Notesale: Turn your study into money

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Chapter 01: Perspectives on Maternal, Newborn, and Womens Health
Care
1
...
When developing
programs to assist in decreasing these rates, which factor would most likely
need to be addressed as having the greatest impact?
A)Resolving all language and cultural differences
B) Assuring early and adequate prenatal care
C) Providing more extensive women's shelters
D)Encouraging all women to eat a balanced diet
2
...
When preparing a teaching plan for a group of first-time pregnant women,
the nurse expects to review how maternity care has changed over the years
...
After teaching a group of students about pregnancy-related mortality, the
instructor determines that
additional teaching is needed when the students identify which condition as
a leading cause?
A)Hemorrhage
B) Embolism
C) Obstructed labor
D)Infection
5
...
Which of the
following conditions would the group address as the major problem?
A)Smoking
B) Heart disease
C) Diabetes
D)Cancer

6
...
After teaching a group of nursing students about the issue of informed
consent
...
The nurse is trying to get consent to care for an 11-year-old boy with
diabetic ketoacidosis
...
Which action would be the priority?
A)Getting telephone consent with two people listening to the verbal consent
B) Providing emergency care without parental consent
C) Contacting the childs aunt or uncle to obtain their consent
D)Advocating for termination of parental rights for this situation
9
...

B) Families are not capable of making health care decisions for themselves
...

D)Childbirth is a medical procedure
...
A nursing instructor is preparing a class discussion on the trends in health
care and health care delivery
over the past several centuries
...
A nurse is assigned to care for an Asian American client
...

B) A punishment for sins
...

D) From an imbalance of yin and yang
12
...
Which of the following would be
most important for the nurse to incorporate into that plan?
A) Adhering to strict, specific routines
B) Involving a pediatric physician
C) Educating the client about the importance of a support person
D) Assigning several nurses as a support team

13
...
Which of the following would the
instructor include as a key component? Select all that apply
...
After teaching a group of students about the concept of maternal
mortality, the instructor determines that additional teaching is needed when
the students state which of the following?
A) The rate includes accidental causes for deaths
...

C) The duration of the pregnancy is not a concern
...

15
...

The students demonstrate
understanding of the information when they identify the use of twilight sleep
as a key event during which
time frame?
A) 1700s
B) 1800s
C) 1900s
D) 2000s

16
...
Which action would least likely demonstrate application of the
concept of family-centered care?
A) Focusing on the birth as a normal healthy event for the family
B) Creating opportunities for the family to make informed decisions
C) Encouraging the woman to keep her other children at home
D) Fostering a sense of respect for the mother and the family
17
...
Which of the following would the nurse most
likely include? Select all that apply
...
A nurse is preparing a presentation for a local community group about
health status and children health
...
A group of students are reviewing an article describing information
related to indicators for women's health and the results of a national study
...

A) Smoking cessation
B) Colorectal cancer screening
C) Violence against women
D) Health insurance coverage
E) Mammograms
20
...
Which of the following would the nurse expect to
address when discussing measures to promote health
...

B) Heart disease is no longer viewed as a man's disease
...

D) Heart attacks in women are more easily diagnosed
...
A nurse is working to develop a health education program for a local
community to address breast cancer awareness
...

A) White women have higher rates of breast cancer than African American
women
...

C) Survival at any stage is worse among white women
...

E) Breast cancer is the leading cause of cancer mortality in women
...
A group of nursing students are reviewing information about factors
affecting maternal, newborn, and
women's health
...

A) Literacy
B) Employment opportunities
C) Mobility
D) Political representation
E) Skills

Answer Key
1
...
C
3
...
B

5
...
D
7
...
A
9
...
D
11
...
C
13
...
A
15
...
C
17
...
C
19
...
C
21
...
A,

B, C, D

C, D
E
B
B, C, D, E

Chapter 02: Family-Centered Community-Based Care

1
...
Which of the following
activities would deviate from the characteristics of family-centered care?
A)Softening unpleasant information or prognoses
B) Evaluating and changing the nursing plan of care
C) Collaborating with the child and family as equals
D)Showing respect for the familys beliefs and wishes
2
...
Which of the
following activities would be considered the tertiary level of prevention?
A)Arranging for a physical therapy session
B) Teaching parents to administer albuterol
C) Reminding parent to give a full course of antibiotics
D)Giving a DTaP vaccination at the proper interval
3
...
The student demonstrates a need for
additional study when the nurse identifies which of the following as a reason?
A)Serves as a communication tool for the interdisciplinary team
...

C) Permits others access to allow refusal of medical insurance coverage
...

4
...
After educating the client on the advantages and disadvantages, which
statement would indicate that the client understood the
information?
A)I like having the privacy, but it might be too expensive for me to set up in
my home
...

C) It is safer because I will have a midwife
...

5
...
Assessment reveals that the client is complaining of intermittent
pain, rating it as 8 on a scale of 1 to 10
...
And with
this pain, I havent been drinking and eating like I should
...
My mom has been helping with the baby
...
Which nursing
diagnosis would the nurse identify as the priority for this client?
A)Impaired skin integrity related to cesarean birth incision

B) Fatigue related to effects of surgery and caretaking activities
C) Imbalanced nutrition, less than body requirements related to poor fluid
and food intake
D)Acute pain related to incision and cesarean birth
6
...
After teaching a group of students about the changes in health care
delivery and funding, which of the
following, if identified by the group as a current trend seen in the maternal
and child health care settings,
would indicate that the teaching was successful?
A)Increase in community settings for care
B) Decrease in family poverty level
C) Increase in hospitalization of children
D)Decrease in managed care
8
...
Which action would the nurse include in a primary prevention program in
the community to help reduce the incidence of HIV infection?
A)Provide treatment for clients who test positive for HIV
B) Monitor viral load counts periodically
C) Educate clients in how to practice safe sex
D)Offer testing for clients who practice unsafe sex
10
...
When comparing community-based nursing with nursing in the acute care
setting to a group of nursing
students, the nurse describes the challenges associated with communitybased nursing
...
After teaching a group of students about the different levels of
prevention, the instructor determines a need for additional teaching when
the students identify which of the following as a secondary prevention level
activity in community-based health care?
A) Teaching women to take folic acid supplements to prevent neural tube
defects
B) Working with women who are victims of domestic violence
C) Working with clients at an HIV clinic to provide nutritional and CAM
therapies
D) Teaching hypertensive clients to monitor blood pressure

13
...
The instructor addresses the length of stay for vaginal births during the
past decade, citing that which of the following denotes the
average stay?
A) 2448 hours or less
B) 7296 hours or less
C) 4872 hours or less
D) 96120 hours or less
14
...

B) Women make almost 90% of all health care decisions
...

D) Men use more health services than women
...
A nurse is educating a client about a care plan
...
A nurse is developing cultural competence
...

A) Examining personal sociocultural heritage
B) Reviewing personal biases and prejudices
C) Seeking resources to further understanding of other cultures
D) Becoming familiar with other culturally diverse lifestyles
E) Performing a competent cultural assessment
F) Advocating for social justice to eliminate disparities
...
A nurse is engaged in providing family-centered care for a woman and her
family
...

B) Assisting the woman in breathing techniques to cope with labor
contractions
...
A nurse is considering a change in employment from the acute care
setting to community-based nursing
...
Which of the following would the nurse most likely
find as a possible setting? Select all that apply
...
A nursing instructor is presenting a class for a group of students about
community-based nursing
interventions
...
During class, a nursing student asks, I read an article that was talking
about integrative medicine
...

B) It means that complementary and alternative medicine is used together
with conventional therapies to
reduce pain or discomfort
...

D) It refers to situations when a client and his or her family prefer to use an
unproven method of treatment
over a proven one
...
While a nurse is obtaining a health history, the client tells the nurse that
she practices aromatherapy
...

22
...

She says, I'm thinking about using one but I'm not sure
...
)
A) An alternative for women who are uncomfortable with a home birth
...
A nurse practicing in the community is preparing a presentation for a
group of nursing students about this practice setting
...
A nurse is preparing a teaching plan for a woman who is pregnant for the
first time
...
)
A) Teach survival skills first
B) Use simple, nonmedical language
C) Refrain from using a hands-on approach
D) Avoid repeating information
E) Use visual materials such as photos and videos
25
...
The students demonstrate understanding when they identify
which of the following as the final step?
A) Cultural knowledge
B) Cultural skills
C) Cultural encounter
D) Cultural awareness
Answer Key
1
...
A
3
...
B
5
...
C
7
...
B
9
...
C
11
...
A
13
...
B
15
...
C, D
17
...
A, D, E
19
...

21
...

23
...

25
...
When describing the menstrual cycle to a group of young women, the
nurse explains that estrogen levels are highest during which phase of the
endometrial cycle?
A)Menstrual
B) Proliferative
C) Secretory
D)Ischemic
2
...
A client with a 28-day cycle reports that she ovulated on May 10
...
Which female reproductive tract structure would the nurse describe to a
group of young women as
containing rugae that enable it to dilate during labor and birth?
A)Cervix
B) Fallopian tube
C) Vagina
D)Vulva

5
...
The nurse is assessing a 13-year-old girl who has had her first menses
...
When describing the ovarian cycle to a group of students, which phase
would the instructor include?
A) Luteal phase
B) Proliferative phase
C) Menstrual phase
D) Secretory phase
8
...
Which
hormone would the nurse identify as being primarily responsible for
ovulation?
A)Estrogen
B) Progesterone
C) Follicle-stimulating hormone
D)Luteinizing hormone
9
...
Which structure, if identified by the
group, would indicate to the nurse that the teaching was successful?
A)Testes
B) Seminal vesicles
C) Scrotum
D)Prostate gland
10
...
Which
structure would be inappropriate for the nurse to include as an accessory
gland?
A) Seminal vesicles
B) Prostate gland
C) Cowpers glands

D) Vas deferens
11
...
Which event would the nurse identify as occurring first?
A) Sperm emission
B) Penile vasodilation
C) Psychological release
D) Ejaculation
12
...

As part of the clients evaluation, the nurse would anticipate the need to
evaluate which hormone level?
A) Progesterone
B) Estrogen
C) Gonadotropin-releasing hormone
D) Testosterone
13
...
Which of the following would the nurse include as an external
female reproductive organ?
Select all that apply
...
When describing the hormones involved in the menstrual cycle, a nurse
identifies which hormone as
responsible for initiating the cycle?
A) Estrogen
B) Luteinizing hormone
C) Progesterone
D) Prolactin
15
...
The instructor determines the teaching was successful when the
students identify folliclestimulating hormone as being secreted by which of
the following?
A) Hypothalamus
B) Anterior pituitary gland
C) Ovaries
D) Corpus luteum

16
...
During the visit, the
woman tells the nurse that her
menstrual cycles have become irregular
...

The nurse interprets these findings as which of the following?
A) Menopause
B) Perimenopause
C) Climacteric
D) Menarche
17
...
A woman comes to the clinic complaining of a vaginal discharge
...
When gathering additional
information, which of the following would the nurse be least likely to identify
as placing the client at risk for an infection?
A) Recent antibiotic therapy for an upper respiratory infection
B) Last menstrual period about 5 days ago
...

19
...
The students demonstrate understanding of the
information when they identify which of the following as accessory organs?
(Select all that apply
...
A nurse is examining a female client and tests the clients vaginal pH
...
5
B) 7

C) 8
...
When describing the male sexual response to a group of students, the
instructor determines that the
teaching was successful when they identify emission as which of the
following?
A) Semen forced through the urethra to the outside
B) Movement of sperm from the testes and fluid into the urethras
C) Dilation of the penile arteries with increased blood flow to the tissues
...
A nurse is describing the structure and function of the reproductive
system to an adolescent health class
...
B
2
...
A
4
...
D
6
...
A
8
...
A
10
...
B
12
...
A, B, D
14
...
B
16
...
C
18
...
B, C, D
20
...
B
22
...
After discussing various methods of contraception with a client and her
partner, the nurse determines that the teaching was successful when they
identify which contraceptive method as providing protection against sexually
transmitted infections (STIs)?
A)Oral contraceptives
B) Tubal ligation
C) Condoms
D)Intrauterine system
2
...
A client comes to the clinic with abdominal pain
...
The nurse expects to prepare the client for
which of the following to confirm this suspicion?
A)Pelvic examination
B) Transvaginal ultrasound
C) Laparoscopy
D)Hysterosalpingogram
4
...
The nurse describes
this contraceptive as containing:
A) Synthetic progestin
B) Combined estrogen and progestin
C) Concentrated spermicide
D) Concentrated estrogen
5
...
Which method would the nurse explain as being available only with
a prescription?

A)Condom
B) Spermicide
C) Diaphragm
D)Basal body temperature
6
...

B) The best one is the one that is the least expensive and most convenient
...

D)The best contraceptive is one that you will use correctly and consistently
...
Which of the following measures would the nurse include in the teaching
plan for a woman to reduce the risk of osteoporosis after menopause?
A)Taking vitamin supplements
B) Eating high-fiber, high-calorie foods
C) Restricting fluid to 1,000 mL daily
D)Participating in regular daily exercise
8
...
A client states that she is to have a test to measure bone mass to help
diagnose osteoporosis
...
The nurse is reviewing the medical records of several clients
...
Which of the following would the nurse emphasize when teaching
postmenopausal women about ways to reduce the risk of osteoporosis?
A) Swimming daily
B) Taking vitamin A
C) Following a low-fat diet
D) Taking calcium supplements
12
...
After the nurse teaches a client about ways to reduce the symptoms of
premenstrual syndrome, which client statement indicates a need for
additional teaching?
A) I will make sure to take my estrogen supplements a week before my
period
...

C) I'll cut down on the amount of coffee and colas I drink
...


14
...
The nurse instructs the client that a rise in basal body
temperature indicates which of the following?
A) Onset of menses
B) Ovulation
C) Pregnancy
D) Safe period for intercourse
15
...
The nurse
interprets this as which of the following?
A) Spinnbarkeit mucus
B) Purulent mucus
C) Postovulatory mucus
D) Normal preovulation mucus
16
...
Which finding would be of concern?
A) Negative pregnancy test
B) Hemoglobin level of 10
...
A nurse is preparing a class for a group of women at a family planning
clinic about contraceptives
...
)
A) Protection against pelvic inflammatory disease
B) Reduced risk for endometrial cancer
C) Decreased risk for depression
D) Reduced risk for migraine headaches
E) Improvement in acne
18
...
)
A) Condom
B) Cervical cap
C) Cervical sponge
D) Diaphragm
E) Vaginal ring
19
...
Which
statement by the client would support the nurses suspicions?
A) Ive been having bleeding off and on thats irregular and sometimes heavy
...

