Spiderman 1-7

The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different?

1. Fetal Monitoring throughout Labor

2. Postpartum stay of 10 days

3. Expectant support and family in the operating room for a cesarean birth

4. Hospital support for breastfeeding

Hospital support for breastfeeding

A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient's blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death?

1. Early maternal death

2. Late maternal death

3. Direct obstetric death

4. Indirect obstetric death

Indirect obstetric death

The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered at full term. What will be the most helpful thing to explain to the patient?

1. Uses of extracorporeal membrane oxygenation therapy (ECMO)

2. Uses of exogenous pulmonary surfactant

3. The Baby-Friendly Hospital Initiative

4. The Safe to Sleep campaign

The Safe to Sleep campaign

The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining of

genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of

which condition?

1. Diabetes

2. Blindness

3. Pneumonia

4. Hypertension

Blindness

The nurse is caring for a 15-year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient's baby at higher risk for?

1.Intestinal problems

2.Neonatal conjunctivitis

3.Blindness

4.Pneumonia

Intestinal Problems

The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, "I do not need to stop smoking my electronic cigarette because it will not harm my baby." Which is the best response by the nurse?

1."You are correct. Electronic cigarettes are not harmful during pregnancy."

2."Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity."

3."According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy."

4."Electronic cigarettes are considered harmful only in the first trimester."

"Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity."

The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence?

1.Hypertension

2.Diabetes

3.Alcohol abuse

4.Intraventricular bleeding

3.Alcohol abuse

The nurse is caring for a patient at 7 weeks of gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate?

1."Did you smoke marijuana when pregnant with your other child?"

2."To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester."

3."Using marijuana while pregnant can have a negative effect on the neurological development of your baby."

4."Marijuana use while pregnant greatly increases your risk of miscarriage."

3. "Using marijuana while pregnant can have a negative effect on the neurological development of your baby."

The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching?

1."I will limit my drinking to just one alcoholic beverage per day."

2."It's best for my baby if I avoid drinking during pregnancy."

3."An occasional drink on special occasions is okay."

4."Drinking alcohol is only acceptable in the first trimester."

"It's best for my baby if I avoid drinking during pregnancy."

The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following?

1."My child may be at increased risk for birth injury."

2."My child may have a decreased risk of developing childhood diabetes."

3."I will probably give birth vaginally."

4."I have a lower risk of developing gestational hypertension."

"My child may be at increased risk for birth injury."

A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?

1."Due to my weight, there is a possibility that I may develop gestational diabetes."

2."I am not overweight, but I am still at risk for gestational diabetes."

3."My mother had preeclampsia during one of her pregnancies."

4."I will need to do a glucose tolerance test in my second trimester."

"Due to my weight, there is a possibility that I may develop gestational diabetes."

The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first?

1. Refer the patient to a drug abuse program.

2. Screen the infant for side effects associated with cocaine use.

3. Educate the patient of the risks associated with cocaine use during pregnancy.

4. Advise the patient that her baby will be okay even with the history of cocaine use.

Educate the patient of the risks associated with cocaine use during pregnancy.

A pregnant patient with a BMI of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted illnesses (STIs) and indicated that she is in a committed, long-term relationship with the child's father. Which of the following is accurate?

1. The patient's infant is at increased risk of neonatal blindness.

2. The patient's infant has a decreased risk of birth injury.

3. The patient will have increased risk of wound infection.

4. The patient will have a decreased risk of preeclampsia.

The patient will have an increased risk of wound infection.

The nurse has made it a goal to increase the rate at which women begin prenatal care in the first trimester. The nurse relates this decision to national goals for better maternal and infant outcomes. What guidelines will the nurse use to guide her maternal health goals?

1. WHO Maternal care guidelines

2. State Practice Acts

3. AWHONN white papers

4. Healthy People 2020

Healthy People 2020

A nursing student is asked to set goals that will decrease the fetal death outcomes during delivery. What guidelines will the nursing student use to assist in setting her goals?

1. WHO Maternal care guidelines

2. Healthy People 2020

3. AWHONN white papers

4. State Practice Act

Healthy People 2020

A woman has recently given birth to an infant born at 35 weeks and 5 days gestation. What long-term effects should the nurse be concerned about with the infant being born at this gestation? Select all that apply.

1. Cerebral palsy

2. Respiratory disorders

3. Developmental delays

4. Visual impairments

5. Hearing impairments

1. Cerebral palsy

2. Respiratory disorders

3. Developmental delays

4. Visual impairments

5. Hearing impairments

An infant was recently born weighing 1,498 grams. The nurse understands that the birth weight of this infant is an important indicator of what? Select all that apply.

1. Morbidity rate

2. Prenatal care

3. Mortality rate

4. Infant health outcome

5. Postpartum care

1. Morbidity rate

3. Mortality rate

4. Infant health outcome

The nurse is taking the history of a gravida 2 para 1 patient. Which findings in the patient's history warrant further action? Select all that apply.

