions. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine if the fetus has: - CORRECT ANSAn open neural tube defect. The client demonstrates understanding of the implications for future pregnancies secondary to her classical uterine incision when she states: - CORRECT ANS"Every time I have a baby, I will have to have a cesarean delivery." During the pelvic examination of a 45-year-old client with a history of 4 vaginal deliveries at term, the nurse notes a bulge on the anterior aspect of the vaginal wall. The patient states that she has dyspareunia and urinary incontinence. Which of the following would be the best explanation for the assessment finding? - CORRECT ANS. This is a cystocele A nurse caring for a laboring woman is aware that variable decelerations are caused by: - CORRECT ANSUmbilical cord compression A labor & delivery nurse is caring for a mildly hypertensive full term multiparous patient who presents to OB triage with severe abdominal pain and mild bright red vaginal bleeding. Her vitals are: BP: 108/67, P: 112 R: 21 T: 97.6. She admits to frequently smoking crack cocaine during her pregnancy and last use was 4 hours ago. The priority assessment for this client would be for symptoms of: - CORRECT ANSPlacental abruption Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion? - CORRECT ANSVariable decelerations A nurse should be aware of the strengths and limitations of various antepartum assessments during pregnancy. Which statement is most accurate concerning these assessments? - CORRECT ANSCell free DNA testing identifies chromosomal abnormalities at a 99% detection rate. The clinic nurse receives a telephone call from a 10-day postpartum client who states that she is having persistent lochia rubra and it has increased instead of decreased. The nurse suspects which of the following as the most common cause of this late-postpartum hemorrhage? - CORRECT ANSRetained placental fragments A 32-year-old primigravida woman is admitted with a diagnosis of tubal ectopic pregnancy. Nursing care is based on the knowledge that: - CORRECT ANSHemorrhage is the major concern Welcome to the Prenatal Clinic! You have a very busy morning scheduled. Ms. E. a 34 year old woman. This is her first prenatal visit and she is 6 weeks pregnant. Ms. E's last menstrual period began on January 20, 2018. She informs the nurse that it was a normal period that lasted 5 days. Based on Naegele's, rule Ms. E's estimated date of delivery is: - CORRECT ANSOctober 27, 2018 Welcome to the Prenatal Clinic and a very busy morning! Ms. B is 26 years old at 30 weeks gestation. She started prenatal care at 10 weeks and has not experienced any complications. When measuring Ms. B's fundal height measurement, the nurse obtains a measurement of 33 cm. This finding indicates: - CORRECT ANSThe fundal height measurement is too large and the nurse notifies the health care provider caring for Ms. B. Welcome to the Prenatal Clinic! You have a very busy morning scheduled. Ms. E. a 34 year old woman. This is her first prenatal visit and she is 6 weeks pregnant. When taking the patient's health history, the nurse determines that she has had one full-term birth that resulted in a child who is currently alive and healthy; one birth at 24 weeks of gestation and that baby died shortly after delivery; one miscarriage at 14 weeks of gestation; and one voluntary termination of pregnancy at 8 weeks gestation. Her current pregnancy history is best documented as: - CORRECT ANSG 5 P 1-1-2-1 Welcome to the Prenatal Clinic and a very busy morning! Ms. B is 26 years old at 30 weeks gestation. She started prenatal care at 10 weeks and has not experienced any complications. Ms. B. is in the lithotomy position for an internal vaginal exam and complains of dizziness and nausea. What would be an appropriate nursing action to relieve the patient's discomfort? - CORRECT ANSAssisting to a side-lying position temporarily. Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . At 10 AM, Susan's cervix is checked again, and the nurse determines that Susan is in the active phase of labor. During this phase of labor, many women : - CORRECT ANSRequest pain medication Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . After the birth of Susan's infant, the nurse notes that her fundus is firm and has risen in her abdomen. A gush of dark red blood comes from her vagina and the umbilical cord lengthens. The nurse concludes that: - CORRECT ANSThe placenta has separated from the uterine wall Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . Hours later, Susan abruptly stops her previous breathing techniques during a contraction and begins to push. In addition to looking at the perineum, the priority nursing action is to: - CORRECT ANSAsses fetal heart tones Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . At 8 AM when she is being admitted, Susan is not certain she is in labor. Which of the following will best determine the difference between true and false labor? - CORRECT ANSProgressive cervical effacement and dilation. Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . At 10 AM, the physician examines Susan's cervix and determines it is now 5/50/-1. Susan's contractions are now every four minutes and of moderate intensity. Based on the results of the pelvic exam, the nurse interprets that: - CORRECT ANSThe cervix is dilated 5 cm, effaced 50%, and the presenting part is 1 cm above the ischial spines. Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . As labor progresses, it is noted that Susan's baby is in the occiput posterior (OP) position and she is reporting lower back pain. Which of the following non-pharmacologic interventions should be used to alleviate this pain? - CORRECT ANS. Sacral counter pressure Determine the fetal position presented in this graphic: - CORRECT ANSLeft occipitoposterior Some pregnant clients may complain of changes in their voice and nose bleeds. The nurse can tell these clients that these are common reactions to: - CORRECT ANSCongestion and swelling of the upper respiratory tract. Which statement best represents the first stage or the first period of reactivity in the infant - CORRECT ANSIs an excellent time to acquaint the parents with the newborn Which of the following medications is most likely to be used in active labor because of its rapid onset and short half-life? - CORRECT ANSFentanyl (sublimaze) When administering opioids for labor pain, the nurse knows that : - CORRECT ANSRespiratory depression in the neonate is a primary concern. A nurse is reviewing the record of a newly pregnant client. The physician has documented the presence of a Goodell's sign. The nurse determines this sign indicates: - CORRECT ANSSoftening of the cervix A new mom expresses that she wants to have another baby soon. As part of pre-conceptual counseling, the RN advises the new mom that she should: - CORRECT ANSWait about 18 months before trying to conceive again. When blood from the maternal circulation enters the umbilical cord of the fetus, it takes the path of: - CORRECT ANSDuctus venosus, foramen ovale, ductus arteriosus With regard to the structure and function of the placenta, the maternity nurse should be aware that : - CORRECT ANSAs one of its early functions, the placenta acts as an endocrine gland. The primary difference between the labor of a primipara and that of a multipara is the : - CORRECT ANSTotal duration of labor A breastfeeding woman develops engorged breasts at 3 days postpartum. Which of the following actions would help her reduce her engorgement? - CORRECT ANSBreastfeed every 2 hours for adequate lengths of time. An expected maternal physiologic adaptation during pregnancy is : - CORRECT ANSdecrease in diastolic BP mid-pregnancy Which of the following is true about excessive pain in labor ? - CORRECT ANSIt may result in decreased placental perfusion. The nurse should expect the apical heart rate of a stabilized newborn to be in which range? - CORRECT ANS120 to 140 beats/minute At 1 minute after birth a nurse assesses an infant and notes a heart rate greater than 100 beats per minute; some flexion of extremities; a weak cry; grimacing; and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs? - CORRECT ANS6 If the newborn has excess secretions, the mouth and nasal passages can be easily cleared with a bulb syringe. How should the nurse instruct the parents on the use of this instrument? - CORRECT ANSSuction the mouth first. When the largest diameter of the baby's head is at the level of the ischial spines or "zero" station, this mechanism of labor is called: - CORRECT ANSEngagement A pregnant woman at 25 weeks gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? - CORRECT ANSBabies start responding to sound starting about 24 weeks of gestation . A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who: - CORRECT ANSHas at least six wet diapers per day While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate's urinary meatus appears to be located on the underside of the penis. The physician is notified because the nurse suspects which of the following: - CORRECT ANSHypospadias What 2 hormones promote lactation ? - CORRECT ANS. Oxytocin and Prolactin The _____ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream . - CORRECT ANSChorionic villi The nurse notes that the new prenatal client is obese with a BMI of 42. She counsels the patient that her pregnancy weight goal should be approximately: - CORRECT ANS+15 pounds Which renal system adaptation is an anticipated anatomic change of pregnancy ? - CORRECT ANSIncreased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty Touch and massage are thought to decrease or interrupt the pain of labor by : - CORRECT ANSactivating large myelinated nerve fibers. Which statement would be eliminated from your prenatal education class? - CORRECT ANSThe Measles, Mumps, & Rubella (MMR) vaccine should be given during pregnancy when indicated. A woman in labor has just received an epidural block. The most important nursing intervention is to : - CORRECT ANSMonitor blood pressure for possible hypotension Which breastfeeding position would you recommend for a patient who experienced a cesarean delivery two days ago? - CORRECT ANSFootball hold Which of the following is a contraindication for epidural placement ? - CORRECT ANSMaternal Coagulopathy Which finding may indicate an increased risk in pregnancy? - CORRECT ANSMom recently evacuated from Houston due to Hurricane Harvey. Which of the following signs pertaining to respirations indicate that a newborn is having difficulty adapting to extra-uterine life (select all that apply): - CORRECT ANS-Expiratory grunting -Respirations of 66/min -Inspiratory nasal flaring Which is most important in the immediate care of the newborn? - CORRECT ANSMaintain a patent airway A client who is 14 weeks pregnant states "Ever since I've been pregnant, I've had a hard time having a bowel movement." Increased levels of what hormone is primarily responsible for this common discomfort of pregnancy? - CORRECT ANSProgesterone Which of the following is considered a positive sign for pregnancy ? - CORRECT ANS. Auscultating fetal heart tones During childbirth preparation classes for a group of adolescents, one of the clients asks "How does the baby breathe inside of me?" The nurse responds by explaining fetal circulation, stating that oxygenated blood from the placenta goes to the fetus through the: - CORRECT ANSUmbilical vein As the nurse assists a new mother with breastfeeding, the client asks, "If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better?" What is the nurse's best response? - CORRECT ANSImportant immunoglobulins Which of the following is a result of hypothermia in the newborn? - CORRECT ANSIncreased oxygen demand It is important for the nurse to understand that the placenta : - CORRECT ANSSecretes both estrogen and progesterone. A nurse is reinforcing teaching to a group of pregnant women regarding common discomforts during pregnancy . Which of the following can occur during pregnancy (Select all that apply) - CORRECT ANS-Urinary frequency -Heartburn -Fatigue A nurse is discussing storage of breast milk with a mother whose infant is preterm and in the special care unit. What statement indicates that Abnormal skin lesions on a newborn can result from exposure to the following maternal infections (select all that apply): - CORRECT ANS-Herpes Simplex Virus (HSV) -Varicella - Cytomegalovirus (CMV) -Rubella During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is the most important for the nurse to perform? - CORRECT ANSAssess whether the client understands the discussion A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection and she has been using an over the counter cream for the past two days to treat it. How should the nurse initially respond? - CORRECT ANSAsk the woman to describe the symptoms that indicate to her she has a vaginal infection. A woman is menstruating. If hormonal studies were done at this time, which of the following hormone levels would the nurse expect? - CORRECT ANSBoth estrogen and progesterone are low. The Clinical Nurse Leader has been asked to plan health promotion activity for women in their 50's for a community event. The main focus should be on prevention of: - CORRECT ANSCancer A couple arrives at their first appointment at an infertility center. Which of the following is a noninvasive test performed during the initial diagnostic phase of testing? - CORRECT ANSSemen analysis Based on the Affordable Care Act 0f 2012, HIV counseling and screening for sexually active women should be covered: - CORRECT ANSAnnually Injectable progestins (DMPA, Depo-Provera) are a good contraceptive choice for women who: - CORRECT ANSHave difficulty remembering to take oral contraceptives daily. A non-pregnant, non-sexually-active client reports a thin, white, watery vaginal discharge with a foul odor. The most likely diagnosis is: - CORRECT ANSBacterial Vaginosis Health behaviors and lifestyle choices can affect fertility. Which of the following practices could enhance a couple's ability to conceive? - CORRECT ANSUse balanced nutrition and exercise to achieve a normal BMI Which statement best exemplifies contemporary maternity nursing? - CORRECT ANSFamily-centered care In developing a culture of safety, which of the following actions would be considered "proactive?" - CORRECT ANSTeam STEPPS safety training An example of a positive adoption language statement made by the nurse is: - CORRECT ANS"The couple is in the process of making an adoption plan." The maternity nurse's best defense against an accusation of malpractice or negligence is that the nurse: - CORRECT ANSmet the standards of care for the area in which they practice. An effective relief measure for