C) I get really irritable and moody about a week before my period
...

20
...
A nurse is describing the criteria needed for the diagnosis of premenstrual
dysphoric disorder (PMDD)
...
When reviewing the medical record of a client diagnosed with
endometriosis, which of the following would the nurse identify as a risk factor
for this woman?
A) Low fat in the diet
B) Age of 14 years for menarche
C) Menstrual cycles of 24 days
D) Short menstrual flow
23
...

Which of the following would the nurse expect the physician to prescribe as a
first-line treatment?
A) Progestins
B) Antiestrogens
C) Gonadotropin-releasing hormone analogues
D) NSAIDs
24
...

When reviewing the woman's
history, which of the following would the nurse least likely identify as a
possible risk factor?
A) Age of 25 years
B) History of smoking
C) Diabetes since age 15 years
D) Weight below standard for height and age
25
...
The male partner is
to undergo a semen analysis
...

B) I will place the specimen in a special plastic bag to transport it
...

D) I will withdraw before I ejaculate during sex to collect the specimen
...
A nurse is preparing a class for a group of young adult women about
emergency contraceptives (ECs)
...
Select all
that apply
...

B) ECs provide some protection against STIs
C) ECs are birth control pills in higher, more frequent doses
D) ECs are not to be used in place of regular birth control

E) ECs provide little protection for future pregnancies
...
C
2
...
C
4
...
C
6
...
D
8
...
A
10
...
D
12
...
A
14
...
A
16
...
A, B, E
18
...
A
20
...
C
22
...
D
24
...
C
26
...
The nurse is developing a plan of care for a client who is receiving highly
active antiretroviral therapy (HAART) for treatment of HIV
...
A woman who is HIV-positive is receiving HAART and is having difficulty
with compliance
...
When developing a teaching plan for a community group about HIV
infection, which group would the nurse identify as an emerging risk group for
HIV infection?
A)Native Americans
B) Heterosexual women
C) New health care workers
D)Asian immigrants
4
...
The
nurse determines that the teaching was successful when the group identifies
which of the following?
A)Sexual intercourse
B) Sharing needles for IV drug use
C) Perinatal transmission
D)Blood transfusion
5
...
A
result less than which of the following would indicate to the nurse that the
client has AIDS?
A)1,000 cells/mm3
B) 700 cells/mm3
C) 450 cells/mm3
D)200 cells/mm3
6
...
Assessment of a female client reveals a thick, white vaginal discharge
...
Based on these findings, the
nurse would suspect that the client has:
A)Trichomoniasis
B) Bacterial vaginosis
C) Candidiasis
D)Genital herpes simplex

8
...
The nurse
instructs the client to avoid which of the following while taking this drug?
A)Alcohol
B) Nicotine
C) Chocolate
D)Caffeine
9
...
As part of the newborns care,
the nurse instills erythromycin ophthalmic ointment as a preventive measure
related to which STI?
A)Genital herpes
B) Hepatitis B
C) Syphilis
D)Gonorrhea
10
...
A pregnant woman diagnosed with syphilis comes to the clinic for a visit
...
The nurse encourages a female client with human papillomavirus (HPV) to
receive continued follow-up care because she is at risk for:
A) Infertility
B) Dyspareunia
C) Cervical cancer
D) Dysmenorrhea
13
...
When
reviewing the clients medical record, which of the following would the nurse
expect to find? (Select all that apply
...
4 degrees F
B) Dysmenorrhea
C) Dysuria
D) Lower abdominal tenderness
E) Discomfort with cervical motion
F) Multiparity

14
...

B) Wash your bed linens in bleach and cold water
...

D) Remove the nits with a fine-toothed comb
...
A client with genital herpes simplex infection asks the nurse, Will I ever be
cured of this infection? Which response by the nurse would be most
appropriate?
A) There is a new vaccine available that prevents the infection from
returning
...

C) There is no cure, but drug therapy helps to reduce symptoms and
recurrences
...

16
...
Which of the following would the
nurse expect to include as a possible precipitating factor for a recurrent
outbreak? (Select all that apply
...

17
...

B) STIs have been addressed more on a global scale
...

D) Most individuals with STIs are over the age of 30
...
A group of students are reviewing information about STIs
...
A nurse is assessing a client for possible risk factors for chlamydia and
gonorrhea
...
A nurse at a local community clinic is developing a program to address
STI prevention
...
After teaching a class on preventing pelvic inflammatory disease, the
instructor determines that the teaching was successful when the class
identifies which of the following as an effective method?
A) Advising sexually active females to use hormonal contraception
B) Encouraging vaginal douching on a weekly basis
...
A group of nursing students are reviewing information about vaccines
used to prevent STIs
...
A mother brings her 12-year-old daughter in for well-visit checkup
...
The mother agrees and the daughter receives her first dose
...
A woman comes to the clinic complaining of a vaginal discharge
...
)
A) Urinary frequency

B) Yellow/green discharge
C) Joint pain
D) Blister-like lesions
E) Muscle aches
25
...

Which statement by the client indicates a need for additional teaching?
A) I need to wash my hands after touching any of the ulcers
...

C) I should avoid applying ice or heat to my genital area
...


Answer Key
1
...
A
3
...
A
5
...
B
7
...
A
9
...
B
11
...
C
13
...
D
15
...
A, C, D, E
17
...
B
19
...
B
21
...
C, D, E
23
...
A, B
25
...
The nurse is developing the discharge plan for a woman who has had a
left-sided modified radical mastectomy
...
Which suggestion would most likely increase
the woman's symptoms?
A)Wear gloves when you are doing any gardening
...

C) Wear clothing with elasticized sleeves
...

2
...
for a client who had a right-sided mastectomy 8 hours ago
...
To
obtain the blood specimen, the technician places a tourniquet on the clients
right arm
...

B) Suggest a finger stick be done on one of the clients left fingers
...

D)Call the surgeon to perform a femoral puncture
...
The nurse determines that a woman has implemented prescribed therapy
for her fibrocystic breast disease when the client reports that she has
eliminated what from her diet?
A)Caffeine
B) Cigarettes
C) Dairy products
D)Sweets
4
...
A woman who has undergone a right modified-radical mastectomy returns
from surgery
...

B) Attach a sign above her bed to have BP, IV lines, and lab work in her right
arm
...

D)Position her right arm below heart level
...
A breast biopsy indicates the presence of malignant cells, and the client is
scheduled for a mastectomy
...
A 42-year-old woman is scheduled for a mammogram
...

B) Each breast will be firmly compressed between two plates
...

D)A small needle will be inserted to get a sample for evaluation
...
During a clinical breast examination, the nurse palpates a well-defined,
firm, mobile lump in a 60-year-old woman's left breast
...
Which of the following would the nurse anticipate the physician to
order next?
A)Mammogram
B) Hormone receptor status
C) Fine-needle aspiration
D)Genetic testing for BRCA

9
...
Which agent would the
nurse expect the client to receive?
A)Progestins
B) Tamoxifen
C) Cortisone
D)Estrogen
10
...
This groups primary purpose is to:
A) Help support women who have undergone mastectomies
B) Raise funds to support early breast cancer detection programs
C) Provide all supplies needed after breast surgery for no cost
D) Collect statistics for research for the American Cancer Society
11
...
Which of the
following side effects would the nurse interpret as being most serious?

A) Vomiting
B) Hair loss
C) Fatigue
D) Myelosuppression
12
...
On
examination, the area below the areola is red and slightly swollen, with
tortuous tubular swelling
...
When performing a clinical breast examination, which would the nurse do
first?
A) Palpate the axillary area
...

C) Palpate the breasts
...

14
...
25 inches in diameter
...
The nurse interprets this as indicating that the woman has which
stage of breast cancer?
A) 0
B) I
C) II
D) III
15
...

B) I should use the fingerpads of my three middle fingers to apply pressure to
my breast
...

D) I need to work from the center of my breast outward toward my shoulder
...
A nurse is working with a woman who has been diagnosed with severe
fibrocystic breast disease
...
A group of students are reviewing information about benign and
malignant breast masses
...

(Select all the apply
...
The nurse is developing a plan of care for a woman with breast cancer
who is scheduled to undergo breastconserving surgery
...
A woman comes to the clinic and asks the nurse about when she should
have her first mammogram
...
After teaching a group of nursing students about the different types of
chemotherapeutic agents used to treat breast cancer, the instructor
determines that the teaching was successful when the students identify
which of the following as an example of a selective estrogen receptor
modulator (SERM)? (Select all that apply
...
A woman diagnosed with breast cancer is to receive trastuzumab
...

B) The drug blocks the conversion of androgens to estrogens
C) It interferes with hormone receptors that allow estrogen to enter a cell
D) The drug ultimately attacks areas where micrometastasis has occurred
...
A nurse is conducting a class on breast cancer prevention
...

B) Early breast cancer usually has some symptoms
...

D) If lump is palpable, it has been there for some time
...
When describing programs for breast cancer screening, the nurse include
breast self-examination (BSE)
...

B) A woman performing BSE has breast awareness
...

24
...
Which of
the following would the nurse most likely include? (Select all that apply
...
A woman comes to the clinic and tells the nurse that she has read an
article about certain foods that have anticancer properties and help boost
the immune system
...
C
2
...
A
4
...
C

6
...
B
8
...
B
10
...
D
12
...
D
14
...
B
16
...
C,
18
...
C
20
...
A
22
...
B
24
...
A,

D
C

C, D
B, D, E

Chapter 07: Benign Disorders of the Female Reproductive Tract
1
...
She has nine
living children
...
To assist the woman in regaining control of the urinary sphincter for
urinary incontinence, the nurse should teach the client to do which of the
following?
A)Perform Kegel exercises daily
...

C) Limit her intake of fluid
...

3
...
Which of the following would the nurse include when teaching women
about preventing pelvic support disorders?
A)Performing Kegel isometric exercises
B) Consuming low-fiber diets
C) Using hormone replacement
D)Voiding every 2 hours

5
...
The nurse interprets this
condition as:
A) Protrusion of the posterior bladder wall downward through the anterior
vaginal wall
B) Sagging of the rectum with pressure exerted against the posterior vaginal
wall
C) Bulging of the small intestine through the posterior vaginal wall
D) Descent of the uterus through the pelvic floor into the vagina
6
...
When the nurse is explaining this treatment to the
client, which of the following descriptions would be most appropriate to
include?
A)This procedure helps to tighten the vaginal wall in the front and back so
that your bladder and urethra are in the proper position
...

C) This is a series of exercises that you will learn to do so that you can
strengthen your bladder muscles
...

7
...
A client with polycystic ovarian syndrome (PCOS
...
The nurse understands that the
rationale for this therapy is to:
A)Restore menstrual regularity
B) Induce ovulation
C) Improve insulin uptake
D)Alleviate hirsutism

9
...
A postmenopausal woman with uterine prolapse is being fitted with a
pessary
...
When preparing the discharge teaching plan for the woman who had
surgery to correct pelvic organ prolapse, which of the following would the
nurse include?
A) Care of the indwelling catheter at home
B) Emphasis on coughing to prevent complications
C) Return to usual activity level in a few days
D) Daily douching with dilute vinegar solution
12
...
Just look at me! I have no hair on the front of my head but Ive got
hair on my chin and upper lip
...
Further
assessment reveals breast atrophy and increased muscle mass
...
After teaching a local woman's group about incontinence, the nurse
determines that the teaching was successful when the group identifies which
of the following as characteristic of stress incontinence?
A) Feeling a strong need to void
B) Passing a large amount of urine
C) Most common in women after childbirth
D) Sneezing may be an initiating stimulus

14
...
A postvoid residual
urine specimen is obtained via a catheter
...
After teaching a woman with pelvic organ prolapse about dietary and
lifestyle measures, which of the following statements would indicate the
need for additional teaching?
A) If I wear a girdle, it will help support the muscles in the area
...

C) I will try to drink at least 64 oz of fluid each day
...

16
...
A nurse is providing care to a female client receiving treatment for a
Bartholins cyst
...
The nurse instructs the client that she will have a
follow-up appointment for removal of the plastic tubing at which time?
A) 1 week
B) 2 weeks
C) 3 weeks
D) 4 weeks
18
...
The nurse anticipates that the woman will require:
A) Biopsy
B) No treatment
C) Oral contraceptives
D) Glucophage
19
...
Which of the
following would the nurse include? (Select all that apply
...


B) Tighten your pubococcygeal muscles for a count of 10
...

D) Try bearing down for about 10 seconds for no more than 5 times
...

20
...
A nurse is assessing a female client and suspects that the client may
have endometrial polyps based on which of the following?
A) Bleeding after intercourse
B) Vaginal discharge
C) Bleeding between menses
D) Metrorrhagia
22
...
A nurse is reading a journal article about care of the woman with pelvic
organ prolapse
...
)
A) Rectocele
B) Fecal incontinence
C) Cystocele
D) Urinary incontinence
E) Enterocele
24
...
Which of the following
would lead the nurse to suspect that the client is experiencing polycystic
ovarian syndrome? (Select all that apply)
A) Decreased androgen levels
B) Elevated blood insulin levels
C) Anovulation
D) Waist circumference of 32 inches
E) Triglyceride level of 175 mg/dL
F) High-density lipoprotein level of 40 mg/dL

25
...

Which of the following would the students most likely include in the
presentation?
A) Polyps are rarely the result of an infection
...

C) Cervical polyps are more common than endocervical polyps
...

Answer Key
1
...
A
3
...
A
5
...
A
7
...
A
9
...
D
11
...
A
13
...
D
15
...
C
17
...
B
19
...
D
21
...
A
23
...
B, C, E
25
...
The nurse would refer a client, age 54, for follow-up for suspected
endometrial carcinoma if she reports which of the following?
A)Use of oral contraceptives between ages 18 and 25
B) Onset of painless, red postmenopausal bleeding
C) Menopause occurring at age 46
D)Use of intrauterine device for 3 years
2
...

B) Wear cotton panties on the day of the test
...

D) Do not douche for 48 hours before the test
...
A woman comes to the clinic for a routine checkup
...
A client is scheduled to have a Pap smear
...

B) I will take a bath first thing that morning to make sure I'm clean
...

D)I will get a clean urine specimen when I first wake up the morning of the
test
...
Which finding obtained during a client history would the nurse identify as
increasing a clients risk for ovarian cancer?
A)Multiple sexual partners
B) Consumption of a high-fat diet
C) Underweight
D)Grand multiparity (more than five children)
6
...
The nurse teaches the client about this treatment, explaining that
the tissue will be removed by which method?
A)Freezing
B) Cutting
C) Burning
D)Irradiating

7
...

