MATERNITY EXAM 3

1. 1A nurse is prepared to assess a postpartum woman’s fundus. To facilitate the accuracy and comfort of the examination, the nurse should tell the woman to:

   1. AElevate the head of the bed
   2. BPlce her hands under her head
   3. CFlex her knees
   4. DLie flat with legs extended and toes pointed
2. 2The expected outcome for care when an oxytocic is administered to a postpartum woman is that the woman will:
   

   1. ADemonstrate expected lochial characteristics
   2. BAchieve relief of pain associated with uterine cramping
   3. CRemain free from infection
   4. DVoid spontaneosly within 4 hours of birh
3. 3A nurse is preparing to administer RhoGAM to a postpartum woman. Before implementing this care measure the nurse should:

   1. AEnsure that medication is given within 12 hours after the birth
   2. BVerify that the indirect and direct Coombs test results are negative
   3. CMake sure that the newborn is Rh negative
   4. DCancel the administration of the RhoGAM if it was given to the woman during her pregnancy.
4. 4When teaching a postpartum woman with an episiotomy about using a sitz bath, the nurse should emphasize:

   1. AUsing a sterile equipment
   2. BFilling the sitz bath with hot water (at least 42C)
   3. CTaking a sitz bath once a day for 10 minutes
   4. DSqueezing her buttocks together before sitting down, then relaxing them
5. 5Before discharge at 2 days postpartum, the nurse evaluates a woman’s level of knowledge regarding the care of her second degree perineal laceration. Which statements made by the woman indicate the need for further instruction before she goes home? (Circle all that apply.)
   
   

   1. A“I will wash my stitches at least once a day with mild soap and warm water.”
      
      Lowdermilk, Deitra Leonard; Perry, Shannon E.; Cashion, Mary Catherine; Alden, Kathryn Rhodes. Study Guide for Maternity & Women's Health Care - E-Book (Maternity and Women's Health Care Study Guide) (Page 151). Elsevier Health Sciences. Kindle Edition.
   2. B“I will change my pad every time I go to the bathroom—at least four times each day.”
   3. C“I will position my squeeze bottle upward so that the warm water can remove lochia from my vagina.”
   4. DD. “I will use my squeeze bottle filled with warm water to cleanse my stitches after I urinate.”
   5. EE. “I will wear a pair of clean, disposable gloves when I wash my stitches and change my pad just like the nurses did.”
   6. F“I will apply the anesthetic cream to my stitches at least six times per day.”
6. 6When assessing postpartum women during the first 24 hours after birth, the nurse must be alert for signs that could indicate the development of postpartum physiologic complications. Which signs are of concern to the nurse? (Circle all that apply.)
   
   Lowdermilk, Deitra Leonard; Perry, Shannon E.; Cashion, Mary Catherine; Alden, Kathryn Rhodes. Study Guide for Maternity & Women's Health Care - E-Book (Maternity and Women's Health Care Study Guide) (Page 151). Elsevier Health Sciences. Kindle Edition.

   1. ATemperature—38°C
   2. BFundus—midline, boggy
   3. CC. Lochia—three quarters of pad saturated in 3 hours
   4. DPositive Homans sign in right leg
   5. EAnorexia
   6. FVoids approximately 150 to 200 mL of urine in each of the first three voidings after birth
7. 7During the final phase of the claiming process of a newborn, a mother might say:

   1. A“She has her grandfather’s nose.”
   2. B“His ears lie nice and flat against his head, not like mine and his sister’s, which stick out.”
   3. C“She gave me nothing but trouble during pregnancy and now she is so stubborn she won’t wake up to breastfeed.”
   4. D“He has such a sweet disposition and pleasant expression. I have never seen a baby quite like him before.”
8. 8Which nursing action is least effective in facilitating parental attachment to the new infant?

   1. AReferring the couple to a lactation consultant to ensure continuing success with breastfeeding
   2. BKeeping the baby in the nursery as much as possible for the first 24 hours after birth so the mother can rest
   3. CExtending visiting hours for the woman’s partner or significant other as the couple desires
   4. DProviding guidance and support as the parents care for their baby’s nutrition and hygiene needs
9. 9Which behavior illustrates engrossment?

