Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 1 DOCUMENT OUTLINE Table of Contents Chapter 01: Perspectives on
Maternal, Newborn, and Womens Health Care Chapter 02: Family-Centered
Community-Based Care Chapter 03: Anatomy and Physiology of the Reproductive
System Chapter 04: Common Reproductive Issues Chapter 05: Sexually Transmitted
Infections Chapter 06: Disorders of the Breasts Chapter 07: Benign Disorders of
the Female Reproductive Tract Chapter 08: Cancers of the Female Reproductive
Tract Chapter 09: Violence and Abuse Chapter 10: Fetal Development and Genetics
Chapter 11: Maternal Adaptation During Pregnancy Chapter 12: Nursing Management
During Pregnancy Chapter 13: Labor and Birth Process Chapter 14: Nursing Management
During Labor and Birth Chapter 15: Postpartum Adaptations Chapter 16: Nursing
Management During the Postpartum Period Chapter 17: Newborn Transitioning
Chapter 18: Nursing Management of the Newborn Chapter 19: Nursing Management of
Pregnancy at Risk- Pregnancy Chapter 20: Nursing Management of the Pregnancy at
Risk Chapter 21: Nursing Management of Labor and Birth at Risk Chapter 22:
Nursing Management of the Postpartum Woman at Risk Chapter 23: Nursing Care of
the Newborn With Special Needs Chapter 24: Nursing Management of the Newborn at
Risk 1. The United States ranks 50th in the world for maternal mortality and
41st among industrialized nations for infant mortality rate. When developing
programs to assist in decreasing these rates, which factor would most likely
need to be addressed as having the greatest impact? A)Resolving all language
and cultural differences B) Assuring early and adequate prenatal care C)
Providing more extensive women's shelters D)Encouraging all women to eat a
balanced diet 2. When integrating the principles of family-centered care, the
nurse would include which of the following? A)Childbirth is viewed as a
procedural event B) Families are unable to make informed choices C) Childbirth
results in changes in relationships D)Families require little information to
make appropriate decisions 3. When preparing a teaching plan for a group of
first-time pregnant women, the nurse expects to review how maternity care has
changed over the years. Which of the following would the nurse include when
discussing events of the 20th century? A)Epidemics of puerperal fever B)
Performance of the first cesarean birth C) Development of the x-ray to assess
pelvic size D)Creation of free-standing birth centers 4. After teaching a group
of students about pregnancy-related mortality, the instructor determines that
additional teaching is needed when the students identify which condition as a
leading cause? A)Hemorrhage B) Embolism C) Obstructed labor Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 3
D)Infection 5. The nurse is working with a group of community health members to
develop a plan to address the special health needs of women. Which of the
following conditions would the group address as the major problem? A)Smoking B)
Heart disease C) Diabetes D)Cancer 6. When assessing a family for possible
barriers to health care, the nurse would consider which factor to be most
important? A)Language B) Health care workers attitudes C) Transportation
D)Finances 7. After teaching a group of nursing students about the issue of
informed consent. Which of the following, if identified by the student, would
indicate an understanding of a violation of informed consent? A)Performing a
procedure on a 15-year-old without consent B) Serving as a witness to the
signature process C) Asking whether the client understands what she is signing
D)Getting verbal consent over the phone for emergency procedures 8. The nurse
is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis.
His parents are out of town on vacation, and the child is staying with a
neighbor. Which action would be the priority? A)Getting telephone consent with
two people listening to the verbal consent B) Providing emergency care without
parental consent C) Contacting the childs aunt or uncle to obtain their consent
D)Advocating for termination of parental rights for this situation Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 4 9.
After teaching nursing students about the basic concepts of family-centered
care, the instructor determines that the teaching was successful when the
students state which of the following? A)Childbirth affects the entire family,
and relationships will change. B) Families are not capable of making health
care decisions for themselves. C) Mothers are the family members affected by
childbirth. D)Childbirth is a medical procedure. 10.A nursing instructor is
preparing a class discussion on the trends in health care and health care
delivery over the past several centuries. When discussing the changes during
the past century, which of the following would the instructor be least likely
to include? A) Disease prevention B) Health promotion C) Wellness D) Analysis
of morbidity and mortality 11.A nurse is assigned to care for an Asian American
client. The nurse develops a plan of care with the understanding that based on
this clients cultural background, the client most likely views illness as which
of the following? A) Caused by supernatural forces. B) A punishment for sins.