B) Ive thrown out all my bubble baths and just use soap and water now
...


D)My partner always uses a condom when we have sexual intercourse
...
A client is suspected of having endometrial cancer
...
Which of the following descriptions would the nurse include when teaching
a client about her scheduled colposcopy?
A)A gel will be applied to your abdomen and a microphone-like device will be
moved over the area to identify problem areas
...

C) Scrapings of tissue will be obtained and placed on slides to be examined
under the microscope
...

10
...
Which of the following
would the nurse include?
A) Blood pressure evaluation every 6 months
B) Yearly Pap smears starting at age 40
C) Yearly cholesterol screening starting at age 45
D) Consumption of two to three glasses of red wine per day
11
...
Which response by the nurse
would be most appropriate?
A) Currently there is no reliable screening test for ovarian cancer
...

C) Theres a blood test for a marker, CA-125, that if elevated indicates cancer
...

12
...
A woman is diagnosed with adenocarcinoma of the endometrium in situ
...
When preparing a woman with suspected vulvar cancer for a biopsy, the
nurse expects that the lesion would most likely be located at which area?
A) Labia majora
B) Labia minora
C) Clitoris
D) Prepuce
15
...
When assessing a female client for the possibility of vulvar cancer, which
of the following would the nurse most likely expect the client to report?
(Select all that apply
...
A nurse is reviewing the medical record of a woman diagnosed with vulvar
cancer
...
)
A) Age under 40 years
B) HPV 16 exposure
C) Monogamous sexual partner
D) Hypertension
E) Diabetes
18
...
When collecting
the specimen, which of the following is done first?
A) Insertion of the speculum
B) Swabbing of the endocervix
C) Spreading of the labia

D) Insertion of the cytobrush

19
...
Which
of the following would be an appropriate outcome for this client?
A) Client will verbalize positive statements about self and sexuality
...

C) Client will exhibit positive coping strategies related to diagnosis
...

20
...
Which of the following would the
nurse most likely include? (Select all that apply
...
After teaching a group of students about cervical cancer, the instructor
determines that the teaching was successful when the students identify
which of the following as the area included with a cone biopsy?
A) Clitoris
B) Uterine fundus
C) Ovarian follicle
D) Transformation zone
22
...
The nurse would expect to prepare the woman for which of the
following?
A) CA-125 testing
B) Transvaginal ultrasound
C) Pap smear
D) Mammography
23
...
One of the participants asks, At what age
should a woman have her first Pap smear? The nurse responds by stating
that a woman should have her first Pap smear at which age?
A) 18

B) 21
C) 25
D) 28
24
...
The instructor determines that the teaching was successful
when the students identify which area as most commonly involved?
A) Internal cervical os
B) Junction of the cervix and fundus
C) Squamous-columnar junction
D) External cervical os
25
...
Based on
the nurses understanding of this classification, the nurse would expect which
of the following?
A) Immediate colposcopy
B) Testing for HPV
C) Repeat Pap smear in 4 to 6 months
D) Cone biopsy

Answer Key
1
...
D
3
...
C
5
...
A
7
...
D
9
...
C
11
...
C
13
...
A
15
...
B, C
17
...
C
19
...
B, C, D
21
...
B
23
...
C
25
...
The nurse is presenting a class at a local community health center on
violence during pregnancy
...
Which approach would be most appropriate when counseling a woman
who is a suspected victim of violence?
A)Offer her a pamphlet about the local battered women's shelter
...

C) Wait until she comes in a few more times to make a better assessment
...
When describing an episode, the victim reports that she attempted to
calm her partner down to keep things from escalating
...
A battered pregnant woman reports to the nurse that her husband has
stopped hitting her and promises never to hurt her again
...
I wish you both the best
...

C) He probably didn't mean to hurt you
...

5
...

B) Provide information about a safe home and crisis line
...

D) Discuss her legal and personal rights
...
When describing the cycle of violence to a community group, the nurse
explains that the first phase usually is:

A)Somehow triggered by the victims behavior
B) Characterized by tension-building and minor battery
C) Associated with loss of physical and emotional control
D)Like a honeymoon that lulls the victim
7
...

B) Remember, children do best in two-parent families
...

D)You are a good person and you deserve better than this
...
When a nurse suspects that a client may have been abused, the first
action should be to:
A) Ask the client about the injuries and if they are related to abuse
...

C) Set up an appointment with a domestic violence counselor
...

9
...

B) The physical battery is abrupt and unpredictable
...

D)The victim accepts the anger as legitimately directed at her
...
In addition to providing privacy, which of the following would be most
appropriate initially in situations involving suspected abuse?
A) Allow the client to have a good cry over the situation
...

C) Call the police immediately so they can question the victim
...

11
...

The house was so messy when he got home and I know he hates that
...
No one deserves to be hurt
...

D) Remember, he works hard and you need to meet his needs
...
When developing a presentation for a local community organization on
violence, the nurse is planning to include statistics on intimate partner abuse
and its effects on children
...
The primary goal when working with victims of intimate partner violence
is to:
A) Convince them to leave the abuser soon
B) Help them cope with their life as it is
C) Empower them to regain control of their life
D) Arrest the abuser so he or she can't abuse again
14
...
During a follow-up visit to the clinic, a victim of sexual assault reports that
she has changed her job and moved to another town
...
The nurse interprets these
findings to indicate that the client is in which phase of rape recovery?
A) Disorganization
B) Denial
C) Reorganization
D) Integration
16
...

The nurse asks the woman, Do you feel as though you are reliving the
trauma? The nurse is assessing for which of the following?
A) Physical symptoms
B) Intrusive thoughts
C) Avoidance
D) Hyperarousal
17
...
Which of the following would the students include as being
most accurate? (Select all that apply
...

B) Few women falsely cry rape
...

D) A rape victim feels vulnerable and betrayed afterwards
...


18
...
A nurse is caring for a woman who was recently raped
...
A group of nurses are researching information about risk factors for
intimate partner violence in men
...
)
A) Dysfunctional family system
B) Low academic achievement
C) Victim of childhood violence
D) Heavy alcohol consumption
E) Economic stress
21
...
Which of the following would the nurse suggest
that the woman take with her? (Select all that apply
...
A nurse is presenting a discussion on sexual violence at a local
community college
...
After teaching a class on sexual violence, the instructor determines that
the teaching was successful when the class identifies which of the following
as a type of sexual violence
...
)
A) Female genital cutting

B) Bondage
C) Infanticide
D) Human trafficking
E) Rape
24
...
Which age range
would the nurse expect to find as the peak age for such abuse?
A) 710 years
B) 812 years
C) 1418 years
D) 1822 years
25
...

Answer Key
1
...
D
3
...
B
5
...
B
7
...
A
9
...
B
11
...
A
13
...
C
15
...
B
17
...
D
19
...
B, C, D
21
...
B
23
...
B
25
...
While talking with a pregnant woman who has undergone genetic testing,
the woman informs the nurse that her baby will be born with Down
syndrome
...
A nurse is describing advances in genetics to a group of students
...

B) Genetic testing can identify presymptomatic conditions in children
...

D)Genetic agents may be used in the future to replace drugs
...
After teaching a group of students about fetal development, the instructor
determines that the teaching was successful when the students identify
which of the following as providing the barrier to other sperm after
fertilization?
A)Zona pellucida
B) Zygote
C) Cleavage
D)Morula
4
...
Which of the
following statements would the nurse most likely include?
A)Males are typically carriers of the disorders
...

C) Daughters are more commonly affected with the disorder
...


5
...
Which of the following would the nurse
suspect if the woman's level is decreased?
A)Down syndrome
B) Sickle-cell anemia
C) Cardiac defects
D)Open neural tube defect

6
...
The nurse would identify
that the sex of offspring is determined at the time of:
A)Meiosis
B) Fertilization
C) Formation of morula
D)Oogenesis
7
...

B) The fluid is mostly protein to provide nourishment to your baby
...

D) The amount of fluid remains fairly constant throughout the pregnancy
...
Assessment of a pregnant woman reveals oligohydramnios
...
A couple comes to the clinic for preconception counseling and care
...
A woman just delivered a healthy term newborn
...
)
A) One vein
B) Two veins
C) One artery
D) Two arteries
E) One ligament
F) Two ligaments
11
...
After the nurse describes fetal circulation to a pregnant woman, the
woman asks why her fetus has a different circulation pattern than hers
...

B) Fetal circulation carries highly oxygenated blood to vital areas first
...

D) Fetal heart rates are rapid and circulation time is double that of adults
...
When describing genetic disorders to a group of childbearing couples, the
nurse would identify which as an example of an autosomal dominant
inheritance disorder?
A) Huntingtons disease
B) Sickle cell disease
C) Phenylketonuria
D) Cystic fibrosis
14
...
In explaining to a couple about an elevated alpha-fetoprotein
screening test result, the nurse would discuss the need for:
A) Special care needed for a Down syndrome infant
B) A more specific determination of the acidbase status
C) Further, more definitive evaluations to conclude anything
D) Immediate termination of the pregnancy based on results
15
...

Which the following would the instructor most likely include?
A) Gene replacement therapy for defective genes
B) Individual risk profiling and confidentiality
C) Greater emphasis on the causes of diseases
D) Slower diagnosis of specific diseases
16
...
)
A) Placental
B) Preembryonic
C) Umbilical
D) Embryonic
E) Fetal

17
...
The
woman is 12 weeks pregnant and asks, Whats happening with my baby?
Which of the following would the nurse integrate into the response?
(Select all that apply
...
After teaching a group of students about fetal development, the instructor
determines that the teaching was successful when the students identify
which of the following as essential for fetal lung development?
A) Umbilical cord
B) Amniotic fluid
C) Placenta
D) Trophoblasts
19
...
Which of the following
would the nurse include? (Select all that apply
...
When describing the structures involved in fetal circulation, the nursing
instructor describes which structure as the opening between the right and
left atrium?
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical artery
21
...

The students demonstrate understanding of the information when they
identify which of the following as an example of an autosomal recessive
disorder? (Select all that apply
...
A nurse is assessing a child with Klinefelters syndrome
...
)
A) Gross mental retardation
B) Long arms
C) Profuse body hair
D) Gynecomastia
E) Enlarged testicles
23
...

Which of the following would the nurse include when describing this test?
A) A needle will be inserted directly into the fetuss umbilical vessel
...

C) The doctor will take a sample of fluid from your bag of waters
...

Answer Key
1
...
A
3
...
B
5
...
B
7
...
B
9
...
A
11
...
B
13
...
C
15
...
B, C, E
17
...
B
19
...
B
21
...
B, D
23
...
During a vaginal exam, the nurse notes that the cervix has a bluish color
...
Hegar's sign refers
to the softening of the lower uterine segment or isthmus
...
Ortolani's sign is a maneuver done to
identify developmental dysplasia of the hip in infants
...
The nurse teaches a primigravida client that lightening occurs about 2
weeks before the onset of labor
...
With this descent, pressure on the diaphragm decreases,
easing breathing, but pressure on the bladder increases, leading to urinary
frequency
...
Constipation may
occur throughout pregnancy due to decreased peristalsis, but it is unrelated
to lightening
3
...
Which
response would be most appropriate for the nurse to make?
A)Having to urinate so often is annoying
...

B) You shouldn't be urinating this frequently now; it usually stops by the time
youre eight weeks pregnant
...

D)Women having their second child generally don't have frequent urination
...
This complaint lessens

during the second trimester only to reappear in the third trimester as the
fetus begins to descend into the pelvis, causing pressure on the bladder
...
In a clients seventh month of pregnancy, she reports feeling dizzy, like I'm
going to pass out, when I lie down flat on my back
...
The vena cava is compressed, reducing venous
return, cardiac output, and blood pressure, with increased orthostasis
...
Pressure on the diaphragm would lead to dyspnea
...
A primiparous client is being seen in the clinic for her first prenatal visit
...
The nurse develops a teaching
plan to educate the client about what she will most likely experience during
this period
...
Ankle edema,
backache, and hemorrhoids would be more common during the later stages
of pregnancy
...
A pregnant client in her second trimester has a hemoglobin level of 11
g/dL
...
However, there is a greater increase in the plasma volume
as a result of hormonal factors and sodium and water retention
...
Changes in
maternal iron levels would be more indicative of an iron-deficiency anemia
...
Weight gain does not
correlate with hemoglobin levels
...
The nurse is discussing the insulin needs of a primaparous client with
diabetes who has been using insulin for the past few years
...
If the mother has diabetes, then her
insulin need would most likely increase to meet this demand
...
Estrogen, not estriol, is believed to oppose
insulin
...
Relaxin is not
associated with insulin resistance
...
When teaching a pregnant client about the physiologic changes of
pregnancy, the nurse reviews the effect of pregnancy on glucose
metabolism
...

B) Glucose is utilized more rapidly during a pregnancy
...

D)Glucose moves through the placenta to assist the fetus
...
During the first half of
pregnancy, much of the maternal glucose is diverted to the growing fetus
...
However, the placental
hormones can affect maternal insulin levels
...

Placental hormones, not the woman's dietary intake, play a major role in
glucose metabolism during pregnancy
...
When assessing a woman in her first trimester, which emotional response
would the nurse most likely expect to find?

A)Ambivalence
B) Introversion
C) Acceptance
D)Emotional lability
Feedback:
During the first trimester, the pregnant woman commonly experiences
ambivalence, with conflicting feelings at the same time
...

Acceptance usually occurs during the second trimester
...
The nurse is assessing a pregnant woman in the second trimester
...

B) The client identifies what she must give up to assume her new role
...

D) The client demonstrates unconditional acceptance without rejection
...
In doing so, the woman becomes able to identify
the fetus as a separate individual
...
Identification of what the mother must give up to
assume the new role occurs during the first trimester
...


11
...
Which of the following
would be included as part of this assessment? (Select all that apply
...
Ultrasound visualization of the
fetus, auscultation of a fetal heart beat, and palpation of fetal movements
are considered positive signs of pregnancy
...


12
...
The woman has a pre-pregnancy body mass index of 26
...
Women with a body
mass index of 18
...
9 (considered healthy weight) should gain 25 to 35
pounds
...
5 should gain 28 to
40 pounds
...
A nurse strongly encourages a pregnant client to avoid eating swordfish
and tilefish because these fish contain which of the following?
A) Excess folic acid, which could increase the risk for neural tube defects
B) Mercury, which could harm the developing fetus if eaten in large amounts
C) Lactose, which leads to abdominal discomfort, gas, and diarrhea
D) Low-quality protein that does not meet the woman's requirements
Feedback:
Nearly all fish and shellfish contain traces of mercury and some contain
higher levels of mercury that may harm the developing fetus if ingested by
pregnant women in large amounts
...
Folic acid is found in dark green vegetables,
baked beans, black-eyed peas, citrus fruits, peanuts, and liver
...
Women who are
lactose intolerant experience abdominal discomfort, gas, and diarrhea if they
ingest foods containing lactose
...

