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Women's Health: Disorders & Childbearing - Questions and Answers, Exams of Nursing

Fitchburg State University (FSU)Nursing

A collection of questions and answers related to women's health and childbearing, covering topics such as endometriosis, mastectomy, hysterectomy, pregnancy, postpartum care, and reproductive health. It offers insights into common concerns, procedures, and medical management strategies relevant to women's health.

Typology: Exams

2023/2024

Available from 10/29/2024

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Women's health/Disorders & Childbearing
Questions And Answers 2022-2023
A client with a history of endometriosis has abdominal surgery to remove adhesions.
What should this client's postoperative plan of care include?
1. Encouraging the client to ambulate in the hallway
2. Elevating the client's legs by gatching the bed
3. Helping the client dangle her legs over the side of the bed
4. Maintaining the client on bedrest until the dressings have been removed - ANS-1.
Encouraging the client to ambulate in the hallway
After a mastectomy or a hysterectomy a client may feel incomplete as a woman. What
statement should alert the nurse to this feeling in a client who has undergone total
hysterectomy?
1. "I can't wait to see all my friends again."
2. "I feel washed out; there isn't much left."
3. "I'm planning to recuperate at my daughter's home."
4. "I can't wait to get home; I so want to see my grandchild." - ANS-2. "I feel washed out;
there isn't much left."
A nurse is evaluating a client's understanding regarding postoperative concerns after
mastectomy. Which development near and around the incision noted by the client
should be reported to her practitioner?
1. Persistent itching
2. Decreased sensation
3. Swelling with erythema
4. Irregular-appearing ski - ANS-3. Swelling with erythema
**Swelling and erythema are signs of infection and should be reported to the health care
provider. Itching is a sign of healing that is expected.
The nurse instructs a pregnant client in the sources of protein that can be used to meet
the increased daily requirement during pregnancy. How many grams of protein should
the client eat each day?
1. 65 g
2. 60 g
3. 55 g
4. 50 g - ANS-2. 60 g
**The Food and Nutrition Board of the National Academy of Sciences recommends that
a pregnant woman consume 60 g of protein daily to meet the needs of pregnancy. The
recommended daily intake of protein for a breastfeeding (lactating) woman is 65 g.
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Women's health/Disorders & Childbearing

Questions And Answers 2022- 2023

A client with a history of endometriosis has abdominal surgery to remove adhesions. What should this client's postoperative plan of care include?

  1. Encouraging the client to ambulate in the hallway
  2. Elevating the client's legs by gatching the bed
  3. Helping the client dangle her legs over the side of the bed
  4. Maintaining the client on bedrest until the dressings have been removed - ANS-1. Encouraging the client to ambulate in the hallway After a mastectomy or a hysterectomy a client may feel incomplete as a woman. What statement should alert the nurse to this feeling in a client who has undergone total hysterectomy?
  5. "I can't wait to see all my friends again."
  6. "I feel washed out; there isn't much left."
  7. "I'm planning to recuperate at my daughter's home."
  8. "I can't wait to get home; I so want to see my grandchild." - ANS-2. "I feel washed out; there isn't much left." A nurse is evaluating a client's understanding regarding postoperative concerns after mastectomy. Which development near and around the incision noted by the client should be reported to her practitioner?
  9. Persistent itching
  10. Decreased sensation
  11. Swelling with erythema
  12. Irregular-appearing ski - ANS-3. Swelling with erythema **Swelling and erythema are signs of infection and should be reported to the health care provider. Itching is a sign of healing that is expected. The nurse instructs a pregnant client in the sources of protein that can be used to meet the increased daily requirement during pregnancy. How many grams of protein should the client eat each day?
  13. 65 g
  14. 60 g
  15. 55 g
  16. 50 g - ANS-2. 60 g **The Food and Nutrition Board of the National Academy of Sciences recommends that a pregnant woman consume 60 g of protein daily to meet the needs of pregnancy. The recommended daily intake of protein for a breastfeeding (lactating) woman is 65 g.

On the first postpartum day, a client whose infant is rooming in asks the nurse to return her baby to the nursery and bring the baby to her only at feeding times. How should the nurse respond?

