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OB exam 1 Practice questions

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Jul 11th, 2023
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115 test answers
question
A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate?nA. "We don't really know when such defects occur."nB. "It depends on what caused the defect."nC. "They occur between the third and fifth weeks of development."nD. "They usually occur in the first 2 weeks of development."
answer
c
question
A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate?nA. "Many women imagine what their baby is like."nB. "A baby in utero does respond to the mother's voice."nC. "You'll need to ask the doctor if the baby can hear yet."nD. "Thinking that your baby hears will help you bond with the baby."
answer
b
question
A maternity nurse should be aware of which fact about the amniotic fluid?nA. It serves as a source of oral fluid and as a repository for waste from the fetus.nB. The volume remains about the same throughout the term of a healthy pregnancy.nC. A volume of less than 300 ml is associated with gastrointestinal malformations.nD. A volume of more than 2 L is associated with fetal renal abnormalities
answer
a
question
Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that:nA. Rates of twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing.nB. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins.nC. Identical twins are more common in Caucasian families.nD. Fraternal twins are same gender, usually male.
answer
a
question
The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping:nA. In a side-lying position.nB. On her back with a pillow under her knees.nC. With the head of the bed elevated.nD. On her abdomen.
answer
a
question
A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates that:nA. The fetus is at risk for Down syndrome.nB. The woman is at high risk for developing preterm labor.nC. The lungs are mature.nD. Meconium is present in the amniotic fluid
answer
c
question
Which time span delineates the appropriate length for a normal pregnancy?nA. 9 lunar months, 8.5 calendar months, 39 weeks, 272 daysnB. 10 lunar months, 9 calendar months, 40 weeks, 280 daysnC. 9 calendar months, 10 lunar months, 42 weeks, 294 daysnD. 9 calendar months, 38 weeks, 266 days
answer
b
question
A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination?nA. Fetus is in a breech positionnB. FHR baseline is within normal rangenC. Fetus with possible renal problemsnD. Increased fundal height
answer
c
question
Which developmental finding is accurate with regard to fetal growth?nA. Heart starts beating at 12 weeks.nB. Lungs take shape by 8 weeks.nC. Brain configuration is complete by 8 weeks.nD. Main blood vessels form by 8 weeks
answer
d
question
In reviewing the history of a woman who wants to become pregnant, which medication profile would indicate a potential concern relative to toxic exposure? (Select all that apply.)nA. Tylenol OTC occasionally for a headache; twice last weeknB. Anticonvulsant for seizure disordernC. Lithium for bipolar disordernD. Coumadin for atrial fibrillationnE. Multivitamins once a day
answer
b,c,d
question
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity according to the GTPAL system?nA. 2-0-0-1-1nB. 2-1-0-1-0nC. 3-1-0-1-0nD. 3-0-1-1-0
answer
c
question
Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?nA. RadioimmunoassaynB. Radioreceptor assaynC. Latex agglutination testnD. Enzyme-linked immunosorbent assay (ELISA)
answer
d
question
A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:nA. A positive pregnancy test result.nB. Fetal movement palpated by the nurse-midwife.nC. Braxton Hicks contractions.nD. Quickening.
answer
b
question
During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:nA. Hegar sign.nB. McDonald sign.nC. Chadwick sign.nD. Goodell sign.
answer
a
question
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?nA. Less audible heart sounds (S1, S2)nB. Increased pulse ratenC. Increased blood pressurenD. Decreased red blood cell (RBC) production
answer
b
question
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:nA. PrimiparanB. PrimigravidanC. MultiparanD. Nulligravida
answer
a
question
Which presumptive sign (felt by woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause(s)?nA. Amenorrhea—stress, endocrine problemsnB. Quickening—gas, peristalsisnC. Goodell sign—cervical polypsnD. Chadwick sign—pelvic congestion
answer
c
question
In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that:nA. A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.nB. Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.nC. The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.nD. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.
answer
c
question
Which hematocrit (HCT) and hemoglobin (HGB) results represent the lowest acceptable values for a woman in the third trimester of pregnancy?nA. 38% HCT; 14 g/dL HGBnB. 35% HCT; 13 g/dL HGBnC. 33% HCT; 11 g/dL HGBnD. 32% HCT; 10.5 g/dL HGB
answer
c
question
A pregnant patient is experiencing some integumentary changes and is concerned that they may represent abnormal findings. The nurse provides information to the patient that the following findings would be considered "normal abnormal" findings during pregnancy so that she should not be alarmed. (Select all that apply.)nA. Facial edemanB. MelasmanC. Linea nigranD. Superficial thrombophlebitisnE. Vascular spidersnF. Allodynia
answer
b,c,e
question
A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should tell her:nA. "You don't need to modify your exercising any time during your pregnancy."nB. "Stop exercising, because it will harm the fetus."nC. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."nD. "Jogging is too hard on your joints; switch to walking now."
answer
c
question
A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be:nA. ConstipationnB. Alteration in the pattern of fetal movementnC. Heart palpitationsnD. Edema in the ankles and feet at the end of the day
answer
b
question
A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know whether it is safe for her to have a drink with dinner now. The nurse tells her:nA. "Because you're in your second trimester, there's no problem with having one drink with dinner."nB. "One drink every night is too much. One drink three times a week should be fine."nC. "Because you're in your second trimester, you can drink as much as you like."nD. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."
answer
d
question
Which behavior indicates that a woman is "seeking safe passage" for herself and her infant?nA. She keeps all prenatal appointments.nB. She "eats for two."nC. She drives her car slowly.nD. She wears only low-heeled shoes.
answer
a
question
What type of cultural concern is the most likely deterrent to many women seeking prenatal care?nA. ReligionnB. ModestynC. IgnorancenD. Belief that physicians are evil
answer
b
question
In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that:nA. Nonacceptance of the pregnancy very often equates to rejection of the child.nB. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes.nC. Ambivalent feelings during pregnancy are usually seen only in emotionally immature or very young mothers.nD. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth.
answer
b
question
With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:nA. The father goes through three phases of acceptance of his own.nB. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth.nC. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home.nD. Typically men remain ambivalent about fatherhood right up to the birth of their child.
answer
a
question
With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that during pregnancy:nA. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.nB. The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester.nC. Killed-virus vaccines (e.g., tetanus) should not be given, but live-virus vaccines (e.g., measles) are permissible.nD. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.
answer
a
question
Which statement about multifetal pregnancy is not accurate?nA. The expectant mother often experiences anemia because the fetuses have a greater demand for iron.nB. Twin pregnancies come to term with the same frequency as single pregnancies.nC. The mother should be counseled to increase her nutritional intake and gain more weight.nD. Backache and varicose veins are often more pronounced.
answer
b
question
The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that:nA. She will have to give birth at home.nB. She must see an obstetrician as well as the midwife during pregnancy.nC. She will not be able to have epidural analgesia for labor pain.nD. She must be having a low-risk pregnancy.
answer
d
question
An expectant couple asks the nurse about intercourse during pregnancy and whether it is safe for the baby. The nurse should tell the couple that:nA. Intercourse should be avoided if any spotting from the vagina occurs afterward.nB. Intercourse is safe until the third trimester.nC. Safer-sex practices should be used once the membranes rupture.nD. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.
answer
d
question
A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she:nA. Wiggles and points her toes during the cramp.nB. Applies cold compresses to the affected leg.nC. Extends her leg and dorsiflexes her foot during the cramp.nD. Avoids weight bearing on the affected leg during the cramp.
