NUR 2513 MATERNAL CHILD NURSING EXAM 1, Exams of Nursing

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NUR 2513 MATERNAL CHILD

NURSING EXAM 1 2024-2025 WITH

ACTUAL CORRECT QUESTIONS AND

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COLLEGE)

An 18-year-old female presents to the clinic for evaluation of vaginal discomfort. On exam, the client is noted to have several vesicles on erythematous bases on the right inner labial tissue. What testing would the nurse expect to be ordered by the provider for diagnosis of these lesions?

1. Rapid plasma reagin (RPR) for syphilis
2. Nucleic acid amplification test (NAAT) testing for Chlamydia trachomatis/Neisseria gonorrhea (GC/CT)
3. Viral cultures for herpes simplex virus (HSV) Types 1 & 2
4. Urinalysis

-Viral cultures for herpes simplex virus (HSV) Types 1 & 2

Assessing the fetus surfactant level is a primary estimation of fetal maturity. Which statement by the nurse indicates understanding of the action of surfactant on the fetus?

1. Prevents alveoli from collapsing on expiration
2. Increases lung resistance on inspiration
3. Encourages immunologic competence of lung tissue
4. Promotes the maturation of lung alveoli

Prevents alveoli from collapsing on expiration

Because of increased estrogen during pregnancy, what breast changes would the nurse expect to assess in the client?

1. Slack, soft breast tissue
2. Deeply fissured nipples

3. Enlarged lymph nodes
4. Darkened breast areolae

-darkened breast areolae

Frequent urination results from which of the following causes during the third trimester of pregnancy?

1. Pressure on the bladder from the uterus Correct answer
2. Increased concentration of urine
3. Addition of fetal urine to maternal urine
4. Decreased glomerular selectivity

-Pressure on the bladder from the uterus

The nurse caring for a laboring woman notes a variable deceleration of the fetal heart rate on the electronic fetal monitor strip. What is the nurse's priority intervention for this client?

1. Administer oxygen
2. Notify the physician
3. Start an IV fluid bolus
4. Change the maternal position

-change the maternal position

a perinatal nurse is caring for a women who desires an unmedicated birth. which of the following are options for non-pharmacologic methods of pain control in labor?

1. epidural
2. hydrotherapy
3. massage
4. birthball
5. pudendal block
6. breathing pattern

-hydrotherapy -massage -birthball -breathing patterns

a 22 year-old G2PO presents to the labor and delivery unit at 33 weeks gestation and reports of pressure and cramping in her lower back as well as decreased fetal movement. The nurse in labor and delievery triage anticipates orders for which of the following test? (SATA)

1. fetal fibronectin
2. amnicentesis
3. UA
4. nonstress test
5. CMP

-fetal fibronectin -UA -nonstress test

a newly married young women tells the nurse she hopes to become pregnant soon. What should the nurse recommend to this client to support the 2020 national health goals for pregnancy? (SATA)

1. smoking cessation
2. no need to see prenatal provider until fetal movement is noted
3. take 400 mcg of folic acid daily
4. reduce work hours
5. no alcohol intake

-smoking cessation -take 400 mcg of folic acid daily -no alcohol

a 22-year-old G2P0 at 33 weeks gestation is admitted for preterm labor and magnesium sulfate is initiated via IV infusion. Which of the following will the nurse include in her care of this client? (SATA)

1. ensure that the magnesium is infusing via gravity through the main line IV
2. ensure that calcium gluconate is at the bedside
3. assess respirations every hour
4. continuous monitoring for contractions and fetal heart rate
5. assess DTR every hour

-ensure that calcium gluconate is at the bedside -assess respirations every hour -continuous monitoring for contractions and fetal heart rate -assess DTR every hour

the labor nurse assesses the fetal heart rate pattern below immediately following an epidural procedure. in response to her assessment, which of the following actions would be appropriate (SATA)

1. turn the client to her left side
2. admin oxytocin
3. admin oxygen
4. admin an IV fluid bolus

-turn the client to her left side -admin oxygen -admin an IV fluid bolus

the nurse has noticed a change in the type of care to support maternal and child health issues. which of the following type of changes have occurred un health care for maternal and child health? (SATA)

1. increased mobility of families
2. less domestic violence
3. more employed mothers
4. stable home environments
5. more single-parent families

-increased mobility of families -more employed mothers -more single-parent families

the nurse is planning to instruct a client who is 12 weeks pregnant on interventions to stop smoking. what should the nurse include in these instructions (SATA)

