Ch 21 and 15 Flashcards Preview

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Flashcards in Ch 21 and 15 Deck (53):
1

Ch 21
1.
After spontaneous rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately places the woman in which position?
A)
Supine
B)
Side-lying
C)
Sitting
D)
Kneeñchest

Kneeñchest

2

2.
A primigravida whose labor was initially progressing normally is now experiencing a decrease in the frequency and intensity of her contractions. The nurse would assess the woman for which condition?
A)
A low-lying placenta
B)
Fetopelvic disproportion
C)
Contraction ring
D)
Uterine bleeding

Fetopelvic disproportion

3

3.
The nurse would be alert for possible placental abruption during labor when assessment reveals which of the following?
A)
Macrosomia
B)
Gestational hypertension
C)
Gestational diabetes
D)
Low parity

Gestational hypertension

4

4.
Assessment of a woman in labor who is experiencing hypertonic uterine dysfunction would reveal contractions that are:
A)
Well coordinated
B)
Poor in quality
C)
Rapidly occurring
D)
Erratic

Erratic

5

5.
A woman in labor is experiencing hypotonic uterine dysfunction. Assessment reveals no fetopelvic disproportion. Which group of medications would the nurse expect to administer?
A)
Sedatives
B)
Tocolytics
C)
Oxytocins
D)
Corticosteroids

Oxytocins

6

6.
The fetus of a woman in labor is determined to be in persistent occiput posterior position. Which of the following would the nurse identify as the priority intervention?
A)
Position changes
B)
Pain relief measures
C)
Immediate cesarean birth
D)
Oxytocin administration

Pain relief measures

7

7.
A woman gave birth to a newborn via vaginal delivery with the use of a vacuum extractor. The nurse would be alert for which of the following in the newborn?
A)
Asphyxia
B)
Clavicular fracture
C)
Caput succedaneum
D)
Central nervous system injury

Caput succedaneum

8

8.
A pregnant client undergoing labor induction is receiving an oxytocin infusion. Which of the following findings would require immediate intervention?
A)
Fetal heart rate of 150 beats/minute
B)
Contractions every 2 minutes, lasting 45 seconds
C)
Uterine resting tone of 14 mm Hg
D)
Urine output of 20 mL/hour

Urine output of 20 mL/hour

9

9.
A woman with a history of crack cocaine abuse is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also complains of acute abdominal pain that is continuous. Which of the following would the nurse suspect?
A)
Amniotic fluid embolism
B)
Shoulder dystocia
C)
Uterine rupture
D)
Umbilical cord prolapse

Uterine rupture

10

10.
When assessing several women for possible VBAC, which woman would the nurse identify as being the best candidate?
A)
One who has undergone a previous myomectomy
B)
One who had a previous cesarean birth via a low transverse incision
C)
One who has a history of a contracted pelvis
D)
One who has a vertical incision from a previous cesarean birth

One who had a previous cesarean birth via a low transverse incision

11

11.
A woman is to undergo an amnioinfusion. Which statement would be most appropriate to include when teaching the woman about this procedure?
A)
ìYou'll need to stay in bed while you're having this procedure.î
B)
ìWe'll give you an analgesic to help reduce the pain.î
C)
ìAfter the infusion, you'll be scheduled for a cesarean birth.î
D)
ìA suction cup is placed on your baby's head to help bring it out.î

You'll need to stay in bed while you're having this procedure

12

12.
Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction?
A)
Posterior position
B)
Firm
C)
Closed
D)
Shortened

Shortened

13

13.
A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately?
A)
Respiratory rate of 16 breaths per minute
B)
Diminished deep tendon reflexes
C)
Urine output of 45 mL/hour
D)
Alert level of consciousness

Diminished deep tendon reflexes

14

14.
A woman who is 42 weeks pregnant comes to the clinic. Which of the following would be most important?
A)
Determining an accurate gestational age
B)
Asking her about the occurrence of contractions
C)
Checking for spontaneous rupture of membranes
D)
Measuring the height of the fundus

Determining an accurate gestational age

15

15.
After teaching a couple about what to expect with their planned cesarean birth, which statement indicates the need for additional teaching?
A)
ìHolding a pillow against my incision will help me when I cough.î
B)
ìI'm going to have to wait a few days before I can start breast-feeding.î
C)
ìI guess the nurses will be getting me up and out of bed rather quickly.î
D)
ìI'll probably have a tube in my bladder for about 24 hours or so.î