1. Anemia

2. Severe hemorrhage

3. Infections

4. Malnutrition

5. Eclampsia

1. Anemia

2. Severe hemorrhage

3. Infections

5. Eclampsia

A nurse is caring for a single teen mother who has just given birth to her first child. The patient notes that the child's father "wants no relationship with his son." The patient goes on to express concerns about the short- and long-term impact of her teen pregnancy on herself and on her child. Which statements made by the nurse are accurate? Select all that apply.

1."You are more likely than others to have additional children before you turn 20."

2."You may have difficulty completing high school or college."

3."Your child is less likely to experience behavioral problems."

4."Your child is at increased risk of abusing alcohol when he is a teenager."

5."You may not earn enough money to independently support yourself and your child."

1."You are more likely than others to have additional children before you turn 20."

2."You may have difficulty completing high school or college."

4."Your child is at increased risk of abusing alcohol when he is a teenager."

The nurse is caring for a woman who is pregnant. The patient reports that she has also smoked less than five cigarettes per day and that she has continued to smoke during her pregnancy. Routine prenatal examination and diagnostics have indicated she tested negative for sexually transmitted infections and has a BMI of 25. Based on statistics, which is likely true about the patient and the developing fetus? Select all that apply.

1. She will breastfeed her infant.

2. She is probably aged 20-24.

3. She likely has earned a college degree.

4. Her child may have impaired brain development.

5. Her child is more likely to be born prematurely.

2. She is probably aged 20-24.

4. Her child may have impaired brain development.

5. Her child is more likely to be born prematurely.

The nurse is caring for a patient who is in labor with her first child. The patient's mother is present for support and notes that things have changed in the delivery room since she last gave birth in the early 1980s. Which current trend or intervention may the patient's mother find most different?

1. Fetal Monitoring throughout Labor

2. Postpartum stay of 10 days

3. Expectant support and family in operating room for cesaream birth

4. Hospital support for breastfeeding

Hospital support for breastfeeding

The nurse is providing care for a patient in active labor. The patient continuously asks the nurse for medication to "stop the pain." Which ethical principle does the nurse use when replying, "We need to protect the baby from being overmedicated. Let me help you with some breathing and relaxation techniques?"

1. Veracity

2. Beneficence

3. Nonmalefience

4. Fidelity

2. Beneficence

i lowkey feel like this would be nonmaleficence? -g

A patient at 33 weeks gestation with a first pregnancy arrives at the labor and delivery unit with contractions. After monitoring the patient, the nurse determines the woman is in active labor and calls the health care provider (HCP), who prescribes a sleeping medication and sends the patient home. Which action does the nurse take?

1. Questions the HCP's prescribed treatment

2. Administers the medication and keeps the patient

3. Calls another HCP for a different prescription

4. Follows the HCP's instructions as prescribed

Questions the HCP's prescribed treatment

The nurse is providing care for a patient in labor. The unborn fetus was diagnosed with severe microcephaly at 20 weeks' gestation. The patient tells the nurse, "We want everything done to save our baby who has as much right to a good life as anyone else." Which ethical approach does this represent?

1. Autonomy

2. Libertarianism

3. Egalitarianism

4. Utilitarianism

3. Egalitarianism

The nurse is employed in a NICU. With each new admission, the neonate is classified in a specific category regarding care. The nurse is in the process of admitting a neonate at 22 weeks gestation with multiple life-threatening conditions involving both cardiac and respiratory systems. In which category of care does the nurse expect the neonate to be placed?

1. The category where aggressive care is probably futile.

2. The category where aggressive care is mostly uncertain.

3. The category where aggressive care is likely to be beneficial.

4. The category of "wait and see" to determine possible survival.

The category where aggressive care is probably futile.

The nurse is experiencing an ethical dilemma when confronted with a situation in which either the mother or fetus is predicted to die. The nurse feels bound by the ANA Code of Ethics to protect both patients. Which aspect of care during an ethical dilemma will guide the nurse?

1. Maternity nurses are bound to advocate first and foremost for the well-being of the mother.

2. The nurse is ethically bound to provide the best care for both the mother and fetus.

3. If the fetus is viable and healthy, its survival is the priority of the maternity nurse.

4. Survival of the mother is solely based on both patient and family decision making.

1. Maternity nurses are bound to advocate first and foremost for the well-being of the mother.

The nurse on a maternity unit is an Orthodox Jew whose rabbi teaches that pregnancy terminations are permitted only to save the life of the mother. Which situation becomes possible if the nurse puts aside personal values and assists with elective terminations?

1. Moral distress

2. Legal actions

3. Loss of spirituality

4. Professional dilemma

1. Moral Distress

The nurse works in the maternal-newborn unit dedicated to the management of high-risk pregnancy and delivery. A patient has delivered two children who died from a genetic disorder. The current pregnancy tests positive for the same disorder. Which ethical decision-making model will the nurse use with this patient?

1. The model that focuses on medical treatment

2. The model that focuses on patient preference

3. The model that focuses on religion and culture

4. The model that focuses on the quality of life

4. The model that focuses on the quality of life

8. The nurse is assisting a patient in the use of an ethical decision-making model related to quality of life. Which question is inappropriate when using this model?