answer
c
question
An expectant father confides in the nurse that his pregnant wife, at 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's best response is:nA. "This is normal behavior and should begin to subside by the second trimester."nB. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor I know."nC. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant."nD. "You seem impatient with her. Perhaps this is precipitating her behavior."
answer
c
question
Which suggestion about weight gain is not an accurate recommendation?nA. Underweight women should gain 12.5 to 18 kg.nB. Obese women should gain at least 7 kg.nC. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale.nD. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.
answer
d
question
A pregnant woman experiencing nausea and vomiting should:nA. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.nB. Eat small, frequent meals (every 2 to 3 hours).nC. Increase her intake of high-fat foods to keep the stomach full and coated.nD. Limit fluid intake throughout the day.
answer
b
question
A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important?nA. Several glasses of fluidnB. Extra protein sources, such as peanut butternC. Salty foods to replace lost sodiumnD. Easily digested sources of carbohydrate
answer
a
question
Women with inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:nA. Spina bifida.nB. Intrauterine growth restriction.nC. Diabetes mellitus.nD. Down syndrome
answer
b
question
Which minerals and vitamins are usually recommended to supplement a pregnant woman's diet?nA. Fat-soluble vitamins A and DnB. Water-soluble vitamins C and B6nC. Iron and folatenD. Calcium and zinc
answer
c
question
With regard to nutritional needs during lactation, a maternity nurse should be aware that:nA. The mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy.nB. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.nC. Critical iron and folic acid levels must be maintained.nD. Lactating women can go back to their prepregnant calorie intake
answer
b
question
When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:nA. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.nB. Iron absorption is inhibited by a diet rich in vitamin C.nC. Iron supplements are permissible for children in small doses.nD. Constipation is common with iron supplements.
answer
d
question
A 22-year-old woman pregnant with a single fetus had a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this finding?nA. This weight gain indicates possible gestational hypertension.nB. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).nC. This weight gain cannot be evaluated until the woman has been observed for several more weeks.nD. The woman's weight gain is appropriate for this stage of pregnancy.
answer
d
question
With regard to protein in the diet of pregnant women, nurses should be aware that:nA. Many protein-rich foods are also good sources of calcium, iron, and B vitamins.nB. Many women need to increase their protein intake during pregnancy.nC. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.nD. High-protein supplements can be used without risk by women on macrobiotic diets
answer
a
question
Which findings could be considered to be a barrier to a pregnant woman seeking prenatal care? (Select all that apply.)nA. Patient would prefer to be cared for by a midwife instead of a physician.nB. Economic cost of health care.nC. Patient's cultural beliefs do not include prenatal care as being valued.nD. Patient speaks several languages.nE. Patient had a bad experience the last time she went to a doctor for care.
answer
b,c,e
question
With regard to primary and secondary powers, the maternity nurse should understand that:nA. Primary powers are responsible for effacement and dilation of the cervix. nB. Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnancies.nC. Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation.nD. Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs.
answer
a
question
Which sign does not precede the onset of labor?nA. A return of urinary frequency as a result of increased bladder pressurenB. Persistent low backache from relaxed pelvic jointsnC. Stronger and more frequent uterine (Braxton Hicks) contractionsnD. A decline in energy, as the body stores up for labor
answer
d
question
In order to accurately assess the health of the mother accurately during labor, the nurse should be aware that:nA. The woman's blood pressure increases during contractions and falls back to prelabor normal between contractions.nB. Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia.nC. Having the woman point her toes reduces leg cramps.nD. The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation.
answer
d
question
The nurse knows that the second stage of labor, the descent phase, has begun when:nA. The amniotic membranes rupture.nB. The cervix cannot be felt during a vaginal examination. nC. The woman experiences a strong urge to bear down.nD. The presenting part is below the ischial spines
answer
b
question
Which statement is inaccurate with regard to normal labor?nA. A single fetus presents by vertex.nB. It is completed within 8 hours. nC. A regular progression of contractions, effacement, dilation, and descent occurs.nD. No complications are involved.
answer
b
question
Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?nA. Latent: mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hoursnB. Active: moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hoursnC. Lull: no contractions; dilation stable; duration of 20 to 60 minutesnD. Transition: very strong but irregular contractions; 8 to 10 cm dilation; duration of 1 to 2 hours
answer
b
question
Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased?nA. SemirecumbentnB. SittingnC. SquattingnD. Side-lying
answer
c
question
Fetal circulation can be affected by many factors during labor. Accurate assessment of the laboring woman and fetus requires knowledge of these expected adaptations. Which factor will not affect fetal circulation during labor?nA. Fetal position nB. Uterine contractionsnC. Blood pressurenD. Umbilical cord blood flow
answer
a
question
Concerning the third stage of labor, nurses should be aware that:nA. The placenta eventually detaches itself from a flaccid uterus.nB. The duration of the third stage may be as short as 3 to 5 minutes. nC. It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surface.nD. The major risk for women during the third stage is a rapid heart rate.
answer
b
question
Which of the following findings would be a cause for concern for a nurse who is monitoring an obstetric patient who is in early labor? (Select all that apply.)nA. Biparietal diameter of less than 9.25 cm nB. Vertex presenting partnC. Transverse lie nD. General flexion attitudenE. Android pelvis
answer
a,c,e
question
1. A woman in active labor receives an opioid agonist analgesic. Which medication relieves severe, persistent, or recurrent pain, creates a sense of well-being, overcomes inhibitory factors, and may even relax the cervix but should be used cautiously in women with cardiac disease?nA. Meperidine (Demerol) nB. Promethazine (Phenergan)nC. Butorphanol tartrate (Stadol)nD. Nalbuphine (Nubain
answer
a
question
A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:nA. Notify the woman's physician.nB. Tell the woman to slow the pace of her breathing.nC. Administer oxygen via a mask or nasal cannula.nD. Help her breathe into a paper bag. Correct
answer
d
question
A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure is to use:nA. Counterpressure against the sacrum. nB. Pant-blow (breaths and puffs) breathing techniques.nC. Effleurage.nD. Biofeedback.
answer
a
question
Nurses should be aware of the difference that experience can make in labor pain, such as:nA. Sensory pain for nulliparous women often is greater than for multiparous women during early labor. nB. Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor.nC. Women with a history of substance abuse experience more pain during labor.nD. Multiparous women have more fatigue from labor and therefore experience more pain.
answer
a
question
In the current practice of childbirth preparation, emphasis is placed on:nA. The Dick-Read (natural) childbirth method.nB. The Lamaze (psychoprophylactic) method.nC. The Bradley (husband-coached) method.nD. Encouraging expectant parents to attend childbirth preparation in any or no specific method.
answer
d
question
With regard to breathing techniques during labor, maternity nurses should be aware that:nA. Breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction. nB. By the time labor has begun, it is too late for instruction in breathing and relaxation.nC. Controlled breathing techniques are most difficult near the end of the second stage of labor.nD. The patterned-paced breathing technique can help prevent hyperventilation.
answer
a
question
With regard to what might be called the tactile approaches to comfort management, nurses should be aware that:nA. Either hot or cold applications may provide relief, but they should never be used together in the same treatment.nB. Acupuncture can be performed by a skilled nurse with just a little training.nC. Hand and foot massage may be especially relaxing in advanced labor, when a woman's tolerance for touch is limited. nD. Therapeutic touch (TT) uses handheld electronic stimulators that produce sympathetic vibrations.