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

16

16.
The nurse is providing care to several pregnant women who may be scheduled for labor induction. The nurse identifies the woman with which Bishop score as having the best chance for a successful induction and vaginal birth?
A)
11
B)
8
C)
6
D)
3

11

17

17.
After teaching a group of nursing students about risk factors associated with dystocia, the instructor determines that the teaching was successful when the students identify which of the following as increasing the risk? (Select all that apply.)
A)
Pudendal block anesthetic use
B)
Multiparity
C)
Short maternal stature
D)
Maternal age over 35
E)
Breech fetal presentation

Short maternal stature
Maternal age over 35
Breech fetal presentation

18

18.
A nurse is preparing an inservice education program for a group of nurses about dystocia involving problems with the passenger. Which of the following would the nurse most likely include as the most common problem?
A)
Macrosomia
B)
Breech presentation
C)
Persistent occiput posterior position
D)
Multifetal pregnancy

Persistent occiput posterior position

19

19.
After teaching a group of nursing students about tocolytic therapy, the instructor determines that the teaching was successful when they identify which drug as being used for tocolysis? (Select all that apply.)
A)
Nifedipine
B)
Terbutaline
C)
Dinoprostone
D)
Misoprostol
E)
Indomethacin

Nifedipine
Terbutaline
Indomethacin

20

20.
A nurse is assessing a pregnant woman who has come to the clinic. The woman reports that she feels some heaviness in her thighs since yesterday. The nurse suspects that the woman may be experiencing preterm labor based on which additional assessment findings?
A)
Dull low backache
B)
Malodorous vaginal discharge
C)
Dysuria
D)
Constipation

Dull low backache

21

21.
A nurse is teaching a pregnant woman at risk for preterm labor about what to do if she experiences signs and symptoms. The nurse determines that the teaching was successful when the woman states that if she experiences any symptoms, she will do which of the following?
A)
ìI'll sit down to rest for 30 minutes.î
B)
ìI'll try to move my bowels.î
C)
ìI'll lie down with my legs raised.î
D)
ìI'll drink several glasses of water.î

I'll drink several glasses of water

22

22.
A nurse is describing the risks associated with prolonged pregnancies as part of an inservice presentation. Which of the following would the nurse be least likely to incorporate in the discussion as an underlying reason for problems in the fetus?
A)
Aging of the placenta
B)
Increased amniotic fluid volume
C)
Meconium aspiration
D)
Cord compression

Increased amniotic fluid volume

23

23.
A group of nursing students are reviewing information about methods used for cervical ripening. The students demonstrate understanding of the information when they identify which of the following as a mechanical method?
A)
Herbal agents
B)
Laminaria
C)
Membrane stripping
D)
Amniotomy

Laminaria

24

24.
The nurse notifies the obstetrical team immediately because the nurse suspects that the pregnant woman may be exhibiting signs and symptoms of amniotic fluid embolism. Which findings would the nurse most likely assess? (Select all that apply.)
A)
Significant difficulty breathing
B)
Hypertension
C)
Tachycardia
D)
Pulmonary edema
E)
Bleeding with bruising

Significant difficulty breathing
Tachycardia
Pulmonary edema
Bleeding with bruising

25

25.
A group of nursing students are reviewing information about cesarean birth. The students demonstrate understanding of the information when they identify which of the following as an appropriate indication? (Select all that apply..
A)
Active genital herpes infection
B)
Placenta previa
C)
Previous cesarean birth
D)
Prolonged labor
E)
Fetal distress

Active genital herpes infection
Placenta previa
Previous cesarean birth
Fetal distress

26

26.
A pregnant woman is receiving misoprostol to ripen her cervix and induce labor. The nurse assesses the woman closely for which of the following?
A)
Uterine hyperstimulation
B)
Headache
C)
Blurred vision
D)
Hypotension

Uterine hyperstimulation

27

Ch 15
1.
A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus, expecting it to be at which location?
A)
Two fingerbreadths above the umbilicus
B)
At the level of the umbilicus
C)
Two fingerbreadths below the umbilicus
D)
Four fingerbreadths below the umbilicus