C) Due to spirits or demons. D) From an imbalance of yin and yang 12.A nurse is
developing a plan of care for a woman to ensure continuity of care during
pregnancy, labor, and childbirth. Which of the following would be most important
for the nurse to incorporate into that plan? A) Adhering to strict, specific
routines B) Involving a pediatric physician C) Educating the client about the
importance of a support person D) Assigning several nurses as a support team
13.A nursing instructor is preparing a class discussion on case management in
maternal and newborn health care. Which of the following would the instructor
include as a key component? Select all that apply. Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 5 A) Advocacy B)
Coordination C) Communication D) Resource management E) Event managed care
14.After teaching a group of students about the concept of maternal mortality,
the instructor determines that additional teaching is needed when the students
state which of the following? A) The rate includes accidental causes for
deaths. B) It addresses pregnancy-related causes. C) The duration of the
pregnancy is not a concern. D) The time frame is typically for a specified
year. 15.A group of students are reviewing the historical aspects about
childbirth. The students demonstrate understanding of the information when they
identify the use of twilight sleep as a key event during which time frame? A)
1700s B) 1800s C) 1900s D) 2000s 16.A nurse is providing care to a woman who
has just delivered a healthy newborn. Which action would least likely
demonstrate application of the concept of family-centered care? A) Focusing on
the birth as a normal healthy event for the family B) Creating opportunities
for the family to make informed decisions C) Encouraging the woman to keep her
other children at home D) Fostering a sense of respect for the mother and the
family 17.When discussing fetal mortality with a group of students, a nurse
addresses maternal factors. Which of the following would the nurse most likely
include? Select all that apply. Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 6 A) Chromosomal abnormalities B)
Malnutrition C) Preterm cervical dilation D) Underlying disease condition E)
Poor placental attachment 18.A nurse is preparing a presentation for a local
community group about health status and childrens health. Which of the
following would the nurse include as one of the most significant measures? A)
Fetal mortality rate B) Neonatal mortality rate C) Infant mortality rate D)
Maternal mortality rate 19.A group of students are reviewing an article
describing information related to indicators for women's health and the results
of a national study. Which of the following would the students identify as
being satisfactory for women? Select all that apply. A) Smoking cessation B)
Colorectal cancer screening C) Violence against women D) Health insurance
coverage E) Mammograms 20.A nurse is preparing a presentation for a local
women's group about heart disease and women. Which of the following would the
nurse expect to address when discussing measures to promote health. A) Women
have similar symptoms as men for a heart attack. B) Heart disease is no longer
viewed as a man's disease. C) Women experiencing a heart attack are at greater
risk for dying. D) Heart attacks in women are more easily diagnosed. Test Bank
- Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 7
21.A nurse is working to develop a health education program for a local
community to address breast cancer awareness. Which of the following would the
nurse expect to include when describing this problem to the group? Select all
that apply. A) White women have higher rates of breast cancer than African
American women. B) African American women are more likely to die from breast
cancer at any age. C) Survival at any stage is worse among white women. D)
Women living in South America have the highest rates of breast cancer. E) Breast
cancer is the leading cause of cancer mortality in women. 22.A group of nursing
students are reviewing information about factors affecting maternal, newborn,
and women's health. The students demonstrate understanding of the information
when they identify which of the following deficiencies as being associated with
poverty? Select all that apply. A) Literacy B) Employment opportunities C)
Mobility D) Political representation E) Skills Chapter 02: Family-Centered
Community-Based Care 1. The nurse is caring for a 2-week-old newborn girl with
a metabolic disorder. Which of the following activities would deviate from the
characteristics of family-centered care? A)Softening unpleasant information or
prognoses B) Evaluating and changing the nursing plan of care C) Collaborating
with the child and family as equals D)Showing respect for the familys beliefs
and wishes 2. The nurse is providing home care for a 6-year-old girl with
multiple medical challenges. Which of the following activities would be
considered the tertiary level of prevention? A)Arranging for a physical therapy
session B) Teaching parents to administer albuterol C) Reminding parent to give
a full course of antibiotics D)Giving a DTaP vaccination at the proper interval
3. A nursing student is reviewing information about documenting client care and
education in the medical record and the purposes that it serves. The student
demonstrates a need for additional study when the nurse identifies which of the
following as a reason? A)Serves as a communication tool for the
interdisciplinary team. B) Demonstrates education the family has received if
legal matters arise. C) Permits others access to allow refusal of medical
insurance coverage. D)Verifies meeting client education standards set by the
Joint Commission. 4. A pregnant client tells her nurse that she is interested
in arranging a home birth. After educating the client on the advantages and
disadvantages, which statement would indicate that the client understood the
information? A)I like having the privacy, but it might be too expensive for me
to set up in my home. B) I want to have more control, but I am concerned if an
emergency would arise. C) It is safer because I will have a midwife. Test Bank
- Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 10
D)The midwife is trained to resolve any emergency, and she can bring any pain
meds. 5. The nurse is making a home visit to a client who had a cesarean birth
3 days ago. Assessment reveals that the client is complaining of intermittent
pain, rating it as 8 on a scale of 1 to 10. She states, I'm pretty tired. And
with this pain, I havent been drinking and eating like I should. The medication
helps a bit but not much. My mom has been helping with the baby. Her incision
is clean, dry, and intact. Which nursing diagnosis would the nurse identify as
the priority for this client? A)Impaired skin integrity related to cesarean
birth incision B) Fatigue related to effects of surgery and caretaking
activities C) Imbalanced nutrition, less than body requirements related to poor
fluid and food intake D)Acute pain related to incision and cesarean birth 6.
When caring for childbearing families from cultures different from ones own,
which of the following must be accomplished first? A)Adapt to the practices of
the familys culture B) Determine similarities between both cultures C) Assess
personal feelings about that culture D)Learn as much as possible about that
culture 7. After teaching a group of students about the changes in health care
delivery and funding, which of the following, if identified by the group as a
current trend seen in the maternal and child health care settings, would
indicate that the teaching was successful? A)Increase in community settings for
care B) Decrease in family poverty level C) Increase in hospitalization of
children D)Decrease in managed care 8. The nurse would recommend the use of
which supplement as a primary prevention strategy to prevent neural tube
defects with pregnant women? A)Calcium B) Folic acid C) Vitamin C Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 11
D)Iron 9. Which action would the nurse include in a primary prevention program
in the community to help reduce the incidence of HIV infection? A)Provide
treatment for clients who test positive for HIV B) Monitor viral load counts
periodically C) Educate clients in how to practice safe sex D)Offer testing for
clients who practice unsafe sex 10.When assuming the role of discharge planner
for a woman requiring ventilator support at home, the nurse would do which of
the following? A) Confer with the clients mother B) Teach new self-care skills
to the client C) Determine if there is a need for back-up power D) Discuss
coverage with the insurance company 11.When comparing community-based nursing
with nursing in the acute care setting to a group of nursing students, the
nurse describes the challenges associated with community-based nursing. Which
of the following would the nurse include? A) Increased time available for
education B) Improved access to resources C) Decision making in isolation D)