1. What are the prospects for a normal life?

2. Are arrangements made for prolonging life?

3. Which type of deficits for the patient are likely?

4. Does a present or future condition make life undesirable?

2. Are arrangements made for prolonging life?

9. The nurse in an obstetrician's office is discussing a patient's request for legally terminating an unwanted pregnancy after the fetus tests positive for Down syndrome. The woman and her spouse have five children from ages 11 to 17 years, and the family lives in an isolated rural area. Which action does the nurse take?

1. Inform the patient of programs to meet the needs of special children.

2. Share that children with Down syndrome can be high functioning.

3. Tell the physician of contextual factors identifying an ethical dilemma.

4. Inquire about the presence of an extended family support system

3. Tell the physician of contextual factors identifying an ethical dilemma.

A nurse is suspended for refusal to participate in the performance of an elective termination of a pregnancy. Which specific group's standards does the nurse use for job reinstatement?

1. American Nurses Association (ANA)

2. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)

3. State board of nursing

4. Facility ethics committee

2. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)

11. The nurse in an OB's office is evaluating a patient who exhibits vaginal bleeding at 30 weeks gestation. The patient is prescribed bedrest at home and instructed to avoid lifting. The patient states, "I cannot go to bed, I have an 18-month-old at home." On which topic of the Jonsen model for ethical decision making will the nurse focus?

1. Contextual features

2. Quality of life

3. Patient preferences

4. Medical indications

4. Medical indications

12. The nurse works in the labor and delivery department. Which action by the nurse indicates a breach in the nursing care principles outlined by AWHONN?

1. Assists with an emergency delivery of a woman in a homeless shelter

2. Informs employer of religious beliefs against pregnancy termination

3. Suggests a nurse care for a patient who speaks the same native language

4. Declines a patient assignment because of a history of illegal drug use

4. Declines a patient assignment because of a history of illegal drug use

The nurse manager in the labor and delivery unit decides that all unit nurses are to take a course in electronic fetal monitoring (EFM) as recommended by AWHONN. Which is the most important issue related to EFM the nurse manager is expecting to address?

1. Eliminate the amount of litigation related to fetal injury.

2. Strengthen the staff's level of confidence with monitoring.

3. Reduce failure to accurately assess maternal and fetal status.

4. Improve the lack of communication with health care providers.

Reduce failure to accurately assess maternal and fetal status.

The nurse works in a postpartum maternal-newborn unit and notices a newborn who is exhibiting signs of distress. Through investigation, the nurse learns the newborn's mother has a history of abusing street drugs. Which facility system does the nurse report as being deficient?

1. Risk management

2. Newborn monitoring

3. Patient information

4. Admission process

1. Risk management

An experienced OB nurse has accepted a position in labor and delivery of an inner-city hospital providing care for multicultural clients. Which action by the nurse is most helpful in preparation for this position?

1. Reviewing quantitative research focused on current birth procedures

2. Comparing facility policies with recent research recommendations

3. Intensely studying qualitative research focused on practice enhancement

4. Obtaining access to the department's recent research of evidence-based practice

3. Intensely studying qualitative research focused on practice enhancement

Parents of a neonate are grieving over their child's life-threatening disabilities. The neonate's course of treatment has changed three times in the last 24 hours due to irrational parenteral decisions. Which interventions will the NICU nurse implement in order to fulfill nursing responsibility to both the parents and the neonate? Select all that apply.

1. Inform the parents as to realistic expectations.

2. Use neonate's status with parenteral counseling.

3. Elicit parenteral input regarding medical care.

4. Advocate for medical support of the neonate.

5. Inform parents they are the final decision makers.

1. Inform the parents as to realistic expectations.

2. Use neonate's status with parenteral counseling.

4. Advocate for medical support of the neonate.

17. The labor and delivery nurse is providing care to a patient in active labor. The nurse notes EFM changes that suggest fetal distress and monitors the fetus for an additional 20 minutes before calling the health care provider. The health care provide determines that an emergency cesarean delivery is required. During transport, EFM is interrupted and not resumed due to expectations of an emergent procedure. A stillborn fetus is delivered. For which actions can the nurse be held legally responsible? Select all that apply.

1. Inappropriate use of oxytocin, causing fetal distress.

2. Lack of appropriate response to fetal compromise.

3. Inability to initiate resuscitation to a compromised fetus.

4. Delayed communication resulting in a delay of cesarean.

5. Performance of a technical error related to monitoring.

2, 4, 5

2. Lack of appropriate response to fetal compromise.

4. Delayed communication resulting in a delay of cesarean.

5. Performance of a technical error related to monitoring.

The nursing department of a large facility is interested in improving clinical care with the introduction of EBP. Which barriers to EBP does the nursing department expect within the facility? Select all that apply.

1. Changes in nursing academia to include how to integrate research into practice

2. Outdated facility politics and policies that do not embrace research-based change

3. A general lack of information addressing nursing-focused research and change

4. Limited resources available to clinical care providers from nursing administration

5. Resistance by other health care professionals to providing nursing with autonomy

2, 4

2. Outdated facility politics and policies that do not embrace research-based change

4. Limited resources available to clinical care providers from nursing administration

Which factors will facilitate the integration of evidence-based practice (EBP) in the maternity-newborn clinical setting? Select all that apply.

