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Maternal Child Final Exam guide
What is the purpose of the White House Conference on Children and Youth? a. Set criteria for normal growth patterns. b. Examine the number of live births in minority populations. c. Raise money to support well-child clinics in rural areas. d. Promote comprehensive child welfare. ANS: D White House Conferences on Children and Youth are held every 10 years to promote comprehensive child welfare. How many hours of hospital stay does legislation currently allow for a postpartum patient who has delivered vaginally without complications?
a. 24 b. 48 c. 36 d. 72 ANS: B Postpartum patients who deliver vaginally stay in the hospital for an average of 48 hours; patients who have had a cesarean delivery usually stay 4 days. How does the clinical pathway or critical pathway improve quality of care? a. Lists diagnosis-specific implementations b. Outlines expected progress with stated timelines c. Prioritizes effective nursing diagnoses d. Describes common complications ANS: B Critical pathways outline expected progress with stated timelines. Any deviation from those timelines is called a variance How does electronic charting ensure comprehensive charting more effectively than handwritten charting?
The nurse is speaking with a couple trying to conceive a child. What will the nurse remind the couple is a factor that can decrease sperm production? a. Infrequent sexual intercourse b. The man not being circumcised c. The penis and testes being small d. The testes being too warm ANS: D The scrotum is suspended away from the perineum to lower the temperature of the testes for sperm production. The nurse is assisting with pelvic inlet measurements on a pregnant woman. What measurement will provide the nurse with information about whether the woman can deliver vaginally? a. Diagonal conjugate b. Obstetric conjugate c. Transverse diameter d. Anteroposterior diameter ANS: B This measurement determines if the fetus can pass through the birth canal.
The nurse is aware that the diagonal conjugate is 12 centimeters. What is the measurement in centimeters of the obstetric conjugate? a. 10 to 10. b. 11 to 11. c. 12.5 to 13 d. 14 to 14. ANS: A The obstetric conjugate is approximately 1.5 to 2 centimeters shorter than the diagonal conjugate. How long does sperm remain viable in the female reproductive tract? a. 12 hours b. 1 day c. 2 days d. 4 days ANS: D Sperm can remain viable in the reproductive tract of the female for as long as 4 to 5 days. Which hormone initiates the maturation of the ovarian follicle?
a. Dizygotic twins b. Monozygotic twins c. Conjoined twins d. High birth-weight twins ANS: A Dizygotic twins always have two amnions and two chorions (placentas). The nurse explains that the birth weight of monozygotic twins is frequently below average. What is the most likely cause? a. Inadequate space in the uterus b. Inadequate blood supply c. Inadequate maternal health d. Inadequate placental nutrition ANS: D The single placenta may not be able to provide adequate nutrition to two fetuses. Of what is the normal umbilical cord comprised? a. 1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetus
b. 1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetus c. 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus d. 2 arteries carrying blood to the fetus and 2 veins carrying blood away from the fetus ANS: C The umbilical cord is comprised of 2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus. A woman reports that her last normal menstrual period began on August 5, 2013. What is this woman's expected delivery date using Nägele's rule? a. April 30, 2014 b. May 5, 2014 c. May 12, 2014 d. May 26, 2014 ANS: C To determine the expected date of delivery, count backward 3 months from the first day of the last menstrual period, then add 7 days and change the year if necessary.
d. Gravida 2, para 11110 term- ANS: C Refer to Box 4-1 in the textbook for the TPALM system of identifying gravida and para. A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy? a. Amenorrhea b. Uterine enlargement c. HCG detected in the urine d. Fetal heartbeat ANS: D Positive indications are caused only by the developing fetus and include fetal heart activity, visualization by ultrasound, and fetal movements felt by the examiner. What symptom presented by a pregnant women is indicative of abruptio placentae? a. Painless vaginal bleeding b. Uterine irritability with contractions c. Vaginal bleeding and back pain
d. Premature rupture of membranes ANS: C Bleeding accompanied by abdominal or lower back pain is a typical manifestation of abruptio placentae. The nurse is preparing a pregnant patient for an abdominal ultrasound at 8 weeks' gestation. What intervention will the nurse implement before this diagnostic test? a. Instruct the patient to take nothing by mouth after midnight the night before the test. b. Initiate an IV. c. Encourage the patient to drink 1 to 2 quarts of water before the test. d. Instruct the patient to remove all jewelry. ANS: C Ultrasound uses high-frequency sound waves to visualize structures within the body; the examination may use a transvaginal probe or an abdominal transducer; abdominal ultrasound during early pregnancy requires a full bladder for proper visualization (have the woman drink 1 to 2 quarts of water before the examination).