1. purchase nicotine chewing gum
2. follow a smoking cessation plan
3. utilize a support system while attempting to stop smoking
4. apply a nicotine patch when the cravings become aware
5. have the client switch to using an vape

-follow a smoking cessation plan -utilize a support system while attempting to stop smoking

the nurse understands that which of the following are important functions of amniotic fluid for fetal well-being (SATA)

1. providing oxygen to the lungs
2. cushioning of the baby from minor trauma
3. temp control
4. nutrition for the baby
5. permits free movement of the baby

-cushioning of the baby from minor trauma

• temp control -permits free movement of the baby

which of the following routine tests would the nurse anticipate the provider to order during the first trimester (SATA)

1. blood type and Rh factor
2. group b strep vaginal culture
3. amniocentesis
4. CBC
5. HIV

-blood type and Rh factor -CBC -HIV

a 26 year-old G1 with a history of oligohydramnios has delivered a small for gestational age (SGA) neonate. The neonatal nurse recognizes the newborn should be evaluated closely for abnormalities of which system?

1. neurologic
2. renal
3. cardiovascular
4. musculoskeletal

-renal

a 28-year-old G1P0 presents to the OB clinic for her prenatal visit. on assessment the nurse notes a body mass index of 32. when discussing expected weight gain during the pregnancy, what is the recommended weight gain for this client?

1. 5-10lbs
2. 11-20lbs
3. 15-25lbs
4. 25-35lbs

-11-20lbs

the nurse includes screening for domestic violence in the first prenatal visit for all patients. What is an appropriate question by the nurse?

1. "this is something that we ask everyone. do you feel safe in your current living environment and relationship?"
2. "this is something we ask everyone. do you have any abuse in your life right now?"
3. "is your partner threatening or harming you in any way right now?"
4. "I need to ask you, do you feel safe from abuse right now?"

-"this is something that we ask everyone. do you feel safe in your current living environment and relationship"

a Rh-negative woman who is 6 weeks gestation plans a medically induced termination. Which outcome should the nurse identify as appropriate for this client?

1. receive Pho(D) immune globulin
2. no need for Pho(D) immune globulin since the amount of fetal blood is so minimal
3. Rho(D) immune globulin will be given if testing of the fetus shows Rh+ blood
4. receive Rho(D) immune globulin if the father of the baby has Rh+ blood

-receive Pho(D) immune globulin

a client has gestational hypertension. what is a potential problem related to this diagnosis?

1. fetal macrosomia
2. decreased sodium levels
3. dependent edema
4. vasoconstriction of blood vessels

-vasoconstriction of blood vessels

a client in the prenatal clinic reports episodes of dizziness when lying on her back. which response by the nurse explains this change during pregnancy?

1. this is due to an increase of blood volume
2. this is due to fluctuations in cardiac output
3. this is due to pressure from the uterus on the diaphragm
4. this is due to the weight of the uterus on the vena cava

-this is due to the weight of the uterus on the vena cava

a client makes an appointment at the prenatal clinic because she thinks she might be pregnant. which assessment is a positive sign of pregnancy?

1. amenorrhea
2. audible fetal heart tones with a doppler
3. N/V
4. a positive pregnancy test

-audible fetal heart tones with doppler

a client with type 1 diabetes in the first trimester of pregnancy is having difficulty keeping blood glucose levels within normal limits. the client explains she has been "eating for two so the baby is healthy". how should the nurse respond to the client?

1. you need to restrict your diet
2. a pregnant women needs to eat about 300 additional cals a day extra to support a growing fetus
3. a pregnant women shouldn't eat for two. you are going to end up having a large baby
4. why would you be eating for 2

-a pregnant women needs to eat about 300 additional calories a day extra to support a growing fetus

a client with hypertension who is receiving intravenous magnesium sulfate therapy has requested an epidural anesthetic. the perinatal nurse should first review the clients CBC results for which of the following?

1. decreased platelet count
2. elevated glucose
3. decreased protein level
4. absence of sodium

-decreased platelet count

a clinical nurse is caring for a client who asks what her estimated date of delivery will be if her last menstrual period started May 4, 2020 which of the following is the appropriate response by the nurse

1. Feb 11, 2021
2. Feb 26, 2021
3. July 1, 2021
4. April 26, 2021

-Feb 11, 2021

a father is preparing a 4-year-old son for the arrival of a new baby. which statement should the nurse suggest the father use to explain this to the child?