Greater environmental structure 12.After teaching a group of students about the
different levels of prevention, the instructor determines a need for additional
teaching when the students identify which of the following as a secondary
prevention level activity in community-based health care? A) Teaching women to
take folic acid supplements to prevent neural tube defects B) Working with
women who are victims of domestic violence C) Working with clients at an HIV
clinic to provide nutritional and CAM therapies D) Teaching hypertensive
clients to monitor blood pressure Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 12 13.A nursing instructor is
describing trends in maternal and newborn health care. The instructor addresses
the length of stay for vaginal births during the past decade, citing that which
of the following denotes the average stay? A) 2448 hours or less B) 7296 hours
or less C) 4872 hours or less D) 96120 hours or less 14. Which of the following
statements is accurate regarding women's health care in todays system? A) Women
spend 95 cents of every dollar spent on health care. B) Women make almost 90%
of all health care decisions. C) Women are still the minority in the United
States. D) Men use more health services than women. 15.A nurse is educating a
client about a care plan. Which of the following statements would be
appropriate to assess the clients learning ability? A) Did you graduate from
high school; how many years of schooling did you have? B) Do you have someone
in your family who would understand this information? C) Many people have
trouble remembering information; is this a problem for you? D) Would you prefer
that the doctor give you more detailed medical information? 16.A nurse is
developing cultural competence. Which of the following indicates that the nurse
is in the process of developing cultural knowledge? Select all that apply. A)
Examining personal sociocultural heritage B) Reviewing personal biases and
prejudices C) Seeking resources to further understanding of other cultures D)
Becoming familiar with other culturally diverse lifestyles E) Performing a
competent cultural assessment F) Advocating for social justice to eliminate
disparities. Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 13 17.A nurse is engaged in providing family-centered
care for a woman and her family. The nurse is providing instrumental support
with which activity? A) Explaining to the woman and family what to expect
during the birth process. B) Assisting the woman in breathing techniques to
cope with labor contractions. C) Reinforcing the woman's role as a mother after
birth D) Helping the family obtain extra financial help for prescribed
phototherapy 18.A nurse is considering a change in employment from the acute
care setting to community-based nursing. The nurse is focusing her job search
on ambulatory care settings. Which of the following would the nurse most likely
find as a possible setting? Select all that apply. A) Urgent care center B)
Hospice care C) Immunization clinic D) Physicians office E) Day surgery center
F) Nursing home 19.A nursing instructor is presenting a class for a group of
students about community-based nursing interventions. The instructor determines
that additional teaching is needed when the students identify which of the
following? A) Conducting childbirth education classes B) Counseling a pregnant
teen with anemia C) Consulting with a parent of a child who is vomiting D)
Performing epidemiologic investigations 20.During class, a nursing student
asks, I read an article that was talking about integrative medicine. What is
that? Which response by the instructor would be most appropriate? A) It refers
to the use of complementary and alternative medicine in place of traditional
therapies for a condition. B) It means that complementary and alternative
medicine is used together with conventional therapies to reduce pain or
discomfort. Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 14 C) It means that mainstream medical therapies and
complementary and alternative therapies are combined based on scientific
evidence for being effective. D) It refers to situations when a client and his
or her family prefer to use an unproven method of treatment over a proven one.
21.While a nurse is obtaining a health history, the client tells the nurse that
she practices aromatherapy. The nurse interprets this as which of the
following? A) Use of essential oils to stimulate the sense of smell to balance
the mind and body B) Application of pressure to specific points to allow
self-healing C) Use of deep massage of areas on the foot or hand to rebalance
body parts D) Participation in chanting and praying to promote healing. 22.A
pregnant woman asks the nurse about giving birth in a birthing center. She
says, I'm thinking about using one but I'm not sure. Which of the following
would the nurse need to integrate into the explanation about this birth
setting? (Select all that apply.) A) An alternative for women who are
uncomfortable with a home birth. B) The longer length of stay needed when
compared to hospital births C) Focus on supporting women through labor instead
of managing labor D) View of labor and birth as a normal process requiring no
intervention E) Care provided primarily by obstetricians with midwives as
backup care 23.A nurse practicing in the community is preparing a presentation
for a group of nursing students about this practice setting. Which of the
following would the nurse include as characteristic of this role? A) Greater
emphasis on direct physical care B) Broader assessment to include the
environment C) Increased dependency on physician D) Limited decision making and
support 24.A nurse is preparing a teaching plan for a woman who is pregnant for
the first time. Which of the following would the nurse incorporate into the
teaching plan to foster the clients learning? (Select all that apply.) A) Teach
survival skills first Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 15 B) Use simple, nonmedical language C) Refrain
from using a hands-on approach D) Avoid repeating information E) Use visual
materials such as photos and videos 25.A group of nurses are reviewing the
steps for developing cultural competence. The students demonstrate
understanding when they identify which of the following as the final step? A)
Cultural knowledge B) Cultural skills C) Cultural encounter D) Cultural
awareness Chapter 03: Anatomy and Physiology of the Reproductive System 1. When
describing the menstrual cycle to a group of young women, the nurse explains
that estrogen levels are highest during which phase of the endometrial cycle?
A)Menstrual B) Proliferative C) Secretory D)Ischemic 2. After teaching a group
of adolescent girls about female reproductive development, the nurse determines
that teaching was successful when the girls state that menarche is defined as a
woman's first: A)Sexual experience B) Full hormonal cycle C) Menstrual period
D)Sign of breast development 3. A client with a 28-day cycle reports that she
ovulated on May 10. The nurse would expect the clients next menses to begin on:
A)May 24 B) May 26 C) May 30 D)June 1 4. Which female reproductive tract structure
would the nurse describe to a group of young women as containing rugae that
enable it to dilate during labor and birth? A)Cervix B) Fallopian tube C)
Vagina D)Vulva Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 18 5. After teaching a group of pregnant women about
breast-feeding, the nurse determines that the teaching was successful when the
group identifies which hormone as important for the production of breast milk
after childbirth? A)Placental estrogen B) Progesterone C)
Gonadotropin-releasing hormone D)Prolactin 6. The nurse is assessing a
13-year-old girl who has had her first menses. Which of the following events
would the nurse expect to have occurred first? A)Evidence of pubic hair B)
Development of breast buds C) Onset of menses D)Growth spurt 7. When describing
the ovarian cycle to a group of students, which phase would the instructor
include? A) Luteal phase B) Proliferative phase C) Menstrual phase D) Secretory
phase 8. The nurse is explaining the events that lead up to ovulation. Which
hormone would the nurse identify as being primarily responsible for ovulation?
A)Estrogen B) Progesterone C) Follicle-stimulating hormone D)Luteinizing
hormone 9. The nurse is teaching a health education class on male reproductive
anatomy and asks the students to identify the site of sperm production. Which
structure, if identified by the group, would indicate to the nurse that the
teaching was successful? Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 19 A)Testes B) Seminal vesicles C) Scrotum
D)Prostate gland 10.The nurse is creating a diagram that illustrates the
components of the male reproductive system. Which structure would be
inappropriate for the nurse to include as an accessory gland? A) Seminal
vesicles B) Prostate gland C) Cowpers glands D) Vas deferens 11.The nurse is
preparing an outline for a class on the physiology of the male sexual response.