d. In the knee-chest position to reduce pressure on the placenta ANS: B The prenatal patient with placenta previa is best placed on her side with a pillow for support. This position not only reduces stress on the placenta but also reduces the possibility of supine hypotension. A woman who is 35 weeks pregnant has a total placenta previa. She asks the nurse, "Will I be able to deliver vaginally?" What explanation by the nurse is the most appropriate? a. "Yes, you can deliver vaginally until 36 weeks." b. "A vaginal delivery can be attempted, but if bleeding occurs, a cesarean section will be done." c. "A cesarean section is performed when the mother has a total placenta previa." d. "There is no reason why you cannot have a vaginal delivery." ANS: C A cesarean delivery is done for a partial or total placenta previa.
What drug will the nurse plan to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient? a. Ergonovine maleate (Ergotrate) b. Oxytocin c. Calcium gluconate d. Hydralazine (Apresoline) ANS: C Calcium gluconate reverses the effects of magnesium sulfate and should be available for immediate use when a woman receives magnesium sulfate. We have an expert-written solution to this problem! A woman seeking prenatal care relates a history of macrosomic infants, two stillbirths, and polyhydramnios with each pregnancy. What does the nurse recognize these factors highly suggest? a. Toxoplasmosis b. Abruptio placentae c. Hydatidiform mole d. Diabetes mellitus
b. Count respirations and report a rate of more than 20 breaths/min. c. Check blood pressure and report a rate of less than 100/60 mm Hg. d. Monitor urinary output and report a rate of less than 100 mL/hr. ANS: A Excessive magnesium sulfate may cause respiratory depression A patient who is 28 weeks pregnant presents with consistent hypertension. What need would the home health nurse make the first priority? a. Activity restriction b. Balanced nutrition c. Increased fluid intake to ensure adequate hydration d. Instruction about the effect of diuretics ANS: A Bed rest reduces the flow of blood to skeletal muscles, making more blood available to the placenta and enhancing fetal oxygenation. We have an expert-written solution to this problem!
While caring for a laboring woman, the nurse notices a pattern of variable decelerations in fetal heart rate with uterine contractions. What is the nurse's initial action? a. Stop the oxytocin infusion. b. Increase the intravenous flow rate. c. Reposition the woman on her side. d. Start oxygen via nasal cannula. ANS: C Repositioning the woman is the first response to a pattern of variable decelerations. If the decelerations continue, then oxygen should be administered and/or the flow rate of oxygen should be increased. We have an expert-written solution to this problem! What is the best nursing action to implement when late decelerations occur? a. Reposition the patient to supine b. Decrease flow of intravenous (IV) fluids c. Increase oxygen to 10 L/minute d. Prepare to increase oxytocin drip
b. Fluid amount c. Maternal blood pressure d. Deep tendon reflexes ANS: A The FHR should be assessed for at least 1 full minute after the membranes rupture and must be recorded and reported. Marked slowing of the rate or variable decelerations suggests that the fetal umbilical cord may have descended with the fluid gush and is being compressed. Fluid amount should be assessed and recorded but is not the top priority. Maternal blood pressure and deep tendon reflexes are not appropriate assessments following rupture of membranes. What is the most important nursing intervention during the fourth stage of labor? a. Monitor the frequency and intensity of contractions. b. Provide comfort measures. c. Assess for hemorrhage. d. Promote bonding. ANS: C Immediately after giving birth, every woman is assessed for signs of hemorrhage.
We have an expert-written solution to this problem! The nurse formulates a nursing diagnosis for a woman in the fourth stage of labor. What is the most appropriate nursing diagnosis? a. Pain related to increasing frequency and intensity of contractions. b. Fear related to the probable need for cesarean delivery. c. Dysuria related to prolonged labor and decreased intake. d. Risk for injury related to hemorrhage. ANS: D In the fourth stage of labor, a priority nursing action is identifying and preventing hemorrhage. We have an expert-written solution to this problem! A woman who is 6 cm dilated has the urge to push. What will the nurse instruct the woman to do during the contraction? a. Use slow-paced breathing.