answer
c
question
With regard to systemic analgesics administered during labor, nurses should be aware that:nA. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier.nB. Effects on the fetus and newborn can include decreased alertness and delayed sucking. nC. IM administration is preferred over IV administration.nD. IV patient-controlled analgesia (PCA) results in increased use of an analgesic.
answer
b
question
With regard to spinal and epidural (block) anesthesia, nurses should know that:nA. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births.nB. A high incidence of postbirth headache is seen with spinal blocks. nC. Epidural blocks allow the woman to move freely.nD. Spinal and epidural blocks are never used together.
answer
b
question
After change of shift report, the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks, and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is:nA. VisceralnB. Referred nC. SomaticnD. Afterpain
answer
b
question
Fetal bradycardia is most common during:nA. Maternal hyperthyroidism.nB. Fetal anemia.nC. Viral infection. nD. Tocolytic treatment using ritodrine.
answer
c
question
The nurse providing care for the laboring woman understands that accelerations with fetal movement:nA. Are reassuring. nB. Are caused by umbilical cord compression.nC. Warrant close observation.nD. Are caused by uteroplacental insufficiency
answer
a
question
The most common cause of decreased variability in the FHR that lasts 30 minutes or less is:nA. Altered cerebral blood flow.nB. Fetal hypoxemia.nC. Umbilical cord compression.nD. Fetal sleep cycles.
answer
d
question
You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase IV fluid, and perform a vaginal exam. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should you take?nA. Call for help.nB. Insert a Foley catheter.nC. Start oxytocin (Pitocin).nD. Notify the primary health care provider immediately.
answer
d
question
When using intermittent auscultation (IA) to assess uterine activity, nurses should be aware that:nA. The examiner's hand should be placed over the fundus before, during, and after contractions. nB. The frequency and duration of contractions are measured in seconds for consistency.nC. Contraction intensity is given a judgment number of 1 to 7 by the nurse and client together.nD. The resting tone between contractions is described as either placid or turbulent.
answer
a
question
A nurse caring for a woman in labor understands that increased variability of the fetal heart rate might be caused by:nA. Narcotics.nB. Barbiturates.nC. Methamphetamines. nD. Tranquilizers
answer
c
question
Which of the following statements is not used to describe a characteristic of a uterine contraction?nA. Frequency (how often contractions occur)nB. Intensity (the strength of the contraction at its peak)nC. Resting tone (the tension in the uterine muscle)nD. Appearance (shape and height)
answer
d
question
The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by:nA. Change in position. nB. Oxytocin administration.nC. Regional anesthesia.nD. Intravenous analgesic.
answer
a
question
Fetal well-being during labor is assessed by:nA. The response of the fetal heart rate (FHR) to uterine contractions (UCs).nB. Maternal pain control.nC. Accelerations in the FHR.nD. An FHR greater than 110 beats/min
answer
a
question
A group of fetal monitoring experts (National Institute of Child Health and Human Development, 2008) recommends that fetal heart rate (FHR) tracings demonstrate certain characteristics to be described as reassuring or normal (category I). These characteristics include:nA. Bradycardia not accompanied by baseline variability.nB. Early decelerations, either present or absent. nC. Sinusoidal pattern.nD. Tachycardia.
answer
b
question
A nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates her understanding of the instructions when the woman states:nA. "True labor contractions will subside when I walk around."nB. "True labor contractions will cause discomfort over the top of my uterus."nC. "True labor contractions will continue and get stronger even if I relax and take a shower." nD. "True labor contractions will remain irregular but become stronger."
answer
c
question
Under which circumstance would a nurse not perform a vaginal examination on a patient in labor?nA. An admission to the hospital at the start of labornB. When accelerations of the fetal heart rate (FHR) are noted nC. On maternal perception of perineal pressure or the urge to bear downnD. When membranes rupture
answer
b
question
When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include:nA. Encouraging the woman to try various upright positions, including squatting and standing. nB. Telling the woman to start pushing as soon as her cervix is fully dilated.nC. Continuing an epidural anesthetic so that pain is reduced and the woman can relax.nD. Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction.
answer
a
question
Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period?nA. The healthy newborn should be taken to the nursery for a complete assessment.nB. After drying, the infant should be given to the mother wrapped in a receiving blanket.nC. Skin-to-skin contact of mother and baby should be encouraged. nD. The father or support person should be encouraged to hold the infant while awaiting delivery of the placenta.
answer
c
question
Which description of the phases of the second stage of labor is accurate?nA. Latent phase: feels sleepy, fetal station is 2+ to 4+, duration is 30 to 45 minutesnB. Active phase: overwhelmingly strong contractions, Ferguson reflux activated, duration is 5 to 15 minutesnC. Descent phase: significant increase in contractions, Ferguson reflux activated, average duration varies nD. Transitional phase: woman "laboring down," fetal station is 0, duration is 15 minutes
answer
c
question
When performing vaginal examinations on a laboring woman, the nurse should be guided by what principle?nA. Cleanse the vulva and perineum before and after the examination as needed. nB. Wear a clean glove lubricated with tap water to reduce discomfort.nC. Perform the examination every hour during the active phase of the first stage of labor.nD. Perform an examination immediately if active bleeding is present.
answer
a
question
Which test is performed to determine whether membranes are ruptured?nA. Urine analysisnB. Fern test nC. Leopold maneuversnD. AROM
answer
b
question
When assessing a multiparous woman who has just given birth to an 8-pound boy, the nurse notes that the woman's fundus is firm and has become globular. A gush of dark red blood comes from her vagina. The nurse concludes that:nA. The placenta has separated. nB. A cervical tear occurred during the birth.nC. The woman is beginning to hemorrhage.nD. Clots have formed in the upper uterine segment
answer
a
question
A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is:nA. "Don't worry about it. You'll do fine."nB. "It's normal to be anxious about labor. Let's discuss what makes you afraid." nC. "Labor is scary to think about, but the actual experience isn't."nD. "You may have an epidural. You won't feel anything."
answer
b
question
Which of the following would not be included in a labor nurse's plan of care for an expectant mother?nA. The onset of progressive, regular contractionsnB. The bloody, or pink, shownC. The spontaneous rupture of membranesnD. Formulation of the woman's plan of care for labor
answer
d
question
If a woman complains of back labor pain, the nurse might best suggest that she:nA. Lie on her back for a while with her knees bent.nB. Do less walking around.nC. Take some deep, cleansing breaths.nD. Lean over a birth ball with her knees on the floor.
answer
d
question
In a variation of rooming-in called couplet care, the mother and infant share a room and the mother shares the care of the infant with:nA. The father of the infant.nB. Her mother (the infant's grandmother).nC. Her eldest daughter (the infant's sister).nD. The nurse.
answer
d
question
The breasts of a woman who is bottle feeding her baby are engorged. The nurse should instruct her to:nA. Wear a snug, supportive bra. nB. Allow warm water to soothe the breasts during a shower.nC. Express milk from breasts occasionally to relieve discomfort.nD. Place absorbent pads with plastic liners into her bra to absorb leakage
answer
a
question
A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious likely consequence of bladder distention is:nA. Urinary tract infection.nB. Excessive uterine bleeding. nC. A ruptured bladder.nD. Bladder wall atony.
answer
b
question
What statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth?nA. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter."nB. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." nC. "I will not have a menstrual cycle for 6 months after childbirth."nD. "My first menstrual cycle will be heavier than normal and then will be light for several months after."