   1. AA father is sitting in a rocking chair, holding his new baby boy, touching his toes, and making eye contact.
   2. BA mother tells her friends that her baby’s eyes and nose are just like hers.
   3. CA mother picks up and cuddles her baby girl when she begins to cry.
   4. DA grandmother gazes into her new grandson’s face, which she holds about 8 inches away from her own; she and the baby make eye-to-eye contact.
10. 10A woman expresses a need to review her labor and birth experience with the nurse who cared for her while in labor. This behavior is most characteristic of which phase of maternal postpartum adjustment?

    1. ATaking-hold (dependent-independent phase)
    2. BTaking-in (dependent phase)
    3. CLetting-go (interdependent)
    4. DPostpartum blues (baby blues)

11. 11Before discharge, a postpartum woman and her partner ask the nurse about the baby blues. “Our friend said she felt so let down after she had her baby and we have heard that some women actually become very depressed. Is there anything we can do to prevent this from happening to us or at least to cope with the blues if they occur?” The nurse could tell this couple:

    1. A“Postpartum blues usually happen in pregnancies that are high risk or unplanned, so there is no need for you to worry.”
    2. BTry to become skillful in breastfeeding and caring for your baby as quickly as you can.”
    3. C“Get as much rest as you can and sleep when the baby sleeps, because fatigue can precipitate the blues or make them worse.”
    4. DD. “I will call your doctor before you leave to get you a prescription for an antidepressant to prevent the blues from happening.”
12. 12 A newborn, at 5 hours old, wakes from a sound sleep and becomes very active and begins to cry. Which signs, if exhibited by this newborn, indicate expected adaptation to extrauterine life? (Circle all that apply.)

    1. AA. Increased mucus production
    2. BPassage of meconium
    3. CHeart rate of 160 beats/minute
    4. DRespiratory rate of 24 breaths/minute and irregular
    5. EFine crackles on auscultation
    6. FExpiratory grunting with nasal flaring
13. 13When assessing a newborn boy at 12 hours of age, the nurse notes a rash on his abdomen and thighs. The rash appears as irregular reddish blotches with scattered papules. The nurse:

    1. ADocuments the finding as erythema toxicum
    2. B. Isolates the newborn and his mother until infection is ruled out
    3. CApplies an antiseptic ointment to each lesion
    4. DRequests nonallergenic linens from the laundry
14. 14A breast-fed full-term newborn girl is 12 hours old and being prepared for early discharge. If present, which assessment findings could delay discharge? (Circle all that apply.)

    1. ADark green–black stool, thick consistency
    2. BYellowish tinge in sclera and on face
    3. CSwollen breasts with a scant amount of thin discharge
    4. DBlood-tinged mucoid vaginal discharge
    5. EBlood glucose level of 35 mg/dL
    6. FAcrocyanosis
15. 15As part of a thorough assessment of a newborn, the pediatric nurse practitioner (PNP) should check for hip dislocation and dysplasia. Which technique does the PNP use?

    1. ACheck for syndactyly bilaterally
    2. BStepping or walking reflex
    3. CMagnet reflex
    4. DOrtolani maneuver
16. 16When assessing a newborn after birth, the nurse notes flat, irregular, pinkish marks on the bridge of the nose, nape of the neck, and over the eyelids. The areas blanch when pressed with a finger. The nurse documents this finding as:

    1. AMilia
    2. BNevus vasculosus
    3. CTelangiectatic nevi
    4. DNevus flammeus
17. 17A newborn male is estimated to be at 40 weeks of gestation following an assessment using the New Ballard Scale. New Ballard Scale findings consistent with this newborn’s full-term status are: (Circle all that apply.)

    1. AApical pulse rate of 120 beats/minute, regular, and strong
    2. BPopliteal angle of 160 degrees
    3. CWeight of 3200 g, placing him at the 50th percentile
    4. DThinning of lanugo with some bald areas
    5. ETestes descended into the scrotum
    6. FElbow does not pass midline when arm is pulled across the chest
18. 18The nurse evaluates the laboratory test results of a newborn who is 4 hours old. Which results require notification of the pediatrician? (Circle all that apply.)

    1. AHemoglobin 20 g/dL
    2. BHematocrit 54%
    3. CGlucose 34 mg/dL
    4. DWhite blood cell count 24,000/mm3
    5. ECalcium 7 mg/dL
19. 19A newborn male has been designated as large for gestational age. His mother was diagnosed with gestational diabetes late in her pregnancy. The nurse should be alert for signs of hypoglycemia. Which assessment finding is consistent with a diagnosis of hypoglycemia?