  1. "It seems that you've changed your mind about rooming in."
  2. "I think you're having difficulty caring for the baby."
  3. "All right. I'll inform the other nurses of your decision."
  4. "You must be tired. I'll bring the baby back at feeding time." - ANS-1. "It seems that you've changed your mind about rooming in." A nurse on the postpartum unit discusses breast care with a client who is formula feeding her newborn. Which statement indicates to the nurse that more teaching is needed?
  5. "The discomfort will be better after a couple of days."
  6. "I need to ask my husband to bring me my new bra."
  7. "Applying heat to my breasts will help ease the discomfort."
  8. "Pain medication will help with the pain from engorgement." - ANS-3. "Applying heat to my breasts will help ease the discomfort." A nurse is discussing immunizations needed to confer active immunity with a pregnant client during her first visit to the prenatal clinic. What information should the nurse consider including that the client will understand with regard to active immunity?
  9. Protein antigens are formed in the blood to fight invading antibodies.
  10. Protein substances are formed by the body to destroy or neutralize antigens.
  11. Blood antigens are aided by phagocytes in defending the body against pathogens.
  12. Sensitized lymphocytes from an immune donor act as antibodies against invading pathogens. - ANS-2. Protein substances are formed by the body to destroy or neutralize antigens. The school nurse is teaching a group of 16-year-old girls about the female reproductive system. One student asks how long after ovulation it is possible for conception to occur. The most accurate response by the nurse is based on the knowledge that an ovum is no longer viable after:
  13. 12 hours
  14. 24 hours
  15. 48 hours
  16. 72 hours - ANS-2. 24 hours **The ovum is viable for about 24 hours after ovulation; if not fertilized before this time, it degenerates. A nurse is obtaining a health history from a primigravida on her first visit to the prenatal clinic. Before discussing the client's health habits with her, what does the nurse consider the most important factor in the survival of the client's newborn?
  17. Reproductive history
  18. Adequacy of prenatal care
  19. Health habits and social class

**Respiratory depression of the newborn will not occur if the medication is given during the active phase; it should not be given when birth is expected to occur within 2 hours. During a pelvic examination of a 24-year-old woman, the nurse suspects a vaginal infection because of the presence of a white curdlike vaginal discharge. What other assessment supports a fungal vaginal infection?

  1. A foul odor
  2. An itchy perineum
  3. An ischemic cervix
  4. A forgotten tampon - ANS-2. An itchy perineum A primigravida complains of morning sickness. What should the nurse plan to teach her?
  5. Increasing her fluid intake
  6. Eat three small meals a day
  7. Increase the calcium in her diet
  8. Avoid long periods without food - ANS-4. Avoid long periods without food Which statements by a client with hyperemesis gravidarum would confirm that the client needs further teaching? (Select all that apply.)
  9. "I'll start drinking protein shakes."
  10. "I'll start drinking plenty of fluids."
  11. "I'll start limiting my carbohydrates."
  12. "I'll lie down for at least 2 hours after I eat."
  13. "I'll be sure to schedule rest periods throughout the day so I won't get tired." - ANS-3. "I'll start limiting my carbohydrates."
  14. "I'll lie down for at least 2 hours after I eat." An estrogen-progestin oral contraceptive is prescribed for a client. Which adverse effects should the nurse teach the client to report to the health care provider? (Select all that apply.)
  15. Lethargy 2 .Dizziness
  16. Chest pain
  17. Constipation
  18. Breast soreness
  19. Calf tenderness - ANS-3. Chest pain
  20. Breast soreness
  21. Calf tenderness A woman is admitted for a hysterectomy and bilateral salpingo-oophorectomy. The nurse reviews the client's gynecological history. What condition does the client have that causes the nurse to anticipate an abdominal, rather than a vaginal, hysterectomy?
  22. Prolapsed uterus
  23. Large uterine fibroids
  1. Mild dysplasia of the cervical os
  2. Urinary incontinence when coughing - ANS-2. Large uterine fibroids **Attempting to remove a uterus with large uterine fibroids vaginally can cause trauma, resulting in hemorrhage. A client with endometriosis asks the nurse what side effects to expect from leuprolide (Lupron). What should the nurse include in the response?
  3. Weight gain
  4. Increased libido
  5. Frequent urination
  6. Heavy menstrual bleeding - ANS-1. Weight gain **The nurse should teach the client that the side effects of leuprolide (Lupron) include edema, which causes an increase in weight. A nurse is instructing a client to cough and deep-breathe after an emergency cesarean birth. The client says, "Get out of here. Can't you see that I'm in pain?" Which response will be the most effective?
  7. "I'm sure you're in pain. I'll come back later."
  8. "If you can't cough, try taking six very deep breaths."
  9. "Your pain is to be expected, but you must exercise your lungs."
  10. "I'll give you something for your pain. We can start the coughing tomorrow." - ANS-2. "If you can't cough, try taking six very deep breaths." **Having the client take deep breaths is important because deep breathing promotes full expansion of the alveoli and prevents stasis of pulmonary secretions. A nurse is teaching a breastfeeding client about medications that are safe and unsafe for her to take. Which medication is contraindicated?
  11. Heparin (Hep-Lock)
  12. Propylthiouracil (PTU)
  13. Gentamicin (Garamycin)
  14. Diphenhydramine (Benadryl) - ANS-2. Propylthiouracil (PTU) **The concentration of propylthiouracil (PTU) excreted in breast milk is three to 12 times higher than its level in maternal serum; this may cause agranulocytosis or goiter in the infant. During a routine prenatal office visit at 26 weeks' gestation, a client states that she is getting fat all over and that she even needed to buy bigger shoes. What is the next nursing action?
  15. Obtaining the client's weight and blood pressure
  16. Reassuring the client that weight gain is expected
  17. Supporting the client's decision to buy comfortable shoes