answer
b
question
With regard to afterbirth pains, nurses should be aware that these pains are:nA. Caused by mild, continual contractions for the duration of the postpartum period.nB. More common in first-time mothers.nC. More noticeable in births in which the uterus was overdistended. nD. Alleviated somewhat when the mother breastfeeds
answer
c
question
Postbirth uterine/vaginal discharge, called lochia:nA. Is similar to a light menstrual period for the first 6 to 12 hours.nB. Is usually greater after cesarean births.nC. Will usually decrease with ambulation and breastfeeding.nD. Should smell like normal menstrual flow unless an infection is present.
answer
d
question
Which description of postpartum restoration or healing times is accurate?nA. The cervix shortens, becomes firm, and returns to form within a month postpartum.nB. Rugae reappear within 3 to 4 weeks.nC. Most episiotomies heal within a week.nD. Hemorrhoids usually decrease in size within 2 weeks of childbirth.
answer
b
question
With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that:nA. Kidney function returns to normal a few days after birth.nB. Diastasis recti abdominis is a common condition that alters the voiding reflex.nC. Fluid loss through perspiration and increased urinary output account for a weight loss of more than 2 kg during the puerperium.nD. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth.
answer
c
question
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman 1 day postpartum. An expected finding is:nA. Little if any change. nB. Leakage of milk at let-down.nC. Swollen, warm and tender on palpation.nD. A few blisters and a bruise on each areola.
answer
a
question
Which of the following findings would raise concern for the nurse who is monitoring a postpartum patient who had a spontaneous vaginal delivery (SVD) of a 10-lb baby boy?nA. Lochia rubra with minimal clots expressed on fundal massagenB. Fundus midline and firm with nonpalpable bladdernC. Fundus midline and firm with spurts of bright red blood upon fundal massage nD. Patient report of mild to moderate cramping and request for pain medication
answer
c
question
Which of the following changes are consistent with metabolic function during the postpartum period? (Select all that apply.)nA. Moderate hyperglycemianB. Increased BMR in the immediate postpartum period nC. Secretion of insulinase nD. Mildly increased T3 and T4 levels for the first several weeks postpartumnE. Decrease in estrogen and cortisol levels
answer
b,c,e
question
Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:nA. Uses soap and warm water to wash the vulva and perineum.nB. Washes from symphysis pubis back to the episiotomy.nC. Changes her perineal pad every 2 to 3 hours.nD. Uses the peribottle to rinse upward into her vagina.
answer
d
question
On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:nA. Begin an IV infusion of Ringer's lactate solution.nB. Assess the woman's vital signs.nC. Call the woman's primary health care provider.nD. Massage the woman's fundus.
answer
d
question
Excessive blood loss after childbirth can have several causes; however, the most common is:nA. Vaginal or vulvar hematomas.nB. Unrepaired lacerations of the vagina or cervix.nC. Failure of the uterine muscle to contract firmly. nD. Retained placental fragments.
answer
c
question
Baby-friendly hospitals mandate that infants be put to breast within the first _______ after birth.nA. 1 hour nB. 30 minutesnC. 2 hoursnD. 4 hours
answer
1
question
Which finding would be a source of concern if noted during the assessment of a woman at 12 hours postpartum?nA. Postural hypotensionnB. Temperature of 38° CnC. Bradycardia—pulse rate of 55 beats/minnD. Pain in left calf with dorsiflexion of left foot
answer
d
question
The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action is to:nA. Place her on a bedpan to empty her bladdernB. Massage her fundus nC. Call the physiciannD. Administer methylergonovine (Methergine), 0.2 mg IM, which has been ordered prn
answer
b
question
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse suspects:nA. Bladder distentionnB. Uterine atonynC. ConstipationnD. Hematoma formation
answer
d
question
Nurses are getting ready for bedside reporting at change of shift. A benefit of this type of change of shift report is that:nA. Information is transparent so that the nurses and patients are aware of all pertinent data and delivery of care aspects.nB. Patients can ask questions of the nurses during change of shift report so that they can better direct the delivery of their health care.nC. Nurses are able to visualize their patient's directly at the time of report leading to better patient satisfaction. nD. There is no need for additional information to be exchanged as the patient is right there to answer questions and voice concerns.
answer
c
question
Which test result would provide evidence of fetal blood in maternal circulation?nA. Positive Fern test resultnB. Positive Coombs test resultnC. Positive Kleihauer-Betke test result nD. Negative Coombs test result
answer
c
question
The nurse is observing a postpartum patient who has been bleeding excessively during the first hour, saturating multiple pads. Which interventions would the nurse anticipate that the physician would order? (Select all that apply.)nA. Document findings in the health care recordnB. Decrease flow rate for intravenous fluid administrationnC. Administer oxygen via nonrebreather mask @ 10 L/minute nD. Insert a secondary intravenous line access nE. Type & screen for 2 units of blood
answer
c,d
question
The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?nA. Talks and coos to her sonnB. Seldom makes eye contact with her sonnC. Cuddles her son close to hernD. Tells visitors how well her son is feeding
answer
b
question
The process in which the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics is called:nA. Mutuality. nB. Bonding.nC. Claiming.nD. Acquaintance.
answer
a
question
In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which of the following is a facilitating behavior?nA. The parents have difficulty naming the infant.nB. The parents hover around the infant, directing attention to and pointing at the infant. nC. The parents make no effort to interpret the actions or needs of the infant.nD. The parents do not move from fingertip touch to palmar contact and holding
answer
b
question
Which statement is inaccurate with regard to a nurse working with parents who have a sensory impairment?nA. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals.nB. Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact.nC. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities.nD. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information.
answer
b
question
Health care providers demonstrate a variety of reactions to lesbian couples, including failure to acknowledge the "other mother's" role in pregnancy, birth, and parenting. Integration of the nonchildbearing partner into care includes offering the same opportunities afforded male partners of heterosexual women. Which opportunity could not be provided to male partners?nA. Labor supportnB. Cutting the cordnC. Rooming-in during hospitalizationnD. Breastfeeding the infant
answer
d
question
While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically:nA. Express a strong need to review the events and her behavior during the process of labor and birth.nB. Exhibit a reduced attention span, limiting readiness to learn.nC. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn.nD. Have reestablished her role as a spouse or partner.
answer
c
question
Parents can facilitate the adjustment of their other children to a new baby by:nA. Having children at home choose or make a gift to give the new baby on his or her arrival home. nB. Emphasizing activities that keep the new baby and other children together.nC. Having the mother carry the new baby into the home so she can show the other children the baby.nD. Reducing stress on the other children by limiting their involvement and care of the new baby.
answer
a
question
The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about a half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?nA. PPD symptoms are consistently severe.nB. This syndrome affects only new mothers.nC. PPD can easily go undetected. nD. Only mental health professionals should teach new parents about this condition.
answer
c
question
Which statement accurately reflects the La cuarentena ritual for a Hispanic patient?nA. No restrictions are placed on the mother during this ritual period.nB. This ritual occurs over a period of 40 days. nC. Spicy foods are encouraged as part of the maternal diet.nD. The ritual is limited to preparing the woman to become a good mother
answer
b
question
Which behaviors would be exhibited during the letting-go phase of maternal role adaptation? (Select all that apply.)nA. Emergence of family unit nB. Dependent behaviorsnC. Sexual intimacy relationship continuingnD. Defining one's individual roles nE. Being talkative and excited about becoming a mother
answer
a,c,d
1 of 115
question
A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate?nA. "We don't really know when such defects occur."nB. "It depends on what caused the defect."nC. "They occur between the third and fifth weeks of development."nD. "They usually occur in the first 2 weeks of development."