14
...
There is an increase in the normal
lumbosacral curve (lordosis)
...
Increased swayback and an upper spine
extension to compensate for the enlarging abdomen occur
...

15
...
The nurse documents this as which of the following?
A) Linea nigra
B) Striae gravidarum
C) Melasma
D) Vascular spiders
Feedback:
Linea nigra refers to the darkened line of pigmentation down the middle of
the abdomen in pregnant women
...
Melasma
refers to the increased pigmentation on the face, also known as the mask of
pregnancy
...


16
...
When
assessing the woman's gastrointestinal tract, which of the following would
the nurse expect to find? (Select all that apply
...

17
...
The nurse would explain that which of the
following would confirm the pregnancy?
A) Absence of menstrual period
B) Abdominal enlargement
C) Palpable fetal movement
D) Morning sickness
Feedback:

Only positive signs of pregnancy would confirm a pregnancy
...
Visualizing
the fetus by ultrasound, palpating for fetal movements, and hearing a fetal
heartbeat are all signs that make the pregnancy a certainty
...
Abdominal enlargement is a
probable sign
...
A nurse is developing a teaching plan about nutrition for a group of
pregnant women
...
)
A) Keep weight gain to 15 lb
B) Eat three meals with snacking
C) Limit the use of salt in cooking
D) Avoid using diuretics
E) Participate in physical activity
Feedback:
To promote optimal nutrition, the nurse would recommend gradual and
steady weight gain based on the client's prepregnant weight, eating three
meals with one or two snacks daily, not restricting the use of salt unless
instructed to do so by the health care provider, avoiding the use of diuretics,
and participating in reasonable physical activity daily
...
Assessment of a pregnant woman reveals that she compulsively craves
ice
...

Quickening refers to the mother's sensation of fetal movement
...
Linea nigra
refers to the pigmented line that develops in the middle of the woman's
abdomen
...
A woman in her second trimester comes for a follow-up visit and says to
the nurse, I feel like I'm on an emotional roller-coaster
...

C) Mood swings are completely normal during pregnancy
...
One
moment a woman can feel great joy, and within a short time she can feel
shock and disbelief
...
Some women feel as though they are riding an emotional
roller-coaster
...
Clear explanations
about how common mood swings are during pregnancy are essential
...
While talking with a woman in her third trimester, which behavior
indicates to the nurse that the woman is learning to give of oneself?
A) Showing concern for self and fetus as a unit
B) Unconditionally accepting the pregnancy without rejection
C) Longing to hold infant
D) Questioning ability to become a good mother
Feedback:
Learning to give of oneself would be demonstrated when the woman
questions her ability to become a good mother to the infant
...
Unconditionally accepting the
pregnancy reflects the task of seeking acceptance of the infant by others
...

22
...
The students
demonstrate understanding of the information when they identify which as
presumptive signs? (Select all that apply
...
Abdominal enlargement and Braxton-Hicks
contractions are probable signs of pregnancy
...

23
...
Which of the following would the instructor
least likely include as opposing insulin?
A) Prolactin
B) Estrogen

C) Progesterone
D) Cortisol
Feedback:
Prolactin, estrogen, and progesterone are all thought to oppose insulin
...
After the first trimester, hPL from the
placenta and steroids (cortisol) from the adrenal cortex act against insulin
...
A woman is at 20 weeks gestation
...
By 20 weeks' gestation, the fundus, or top of the
uterus, is at the level of the umbilicus and measures 20 cm
...

25
...
The nurse suspects vulvovaginal
candidiasis based on which assessment finding?
A) Fever
B) Vaginal itching
C) Urinary frequency
D) Incontinence
Feedback:
Vaginal secretions become more acidic, white, and thick during pregnancy
...
This is normal except when it is accompanied by itching and
irritation, possibly suggesting Candida albicans, a monilial vaginitis, which is
a very common occurrence in this glycogen-rich environment
...
Urinary frequency occurs commonly in the
first trimester, disappears during the second trimester, and reappears during
the third trimester
...
Incontinence would require additional evaluation
...
C
2
...
C
4
...
B
6
...
B
8
...
A
10
...
A, D, F
12
...
B
14
...
A
16
...
C
18
...
B
20
...
D
22
...
D
24
...
B

Chapter 12: Nursing Management During Pregnancy
1
...
The woman's pregnancy has been
uneventful
...

B) Intercourse at this time is likely to cause rupture of membranes
...

D)Intercourse at this time is likely to result in premature labor
...

2
...
The nurse
records this finding as:
A)Hegars sign
B) Goodells sign
C) Chadwicks sign
D)Homans sign
Feedback:
Chadwick's sign refers to the bluish coloration of the cervix and vaginal
mucosa
...

a
...
Goodell's sign: oftening of the cervix
d
...

3
...
It also includes preparation for breastfeeding, infant care,
transition to new parenting roles, relationships skills, family health
promotion, and sexuality
...
Information provided in childbirth education classes
helps to minimize anxiety and provide the couple with control over the
situation, but elimination of anxiety or total control is unrealistic
4
...
Hemoglobin and hematocrit, as part of a
complete blood count, would be done on the initial visit and then repeated if
the woman's status indicates a need for doing so
...
A culture would be done if there are
signs and symptoms of an infection
...


5
...
The nurse finds
her pulse to be 100 beats per minute (increased from baseline readings of 70
to 74 beats per minute
...
Which nursing diagnosis would be the priority for this client?
A)Ineffective tissue perfusion related to supine hypotensive syndrome
B) Impaired gas exchange related to pulmonary congestion
C) Activity intolerance related to increased metabolic requirements
D)Anxiety related to fear of pregnancy outcome
Feedback:
Typically, heart rate increases by approximately 10 to 15 beats per minute
during pregnancy and the lungs should be clear
...
However, the findings described indicate that the
woman is experiencing impaired gas exchange
...

6
...

B) Swallow the pre-procedure sedative
...

D)Lie on her left side
...

Showering with an antiseptic scrub and pre-procedural sedation are not
necessary
...

7
...
Her history reveals she has 7-year-old twins who were born at 34 weeks
gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous

abortion 1 year ago at 6 weeks gestation
...
A clients last menstrual period was April 11
...
Would be:
A)January 4
B) January 18
C) January 25
D)February 24
Feedback:
April 11 + 7 days - 3 months
9
...
The nurse interprets
this as:
A)Variable decelerations
B) Fetal tachycardia
C) A nonreactive pattern
D)Reactive pattern
Feedback:
A reactive non stress test indicates fetal activity, as evidenced by
acceleration of the fetal heart rate by at least 15 ppm for at least 15 seconds
within a 20 minute recording period
...
An increase in the fetal heart rate does not indicate
variable decelerations
...
A clients maternal serum alpha-fetoprotein (MSAFP
...
The nurse suspects which of the following?
A) Fetal hypoxia
B) Open spinal defects
C) Down syndrome

D) Maternal hypertension
Feedback:
Elevated MSAFP levels are associated with open neural tube defects
...

MSAFP in conjunction with marker screening tests would be more reliable for
detecting Down syndrome
...

11
...
It improves after a night's sleep
...

12
...
After careful assessment, the nurse
determines that this is an expected finding at this stage of pregnancy
...

B) Eliminate salt from your diet
...

D) Wear Spandex-type full-length pants
...

The best suggestion would be to encourage the PT to elevate her legs when
sitting to promote venous return and minimize the effects of gravity
...

13
...
Which of the
following vaccinations would the nurse ensure that the woman receives?
A) Measles
B) Mumps

C) Rubella
D) Hepatitis B
Feedback:
Hepatitis B vaccine should be considered during pregnancy
...

14
...
After
teaching the woman about traveling during pregnancy, which statement
indicates that the teaching was successful?
A) I'll sit in a window seat so I can focus on the sky to help relax me
...

C) I'll get up and walk around the airplane about every 2 hours
...

Feedback:
When traveling by airplane, the woman should get up and walk about the
plane every 2 hours to promote circulation
...
drinking water throughout the
flight is encouraged to maintain hydration
...

15
...

B) Youll have an ultrasound first and then the test
...

D) This test is very helpful for identifying spinal defects
...
Results are
usually available within 48 hrs
...
CVS can be used to
detect numerous genetic disorders but not neural tube (spinal) defects
16
...
When discussing this test with the woman, the nurse reviews what
can be evaluated with the specimens collected
...
)
A) Rh incompatibility
B) Fetal acidbase status
C) Sex-linked disorders
D) Enzyme deficiencies
E) Coagulation studies
Feedback:

Specimens obtained via percutaneous umbilical cord sampling can be
evaluated for coagulation studies, blood group typing, complete blood count,
karyotyping, and blood gas analysis
...

Sex-linked disorders and enzyme deficiencies can be evaluated with
chorionic villus sampling
...
A biophysical profile has been completed on a pregnant woman
...
A total score of 10 is possible if the NST is used
...
A score of 6 or below is suspicious, possibly indicating a
compromised fetus; further investigation of fetal well-being is needed
...
After teaching a group of students about the discomforts of pregnancy,
the students demonstrate understanding of the information when they
identify which as common during the first trimester? (Select all that apply
...

Backache and leg cramps are common during the second trimester
...

1st: 0 -13 weeks
2nd: 14 - 26 weeks
3rd: 27 - 40 weeks
19
...
The nurse interprets this to indicate the number of:
A) Deliveries
B) Pregnancies

C) Spontaneous abortions
D) Pre-term births
Feedback:
Gravid refers to a pregnant woman - gravid I during the first pregnancy,
gravid II during the second pregnancy, and so on
...

A would be the number of abortions
P would be the number preterm births
20
...
The nurse interprets this to indicate which of the following?
A) 14 weeks gestation
B) 20 weeks gestation
C) 28 weeks gestation
D) 36 weeks gestation
Feedback:
Typically, the height of the fundus is measured when the uterus arises out of
the pelvis to evaluate fetal growth
...

At 16 weeks' gestration the fundus is midway between the symhysis and the
umbilicus
...

21
...
The
nurse explains that this test measures which of the following?
A) Platelet level
B) Rh status
C) Immunity to German measles
D) Red blood cell count
Feedback:
A rubella titer detects antibodies for the virus that causes German measles
...

Platelet level and red blood cell count would be determined by a complete
blood count
...

22
...
Which statement by the woman indicates that she
understands the scheduling?

A) I need to make visits every 2 months until I'm 36 weeks pregnant
...

C) From now until I'm 28 weeks, I'll be coming once a month
...

Feedback:
Continuous prenatal care is important for a successful pregnancy outcome
...
A nursing instructor is describing the various childbirth methods
...
After teaching a group of students about the different perinatal education
methods, the instructor determines that the teaching was successful when
the students identify which of the following as the
Bradley method?
A) Psychoprophylactic method
B) Partner-coached method
C) Natural childbirth method
D) Mind prevention method
Feedback:
The Bradley meth is also a partner-coached method that uses various
exercises and slow, controlled abdominal breathing to accomplish relaxation
and active participation of the partner as labor coach
...
Dick-Read believed
that prenatal instruction was essential for pain relief and that emotional
factors during labor interfered with the normal labor progression
...


25
...
Which of the following suggestions
would be helpful for the woman?
A) Watch how much beans and onions you eat
...

D) Some say that eating mints can help
...

Feedback:
For gas and bloating, the nurse would instruct the woman to avoid gasforming foods, such as beans, cabbage, and onions, as well as foods that
have a high content of white sugar
...
In addition, reducing the amount of swallowed air when chewing gum
or smoking will reduce gas build-up
...

Answer Key
1
...
C
3
...
D
5
...
C
7
...
B
9
...
B
11
...
C
13
...
C
15
...
A, B, E
17
...
A, B, C
19
...
C
21
...
C
23
...
B
25
...
A woman in her 40th week of pregnancy calls the nurse at the clinic and
says shes not sure whether she is in true or false labor
...

B) My contractions are about 6 minutes apart and regular
...

D)If I try to talk to my partner during a contraction, I cant
...
True labor contractions
begin in the back and radiate around toward the front of the abdomen
...

2
...
Additional signs include a sudden trickle of
blood from the vaginal opening, and lengthening (not shortening) of the
umbilical cord
...
Expulsion of the mucous plug is a
premonitory sign of labor
...
When assessing cervical effacement of a client in labor, the nurse
assesses which of the following characteristics?
A)Extent of opening to its widest diameter
B) Degree of thinning
C) Passage of the mucous plug
D)Fetal presenting part

Feedback:
Effacement refers to the degree of thinning of the cervix
...
Passage of the
mucous plug occurs with bloody show is a premonitory sign of labor
...

4
...
The
nurse would urge the client to come to the facility if the client reports which
of the following?
A)Increased energy level with alternating strong and weak contractions
B) Moderately strong contractions every 4 minutes, lasting about 1 minute
C) Contractions noted in the front of abdomen that stop when she walks
D)Pink-tinged vaginal secretions and irregular contractions lasting about 30
seconds
Feedback:
Moderately strong regular contractions 60 seconds in duration indicate that
the client is probably in the active phase of the first stage of labor
...

5
...
The nurse would encourage her to
assume which position to facilitate the progress of labor?
A)Supine
B) Lithotomy
C) Upright
D)Kneechest
Feedback:
The use of any upright position helps to reduce the length of labor
...
The knee-chest position would assist
in rotating the fetus in a posterior position
...
A client has not received any medication during her labor
...
Her cervix is 8 cm dilated and 90% effaced
...
The latent phase is
characterized by mild contractions every 5 to 10 minutes, cervical dilation of
0 to 3 cm and effacement of 0% to 40%, and excitement and frequent talking
by the mother
...
The pelvic phase of the second stage of labor is characterized by
complete cervical dilation and effacement, with strong contractions every 2
to 3 minutes; the mother focuses on pushing
...
The fetus of a nulliparous woman is in a shoulder presentation
...
Vaginal birth, forceps-assisted, and vacuum
extraction births are not appropriate
...
Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical
effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting
about 40 seconds
...
The active phase is characterized by
cervical dilation of 4 to 7 cm, effacement of 40% to 80%, and contractions
occurring every 2 to 5 minutes lasting 45 to 60 seconds
...
The perineal phase of the second stage occurs with complete
cervical dilation and effacement, contractions occurring every 2 to 3 minutes
and lasting 60 to 90 seconds, and a tremendous urge to push by the mother

9
...
On review
of her medical record, the nurse determines that the clients pelvic shape as
identified in the ante-partal progress notes is the most favorable one for a
vaginal delivery
...

