| A woman has been diagnosed as having gestational hypertension Which symptom for this condition is the most typical?
a. increased perspiration'
b. weight loss
c. susceptibility to infection
d. blood pressure elevation | d. blood pressure elevation |
| A prenatal client who is 6 weeks' gestation calls the clinic to report vaginal bleeding, For what concern will the nurse further assess the client?
a. spontaneous abortion (miscarriage)
b. nuchal cord
c. urinary tract infection
d. Braxton Hicks contractions | a. spontaneous abortion |
| The nurse is giving discharge instructions to a client who experienced a complete spontaneous abortion (miscarriage). Which question should the nurse prioritize at this time? | "Do you have someone to talk to or may I give you the names and numbers for some possible grief counselors? |
| A client suffering a miscarriage at 12 weeks' gestation is very upset that the health care provider has ordered a D&C. How should the nurse respond after the client states she didn't have D&C the time she lost a previous baby at 5 weeks' gestation? | "This procedure is needed to adequately remove all the fetal tissue" |
| A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that: | As long as she receives Rho(D) immune globulin, there is no limit |
| A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient? | Assess fetal heart sounds with an external monitor. |
| A client is 20 weeks pregnant. At a prenatal visit, the nurse begins the prenatal assessment, Which finding would necessitate calling the primary care provider to assess the client? | The client has pink vaginal discharge an pelvic pressure |
| The nurse is approaching the medical record of a pregnant client who is resting in a darkened room and receiving betamethasone and magnesium sulfate. The nurse recognizes the client is being treated fro which condition? | gestational diabetes |
| After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? | "I will be sure to avoid getting pregnant for at least 1 year" |
| The nurse is comforting and listening to a young couple who just suffered a spontaneous abortion (miscarriage), When asked why this happened, which reason should the nurse share as a common cause? | Chromosomal abnormality |
| A young mother gives birth to twin boys who shared the same placenta, What serious complications are they at risk for? | Twin-to-twin transfusion syndrome (TTS) |
| A pregnant woman is admitted to the hospital with a diagnosis of placenta previa, Which action would be the priority for this woman on admission? | Assessing fetal heart tomes by use of an external monitor |
| What would be the physiologic basis for a placenta previa? | low placental implantation |
| A pregnant patient with a history of premature cervical dilation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful? | The client delivers a full-term fetus at 39 weeks' gestation |
| A woman active in labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly the woman grabs the nurse's hand and states, "Something inside me is tearing" The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication? | Uterine rupture |
| The nurse is admitting a client in labor. The nurse determines that the fetus is in a transverse lie by performing Leopold maneuvers. What intervention should the nurse provide for the client? | Administer an analgesic to the client |
| The nurse is reviewing the physical examination findings for a client who is to undergo labor instructions. Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction? | shortened |
| The nurse is caring for a patient in labor whose fetus is in an occiput posterior position, Which intervention should the nurse use to reduce this patient's discomfort? | Massage at the lower back. |
| A 16-year-old- client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilation (dilatation) is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? | cesarean birth |
| While the placenta is being delivered after labor, a patient experiences an amniotic fluid embolism. What should the nurse do first to help this patient? | administer oxygen mask |
| A client at 38 weeks' gestation has an ultrasound performed at a routine office visit and learns that her fetus has not moved out of a breech position. Which intervention does the nurse anticipate for this client? | External cephalic version |
| When caring for a client requiring a forceps-assisted birth, the nurse would be alert for? | potential lacerations and bleeding |
| A client's membrane have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client? | Assess fetal heart sounds |
| After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which postion? | knee-chest |
| A laboring client is experiencing dysfunctional labor or dystocia due to the malfunction of one or more of the "four Ps" of labor. Which scenario best illustrates a power problem? | Uterine contractions are weak and ineffective |
| What is the most common cause of deficiency anemia? | iron-deficiency anemia |