    1. AHigh-pitched cry
    2. BJitteriness
    3. CHyperthermia
    4. DLaryngospasm
20. 20A radiant warmer will be used to help a newborn girl to stabilize her temperature. The nurse implementing this care measure should:

    1. AUndress and dry the infant before placing her under the warmer
    2. BSet the control panel between 35°C and 38°C
    3. CPlace the thermistor probe on her abdomen just below her umbilical cord
    4. DAssess her rectal temperature every hour until her temperature stabilizes
21. 21A newborn male has been scheduled for a circumcision. Essential nursing care measures following this surgical procedure include:

    1. AUse the New Ballard Score to determine if the newborn is in pain
    2. BApplying petroleum ointment to the site with every diaper change until the site is healed
    3. CChecking the penis for bleeding every 15 minutes for the first 4 hours
    4. DTeaching the parents to remove the yellowish exudate that forms over the glans using a diaper wipe
22. 22A physician has ordered that a newborn receive a hepatitis B vaccination prior to discharge. In fulfilling this order the nurse should: (Circle all that apply.)

    1. AConfirm that the mother is hepatitis B positive before the injection is given
    2. BObtain parental consent prior to administering the vaccination
    3. CInform the parents that the next vaccine in the series needs to be given at 1 to 2 months
    4. DAdminister the injection into the vastus lateralis muscle
    5. EUse a 1-inch 23-gauge needle F. Insert the needle at a 45-degree angle
23. 23A nurse is preparing to administer erythromycin ophthalmic ointment 0.5% to a newborn after birth. Which nursing actions are appropriate? (Circle all that apply.)

    1. AAdminister the ointment within 30 minutes of the birth
    2. BWear gloves
    3. CCleanse the eyes if secretions are present
    4. DSqueeze an ointment ribbon of 3 cm into the lower conjunctival sac
    5. EWipe away excess ointment after 1 minute
    6. FApply the ointment from the inner to outer canthus
24. 24During a home visit, the mother of a 1-week-old infant son tells the nurse that she is very concerned about whether her baby is getting enough breast milk. The nurse should tell this mother that at 1 week of age a well-nourished newborn should exhibit:

    1. AWeight gain sufficient to reach his birth weight
    2. BA minimum of three bowel movements each day of soft, yellow, seedy stools
    3. CApproximately 10 to 12 wet diapers each day
    4. DBreastfeeding at a frequency of every 4 hours, or about 6 times each day
25. 25A woman is trying to calm her fussy baby daughter in preparation for feeding. She exhibits a need for further instruction if she:

    1. ARemoves all clothing from the infant except the diaper
    2. BDims the lights in the room and turns off the television
    3. C. Gently rocks the baby and talks to her in a low voice
    4. DAllows the baby to suck on her finger
26. 26The nurse should teach breastfeeding mothers about breast care measures to preserve the integrity of the nipples and areola. What should the nurse include in these instructions?

    1. ACleanse nipples and areola twice a day with mild soap and water
    2. BApply vitamin E cream to nipples and areola at least four times each day before a feeding
    3. CInsert plastic-lined pads into the bra to absorb leakage and protect clothing.
    4. DApply modified lanolin to both dry and sore nipples.
27. 27A breastfeeding woman asks the nurse about a reliable and safe method of birth control she should use during the postpartum period. The best recommendation for a safe yet effective method during the first 6 weeks after birth is:

    1. ACombination oral contraceptive that she used before she was pregnant
    2. BBarrier method using a combination of a condom and spermicide foam
    3. CThe diaphragm she used prior to getting pregnant
    4. DComplete breastfeeding—baby only receives breast milk for nourishment
28. 28A woman has determined that bottle-feeding is the best feeding method for her. Instructions that the woman should receive regarding this feeding method include

    1. ACheck nipple before feeding to ensure that it allows passage of formula in a slow stream.
    2. BSterilize water by boiling; then cool and mix with formula powder or concentrate
    3. CExpect a 2-week-old newborn to drink approximately 90 to 150 mL of formula at each feeding.
    4. DMicrowave refrigerated formula for about 2 minutes before feeding the newborn.
29. 29At a home visit 1 week after birth, a nurse is evaluating a woman’s breastfeeding technique. Which actions indicate that the woman needs further instruction regarding breastfeeding to ensure success? (Circle all that apply.)