before taking any oral medications. What physiological alteration associated with pregnancy may change the client's response to medication?

  1. Decreased glomerular filtration rate
  2. Longer gastrointestinal emptying time
  3. Increased secretion of hydrochloric acid
  4. Development of fetal-placental circulation - ANS-2. Longer gastrointestinal emptying time **Gastrointestinal motility is reduced during pregnancy because of the high level of placental progesterone and displacement of the stomach superiorly and the intestines laterally and posteriorly; absorption of some drugs, vitamins, and minerals may be increased because of their slow passage through the gastrointestinal tract. A 35-year-old client is scheduled for a vaginal hysterectomy. She asks the nurse about the changes she should expect after surgery. How should the nurse respond?
  5. "You will stop ovulating."
  6. "Surgical menopause will happen immediately."
  7. "Sexual intercourse will be uncomfortable when you resume it."
  8. "A hysterectomy doesn't affect the chronological age when menopause usually occurs." - ANS-4. "A hysterectomy doesn't affect the chronological age when menopause usually occurs." A client seeking advice about contraception asks a nurse about how an intrauterine device (IUD) prevents pregnancy. How should the nurse respond?
  9. "It covers the entrance to the cervical os."
  10. "The openings to the fallopian tubes are blocked."
  11. "The sperm are kept from reaching the vagina."
  12. "It produces a spermicidal intrauterine environment." - ANS-4. "It produces a spermicidal intrauterine environment." A client with cervical cancer is to undergo a course of internal radiation. The client returns to her lead-lined room on the oncology unit with an indwelling urinary catheter and a vaginal applicator in place. Once the practitioner has loaded the applicator with the radiation source, the nurse's plan of care should include:
  13. Changing linens several times a day
  14. Leaving the urinary catheter undisturbed
  15. Cleansing the perineal area with a mild antiseptic twice daily
  16. Removing equipment from the room immediately after it is used - ANS-2. Leaving the urinary catheter undisturbed The day after a client has a cesarean birth, the indwelling catheter is removed. The nurse concludes that urinary function has returned when the:
  17. Client has 90 mL of residual urine after voiding
  18. Client's daily urinary output is at least 1500 mL
  19. Client's urinalysis indicates that no bacteria are present
  1. Client voids 300 mL of urine within 4 hours of catheter removal - ANS-4. Client voids 300 mL of urine within 4 hours of catheter removal **Voiding 300 mL of urine within 4 hours of catheter removal indicates that urinary sphincter tone has not been affected by the catheter and that urine retention with overflow has not occurred. A client who is visiting the family planning clinic is prescribed an oral contraceptive. As part of teaching, the nurse plans to inform the client of the possibility of:
  2. Cervicitis
  3. Ovarian cysts
  4. Fibrocystic disease
  5. Breakthrough bleeding - ANS-4. Breakthrough bleeding A client has a child with Tay-Sachs disease and wants to become pregnant again. She tells the nurse, "I'm worried it will happen again." How should the nurse respond?
  6. "Did you discuss this with your physician?"
  7. "Have you considered the option of genetic counseling?"
  8. "Can you remember if Tay-Sachs occurred before in your family?"
  9. "It is a rare disease that is statistically improbable to happen again." - ANS-2. "Have you considered the option of genetic counseling?" A client who recently gave birth is transferred to the postpartum unit by the nurse. What must the nurse do first to avoid a charge of abandonment?
  10. Assess the client's condition
  11. Document the client's condition and the transfer
  12. Orient the client to the room and explain unit routines
  13. Report the client's condition to the responsible staff member - ANS-4. Report the client's condition to the responsible staff member **Because the nurse is responsible for the client's care until another nurse assumes that responsibility, the nurse should report directly to the client's primary nurse. A client at 7 weeks' gestation tells the nurse in the prenatal clinic that she has been bothered by episodes of nausea, but no vomiting, throughout the day. What should the nurse recommend? (Select all that apply.)
  14. Focus on and repeat a rhythmic chant.
  15. Sit upright for 30 minutes after meals.
  16. Take low-sodium antacids after meals.
  17. Drink carbonated beverages with meals.
  18. Eat small, frequent meals and eat dry crackers in between. - ANS-1. Focus on and repeat a rhythmic chant.
  19. Eat small, frequent meals and eat dry crackers in between.

