Maternity Midterm Ch 2-12

Front 1

when providing care for a pregnant woman, the nurse should be aware that one of the most frequently reported material medical risk factors is:

Back 1

Diabetes Mellitus

Front 2

a married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. On the basis of the information given, what family form best describes this family?

Back 2

married blended family

Front 3

a mother's household consists of her husband, his mother, and another child. she is living in an

Back 3

extended family

Front 4

a traditional family structure in which male and female partners and their children live as an independent unit is known as an

Back 4

nuclear family

Front 5

the two primary functions of the ovary are
*

Front 7

unique muscle fibers make the uterine myometrium ideally suited for

Back 7

the birth process

Front 8

the hormone responsible for maturation of mammary gland tissue is

Back 8

progesterone

Front 9

because of the effect of cyclic ovarian changes on e breast, the best time for breast self-examination (BSE) is

Back 9

5 to 7 days after menses ceases

Front 10

menstruation is periodic uterine bleeding

Back 10

that is regulated b ovarian hormones

Front 11

a woman arrives at the clinic for her annual examination. she tells the nurse that she thinks she has a vaginal infection and she has been using OTC cream for the past 2 days to treat it. the nurse's initial response should be to:

Back 11

ask the woman to describe the symptoms that indicate to her that she has a vaginal infection

Front 12

the transition phase during which ovarian function and hormone production decline is called

Back 12

the climacteric

Front 13

the body part that both protects the pelvic structures and accommodates the growing fetus during pregnancy is

Back 13

bony pelvis

Front 14

a fully matured endometrium that has reached the thickness of heavy, soft velvet describes the ____ phase of the endometrial cycle

Back 14

secretory

Front 15

Certain fatty acids classified as hormones that are found in manybody tissues and that have roles in many reproductive functions are known as:

Back 15

Prostaglandins (PGs)

Front 16

A patient at 24 weeks of gestation says she has a glass of winewith dinner every evening. The nurse will counsel her to eliminate all alcohol intakebecause:

Back 16

The fetus is placed at riskfor altered brain growth.

Front 17

As a powerful centralnervous system stimulant, which of these substances can lead to miscarriage,preterm labor, placental separation (abruption), and stillbirth?

Back 17

cocaine

Front 18

The microscopic examinationof scrapings from the cervix, endocervix, or other mucous membranes to detectpremalignant or malignant cells is called:

Back 18

A Papanicolaou (Pap) test.

Front 19

The most dangerous effect on the fetus of a mother who smokescigarettes while pregnant is:

Back 19

Intrauterine growth restriction

Front 20

When assessing a patientfor amenorrhea, the nurse should be aware that this is unlikely to be causedby:

Back 20

Lack of exercise.

Front 21

When a nurse is counselinga woman for primary dysmenorrhea, which nonpharmacologic intervention might berecommended?

Back 21

Using a heating pad on theabdomen to relieve cramping

Front 22

A woman complains of severeabdominal and pelvic pain around the time of menstruation that has gotten worseover the last 5 years. She also complains of pain during intercourse and hastried unsuccessfully to get pregnant for the past 18 months. These symptoms aremost likely related to:

Back 22

Endometriosis.

Front 23

Nafarelin is currently usedas a treatment for mild-to-severe endometriosis. The nurse should tell a womantaking this medication that the drug:

Back 23

Can cause her to experiencesome hot flashes and vaginal dryness.

Front 24

The two primary areas of risk for sexually transmitted infections(STIs) are:

Back 24

Risky sexual behaviors andinadequate preventive health behaviors.

Front 25

The viral sexuallytransmitted infection (STI) that affects most people in the United States todayis:

Back 25

Human papillomavirus (HPV).

Front 26

The nurse providing care ina women’s health care setting must be aware regarding which sexuallytransmitted infection that can be successfully treated and cured?

Back 26

Chlamydia

Front 27

In vitrofertilization-embryo transfer (IVF-ET) is a common approach for women withblocked fallopian tubes or unexplained infertility and for men with very lowsperm counts. A husband and wife have arrived for their preproceduralinterview. The husband asks the nurse to explain what the procedure entails.The nurse’s most appropriate response is:

Back 27

“IVF-ET is a type ofassisted reproductive therapy that involves collecting eggs from your wife’sovaries, fertilizing them in the laboratory with your sperm, and transferringthe embryo to her uterus.”

Front 28

A woman has chosen thecalendar method of conception control. During the assessment process, it ismost important that the nurse:

Back 28

Obtain a history ofmenstrual cycle lengths for the past 6 to 12 months.