The anthropoid pelvis is favorable for vaginal birth but it is not the most
favorable shape
...
Women with a platypelloid pelvis usually require cesarean
birth
...
A woman telephones her health care provider and reports that her water
just broke
...

B) Come to the clinic or emergency department for an evaluation
...

D) Come in as soon as you feel the urge to push
...
Therefore, the
nurse should suggest that the woman come in for an evaluation
...
Telling the
client to wait until she feels the urge to push is inappropriate because this
occurs during the second stage of labor
...
After teaching a group of students about the maternal bony pelvis, which
statement by the group indicates that the teaching was successful?
A) The bony pelvis plays a lesser role during labor than soft tissue
...

C) The false pelvis lies below the imaginary linea terminalis
...

Feedback:
The maternal bony pelvis consists of the true and false portions
...

The bony pelvis is the more important part of the passageway because it is
relatively unyielding
...
The true pelvis is the bony passageway through which the fetus
must travel
...
A fetus is assessed at 2 cm above the ischial spines
...
Since the measurement is 2 cm, the station would be -2
...
Positive stations indicate that the presenting part is below the level of
the ischial spines
...
Assessment of a fetus identifies the buttocks as the presenting part, with
the legs extended upward
...
In a full or complete breech, the fetus sits cross-legged
above the cervix
...

14
...

During assessment the woman reports that her breathing has become much
easier in the last week but she has noticed increased pelvic pressure,
cramping and lower back pain
...
The uterus lowers and moves into the maternal pelvis
...
The
woman usually notes that her breathing is much easier
...

Although cervical dilation also may be occurring, it does not account for the
woman's complaints
...
It occurs with the onset of labor
...
They also
help in ripening and softening the cervix
...
After teaching a group of students about the factors affecting the labor
process, the instructor determines that the teaching was successful when the
group identifies which of the following as a component of the
true pelvis? (Select all that apply
...
The cervix, vagina, and pelvic floor muscles are the soft tissues
of the passageway
...
A nurse is documenting fetal lie of a woman in labor
...
There are two primary lies: longitudinal and
transverse
...

Cephalic is a term used to describe fetal presentation
17
...
The nurse interprets this
information as indicating which of the following is the presenting part?
A) Occiput
B) Face
C) Buttocks
D) Shoulder
Feedback:
The second letter denotes the presenting part which in this case is "S" or the
sacrum or buttocks
...
The letter "M" would denote the mentum (chin) or face

presentation
...

18
...

When describing the typical movements that the fetus goes through as it
travels through the passageway, which of the following would the nurse most
likely include? (Select all that apply
...
The fetus does not undergo abduction or pronation
...
The nurse is reviewing the monitoring strip of a woman in labor who is
experiencing a contraction
...
The nurse interprets this time as
which of the following?
A) Increment
B) Acme
C) Peak
D) Decrement
Feedback:
Each contraction has three phases: increment or the buildup of the
contraction; acme or the peak or highest intensity; and the decrement or
relaxation of the uterine muscle fibers
...

20
...
Which finding would the nurse
identify as a cause for concern during a contraction?
A) Heart rate increase from 76 bpm to 90 bpm
B) Blood pressure rise from 110/60 mm Hg to 120/74
C) White blood cell count of 12,000 cells/mm3
D) Respiratory rate of 10 breaths /minute
Feedback:
During labor, the mother experiences various physiologic responses
including an increase in heart rate by 10 to 20 bpm, a rise in blood pressure
by up to 35 mm Hg during a contraction, an increase in white blood cell
count to 25,000 to 30,000 cells/mm3, perhaps as a result of tissue trauma,
and an increase in respiratory rate with greater oxygen consumption due to

the increase in metabolism
...

21
...
Contractions occur during the first and second stages of
labor
...
Placental separation occurs during the third stage of
labor
...
A nurse is caring for several women in labor
...
Contractions every 5
minutes with cervical dilation of 3 cm is typical of the latent phase
...

23
...
Which of the following would the nurse most likely
include when discussing measures to promote coping for a positive labor
experience? (Select all that apply
...


Having the presence and support of a valued partner during labor, engaging
in exercise during pregnancy, viewing the birthing experience as a
meaningful rather than stressful event, and a low anxiety level can promote
a woman's ability to cope
...

24
...

B) Since this is your first pregnancy, you can estimate it will be about 10
hours
...

D) Time isn't important; your health and the babys health are key
...
There is no way to estimate
the likely strength and frequency of uterine contractions, the extent to which
the cervix will soften and dilate, and how much the fetal head will mold to fit
the birth canal
...
All of these
factors are unknowns when a woman starts labor
...
It is highly individualized
...
A nurse is describing how the fetus moves through the birth canal
...
Fontanelles are the
intersections formed by the sutures
...
The biparietal diameter is an important diameter that can affect the
birth process
...
Assessment of a pregnant woman reveals that the presenting part of the
fetus is at the level of the maternal ischial spines
...
Fetal station is measured in centimeters and is
referred to as a minus or plus, depending on its location above or below the
ischial spines
...
When the presenting part is above
the ischial spines, the distance is recorded as minus stations
...
C
2
...
B
4
...
C
6
...
A
8
...
B
10
...
B
12
...
A
14
...
A, C, D
16
...
C
18
...
A
20
...
B
22
...
A, C, E

24
...
A
26
...
A woman in labor who received an opioid for pain relief develops
respiratory depression
...
Butorphanol and fentanyl are opioids and would
cause further respiratory depression
...


2
...
Which of the following would the nurse do
next?
A)Check the fetal heart rate
...

C) Notify the physician immediately
...

Feedback:
When membranes rupture, the priority focus is on assessing fetal heart rate
first to identify a deceleration, which might indicate cord compression
secondary to cord prolapse
...
The physician should be notified, but this
is not a priority at this time
...

3
...
The nurse would
focus care on which of the following?
A)Encouraging the woman to push when she has a strong desire to do so

B) Alleviating perineal discomfort with the application of ice packs
C) Palpating the woman's fundus for position and firmness
D)Completing the identification process of the newborn with the mother
Feedback:
During the second stage of labor, nursing interventions focus on motivating
the woman, encouraging her to put all her efforts toward pushing
...
Completing the newborn
identification process would be appropriate during the third stage of labor
...
The nurse notes persistent early decelerations on the fetal monitoring
strip
...

B) Perform a vaginal exam to assess cervical dilation and effacement
...

D)Administer oxygen after turning the client on her left side
...
Therefore, the nurse would continue to monitor the fetal heart
rate pattern
...
They are thought to
be a result of fetal head compression that results in a reflex vagal response
with a resultant slowing of the FHR during uterine contractions
...

5
...
Vaginal examination
reveals that the presenting part is approximately 2 cm above the ischial
spines
...
If
the presenting part is palpated higher than the maternal ischial spines, a
negative number is assigned
...
If the presenting part is below the ischial spines, then
the station would be +2
...

6
...
Which action would the nurse do first?

A)Feel for the fetal buttocks or head while palpating the abdomen
...

C) Palpate for the presenting part in the area just above the symphysis pubis
...

Feedback:
The first maneuver involves feeling for the buttocks and head
...
The third maneuver
determines presentation and involves palpating the area just above the
symphysis pubis
...

7
...
The nurse tests the fluid with Nitrazine paper and confirms
membrane rupture if the paper turns:
A)Yellow
B) Olive green
C) Pink
D)Blue
Feedback:
Amniotic fluid is alkaline and turns Nitrazine paper blue
...

8
...
The nurse reviews the woman's medical record to ensure which
of the following as being required?
A)Intact membranes
B) Cervical dilation of 2 cm or more
C) Floating presenting fetal part
D)A neonatologist to insert the electrode
Feedback:
For continuous internal electronic fetal monitoring, four criteria must be met:
ruptured membranes, cervical dilation of at least 2 cm, fetal presenting part
low enough to allow placement of the electrode, and a skilled practitioner
available to insert the electrode
...
When assessing fetal heart rate, the nurse finds a heart rate of 175 bpm,
accompanied by a decrease in variability and late decelerations
...

B) Administer oxygen
...

D)Continue to monitor the pattern every 15 minutes
...
The health care
provider should be notified immediately and then measures should be
instituted such as having the woman lie on her side and administering
oxygen
...

10
...
Which statement by the woman would lead the nurse to suspect that
the woman needs additional teaching?
A) The warmth and buoyancy of the water has a nice relaxing effect
...

C) My cervix should be dilated more than 5 cm before I try using this method
...

Feedback:
Hydrotherapy is an effective pain relief method
...
Therefore, a temperature of 105° F
would be too warm
...

The woman should be in active labor with cervical dilation greater than 5 cm
...
A woman in labor received an opioid close to the time of birth
...
Urinary retention may occur in the woman
who received neuraxial opioids
...
Hyporeflexia would be more commonly associated with
central nervous system depression due to opioids
...
When applying the ultrasound transducers for continuous external
electronic fetal monitoring, at which location would the nurse place the
transducer to record the FHR?
A) Over the uterine fundus where contractions are most intense
B) Above the umbilicus toward the right side of the diaphragm

C) Between the umbilicus and the symphysis pubis
D) Between the xiphoid process and umbilicus
Feedback:
The ultrasound transducer is positioned on the maternal abdomen in the
midline between the umbilicus and the symphysis pubis
...

13
...

B) Unfortunately, I'm going to have to stay quite still in bed while it is in
place
...

D) Youll be inserting a special electrode into my babys scalp
...
Continuous
internal monitoring is considered the most accurate method, but it can be
used only if certain criteria are met, such as rupture of membranes
...

14
...

FHR is assessed every 30 to 60 minutes during the latent phase of labor
...
Blood pressure,
pulse, and respirations are assessed every hour during the latent phase and
every 30 minutes during the active and transition phases
...

15
...
Offering fluids, encouraging voiding, and
assisting with perineal care are important but not an immediate priority
16
...
The nurse interprets this finding as indicating which type of
contraction?
A) Intense
B) Strong
C) Moderate
D) Mild
Feedback:
A contraction that feels like the chin typically represents a moderate
contraction
...
A strong contraction feels like the forehead
...
A nurse palpates a woman's fundus to determine contraction intensity
...
Using the finger
tips, palm, or back of the hand would be inappropriate
18
...
The nurse interprets this
finding as which of the following?
A) Normal
B) Possible infection
C) Meconium passage
D) Transient fetal hypoxia
Feedback:
Amniotic fluid should be clear when the membranes rupture, either
spontaneously or artificially through an amniotomy (a disposable plastic hook
[Amnihook] is used to perforate the amniotic sac)
...
Green fluid may indicate that the fetus has
passed meconium secondary to transient hypoxia, prolonged pregnancy,
cord compression, intrauterine growth restriction, maternal hypertension,

diabetes, or chorioamnionitis; however, it is considered a normal occurrence
if the fetus is in a breech presentation
...
After teaching a group of students about fetal heart rate patterns, the
instructor determines the need for additional teaching when the students
identify which of the following as indicating normal fetal acid-base status?
(Select all that apply
...
Sinusoidal pattern, recurrent variable decelerations,
and fetal bradycardia are predictive of abnormal fetal acid-base status
...
A nurse is reviewing the fetal heart rate pattern and observes abrupt
decreases in FHR below the baseline, appearing as a U-shape
...

The shape of variable decelerations may be U, V, or W, or they may not
resemble other patterns
...
They are thought
to be a result of fetal head compression that results in a reflex vagal
response with a resultant slowing of the FHR during uterine contractions
...
The FHR does
not return to baseline levels until well after the contraction has ended
...
Late decelerations are associated with uteroplacental
insufficiency
...


21
...
Which of the following would the nurse include in the
explanation?
A) This technique focuses on manipulating body tissues
...

C) This technique redirects energy fields that lead to pain
...

Feedback:
Therapeutic touch is an energy therapy and is based on the premise that the
body contains energy fields that lead to either good or ill health and that the
hands can be used to redirect the energy fields that lead to pain
...
Massage
focuses on manipulating body tissues
...

22
...
The students demonstrate understanding of the
information when they identify which agent as the most commonly used
opioid?
A) Butorphanol
B) Nalbuphine
C) Fentanyl
D) Meperidine
Feedback:
Of all of the synthetic opioids (butorphanol [Stadol], nalbuphine [Nubain],
fentanyl [Sublimaze], and meperidine [Demerol]), meperidine is the most
commonly used opioid for the management of pain during labor
...
A nurse is describing the different types of regional analgesia and
anesthesia for labor to a group of pregnant women
...

B) Higher anesthetic doses are needed for patient-controlled epidural
analgesia
...

D) Local infiltration using lidocaine is an appropriate method for controlling
contraction pain
...
Patient-controlled epidural
analgesia provides equivalent analgesia with lower anesthetic use, lower

rates of supplementation, and higher client satisfaction
...
Local infiltration using
lidocaine does not alter the pain of uterine contractions, but it does numb
the immediate area of the episiotomy or laceration
...
A nurse is completing the assessment of a woman admitted to the labor
and birth suite
...
)
A) Current pregnancy history
B) Fundal height measurement
C) Support system
D) Estimated date of birth
E) Membrane status
F) Contraction pattern
Feedback:
As part of the admission physical assessment, the nurse would assess fundal
height, membrane status and contractions
...

25
...
Which of the following would the
nurse expect to include when developing a plan of care for this women?
(Select all that apply
...

E) Electing for the use of forceps-assisted delivery
Feedback:
To reduce perinatal transmission, HIV-positive women are given zidovudine
(ZDV) (2 mg/kg IV over an hour, and then a maintenance infusion of 1 mg/kg
per hour until birth) or a single 200-mg oral dose of nevirapine at the onset
of labor; the newborn is given ZDV orally (2 mg/kg body weight every 6
hours) and should be continued for 6 weeks (Gardner, Carter, Enzman-Hines,
& Hernandez, 2011)
...
S
...
Additional interventions to reduce the transmission risk would include
avoiding use of scalp electrode for fetal monitoring or doing a scalp blood
sampling for fetal pH, delaying amniotomy, encouraging formula feeding

after birth, and avoiding invasive procedures such as forceps or vacuumassisted devices
...
Which position would be most appropriate for the nurse to suggest as a
comfort measure to a woman who is in the first stage of labor? (Select all
that apply
...

27
...

B) Choose whatever method you feel most comfortable with for pushing
...