answer
c
question
A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate?nA. "Many women imagine what their baby is like."nB. "A baby in utero does respond to the mother's voice."nC. "You'll need to ask the doctor if the baby can hear yet."nD. "Thinking that your baby hears will help you bond with the baby."
answer
b
question
A maternity nurse should be aware of which fact about the amniotic fluid?nA. It serves as a source of oral fluid and as a repository for waste from the fetus.nB. The volume remains about the same throughout the term of a healthy pregnancy.nC. A volume of less than 300 ml is associated with gastrointestinal malformations.nD. A volume of more than 2 L is associated with fetal renal abnormalities
answer
a
question
Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that:nA. Rates of twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing.nB. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins.nC. Identical twins are more common in Caucasian families.nD. Fraternal twins are same gender, usually male.
answer
a
question
The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping:nA. In a side-lying position.nB. On her back with a pillow under her knees.nC. With the head of the bed elevated.nD. On her abdomen.
answer
a
question
A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates that:nA. The fetus is at risk for Down syndrome.nB. The woman is at high risk for developing preterm labor.nC. The lungs are mature.nD. Meconium is present in the amniotic fluid
answer
c
question
Which time span delineates the appropriate length for a normal pregnancy?nA. 9 lunar months, 8.5 calendar months, 39 weeks, 272 daysnB. 10 lunar months, 9 calendar months, 40 weeks, 280 daysnC. 9 calendar months, 10 lunar months, 42 weeks, 294 daysnD. 9 calendar months, 38 weeks, 266 days
answer
b
question
A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination?nA. Fetus is in a breech positionnB. FHR baseline is within normal rangenC. Fetus with possible renal problemsnD. Increased fundal height
answer
c
question
Which developmental finding is accurate with regard to fetal growth?nA. Heart starts beating at 12 weeks.nB. Lungs take shape by 8 weeks.nC. Brain configuration is complete by 8 weeks.nD. Main blood vessels form by 8 weeks
answer
d
question
In reviewing the history of a woman who wants to become pregnant, which medication profile would indicate a potential concern relative to toxic exposure? (Select all that apply.)nA. Tylenol OTC occasionally for a headache; twice last weeknB. Anticonvulsant for seizure disordernC. Lithium for bipolar disordernD. Coumadin for atrial fibrillationnE. Multivitamins once a day
answer
b,c,d
question
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity according to the GTPAL system?nA. 2-0-0-1-1nB. 2-1-0-1-0nC. 3-1-0-1-0nD. 3-0-1-1-0
answer
c
question
Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?nA. RadioimmunoassaynB. Radioreceptor assaynC. Latex agglutination testnD. Enzyme-linked immunosorbent assay (ELISA)
answer
d
question
A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:nA. A positive pregnancy test result.nB. Fetal movement palpated by the nurse-midwife.nC. Braxton Hicks contractions.nD. Quickening.
answer
b
question
During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:nA. Hegar sign.nB. McDonald sign.nC. Chadwick sign.nD. Goodell sign.
answer
a
question
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?nA. Less audible heart sounds (S1, S2)nB. Increased pulse ratenC. Increased blood pressurenD. Decreased red blood cell (RBC) production
answer
b
question
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:nA. PrimiparanB. PrimigravidanC. MultiparanD. Nulligravida
answer
a
question
Which presumptive sign (felt by woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause(s)?nA. Amenorrhea—stress, endocrine problemsnB. Quickening—gas, peristalsisnC. Goodell sign—cervical polypsnD. Chadwick sign—pelvic congestion
answer
c
question
In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that:nA. A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.nB. Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.nC. The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.nD. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.
answer
c
question
Which hematocrit (HCT) and hemoglobin (HGB) results represent the lowest acceptable values for a woman in the third trimester of pregnancy?nA. 38% HCT; 14 g/dL HGBnB. 35% HCT; 13 g/dL HGBnC. 33% HCT; 11 g/dL HGBnD. 32% HCT; 10.5 g/dL HGB
answer
c
question
A pregnant patient is experiencing some integumentary changes and is concerned that they may represent abnormal findings. The nurse provides information to the patient that the following findings would be considered "normal abnormal" findings during pregnancy so that she should not be alarmed. (Select all that apply.)nA. Facial edemanB. MelasmanC. Linea nigranD. Superficial thrombophlebitisnE. Vascular spidersnF. Allodynia
answer
b,c,e
question
A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should tell her:nA. "You don't need to modify your exercising any time during your pregnancy."nB. "Stop exercising, because it will harm the fetus."nC. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."nD. "Jogging is too hard on your joints; switch to walking now."
answer
c
question
A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be:nA. ConstipationnB. Alteration in the pattern of fetal movementnC. Heart palpitationsnD. Edema in the ankles and feet at the end of the day
answer
b
question
A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know whether it is safe for her to have a drink with dinner now. The nurse tells her:nA. "Because you're in your second trimester, there's no problem with having one drink with dinner."nB. "One drink every night is too much. One drink three times a week should be fine."nC. "Because you're in your second trimester, you can drink as much as you like."nD. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."
answer
d
question
Which behavior indicates that a woman is "seeking safe passage" for herself and her infant?nA. She keeps all prenatal appointments.nB. She "eats for two."nC. She drives her car slowly.nD. She wears only low-heeled shoes.
answer
a
question
What type of cultural concern is the most likely deterrent to many women seeking prenatal care?nA. ReligionnB. ModestynC. IgnorancenD. Belief that physicians are evil
answer
b
question
In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that:nA. Nonacceptance of the pregnancy very often equates to rejection of the child.nB. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes.nC. Ambivalent feelings during pregnancy are usually seen only in emotionally immature or very young mothers.nD. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth.
answer
b
question
With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:nA. The father goes through three phases of acceptance of his own.nB. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth.nC. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home.nD. Typically men remain ambivalent about fatherhood right up to the birth of their child.
answer
a
question
With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that during pregnancy:nA. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.nB. The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester.nC. Killed-virus vaccines (e.g., tetanus) should not be given, but live-virus vaccines (e.g., measles) are permissible.nD. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.
answer
a
question
Which statement about multifetal pregnancy is not accurate?nA. The expectant mother often experiences anemia because the fetuses have a greater demand for iron.nB. Twin pregnancies come to term with the same frequency as single pregnancies.nC. The mother should be counseled to increase her nutritional intake and gain more weight.nD. Backache and varicose veins are often more pronounced.
answer
b
question
The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that:nA. She will have to give birth at home.nB. She must see an obstetrician as well as the midwife during pregnancy.nC. She will not be able to have epidural analgesia for labor pain.nD. She must be having a low-risk pregnancy.
answer
d
question
An expectant couple asks the nurse about intercourse during pregnancy and whether it is safe for the baby. The nurse should tell the couple that:nA. Intercourse should be avoided if any spotting from the vagina occurs afterward.nB. Intercourse is safe until the third trimester.nC. Safer-sex practices should be used once the membranes rupture.nD. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.
answer
d
question
A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she:nA. Wiggles and points her toes during the cramp.nB. Applies cold compresses to the affected leg.nC. Extends her leg and dorsiflexes her foot during the cramp.nD. Avoids weight bearing on the affected leg during the cramp.