    1. AWaits to feed her baby until he wakes up and begins to cry.
    2. BMassages a small amount of breast milk into her nipple and areola before and after each feeding.
    3. CSqueezes her nipple and areola between her thumb and forefinger and then inserts her nipple into the baby’s mouth.
    4. DPositions her baby, supporting back and shoulders securely, and then brings her breast toward the baby, putting the nipple in the baby’s mouth
    5. EInserts her finger into the corner of her baby’s mouth between the gums before removing the baby from the breast.
30. 30A new breastfeeding mother asks the nurse how to prevent nipple soreness. The nurse tells this woman that the key to preventing sore nipples is:

    1. ALimiting the length of breastfeeding to no more than 10 minutes on each breast until the milk comes in
    2. BApplying lanolin to each nipple and areola after each feeding
    3. CUsing correct technique for latch-on and removal from the breast
    4. D. Using breast shells to protect the nipples and areola between feedings
31. 31A 34-year-old woman at 36 weeks of gestation has been scheduled for a biophysical profile. She asks the nurse why the test needs to be performed. The nurse tells her that the test is performed because it:

    1. ADetermines how well her baby will breathe after it is born
    2. BEvaluates the response of her baby’s heart to uterine contractions
    3. CMeasures her baby’s head and length
    4. DObserves her baby’s activities in utero to ensure that her baby is getting enough oxygen
32. 32As part of preparing a 24-year-old woman at 42 weeks of gestation for a nonstress test, the nurse should:

    1. ATell the woman to fast for 8 hours before the test
    2. B. Explain that the test will evaluate how well her baby is moving inside her uterus
    3. CShow her how to indicate when her baby moves
    4. DAttach a spiral electrode to the presenting part to determine FHR patterns
33. 33A 40-year-old woman at 18 weeks of gestation is having a quad marker test performed. She is obese, and her health history reveals that she is Rh negative. The primary purpose of this test is to screen for:

    1. A. Spina bifida
    2. BDown Syndrome
    3. CGestational Diabetes
    4. DRh antibodies
34. 34During a contraction stress test, four contractions lasting 45 to 55 seconds each were recorded in a 10-minute period. A late deceleration was noted during the third contraction. The nurse conducting the test documents the result as:

    1. ANegatice
    2. BPositive
    3. CEquivocal or suspicious
    4. DUnsatisfactory
35. 35A pregnant woman is scheduled for a transvaginal ultrasound test to establish gestational age. In preparing this woman for the test the nurse should:

    1. APlace the woman in a supine position with her hips elevated on a folded pillow
    2. BInstruct her the woman to come for the test with a full bladder
    3. CAdminister an analgesic 30 minutes before the test
    4. DLubricate the vaginal probe with transmission gel
36. 36A pregnant woman at 42 weeks of gestation is undergoing a nonstress test. During the test an evaluation of the monitor tracing indicated that two accelerations of the fetal heart rate occurred within a 20-minute period. The first acceleration of 18 beats/minute lasted 20 seconds and the second acceleration of 20 beats/minute lasted 16 seconds. The nurse conducting the test records the test result as:

    1. AReactive
    2. BPositive
    3. CNonreactive
    4. DEquivocal hyperstimulatory
37. 37When measuring the blood pressure to ensure consistency and to facilitate early detection of blood pressure changes consistent with preeclampsia, the nurse should:

    1. APlace the woman in a sitting position with feet flat on the floor
    2. BAllow the woman to rest for 5 minutes after positioning her before measuring her blood pressure
    3. CRecord Korotkoff phase IV (muffled sound) as the diastolic pressure
    4. DUse a proper-sized cuff that covers at least 50% of her upper arm
38. 38When caring for a woman with preeclampsia without severe features, it is critical that during assessment the nurse be alert for signs of progress to preeclampsia with severe features. Progress to preeclampsia with severe features is indicated by which of the following assessment findings?

    1. ASerum creatinine 0.9 mg/dL
    2. BPlatelet count of 180,000/mm3
    3. CPositive ankle clonus response with DTRs 41 bilaterally
    4. DBlood pressure of 150/88 and 154/96 mm Hg, 6 hours apart
39. 39A woman with preeclampsia is admitted to the hospital and her primary health care provider has ordered that an infusion of magnesium sulfate be started. In implementing this order, the nurse should: (Circle all that apply.)

