A postpartum patient who has had a vaginal birth asks the nurse I was wondering of my cervix will return to its previous shape before I had the baby
The cervix will now have a slit-like shape
A patient who is 6 months pregnant has sought medical attention saying she fell down the stairs which scenario would cause an emergency department nurse to suspect that the woman has been battered
The woman has injuries on various parts of her body that are in different stages of healing
The nurse is reviewing the principles of family centered care with primiparous patient which patient statement
Because childbirth is normal after my baby's birth our family dynamics will not change
The nurse in labor and birth is caring for a Muslim patient during the active phase of labor the nurse notes that the patient quickly draws away when touched which intervention should the nurse implement
Limit touching to a minimum because physical contact may not be acceptable in her culture
The clinic nurse is reviewing breastfeeding with a pregnant patient which hormone will the nurse explain is responsible for milk production after the birth of the placenta
A patient tells the nurse at a prenatal interview that she has quit smoking and only has one glass of wine with dinner which response by the nurse will be most helpful in promoting a lifestyle change
You have made some good progress toward having s healthy baby lets talk about the changes you have made
A 35 year old patient has an amniocentesis performed to identify whether her baby has a chromosomal defect which statement indicates that the patient understands the situation
“When all the lab results come back, my husband and I will make a decision about the pregnancy.”
The patient indicates to the clinic nurse that she is trying to become pregnant the clinic nurse reviews the patient's chart and notes the following laboratory values: Blood type 0- RPR nonreactive, rubella non-immune HCT 35% which laboratory value is most concerning to the nurse
One of the assessments performed in the birth room is checking the umbilical cord for blood vessels which finding is considered to be within normal limits
Two arteries and one vein
The nurse is conducting a staff in-service on multifetal pregnancy which statement regarding dizygotic twin development should the nurse include in the teaching session
Dizygotic twins arise from two fertilized ova and may be the same sex or different sexes.
The nurse is explaining the function of the placenta to a pregnant patient which statement indicates to the nurse that further clarification is necessary
The placenta helps maintain a stable temperature for my baby
An expectant mother says to the nurse, “When my sister’s baby was born, it was covered in a cheese-like coating. What is the purpose of this coating?” The correct response by the nurse is to explain that the purpose of vernix caseosa is to
Protect the fetal skin from the amniotic fluid
A pregnant patient asks the nurse how her baby gets oxygen to breathe. What is the nurse’s best response?
Oxygen-rich blood is delivered through the umbilical vein to the baby.”
During vital sign assessment of a pregnant patient in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is most appropriate?
Have the patient turn to her left side and recheck her blood pressure in 5 minutes.
A pregnant woman notices that she is beginning to develop dark skin patches on her face. She denies using any different types of facial products as a cleansing solution or makeup. What would the priority nursing intervention be in response to this situation?
Let the patient know that this is a common finding that occurs during pregnancy.
While providing education to a primiparous patient regarding the normal changes of pregnancy, what is an important information for the nurse to share regarding Braxton Hicks contractions?
These occur throughout pregnancy, but you may not feel them until the third trimester.
Physiologic anemia often occurs during pregnancy due to
dilution of hemoglobin concentration
Which comment made by a patient in her first trimester indicates ambivalent feelings?
“I wanted to become pregnant, but I’m scared about being a mother.”
An expectant patient in her third trimester reports that she developed a strong tie to her baby from the beginning and now is really in tune to her baby’s temperament. The nurse interprets this as the development of which maternal task of pregnancy?
Developing attachment with the baby
The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick’s sign. When the patient asks the nurse what this means, how would the nurse respond?
This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix.”
An expected change during pregnancy is a darkly pigmented vertical mid abdominal line the nurse recognizes this alteration as
Which finding is a positive sign of pregnancy?
Visualization of fetus by ultrasound
Which advice to the patient is one of the most effective methods for preventing venous stasis?
Rest often with the feet elevated.