Two fingerbreadths below the umbilicus

28

2.
When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be:
A)
Greater than after a vaginal delivery
B)
About the same as after a vaginal delivery
C)
Less than after a vaginal delivery
D)
Saturated with clots and mucus

Less than after a vaginal delivery

29

3.
The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which of the following would the nurse include in the teaching plan to facilitate suppression of lactation?
A)
Encouraging the woman to manually express milk
B)
Suggesting that she take frequent warm showers to soothe her breasts
C)
Telling her to limit the amount of fluids that she drinks
D)
Instructing her to apply ice packs to both breasts every other hour

Instructing her to apply ice packs to both breasts every other hour

30

4.
The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which of the following would the nurse expect to find when assessing the client's fundus?
A)
Cannot be palpated
B)
2 cm below the umbilicus
C)
6 cm below the umbilicus
D)
10 cm below the umbilicus

Cannot be palpated

31

5.
A client who is breast-feeding her newborn tells the nurse, ìI notice that when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why am I having contractions now?î Which response by the nurse would be most appropriate?
A)
ìYour uterus is still shrinking in size; that's why you're feeling this pain.î
B)
ìLet me check your vaginal discharge just to make sure everything is fine.î
C)
ìYour body is responding to the events of labor, just like after a tough workout.î
D)
ìThe baby's sucking releases a hormone that causes the uterus to contract.î

The baby's sucking releases a hormone that causes the uterus to contract

32

6.
When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding would warrant further investigation?
A)
Deep red, fleshy-smelling lochia
B)
Voiding of 350 cc
C)
Heart rate of 120 beats/minute
D)
Profuse sweating

Heart rate of 120 beats/minute

33

7.
A postpartum client who is bottle feeding her newborn asks, ìWhen should my period return?î Which response by the nurse would be most appropriate?
A)
ìIt's difficult to say, but it will probably return in about 2 to 3 weeks.î
B)
ìIt varies, but you can estimate it returning in about 7 to 9 weeks.î
C)
ìYou won't have to worry about it returning for at least 3 months.î
D)
ìYou don't have to worry about that now. It'll be quite a while.î

It varies, but you can estimate it returning in about 7 to 9 weeks

34

8.
The nurse interprets which of the following as evidence that a client is in the taking-in phase?
A)
Client states, ìHe has my eyes and nose.î
B)
Client shows interest in caring for the newborn.
C)
Client performs self-care independently.
D)
Client confidently cares for the newborn.

Client states, He has my eyes and nose

35

9.
Which of the following would the nurse interpret as being least indicative of paternal engrossment?
A)
Demonstrating pleasure when touching or holding the newborn
B)
Identifying imperfections in the newborn's appearance
C)
Being able to distinguish his newborn from others in the nursery
D)
Showing feelings of pride with the birth of the newborn

Identifying imperfections in the newborn's appearance

36

10.
A postpartum client comes to the clinic for her 6-week postpartum checkup. When assessing the client's cervix, the nurse would expect the external cervical os to appear:
A)
Shapeless
B)
Circular
C)
Triangular
D)
Slit-like

Slit-like

37

11.
The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform Kegel exercises. The nurse includes this information for which reason?
A)
Reduce lochia
B)
Promote uterine involution
C)
Improve pelvic floor tone
D)
Alleviate perineal pain

Improve pelvic floor tone

38

12.
A father of a newborn tells the nurse, ìI may not know everything about being a dad, but I'm going to do the best I can for my son.î The nurse interprets this as indicating the father is in which stage of adaptation?
A)
Expectations
B)
Transition to mastery
C)
Reality
D)
Taking-in

Transition to mastery

39

13.
A postpartum client is experiencing subinvolution. When reviewing the woman's labor and birth history, which of the following would the nurse identify as being least significant to this condition?
A)
Early ambulation
B)
Prolonged labor
C)
Large fetus
D)
Use of anesthetics

Early ambulation

40

14.
Which of the following would lead the nurse to suspect that a postpartum woman is experiencing a problem?
A)
Elevated white blood cell count
B)
Acute decrease in hematocrit
C)
Increased levels of clotting factors
D)
Pulse rate of 60 beats/minute