answer
c
question
An expectant father confides in the nurse that his pregnant wife, at 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's best response is:nA. "This is normal behavior and should begin to subside by the second trimester."nB. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor I know."nC. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant."nD. "You seem impatient with her. Perhaps this is precipitating her behavior."
answer
c
question
Which suggestion about weight gain is not an accurate recommendation?nA. Underweight women should gain 12.5 to 18 kg.nB. Obese women should gain at least 7 kg.nC. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale.nD. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.
answer
d
question
A pregnant woman experiencing nausea and vomiting should:nA. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.nB. Eat small, frequent meals (every 2 to 3 hours).nC. Increase her intake of high-fat foods to keep the stomach full and coated.nD. Limit fluid intake throughout the day.
answer
b
question
A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important?nA. Several glasses of fluidnB. Extra protein sources, such as peanut butternC. Salty foods to replace lost sodiumnD. Easily digested sources of carbohydrate
answer
a
question
Women with inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:nA. Spina bifida.nB. Intrauterine growth restriction.nC. Diabetes mellitus.nD. Down syndrome
answer
b
question
Which minerals and vitamins are usually recommended to supplement a pregnant woman's diet?nA. Fat-soluble vitamins A and DnB. Water-soluble vitamins C and B6nC. Iron and folatenD. Calcium and zinc
answer
c
question
With regard to nutritional needs during lactation, a maternity nurse should be aware that:nA. The mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy.nB. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.nC. Critical iron and folic acid levels must be maintained.nD. Lactating women can go back to their prepregnant calorie intake
answer
b
question
When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:nA. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.nB. Iron absorption is inhibited by a diet rich in vitamin C.nC. Iron supplements are permissible for children in small doses.nD. Constipation is common with iron supplements.
answer
d
question
A 22-year-old woman pregnant with a single fetus had a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this finding?nA. This weight gain indicates possible gestational hypertension.nB. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).nC. This weight gain cannot be evaluated until the woman has been observed for several more weeks.nD. The woman's weight gain is appropriate for this stage of pregnancy.
answer
d
question
With regard to protein in the diet of pregnant women, nurses should be aware that:nA. Many protein-rich foods are also good sources of calcium, iron, and B vitamins.nB. Many women need to increase their protein intake during pregnancy.nC. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.nD. High-protein supplements can be used without risk by women on macrobiotic diets
answer
a
question
Which findings could be considered to be a barrier to a pregnant woman seeking prenatal care? (Select all that apply.)nA. Patient would prefer to be cared for by a midwife instead of a physician.nB. Economic cost of health care.nC. Patient's cultural beliefs do not include prenatal care as being valued.nD. Patient speaks several languages.nE. Patient had a bad experience the last time she went to a doctor for care.
answer
b,c,e
question
With regard to primary and secondary powers, the maternity nurse should understand that:nA. Primary powers are responsible for effacement and dilation of the cervix. nB. Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnancies.nC. Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation.nD. Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs.
answer
a
question
Which sign does not precede the onset of labor?nA. A return of urinary frequency as a result of increased bladder pressurenB. Persistent low backache from relaxed pelvic jointsnC. Stronger and more frequent uterine (Braxton Hicks) contractionsnD. A decline in energy, as the body stores up for labor
answer
d
question
In order to accurately assess the health of the mother accurately during labor, the nurse should be aware that:nA. The woman's blood pressure increases during contractions and falls back to prelabor normal between contractions.nB. Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia.nC. Having the woman point her toes reduces leg cramps.nD. The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation.
answer
d
question
The nurse knows that the second stage of labor, the descent phase, has begun when:nA. The amniotic membranes rupture.nB. The cervix cannot be felt during a vaginal examination. nC. The woman experiences a strong urge to bear down.nD. The presenting part is below the ischial spines
answer
b
question
Which statement is inaccurate with regard to normal labor?nA. A single fetus presents by vertex.nB. It is completed within 8 hours. nC. A regular progression of contractions, effacement, dilation, and descent occurs.nD. No complications are involved.
answer
b
question
Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?nA. Latent: mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hoursnB. Active: moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hoursnC. Lull: no contractions; dilation stable; duration of 20 to 60 minutesnD. Transition: very strong but irregular contractions; 8 to 10 cm dilation; duration of 1 to 2 hours
answer
b
question
Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased?nA. SemirecumbentnB. SittingnC. SquattingnD. Side-lying
answer
c
question
Fetal circulation can be affected by many factors during labor. Accurate assessment of the laboring woman and fetus requires knowledge of these expected adaptations. Which factor will not affect fetal circulation during labor?nA. Fetal position nB. Uterine contractionsnC. Blood pressurenD. Umbilical cord blood flow
answer
a
question
Concerning the third stage of labor, nurses should be aware that:nA. The placenta eventually detaches itself from a flaccid uterus.nB. The duration of the third stage may be as short as 3 to 5 minutes. nC. It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surface.nD. The major risk for women during the third stage is a rapid heart rate.
answer
b
question
Which of the following findings would be a cause for concern for a nurse who is monitoring an obstetric patient who is in early labor? (Select all that apply.)nA. Biparietal diameter of less than 9.25 cm nB. Vertex presenting partnC. Transverse lie nD. General flexion attitudenE. Android pelvis
answer
a,c,e
question
1. A woman in active labor receives an opioid agonist analgesic. Which medication relieves severe, persistent, or recurrent pain, creates a sense of well-being, overcomes inhibitory factors, and may even relax the cervix but should be used cautiously in women with cardiac disease?nA. Meperidine (Demerol) nB. Promethazine (Phenergan)nC. Butorphanol tartrate (Stadol)nD. Nalbuphine (Nubain
answer
a
question
A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:nA. Notify the woman's physician.nB. Tell the woman to slow the pace of her breathing.nC. Administer oxygen via a mask or nasal cannula.nD. Help her breathe into a paper bag. Correct
answer
d
question
A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure is to use:nA. Counterpressure against the sacrum. nB. Pant-blow (breaths and puffs) breathing techniques.nC. Effleurage.nD. Biofeedback.
answer
a
question
Nurses should be aware of the difference that experience can make in labor pain, such as:nA. Sensory pain for nulliparous women often is greater than for multiparous women during early labor. nB. Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor.nC. Women with a history of substance abuse experience more pain during labor.nD. Multiparous women have more fatigue from labor and therefore experience more pain.
answer
a
question
In the current practice of childbirth preparation, emphasis is placed on:nA. The Dick-Read (natural) childbirth method.nB. The Lamaze (psychoprophylactic) method.nC. The Bradley (husband-coached) method.nD. Encouraging expectant parents to attend childbirth preparation in any or no specific method.
answer
d
question
With regard to breathing techniques during labor, maternity nurses should be aware that:nA. Breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction. nB. By the time labor has begun, it is too late for instruction in breathing and relaxation.nC. Controlled breathing techniques are most difficult near the end of the second stage of labor.nD. The patterned-paced breathing technique can help prevent hyperventilation.
answer
a
question
With regard to what might be called the tactile approaches to comfort management, nurses should be aware that:nA. Either hot or cold applications may provide relief, but they should never be used together in the same treatment.nB. Acupuncture can be performed by a skilled nurse with just a little training.nC. Hand and foot massage may be especially relaxing in advanced labor, when a woman's tolerance for touch is limited. nD. Therapeutic touch (TT) uses handheld electronic stimulators that produce sympathetic vibrations.