**The uterus is often erroneously believed necessary for a satisfying sex life. A client is scheduled for a vacuum aspiration abortion to terminate an unwanted pregnancy. What information should the nurse's teaching plan include?

  1. It is a lengthy procedure but will cause no pain.
  2. Both she and the father must sign the consent form.
  3. A temperature of 100.4° F (38° C) or higher should be reported immediately.
  4. She will experience a heavy menstrual flow for 1 to 2 weeks after the procedure. - ANS-3. A temperature of 100.4° F (38° C) or higher should be reported immediately. A 2-day-old infant who weighs 6 lb (2722 g) is fed formula every 4 hours. Newborns need about 73 mL of fluid per pound of body weight each day. In light of this information, approximately how much formula should the infant receive at each feeding?
  5. 1 to 2 oz
  6. 2 to 3 oz
  7. 3 to 4 oz
  8. 4 to 5 oz - ANS-2. 2 to 3 oz During a class for prepared childbirth, the nurse teacher discusses the importance of the spurt of energy that occurs before labor. Why is it important to conserve this energy?
  9. Fatigue may increase the progesterone level.
  10. Extra energy decreases the intensity of contractions.
  11. Extra energy is needed to push during the first stage
  12. Fatigue may influence pain medication requirements. - ANS-4. Fatigue may influence pain medication requirements. In childbirth classes the nurse is teaching paced breathing techniques for use during labor. In which order should the breathing techniques be used as labor progresses?
  13. Slow, deep breaths
  14. Pant-blow breathing
  15. Modified-paced breathing
  16. Slow, exhalation pushing
  17. Cleansing breaths - ANS-5. Cleansing breaths
  18. Slow, deep breaths
  19. Modified-paced breathing
  20. Pant-blow breathing
  21. Slow, exhalation pushing A nurse at a women's health clinic confirms that client teaching regarding the use of an oral contraceptive is understood when the client states, "I:
  22. Can stop the pill and try to get pregnant right away"
  23. May miss two periods and not worry about being pregnant"
  24. Will put a baby's picture on my bathroom mirror so I'll see it every morning"
  1. Am so glad we won't have to use condoms even if I miss just one pill during the month" - ANS-3. Will put a baby's picture on my bathroom mirror so I'll see it every morning" **Putting a baby's picture on the bathroom mirror serves as a reminder that the oral contraceptive must be taken every day. A nurse is teaching a prenatal class about the changes that occur during the second trimester of pregnancy. What cardiovascular changes should the nurse include? (Select all that apply.)
  2. Cardiac output increases.
  3. Blood pressure decreases.
  4. The heart is displaced upward.
  5. The blood plasma volume peaks.
  6. The hematocrit level is lowered - ANS-1. Cardiac output increases.
  7. Blood pressure decreases.
  8. The heart is displaced upward. During the fourth stage of labor, the assessment of a primipara who has had a vaginal birth reveals a moderate to large amount of lochia rubra, a firm fundus that is at the umbilicus and deviated to the right, and pain that she rates as a 3 on a scale of 1 to 10. What is the priority nursing action?
  9. Massaging the fundus
  10. Helping the client void
  11. Increasing the rate of the oxytocin infusion
  12. Administering the prescribed pain medication - ANS-2. Helping the client void **A fundus that is deviated to the right during the fourth stage of labor commonly is caused by a distended bladder ; if the bladder remains distended, involution will be inhibited, resulting in a boggy uterus that is prone to hemorrhage. Which risk factors are associated with the future development of osteoporosis in women? (Select all that apply.)
  13. Cigarette smoking
  14. Moderate exercise
  15. Use of street drugs
  16. Familial predisposition
  17. Inadequate intake of dietary calcium - ANS-1. Cigarette smoking
  18. Familial predisposition
  19. Inadequate intake of dietary calcium A nurse is teaching a postpartum client the characteristics of lochia and any deviations that should be reported immediately. What client statement indicates that the teaching was effective?
  20. "If I pass any clots, I'll notify the clinic."
  21. "I'll call the clinic if my lochia changes from red to pink."