D) Bear down like youre having a bowel movement with every contraction
...
In the absence of any complications, nurses should
not be controlling this stage of labor, but empowering women to achieve a
satisfying experience
...
Research
suggests that directed pushing during the second stage may be
accompanied by a significant decline in fetal pH and may cause maternal
muscle and nerve damage if done too early
...
Supporting spontaneous pushing and encouraging women to
choose their own method of pushing should be accepted as best clinical
practice
...
A nurse is assessing a woman after birth and notes a second-degree
laceration
...

29
...
The fetal head has just
emerged
...
If it is, the cord is
slipped over the head to facilitate delivery
...
Finally the umbilical cord is doubleclamped and cut between the clamps
...


30
...

Which of the following would alert the nurse that the placenta is separating?
(Select all that apply
...

Answer Key

1
...
A
3
...
A
5
...
A
7
...
B
9
...
D
11
...
C
13
...
C
15
...
C
17
...
B
19
...
B
21
...
D
23
...
B,
25
...
A,
27
...
B
29
...
C

B, C

E, F
C, D
B, D

Chapter 15: Postpartum Adaptations
1
...
The nurse palpates the clients fundus, expecting it to be at which
location?
A)Two finger-breadths above the umbilicus
B) At the level of the umbilicus
C) Two finger-breadths below the umbilicus
D)Four finger-breadths below the umbilicus
2
...
The nurse is developing a teaching plan for a client who has decided to
bottle feed her newborn
...
The nurse is making a follow-up home visit to a woman who is 12 days
postpartum
...
A client who is breast-feeding her newborn tells the nurse, I notice that
when I feed him, I feel fairly strong contraction-like pain
...
Why
am I having contractions now? Which response by the nurse would be most
appropriate?
A)Your uterus is still shrinking in size; thats why youre feeling this pain
...

C) Your body is responding to the events of labor, just like after a tough
workout
...

6
...
A postpartum client who is bottle feeding her newborn asks, When should
my period return? Which response by the nurse would be most appropriate?
A)Its difficult to say, but it will probably return in about 2 to 3 weeks
...

C) You won't have to worry about it returning for at least 3 months
...
It'll be quite a while
...
The nurse interprets which of the following as evidence that a client is in
the taking-in phase?
A) Client states, He has my eyes and nose
...

C) Client performs self-care independently
...

9
...
A postpartum client comes to the clinic for her 6-week postpartum
checkup
...
The nurse develops a teaching plan for a postpartum client and includes
teaching about how to perform Kegel exercises
...
A father of a newborn tells the nurse, I may not know everything about
being a dad, but I'm going to do the best I can for my son
...
A postpartum client is experiencing subinvolution
...
Which of the following would lead the nurse to suspect that a postpartum
woman is experiencing a problem?
A) Elevated white blood cell count
B) Acute decrease in hematocrit
C) Increased levels of clotting factors
D) Pulse rate of 60 beats/minute
15
...
Which response by the nurse would be
most appropriate?
A) You must have an infection, so let me get a urine specimen
...

C) Your uterus is not contracting as quickly as it should
...

16
...

The students demonstrate understanding when they identify which hormone
as responsible for milk let-down?
A) Prolactin
B) Estrogen
C) Progesterone
D) Oxytocin
17
...
The woman's breasts are swollen, hard, and
tender to the touch
...
A nurse is assessing a postpartum woman's adjustment to her maternal
role
...
The partner of a woman who has given birth to a healthy newborn says to
the nurse, I want to be involved, but I'm not sure that I'm able to care for
such a little baby
...
A group of nursing students are reviewing information about maternal and
paternal adaptations to the birth of a newborn
...
The nurse
documents this as which of the following?
A) Puerperium
B) Lactation
C) Attachment
D) Engrossment
21
...
A nurse is visiting a postpartum woman who delivered a healthy newborn
5 days ago
...
A nurse teaches a postpartum woman about her risk for
thromboembolism
...
A nursing student is preparing a class presentation about changes in the
various body systems during the postpartum period and their effects
...
)
A) Use of an opioid anesthetic during labor
B) Generalized swelling of the perineum
C) Decreased bladder tone from regional anesthesia
D) Use of oxytocin to augment labor

E) Need for an episiotomy
25
...
Which response by the nurse
would be most appropriate?
A) Youll notice that this will fade to silvery lines
...

C) Expect the color to lighten somewhat
...

26
...
The students demonstrate
understanding of the information when they identify which of the following as
a postpartum adaptation?
A) Continued shortness of breath
B) Relief of rib aching
C) Diaphragmatic elevation
D) Decrease in respiratory rate
27
...
C
2
...
D
4
...
D
6
...
B
8
...
B
10
...
C
12
...
A
14
...
B
16
...
B

18
...

20
...

22
...

24
...

26
...


C
B
C
D
B
D
B, C, D
B
B
A

Chapter 16: Nursing Management During the Postpartum Period
1
...
Now, the nurse finds a pulse of 60 beats per
minute
...

B) Contact the physician, as it indicates early DIC
...

D)Obtain an order for a CBC, as it suggests postpartum anemia
...
To decrease the pain associated with an episiotomy immediately after
birth, which action by the nurse would be most appropriate?
A)Offer warm blankets
...

C) Apply an ice pack to the site
...

3
...
The nurse
would expect which of the following medications to be ordered?
A)Ferrous sulfate (Feosol)
B) Methylergonovine (Methergine)
C) Docusate (Colace)
D)Bromocriptine (Parlodel)
4
...

B) He looks like a frog to me
...

5
...
When the community health nurse makes a home visit 2 days

later, which finding would alert the nurse to the need for further
intervention?
A)Presence of lochia serosa
B) Frequent scant voidings
C) Fundus firm, below umbilicus
D)Milk filling in both breasts
6
...
Which instruction would be
most appropriate to aid in relieving her discomfort?
A)Express some milk from your breasts every so often to relieve the
distention
...

C) Apply ice packs to your breasts to reduce the amount of milk being
produced
...

7
...
Which of the following factors in a clients history would alert the nurse to
an increased risk for postpartum hemorrhage?
A)Multiparity, age of mother, operative delivery
B) Size of placenta, small baby, operative delivery
C) Uterine atony, placenta previa, operative procedures
D)Prematurity, infection, length of labor
9
...
A nurse is working as part of a committee to establish policies to promote
bonding and attachment
...
When developing the plan of care for the parents of a newborn, the nurse
identifies interventions to promote bonding and attachment based on the
rationale that bonding and attachment are most supported by which
measure?
A) Early parentinfant contact following birth
B) Expert medical care for the labor and birth
C) Good nutrition and prenatal care during pregnancy
D) Grandparent involvement in infant care after birth
12
...
Which of the following would be least effective in helping to
stimulate voiding?
A) Pouring warm water over her perineal area
B) Having her hear the sound of water running nearby
C) Placing her hand in a basin of cool water
D) Standing her in the shower with the warm water on
13
...
Which of the following would be a priority?
A) Placing the call light within her reach
B) Teaching her how the sitz bath works
C) Telling her to use the sitz bath for 30 minutes
D) Cleaning the perineum with the peri-bottle
14
...
The nurse
identifies that the woman is at risk for a postpartum infection based on which
of the following? (Select all that apply
...
A nurse is completing a postpartum assessment
...
The nurse is assessing a postpartum clients lochia and finds that there is
about a 4-inch stain on the perineal pad
...
When reviewing the medical record of a postpartum client, the nurse
notes that the client has experienced a third-degree laceration
...
A nurse is observing a postpartum client interacting with her newborn and
notes that the mother is engaging with the newborn in the en face position
...

B) Mother making eye-to-eye contact with the newborn
C) Mother gently stroking the newborns face
D) Mother holding the newborn upright at the shoulder
19
...
)
A) Prolonged labor
B) Placenta previa
C) Null parity
D) Hydramnios
E) Labor augmentation
20
...
Which of the following would be least appropriate
for the nurse to suggest?
A) Use of a mild analgesic about 1 hour before breast-feeding
B) Application of expressed breast milk to the nipples
C) Application of glycerin-based gel to the nipples
D) Reinstruction about proper latching-on technique
21
...
Which of the following
would the nurse most likely include? (Select all that apply
...
After teaching a postpartum woman about breast-feeding, the nurse
determines that the teaching was successful when the woman states which
of the following?
A) I should notice a decrease in abdominal cramping during breast-feeding
...

C) The baby can be awake or sleepy when I start to feed him
...

23
...
A nurse is observing a postpartum woman and her partner interact with
the their newborn
...
)
A) Frequently ask for the newborn to be taken from the room
B) Identify common features between themselves and the newborn
C) Refer to the newborn as having a monkey-face
D) Make direct eye contact with the newborn
E) Refrain from checking out the newborns features
25
...

B) Sleep usually helps to resolve the blues
...

D) Extended psychotherapy is needed for treatment
...
A
2
...
C
4
...
B

6
...
B
8
...
C
10
...
A
12
...
A
14
...
C
16
...
C
18
...
B,
20
...
B,
22
...
B
24
...
B

D, E

D, E
C, E
D

Chapter 17: Newborn Transitioning
1
...
A new mother reports that her newborn often spits up after feeding
...
The nurse responds integrating
understanding that this most likely is due to which of the following?
A)Placing the newborn prone after feeding
B) Limited ability of digestive enzymes
C) Underdeveloped pyloric sphincter
D)Relaxed cardiac sphincter
3
...
Twenty minutes after birth, a baby begins to move his head from side to
side, making eye contact with the mother, and pushes his tongue out several
times
...
The nurse institutes measure to maintain thermoregulation based on the
understanding that newborns have limited ability to regulate body
temperature because they:
A)Have a smaller body surface compared to body mass
B) Lose more body heat when they sweat than adults
C) Have an abundant amount of subcutaneous fat all over
D)Are unable to shiver effectively to increase heat production
6
...
Which response by the nurse would be most
appropriate?
A)You probably took iron during your pregnancy
...

C) I'll take a sample and check it for possible bleeding
...

7
...
The nurse explains that this behavior indicates which of
the following?
A)Normal progression of behavior
B) Probable hypoglycemia
C) Physiological abnormality
D)Inadequate oxygenation
8
...

B) Put a hat on the newborns head
...

D)Wrap the newborn in a blanket
...
Assessment of a newborn reveals rhythmic spontaneous movements
...
After teaching new parents about the sensory capabilities of their
newborn, the nurse determines that the teaching was successful when they
identify which sense as being the least mature?
A) Hearing
B) Touch
C) Taste
D) Vision
11
...
The nurse does so to minimize heat loss via which mechanism?
A) Evaporation
B) Conduction
C) Convection
D) Radiation
12
...
A nurse is counseling a mother about the immunologic properties of
breast milk
...
The nurse is teaching a group of students about the similarities and
differences between newborn skin and adult skin
...

B) The lipid composition of the skin of a newborn and adult is about the
same
...

D) The newborn has more fibrils connecting the dermis and epidermis
...
A nurse is developing a teaching plan for the parents of a newborn
...
The nurse is assessing the respirations of several newborns
...
A new mother asks the nurse, Why has my baby lost weight since he was
born? The nurse integrates knowledge of which of the following when
responding to the new mother?
A) Insufficient calorie intake
B) Shift of water from extracellular space to intracellular space
C) Increase in stool passage
D) Overproduction of bilirubin
18
...

Which of the following would the nurse expect to find?
A) Greenish black, tarry stool
B) Yellowish-brown, seedy stool
C) Yellow-gold, stringy stool
D) Yellowish-green, pasty stool
19
...
The nurse would
expect this newborn to exhibit which of the following? (Select all that apply
...
A nurse is assessing a newborn and observes the newborn moving his
head and eyes toward a loud sound
...
A newborn is experiencing cold stress
...
)
A) Respiratory distress

B) Decreased oxygen needs
C) Hypoglycemia
D) Metabolic alkalosis
E) Jaundice
22
...
The students
demonstrate understanding of this information when they identify which of
the following as the first event?
A) Expansion of the lungs
B) Increased pulmonary blood flow
C) Initiation of respiratory movement
D) Redistribution of cardiac output
23
...
Which result
would the nurse identify as a cause for concern?
A) Hemoglobin 19 g/dL
B) Platelets 75,000/uL
C) White blood cells 20,000/mm3
D) Hematocrit 52%
24
...
When
describing the change from fetal to newborn circulation, which of the
following would the instructor most likely include? (Select all that apply
...

B) Increase in oxygen levels leads to a decrease in systemic vascular
resistance
...

D) Increase in pressure in the left atrium results from increases in pulmonary
blood flow
...

25
...
Which of the following would the student include as a measure
to prevent heat loss through convection?
A) Placing a cap on a newborns head
B) Working inside an isolette as much as possible
...
After teaching a group of nursing students about a neutral thermal
environment, the instructor determines that the teaching was successful
when the students identify which of the following as the newborns primary
method of heat production?

A) Convection
B) Nonshivering thermogenesis
C) Cold stress
D) Bilirubin conjugation
27
...
The nurse
identifies this behavior as which of the following?
A) Habituation
B) Self-quieting ability
C) Social behaviors
D) Orientation
Answer Key
1
...
D
3
...
A
5
...
B
7
...
A
9
...
D
11
...
D
13
...
C
15
...
D
17
...
B
19
...
D
21
...
C
23
...
A, C, D, E
25
...
B
27
...
Prior to discharging a 24-hour-old newborn, the nurse assesses her
respiratory status
...
The nurse encourages the mother of a healthy newborn to put the
newborn to the breast immediately after birth for which reason?
A)To aid in maturing the newborns sucking reflex
B) To encourage the development of maternal antibodies
C) To facilitate maternalinfant bonding
D)To enhance the clearing of the newborns respiratory passages
3
...
In one corner of the bassinet is a soft stuffed animal and
at the other end is a bulb syringe
...

B) Stuffed animals should not be in areas where infants sleep
...

D)This newborn should be sleeping in a crib
...
Assessment of a newborn reveals a heart rate of 180 beats/minute
...
Just after delivery, a newborns axillary temperature is 94 C
...

B) Rewarm the newborn gradually
...

D) Notify the physician if the temperature goes lower
...
The parents of a newborn become concerned when they notice that their
baby seems to stop breathing for a few seconds
...


B) Assess the newborn for signs of respiratory distress
...

D)Tell the parents not to worry since his color is fine
...
When assessing a newborn 1 hour after birth, the nurse measures an
axillary temperature of 95
...
Which nursing diagnosis takes highest
priority?
A)Hypothermia related to heat loss during birthing process
B) Impaired parenting related to addition of new family member
C) Risk for deficient fluid volume related to insensible fluid loss
D)Risk for infection related to transition to extrauterine environment
8
...
The nurse completes the initial assessment of a newborn
...
During a physical assessment of a newborn, the nurse observes bluish
markings across the newborns lower back
...
While making rounds in the nursery, the nurse sees a 6-hour-old baby girl
gagging and turning bluish
...