Primary Dysmenorrhea would be: - CORRECT ANSNon-steroidal anti-inflammatories (NSAID's) According to the Davidson model of grief, the initial stage of grief is characterized by: - CORRECT ANSshock & numbness Women who identify themselves as lesbian and bisexual women are more likely to experience intimate partner violence than women who identify themselves as heterosexual. - CORRECT ANSTrue Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasing hormone (GnRH) and follicle-stimulating hormone (FSH)? - CORRECT ANSFollicular Phase You are providing a postpartum patient with information about contraception. She asks you "Is breastfeeding an effective method of birth control?" Which of the following is the most accurate response? - CORRECT ANS"You will need another form of contraception once you start menstruating or at 6 months postpartum - whichever is sooner." You are the nurse caring for Arnold and Cecile, a couple in their early 30s who have been trying to get pregnant for the last 18 months. A thorough health and sexual history reveals that Cecile had chlamydia and gonorrhea twice in her twenties. This history put the couple at risk for infertility related to: - CORRECT ANSFallopian tube obstruction Which of the following methods of contraception is most likely to result in an unwanted pregnancy? - CORRECT ANSCondoms In a normal 28 day menstrual cycle when would you expect the luteinizing hormone (LH) surge to occur? - CORRECT ANSDays 13-15 A nurse is teaching a group of peer health care workers about sexually transmitted infections. You know your teaching is effective when one participant states: - CORRECT ANS"Chlamydia rates have steadily increased over the last two decades." You are teaching your patient about her menstrual cycle and fertility awareness. Which of the following sign or symptom is associated with ovulation : - CORRECT ANSIncrease in Basal Body Temperature A woman gave birth to twin girls, one of whom was stillborn. Which nursing action would be least helpful in supporting the woman as she copes with her loss? - CORRECT ANSRemind her that that one daughter survived and is healthy. The RN should be familiar with the use of the 5P's tool for evaluating risk behaviors for sexually transmitted infections. Which components would the nurse include when utilizing the 5 's assessment tool (select all that apply) - CORRECT ANS-Number of partners -Prevention of pregnancy -Protection from STI's -Past History of STI's A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? - CORRECT ANSExplain to the woman the importance of keeping her prenatal care appointments. A client tells the nurse one week after the death of their newborn, "Ever since the baby's funeral, my husband won't talk about the baby. He just goes to work and acts like nothing happened." The husband's behavior most likely represents: - CORRECT ANSInhibited or absent grieving The pregnant woman who becomes infected with chickenpox should be taught to promptly report: - CORRECT ANSCough and/or dyspnea A patient is scheduled for a repeat cesarean. In regards to informed consent, the RN's legal obligation is to: - CORRECT ANSWitness and document that the patient has signed the consent. A client who recently was diagnosed with diabetes verbalizes symptoms of intense itching and white patches on her labia and in her vagina. The nurse anticipates that the APRN will prescribe which of the following medications? - CORRECT ANSFluconazole A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to: - CORRECT ANSEndometriosis A nurse is assessing a newborn born to a mother who used heroin throughout her pregnancy. The nurse knows that the following are signs or symptoms of withdrawal in infants: (Select all that apply) - CORRECT ANS-Irritability -High Pitched Cry -Weight loss or failure to gain weight When assessing women, it is important for a nurse to keep in mind the possibility that they are victims of violence. The nurse should: - CORRECT ANSuse an abuse assessment screen at every encounter. The nurse at the family planning clinic has done some teaching on combined oral contraceptives (COCs) with a client who is 36 years old. The nurse knows that the teaching has been effective when the client responds: - CORRECT ANS"I need to stop smoking before I start taking this type of birth control because I have an increased risk of having a heart attack if I continue". An important teaching point for patients with polycystic ovary syndrome (PCOS) is their increased risk for: - CORRECT ANSType 2 diabetes Which term is an accurate description of the process by which people retain some of their own culture while adopting the practices of the dominant society? - CORRECT ANSAcculturation A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that her best chance is when: - CORRECT ANSLuteinizing hormone is high. Which statement regarding emergency contraception is most correct? - CORRECT ANSEmergency