1. Frame clinical questions in PICOT format.

2. Collect the best and most relevant evidence.

3. Cultivate a spirit of inquiry in the workplace.

4. Encourage the use of trial and error methods.

5. Base practical decisions on nursing consensus.

1, 2, 3

1. Frame clinical questions in PICOT format.

2. Collect the best and most relevant evidence.

3. Cultivate a spirit of inquiry in the workplace.

1. A patient arrives for her fourth month prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discuss during this visit?

1. Signs of infection

2. Breast changes

3. A change in EDD

4. Support Bras

2. Breast Changes

A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks gestation. The nurse monitors the patient for indications of physiological demands by the fetus on the patient. Which finding causes the nurse concern?

1. Hgb of 9.5 g/dL and Hct. of 30%

2. PT of 16.5 seconds

3. WBCs of 16,000 mm3

4. Heart rate up 20 bpm

1. Hgb of 9.5 g/dL and Hct. of 30%

A patient in the first trimester of pregnancy states, "I don't understand how a term baby can be accommodated by my uterus." Which information by the nurse specifically addresses the patient's comment?

1. The uterus size increases in size 20 times over a nonpregnant uterus.

2. The weight of the uterus increases from 7 g to 1,100 g during pregnancy.

3. About 80% of the increased capacity of the uterus is related to uteroplacental content.

4. About 75% of the increase in uterus size during pregnancy is related to stretching.

1. The uterus size increases in size 20 times over a nonpregnant uterus.

The nurse is providing care for a patient at 30 weeks gestation. Which topic related to patient concern or discomfort is most important for the nurse to address?

1. Increased breast enlargement

2. Dizziness when lying supine

3. Dependent edema and varicosities

4. Hyperpigmentation on the face

2. Dizziness when lying supine

The nurse is counseling a patient who shares the intention to become pregnant. Which finding during the collection of health information will the nurse feel the least concern to address?

1. The patient smokes a pack of cigarettes a week.

2. The patient lives in a recently renovated house.

3. The patient travels outside the country for work.

4. The patient has a family history of diabetes mellitus.

2. The patient lives in a recently renovated house.

A patient expresses a desire to become pregnant for a second child. The nurse notes that the patient's first child was born with a serious neural tube defect (NTD) and died of complications at 18 months of age. Which recommendation does the nurse make to this client?

1. Folic acid 0.6 mg/day orally 1 month before conception and throughout pregnancy.

2. Folic acid 0.4 mg/day orally started when pregnant and continued throughout

pregnancy

3. Folic acid 4 mg/day orally started when pregnant and continued throughout pregnancy

4. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

4. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

The nurse is collecting health information from a patient who is early in the first trimester of pregnancy. Which topic is most important for the nurse to discuss with the patient after learning that the patient works for a commercial cleaning company?

1. Risk related to exposure to environmental toxins

2. Weight limit for lifting during the patient's pregnancy

3. Importance of resting with feet up during the day

4. Reasons for the patient to look for a safer job

1. Risk related to exposure to environmental toxins

A patient arrives at a maternal health client and tells the nurse she has missed a period and thinks she is pregnant. Which information shared with the nurse is a presumptive sign of pregnancy?

1. Positive results on a home pregnancy test

2. Breast enlargement, tenderness, and tingling

3. First awareness of fetal movements

4. Increased appetite

2. Breast enlargement, tenderness, and tingling

A patient who is pregnant asks the nurse when her baby is due to be born. The patient reports her last menstrual period (LMP) date as April 14. Using Naegele's rule, the nurse will set the estimated date of delivery (EDD) as what date?

1. July 21

2. January 7

3. July 14

4. January 21

4. January 21

remember: LMP - 3 months + 7 days

A patient who is pregnant does not remember the last date of her menstrual period. In which manner does the nurse expect the estimated date of delivery (EDD) to be determined for this patient?

1. Having an ultrasound examination

2. Using the gestational wheel

3. Asking when previous babies were born

4. Obtaining a history of gestational length

1. Having an ultrasound examination

A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks gestation, respectively, a singleton birth born at 39 weeks gestation, and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history?

1. G4, T3, P2, A2, L3

2. G6, T1, P4, A2, L5

3. G5, T1, P2, A2, L5

4. G6, T4, P0, A4, L3

2. G6, T1, P4, A2, L5

A patient who is pregnant shares details of being in a physically and psychologically abusive relationship with her baby's father. Which statement by the nurse is indicative of AWHONN's standing regarding intimate partner violence (IPV)?

1. "If you are all alone, you need to make arrangements for someone to stay with you."

2. "Your partner needs to come to the office so that we can confront his behavior."

3. "I will call a women's shelter to make arrangement for you to move in immediately."

4. "Let's explore ways to protect you and stop the abuse you have been enduring."

4. "Let's explore ways to protect you and stop the abuse you have been enduring."