Front 29

A woman who has a seizuredisorder and takes barbiturates and phenytoin sodium daily asks the nurse aboutthe pill as a contraceptive choice. The nurse’s most appropriate response wouldbe:

Back 29

“Your current medicationswill reduce the effectiveness of the pill.”

Front 30

A woman is 16 weekspregnant and has elected to terminate her pregnancy. The nurse knows that themost common technique used for medical termination of a pregnancy in the secondtrimester is:

Back 30

Dilation and evacuation (D&E).

Front 31

Which contraceptive methodbest protects against sexually transmitted infections (STIs) and humanimmunodeficiency virus (HIV)?

Back 31

Barrier methods

Front 32

A father and mother arecarriers of phenylketonuria (PKU). Their 2-year-old daughter has PKU. Thecouple tells the nurse that they are planning to have a second baby. Becausetheir daughter has PKU, they are sure that their next baby won’t be affected.What response by the nurse is most accurate?

Back 32

“You are both carriers, so each baby has a 25% chance of being affected.”

Front 33

The nurse is providing genetic counseling for an expectant couplewho already have a child with trisomy 18. The nurse should:

Back 33

Discuss options with thecouple, including amniocentesis to determine whether the fetus is affected.

Front 34

A key finding from the Human Genome Project is:

Back 34

Approximately 20,000 genesmake up the genome.

Front 35

You are a maternal-newbornnurse caring for a mother who just delivered a baby born with Down syndrome.What nursing diagnosis would be the most essential in caring for the mother ofthis infant?

Back 35

Interrupted family processes

Front 36

A couple has been counseled for genetic anomalies. They ask you,“What is karyotyping?” Your best response is:

Back 36

“Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes.”

Front 37

The nurse must be cognizant that an individual’s genetic makeup isknown as his or her:

Back 37

Genotype.

Front 38

At approximately _____weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelidsopen, and the fetus measures approximately 27 cm crown to rump and weighsapproximately 1110 g.

Back 38

28

Front 39

The nurse caring for thelaboring woman should know that meconium is produced by:

Back 39

Fetal intestines.

Front 40

A woman asks the nurse,“What protects my baby’s umbilical cord from being squashed while the baby’sinside of me?” The nurse’s best response is:

Back 40

“Your baby’s umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby.”

Front 41

The _____ is/areresponsible for oxygen and carbon dioxide transport to and from the maternalbloodstream.

Back 41

Chorionic villi

Front 42

Sally comes in for herfirst prenatal examination. This is her first child. She asks you (the nurse),“How does my baby get air inside my uterus?” The correct response is:

Back 42

“The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream.”

Front 43

The most basic information a maternity nurse should haveconcerning conception is that:

Back 43

Implantation in the endometrium occurs 6 to 10 days after conception.

Front 44

a maternity nurse should be aware of which fact about amniotic fluid

Back 44

it serves as a source of oral fluid and a respiratory for waste for the fetus

Front 45

as relates to the structure and function of the placenta, the maternity nurse should be aware that

Back 45

as one of its early functions, the placenta acts as an endocrine gland

Front 46

a new mother asks the nurse about the "white substance" covering her infant. the nurse explains that the purpose of vernix caseosa is to

Back 46

protect the fetal skin from amniotic fluid

Front 47

Congenital disorders refer to conditions that are present atbirth. These disorders may be inherited and caused by environmental factors ormaternal malnutrition. Toxic exposures have the greatest effect on developmentbetween 15 and 60 days of gestation. For the nurse to be able to conduct acomplete assessment of the newly pregnant client, she should understand thesignificance of exposure to known human teratogens. These include (Selectall that apply):

Back 47

Infections.

Radiation.

Maternal conditions.

Drugs.

Chemicals.

Front 48

Which congenitalmalformations result from multifactorial inheritance (Select all that apply)?

Back 48

Cleft lip

Congenital heart disease

Anencephaly

Pyloric stenosis

Front 49

A woman’s obstetric historyindicates that she is pregnant for the fourth time and all of her children fromprevious pregnancies are living. One was born at 39 weeks of gestation, twinswere born at 34 weeks of gestation, and another child was born at 35 weeks ofgestation. What is her gravidity and parity using the GTPAL system?

Back 49

4-1-2-0-4

Front 50

A woman at 10 weeks ofgestation who is seen in the prenatal clinic with presumptive signs andsymptoms of pregnancy likely will have:

Back 50

Amenorrhea.

Front 51

The nurse teaches apregnant woman about the presumptive, probable, and positive signs of pregnancy.The woman demonstrates understanding of the nurse’s instructions if she statesthat a positive sign of pregnancy is:

Back 51

Fetal movement palpated by the nurse-midwife.