Which event would the nurse identify as occurring first? A) Sperm emission B)
Penile vasodilation C) Psychological release D) Ejaculation 12.A woman comes to
the clinic complaining that she has little sexual desire. As part of the
clients evaluation, the nurse would anticipate the need to evaluate which
hormone level? A) Progesterone B) Estrogen C) Gonadotropin-releasing hormone D)
Testosterone 13.A nurse is conducting a class for a group of teenage girls
about female reproductive anatomy and physiology. Which of the following would
the nurse include as an external female reproductive organ? Select all that
apply. A) Mons pubis Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 20 B) Labia C) Vagina D) Clitoris E) Uterus
14.When describing the hormones involved in the menstrual cycle, a nurse identifies
which hormone as responsible for initiating the cycle? A) Estrogen B)
Luteinizing hormone C) Progesterone D) Prolactin 15.A nursing instructor is
describing the hormones involved in the menstrual cycle to a group of nursing
students. The instructor determines the teaching was successful when the
students identify follicle-stimulating hormone as being secreted by which of
the following? A) Hypothalamus B) Anterior pituitary gland C) Ovaries D) Corpus
luteum 16.A woman comes to the clinic for an evaluation. During the visit, the
woman tells the nurse that her menstrual cycles have become irregular. Ive also
been waking up at night feeling really hot and sweating. The nurse interprets
these findings as which of the following? A) Menopause B) Perimenopause C)
Climacteric D) Menarche 17.After teaching a group of students about female
reproductive anatomy, the instructor determines that the teaching was
successful when the students identify which of the following as the site of
fertilization? A) Vagina Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 21 B) Uterus C) Fallopian tubes D)
Vestibule 18.A woman comes to the clinic complaining of a vaginal discharge.
The nurse suspects that the client has an infection. When gathering additional
information, which of the following would the nurse be least likely to identify
as placing the client at risk for an infection? A) Recent antibiotic therapy
for an upper respiratory infection B) Last menstrual period about 5 days ago. C)
Weekly douching D) Frequent use of feminine hygiene sprays. 19.A group of
nursing students are reviewing information about the male reproductive
structures. The students demonstrate understanding of the information when they
identify which of the following as accessory organs? (Select all that apply.)
A) Testes B) Vas deferens C) Bulbourethral glands D) Prostate gland E) Penis
20.A nurse is examining a female client and tests the clients vaginal pH. Which
finding would the nurse interpret as normal? A) 4.5 B) 7 C) 8.5 D) 10 21.When
describing the male sexual response to a group of students, the instructor
determines that the teaching was successful when they identify emission as
which of the following? Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 22 A) Semen forced through the urethra to the
outside B) Movement of sperm from the testes and fluid into the urethras C)
Dilation of the penile arteries with increased blood flow to the tissues. D)
Bodys return to the physiologic nonstimulated state 22.A nurse is describing
the structure and function of the reproductive system to an adolescent health
class. The nurse describes the secretion of the seminal vesicles as which of
the following? A) Mucus-like B) Alkaline C) Acidic D) Semen Chapter 04: Common
Reproductive Issues 1. After discussing various methods of contraception with a
client and her partner, the nurse determines that the teaching was successful
when they identify which contraceptive method as providing protection against
sexually transmitted infections (STIs)? A)Oral contraceptives B) Tubal ligation
C) Condoms D)Intrauterine system 2. When discussing contraceptive options,
which method would the nurse recommend as being the most reliable? A)Coitus
interruptus B) Lactational amenorrheal method (LAM) C) Natural family planning
D)Intrauterine system 3. A client comes to the clinic with abdominal pain.
Based on her history the nurse suspects endometriosis. The nurse expects to
prepare the client for which of the following to confirm this suspicion?
A)Pelvic examination B) Transvaginal ultrasound C) Laparoscopy
D)Hysterosalpingogram 4. A client is to receive an implantable contraceptive.
The nurse describes this contraceptive as containing: A) Synthetic progestin B)
Combined estrogen and progestin C) Concentrated spermicide D) Concentrated
estrogen Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 25 5. The nurse discusses various contraceptive methods
with a client and her partner. Which method would the nurse explain as being
available only with a prescription? A)Condom B) Spermicide C) Diaphragm D)Basal
body temperature 6. When developing a teaching plan for a couple considering
contraception options, which of the following statements would the nurse
include? A)You should select one that is considered to be 100% effective. B)
The best one is the one that is the least expensive and most convenient. C) A
good contraceptive doesnt require a physicians prescription. D)The best contraceptive
is one that you will use correctly and consistently. 7. Which of the following
measures would the nurse include in the teaching plan for a woman to reduce the
risk of osteoporosis after menopause? A)Taking vitamin supplements B) Eating
high-fiber, high-calorie foods C) Restricting fluid to 1,000 mL daily
D)Participating in regular daily exercise 8. When teaching a group of
postmenopausal women about hot flashes and night sweats, the nurse would
address which of the following as the primary cause? A)Poor dietary intake B)
Estrogen deficiency C) Active lifestyle D)Changes in vaginal pH 9. A client
states that she is to have a test to measure bone mass to help diagnose
osteoporosis. The nurse would most likely plan to prepare the client for: Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 26 A)DEXA scan B) Ultrasound C) MRI D)Pelvic x-ray 10.The nurse is
reviewing the medical records of several clients. Which client would the nurse
expect to have an increased risk for developing osteoporosis? A) A woman of
African American descent B) A woman who plays tennis twice a week C) A thin
woman with small bones D) A woman who drinks one cup of coffee a day 11.Which
of the following would the nurse emphasize when teaching postmenopausal women
about ways to reduce the risk of osteoporosis? A) Swimming daily B) Taking
vitamin A C) Following a low-fat diet D) Taking calcium supplements 12. Which
finding would the nurse expect to find in a client with endometriosis? A) Hot
flashes B) Dysuria C) Fluid retention D) Fever 13.After the nurse teaches a
client about ways to reduce the symptoms of premenstrual syndrome, which client
statement indicates a need for additional teaching? A) I will make sure to take
my estrogen supplements a week before my period. B) Ive signed up for an
aerobic exercise class three times a week. Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 27 C) I'll cut down on the