A client is scheduled to have a contraction stress test (CST) to determine fetal well- being. Which type of fetal heart rate (FHR) decelerations constitutes a nonreassuring outcome?

  1. Late
  2. Early
  3. Baseline
  4. Variable - ANS-1. Late A husband sits in the waiting room while his wife is getting her infertility prescription refilled by the clinic pharmacist. As the nurse sits down beside him, he blurts, "It's like there are three of us in bed—my wife, me, and the doctor." What feeling is reflected by this statement?
  5. Guilt
  6. Anger
  7. Depression
  8. Unworthiness - ANS-2. Anger A 63-year-old woman with the diagnosis of estrogen-receptor positive cancer of the breast undergoes lumpectomy and radiation therapy, and tamoxifen (Nolvadex) is prescribed. The client asks the nurse how long she will have to take the medication. The nurse responds:
  9. "You'll have to take it for the rest of your life."
  10. "You'll need to take it for 10 days, like an antibiotic."
  11. "You'll need to take it for 5 years, after which it will be discontinued."
  12. "You'll need to take it for several months, until the bone pain subsides." - ANS-3. "You'll need to take it for 5 years, after which it will be discontinued." A client comes to the fertility clinic for hysterosalpingography using radiopaque contrast material to determine whether her fallopian tubes are patent. When preparing for the test, the nurse explains to the client that she:
  13. Will receive a local anesthetic and the pain will lessen
  14. Will have to rest in bed for 8 hours after the test is completed
  15. May have some persistent shoulder pain for 14 hours after the test
  16. May become nauseated during the test, but the nausea will subside - ANS-3. May have some persistent shoulder pain for 14 hours after the test A client measuring at 18 weeks' gestation visits the prenatal clinic stating that she is still very nauseated and vomits frequently. Physical examination reveals a brown vaginal discharge and a blood pressure of 148/90 mm Hg. What condition does the nurse suspect the client is experiencing?
  17. Dehydration
  18. Choriocarcinoma
  19. Hydatidiform mole
  20. Threatened abortion - ANS-3. Hydatidiform mole

A pregnant client with an infection tells the nurse that she has taken tetracycline (Tetracyn) for infections on other occasions and prefers to take it now. The nurse tells the client that tetracycline is avoided in the treatment of infections in pregnant women because it:

  1. Affects breastfeeding adversely
  2. Influences the fetus's teeth buds
  3. Causes fetal allergies to the medication
  4. Increases the fetus's tolerance to the medication - ANS-2. Influences the fetus's teeth buds A pregnant client at 30 weeks' gestation begins to experience contractions every 5 to 7 minutes. She is admitted with a diagnosis of preterm labor. Although the client is being given tocolytic therapy her cervix continues to dilate, and it is determined that a preterm birth is inevitable. Which medication does the nurse expect the health care provider to prescribe?
  5. Norgestrel
  6. Aminophylline
  7. Dexamethasone
  8. Magnesium sulfate - ANS-3. Dexamethasone **Dexamethasone is a glucocorticoid that stimulates the production of fetal lung surfactants, which are needed for fetal lung maturity; administration is started 48 hours before the expected birth. A client asks the nurse about the use of an intrauterine device (IUD) for contraception. What information should the nurse include in the response? (Select all that apply.)
  9. Expulsion of the device
  10. Occasional dyspareunia
  11. Delay of return to fertility
  12. Risk for perforation of the uterus
  13. Increased number of vaginal infections - ANS-1. Expulsion of the device
  14. Occasional dyspareunia
  15. Risk for perforation of the uterus A primigravida at term is admitted to the birthing room in active labor. Later, when the client is dilated 8 cm, she tells the nurse that she has the urge to push. The nurse instructs her to pant-blow at this time because pushing can cause which of the following?
  16. Prolapse the cord
  17. Rupture the uterus
  18. Cervical edema
  19. Lead to a precipitous birth - ANS-3. Cervical edema A pregnant client has a positive group B Streptoccus (GBS) test at 36 weeks' gestation. What is the priority instruction that the nurse will include in the client's teaching plan?
  20. "Go straight to the outpatient area of the maternity unit for a nonstress test."