1. mother will need to spend a lot of time with the new baby
2. it will be fun to have a sister or brother to give your old toys to
3. the new baby will need your bed se we're buying you a new one
4. a new baby will make our family bigger but not change our love for you

-a new baby will make our family bigger but not change our love for you

a health care provider has recommended that a pregnant client have an amniocentesis. for which genetic condition should the nurse teach the client this diagnostic test will detect?

1. Rh sensitization
2. Trisomy 21 (down syndrome)

3. diabetes mellitus
4. breast cancer

-trisomy 21 (down syndrome)

a nurse is in labor and delivery unit is caring for a client in labor and applies an external fetal monitor. the fetal heart rate is 140 beats/min. Contractions are occurring every 8 min and lasting 30-40 secs in durations. the nurse performs a vaginal exam and finds the cervix is 2 cm dilated. 50% effaced and the fetus is at a -2 station. which of the following stages and phases of labor is this client experiences?

1. first stage, latent phase
2. first stage, active phase
3. first stage, transition phase
4. first stage, emergent phase

-first stage, latent phase

a nurse is caring for a client at 42 weeks gestation who is in active labor. after assessing the client, which of the following findings is the fetus at risk for developing?

1. intrauterine growth restriction
2. hyperglycemia
3. meconium aspiration
4. polyhydramnios

-meconium aspiration

a nursing is caring for a client who is in labor and observes the tracing pictured. the nurse interprets this pattern as indication which of the following?

1. maternal bradycardia
2. umbilical cord compression
3. uteroplacental insufficiency
4. fetal head compression

Uteroplacental insufficiency

A nurse is caring for a primiparous woman who is 7 weeks gestation and asks the nurse when she can expect to experience quickening. How should the nurse respond to this client?

1. this will occur in the last trimester of pregnancy
2. this will occur between the sixteenth to twentieth (16 to 20) weeks of pregnancy.
3. this will occur at the end of the first trimester of pregnancy
4. this will occur when the uterus begins to rise out of the pelvis

-this will occur between the 16-20 weeks of pregnancy

A nurse is caring for the following clients on the obstetrical unit. The nurse recognizes it is safe to administer tocolytic therapy to which of the following clients?

1. a client that is experiencing fetal death at 34 weeks gestation
2. a client who is experiencing preterm labor at 29 weeks gestation
3. a client who is experiencing braxton-hicks contractions at 37 weeks gestation
4. a client who has a post-term pregnancy at 41 weeks gestation

• a client who is experiencing preterm labor at 29 weeks gestation

A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client's newborn at risk for which of the following complications?

1. hearing loss
2. diabetes types 1
3. intrauterine growth restriction
4. congenital heart defects

-intrauterine growth restrictions

A nurse is measuring the fundal height of a client who is at 21 weeks gestation. At which location should the nurse expect to palpate the fundus?

1. 3 cm above the umbilicus
2. slight above the umbilicus
3. 3 cm below the umbilicus
4. halfway between the symphysis pubis and umbilicus

-slightly above the umbilicus

A nurse is reviewing a prescription for ferrous sulfate with a client who is at 12 weeks gestation. Which of the following statements by the client indicates understanding of the teaching?

1. i will take this pill with my breakfest
2. i will take this medication with a glass of milk
3. i plan to add more calcium-rich foods to my diet while taking this medication
4. i plan to drink more orange juice while taking this pill

-i plan to drink more orange juice while taking this pill

A nurse on the labor and delivery floor admits a client who is 38 weeks gestation and reports heavy, red vaginal bleeding. The bleeding started spontaneously in the morning and is not accompanied by contractions. The client is not in distress and she states that she can "feel the baby moving." An ultrasound is scheduled stat. The nurse should explain to the client that the purpose of the ultrasound is to determine which of the following?

1. placenta placement
2. gestational age
3. fetal lung maturity
4. fetal measurement for dating

-placenta placement

A pregnant client is being admitted for severe preeclampsia. Which room location should the charge nurse assign this client on the obstetrical unit?

1. near the nursery
2. near the elevator
3. near the nurses station
4. near the waiting room

near the nurses station

A pregnant client is concerned her baby is going to drown in the uterus because of the fluid. How should the nurse respond about fetal respiration?