B) Administer oxygen via facial mask by positive pressure
...

D) Aspirate the oral and nasal pharynx with a bulb syringe
...
While performing a physical assessment of a newborn boy, the nurse
notes diffuse edema of the soft tissues of his scalp that crosses suture lines
...
Assessment of a newborn reveals uneven gluteal (buttocks
...
Which of the following
would the nurse suspect?
A) Slipping of the periosteal joint
B) Developmental hip dysplasia
C) Normal newborn variation
D) Overriding of the pelvic bone
14
...
The nurse administers vitamin K intramuscularly to the newborn based on
which of the following
rationales?
A) Stop Rh sensitization
B) Increase erythopoiesis
C) Enhance bilirubin breakdown
D) Promote blood clotting
16
...
The rash consists of small papules and is
scattered with no pattern
...
After teaching a group of nursing students about variations in newborn
head size and appearance, the instructor determines that the teaching was
successful when the students identify which of the following as a normal
variation? (Select all that apply
...
5 cm

18
...
Which of the following would the
nurse identify as normal?
(Select all that apply
...
Assessment of a newborns head circumference reveals that it is 34 cm
...
The nurse is auscultating a newborns heart and places the stethoscope at
the point of maximal impulse at which location?
A) Just superior to the nipple, at the midsternum
B) Lateral to the midclavicular line at the fourth intercostal space
C) At the fifth intercostal space to the left of the sternum
D) Directly adjacent to the sternum at the second intercostals space
21
...
Which of
the following would alert the nurse to a possible problem?
A) Limited rugae
B) Large scrotum
C) Palpable testes in scrotal sac
D) Absence of engorgement
22
...
The nurse documents which reflex as being positive?
A) Palmar grasp reflex
B) Tonic neck reflex
C) Moro reflex
D) Rooting reflex
23
...
The nurse
determines that the teaching was successful when the parents state which of
the following?
A) We can put a tiny bit of lotion on his skin and then rub it in gently
...

C) We need to bathe him at least four to five times a week
...

24
...

B) Make sure he drinks at least 5 minutes on each breast
...

D) If his lips are moist, then hes okay
...
A nurse is teaching postpartum client and her partner about caring for
their newborns umbilical cord site
...

B) The cord stump should change from brown to yellow
...

D) We need to call the doctor if we notice a funny odor
...
While changing a female newborns diaper, the nurse observes a mucuslike, slightly bloody vaginal discharge
...
A nursing instructor is describing the advantages and disadvantages
associated with newborn circumcision to a group of nursing students
...

B) The rate of penile cancer is less for circumcised males
...

D) Circumcision is a risk factor for acquiring HIV infection
...
A newborn is scheduled to undergo a screening test for phenylketonuria
(PKU)
...
Assessment of a newborn reveals transient tachypnea
...
Which of the following would the nurse be
least likely to identify as a risk factor for this condition?
A) Cesarean birth

B) Shortened labor
C) Central nervous system depressant during labor
D) Maternal asthma
30
...
Which of the following would the nurse be most likely to
include in the teaching? (Select all that apply
...
A
2
...
B
4
...
B
6
...
A
8
...
C
10
...
D
12
...
B
14
...
D
16
...
A, B, D
18
...
B
20
...
A
22
...
B
24
...
B
26
...
B
28
...
B
30
...
After teaching a woman who has had an evacuation for a hydatidiform
mole (molar pregnancy
...

B) My intake of iron will have to be closely monitored for 6 months
...

D)I won't use my birth control pills for at least a year or two
...
Which of the following findings on a prenatal visit at 10 weeks might lead
the nurse to suspect a
hydatidiform mole?
A)Complaint of frequent mild nausea
B) Blood pressure of 120/84 mm Hg
C) History of bright red spotting 6 weeks ago
D)Fundal height measurement of 18 cm
3
...
Which finding
would the nurse interpret as indicating a therapeutic level of medication?
A)Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D)Difficulty in arousing
4
...
Which of the following responses by the nurse would be most
appropriate?
A)Why are you crying?
B) Will a pill help your pain?
C) I'm sorry you lost your baby
...

Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing
(4th Edition) 145
5
...
In a woman who is suspected of having a ruptured ectopic pregnancy, the
nurse would expect to assess for which of the following as a priority?

A)Hemorrhage
B) Jaundice
C) Edema
D)Infection
7
...
It is determined that a clients blood Rh is negative and her partners is
positive
...
The nurse is developing a plan of care for a woman who is pregnant with
twins
...
A woman hospitalized with severe preeclampsia is being treated with
hydralazine to control blood pressure
...
After reviewing a clients history, which factor would the nurse identify as
placing her at risk for gestational hypertension?
A) Mother had gestational hypertension during pregnancy
...

C) Sister-in-law had gestational hypertension
...


12
...
Which of the following would the
nurse expect to include in the clients plan of care?
A) Clear liquid diet
B) Total parenteral nutrition
C) Nothing by mouth
D) Administration of labetalol
13
...

Which one of the following findings would alert the nurse to the development
of HELLP syndrome?
A) Hyperglycemia
B) Elevated platelet count
C) Leukocytosis
D) Elevated liver enzymes
14
...
Which assessment finding would lead the nurse to suspect infection as
the cause of a clients PROM?
A) Yellow-green fluid
B) Blue color on Nitrazine testing
C) Ferning
D) Foul odor
16
...
)
A) History of diabetes
B) Complaints of shortness of breath
C) Identifiable fetal parts on abdominal palpation
D) Difficulty obtaining fetal heart rate
E) Fundal height below that for expected gestataional age
17
...
A pregnant woman is admitted with premature rupture of the membranes
...
Which of the following would lead the
nurse to suspect that the
woman is developing an infection? (Select all that apply
...
A nurse is teaching a pregnant woman with preterm premature rupture of
membranes who is about to be discharged home about caring for herself
...

B) I need to call my doctor if my temperature increases
...

D) I can shower but I shouldn't take a tub bath
...
A nurse is assessing a pregnant woman with gestational hypertension
...
A nurse suspects that a pregnant client may be experiencing abruption
placenta based on assessment of which of the following? (Select all that
apply
...
The health care provider orders PGE2 for a woman to help evacuate the
uterus following a spontaneous abortion
...

B) Keep the gel cool until ready to use
...


D) Administer intramuscularly into the deltoid area
...
A nursing student is reviewing an article about preterm premature rupture
of membranes
...
)
A) High body mass index
B) Urinary tract infection
C) Low socioeconomic status
D) Single gestations
E) Smoking
24
...
The woman and fetus are stable
...
Which statement by the woman would
suggest to the nurse that home care might be inappropriate?
A) My mother lives next door and can drive me here if necessary
...

C) I know to call my health care provider right away if I start to bleed again
...

25
...
Which suggestion would be most
appropriate for the nurse to make?
A) Make sure that anything around your waist is quite snug
...

C) Drink fluids in between meals rather than with meals
...
A woman with gestational hypertension experiences a seizure
...
A woman is receiving magnesium sulfate as part of her treatment for
severe preeclampsia
...
Which level would the nurse identify as therapeutic?
A) 3
...
1 mEq/L
C) 8
...
8 mEq/L

Answer Key
1
...
D
3
...
C
5
...
A
7
...
D
9
...
C
11
...
C
13
...
A
15
...
A, B, D
17
...
B, C, E
19
...
D
21
...
C
23
...
B
25
...
B
27
...
The nurse is teaching a pregnant woman with type 1 diabetes about her
diet during pregnancy
...

B) Because I need extra protein, I'll have to increase my intake of milk and
meat
...

D)I'll adjust my diet and insulin based on the results of my urine tests for
glucose
...
A nurse is developing a program for pregnant women with diabetes about
reducing complications
...
within normal limits
3
...
A woman with diabetes is considering becoming pregnant
...
The nurses response is based on the understanding that oral
hypoglycemics:
A)Can be used as long as they control serum glucose levels
B) Can be taken until the degeneration of the placenta occurs
C) Are usually suggested primarily for women who develop gestational
diabetes
D)Show promising results but more studies are needed to confirm their
effectiveness
5
...
level of 13%
...
After teaching a group of students about the use of antiretroviral agents in
pregnant women who are HIVpositive, the instructor determines that the
teaching was successful when the group identifies which of the following as
the underlying rationale?
A)Reduction in viral loads in the blood
B) Treatment of opportunistic infections
C) Adjunct therapy to radiation and chemotherapy
D)Can cure acute HIV/AIDS infections

7
...
There is also evidence suggesting vasoconstriction
...
When teaching a class of pregnant women about the effects of substance
abuse during pregnancy, which of the following would the nurse most likely
include?
A)Low-birth-weight infants
B) Excessive weight gain
C) Higher pain tolerance
D)Longer gestational periods
9
...
She voices concern
about her newborns risk for the infection
...

B) Antibodies cross the placenta and provide immunity to the newborn
...

D)Antiretroviral medications are available to help reduce the risk of
transmission
...
When assessing a pregnant woman with heart disease throughout the
antepartal period, the nurse would be especially alert for signs and
symptoms of cardiac decompensation at which time?
A) 16 to 20 weeks gestation
B) 20 to 24 weeks gestation
C) 24 to 28 weeks gestation
D) 28 to 32 weeks gestation
11
...
Which medication would the nurse question if ordered to control a
pregnant woman's asthma?
A) Budesonide
B) Albuterol
C) Salmeterol

D) Oral prednisone
13
...

B) I should avoid drinking orange juice
...

D) I'll call the doctor if my stool is black and tarry
...
A nurse is providing care to several pregnant women at the clinic
...
The nurse is assessing a newborn of a woman who is suspected of
abusing alcohol
...
After teaching a group of nursing students about the impact of pregnancy
on the older woman, the
instructor determines that the teaching was successful when the students
state which of the following?
A) The majority of women who become pregnant over age 35 experience
complications
...

C) Women over age 35 and are pregnant have an increased risk for
spontaneous abortions
...

17
...
The students demonstrate
understanding of the information when they identify which infection as being
responsible for ophthalmia neonatorum?
A) Syphilis
B) Gonorrhea
C) Chlamydia
D) HPV

18
...
When
describing the infections, which infection would the nurse include as the
most common congenital and perinatal viral infection in the world?
A) Rubella
B) Hepatitis B
C) Cytomegalovirus
D) Parvovirus B19
19
...
Will the
caffeine in my coffee hurt my baby? Which response by the nurse would be
most appropriate?
A) The caffeine in coffee has been linked to birth defects
...

C) Caffeine is a stimulant and needs to be avoided completely
...

20
...

Which of the following would the nurse assess? (Select all that apply
...
A nurse has been invited to speak at a local high school about adolescent
pregnancy
...
)
A) Peer pressure to become sexually active
B) Rise in teen birth rates over the years
...
A nurse is counseling a pregnant woman with rheumatoid arthritis about
medications that can be used during pregnancy
...
A nurse is preparing a teaching program for a group of pregnant women
about preventing infections during pregnancy
...
A pregnant woman tests positive for HBV
...
After teaching a pregnant woman with iron deficiency anemia about
nutrition, the nurse determines that the teaching was successful when the
woman identifies which of the following as being good sources of iron in her
diet? (Select all that apply
...
A group of nursing students are preparing a presentation for their class
about measures to prevent
toxoplasmosis
...

A) Washing raw fruits and vegetables before eating them
B) Cooking all meat to an internal temperature of 140 F
C) Wearing gardening gloves when working in the soil
D) Avoiding contact with a cats litter box
...
A pregnant woman with gestational diabetes comes to the clinic for a
fasting blood glucose level
...
C
2
...
A

4
...
A
6
...
D
8
...
D
10
...
B
12
...
C
14
...
B
16
...
B
18
...
D
20
...
A, C, D
22
...
A
24
...
A, B, C
26
...
A

Chapter 21: Nursing Management of Labor and Birth at Risk
1
...
The nurse immediately places the woman in which position?
A)Supine
B) Side-lying
C) Sitting
D)Kneechest
2
...
The nurse would assess the
woman for which condition?
A)A low-lying placenta
B) Fetopelvic disproportion
C) Contraction ring
D)Uterine bleeding

3
...
Assessment of a woman in labor who is experiencing hypertonic uterine
dysfunction would reveal
contractions that are:
A)Well coordinated
B) Poor in quality
C) Rapidly occurring
D)Erratic
5
...

Assessment reveals no fetopelvic
disproportion
...
The fetus of a woman in labor is determined to be in persistent occiput
posterior position
...
A woman gave birth to a newborn via vaginal delivery with the use of a
vacuum extractor
...
A pregnant client undergoing labor induction is receiving an oxytocin
infusion
...
A woman with a history of crack cocaine abuse is admitted to the labor
and birth area
...
Inspection of the abdomen reveals an irregular wall
contour
...
Which of the following would the nurse suspect?
A)Amniotic fluid embolism
B) Shoulder dystocia
C) Uterine rupture
D)Umbilical cord prolapse
10
...
A woman is to undergo an amnioinfusion
...

B) Well give you an analgesic to help reduce the pain
...

D) A suction cup is placed on your babys head to help bring it out
...
Which finding would indicate to the nurse that a woman's cervix is ripe in
preparation for labor induction?
A) Posterior position
B) Firm
C) Closed
D) Shortened
13
...
Which
finding would require the nurse to intervene immediately?
A) Respiratory rate of 16 breaths per minute
B) Diminished deep tendon reflexes
C) Urine output of 45 mL/hour
D) Alert level of consciousness
14
...
Which of the
following would be most important?
A) Determining an accurate gestational age
B) Asking her about the occurrence of contractions
C) Checking for spontaneous rupture of membranes
D) Measuring the height of the fundus

15
...

B) I'm going to have to wait a few days before I can start breast-feeding
...

D) I'll probably have a tube in my bladder for about 24 hours or so
...
The nurse is providing care to several pregnant women who may be
scheduled for labor induction
...
After teaching a group of nursing students about risk factors associated
with dystocia, the instructor
determines that the teaching was successful when the students identify
which of the following as increasing the risk? (Select all that apply
...
A nurse is preparing an inservice education program for a group of nurses
about dystocia involving
problems with the passenger
...
After teaching a group of nursing students about tocolytic therapy, the
instructor determines that the
teaching was successful when they identify which drug as being used for
tocolysis? (Select all that apply
...
A nurse is assessing a pregnant woman who has come to the clinic
...