    1. APrepare a solution of 20 g of magnesium sulfate in 100 mL of 5% glucose in water
    2. BMonitor maternal vital signs, fetal heart rate (FHR) patterns, and uterine contractions every hour
    3. CExpect the maintenance dose to be approximately 1 to 3 g/hour
    4. DAdminister a loading dose of 4 to 6 g over 15 to 30 minutes
    5. EPrepare to administer hydralazine (Apresoline) if signs of magnesium toxicity occur
    6. FReport a respiratory rate of less than 12 breaths/minute to the primary health care provider immediately
40. 40The primary expected outcome for nursing care associated with the administration of magnesium sulfate would be met if which assessment finding is present?

    1. AThe woman exhibits a decrease in both systolic and diastolic blood pressure.
    2. B. The woman experiences no seizures.
    3. CThe woman states that she feels more relaxed and calm.
    4. DThe woman urinates more frequently, resulting in a decrease in pathologic edema.
41. 41A woman has been diagnosed with preeclampsia without severe features and will be treated at home. In teaching this woman about her treatment regimen for preeclampsia, the nurse should tell her to: (Circle all that apply.)

    1. A. Follow a low-salt diet
    2. BUse a dipstick to check a clean catch specimen of her urine for protein
    3. CMaintain a fluid intake of six to eight 8-ounce glasses of water each day
    4. DIncrease the roughage in her diet
    5. EPerform gentle range-of-motion exercises of her upper and lower extremities
    6. FAsk her friends to avoid visiting or calling her because she needs to rest
42. 42A woman with preeclampsia with severe features is receiving nifedipine (Procardia). She asks the nurse what this medication is for. The nurse should tell her that nifedipine is used to:

    1. APrevent seizures
    2. BRelieve the headaches she is starting to have
    3. CDecrease her blood pressure
    4. DReduce the edema in her hands and legs
43. 43A woman with preeclampsia gave birth by cesarean section 1 hour ago. She is still receiving a magnesium sulfate infusion at 1 g/hour. A major concern regarding the administration of magnesium sulfate at this time is:

    1. AIncreased risk for seizures
    2. BCentral nervous system depression
    3. CHyptension
    4. DDiuresis
44. 44Following vaginal birth 2 hours ago a woman with preeclampsia is experiencing a heavy flow as a result of a boggy uterus. It is determined that she will require medication to reduce the amount of blood loss. Which medication would the nurse anticipate administering?

    1. AMethergine (methylergonovine
    2. BCalcium gluconate
    3. CPitocin (oxytocin)
    4. DNormodyne (labetalol)
45. 45A woman, who is at 35 weeks of gestation with preeclampsia, has a seizure. Immediately after the seizure the nurse’s priority action is to:

    1. AEvaluate fetal heart rate and pattern for signs of decreasing variability, late decelerations, or bradycardia
    2. BAssess status of the maternal airway, respiratory effort, and pulse
    3. CDetermine if membranes have ruptured and if the amniotic fluid contains meconium
    4. D. Prepare to increase the amount of magnesium sulfate being infused from 1 g/hour to 2 g/hour
46. 46A primigravida at 10 weeks of gestation reports mild uterine cramping and slight vaginal spotting without passage of tissue. When she is examined, no cervical dilation is noted. The nurse caring for this woman should:

    1. AAnticipate that the woman will be sent home with instructions to limit her activity and to avoid stress or orgasm
    2. BPrepare the woman for a dilation and curettage
    3. C. Notify a grief counselor to assist the woman with the imminent loss of her fetus
    4. DTell the woman that the doctor will most likely perform a cerclage to help her maintain her pregnancy
47. 47A woman is admitted through the emergency department with a medical diagnosis of ruptured ectopic pregnancy. The primary nursing diagnosis at this time is:

    1. A. Acute pain related to irritation of the peritoneum with blood
    2. B. Deficient fluid volume related to blood loss associated with rupture of the uterine tube
    3. CRisk for infection related to tissue trauma
    4. DAnticipatory grieving related to unexpected pregnancy outcome
48. 48A woman diagnosed with an ectopic pregnancy is to receive methotrexate. The nurse should explain to the woman that: (Circle all that apply.)