contraceptive pills do not cause an abortion and do not work if the patient is already pregnant. A 30-week pregnant woman presents to OB triage with bright red vaginal bleeding. She reports substance use. Placental abruption is suspected. Which is the most likely etiology? - CORRECT ANSCocaine The nurse in the outpatient clinic has been asked to discuss "the combination pill" with a 17-year old female. Which of the following must be taught to this teen? (select all that apply): - CORRECT ANS-Take one pill at the same time everyday whether you have sex or not. -Call the health care provider right away if you have a severe headache, chest pain, or leg swelling. -The use of "the pill" does not protect you or your partner from sexually transmitted infections. The nurse explains to the clients that clomiphene citrate's (Clomid) action is to: - CORRECT ANSstimulate ovulation. After an initial loading dose of penicillin, the physician writes an order for the laboring woman to receive the medication every four hours until delivery. The rationale for this order is because the laboring woman had the following lab value. - CORRECT ANSGroup B Streptococcus (GBS) positive A 36-year-old woman has been diagnosed with having uterine fibroids. When planning care for this client, the nurse should know that: - CORRECT ANSMenorrhagia is a common finding. With regard to the assessment of female, male and couple infertility, the nurse should be aware of what information? - CORRECT ANSThe investigation will take several months and can be very costly. According to Rubin's Theory of maternal adjustment, the postpartum woman who continually repeats the story of her labor and delivery experience is: - CORRECT ANSTaking-in and focusing on herself. A nurse in labor and delivery receives a call from the emergency department informing her that they are sending up a stable pregnant patient at 32 week gestation who fell down the stairs. The nurse knows that this patient is at highest risk for which of the following: - CORRECT ANSPlacental abruption How does the nurse document results of a Non-Stress Test during with two or more FHR accelerations of at least 15 beats per minute occurring with fetal movement in a 20-minute period? - CORRECT ANSReactive A patient who delivered 2 days ago reports a heavy, foul-smelling lochia with strong uterine contractions persisting after birth and unrelieved with Motrin. Her temperature has been elevated ranging from 100.6 F to 101.3F, for the past 2 days. Her uterus is firm at 3 fingerbreadths above the umbilicus and very tender. The nurse would suspect: - CORRECT ANSEndometritis On the first postpartum day, a patient reports perineal pressure and pain that was unrelieved by ibuprofen 600 mg given just 2 hours ago. The assessment reveals a firm fundus at U/U and only small lochia rubra. The nurse would assess for which of the following: - CORRECT ANSPerineal hematoma Which of the following data on a client's health history would most likely place her at highest risk for an ectopic pregnancy? - CORRECT ANSRecurrent pelvic infections An amniotic fluid embolism is likely to lead to immediate respiratory distress, cyanosis and/or cardiac arrest. - CORRECT ANSTrue 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. Her fetus is at the greatest risk for which condition? - CORRECT ANSMacrosomia A patient is undergoing induction of labor and is currently in the transition phase of labor. While evaluating the external fetal monitor tracing, the nurse notes the fetal heart rate (FHR) tracing below. What is the priority independent nursing intervention the nurse should implement: -Normal HR -Early Decels - CORRECT ANSDocument the finding in the client's record. After delivery of the head, a client develops shoulder dystocia. The nurse can assist the health care provider by performing which of the following interventions? - CORRECT ANSApply suprapubic pressure to maneuver the anterior shoulder under the pubic bone A woman telephones the labor unit and says she has been having increasingly worse back discomfort that "comes and goes" all day and is unrelieved with rest, hydration and urination. She is at 32 weeks gestation. The nurse should tell the woman that she: - CORRECT ANSShould come to the hospital for further evaluation Which of the following observations may indicate compromise of fetal well-being? - CORRECT ANSA positive contraction stress test The major advantage of chorionic villus sampling over amniocentesis is that it : - CORRECT ANSCan be performed earlier in gestation. A nurse has assessed a woman who gave birth vaginally 12 hours ago with small lochia rubra. Which of the following findings would require further assessment? - CORRECT ANSSeparation of the longitudinal abdominal wall muscles A pregnant woman is 28 weeks pregnant when she experiences vaginal bleeding. Upon her arrival at the hospital, what would be an expected procedure? - CORRECT