amount of coffee and colas I drink. D) I quit smoking about a month ago, so
that should help. 14.A woman has opted to use the basal body temperature method
for contraception. The nurse instructs the client that a rise in basal body
temperature indicates which of the following? A) Onset of menses B) Ovulation C)
Pregnancy D) Safe period for intercourse 15.A woman using the cervical mucus
ovulation method of fertility awareness reports that her cervical mucus looks
like egg whites. The nurse interprets this as which of the following? A)
Spinnbarkeit mucus B) Purulent mucus C) Postovulatory mucus D) Normal
preovulation mucus 16.The nurse is reviewing the laboratory test results of a
client with dysfunctional uterine bleeding (DUB). Which finding would be of
concern? A) Negative pregnancy test B) Hemoglobin level of 10.1 g/dL C)
Prothrombin time of 60 seconds D) Serum cholesterol of 140 mg/dL 17.A nurse is
preparing a class for a group of women at a family planning clinic about
contraceptives. When describing the health benefits of oral contraceptives,
which of the following would the nurse most likely include? (Select all that
apply.) A) Protection against pelvic inflammatory disease B) Reduced risk for
endometrial cancer C) Decreased risk for depression Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 28 D) Reduced risk
for migraine headaches E) Improvement in acne 18.After teaching a group of
students about the different methods for contraception, the instructor
determines that the teaching was successful when the students identify which of
the following as a mechanical barrier method? (Select all that apply.) A)
Condom B) Cervical cap C) Cervical sponge D) Diaphragm E) Vaginal ring 19.After
assessing a woman who has come to the clinic, the nurse suspects that the woman
is experiencing dysfunctional uterine bleeding. Which statement by the client
would support the nurses suspicions? A) Ive been having bleeding off and on
thats irregular and sometimes heavy. B) I get sharp pain in my lower abdomen
usually starting soon after my period comes. C) I get really irritable and
moody about a week before my period. D) My periods have been unusually long and
heavy lately. 20.After teaching a group of students about premenstrual
syndrome, the instructor determines that additional teaching is needed when the
students identify which of the following as a prominent assessment finding? A)
Bloating B) Tension C) Dysphoria D) Weight loss 21.A nurse is describing the
criteria needed for the diagnosis of premenstrual dysphoric disorder (PMDD).
Which of the following would the nurse include as a mandatory requirement for
the diagnosis? A) Appetite changes B) Sleep difficulties Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 29 C)
Persistent anger D) Chronic fatigue 22.When reviewing the medical record of a
client diagnosed with endometriosis, which of the following would the nurse
identify as a risk factor for this woman? A) Low fat in the diet B) Age of 14
years for menarche C) Menstrual cycles of 24 days D) Short menstrual flow 23.A
client who has come to the clinic is diagnosed with endometriosis. Which of the
following would the nurse expect the physician to prescribe as a first-line
treatment? A) Progestins B) Antiestrogens C) Gonadotropin-releasing hormone analogues
D) NSAIDs 24.A woman comes to the clinic because she has been unable to
conceive. When reviewing the woman's history, which of the following would the
nurse least likely identify as a possible risk factor? A) Age of 25 years B)
History of smoking C) Diabetes since age 15 years D) Weight below standard for
height and age 25.A couple comes to the clinic for a fertility evaluation. The
male partner is to undergo a semen analysis. After teaching the partner about
this test, which client statement indicates that the client has understood the
instructions? A) I need to bring the specimen to the lab the day after
collecting it. B) I will place the specimen in a special plastic bag to
transport it. C) I have to abstain from sexual activity for about 12 days before
the sample. Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 30 D) I will withdraw before I ejaculate during sex to
collect the specimen. 26.A nurse is preparing a class for a group of young
adult women about emergency contraceptives (ECs). Which of the following would
the nurse need to stress to the group. Select all that apply. A) ECs induce an
abortion like reaction. B) ECs provide some protection against STIs C) ECs are
birth control pills in higher, more frequent doses D) ECs are not to be used in
place of regular birth control E) ECs provide little protection for future
pregnancies. Chapter 05: Sexually Transmitted Infections 1. The nurse is
developing a plan of care for a client who is receiving highly active antiretroviral
therapy (HAART) for treatment of HIV. The goal of this therapy is to: A)Promote
the progression of disease B) Intervene in late-stage AIDS C) Improve survival
rates D)Conduct additional drug research 2. A woman who is HIV-positive is
receiving HAART and is having difficulty with compliance. To promote adherence,
which of the following areas would be most important to assess initially? A)The
woman's beliefs and education B) The woman's financial situation and insurance
C) The woman's activity level and nutrition D)The woman's family and living
arrangements 3. When developing a teaching plan for a community group about HIV
infection, which group would the nurse identify as an emerging risk group for
HIV infection? A)Native Americans B) Heterosexual women C) New health care
workers D)Asian immigrants 4. After teaching a group of adolescents about HIV,
the nurse asks them to identify the major means by which adolescents are
exposed to the virus. The nurse determines that the teaching was successful
when the group identifies which of the following? A)Sexual intercourse B)
Sharing needles for IV drug use C) Perinatal transmission Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 33
D)Blood transfusion 5. The nurse reviews the CD4 cell count of a client who is
HIV-positive. A result less than which of the following would indicate to the
nurse that the client has AIDS? A)1,000 cells/mm3 B) 700 cells/mm3 C) 450
cells/mm3 D)200 cells/mm3 6. When obtaining the health history from a client,
which factor would lead the nurse to suspect that the client has an increased
risk for sexually transmitted infections (STIs)? A)Hive-like rash for the past
2 days B) Five different sexual partners C) Weight gain of 5 lbs in 1 year D)Clear
vaginal discharge 7. Assessment of a female client reveals a thick, white
vaginal discharge. She also reports intense itching and dyspareunia. Based on
these findings, the nurse would suspect that the client has: A)Trichomoniasis
B) Bacterial vaginosis C) Candidiasis D)Genital herpes simplex 8. A client with
trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the
client to avoid which of the following while taking this drug? A)Alcohol B)
Nicotine C) Chocolate D)Caffeine Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 34 9. A woman gives birth to a healthy
newborn. As part of the newborns care, the nurse instills erythromycin
ophthalmic ointment as a preventive measure related to which STI? A)Genital