**Syphilis is primarily a vascular disease; aortitis, valvular insufficiency, and aortic aneurysms are the most prevalent problems in tertiary syphilis. The nurse is teaching a sex education course to high school students. What should the nurse teach them about why gonorrhea is difficult to control? (Select all that apply.)

  1. Symptoms of the disease are vague.
  2. Screening blood tests are expensive.
  3. The incubation period is relatively short.
  4. Causative organisms have become resistant to treatment.
  5. Diagnostic tests for the causative organism are not yet available. - ANS-1. Symptoms of the disease are vague.
  6. The incubation period is relatively short.
  7. Diagnostic tests for the causative organism are not yet available. Which behavior indicates to a nurse that a new mother is in the taking-hold phase?
  8. Calling the baby by name
  9. Talking about the labor and birth
  10. Touching the baby with her fingertips
  11. Being involved with the infant's need to eat and sleep - ANS-1. Calling the baby by name **The mother has moved into the taking-hold phase when she takes control and becomes actively involved with her infant and calls the infant by name A primigravida tells the nurse that she has morning sickness. What suggestion should the nurse make to help relieve the nausea?
  12. Eating three small meals a day
  13. Increasing dietary calcium intake
  14. Avoiding long periods without food
  15. Drinking 2 quarts or more of fluid a day - ANS-3. Avoiding long periods without food **Fasting results in hypoglycemia, which can cause nausea; in addition, the developing fetus should not be deprived of nutrients for any length of time. A client has a modified radical mastectomy because of a malignant tumor of the breast. What does the nurse plan to teach the client during the early postoperative period?
  16. Keep the arm in an elevated position.
  17. Observe the incision site for redness and bleeding.
  18. Maintain a high Fowler position with the affected arm on a pillow.
  19. Perform range-of-motion exercises, including flexion and abduction of the affected arm. - ANS-1. Keep the arm in an elevated position. The clinic nurse is providing home care instructions for a client with pelvic inflammatory disease. What resting position should be recommended by the nurse?
  20. Sims
  21. Fowler
  1. Supine with knees flexed
  2. Lithotomy with head elevated - ANS-2. Fowler **The Fowler position facilitates localization of the infection by pooling exudate in the lower pelvis. A client's nipples become sore and tender as a result of her newborn's vigorous suckling. What should the nurse recommend that the mother do to alleviate the soreness? (Select all that apply.)
  3. Apply ice packs before each feeding.
  4. Formula feed the baby for a few days.
  5. Take the prescribed analgesic medication.
  6. Expose the nipples to air several times a day.
  7. Apply hydrogel pads to the nipples after each feeding. - ANS-4. Expose the nipples to air several times a day.
  8. Apply hydrogel pads to the nipples after each feeding. **Exposure of the nipples to air dries the nipples by way of evaporation; exposure also tends to harden the nipples, making them less tender. Hydrogel pads create a moist environment conducive to healing. A client in her 30th week of gestation is in preterm labor, and the practitioner prescribes betamethasone (Celestone). The client asks the nurse why she is being given this drug. As a basis for the response the nurse takes into consideration that it:
  9. Prevents chorioamnionitis
  10. Increases uteroplacental exchange
  11. Promotes neonatal pulmonary maturity
  12. Is used to treat fetal respiratory distress syndrome - ANS-3. Promotes neonatal pulmonary maturity A client's temperature is 100.4° F 12 hours after a spontaneous vaginal birth. What does the nurse suspect is the cause of the increased temperature?
  13. Mastitis
  14. Dehydration
  15. Puerperal infection
  16. Urinary tract infection - ANS-2. Dehydration A woman has made the decision to have breast augmentation surgery, and the procedure is to be performed on an outpatient basis. As part of the preoperative protocol, the nurse provides teaching regarding the discharge instructions. Which instructions apply to this type of surgery? (Select all that apply.)
  17. Avoid taking aspirin or NSAIDs (e.g., ibuprofen [Advil]) for pain relief.
  18. Sleep with your head and torso elevated for at least 1 week.
  19. You may sleep on your back or sides but not on your stomach.
  20. Begin slowly raising your arms over your head after the first week.
  1. Tailor sitting
  2. Pelvic rocking
  3. Forward tilting
  4. Sacral pressure
  5. Kegel exercises - ANS-2. Pelvic rocking
  6. Forward tilting
  7. Sacral pressure A client who has just begun breastfeeding complains that her nipples feel very sore. What should the nurse encourage the mother to do? (Select all that apply.)
  8. Apply cool packs to her breasts to reduce the discomfort
  9. Take the analgesic medication prescribed to limit the discomfort
  10. Remove the infant from the breast for a few days to rest the nipples
  11. Never expose the nipples to air, only wear a tight fitting brassiere
  12. Assume a different position when breastfeeding to adjust the infant's sucking - ANS-
  13. Apply cool packs to her breasts to reduce the discomfort
  14. Take the analgesic medication prescribed to limit the discomfort
  15. Assume a different position when breastfeeding to adjust the infant's sucking A client who had a child with Tay-Sachs disease is pregnant and is to have an amniocentesis to determine whether the fetus has the disease. The nurse counsels her to plan for the procedure at the optimal time for the procedure at:
  16. 6 to 8 weeks' gestation
  17. 14 to 16 weeks' gestation
  18. 18 to 20 weeks' gestation
  19. 22 to 24 weeks' gestation - ANS-2. 14 to 16 weeks' gestation **An amniocentesis is done at this time because a therapeutic abortion may be legally and safely performed if desired by the parents. A nurse is caring for a client who is being given intravenous magnesium sulfate to treat preeclampsia. Which adverse side effect alerts the nurse to notify the health care provider?
  20. Respiratory rate of 18 breaths/min
  21. 2+ patellar reflex response
  22. Magnesium blood level of 5 mEq/L
  23. Urine output of less than 100 mL in 4 hours - ANS-4. Urine output of less than 100 mL in 4 hours A pregnant client who is scheduled for a nonstress test (NST) asks a nurse how the test can show that "my baby is all right." The nurse explains that it is a way of evaluating the condition of the fetus by comparing the fetal heart rate (FHR) with:
  24. Fetal gestational age
  25. Fetal physical activity
  26. Maternal blood pressure
  27. Maternal uterine contractions - ANS-2. Fetal physical activity