    1. AMethotrexate is an analgesic that will relieve the dull abdominal pain she is experiencing.
    2. BShe should double-flush the toilet with the lid down for 72 hours after receiving methotrexate.
    3. CShe will receive the medication intramuscularly
    4. DShe must stop taking folic acid supplements as long as she is on methotrexate
    5. EHer partner should use a condom during intercourse
    6. FShe must return weekly for a measurement of her progesterone level to determine if the methotrexate therapy has been effective.
49. 49A pregnant woman at 32 weeks of gestation comes to the emergency department because she has begun to experience bright red vaginal bleeding. She reports that she has no pain. The admission nurse suspects that the woman is experiencing:

    1. AAbruptio placentae
    2. BDisseminated intravascular coagulation
    3. CPlacenta previa
    4. DPreterm labor
50. 50A pregnant woman at 38 weeks of gestation and diagnosed with marginal placenta previa has just given birth to a healthy newborn male. The nurse recognizes that the immediate focus for the care of this woman is:

    1. APreventing hemorrhage
    2. BRelieving acute pain
    3. CPreventing infection
    4. DFostering attachment of the woman with her new son
51. 51A pregestational diabetic woman at 20 weeks of gestation exhibits the following: thirst, nausea and vomiting, abdominal pain, drowsiness, and increased urination. Her skin is flushed and dry and her breathing is rapid, with a fruity odor. A priority nursing action when caring for this woman is to

    1. AProvide the woman with a simple carbohydrate immediately
    2. BRequest an order for an antiemetic
    3. CAssist the woman into a lateral position to rest
    4. DAdminister insulin according to the woman’s blood glucose level
52. 52During her pregnancy a woman with pregestational diabetes has been monitoring her blood glucose level several times a day. Which level requires further assessment?

    1. A85 mg/dL—15 minutes prior to breakfast
    2. B98 mg/dL—prior to lunch
    3. C140 mg/dL—2 hours after lunch
    4. D126 mg/dL—1 hour after supper
53. 53Specific guidelines should be followed when planning a diet with a pregestational diabetic woman (BMI 24) to ensure a euglycemic state. Which dietary practices does the woman need to modify? (Circle all that apply.)

    1. AFollows a diet that reflects 45 kcal per kg daily based on her preconception BMI
    2. BEats three meals a day along with a midmorning, a midafternoon, and a bedtime snack
    3. CDrinks a cup of tea and a piece of dry toast as her bedtime snack
    4. DDivides her daily carbohydrate intake as 50% simple carbohydrates and 50% complex carbohydrates
    5. EMaintains a fat intake of approximately 25% of the total daily kcal recommendation
    6. FMonitors the appropriateness of her nutritional intake by checking her blood glucose levels before and after meals
54. 54An obese pregnant woman with gestational diabetes is learning self-injection of insulin. While evaluating the woman’s technique for self-injection of rapid-acting and NPH insulin, the nurse evaluates that the woman understands the instructions when she: (Circle all that apply.)

    1. AWashes her hands and puts on a pair of clean gloves
    2. BGently rotates the NPH insulin vial to fully mix the insulin
    3. CDraws the NPH insulin into her syringe first when mixing it with regular insulin
    4. DSpreads her skin taut and punctures the skin at a 90-degree angle
    5. ECleanses the top of each insulin vial thoroughly with warm water and soap
    6. FWipes the injection site gently with alcohol, waiting until it dries to administer the insulin
55. 55A woman has just been admitted with a diagnosis of hyperemesis gravidarum. She has been unable to retain any oral intake and as a result has lost weight and is exhibiting signs of dehydration with electrolyte imbalance and acetonuria. The nurse anticipates that the care management of this woman will include:

    1. AAdministering vitamin K to control nausea and vomiting
    2. B. Separating liquids from solids, alternating them every 2 to 3 hours once she is able to tolerate oral intake
    3. CAvoiding oral hygiene until the woman is able to tolerate oral fluids
    4. DProviding three daily meals of bland foods with warm fluids once the woman is able to tolerate oral intake
56. 56When assessing a pregnant woman at 28 weeks of gestation who is diagnosed with mitral valve stenosis, it is important that the nurse be alert for signs and symptoms indicating cardiac decompensation. Signs and symptoms of cardiac decompensation include: (Circle all that apply.)