A gravida 1 patient at 32 weeks of gestation reports that she has severe lower back pain. What should the nurse’s assessment include
Observation of posture and body mechanics
When documenting a patient encounter, which term will the nurse use to describe the woman who is in the 28th week of her first pregnancy?
Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one gestation, and one infant at 38 weeks’ gestation.
G5 T1 P1 A2 L2
The nurse is scheduling the next appointment for a healthy primigravida currently at 28 weeks gestation. When will the nurse schedule the next prenatal visit?
Which type of cutaneous stimulation involves massage of the abdomen
Which patient would require additional calories and nutrients?
A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
Which effect is a common response to both smoking and cocaine use in the pregnant patient?
What does a birth plan help the parents accomplish?
Taking an active part in planning the birth experience
When explaining the recommended weight gain to your patient, the nurse’s teaching should include which statement?
“Weight gain in pregnancy is based on the patient’s prepregnant body mass index.”
Uncontrolled maternal hyperventilation during labor results in
A pregnant patient asks the nurse if she can double her prenatal vitamin dose because she does not like to eat vegetables. What is the nurse’s response regarding the danger of taking excessive vitamins?
Has toxic effects on the fetus
Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position?
Which fetal position may cause the laboring patient increased back discomfort?
Left occiput posterior
Which physiologic event is the key indicator of the commencement of true labor?
Cervical dilation and effacement
To improve placental blood flow immediately after the injection of an epidural anesthetic, the nurse should
place a wedge under the woman’s right hip.
The clinic nurse is reviewing charts on prenatal patients. Which patient histories indicate that a referral to a genetic counselor is warranted? (SATA)
A family history of unexplained stillbirths
A patient with a family history of birth defects
A patient who is a carrier of an X-linked disorder
A nurse is conducting prenatal education classes for a group of expectant parents. Which information should the nurse include in her discussion of the purpose of amniotic fluid?(SATA)
Cushions the fetus
Allows for buoyancy for fetal movement
Maintains a stable temperature for the fetus
Which clinical finding should the nurse expect to assess in the third stage of labor that indicates the placenta has separated from the uterine wall?(SATA)
A gush of blood appears.
The uterus rises upward in the abdomen.
The cord descends further from the vagina.
The United States ranks poorly in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?
Ensuring early and adequate prenatal care
Which patient will most likely seek prenatal care?
A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
The nurse did not document fetal heart tones (FHR) during the second stage of labor.
A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, –1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse’s response, based on the ethical principle of nonmaleficence, is which of the following?
Instruct the patient that only a physician or certified midwife can perform this procedure
A pregnant client tells the nurse that she is worried about the blotchy,brownish coloring over her cheeks,nose and forehead the nurse can reassure the client that is normal condition related to hormonal change, commonly called the mask of pregnancy or significantly known as
A pregnant patient is admitted to the hospital for hyperemesis the provider orders intravenous fluid hydration with 1 L of lactated ringers every eight hours with a 250 mL bolus over 30 minutes the nurse should infuse the first 250 mL at how many drops per minute using a 10gtt/mL drop factor
The nurse encourages this patient more of which food in order to increase calcium intake
The nurse is providing care for the laboring woman should understand that the fetal heart rate (FHR) decelerations can be caused by (SATA)
Altered fetal cerebral blood flow
Umbilical cord compression
The diagnosis of pregnancy is based on which positive signs of pregnancy (SATA)
Identification of fetal heartbeat
Visualization of the fetus
Verification of fetal movement
A patient just moved to the United States from Central America she is 3 months pregnant and has arrived for her first prenatal visit during the assessment interview the nurse discovers that she has not had any immunizations which immunizations should she receive at this stage (SATA)
Signs that precede labor include (SATA)
rupture of membranes
A pregnant patient is seen in the prenatal clinic and has the following obstetrical history one was born at 39 weeks of gestation twins were born at 34 weeks of gestation and another child was born at 35 weeks of gestation and all alive and well one miscarriage at 18 weeks what is gravidity and parity using the GTPAL
When teaching a patient about structure and function of the placenta which information should the nurse include
As one of its early functions the placenta acts as an endocrine gland
A pregnant patient at 18 weeks of gestation calls the clinic to report experiencing occasional backaches of mild to moderate intensity the nurse recommends which action
Pelvic rock exercises
Assessment of a pregnant patients nutritional status includes a diet history medication regimen physical examination and relevant laboratory tests what should a maternity nurse performing such an assessment consider
Illnesses that have created nutritional deficits such as phenylketonuria may require nutritional care before conception
When working with pregnant clients of various cultures, a nurse practitioner has observed various practices that seem strange or unusual and has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose?