ANSUltrasound for placental location A woman with pre-eclampsia is being treated with bed rest and intravenous magnesium sulfate. The indication for this medication is to act as a(n): - CORRECT ANSAnticonvulsant A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant via cesarean section following a pregnancy with placenta previa. The nurse reviews the plan of care and knows that the highest risk associated with this diagnosis is: - CORRECT ANSHemorrhage A woman 24 hours postpartum complains of profuse diaphoresis. She has no other complaints. Which of the following actions by the nurse is appropriate? - CORRECT ANSReassure the women that this is normal. A woman is having an eclamptic seizure. What is the nurse's highest priority during a seizure? - CORRECT ANSTo stay with the client and call for help A client is scheduled for an external cephalic version for breech position. The nurse would expect to prepare which of the following medications to be administered prior to the procedure. - CORRECT ANSTerbutaline (Brethine) Which newborn complication is commonly seen with a vacuum assisted delivery? - CORRECT ANSHyperbilirubinemia You are assessing the midline episiotomy of a postpartum patient. Which of the following findings would you expect to see? - CORRECT ANSWell-approximated edges Based on the fetal heart rate and contraction pattern below of a patient being augmented during her labor, which priority nursing action is indicated? -normal rate -looks like late decels idk wtf the deal is - CORRECT ANS. Continue to provide routine labor support and document. Which of the following documentation entries in the client's medical record on postpartum day 10 indicates normal postpartum adaptation? - CORRECT ANSFundus below the symphysis and not palpable The prenatal clinic nurse assesses a 30-year-old primigravid woman at 16 weeks' gestation. The patient's blood pressure, measured twice at intervals 24 hour apart, is 146/86 mmHg & 142/96 mmHg. This Hypertension in Pregnancy finding is best described as: - CORRECT ANSChronic hypertension A woman gave birth to a healthy infant five days ago. What type of lochia does the nurse expect to find when evaluating this client? - CORRECT ANSLochia serosa The fetal heart rate is monitored during labor of a full term fetus. Components of a Category I tracing must include: (Select all that apply) - CORRECT ANS-Fetal heart rate baseline from 110- 160 beats per minute -Moderate baseline variability -Absence or presence of fetal heart rate accelerations Cytotec (misoprostol) has been ordered for a pregnant woman at 41 weeks gestation. The nurse recognizes that this medication will be administered to - CORRECT ANSRipen the cervix in preparation for labor induction Which statement best describes postpartum depression? - CORRECT ANSSigns include ambivalence toward newborn, weight loss, and sleeplessness that may last up to one year after delivery. The RN is assigned to a patient whose labor is being induced with an IV oxytocin (Pitocin) infusion. Which of the following adverse effects of this medication will the nurse need to monitor for? Select all that apply - CORRECT ANS-Uterine rupture -Fetal hypoxia -Water intoxication -Uterine tachysystole The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve: - CORRECT ANSIV therapy to correct fluid and electrolyte imbalances. A woman, who is 8 weeks pregnant, is diagnosed as having an inevitable abortion. All of the following symptoms may be present with spontaneous abortions. In order to be classified as an inevitable abortion, which of these symptoms must be present? - CORRECT ANS. Cervical dilation A woman is in active labor. During artificial rupture of her membranes, the nurse notices variable decelerations of the fetal heart rate, followed by fetal bradycardia. Upon on further assessment, a small section of the umbilical cord is seen protruding from the vagina. What should be done do next? - CORRECT ANSPlace patient in Trendelenburg or knee-chest position In planning for the care of a 30-year-old woman with pre-gestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: - CORRECT ANSDegree of glycemic control during pregnancy A postpartum client calls the office where you are a nurse and complains of a unilateral, reddened, swollen, and tender breast 12 days after delivery. Based on this finding, the nurse would advise the client that: - CORRECT ANSThese symptoms suggest an inflammatory or infectious process and she needs to be seen by her provider for follow-up. A patient at 39 weeks gestation is admitted for induction. Which of the following are contraindications for induction of labor? (Select all that apply): - CORRECT ANS-Placenta previa -Active maternal genital herpes infection -Breech presentation -Placenta previa A pregnant woman's BPP score is 8. She asks the nurse to explain the results. How should the nurse respond at this time? - CORRECT ANS"The test results are within normal limits." The nurse observes that a mother who is 3 days postpartum seems to ignore her newborn. A strategy that the nurse can use to facilitate mother-infant attachment in this mother is to: - CORRECT ANSshow the mother how the baby initiates and reciprocates during interactions. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine if the fetus has: - CORRECT ANSAn open neural tube defect. The client demonstrates understanding of the implications for future pregnancies secondary to her classical uterine incision when she states: - CORRECT ANS"Every time I have a baby, I will have to have a cesarean delivery." During the pelvic examination of a 45-year-old client with a history of 4 vaginal deliveries at term, the nurse notes a bulge on the anterior aspect of the vaginal wall. The patient states that she has dyspareunia and urinary incontinence. Which of the following would be the best explanation for the assessment finding? - CORRECT ANS. This is a cystocele A nurse caring for a laboring woman is aware that variable decelerations are caused by: - CORRECT ANSUmbilical cord compression A labor & delivery nurse is caring for a mildly hypertensive full term multiparous patient who presents to OB triage with severe abdominal pain and mild bright red vaginal bleeding. Her vitals are: BP: 108/67, P: 112 R: 21 T: 97.6. She admits to frequently smoking crack cocaine during her pregnancy and last use was 4 hours ago. The priority assessment for this client would be for symptoms of: - CORRECT ANSPlacental abruption Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion? - CORRECT ANSVariable decelerations A nurse should be aware of the strengths and limitations of various antepartum assessments during pregnancy. Which statement is most accurate concerning these assessments? - CORRECT ANSCell free DNA testing identifies chromosomal abnormalities at a 99% detection rate. The clinic nurse receives a telephone call from a 10-day postpartum client who states that she is having persistent lochia rubra and it has increased instead of decreased. The nurse suspects which of the following as the most common cause of this late-postpartum hemorrhage? - CORRECT ANSRetained placental fragments A 32-year-old primigravida woman is admitted with a diagnosis of tubal ectopic pregnancy. Nursing care is based on the knowledge that: - CORRECT ANSHemorrhage is the major concern Welcome to the Prenatal Clinic! You have a very busy morning scheduled. Ms. E. a 34 year old woman. This is her first prenatal visit and she is 6 weeks pregnant. Ms. E's last menstrual period began on January 20, 2018. She informs the nurse that it was a normal period that lasted 5 days. Based on Naegele's, rule Ms. E's estimated date of delivery is: - CORRECT ANSOctober 27, 2018 Welcome to the Prenatal Clinic and a very busy morning! Ms. B is 26 years old at 30 weeks gestation. She started prenatal care at 10 weeks and has not experienced any complications. When measuring Ms. B's fundal height measurement, the nurse obtains a measurement of 33 cm. This finding indicates: - CORRECT ANSThe fundal height measurement is too large and the nurse notifies the health care provider caring for Ms. B. Welcome to the Prenatal Clinic! You have a very busy morning scheduled. Ms. E. a 34 year old woman. This is her first prenatal visit and she is 6 weeks pregnant. When taking the patient's health history, the nurse determines that she has had one full-term birth that resulted in a child who is currently alive and healthy; one birth at 24 weeks of gestation and that baby died shortly after delivery; one miscarriage at 14 weeks of gestation; and one voluntary termination of pregnancy at 8 weeks gestation. Her current pregnancy history is best documented as: - CORRECT ANSG 5 P 1-1-2-1 Welcome to the Prenatal Clinic and a very busy morning! Ms. B is 26 years old at 30 weeks gestation. She started prenatal care at 10 weeks and has not experienced any complications. Ms. B. is in the lithotomy position for an internal vaginal exam and complains of dizziness and nausea. What would be an appropriate nursing action to relieve the patient's discomfort? - CORRECT ANSAssisting to a side-lying position temporarily. Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . At 10 AM, Susan's cervix is checked again, and the nurse determines that Susan is in the active phase of labor. During this phase of labor, many women : - CORRECT ANSRequest pain medication Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . After the birth of Susan's infant, the nurse notes that her fundus is firm and has risen in her abdomen. A gush of dark red blood comes from her vagina and the umbilical cord lengthens. The nurse concludes that: - CORRECT ANSThe placenta has separated from the uterine wall Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . Hours later, Susan abruptly stops her previous breathing techniques during a contraction and begins to push. In addition to looking at the perineum, the priority nursing action is to: - CORRECT ANSAsses fetal heart tones Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . At 8 AM when she is being admitted, Susan is not certain she is in labor. Which of the following will best determine the difference between true and false labor? - CORRECT ANSProgressive cervical effacement and dilation. Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . At 10 AM, the physician examines Susan's cervix and determines it is now 5/50/-1. Susan's contractions are now every four minutes and of moderate intensity. Based on the results of the pelvic exam, the nurse interprets that: - CORRECT ANSThe cervix is dilated 5 cm, effaced 50%, and the presenting part is 1 cm above the ischial spines. Susan S. is a 34 year old G2P1 at 38 weeks gestation. She presents to the Labor and Delivery unit at 8 AM stating that she has been having mild to moderate contractions every 5 minutes for an hour. A pelvic exam reveals that her cervix is 2 cm dilated and 25% effaced. She also informs the nurse that she has been leaking some fluid since the middle of the night . As labor progresses, it is noted that Susan's baby is in the occiput posterior (OP) position and she is reporting lower back pain. Which of the following non-pharmacologic interventions should be used to alleviate this pain? - CORRECT ANS. Sacral counter pressure Determine the fetal position presented in this graphic: - CORRECT ANSLeft occipitoposterior Some pregnant clients may complain of changes in their voice and nose bleeds. The nurse can tell these clients that these are common reactions to: - CORRECT ANSCongestion and swelling of the upper respiratory tract. Which statement best represents the first stage or the first period of reactivity in the infant - CORRECT ANSIs an excellent time to acquaint the parents with the newborn Which of the following medications is most likely to be used in active labor because of its rapid onset and short half-life? - CORRECT ANSFentanyl (sublimaze) When administering opioids for labor pain, the nurse knows that : - CORRECT ANSRespiratory depression in the neonate is a primary concern. A nurse is reviewing the record of a newly pregnant client. The physician has documented the presence of a Goodell's sign. The nurse determines this sign indicates: - CORRECT ANSSoftening of the cervix A new mom expresses that she wants to have another baby soon. As part of pre-conceptual counseling, the RN advises the new mom that she should: - CORRECT ANSWait about 18 months before trying to conceive again. When blood from the maternal circulation enters the umbilical cord of the fetus, it takes the path of: - CORRECT ANSDuctus venosus, foramen ovale, ductus arteriosus With regard to the structure and function of the placenta, the maternity nurse should be aware that : - CORRECT ANSAs one of its early functions, the placenta acts as an endocrine gland. The primary difference between the labor of a primipara and that of a multipara is the : - CORRECT ANSTotal duration of labor A breastfeeding woman develops engorged breasts at 3 days postpartum. Which of the following actions would help her reduce her engorgement? - CORRECT ANSBreastfeed every 2 hours for adequate lengths of time. An expected maternal physiologic adaptation during pregnancy is : - CORRECT ANSdecrease in diastolic BP mid-pregnancy Which of the following is true about excessive pain in labor ? - CORRECT ANSIt may result in decreased placental perfusion. The nurse should expect the apical heart rate of a stabilized newborn to be in which range? - CORRECT ANS120 to 140 beats/minute At 1 minute after birth a nurse assesses an infant and notes a heart rate greater than 100 beats per minute; some flexion of extremities; a weak cry; grimacing; and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs? - CORRECT ANS6 If the newborn has excess secretions, the mouth and nasal passages can be easily cleared with a bulb syringe. How should the nurse instruct the parents on the use of this instrument? - CORRECT ANSSuction the mouth first. When the largest diameter of the baby's head is at the level of the ischial spines or "zero" station, this mechanism of labor is called: - CORRECT ANSEngagement A pregnant woman at 25 weeks gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? - CORRECT ANSBabies start responding to sound starting about 24 weeks of gestation . A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who: - CORRECT ANSHas at least six wet diapers per day While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate's urinary meatus appears to be located on the underside of the penis. The physician is notified because the nurse suspects which of the following: - CORRECT ANSHypospadias What 2 hormones promote lactation ? - CORRECT ANS. Oxytocin and Prolactin The _____ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream . -