Maternal-Newborn chapter 7 test bank questions and answers latest update 2024, Exams of Nursing

Download Maternal-Newborn chapter 7 test bank questions and answers latest update 2024 and more Exams Nursing in PDF only on Docsity! Maternal-Newborn chapter 7 test bank questions and answers latest update 2024 Which suggestion is most helpful for the pregnant patient who is experiencing heartburn? A: drink plenty of fluids at bedtime B: eat only three meals a day so the stomach is empty between meals C: drink coffee or orange juice immediately on arising in the morning D: use Tums or Rolaids to obtain relief, as directed by the health care provider. - Correct Answer D: use Tums or Rolaids to obtain relief, as directed by the health care provider Antacids high in calcium (e.g., Tums, Rolaids) can provide temporary relief. Fluids overstretch the stomach and may precipitate reflux when lying down. Instruct the patient to eat five or six small meals per day rather than three full meals. Coffee and orange juice stimulate acid formation in the stomach and may need to be eliminated from the diet. What is the rationale for a woman in her first trimester of pregnancy to expect to visit her health care provider every 4 weeks? A: problems can be eliminated B: she develops trust in the health care team C: her questions about labor can be answered D: the conditions of the expectant mother and fetus can be monitored - Correct Answer D: the conditions of the expectant mother and fetus can be monitored This routine allows for monitoring maternal health and fetal growth and ensures that problems will be identified early. All problems cannot be eliminated because of prenatal visits; however, they can be identified early. Developing a trusting relationship should be established during these visits, but that is not the primary reason. Most women do not have questions concerning labor until the last trimester of the pregnancy. Which advice to the patient is one of the most effective methods for preventing venous stasis? A: sit with the legs crossed B: rest often with the feet elevated C: sleep with the foot of the bed elevated D: wear elastic stockings in the afternoon - Correct Answer B: rest often with the feet elevated Elevating the feet and legs improves venous return and prevents venous stasis. Sitting with the legs crossed will decrease circulation in the legs and increase venous stasis. Elevating the legs at night may cause pressure on the diaphragm and increase breathing problems. Elastic stockings should be applied before lowering the legs in the morning. What is the gravid and para for a patient who delivered triplets 2 years ago and is now pregnant again? A: 2,3 B: 1,2 C: 2,1 D: 1,3 - Correct Answer C: 2,1 She has had two pregnancies (gravida 2); para refers to the outcome of the pregnancy rather than the number of infants from that pregnancy. She is pregnant now, so that would make her a gravida 2. She is para 1 because she had one pregnancy that progressed to the age of viability. A patient, gravida 2, para 1, comes for a prenatal visit at 20 weeks of gestation. Her funds is palpated 3 cm below the umbilicus. This finding is: A: appropriate for gestational age B: a sign of impending complications C: lower than normal for gestational age D: higher than normal for gestational age - Correct Answer C: lower than normal for gestational age By 20 weeks, the fundus should reach the umbilicus. The fundus should be at the umbilicus at 20 weeks, so 3 cm below the umbilicus is an inappropriate height and needs further assessment. This is lower than expected at this date. It may be a complication, but it may also be because of incorrect dating of the pregnancy. Which complaint made by a patient at 35 weeks of gestation requires additional assessment? A: abdominal pain B: ankle edema in the afternoon C: backache with prolonged standing D: shortness of breath when climbing stairs - Correct Answer A: abdominal pain Abdominal pain at 35 weeks gestation may indicate preeclampsia, or abruptio placentae. Ankle edema in the afternoon is a normal finding at this stage of the pregnancy. Backaches while standing is a normal finding in the later stages of pregnancy. Shortness of breath is an expected finding at 35 weeks. and Chadwick'ssigns should be present and are considered a normal finding. Increased vaginal secretions are normal during pregnancy as a result of increased vascularity. Determine the obstetric history of a patient in her fifth pregnancy who had two spontaneous abortions in the first trimester, one infant at 32 weeks' gestation, and one infant at 38 weeks' gestation. A: G5 T1 P2 A2 L 2 B: G5 T1 P1 A1 L2 C: G5 T0 P2 A2 L2 D: G5 T1 P1 A2 L2 - Correct Answer D: G5 T1 P1 A2 L2 This patient is in her fifth pregnancy, which is G5, she had one viable term infant (between 38 and 42 weeks' gestation), which is T1, she had one viable preterm infant (between 20 and 37 weeks' gestation), which is P1, two spontaneous abortions (before 20 weeks' gestation), which is A2, and she has two living children, which is L2. Use Nägele's rule to determine the EDD (estimated day of delivery) for a patient whose last menstrual period start on April 12. A: February 19 B: January 19 C: January 21 D: February 7 - Correct Answer B: January 19 Nägele's rule subtracts 3 months from the month of the last menstrual period (month 4 - 3 = January) and adds 7 days to the day that the last menstrual period started (April 12 + 7 days = April 19), so the Correct Answer is January 19 of the following calendar year. Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy? A: sexual intercourse 2-3 times weekly B: moderate exercise for 30 minutes daily C: working 40 hours a week as a secretary in a travel agency D: relaxing in a hot tub for 30 minutes a day, several days a week - Correct Answer D: relaxing in a hot tub for 30 minutes a day, several days a week Pregnant women should avoid activities that might cause hyperthermia. Maternal hyperthermia, particularly during the first trimester, may be associated with fetal anomalies. She should not be in a hot tub for more than 10 minutes at less than 100F. Sexual intercourse is generally safe for the healthy pregnant woman; moderate exercise during pregnancy can strengthen muscles, reduce backache and stress, and provide a feeling of well-being; working during pregnancy is acceptable as long as the woman is not continually on her feet or exposed to environmental toxins and industrial hazards. A patient who comes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition? A: congenital anomalies B: death before or after birth C: neonatal hypoglycemia D: neonatal withdrawal syndrome - Correct Answer B: death before or after birth Smoking during pregnancy increases the risk for spontaneous abortion, low birth weight, abruptio placentae, placenta previa, preterm birth, perinatal mortality, and SIDS. Smoking does not appear to cause congenital anomalies, hypoglycemia, or withdrawal syndrome. A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action? A: a therapeutic abortion will need to be scheduled since fetal damage is inevitable B: hormonal analysis will be done to determine the underlying cause of the false-positive test result C: the IUD will need to be removed to avoid complications such as miscarriage or infection D: the IUD will need to remain in place to avoid injuring the fetus - Correct Answer C: the IUD will need to be removed to avoid complications such as miscarriage or infection Pregnancy with an IUD in place is unusual; however, it can occur and cause complications such as spontaneous abortion and infection. A therapeutic abortion is not indicated unless infection occurs. The health care provider reports that the primigravida's funds can be palpated at the umbilicus. Which priority questions will the nurse include in the patient's assessment? A: "have you noticed that it is easier for you to breath now" B: "would you like to hear the baby's heartbeat for the first time" C: "have you felt a fluttering sensation in your lower pelvic area yet" D: "have you recently developed any unusual cravings, such as for chalk or dirt" - Correct Answer C: "have you felt a fluttering sensation in your lower pelvic area yet" Quickening is the first maternal sensation of fetal movement and is often described as a fluttering sensation. Quickening is detected at approximately 20 weeks in the primigravida and as early as 16 weeks in the multigravida. The fundus is at the umbilicus at 20 weeks' gestation. Lightening is associated with descent of the fetal head into the maternal pelvis and is associated with improved lung expansion. Lightening occurs approximately 2 weeks before birth in the primipara. Fetal heart tones can be detected by Doppler as early as 9 to 12 weeks of gestation. Pica is the craving for nonnutritive substances such as chalk, dirt, clay, or sand. It can develop at any time during pregnancy. It can be associated with malnutrition and the health care provider should monitor the patient's hematocrit and hemoglobin, zinc, and iron levels. The nurse is scheduling the next appointment for a healthy primigravida currently at 28 weeks gestation. When will the nurse schedule the next prenatal visit? A: 1 week B: 2 weeks C: 3 weeks D: 4 weeks - Correct Answer B: 2 weeks From 29-36 weeks, routine prenatal assessment is every 2 weeks. If the pregnancy is high risk, the patient will see the health care provider more frequently. Which information is covered by early pregnancy classes offered in the first and second trimesters? A: methods of pain relief B: the phases and stages of labor C: coping with common discomforts of pregnancy D: rebirth and post birth care of a patient having a cesarean birth - Correct Answer C: coping with common discomforts of pregnancy Early pregnancy classes focus on the first two trimesters and cover information on adapting to pregnancy, dealing with early discomforts, and understanding what to expect in the months ahead. Methods of pain relief are discussed in a childbirth preparation class. The phases and stages of labor are usually covered in a childbirth preparation class. Cesarean birth preparation