Front 52

During a client’s physicalexamination the nurse notes that the lower uterine segment is soft onpalpation. The nurse would document this finding as:

Back 52

Hegar’s sign

Front 53

Cardiovascular system changes occur during pregnancy. Whichfinding would be considered normal for a woman in her second trimester?

Back 53

Increased pulse rate

Front 54

Numerous changes in theintegumentary system occur during pregnancy. Which change persists after birth?

Back 54

Striae gravidarum

Front 55

A woman is in her seventhmonth of pregnancy. She has been complaining of nasal congestion and occasionalepistaxis. The nurse suspects that:

Back 55

This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.

Front 56

The nurse caring for thepregnant client must understand that the hormone essential for maintainingpregnancy is:

Back 56

Progesterone.

Front 57

A patient at 24 weeks ofgestation contacts the nurse at her obstetric provider’s office to complainthat she has cravings for dirt and gravel. The nurse is aware that thiscondition is known as ________ and may indicate anemia.

Back 57

Pica

Front 58

Which time-based description of a stage of development inpregnancy is accurate?

Back 58

Term—pregnancy from the beginning of week 38 of gestation to the end of week 42

Front 59

Which statement about a condition of pregnancy is accurate?

Back 59

Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.

Front 60

A first-time mother at 18weeks of gestation comes for her regularly scheduled prenatal visit. The clienttells the nurse that she is afraid that she is going into premature laborbecause she is beginning to have regular contractions. The nurse explains thatthis is the Braxton Hicks sign and teaches the client that this type ofcontraction:

Back 60

Is painless.

Front 61

The maternity nurseunderstands that vascular volume increases 40% to 60% during pregnancy to:

Back 61

Provide adequate perfusion of the placenta.

Front 62

The diagnosis of pregnancyis based on which positive signs of pregnancy (Select all that apply)?

Back 62

Identification of fetalheartbeat

Visualization of the fetus

Verification of fetalmovement

Front 63

A woman is 3 months pregnant. At her prenatal visit, she tells thenurse that she doesn’t know what is happening; one minute she’s happy that sheis pregnant, and the next minute she cries for no reason. Which response by thenurse is most appropriate?

Back 63

“Hormonal changes during pregnancy commonly result in mood swings.”

Front 64

Which statement aboutpregnancy is accurate?

Back 64

A normal pregnancy lasts about 10 lunar months.

Front 65

While you are assessing thevital signs of a pregnant woman in her third trimester, the patient complainsof feeling faint, dizzy, and agitated. Which nursing intervention isappropriate?

Back 65

Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

Front 66

Signs and symptoms that awoman should report immediately to her health care provider include (Select all that apply):

Back 66

Vaginal bleeding.

Heartburn accompanied bysevere headache.

Rupture of membranes.

Front 67

A woman has just moved tothe United States from Mexico. She is 3 months pregnant and has arrived for herfirst prenatal visit. During her assessment interview, you discover that shehas not had any immunizations. Which immunizations should she receive at thispoint in her pregnancy (Select all that apply)?

Back 67

Tetanus

Diphtheria

Hepatitis B

Front 68

A pregnant woman experiencing nausea and vomiting should:

Back 68

Eat small, frequent meals (every 2 to 3 hours).

Front 69

Most women withuncomplicated pregnancies can use the nurse as their primary source fornutritional information. The nurse or midwife should refer a client to aregistered dietitian for in-depth nutritional counseling in the followingsituations (Select all that apply).

Back 69

Preexisting or gestationalillness such as diabetes

Ethnic or cultural foodpatterns

Vegetarian diet

Obesity

Front 70

A 41-week pregnantmultigravida presents in the labor and delivery unit after a nonstress testindicated that her fetus could be experiencing some difficulties in utero.Which diagnostic tool would yield more detailed information about the fetus?

Back 70

Biophysical profile (BPP)

Front 71

At 35 weeks of pregnancy a woman experiences preterm labor.Tocolytics are administered and she is placed on bed rest, but she continues toexperience regular uterine contractions, and her cervix is beginning to dilateand efface. What would be an important test for fetal well-being at this time?

Back 71

Amniocentesis for fetal lung maturity

Front 72

Nurses should be aware thatthe biophysical profile (BPP):

Back 72

Is an accurate indicator of impending fetal death.

Front 73

Risk factors tend to beinterrelated and cumulative in their effect. While planning the care for alaboring client with diabetes mellitus, the nurse is aware that she is at agreater risk for:

Back 73

Polyhydramnios.

Front 74

A pregnant woman’sbiophysical profile score is 8. She asks the nurse to explain the results. Thenurse’s best response is:

Back 74

“The test results are within normal limits.”