The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is most likely to be needed during this time?

1. Update on fetus growth and behavioral patterns

2. Management for commonly experienced discomforts

3. General health maintenance and promotion topics

4. Counseling and guidance about diet and exercise

2. Management for commonly experienced discomforts

A patient in the third trimester of pregnancy expresses concern to the nurse about changes to her muscles, joints, and bones. Which conditions does the nurse reassure the patient are normal changes of pregnancy? Select all that apply.

1. Waddling gait

2. Low back pain

3. Increased risk of falls

4. Fractures

5. Severe muscle aches

1. Waddling gait

2. Low back pain

3. Increased risk of falls

The nurse is providing dietary teaching to a patient in the first trimester of pregnancy who is overweight. Which daily dietary suggestions does the nurse make? Select all that apply.

1. One cup of 100% juice and cup of dried fruit.

2. Three cups of raw leafy and 1 cup cooked vegetables

3. One and a half cups of cooked pasta, rice, or cereal

4. Six ounces of lean meat, 2 eggs, and cup of beans

5. One cup of milk, 1 cup of yogurt, and oz of cheese

1. One cup of 100% juice and cup of dried fruit.

5. One cup of milk, 1 cup of yogurt, and oz of cheese

The nurse explains to a patient who has missed a second menstrual cycle that a combination of presumptive and probable signs is used to make a practical diagnosis of pregnancy. Which signs are expected by the nurse when making a practical diagnosis? Select all that apply.

1. Elevated hCG levels in blood and urine

2. Brownish pigmentation on the face

3. Fetal movement detected by the examiner

4. Bluish-purple coloration of vagina and cervix

5. Occasional mild contractions

1. Elevated hCG levels in blood and urine

2. Brownish pigmentation on the face

4. Bluish-purple coloration of the vagina and cervix

The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply.

1. Perform an ongoing assessment of risk status

2. Determine parental outlook on immunizations

3. Build rapport with the childbearing family

4. Make a referral to specific resources as needed

5. Implement a risk-appropriate intervention

1. Perform an ongoing assessment of risk status

3. Build rapport with the childbearing family

4. Make referral to specific resources as needed

5. Implement a risk-appropriate intervention

A patient in the third trimester of pregnancy reports having heartburn nearly every day. Which recommendations does the nurse make to alleviate the problem? Select all that apply.

1. Consume three moderate-sized meals daily.

2. Sip clear, carbonated beverages when eating.

3. Assume a low Fowler position after meals.

4. Avoid eating 3 hours prior to bedtime.

5. Avoid consuming spicy, fatty, or fried food.

4. Avoid eating 3 hours prior to bedtime.

5. Avoid consuming spicy, fatty, or fried food.

The nurse is planning an assessment on a patient in the second trimester of pregnancy. For which assessments will the nurse plan? Select all that apply.

1. Urine testing with a dipstick

2. Presence of dependent edema

3. Determine estimated date of delivery (EDD) by Naegele'srule

4. Signs or symptoms of hypertensive disorders

5. Antibody screening for Rh-negative women

1. Urine testing with a dipstick

2. Presence of dependent edema

4. Signs or symptoms of hypertensive disorders

5. Antibody screening for Rh-negative women

The nurse at a prenatal clinic is aware of the important tasks that each expectant mother will need to address. When an expectant mother states, "I will give up everything I have to make sure this baby is safe and well-cared for," which task is the mother addressing?

1. Expressing an attachment to the child

2. Ensuring safe birth for mother and child

3. Stating a willingness to give of oneself

4. Ensuring social acceptance of the child

3. Stating a willingness to give of oneself

The nurse is providing prenatal care for a patient who is pregnant with a second child. Which understanding about complexity of a second pregnancy does the nurse use to assist the patient with the acceptance of this pregnancy?

1. Point out that the financial obligation is always less with a second child.

2. Make suggestions of how the first child will be a "helper" with the new baby.

3. Recommend career decisions needed because of additional parenting tasks.

4. Offer strategies for working out a new relationship with the first child.

4. Offer strategies for working out a new relationship with the first child.

The nurse works in a prenatal clinic and interacts with multiple patients from various socioeconomic backgrounds. Which patient does the nurse assess most carefully for a mental health issue?

1. A woman who chooses single parenthood

2. A military veteran who was deployed twice

3. The pregnant partner of a lesbian relationship

4. The mother who is multigestational with triplets

2. A military veteran who was deployed twice

The nurse is providing care in a school clinic established for the care of adolescent mothers. When assessing a patient who is 11 years of age and pregnant, which deduction regarding the patient's psychosocial development will the nurse recognize?

1. The adolescent is self-centered and oriented toward the present.

2. At this age, pregnancy is likely a result of attachment to a first love.

3. Moving into the mothering role will be nearly impossible at this age.

4. The role of the grandmother will be as the baby's primary caretaker.

1. The adolescent is self-centered and oriented toward the present.

The nurse is providing care for a patient who is 42 years of age and in the first trimester of her pregnancy. For which possible complication will the nurse closely monitor the patient and fetus?