To promote healthy habits during pregnancy
What are the components of the umbilical cord?
Two arteries one vein Wharton's jelly
The doctor writes an order for vancomycin 1 g to be given over 120 minutes. The pharmacy sends up vancomycin 250 mL. What rate should be infusion pump be set at?
Determine the infusion time for 1500 mL of D5W at a rate of 10 mL/hr.
A pregnant client is admitted to the hospital for dehydration. The physician orders 1000 mL D5 1/2 NS to run over six hours via a micro drip infusion set tubing. Calculate the flow rate in gtt/min.
The physician orders Solu-Medrol 125 mg IM to be given at 10am. The nursery constitutes 250 mg with 5 mL bacteriostatic water. How many mL should be drawn up and administered?
A client arrives at the clinic for a pregnancy test. The last menstrual period was December 2016 when is the expected date of birth? **
September 28 2017
How does the client's family most impact the maternity nurse?
Family culture and structure will influence nursing care decisions
____ use/abuse during pregnancy causes vasoconstriction and
placental perfusion, resulting in maternal and neonatal complications.
Sexual assault is best described by which phrase?
Act of force in which an unwanted and uncomfortable sexual act occurs
A nurse should be aware that a partner's main role in pregnancy is which action?
Support and nurture the pregnant woman
Identify the term that describes maternity nursing care that is based
knowledge gained through research and clinical trials.
.What is an unexpected negative occurrence involving death or serious physical or psychological injury?
A sentinel event
The nurse who provides preconception care implements which concept?
Could include interventions to reduce substance use and abuse
A first time mother at 18 weeks of gestation is in for a regularly
prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. Which information is most correct for teaching the client about Braxton Hicks contractions?
This type of contraction is painless
The nurse should include which in the patient's teaching regarding weight gain during pregnancy?
Pregnant patients with inadequate weight gain have an increased risk
delivering an infant with intrauterine growth restriction
.A nurse is assessing a client during her first prenatal visit to the clinic. The nurse takes the client's temperature: 100.2°F. Which of the following actions on the part of the nurse is appropriate?
Obtain an order for antibiotics
Which are positive signs of pregnancy?
Determined by ultrasound
.A pregnant patient is at 22 weeks of gestation. The nurse expects to palpate the fundus at which level?
Slightly above the umbilicus
A woman in week 34 of pregnancy reports that she is very
because of heartburn. The nurse would suggest that the woman:
Eat five small meals a day
The nurse has received a report about a woman in labor the woman's last vaginal examination was recorded as 3cm 50% and -2 the nurse's interpretation is that
The cervix is 3 cm dilated, it is effaced 50%, and the presenting part is 2 cm above the ischial spine
A woman in labor has just received an epidural block. The most important nursing Intervention is to:
Monitor the maternal blood pressure for possible hypotension
.A woman can expect to experience what change with pregnancy?
Will have increased lordosis
During the first trimester a woman can expect which change in sexual desire?
Decrease, because of nausea and fatigue
.Which statement about pregnancy is accurate?
A normal pregnancy lasts about 10 lunar months
Identify the term that describes when the fetus begins to descend and drop into the pelvis.
The nurse is collecting data from a client who is 32 weeks gestation. The nurse measures the fundal height in centimeters and expects the findings to be which height?
.A pregnant client calls the nurse at the providers office and reports that she has noticed a thin, colorless, vaginal drainage. Which information would be best for the nurse to provide to the client
The vaginal discharge may be bothersome but it is a normal occurrence
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurses instructions if she states that a presumptive sign of pregnancy is:
Fetal movement palpated by the nurse midwife
.Due to the musculoskeletal system adaptation to the changes that occur during pregnancy, which is the highest risk potential?