1. your baby receives oxygen from the amniotic fluids
2. the baby does not have breathing movements until delivery
3. the amniotic fluid does not enter the baby's lungs during pregnancy
4. oxygen is provided to the baby though the placenta

-oxygen is provided to the baby through the placenta

A pregnant client's blood type is O-negative. Following the birth of her baby, the cord blood was tested and found to be B-positive. The nurse administers her Rho(D) immune globulin. What is the purpose of administering Rho(D) immune globulin?

1. promote maternal D antibody formation
2. prevent maternal D antibody formation
3. stimulate maternal D immune antigens
4. prevent fetal Ph blood formation

-prevent maternal D antibody formation

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which of the following actions would the nurse expect to perform for this woman on admission?

1. performing an internal sterile vaginal examination to assess the extent of bleeding
2. helping the women remain ambulatory to reduce bleeding
3. assessing fetal heart tones by use of an external monitor
4. assessing uterine contractions by an internal pressure gauge

-assessing fetal heart tones by use of an external monitor

A screening at 24 weeks gestation reveals a pregnant woman has gestational diabetes mellitus (GDM). In planning client care, the nurse and the woman agree that a goal is to prevent fetal injury from GDM. What does the nurse identify as the greatest risk for the fetus?

1. preterm birth
2. macrosomia
3. low birth weight
4. congenital anomalies

-macrosomia

A woman develops HELLP syndrome during labor and has thrombocytopenia. Which of the following orders by the healthcare provider would the nurse question?

1. prepare her for epidural anesthesia
2. assess her blood pressure every 15 minutes
3. assess the urine output every hour
4. urge her to lie on her left side during labor

-prepare her for epidural anesthesia

A woman has an appointment at the clinic for prenatal care at 18 weeks gestation. The client's prenatal lab results show glucose in her urine. What does this finding indicate to the nurse?

1. the client should have further testing for gestation diabetes
2. the client should have a liver enzyme panel completed
3. the client is eating excessive calories
4. it is because of a decrease in GFR

-the client should have further testing for gestational diabetes

A woman is experiencing preterm labor at 32 weeks gestation. The nurse administered tocolytics and the client is placed on bedrest. The client continues to experience regular contractions, and her cervix is beginning to dilate and efface. What additional medication should be considered to assist the development of fetal lung maturity?

1. Oxytocin
2. Misoprostol
3. Betamethasone
4. Terbutaline

-betamethasone

A woman who is 32 weeks gestation is experiencing preterm labor. Which of the following is an inappropriate nursing intervention for this client?

1. Ambulate the client for comfort
2. Administer IV fluid with a 500 ml bolus as prescribed
3. Initiate fetal (tocodynamometer) monitoring
4. Obtain a urine specimen

-ambulate the client for comfort

A woman who is 4 months pregnant has pyrosis (heartburn). Which of the following suggestion would the nurse provide the client?

1. Take 30 mL of milk of magnesia after every meal.
2. Eat small meals and do not lie down after meals.
3. Try to include complex carbohydrates in meals.
4. Increase vitamin intake by adding more citrus fruit.

-Eat small meals and do not lie down after meals.

A woman who professes to be a strict vegan voices concern about her ability to meet the nutritional needs of her fetus. Which concerns should be addressed in this session?

1. Her diet will need to have an increase in fruits and vegetables to meet the nutritional requirements of her baby.
2. The supplementation of vitamin B 12 should be addressed.
3. There are not special concerns for vegans as they can easily meet the dietary requirements without violating their "no meat" rule.
4. She should be advised to forgo her beliefs during the pregnancy to adequately provide the nutritional requirements for her pregnancy.

-the supplementation of vitamin B 12 should be addressed

A woman with the diagnosis of hyperemesis gravidarum requires hospitalization. What is the difference between this condition and the nausea/vomiting experienced by 70% of pregnant women?

1. She has vomiting severe and persistent enough to cause weight loss, dehydration and electrolyte imbalance.
2. Often inspires similar, milder symptoms in their male partners and mothers
3. There is no difference, it is the same condition
4. Women with hyperemesis gravidarum need continuous intravenous (IV) fluid and nutrition throughout their pregnancy.

-she has vomiting severe and persistent enough to cause weight loss, dehydration and electrolyte imbalance

After assessing a client, the nurse determines combination oral contraception would be contraindicated based on the client history. What finding by the nurse would indicate this method would not be contraindicated for the client?

1. Smoking
2. Hypertension
3. Abnormal uterine shape
4. Thromboembolic disease

-abnormal uterine shape