answer
c
question
With regard to systemic analgesics administered during labor, nurses should be aware that:nA. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier.nB. Effects on the fetus and newborn can include decreased alertness and delayed sucking. nC. IM administration is preferred over IV administration.nD. IV patient-controlled analgesia (PCA) results in increased use of an analgesic.
answer
b
question
With regard to spinal and epidural (block) anesthesia, nurses should know that:nA. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births.nB. A high incidence of postbirth headache is seen with spinal blocks. nC. Epidural blocks allow the woman to move freely.nD. Spinal and epidural blocks are never used together.
answer
b
question
After change of shift report, the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks, and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is:nA. VisceralnB. Referred nC. SomaticnD. Afterpain
answer
b
question
Fetal bradycardia is most common during:nA. Maternal hyperthyroidism.nB. Fetal anemia.nC. Viral infection. nD. Tocolytic treatment using ritodrine.
answer
c
question
The nurse providing care for the laboring woman understands that accelerations with fetal movement:nA. Are reassuring. nB. Are caused by umbilical cord compression.nC. Warrant close observation.nD. Are caused by uteroplacental insufficiency
answer
a
question
The most common cause of decreased variability in the FHR that lasts 30 minutes or less is:nA. Altered cerebral blood flow.nB. Fetal hypoxemia.nC. Umbilical cord compression.nD. Fetal sleep cycles.
answer
d
question
You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase IV fluid, and perform a vaginal exam. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should you take?nA. Call for help.nB. Insert a Foley catheter.nC. Start oxytocin (Pitocin).nD. Notify the primary health care provider immediately.
answer
d
question
When using intermittent auscultation (IA) to assess uterine activity, nurses should be aware that:nA. The examiner's hand should be placed over the fundus before, during, and after contractions. nB. The frequency and duration of contractions are measured in seconds for consistency.nC. Contraction intensity is given a judgment number of 1 to 7 by the nurse and client together.nD. The resting tone between contractions is described as either placid or turbulent.
answer
a
question
A nurse caring for a woman in labor understands that increased variability of the fetal heart rate might be caused by:nA. Narcotics.nB. Barbiturates.nC. Methamphetamines. nD. Tranquilizers
answer
c
question
Which of the following statements is not used to describe a characteristic of a uterine contraction?nA. Frequency (how often contractions occur)nB. Intensity (the strength of the contraction at its peak)nC. Resting tone (the tension in the uterine muscle)nD. Appearance (shape and height)
answer
d
question
The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by:nA. Change in position. nB. Oxytocin administration.nC. Regional anesthesia.nD. Intravenous analgesic.
answer
a
question
Fetal well-being during labor is assessed by:nA. The response of the fetal heart rate (FHR) to uterine contractions (UCs).nB. Maternal pain control.nC. Accelerations in the FHR.nD. An FHR greater than 110 beats/min
answer
a
question
A group of fetal monitoring experts (National Institute of Child Health and Human Development, 2008) recommends that fetal heart rate (FHR) tracings demonstrate certain characteristics to be described as reassuring or normal (category I). These characteristics include:nA. Bradycardia not accompanied by baseline variability.nB. Early decelerations, either present or absent. nC. Sinusoidal pattern.nD. Tachycardia.
answer
b
question
A nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates her understanding of the instructions when the woman states:nA. "True labor contractions will subside when I walk around."nB. "True labor contractions will cause discomfort over the top of my uterus."nC. "True labor contractions will continue and get stronger even if I relax and take a shower." nD. "True labor contractions will remain irregular but become stronger."
answer
c
question
Under which circumstance would a nurse not perform a vaginal examination on a patient in labor?nA. An admission to the hospital at the start of labornB. When accelerations of the fetal heart rate (FHR) are noted nC. On maternal perception of perineal pressure or the urge to bear downnD. When membranes rupture
answer
b
question
When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include:nA. Encouraging the woman to try various upright positions, including squatting and standing. nB. Telling the woman to start pushing as soon as her cervix is fully dilated.nC. Continuing an epidural anesthetic so that pain is reduced and the woman can relax.nD. Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing-down efforts with each contraction.
answer
a
question
Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period?nA. The healthy newborn should be taken to the nursery for a complete assessment.nB. After drying, the infant should be given to the mother wrapped in a receiving blanket.nC. Skin-to-skin contact of mother and baby should be encouraged. nD. The father or support person should be encouraged to hold the infant while awaiting delivery of the placenta.
answer
c
question
Which description of the phases of the second stage of labor is accurate?nA. Latent phase: feels sleepy, fetal station is 2+ to 4+, duration is 30 to 45 minutesnB. Active phase: overwhelmingly strong contractions, Ferguson reflux activated, duration is 5 to 15 minutesnC. Descent phase: significant increase in contractions, Ferguson reflux activated, average duration varies nD. Transitional phase: woman "laboring down," fetal station is 0, duration is 15 minutes
answer
c
question
When performing vaginal examinations on a laboring woman, the nurse should be guided by what principle?nA. Cleanse the vulva and perineum before and after the examination as needed. nB. Wear a clean glove lubricated with tap water to reduce discomfort.nC. Perform the examination every hour during the active phase of the first stage of labor.nD. Perform an examination immediately if active bleeding is present.
answer
a
question
Which test is performed to determine whether membranes are ruptured?nA. Urine analysisnB. Fern test nC. Leopold maneuversnD. AROM
answer
b
question
When assessing a multiparous woman who has just given birth to an 8-pound boy, the nurse notes that the woman's fundus is firm and has become globular. A gush of dark red blood comes from her vagina. The nurse concludes that:nA. The placenta has separated. nB. A cervical tear occurred during the birth.nC. The woman is beginning to hemorrhage.nD. Clots have formed in the upper uterine segment
answer
a
question
A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is:nA. "Don't worry about it. You'll do fine."nB. "It's normal to be anxious about labor. Let's discuss what makes you afraid." nC. "Labor is scary to think about, but the actual experience isn't."nD. "You may have an epidural. You won't feel anything."
answer
b
question
Which of the following would not be included in a labor nurse's plan of care for an expectant mother?nA. The onset of progressive, regular contractionsnB. The bloody, or pink, shownC. The spontaneous rupture of membranesnD. Formulation of the woman's plan of care for labor
answer
d
question
If a woman complains of back labor pain, the nurse might best suggest that she:nA. Lie on her back for a while with her knees bent.nB. Do less walking around.nC. Take some deep, cleansing breaths.nD. Lean over a birth ball with her knees on the floor.
answer
d
question
In a variation of rooming-in called couplet care, the mother and infant share a room and the mother shares the care of the infant with:nA. The father of the infant.nB. Her mother (the infant's grandmother).nC. Her eldest daughter (the infant's sister).nD. The nurse.
answer
d
question
The breasts of a woman who is bottle feeding her baby are engorged. The nurse should instruct her to:nA. Wear a snug, supportive bra. nB. Allow warm water to soothe the breasts during a shower.nC. Express milk from breasts occasionally to relieve discomfort.nD. Place absorbent pads with plastic liners into her bra to absorb leakage
answer
a
question
A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious likely consequence of bladder distention is:nA. Urinary tract infection.nB. Excessive uterine bleeding. nC. A ruptured bladder.nD. Bladder wall atony.
answer
b
question
What statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth?nA. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter."nB. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." nC. "I will not have a menstrual cycle for 6 months after childbirth."nD. "My first menstrual cycle will be heavier than normal and then will be light for several months after."