herpes B) Hepatitis B C) Syphilis D)Gonorrhea 10. Which findings would the
nurse expect to find in a client with bacterial vaginosis? A) Vaginal pH of 3
B) Fish-like odor of discharge C) Yellowish-green discharge D) Cervical
bleeding on contact 11.A pregnant woman diagnosed with syphilis comes to the
clinic for a visit. The nurse discusses the risk of transmitting the infection
to her newborn, explaining that this infection is transmitted to the newborn
through the: A) Amniotic fluid B) Placenta C) Birth canal D) Breast milk 12.The
nurse encourages a female client with human papillomavirus (HPV) to receive
continued follow-up care because she is at risk for: A) Infertility B)
Dyspareunia C) Cervical cancer D) Dysmenorrhea 13.A client is diagnosed with pelvic
inflammatory disease (PID). When reviewing the clients medical record, which of
the following would the nurse expect to find? (Select all that apply.) Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 35 A) Oral temperature of 100.4 degrees F B) Dysmenorrhea C) Dysuria
D) Lower abdominal tenderness E) Discomfort with cervical motion F) Multiparity
14. Which instructions would the nurse include when teaching a woman with
pediculosis pubis? A) Take the antibiotic until you feel better. B) Wash your
bed linens in bleach and cold water. C) Your partner doesnt need treatment at
this time. D) Remove the nits with a fine-toothed comb. 15.A client with
genital herpes simplex infection asks the nurse, Will I ever be cured of this
infection? Which response by the nurse would be most appropriate? A) There is a
new vaccine available that prevents the infection from returning. B) All you
need is a dose of penicillin and the infection will be gone. C) There is no
cure, but drug therapy helps to reduce symptoms and recurrences. D) Once you
have the infection, you develop an immunity to it. 16.A nurse is preparing a
presentation for a group of women at the clinic who have been diagnosed with
genital herpes. Which of the following would the nurse expect to include as a
possible precipitating factor for a recurrent outbreak? (Select all that
apply.) A) Exposure to ultraviolet light B) Exercise C) Use of corticosteroids
D) Emotional stress E) Sexual intercourse. Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 36 17.After teaching a class
on sexually transmitted infections, the instructor determines that the teaching
was successful when the class identifies which statement as true? A) STIs can
affect anyone if exposed to the infectious organism. B) STIs have been
addressed more on a global scale. C) Clients readily view the diagnosis of STI
openly. D) Most individuals with STIs are over the age of 30. 18.A group of
students are reviewing information about STIs. The students demonstrate
understanding of the information when they identify which of the following as
the most common bacterial STI in the United States? A) Gonorrhea B) Chlamydia
C) Syphilis D) Candidiasis 19.A nurse is assessing a client for possible risk
factors for chlamydia and gonorrhea. Which of the following would the nurse
identify? A) Asian American ethnicity B) Age under 25 years C) Married D)
Consistent use of barrier contraception 20.A nurse at a local community clinic
is developing a program to address STI prevention. Which of the following would
the nurse least likely include in the program? A) Outlining safer sexual
behavior B) Recommending screening for symptomatic individuals C) Promoting the
use of barrier contraceptives D) Offering education about STI transmission
21.After teaching a class on preventing pelvic inflammatory disease, the
instructor determines that the teaching was successful when the class
identifies which of the following as an effective method? Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 37 A) Advising
sexually active females to use hormonal contraception B) Encouraging vaginal
douching on a weekly basis. C) Emphasizing the need for infected sexual
partners to receive treatment D) Promoting routine treatment for asymptomatic
females as risk 22.A group of nursing students are reviewing information about
vaccines used to prevent STIs. The students would expect to find information
about which of the following? A) HIV B) HSV C) HPV D) HAV E) HBV 23.A mother
brings her 12-year-old daughter in for well-visit checkup. During the visit,
the nurse is discussing the use of prophylactic HPV vaccine for the daughter.
The mother agrees and the daughter receives her first dose. The nurse schedules
the daughter for the next dose, which would be given at which time? A) In 2
month B) In 2 months C) In 3 months D) In 4 months 24.A woman comes to the
clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis
based on which of the following? (Select all that apply.) A) Urinary frequency
B) Yellow/green discharge C) Joint pain D) Blister-like lesions E) Muscle aches
25.A nurse is teaching a women with genital ulcers how to care for them. Which
statement by the client Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 38 indicates a need for additional
teaching? A) I need to wash my hands after touching any of the ulcers. B) I
need to abstain from intercourse primarily when the lesions are present. C) I
should avoid applying ice or heat to my genital area. D) I can try lukewarm
sitz baths to help ease the discomfort. Chapter 06: Disorders of the Breasts 1.
The nurse is developing the discharge plan for a woman who has had a left-sided
modified radical mastectomy. The nurse is including instructions for ways to
minimize lymphedema. Which suggestion would most likely increase the woman's
symptoms? A)Wear gloves when you are doing any gardening. B) Have your blood
pressure taken in your right arm. C) Wear clothing with elasticized sleeves.
D)Avoid driving to and from work every day. 2. A laboratory technician arrives
to draw blood for a complete blood count (CBC. for a client who had a
right-sided mastectomy 8 hours ago. The client has an intravenous line with
fluid infusing in her left antecubital space. To obtain the blood specimen, the
technician places a tourniquet on the clients right arm. Which action by the
nurse would be most appropriate? A)Assist in holding the clients arm still. B)
Suggest a finger stick be done on one of the clients left fingers. C) Tell the
technician to obtain the blood sample from the clients left arm. D)Call the
surgeon to perform a femoral puncture. 3. The nurse determines that a woman has
implemented prescribed therapy for her fibrocystic breast disease when the
client reports that she has eliminated what from her diet? A)Caffeine B)
Cigarettes C) Dairy products D)Sweets 4. When assessing a client with suspected
breast cancer, which of the following would the nurse expect to find? A)Painful
lump B) Absence of dimpling C) Regularly shaped mass Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 41 D)Nipple
retraction 5. A woman who has undergone a right modified-radical mastectomy
returns from surgery. Which nursing intervention would be most appropriate at
this time? A)Ask the client how she feels about having her breast removed. B)
Attach a sign above her bed to have BP, IV lines, and lab work in her right
arm. C) Encourage her to turn, cough, and deep breathe at frequent intervals.