A woman's obstetric history states that she is currently pregnant. She also states she has a 5-year-old twins at home was born at 38 weeks of gestation, one baby was born at 36 weeks gestation, and another child was born at 30 weeks gestation. She also had 1 miscarriage at 19 weeks. What is her gravidity and parity using the GTPAL system? Page 170 A.G3-T1-P1-A1-L3
The same female states he last menstrual period (LMP) began on October 8, 2017. Using her (LMP) what is her estimated date of delivery (EDD)?
July 15, 2018
A patient is 26 weeks pregnant. She needs NS to start @ 12 midnight. The doctor order is 1000ml NS to run for 8 hours. The nurse uses a drop factor of 60 gtt/minute. How many gtt/minute would she receive? Round off to the nearest whole number.
Which blood pressure (BP) finding during the second trimester indicates a risk for pregnancy-induced hypertension?
Baseline BP 108/72, current BP 139 /88
A pregnant multigravida female states that her grandmother told her that the round shape of her abdomen indicates that she will be having a male child. Although the nurse may not be able to confirm this information, at what gestation age may a sonogram identity external genitalia?
16 weeks gestation
A 21-year-old female states that she might be 16 weeks pregnant. The nurse knows that there are the presumptive, probable and positive signs of pregnancy. Which of the following is the presumptive sign of pregnancy?
"I can't keep any food down especially in the morning"
Nurse intervention and implementation (such as skin-to-skin with baby and mother after birth improves thermoregulation) that has been research and validated is considered which of the following?
Evidence Based Practice
A 27-year-old pregnant woman had a pre-conceptual body mass index (BMI) of 18.0. The nurse knows that this woman's total recommended weight gain during pregnancy should be at most:
16 kg (35 Ibs).
Prenatal testing for the human immunodeficiency virus (HIV) is recommended for which pregnant women?
All women, regardless of risk factors
With regard to the initial visit with a patient who is beginning prenatal care, nurses should be aware that:
Nurses should be alert to the appearance of potential parenting problems such as depression or lack of family support.
With regard to the position of the laboring woman, maternity nurses should be able to tell the woman that:
Frequent changes in position will help relieve her fatigue and increase her comfort
In her prenatal care the mother was given azithromycin (Zithromax). The medication was given for a positive Chlamydia result. The MD orders 1000 mg tablet of the medication to be taken once. Each capsule is 250 mg. The nurse knows that the total amount of the tablet/s
The two primary areas of risk for sexually transmitted infections (STIs) are:
Risky sexual behaviors and inadequate preventive health behaviors.
The nurse has received a report about a woman in labor. The woman's last vaginal examination was recorded as 9 cm, 80%, and +3 (9/80/+3). The nurse's interpretation of this assessment is that:
The cervix is dilated 9 cm, it is effaced 80%, and the presenting part is 3 cm below the ischial spines.
A 30-year-old mother is 27 week pregnant. This is her first appointment in the prenatal clinic. This mother is concerned about immunization during pregnancy. Which information provided by the nurse is CORRECT?
Tetanus vaccine is recommended during pregnancy
A 21-year prima gravida mother is in labor. She is in the 2nd stage of labor. The nurse is teaching a new nurse about the stages of labor. The nurse knows that the new nurse needs additional teaching if she states which of the following:
The 2nd stage of labor start after the placenta is delivered
With regard to the structure and function of the placenta, the maternity nurse should be aware that:
As one of its early functions, the placenta acts as an endocrine gland.
A 22-year-old mother is 39 weeks pregnant and is in labor but is having problem with delivery. The anesthesiology speaks to the mother about pain management during labor. What information about general anesthesia is INCORRECT?
General anesthesia is widely used for vaginal delivery
A woman is at 23 weeks of gestation. The nurse would expect to palpate the fundus at which level
Slightly above the umbilicus
A woman in labor has just received an epidural block. The most important nursing intervention is to
Monitor the maternal blood pressure for possible hypotension
With regard to fetal positioning during labor, nurses should be aware that:
Birth is imminent when the presenting part is at +4 to +5 cm, below the spine
In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose?
To protect the mother and fetus during pregnancy
A patient needs to be started on D5RL post- cesarean surgery. Dr. Mann orders D5RL (Dextrose 5 with Ringer's Lactate) continuous at 125ml/hour. The nurse hangs 1000 ml of the IVF. How long will the 1000 ml last?
A hospital is investigating report of a sentinel event to prevent such situation from occurring. Based on the nurse's knowledge of sentinel event which of the following would be classified as sentinel event?
A healthy 43 year old female developed DVT (Deep Vein Thrombosis) after giving birth vaginally to a preterm baby girl at 39 weeks gestation
A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:
This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
To reassure and educate pregnant patients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:
Increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty.
With regard to work and travel during pregnancy, nurses should be aware that:
While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.
Which statement about multifetal pregnancy is NOT accurate?
Twin pregnancies come to term with the same frequency as single pregnancies.
Which time-based description of a stage of development in pregnancy is accurate?
Postdate-pregnancy that extends beyond 42 weeks
To help a woman reduce the severity of nausea caused by morning sickness, the nurse might suggest that she:
Try a tart food or drink such as lemonade or salty foods such as potato chips.
The phenomenon of someone other than the mother-to-be experiencing pregnancy-like symptoms such as nausea and weight gain applies to the:
To assess the health of the mother accurately during labor, the nurse should be aware that:
The endogenous endorphins released during labor will raise the woman's pain threshold and production
The health care facility is training its staff about cultural sensitivity. Which of the following Does NOT promote cultural sensitivity?
inform the patient mother's that she cannot pray in the delivery room
The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:
A 20 years old is 30 weeks pregnant as a result of sexual assault. The nurse explains to the patient about sexual assault. Which of the following is INCORRECT about sexual assault
Patients are always ready to report the perpetrator of sexual assault
A 31 year old is 29-week gestation. She complains of difficulty in ambulation. The nurse knows that because of the shift in musculoskeletal system, the nurse should include which of the following in the care plan?
High Risk for fall
During the first trimester a woman can expect which of the following changes in her sexual desire?
A decrease, because of nausea and fatigue
100.9 degree Fahrenheit. The order Acetaminophen 650 mg orally every 4 hours as needed for temperature over 100.4 degree Fahrenheit. The medication is available in 325mg tablet. How many tablets should the nurse administer per dose?
A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate?
"Babies respond to sound starting at about 24 weeks of gestation.
. A pregnant woman's diet history indicates that she likes the following list of foods. The nurse would encourage this woman to consume more of which food to increase her calcium intake?
. With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that:
Both prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.
What represents a typical progression through the phases of a woman's establishing a relationship with the fetus?
I am pregnant." -"I am going to have a baby."-"I am going to be a mother.
A 25-year-old female tells the nurse that she has difficult with getting pregnancy so she wants to know what she can do. After the interview, the necessary lab tests were taken and physical examination was, the nurse begins her preconception teaching. Which of the following should be included in the teaching?
It is important to take folic acid to reduce neural tube deficit
Avoid alcohol and "recreational" drug abuse
Avoid behaviors that that will put her at high risk for Sexual Transmitted Disease(STD)
The nurse is teaching a new mother about the function of the placenta. Which of the following are the functions of the placenta. (Choose all that applies)
It supplies the baby with oxygen
It supplies the fetus with nutrient
The nurse who is evaluating the woman for potential abuse should be aware that intimate partner violence includes (choose all that apply)
Some non-pharmacological interventions for pain relief may include which of the following.
Heat and cold application
Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse or midwife should refer a patient to a registered dietitian for in depth nutritional counseling when which of the following exist(s)? (Choose all that apply.)
Preexisting or gestational illness such as diabetes
Ethnic or cultural food patterns