| A pregnant woman comes to the clinic and reports redness and swelling in her right calf as well as pain, even when resting, The nurse suspects a deep vein thrombosis (DVT). Which of the following does the nurse diagnose as the biggest danger for this patine? | pulmonary embolism |
| A woman develops gestational diabetes. Which assessment should she make daily? | Measure serum for glucose level by a finger prick |
| A young client with a cardiac problem wants to get pregnant and tells the nurse that she is sad that she will never be able to have a baby. What is the best response by the nurse? | Because of improved management, more women with cardiac problems can complete pregnancies successfully |
| A nurse is caring for a pregnant woman with a pre-existing heart problem realizes the importance of doing which of the following at the very beginning of the pregnancy to help diagnose a complciation? | Establish baseline vital signs |
| A pregnant woman with cardiac disease tells the nurse that she wants to have a healthy baby and likes babies who have some extra weight. What would be the nurse's best response to this patient? | Too much weight gain could overburden your heart and circulatory system |
| The nurse explains to a pregnant client that she will need to take iron during her pregnancy after being diagnosed with iron-deficiency anemia. The nurse suggests that absorption of the supplemental iron can be increased by taking it with which substance? | orange juice |
| A pregnant woman who has had cardiovascular disease for the last 3 years asks the nurse why this disorder makes her pregnancy an "at-risk" pregnancy. What is the nurse's best response? | "Pregnancy taxes the circulatory system of every woman" |
| A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy? | iron-deficiency anemia |
| Which factor would contribute to a high-risk pregnancy? | type 1 diabetes |
| In women with cardiac failure, the maternal blood pressure becomes sufficient to provide an adequate supply of blood to the placenta. The infant will likely experience some undesired effects including which of the following? | low birth weight |
| A woman with an artificial mitral valve develops heart failure at the 20th week of pregnancy. Which measure would the nurse stress with her during the remainder of the pregnancy? | obtaining enough rest |
| A pregnant client with sickle cell anemia is admitted in crisis, Which nursing intervention should the nurse prioritize? | IV fluids |
| A client in week 38 of her pregnancy arrives at the emergency room reporting a sharp pain between her umbilicus and the iliac crest in her lower right abdomen that is increasing. she reports having experienced intense nausea and vomiting for the past 3 hours. Given these symptoms, the nurse suspects which of the following conditions? | Appendicitis |
| A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. Which of the following does the nurse anticipate in this woman's pregnancy? | Potential for greater than usual back pain. |
| The maternal health nurse is caring for a pregnant client with a history of epilepsy. The client's antiepileptic drug (AED) levels have been in the non-therapeutic range the last two times the labs were drawn. Which factor does the nurse associate with this finding/ | Drug metabolism changes during pregnancy |
| A pregnant client with a history of asthma since childhood presents for a prenatal visit. What statement by the client would the nurse prioritize | I sometimes get a bit wheezy |
| A woman who is 8 months' pregnant comes to the clinic with urinary frequency and pain on urination. The client is diagnosed with a urinary tract infection (UIT). Which medication would the nurse anticipate the physician will prescribe? | amoxicillin |
| The nurse is appraising the laboratory results of a pregnant client who is in her second trimester and notes the following: thyroid stimulating hormone (TSH) slightly elevated, glucose in the urine, complete blood count (CBC) low normal, and normal electrolytes. The nurse prioritizes further testing to rule out which condition? | gestational diabetes |
| A patient who is 36 weeks pregnant has been taking phenytoin for a seizure disorder. Which supplement should the nurse anticipate being prescribed for this patient? | Vitamin K |
| A pregnant client with cystic fibrosis (CF) comes to the office for a prenatal visit. She asks the nurse for information on breast-feeding. The best response by the nurse is: | Brest-feeding is not a good idea. Because your breast milk is high in sodium due to CF. There is a risk of the infant receiving too much sodium" |
| A pregnant client with deep vein thrombosis has been diagnosed as having systemic lupus erythematosus (SLE). The nurse would monitor the client closely for the development of which complications? | Fetal malnutrition |
| The health care provider has diagnosed a pregnant client with megaloblastic anemia and has prescribed treatment. When questioned by the client as to what this means, which is the best response from the nurse? | folic acid deficiency anemia |