D)Position her right arm below heart level. 6. A breast biopsy indicates the
presence of malignant cells, and the client is scheduled for a mastectomy.
Which nursing diagnosis would the nurse most likely include in the clients
preoperative plan of care as the priority? A)Risk for deficient fluid volume B)
Activity intolerance C) Disturbed body image D)Impaired urinary elimination 7.
A 42-year-old woman is scheduled for a mammogram. Which of the following would
the nurse include when teaching the woman about the procedure? A)The room will
be darkened throughout the procedure. B) Each breast will be firmly compressed
between two plates. C) Make sure to refrain from eating or drinking after
midnight. D)A small needle will be inserted to get a sample for evaluation. 8.
During a clinical breast examination, the nurse palpates a well-defined, firm,
mobile lump in a 60-year-old woman's left breast. The nurse notifies the
physician. Which of the following would the nurse anticipate the physician to
order next? A)Mammogram B) Hormone receptor status C) Fine-needle aspiration
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 42 D)Genetic testing for BRCA 9. A client with advanced breast cancer,
who has had both chemotherapy and radiation therapy, is to start hormonal
therapy. Which agent would the nurse expect the client to receive? A)Progestins
B) Tamoxifen C) Cortisone D)Estrogen 10.As part of discharge planning, the
nurse refers a woman to Reach to Recovery. This groups primary purpose is to:
A) Help support women who have undergone mastectomies B) Raise funds to support
early breast cancer detection programs C) Provide all supplies needed after
breast surgery for no cost D) Collect statistics for research for the American
Cancer Society 11.A woman with breast cancer is undergoing chemotherapy. Which
of the following side effects would the nurse interpret as being most serious?
A) Vomiting B) Hair loss C) Fatigue D) Myelosuppression 12.A woman comes to the
clinic reporting a nipple discharge. On examination, the area below the areola
is red and slightly swollen, with tortuous tubular swelling. The nurse
interprets these findings as suggestive of which of the following? A)
Fibrocystic breast disorder B) Intraductal papilloma C) Duct ectasia D)
Fibroadenoma Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 43 13. When performing a clinical breast examination,
which would the nurse do first? A) Palpate the axillary area. B) Compress the
nipple for a discharge. C) Palpate the breasts. D) Inspect the breasts.
14.Evaluation of a woman with breast cancer reveals that her mass is
approximately 1.25 inches in diameter. Three adjacent lymph nodes are positive.
The nurse interprets this as indicating that the woman has which stage of
breast cancer? A) 0 B) I C) II D) III 15.After teaching a woman how to perform
breast self-examination, which statement would indicate that the nurses
instructions were successful? A) I should lie down with my arms at my side when
looking at my breasts. B) I should use the fingerpads of my three middle
fingers to apply pressure to my breast. C) I don't need to check under my arm
on that side if my breast feels fine. D) I need to work from the center of my
breast outward toward my shoulder. 16.A nurse is working with a woman who has
been diagnosed with severe fibrocystic breast disease. When describing the
medications that can be used as treatment, which of the following would the
nurse be least likely to include? A) Tamoxifen B) Bromocriptine C) Danazol D)
Penicillin 17.A group of students are reviewing information about benign and
malignant breast masses. The students demonstrate understanding when they
identify which of the following as indicating a benign breast mass. (Select all
the apply.) Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 44 A) Painless B) Unilateral location C) Firm consistency
D) Absence of dimpling E) Fixed to chest wall 18.The nurse is developing a plan
of care for a woman with breast cancer who is scheduled to undergo
breast-conserving surgery. The nurse interprets this as which of the following?
A) Removal of nipple and areolar area B) Lump removal followed by radiation C)
Entire breast removal without lymph nodes D) Axillary lymph node removal 19.A
woman comes to the clinic and asks the nurse about when she should have her
first mammogram. Using the recommendations of the American Cancer Society,
which would the nurse suggest? A) 30 years B) 35 years C) 40 years D) 45 years
20.After teaching a group of nursing students about the different types of
chemotherapeutic agents used to treat breast cancer, the instructor determines
that the teaching was successful when the students identify which of the
following as an example of a selective estrogen receptor modulator (SERM)?
(Select all that apply.) A) Tamoxifen B) Letozole C) Raloxifene D) Exemestane
E) Anastrozole Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 45 21.A woman diagnosed with breast cancer is to receive
trastuzumab. Which of the following would the nurse incorporate into the
explanation about how this drug works? A) It blocks the effect of the HER-2/neu
protein inhibiting the growth of cancer cells. B) The drug blocks the
conversion of androgens to estrogens C) It interferes with hormone receptors
that allow estrogen to enter a cell D) The drug ultimately attacks areas where
micrometastasis has occurred. 22.A nurse is conducting a class on breast cancer
prevention. Which statement would the nurse most likely include in the
discussion? A) Most often a lump is felt before it is seen. B) Early breast
cancer usually has some symptoms. C) If the mass is not painful, it is usually
benign. D) If lump is palpable, it has been there for some time. 23.When
describing programs for breast cancer screening, the nurse include breast
self-examination (BSE). Which of the following most accurately reflects the
current thinking about breast self-examination? A) BSE is essential for early
breast cancer detection. B) A woman performing BSE has breast awareness. C) BSE
plays a minimal role in detecting breast cancer D) A clinical breast exam has
replaced BSE. 24.During a wellness visit to the clinic, a woman asks the nurse
if there is anything she can do to reduce her risk for developing breast
cancer. Which of the following would the nurse most likely include? (Select all
that apply.) A) Eating three servings of fruit daily B) Keeping weight gain
under 11 pounds after age 18 C) Eating at least seven portions of complex
carbohydrates daily D) Limiting the intake of refined sugar products E) Using
salt liberally when cooking Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 46 25.A woman comes to the clinic and
tells the nurse that she has read an article about certain foods that have
anticancer properties and help boost the immune system. The nurse identifies A)
Garlic B) Soybeans C) Milk D) Leeks E) Flax seeds Chapter 07: Benign Disorders
of the Female Reproductive Tract 1. A woman is admitted for repair of cystocele
and rectocele. She has nine living children. In taking her health history,
which of the following would the nurse expect to find? A)Sporadic vaginal
bleeding accompanied by chronic pelvic pain B) Heavy leukorrhea with vulvar
pruritus C) Menstrual irregularities and hirsutism on the chin D)Stress
incontinence with feeling of low abdominal pressure 2. To assist the woman in
regaining control of the urinary sphincter for urinary incontinence, the nurse
should teach the client to do which of the following? A)Perform Kegel exercises
daily. B) Void every hour while awake. C) Limit her intake of fluid. D)Take a
laxative every night. 3. When developing the plan of care for a woman who has
had an abdominal hysterectomy, which of the following would be contraindicated?