1. Elevated blood pressure and proteinuria

2. Indications of maladaptation to pregnancy

3. Alterations in fetal chromosomal studies

4. Subtle indicators of menopause occurring

3. Alterations in fetal chromosomal studies

A patient in the second trimester of pregnancy seems distressed. With encouragement, the patient states, "I have been totally avoiding physical contact with my husband to avoid prompting any sexual activity." Which statement by the nurse is the best response?

1. "Nonsexual expressions of affection are important for both of you."

2. "Be honest and tell your husband the reason you are avoiding him."

3. "You need to agree to sex in order to prevent infidelity from occurring."

4. "Sex during pregnancy is a healthy and normal display of affection."

1. "Nonsexual expressions of affection are important for both of you."

A couple announces to their parents that the couple is pregnant. One expectant grandmother says, "Grandchildren will call me by my first name. I am not ready to be a grandmother." Which feelings are being expressed by the grandmother?

1. The pregnancy presents undeniable evidence the grandmother is growing older.

2. The grandmother has specific wishes about how she is to be addressed as a person.

3. The grandmother is most likely teasing and actually feels overwhelming delight.

4. The grandmother has never thought of herself in this role and will adapt with time.

1. The pregnancy presents undeniable evidence the grandmother is growing older.

A mother has a child who is 4 years of age, and she is expecting another child. The mother expresses concern to the nurse about how the older sibling will receive the newborn. Which intervention shared by the mother does the nurse discourage?

1. "I plan to let him hear the baby's heartbeat at the next prenatal visit."

2. "I think that I will just bring the new baby home as a surprise."

3. "I have enrolled him in a sibling preparation class at the hospital."

4. "I let him pick out a gift for the baby, and have one for him from the baby."

2. "I think that I will just bring the new baby home as a surprise."

A pregnant patient and her spouse live in the same home as the spouse's family who is not supportive of the pregnancy. The patient feels the family is ruining the happiness about the pregnancy. Which is the most important determination for the nurse to make?

1. What the potential for improving the current support network is

2. Who will provide the patient the greatest amount of support

3. Whether the couple's finances support moving into a separate location

4. If threatened or actual abuse from household members occur toward the patient

4. If threatened or actual abuse from household members occur toward the patient

A couple is planning for the birth of their first child and is discussing the difference between a physician and a midwife. Which information presented by the couple does the nurse validate as being true?

1. Midwives are commonly self-taught without formal training.

2. Physicians provide care for both low- and high-risk patients.

3. Midwives primarily deliver babies in the home setting.

4. Physicians rely on the use of technological procedures for birth.

2. Physicians provide care for both low- and high-risk patients.

The nurse is counseling a couple in the third trimester of pregnancy and recommends the couple attend childbirth education classes. For which reason is the nurse least likely to recommend the classes?

1. The classes will affirm the normalcy of birth.

2. The techniques will enable a medication-free delivery.

3. The classes acknowledge a woman's ability to inherently give birth.

4. The classes explore ways to find strength and comfort during labor.

2. The techniques will enable a medication-free delivery.

The labor and delivery nursing staff is conducting research to determine the benefits of childbirth education (CBE). Which finding does evidence-based practice support?

1. Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery.

2. Women who are considered to be at high risk had fewer complications if CBE or a birth plan was used.

3. Women of color, younger in age, and who are multipara respond best to CBE and/or a birth plan.

4. Women with a previous cesarean delivery are more likely to have a vaginal delivery after CBE.

1. Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery.

The nurse notes that a patient in the third trimester of pregnancy feels unable to "mother" her unborn child. Which information about the patient helps the nurse identify the sources of the patient's ambivalence? Select all that apply.

1. The patient is estranged from her mother.

2. The patient asks about classes for baby care.

3. The patient expresses a loss of independence

4. The patient's partner is excited about a baby.

5. The patient expresses disgust about body changes.

1. The patient is estranged from her mother.

3. The patient expresses a loss of independence.

5. The patient expresses disgust about body changes.

What is the definition of sexual orientation?

1. How a person characterizes their emotional and sexual attraction to others

2. How a person currently identifies their sex

3. The sex a person was assigned at birth

4. The orientation of their sexual bias

1. How a person characterizes their emotional and sexual attraction to others

Which of the following is an appropriate question to include on intake and history forms?

1. What is your gender?

2. What sex were you assigned at birth or on your original birth certificate?

3. What is your biological gender?

4. What is your sexual orientation?

4. What is your sexual orientation?

Mercy Ochoa, a 28-year-old Filipino American, is 18 weeks' pregnant. After receiving a prescription for prenatal vitamins, she tells the nurse that her mother has warned her to take only herbal medication during pregnancy. The nurse appropriately:

1. Advises Mercy that the pills are only vitamins and not considered medication.

2. Assesses the significance of Mercy's mother's advice.

3. Reminds her that the vitamins were ordered by the nurse-midwife.

4. Insists that the patient comply with the treatment plan.

2. Assesses the significance of Mercy's mother's advice.

Ethnocentrism is the belief that:

1. Cultural values are major determinants of one's behavior.

2. Every cultural group has a core or center of common beliefs.

3. Values and practices of one's own culture are superior.

4. Every cultural group shares identical common beliefs.

3. Values and practices of one's own culture are superior.

A pregnant patient tells the nurse that her spouse has been diagnosed with Couvade syndrome. Which manifestations does the nurse suspect the spouse is experiencing? Select all that apply.