Acute decrease in hematocrit

41

15.
A woman who gave birth 24 hours ago tells the nurse, ìI've been urinating so much over the past several hours.î Which response by the nurse would be most appropriate?
A)
ìYou must have an infection, so let me get a urine specimen.î
B)
ìYour body is undergoing many changes that cause your bladder to fill quickly.î
C)
ìYour uterus is not contracting as quickly as it should.î
D)
ìThe anesthesia that you received is wearing off and your bladder is working again.î

Your body is undergoing many changes that cause your bladder to fill quickly

42

16.
A group of students are reviewing the process of breast milk production. The students demonstrate understanding when they identify which hormone as responsible for milk let-down?
A)
Prolactin
B)
Estrogen
C)
Progesterone
D)
Oxytocin

Oxytocin

43

17.
A nurse is making a home visit to a postpartum woman who delivered a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as which of the following?
A)
Involution
B)
Engorgement
C)
Mastitis
D)
Engrossment

Engorgement

44

18.
A nurse is assessing a postpartum woman's adjustment to her maternal role. Which of the following would the nurse expect to occur first?
A)
Reestablishing relationships with others
B)
Demonstrating increasing confidence in care of the newborn
C)
Assuming a passive role in meeting her own needs
D)
Becoming preoccupied with the present

Assuming a passive role in meeting her own needs

45

19.
The partner of a woman who has given birth to a healthy newborn says to the nurse, ìI want to be involved, but I'm not sure that I'm able to care for such a little baby.î The nurse interprets this as indicating which of the following stages?
A)
Expectations
B)
Reality
C)
Transition to mastery
D)
Taking-hold

Reality

46

20.
A group of nursing students are reviewing information about maternal and paternal adaptations to the birth of a newborn. The nurse observes the parents interacting with their newborn physically and emotionally. The nurse documents this as which of the following?
A)
Puerperium
B)
Lactation
C)
Attachment
D)
Engrossment

Attachment

47

21.
After teaching a group of nursing students about the process of involution, the instructor determines that additional teaching is needed when the students identify which of the following as being involved?
A)
Catabolism
B)
Muscle fiber contraction
C)
Epithelial regeneration
D)
Vasodilation

Vasodilation

48

22.
A nurse is visiting a postpartum woman who delivered a healthy newborn 5 days ago. Which of the following would the nurse expect to find?
A)
Bright red discharge
B)
Pinkish brown discharge
C)
Deep red mucus-like discharge
D)
Creamy white discharge

Pinkish brown discharge

49

23.
A nurse teaches a postpartum woman about her risk for thromboembolism. Which of the following would the nurse be least likely to include as a factor increasing her risk?
A)
Increased clotting factors
B)
Vessel damage
C)
Immobility
D)
Increased red blood cell production

Increased red blood cell production

50

24.
A nursing student is preparing a class presentation about changes in the various body systems during the postpartum period and their effects. Which of the following would the student include as influencing a postpartum woman's ability to void? (Select all that apply.)
A)
Use of an opioid anesthetic during labor
B)
Generalized swelling of the perineum
C)
Decreased bladder tone from regional anesthesia
D)
Use of oxytocin to augment labor
E)
Need for an episiotomy

Generalized swelling of the perineum
Decreased bladder tone from regional anesthesia
Use of oxytocin to augment labor

51

25.
A postpartum woman who has experienced diastasis recti asks the nurse about what to expect related to this condition. Which response by the nurse would be most appropriate?
A)
ìYou'll notice that this will fade to silvery lines.î
B)
ìExercise will help to improve the muscles.î
C)
ìExpect the color to lighten somewhat.î
D)
ìYou'll notice that your shoe size will increase.î

Exercise will help to improve the muscles

52

26.
A group of nursing students are reviewing respiratory system adaptations that occur during the postpartum period. The students demonstrate understanding of the information when they identify which of the following as a postpartum adaptation?
A)
Continued shortness of breath
B)
Relief of rib aching
C)
Diaphragmatic elevation
D)
Decrease in respiratory rate

Relief of rib aching

53

27.
A woman who delivered a healthy newborn several hours ago asks the nurse, ìWhy am I perspiring so much?î The nurse integrates knowledge that a decrease in which hormone plays a role in this occurrence?
A)
Estrogen
B)
hCG
C)
hPL
D)
Progesterone

Estrogen