The nurse suspects that the woman may be experiencing preterm labor
based on which additional assessment findings?
A) Dull low backache
B) Malodorous vaginal discharge
C) Dysuria
D) Constipation
21
...
The nurse determines
that the teaching was successful when the woman states that if she
experiences any symptoms, she will do which of the following?
A) I'll sit down to rest for 30 minutes
...

C) I'll lie down with my legs raised
...

22
...
Which of the following would the nurse be
least likely to incorporate in the discussion as an underlying reason for
problems in the fetus?
A) Aging of the placenta
B) Increased amniotic fluid volume
C) Meconium aspiration
D) Cord compression
23
...
The
students demonstrate understanding of the information when they identify
which of the following as a
mechanical method?
A) Herbal agents
B) Laminaria
C) Membrane stripping
D) Amniotomy
24
...
Which findings would the nurse most likely assess?
(Select all that apply
...
A group of nursing students are reviewing information about cesarean
birth
...
A pregnant woman is receiving misoprostol to ripen her cervix and induce
labor
...
D
2
...
B
4
...
C
6
...
C
8
...
C
10
...
A
12
...
B
14
...
B
16
...
C, D, E
18
...
A, B, E
20
...
D
22
...
B
24
...
A, B, C, E
26
...
Review of a primiparous woman's labor and birth record reveals a
prolonged second stage of labor and extended time in the stirrups
...
As part of an inservice program, a nurse is describing a transient, selflimiting mood disorder that affects mothers after childbirth
...
A woman who is 2 weeks postpartum calls the clinic and says, My left
breast hurts
...
In addition to pain, the nurse would assess for which of
the following?
A)An inverted nipple on the affected breast
B) No breast milk in the affected breast
C) An ecchymotic area on the affected breast
D)Hardening of an area in the affected breast
4
...

The students demonstrate
understanding of the information when they identify which of the following as
the most common cause?
A)Labor augmentation
B) Uterine atony
C) Cervical or vaginal lacerations
D)Uterine inversion
5
...
A multipara client develops thrombophlebitis after delivery
...
A client experienced prolonged labor with prolonged premature rupture of
membranes
...
When assessing the postpartum woman, the nurse uses indicators other
than pulse rate and blood pressure for postpartum hemorrhage based on the
knowledge that:
A)These measurements may not change until after the blood loss is large
B) The bodys compensatory mechanisms activate and prevent any changes
C) They relate more to change in condition than to the amount of blood lost
D)Maternal anxiety adversely affects these vital signs
9
...
The nurse would be alert for which of the following?
A)Severe uterine pain
B) Board-like abdomen
C) Appearance of petechiae
D)Inversion of the uterus
10
...
Which finding would cause
the nurse to be most concerned?
A) Leg pain on ambulation with mild ankle edema
B) Calf pain with dorsiflexion of the foot
...
A woman experiencing postpartum hemorrhage is ordered to receive a
uterotonic agent
...
Which of the following would be most appropriate when massaging a
woman's fundus?
A) Place the hands on the sides of the abdomen to grasp the uterus
...

C) Wait until the uterus is firm to express clots
...

13
...
4 F
...

C) If I have chills or my discharge has a strange odor, I'll call my doctor
...

14
...
Which of the following would most likely lead the nurse to suspect
this condition?
A) Delirium
B) Feelings of anxiety
C) Sadness
D) Insomnia
15
...
The nurse interprets this
as an infection involving which of the following? (Select all that apply
...
A group of nursing students are reviewing information about mastitis and
its causes
...
coli
B) S
...
A home health care nurse is assessing a postpartum woman who was
discharged 2 days ago
...
Which of the following findings would lead the nurse to
suspect metritis? (Select all that apply
...
A postpartum client comes to the clinic for her routine 6-week visit
...
Assessment of a postpartum client reveals a firm uterus with bright-red
bleeding and a localized bluish bulging area just under the skin at the
perineum
...
The nurse suspects which of the
following?
A) Hematoma
B) Laceration
C) Bladder distention
D) Uterine atony
20
...
Which of the
following would be most important for the nurse to do?
A) Administer the drug as an IV bolus injection
...

C) Piggyback the IV infusion into a primary line
...


21
...
Which of the following would the nurse
expect to assess? (Select all that apply
...
A group of students are reviewing risk factors associated with postpartum
hemorrhage
...
)
A) Rapid labor

B) Retained blood clots
C) Hydramnios
D) Operative birth
E) Fetal malpostion
23
...
A nurse is developing a plan of care for a woman who is at risk for
thromboembolism
...
A postpartum woman who developed deep vein thrombosis is being
discharged on anticoagulant therapy
...

B) I can take ibuprofen if I have any pain
...

D) I will call my health care provider if my stools are black and tarry
...
The nurse is developing a discharge teaching plan for a postpartum
woman who has developed a
postpartum infection
...
)
A) Taking the prescribed antibiotic until it is finished
B) Checking temperature once a week
C) Washing hands before and after perineal care
D) Handling perineal pads by the edges
E) Directing peribottle to flow from back to front
27
...
Which statement
by the client would lead the nurse to suspect that the client may be
developing postpartum depression?
A) I just feel so overwhelmed and tired
...


C) It's strange, one minute I'm happy, the next I'm sad
...

Answer Key
1
...
D
3
...
B
5
...
A
7
...
A
9
...
D
11
...
C
13
...
A
15
...
B
17
...
B
19
...
C
21
...
A, C
23
...
C
25
...
A, C, D
27
...
The nurse is teaching a group of students about the differences between a
full-term newborn and a preterm newborn
...
When assessing a postterm newborn, which of the following would the
nurse correlate with this gestational age variation?
A)Moist, supple, plum skin appearance
B) Abundant lanugo and vernix

C) Thin umbilical cord
D)Absence of sole creases
3
...
are coming to visit for the first time
...
Which action by the
nurse would be most appropriate?
A)Suggest that the parents stay for just a few minutes to reduce their
anxiety
...

C) Encourage the parents to touch their preterm newborn
...

4
...

B) Give chest compressions at a rate of 80 times per minute
...

D) Suction the mouth and then the nose
...
The nurse frequently assesses the respiratory status of a preterm newborn
based on the understanding that the newborn is at increased risk for
respiratory distress syndrome because of which of the following?
A)Inability to clear fluids
B) Immature respiratory control center
C) Deficiency of surfactant
D)Smaller respiratory passages
6
...
Which of the following would the nurse correlate with
this gestational age variation?
A)Strong, brisk motor skills
B) Difficulty in arousing to a quiet alert state
C) Birth weight of 7 lb 14 oz
D)Wasted appearance of extremities
7
...

Which of the following would the nurse do next?
A)Administer intravenous glucose immediately
...

C) Initiate blow-by oxygen therapy
...


8
...
When describing the complications that can occur in
these newborns to the group, which would the nurse include as being at
lowest risk?
A)Small-for-gestational-age (SGA
...
newborns
C) Appropriate-for-gestational-age (AGA
...
While caring for a preterm newborn receiving oxygen therapy, the nurse
monitors the oxygen therapy
duration closely based on the understanding that the newborn is at risk for
which of the following?
A)Retinopathy of prematurity
B) Metabolic acidosis
C) Infection
D)Cold stress
10
...
A woman gives birth to a newborn at 36 weeks gestation
...
Which response by the nurse
would be most appropriate?
A) You are lucky to have given birth to a term newborn
...

C) How do you feel about delivering your baby at 36 weeks?
D) Your baby is premature and needs monitoring in the NICU
...
Which of the following would be most appropriate for the nurse to do
when assisting parents who have experienced the loss of their preterm
newborn?
A) Avoid using the terms death or dying
...

C) Refrain from initiating conversations with the parents
...

13
...
Which of the following would alert the nurse to suspect that a preterm
newborn is in pain?
A) Bradycardia
B) Oxygen saturation level of 94%
C) Decreased muscle tone
D) Sudden high-pitched cry
15
...
2 lb at any gestational
age?
A) Small for gestational age
B) Low birth weight
C) Very low birth weight
D) Extremely low birth weight
16
...
Which of the following would the nurse expect to find?
(Select all that apply
...
The nurse is reviewing the medical record of a newborn born 2 hours ago
...
The
nurse would classify this newborn as which of the following?
A) Preterm
B) Late preterm
C) Full term
D) Postterm
18
...
When describing the preterm newborns risk for perinatal
asphyxia, the instructor includes which of the following as contributing to the
newborns risk? (Select all that apply
...
After determining that a newborn is in need of resuscitation, which of the
following would the nurse do first?
A) Dry the newborn thoroughly
B) Suction the airway
C) Administer ventilations
D) Give volume expanders
20
...
Which of the following would the nurse be least likely to
include in this plan?
A) Stimulate the infant with frequent handling
...

C) Administer oxygen using a oxygen hood
...


21
...
Which of the
following would support the nurses suspicion? (Select all that apply
...
The nurse is assessing a preterm newborns fluid and hydration status
...
The nurse is assessing a preterm newborn who is in the neonatal
intensive care unit (NICU
...
Which
of the following would the nurse be least likely to assess?
A) Increased respirations
B) Flaying hands
C) Periods of apnea
D) Decreased heart rate
24
...
Which of
the following would the students be most likely to find about this topic?
A) Newborn pain is frequently recognized and treated
B) Newborns rarely experience pain with procedures

C) Pain is frequently mistaken for irritability or agitation
D) Newborns may be less sensitive to pain than adult
...
A nurse is developing a plan of care for a preterm newborn to address the
nursing diagnosis of risk for delayed development
...
)
A) Clustering care to promote rest
B) Positioning newborn in extension
C) Using kangaroo care
D) Loosely covering the newborn with blankets
E) Providing nonnutritive sucking
26
...
Which statement by the nurse would be least appropriate?
A) I'll be here to help you all along the way
...

D) Forget about whats happened in the past and focus on the now
...
D
2
...
C
4
...
C
6
...
A
8
...
A
10
...
B
12
...
B
14
...
B
16
...
B
18
...
A
20
...
A, B, E
22
...
A
24
...
A, C, E
26
...
A newborn with severe meconium aspiration syndrome (MAS
...
Which of the following would the
nurse anticipate as possibly necessary for this newborn?
A)Extracorporeal membrane oxygenation (ECMO)
B) Respiratory support with a ventilator
C) Insertion of a laryngoscope for deep suctioning
D)Replacement of an endotracheal tube via x-ray
2
...
Which of the following would the nurse include in the plan of care for a
newborn receiving phototherapy?
A)Keeping the newborn in the supine position
B) Covering the newborns eyes while under the bililights
C) Ensuring that the newborn is covered or clothed
D)Reducing the amount of fluid intake to 8 ounces daily
4
...
The nurse
understands that the newborn most likely acquired this infection from which
of the following?
A)Improper handwashing
B) Contaminated formula
C) Nonsterile catheter insertion
D)Mothers birth canal
5
...

B) Remove the newborn from the birthing area immediately
...

D)Tell the parents that the newborn must go to the nursery immediately
...
The nurse prepares to administer a gavage feeding for a newborn with
transient tachypnea based on the understanding that this type of feeding is
necessary for which reason?
A)Lactase enzymatic activity is not adequate
...

C) Renal solute lead must be considered
...

7
...

B) Pathologic jaundice appears within 24 hours after birth
...

D)Physiologic jaundice requires transfer to the NICU
...
When planning the care of a newborn addicted to cocaine who is
experiencing withdrawal, which of the following would be least appropriate to
include?
A)Wrapping the newborn snugly in a blanket
B) Waking the newborn every hour
C) Checking the newborns fontanels
D)Offering a pacifier
9
...
Which of the
following would the nurse expect to assess?
A)Bradypnea
B) Hydrocephaly
C) Flattened maxilla
D)Hypoactivity
10
...

B) Our newborn could develop a learning disability later on
...

D) We need to get family members to donate blood for transfusion
...
A newborn has an Apgar score of 6 at 5 minutes
...
While reviewing a newborns medical record, the nurse notes that the
chest x-ray shows a ground glass pattern
...
A newborn is suspected of developing persistent pulmonary hypertension
...
Which of the following would alert the nurse to suspect that a newborn
has developed NEC?
A) Irritability
B) Sunken abdomen
C) Clay-colored stools
D) Bilious vomiting
15
...
A group of nursing students are reviewing the different types of
congenital heart disease in infants
...
After teaching the parents of a newborn with retinopathy of prematurity
(ROP
...

C) Well make sure to administer eye drops each day for the next few weeks
...

18
...
Which of the following
would the nurse expect to find? (Select all that apply
...
The nurse is assessing a newborn who is large for gestational age
...
The nurse suspects that the newborn may have
experienced trauma to the upper brachial plexus based on which assessment
findings?
A) Absent grasp reflex
B) Hand weakness
C) Absent Moro reflex
D) Facial asymmetry
20
...
Which of the following would the nurse
expect to assess? (Select all that apply
...
A nurse is developing a plan of care for a newborn with omphalocele
...
A nurse is explaining to the parents of a child with bladder exstrophy
about the care their infant requires
...
)
A) Covering the area with a sterile, clear, nonadherent dressing
B) Irrigating the surface with sterile saline twice a day
C) Monitoring drainage through the suprapubic catheter
D) Administering prescribed antibiotic therapy
E) Preparing for surgical intervention in about 2 weeks
23
...

The student determines that the presentation was successful when the class
states which of the following?
A) Clubfoot is a common genetic disorder
...


C) The exact cause of clubfoot is not known
...

24
...
Which of
the following would the nurse suspect?
A) Phenylketonuria
B) Galactosemia
C) Congenital hypothyroidism
D) Maple syrup urine disease
25
...
The students demonstrate understanding of the
information when they identify which drug as not being associated with
teratogenic effects on the fetus?
A) Alcohol
B) Nicotine
C) Marijuana
D) Cocaine
26
...
The nurse determines that the mother has
understood the teaching when she identifies which of the following as
needing to be restricted?
A) Phenylalanine
B) Protein
C) Lactose
D) Iodine
27
...
The nurse is teaching the parents about signs and
symptoms that need to be reported
...
)
A) Weight loss
B) Pale skin
C) Fever
D) Absence of edema
E) Increased respiratory rate
28
...
A nurse is assisting in the resuscitation of a newborn
...
A newborn is diagnosed with meconium aspiration syndrome
...
)
A) Pigeon chest
B) Prolonged tachypnea
C) Intercostal retractions
D) High blood pH level
E) Coarse crackles on auscultation
Answer Key
1
...
C
3
...
D
5
...
B
7
...
B
9
...
B
11
...
A
13
...
D
15
...
B
17
...
B, C, D
19
...
A, C, D, F
21
...
A, C, D
23
...
C
25
...
C
27
...
B
29
...
B, C, E



---