1. Nausea from unidentifiable causes

2. Physical rejection of sexual advances

3. Significant recent weight gain

4. Unexplainable abdominal pains

5. Self-imposed social isolation

1. Nausea from unidentifiable causes

3. Significant recent weight gain

4. Unexplainable abdominal pains

The nurse notes that a patient in the third trimester of pregnancy feels unable to "mother" her unborn child. Which information about the patient helps the nurse identify the sources of the patient's ambivalence? Select all that apply.

1. The patient asks about classes for baby care.

2. The patient is estranged from her mother.

3. The patient's partner is excited about a baby.

4. The patient expresses a loss of independence.

5. The patient expresses disgust about body changes.

2. The patient is estranged from her mother. 4. The patient expresses a loss of independence.

5. The patient expresses disgust about body changes.

The nurse is encouraging cultural sensitivity among the nonmedical personnel in a prenatal clinic. Which type of family does the nurse identify as including children? Select all that apply.

1. Nuclear family

2. Extended family

3. Cohabitating family

4. Dyad family

5. Blended family

1. Nuclear family

2. Extended family

5. Blended family

A patient is experiencing pregnancy complications. Which factors will affect the client's ability to manage this situation? Select all that apply.

1. Current health status

2. Perceived threat to self or fetus

3. Previously used coping skills

4. Existence of a support network

5. Implemented nursing interventions

1. Current health status

2. Perceived threat to self or fetus

3. Previously used coping skills

4. Existence of a support network

5. Implemented nursing interventions

The nurse works in a prenatal clinic located in a multicultural city. It is important for the nurse to recognize which cultural beliefs as prescriptive? Select all that apply.

1. A pregnant woman allows a clinic staff member to take a photo of her.

2. A pregnant woman denies sexual intercourse during her third trimester.

3. A pregnant woman reaches to an overhead shelf to collect her belongings.

4. A pregnant woman avoids sitting in front of a fan or air conditioner.

5. A pregnant woman refuses to watch a televised eclipse of themoon.

2. A pregnant woman denies sexual intercourse during her third trimester.

5. A pregnant woman refuses to watch a televised eclipse of themoon.

The nurse works in a prenatal clinic that serves a multicultural population. The nurse is culturally aware, and so, which behaviors by a patient are expected due to common restrictive beliefs? Select all that apply.

1. Drinking too much tea will stimulate the fetus and cause a premature birth.

2. The mother invites harm to the fetus during the night by sleeping on her back. 3. The satisfaction of pregnancy cravings will prevent birthmarks on the baby.

4. A safety pin attached to an undergarment will prevent fetal facial deformities. 5. The mother will aid the baby's circulation by remaining active during pregnancy.

3. The satisfaction of pregnancy cravings will prevent birthmarks on the baby.

4. A safety pin attached to an undergarment will prevent fetal facial deformities.

5. The mother will aid the baby's circulation by remaining active during pregnancy.

A couple informs the nurse they have decided to make arrangements for a home birth. Which criteria will the nurse share with the couple regarding a safe home birth? Select all that apply.

1. The couple must be trained on how to be in control of the birth.

2. The birthing home must be within a 1-hour drive of a hospital.

3. The pregnant woman must be in good health with a normal pregnancy.

4. The birthing room needs to be sterile before labor and delivery.

5. Adequate medical supplies and resuscitation equipment is available

3. The pregnant woman must be in good health with a normal pregnancy.

5. Adequate medical supplies and resuscitation equipment is available

The more prepared a pregnant woman feels for the birth of her baby will lower her anxiety and fear. The behavior is referred to as ____________________.

nesting behavior

A nonreactive nonstress test (NST) at 39 weeks' gestation is an indication for:

1. Expedited birth

2. Further testing

3. Reassurance about fetal status

4. An urgent cesarean birth

2. Further testing

A primary method of fetal surveillance during pregnancy is:

1. Fetal kick counts

2. Nonstress testing (NST)

3. Ultrasonography

4. Fundal height measurement

1. Fetal kick counts

1. The nurse is providing care for a 45-year-old patient who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient?

1. Amniocentesis

2. Ultrasonography

3. Daily fetal movement count

4. Chorionic villi sampling

1. Amniocentesis

A patient in the second trimester of pregnancy becomes upset when the health care provider (HCP) schedules several screening tests. The patient voices concern that something is wrong with her baby. Which statement by the nurse will reduce the patient's anxiety?

1. "Multiple screening tests are ordered for every pregnancy."

2. "It is better to identify problems before birth than afterward."

3. "Screening tests are primarily to identify those without disease or abnormality."

4. "Diagnostic testing is a reason for worry because they indicate fetal problems."

3. "Screening tests are primarily to identify those without disease or abnormality."