    1. ADry, hacking cough
    2. BOrthopnea
    3. CWheezing with inspiration and expiration
    4. DRapid pulse that is irregular and weak
    5. EWoman reports that shoes and rings are tight
    6. FSupine hypotension
57. 57A woman at 30 weeks of gestation with a class II cardiac disorder calls her primary health care provider’s office and speaks to the nurse practitioner. She tells the nurse that she has been experiencing a frequent moist cough for the past few days. In addition, she has been feeling more tired and is having difficulty completing her routine activities as a result of some difficulty with breathing. The nurse’s best response is:

    1. A“Have someone bring you to the office so we can assess your cardiac status.”
    2. B“Try to get more rest during the day, because this is a difficult time for your heart.”
    3. C“Take an extra diuretic tonight before you go to bed, because you may be developing some fluid in your lungs.”
    4. D“Ask your family to come over and do your housework for the next few days so you can rest.”
58. 58A pregnant woman with a valvular disorder of her heart requires medication to prevent clot formation. In preparing the woman for this treatment measure, the nurse expects to teach the woman about self-administration of:

    1. Afurosemide (Lasix)
    2. Bpropranolol (Inderal)
    3. Cheparin
    4. Dwarfarin (Coumadin)
59. 59. At a previous antepartum visit, the nurse taught a pregnant woman diagnosed with a class II cardiac disorder about measures to use to lower her risk for cardiac decompensation. This woman indicates a need for further instruction if she:

    1. AIncreases roughage in her diet
    2. BRemains on bed rest, getting out of bed only to go to the bathroom
    3. CSleeps 10 hours every night and rests after meals
    4. DStates that she will call the nurse immediately if she experiences any pain or swelling in her legs
60. 60A pregnant woman has been diagnosed with cholelithiasis. An important component of her treatment regimen is dietary modification. The nurse helps this woman to plan a diet that:

    1. AReduces dietary fat to approximately 60 g per day
    2. BLimits protein to 30% of total calories
    3. CChooses foods that ensure that most calories come from carbohydrates
    4. DAvoids putting spices in foods
61. 61Nurses caring for postpartum women experiencing depression need to be aware of the safety of administering antidepressants. Which antidepressant should be avoided by women who wish to continue breastfeeding?

    1. Adesipramine (Norpramin)
    2. Bsertraline (Zoloft)
    3. Cdoxepin (Sinequan)
    4. Dparoxetine (Paxil)
62. 62Which measure is least effective in helping a woman to prevent postpartum depression?

    1. AShare feelings and emotions with family members and her partner.
    2. BRecognize that emotional problems after having a baby are not unusual.
    3. CCare for the baby by herself to increase her level of self-confidence and self-esteem.
    4. DAsk friends or family members to take care of the baby while she sleeps or has a date with her partner.
63. 63A pregnant woman being treated for major depression arrives for her first prenatal visit. During the health history interview she shows the nurse the cough medicine that she just bought for a cold. The nurse notes that the cough medicine contains dextromethorphan. The nurse is concerned if the woman reports taking which medication for her depression?

    1. Acitalopram (Celexa)
    2. Bdesipramine (Norpramin)
    3. Cclomipramine (Anafranil)
    4. Damoxapine (Asendin)
64. 64A priority question to ask a woman experiencing postpartum depression is:

    1. A“Have you thought about hurting yourself?
    2. BHow often do you cry?”
    3. CHave you been feeling insecure, fragile, or vulnerable?”
    4. D“Does the responsibility of motherhood seem overwhelming?”
65. 65The nurse should recognize that a complication of pregnancy associated with the intravenous use of cocaine is:

    1. A. Prolonged, difficult labor
    2. BPremature separation of the placenta
    3. CIncreased risk for vaginal and urinary tract infections
    4. DSevere fetal/neonatal central nervous system (CNS) depression
66. 66When conducting a health history interview during a pregnant woman’s first prenatal visit, the nurse must determine if the woman is substance dependent. The nurse’s first question should relate to the woman’s use of:

    1. AAlcohol
    2. BTobacco
    3. CCocaine
    4. DOver-the-counter and prescription medications

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Maternity Quiz on MATERNITY EXAM 3, created by reina belches on 21/04/2018.

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reina belches

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