A pregnant client with diabetes is referred to the dietitian in the prenatal clinic for nutritional assessment and counseling. What should the nurse emphasize when reinforcing the client's dietary program?

  1. The need to increase high-quality protein and decreasing fats
  2. The need to increase carbohydrates to meet energy demands and prevent ketosis
  3. The need to eat a low-calorie diet that maintains the current insulin coverage and helps prevent hyperglycemia
  4. The need to eat a pregnancy diet that meets increased dietary needs and to adjust the insulin dosage as necessary - ANS-4. The need to eat a pregnancy diet that meets increased dietary needs and to adjust the insulin dosage as necessary A nurse instructs a client who is taking oral contraceptives to increase her intake of dietary supplements. Which supplement should be increased?
  5. Calcium
  6. Vitamin C
  7. Vitamin E
  8. Potassium - ANS-2. Vitamin C **Oral contraceptives can affect the metabolism of certain vitamins, particularly vitamin C, and supplementation may be required. A client in preterm labor is to receive a tocolytic medication, and bedrest is prescribed. Which position should the nurse suggest that the client maintain while on bedrest?
  9. Lateral
  10. Supine
  11. Fowler
  12. Semi-Fowler - ANS-1. Lateral **The lateral position relieves pressure on the vena cava, thereby promoting venous return and increasing placental perfusion. Before the administration of Rho(D) immune globulin (RhoGAM) the nurse reviews the laboratory data of a pregnant client. Which blood type and Coombs test result must a pregnant woman have to receive RhoGAM after giving birth?
  13. Rh-positive and Coombs positive
  14. Rh-negative and Coombs positive
  15. Rh-positive and Coombs negative
  16. Rh-negative and Coombs negative - ANS-4. Rh-negative and Coombs negative **Rho(D) immune globulin (RhoGAM) is given to an Rh-negative mother after birth if the infant is Rh positive and the Coombs test reveals that the mother was not previously sensitized (negative).