A patient has experienced an uneventful pregnancy but begins to have vaginal spotting at 38 weeks gestation. The health care provider (HCP) suspects placenta previa initiated by cervical thinning. Which testing does the nurse expect the HCP to schedule?

1. Doppler flow studies

2. Nonstress testing

3. Magnetic resonance imaging

4. Ultrasonography studies

4. Ultrasonography studies

A patient is in her first trimester of her second pregnancy. The patient's first child was born with a trisomy 21 defect. The patient is requesting testing to determine whether the current fetus has the same defect. Which initial testing does the nurse expect the HCP to prescribe?

1. Fetal ultrasound

2. Magnetic resonance imaging

3. Chorionic villa sampling

4. Amniocentesis

1. Fetal ultrasound

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate?

1. Place the patient supine with a pillow beneath her head.

2. Explain that pain at 4 or less on a 0 to 10 scale is expected.

3. Ascertain whether the patient has a latex or banana allergy.

4. Request that the patient's partner leave the testing room.

3. Ascertain whether the patient has a latex or banana allergy.

The nurse is assisting a patient who is pregnant to prepare for an MRI scheduled to assess fetal brain development. Which situation causes the nurse to notify the radiology department personnel?

1. The patient had breakfast before the test.

2. The patient reports having an iodine allergy.

3. The patient expresses concern about pain.

4. The patient has a permanent body piercing.

4. The patient has a permanent body piercing.

A patient in the second trimester of pregnancy is scheduled for a Doppler flow study because the health care provider (HCP) is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect?

1. Fetal movement count is less than 8 per hour.

2. Patient shows no weight gain in 2 weeks.

3. Patient exhibits mild lower extremity edema.

4. Fetal growth is below expectation for gestational age.

2. Patient shows no weight gain in 2 weeks.

An Eastern European Jewish couple had two children who died from Tay-Sachs disease. The couple is currently pregnant and have asked for genetic confirmation about this fetus with the intention of early termination if the fetus tests positively. For which reason does the nurse expect chorionic villa sampling to be prescribed?

1. The test is performed as early as 10 weeks gestation.

2. Risks to the fetus and mother are less than other tests.

3. A positive result allows termination during the test.

4. This is the only testing that is disease specific.

1. The test is performed as early as 10 weeks gestation.

An adolescent patient who is 15 weeks pregnant refuses to have an alpha-fetoprotein test performed because, "I don't like needles." Which initial approach does the nurse take to achieve the testing?

1. Insist that testing will be done with or without her cooperation.

2. Explain the testing is important in detecting serious birth defects.

3. Ask an accompanying parent to help persuade the patient.

4. Notify the health care provider of the patient's refusal.

2. Explain the testing is important in detecting serious birth defects.

A patient who is at 30 weeks gestation is involved in a car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being?

1. Ultrasonography

2. Nonstress testing

3. Contraction stress test

4. Fetal movement counting

2. Nonstress testing

A patient is scheduled for a contraction stress test (CST) at 36 weeks gestation. The nurse is aware that a successful testing is dependent on which factor?

1. Whether Braxton-Hicks contractions are occurring

2. Whether uterine contractions can be stimulated

3. If the mother is not overly tired or anxious

4. If the fetus is in an awake cycle and active

2. Whether uterine contractions can be stimulated

The nurse is assessing a patient who just received confirmation of pregnancy. While collecting information about the patient's medical history, which information alerts the nurse to biophysical risk factors? Select all that apply.

1. The patient is primipara who is 38 years of age.

2. The patient has been a strict vegetarian for 25 years.

3. The patient smokes two packs of cigarettes weekly.

4. The patient works as a nuclear medicine technician.

5. The patient is medically treated for rheumatoid arthritis.

2. The patient has been a strict vegetarian for 25 years.

5. The patient is medically treated for rheumatoid arthritis.

A patient who is at 20 weeks gestation is being prepared for an MRI after a nonconclusive ultrasound testing for suspected brain abnormality related to possible zika virus exposure. Which nursing actions are appropriate for this patient? Select all that apply.

1. Provide information regarding the test.

2. Allow patient to express feelings about her high-risk pregnancy.

3. Encourage patient to think about resolutions for negative testing.

4. Promote open communication with her primary health-care providers(HCPs).

5. Provide psychological support to the patient and her partner.

1. Provide information regarding the test.

2. Allow patient to express feelings about her high-risk pregnancy.

4. Promote open communication with her primary health-care providers(HCPs).

5. Provide psychological support to the patient and her partner.

The nurse is providing pre-amniocentesis teaching for a patient who is at 18 weeks gestation. Which information does the nurse provide? Select all that apply.

1. A full bladder will assist in ultrasound visualization.

2. Positioning on the left side will avoid injury to the fetus.

3. Abdominal cramping and bleeding is normal for 24 hours.

4. Avoid lifting heavy objects for a period of 2 weeks.

5. Discomfort will be minimized with a local anesthetic.

1. A full bladder will assist in ultrasound visualization.

5. Discomfort will be minimized with a local anesthetic.