answer
b
question
With regard to afterbirth pains, nurses should be aware that these pains are:nA. Caused by mild, continual contractions for the duration of the postpartum period.nB. More common in first-time mothers.nC. More noticeable in births in which the uterus was overdistended. nD. Alleviated somewhat when the mother breastfeeds
answer
c
question
Postbirth uterine/vaginal discharge, called lochia:nA. Is similar to a light menstrual period for the first 6 to 12 hours.nB. Is usually greater after cesarean births.nC. Will usually decrease with ambulation and breastfeeding.nD. Should smell like normal menstrual flow unless an infection is present.
answer
d
question
Which description of postpartum restoration or healing times is accurate?nA. The cervix shortens, becomes firm, and returns to form within a month postpartum.nB. Rugae reappear within 3 to 4 weeks.nC. Most episiotomies heal within a week.nD. Hemorrhoids usually decrease in size within 2 weeks of childbirth.
answer
b
question
With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that:nA. Kidney function returns to normal a few days after birth.nB. Diastasis recti abdominis is a common condition that alters the voiding reflex.nC. Fluid loss through perspiration and increased urinary output account for a weight loss of more than 2 kg during the puerperium.nD. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth.
answer
c
question
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman 1 day postpartum. An expected finding is:nA. Little if any change. nB. Leakage of milk at let-down.nC. Swollen, warm and tender on palpation.nD. A few blisters and a bruise on each areola.
answer
a
question
Which of the following findings would raise concern for the nurse who is monitoring a postpartum patient who had a spontaneous vaginal delivery (SVD) of a 10-lb baby boy?nA. Lochia rubra with minimal clots expressed on fundal massagenB. Fundus midline and firm with nonpalpable bladdernC. Fundus midline and firm with spurts of bright red blood upon fundal massage nD. Patient report of mild to moderate cramping and request for pain medication
answer
c
question
Which of the following changes are consistent with metabolic function during the postpartum period? (Select all that apply.)nA. Moderate hyperglycemianB. Increased BMR in the immediate postpartum period nC. Secretion of insulinase nD. Mildly increased T3 and T4 levels for the first several weeks postpartumnE. Decrease in estrogen and cortisol levels
answer
b,c,e
question
Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:nA. Uses soap and warm water to wash the vulva and perineum.nB. Washes from symphysis pubis back to the episiotomy.nC. Changes her perineal pad every 2 to 3 hours.nD. Uses the peribottle to rinse upward into her vagina.
answer
d
question
On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:nA. Begin an IV infusion of Ringer's lactate solution.nB. Assess the woman's vital signs.nC. Call the woman's primary health care provider.nD. Massage the woman's fundus.
answer
d
question
Excessive blood loss after childbirth can have several causes; however, the most common is:nA. Vaginal or vulvar hematomas.nB. Unrepaired lacerations of the vagina or cervix.nC. Failure of the uterine muscle to contract firmly. nD. Retained placental fragments.
answer
c
question
Baby-friendly hospitals mandate that infants be put to breast within the first _______ after birth.nA. 1 hour nB. 30 minutesnC. 2 hoursnD. 4 hours
answer
1
question
Which finding would be a source of concern if noted during the assessment of a woman at 12 hours postpartum?nA. Postural hypotensionnB. Temperature of 38° CnC. Bradycardia—pulse rate of 55 beats/minnD. Pain in left calf with dorsiflexion of left foot
answer
d
question
The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action is to:nA. Place her on a bedpan to empty her bladdernB. Massage her fundus nC. Call the physiciannD. Administer methylergonovine (Methergine), 0.2 mg IM, which has been ordered prn
answer
b
question
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse suspects:nA. Bladder distentionnB. Uterine atonynC. ConstipationnD. Hematoma formation
answer
d
question
Nurses are getting ready for bedside reporting at change of shift. A benefit of this type of change of shift report is that:nA. Information is transparent so that the nurses and patients are aware of all pertinent data and delivery of care aspects.nB. Patients can ask questions of the nurses during change of shift report so that they can better direct the delivery of their health care.nC. Nurses are able to visualize their patient's directly at the time of report leading to better patient satisfaction. nD. There is no need for additional information to be exchanged as the patient is right there to answer questions and voice concerns.
answer
c
question
Which test result would provide evidence of fetal blood in maternal circulation?nA. Positive Fern test resultnB. Positive Coombs test resultnC. Positive Kleihauer-Betke test result nD. Negative Coombs test result
answer
c
question
The nurse is observing a postpartum patient who has been bleeding excessively during the first hour, saturating multiple pads. Which interventions would the nurse anticipate that the physician would order? (Select all that apply.)nA. Document findings in the health care recordnB. Decrease flow rate for intravenous fluid administrationnC. Administer oxygen via nonrebreather mask @ 10 L/minute nD. Insert a secondary intravenous line access nE. Type & screen for 2 units of blood
answer
c,d
question
The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?nA. Talks and coos to her sonnB. Seldom makes eye contact with her sonnC. Cuddles her son close to hernD. Tells visitors how well her son is feeding
answer
b
question
The process in which the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics is called:nA. Mutuality. nB. Bonding.nC. Claiming.nD. Acquaintance.
answer
a
question
In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which of the following is a facilitating behavior?nA. The parents have difficulty naming the infant.nB. The parents hover around the infant, directing attention to and pointing at the infant. nC. The parents make no effort to interpret the actions or needs of the infant.nD. The parents do not move from fingertip touch to palmar contact and holding
answer
b
question
Which statement is inaccurate with regard to a nurse working with parents who have a sensory impairment?nA. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals.nB. Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact.nC. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities.nD. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information.
answer
b
question
Health care providers demonstrate a variety of reactions to lesbian couples, including failure to acknowledge the "other mother's" role in pregnancy, birth, and parenting. Integration of the nonchildbearing partner into care includes offering the same opportunities afforded male partners of heterosexual women. Which opportunity could not be provided to male partners?nA. Labor supportnB. Cutting the cordnC. Rooming-in during hospitalizationnD. Breastfeeding the infant
answer
d
question
While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically:nA. Express a strong need to review the events and her behavior during the process of labor and birth.nB. Exhibit a reduced attention span, limiting readiness to learn.nC. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn.nD. Have reestablished her role as a spouse or partner.
answer
c
question
Parents can facilitate the adjustment of their other children to a new baby by:nA. Having children at home choose or make a gift to give the new baby on his or her arrival home. nB. Emphasizing activities that keep the new baby and other children together.nC. Having the mother carry the new baby into the home so she can show the other children the baby.nD. Reducing stress on the other children by limiting their involvement and care of the new baby.
answer
a
question
The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about a half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?nA. PPD symptoms are consistently severe.nB. This syndrome affects only new mothers.nC. PPD can easily go undetected. nD. Only mental health professionals should teach new parents about this condition.
answer
c
question
Which statement accurately reflects the La cuarentena ritual for a Hispanic patient?nA. No restrictions are placed on the mother during this ritual period.nB. This ritual occurs over a period of 40 days. nC. Spicy foods are encouraged as part of the maternal diet.nD. The ritual is limited to preparing the woman to become a good mother
answer
b
question
Which behaviors would be exhibited during the letting-go phase of maternal role adaptation? (Select all that apply.)nA. Emergence of family unit nB. Dependent behaviorsnC. Sexual intimacy relationship continuingnD. Defining one's individual roles nE. Being talkative and excited about becoming a mother
answer
a,c,d