Front 75

While working with thepregnant woman in her first trimester, the nurse is aware that chorionic villussampling (CVS) can be performed during pregnancy at:

Back 75

10 weeks

Front 76

The nurse recognizes that anonstress test (NST) in which two or more fetal heart rate (FHR) accelerationsof 15 beats/min or more occur with fetal movement in a 20-minute period is:

Back 76

Reactive

Front 77

Intrauterine growthrestriction (IUGR) is associated with numerous pregnancy-related risk factors (Selectall that apply).

Back 77

Poor nutrition

Maternal collagen disease

Gestational hypertension

Smoking

Front 78

In assessing the knowledgeof a pregestational woman with type 1 diabetes concerning changing insulinneeds during pregnancy, the nurse recognizes that further teaching is warrantedwhen the client states:

Back 78

“I will need to increase my insulin dosage during the first 3 months of pregnancy.”

Front 79

Screening at 24 weeks ofgestation reveals that a pregnant woman has gestational diabetes mellitus(GDM). In planning her care, the nurse and the woman mutually agree that anexpected outcome is to prevent injury to the fetus as a result of GDM. Thenurse identifies that the fetus is at greatest risk for:

Back 79

Macrosomia.

Front 80

A 26-year-old primigravidahas come to the clinic for her regular prenatal visit at 12 weeks. She appearsthin and somewhat nervous. She reports that she eats a well-balanced diet,although her weight is 5 pounds less than it was at her last visit. The resultsof laboratory studies confirm that she has a hyperthyroid condition. Based onthe available data, the nurse formulates a plan of care. What nursing diagnosisis most appropriate for the woman at this time?

Back 80

Imbalanced nutrition: less than body requirements

Front 81

Maternal phenylketonuria(PKU) is an important health concern during pregnancy because:

Back 81

The fetus may develop neurologic problems.

Front 82

The nurse providing carefor a woman with gestational diabetes understands that a laboratory test forglycosylated hemoglobin Alc:

Back 82

Would be considered evidence of good diabetes control with a result of 5% to 6%.

Front 83

When caring for a pregnantwoman with cardiac problems, the nurse must be alert for signs and symptoms ofcardiac decompensation, which include:

Back 83

Dyspnea; crackles; and an irregular, weak pulse.

Front 84

A woman with asthma isexperiencing a postpartum hemorrhage. Which drug would not be used to treat herbleeding because it may exacerbate her asthma?

Back 84

Hemabate

Front 85

Which major neonatalcomplication is carefully monitored after the birth of the infant of a diabeticmother?

Back 85

Hypoglycemia

Front 86

Women with hyperemesisgravidarum:

Back 86

Have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance.

Front 87

In caring for an immediatepostpartum client, you note petechiae and oozing from her IV site. You wouldmonitor her closely for the clotting disorder:

Back 87

Disseminated intravascular coagulation (DIC)

Front 88

A primigravida is beingmonitored in her prenatal clinic for preeclampsia. What finding should concernher nurse?

Back 88

A dipstick value of 3+ for protein in her urine

Front 89

The labor of a pregnantwoman with preeclampsia is going to be induced. Before initiating the Pitocininfusion, the nurse reviews the woman’s latest laboratory test findings, whichreveal a platelet count of 90,000, an elevated aspartate transaminase (AST)level, and a falling hematocrit. The nurse notifies the physician because thelaboratory results are indicative of:

Back 89

HELLP syndrome.

Front 90

A woman with preeclampsia has a seizure. The nurse’s primary dutyduring the seizure is to:

Back 90

Stay with the client and call for help.

Front 91

A pregnant woman has beenreceiving a magnesium sulfate infusion for treatment of severe preeclampsia for24 hours. On assessment the nurse finds the following vital signs: temperatureof 37.3° C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min,blood pressure (BP) of 148/90 mm Hg, absent deep tendon reflexes, and no ankleclonus. The client complains, “I’m so thirsty and warm.” The nurse:

Back 91

Discontinues the magnesium sulfate infusion.

Front 92

A woman at 39 weeks of gestationwith a history of preeclampsia is admitted to the labor and birth unit. Shesuddenly experiences increased contraction frequency of every 1 to 2 minutes;dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects theonset of:

Back 92

Placental abruption.

Front 93

The patient that you arecaring for has severe preeclampsia and is receiving a magnesium sulfateinfusion. You become concerned after assessment when the woman exhibits:

Back 93

A respiratory rate of 10 breaths/min.

Front 94

Your patient has beenreceiving magnesium sulfate for 20 hours for treatment of preeclampsia. Shejust delivered a viable infant girl 30 minutes ago. What uterine findings wouldyou expect to observe/assess in this client?

Back 94

A boggy uterus with heavy lochia flow