| A client with rheumatoid arthritis (RA) is in week 38 of her pregnancy. Which intervention should the nurse make with this client? | Ask the client to decrease her intake of salicylates |
| A pregnant woman tests positive for tuberculosis (TB). The nurse explains to the woman that additional tests are needed to confirm the diagnosis. When describing these tests, which one(s) would the nurse likely include? Select all that apply. | Chest x-ray
sputum culture |
| A woman in labor for over 12 hours has made very little progress the health care provider thinks that her contractions lack the force needed to propel the infant downward through the birth canal. The provider asks a group of nursing students which hormone may need to be given to increase the force of contraction. Which hormone would be the best answer? | oxytocin, a posterior pituitary hormone |
| A nursing student correctly identifies the problem of fetal buttocks instead of the head presenting first as which type of presentation? | breech presentation |
| What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.8lb) or more at birth? | macrosomnia |
| A nursing instructor identifies which of the following as increasing the chances of infection when coupled with prolonged labor/ | ruptured membranes |
| An infant was born after a face presentation. When selecting a nursing diagnosis for the newborn, which body system does the nurse identify as a priority? | Respiratory |
| A woman gave birth to a newborn via vaginal birth with the use of a vacuum extractor. The nurse would be alert for which possible effect in the newborn? | cephalohematoma |
| During the experience in L&D, a group of nursing students are observing a woman who is having uncoordinated contractions where the monitor shows some contractions. The nurse asks the students, "Which medication may help to stimulate a more effective, consistent pattern of contractions"? Which medication would be considered the best answer? | oxytocin |
| Which actions would be most appropriate for the who experiences dysfunctional labor in the first stage of labor? | Provide ongoing things the woman asks questions about. |
| A client who has been in prolonged labor reports extreme back pain. She asks why her back hurts so much. What would be the best response by the nurse? | Differential fetal positions can cause prolonged labor and back |
| A pregnant client presents to the emergency department reporting back-to-back contractions within 2 hours, the client is completely effaced in 9cm dilated, and the fetal head is showing within minutes the client gives birth with only the nurse in attendance. This is an example of which occurrence? | Precipitate labor |
| After only 45 minutes of labor, the client feels the urge to push. She pushes once and the baby's head is visible. With the next push, the head emerges. What is the immediate risk when the head is delivered too fast? | Perineal tearing |
| During a difficult labor of an infant in the face presentation, the nurse notes the infant has a large amount of facial edema with bruising and ecchymosis. Which assessment would be the priority for this infant? | patent airway |
| A laboring client has been pushing without delivering the fetal shoulders. The primary care provider determine the fetus is experiencing shoulder dystocia. What intervention can the nurse assist with to help with her birth? | McRoberts maneuver |
| A client's membranes rupture. The nurse observes the fetal heart rate drop from 156 to 110. The nurse inspects the client's perineum and sees a loop of umbilical cord. What is the nurse's priority concern in this situation? | Decreased fetal oxygenation |
| The nurse is providing care for a postpartum client who has been diagnosed with a perineal infection and who is being treated with antibiotics. What is the nurse's most appropriate intervention? | Encourage fluid intake |
| About 10 days following birth, a new mother visits her primary care provider with localized symptoms of redness, selling, warmth, and a hard, inflamed vessel in one leg. The nurse should suspect which condition? | femoral thrombophlebitis |
| Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage? | uterine atony |
| A woman who has just given birth to her infant tells the nurse that she is putting the baby for adoption. The nurse must serve as an advocate for this mother. What would the nurse do to assist the client in placing the child for adoption? | Keep the client informed of her rights and options and support her decision |
| A nurse is caring for a postpartum client with urinary tract infection. Which instruction would the nurse include in the teaching plan for the client to help prevent future infections? | Empty your bladder frequently |
| A pregnant client at 32 weeks' gestation is treated with magnesium sulfate for seizure management. The nurse assesses which of the following for evidence of magnesium toxicity? | absence of knee jerk response (tendon reflex) |