classes discuss prebirth and postbirth of a patient having a cesarean birth. Which is the method of childbirth that helps prevent the fear-tension-pain-cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor? A: Bradley B: Lamaze C: Leboyer D: Dick-Read - Correct Answer D: Dick-Read The Dick-Read method helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor. The Lamaze method involves concentration and conditioning to help the woman respond to contractions with relaxation to decrease pain. Viewing childbirth as a traumatic experience, the Leboyer method uses decreased light and noise to help the newborn adapt to extrauterine life more easily. The Bradley method teaches women to use abdominal muscles to increase relaxation and breath control; it emphasizes avoidance of all medications and interventions. Which type of cutaneous stimulation involves massage of the abdomen? Women learn exercises to help them recognize and release tension. The labor partner assists the woman by providing feedback during exercise sessions and labor. A pregnant patient reports that she works in a long-term care setting and is concerned about the impending flu season. She asks about receiving the flu vaccine. As the nurse, you are aware that some immunizations are safe to administer during pregnancy, whereas others are not. Which vaccines could this patient receive? (Select all that apply.) A: tetanus B: varicella C: influenza D: hepatitis A and B E: measles, mumps, rubella (MMR) - Correct Answer A: tetanus C: influenza D: hepatitis A and B Inactivated vaccines such as those for tetanus, hepatitis A, hepatitis B, and influenza are safe to administer to women who have a risk for contracting or developing the disease. Immunizations with live virus vaccines such as, varicella (chickenpox), or smallpox are contraindicated during pregnancy because of the possible teratogenic effects on the fetus. The nurse is planning care for a patient in her first trimester of pregnancy. The patient is experiencing nausea and vomiting. Which interventions should the nurse plan to share with this patient? (Select all that apply.) A: suck on hard candy B: take prenatal vitamins in the morning C: try some herbal tea to relieve the nausea D: drink fluids frequently but separate from meals E: eat crackers or dry cereal before arising in the morning - Correct Answer A: suck on hard candy D: drink fluids frequently but separate from meals E: eat crackers or dry cereal before arising in the morning A patient experiencing nausea and vomiting should be taught to suck on hard candy, drink fluids frequently but separately from meals, and eat crackers, dry toast, or dry cereal before arising in the morning. Prenatal vitamins should be taken at bedtime because they may increase nausea if taken in the morning. Before taking herbal tea, the patient should check with her health care provider. Which factors contribute to the presence of edema in the pregnant patient? (Select all that apply.) A: diet consisting of processed foods B: hemoconcentration C: increase in colloid osmotic pressure D: last trimester of pregnancy E: decreased venous return - Correct Answer A: diet consisting of processed foods D: last trimester of pregnancy E: decreased venous return Processed foods, which are high in sodium content, can contribute to edema formation. As the pregnancy progresses, because of the weight of the uterus, compression takes place, leading to decreased venous return and an increase in edema formation. A decrease in colloid osmotic pressure would contribute to edema formation and fluid shifting. Hemodilution would also lead to edema formation. The prenatal nurse educator is teaching couples the technique of applying sacral pressure during labor. Which should be included in the teaching session? (Select all that apply.) A: the technique can be combined with heat to the area B: a jiggling motion should be used while applying the pressure C: tennis balls may be used to apply the pressure to the sacral area D: the pressure against the sacrum should be intermittent during the contraction E: the hand may be moved slowly or remain positioned directly over the sacrum - Correct Answer A: the technique can be combined with heat to the area C: tennis balls may be used to apply the pressure to the sacral area E: the hand may be moved slowly or remain positioned directly over the sacrum Sacral pressure can be combined with thermal stimulation to increase effectiveness. The hand may be moved slowly over the area or remain positioned directly over the sacrum, but pressure should be continuous and firm throughout the contraction. Care should be taken not to jiggle the woman, which may be irritating. A nurse is teaching a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include? (Select all that apply) A: breast tenderness B: urinary frequency C: epistaxis D: dysuria E: epigastric pain - Correct Answer A: breast tenderness B: urinary frequency C: epistaxis Breast tenderness, urinary frequency, and epistaxis are common discomforts that occur during the first trimester of pregnancy.