A)Ambulating the client B) Massaging the clients legs C) Applying elasticized
stockings D)Encouraging range-of-motion exercises 4. Which of the following would
the nurse include when teaching women about preventing pelvic support
disorders? A)Performing Kegel isometric exercises B) Consuming low-fiber diets
C) Using hormone replacement D)Voiding every 2 hours Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 49 5. A client is
diagnosed with an enterocele. The nurse interprets this condition as: A)
Protrusion of the posterior bladder wall downward through the anterior vaginal
wall B) Sagging of the rectum with pressure exerted against the posterior
vaginal wall C) Bulging of the small intestine through the posterior vaginal
wall D) Descent of the uterus through the pelvic floor into the vagina 6. A
woman is scheduled for an anterior and posterior colporrhaphy as treatment for
a cystocele. When the nurse is explaining this treatment to the client, which
of the following descriptions would be most appropriate to include? A)This
procedure helps to tighten the vaginal wall in the front and back so that your
bladder and urethra are in the proper position. B) Your uterus will be removed
through your vagina, helping to relieve the organ that is putting the pressure
on your bladder. C) This is a series of exercises that you will learn to do so
that you can strengthen your bladder muscles. D)These are plastic devices that
your physician will insert into your vagina to provide support to the uterus
and keep it in the proper position. 7. The nurse would be least likely to find
which of the following in a client with uterine fibroids? A) Regularly shaped,
shrunken uterus B) Acute pelvic pain C) Menorrhagia D) Complaints of bloating
8. A client with polycystic ovarian syndrome (PCOS. is receiving oral
contraceptives as part of her treatment plan. The nurse understands that the
rationale for this therapy is to: A)Restore menstrual regularity B) Induce
ovulation C) Improve insulin uptake D)Alleviate hirsutism 9. When teaching a
woman how to perform Kegel exercises, the nurse explains that these exercises
are Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing
(4th Edition) 50 designed to strengthen which muscles? A)Gluteus B) Lower
abdominal C) Pelvic floor D)Diaphragmatic 10.A postmenopausal woman with
uterine prolapse is being fitted with a pessary. The nurse would be most alert
for which side effect? A) Increased vaginal discharge B) Urinary tract
infection C) Vaginitis D) Vaginal ulceration 11.When preparing the discharge
teaching plan for the woman who had surgery to correct pelvic organ prolapse,
which of the following would the nurse include? A) Care of the indwelling
catheter at home B) Emphasis on coughing to prevent complications C) Return to
usual activity level in a few days D) Daily douching with dilute vinegar
solution 12.A woman with polycystic ovary syndrome tells the nurse, I hate this
disease. Just look at me! I have no hair on the front of my head but Ive got
hair on my chin and upper lip. I don't feel like a woman anymore. Further
assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis
would most likely be a priority? A) Situational low self-esteem related to
masculinization effects of the disease B) Social isolation related to feelings
about appearance C) Risk for suicide related to effects of condition and
fluctuating hormone levels D) Ineffective peripheral tissue perfusion related
to effects of disease on vasculature 13.After teaching a local woman's group
about incontinence, the nurse determines that the teaching was successful when
the group identifies which of the following as characteristic of stress
incontinence? Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 51 A) Feeling a strong need to void B) Passing a large
amount of urine C) Most common in women after childbirth D) Sneezing may be an
initiating stimulus 14.A woman is being evaluated for pelvic organ prolapse. A
postvoid residual urine specimen is obtained via a catheter. Which residual
volume finding would lead the nurse to suspect the need for further testing? A)
50 mL B) 75 mL C) 100 mL D) 120 mL 15.After teaching a woman with pelvic organ
prolapse about dietary and lifestyle measures, which of the following
statements would indicate the need for additional teaching? A) If I wear a
girdle, it will help support the muscles in the area. B) I should take up
jogging to make sure I exercise enough. C) I will try to drink at least 64 oz
of fluid each day. D) I need to increase the amount of fiber I eat every day.
16.After teaching a group of students about genital fistulas, the instructor
determines that the teaching was successful when the students identify which of
the following as a major cause? A) Radiation therapy B) Congenital anomaly C)
Female genital cutting D) Bartholins gland abscess 17.A nurse is providing care
to a female client receiving treatment for a Bartholins cyst. The client has
had a small loop of plastic tubing secured in place to allow for drainage. The
nurse instructs the client that she will have a follow-up appointment for
removal of the plastic tubing at which time? A) 1 week Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 52 B) 2 weeks
C) 3 weeks D) 4 weeks 18.After undergoing diagnostic testing, a woman is
diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will
require: A) Biopsy B) No treatment C) Oral contraceptives D) Glucophage 19.A
nurse is teaching a client how to perform Kegel exercises. Which of the
following would the nurse include? (Select all that apply.) A) Squeeze your
rectal muscles as if you are trying to avoid passing flatus. B) Tighten your
pubococcygeal muscles for a count of 10. C) Contract and relax your
pubococcygeal muscles rapidly 10 times. D) Try bearing down for about 10
seconds for no more than 5 times. E) Do these exercises at least 5 times every
hour. 20.After teaching a group of students about pelvic organ prolapse, the
instructor determines that the teaching was successful when the group
identifies leiomyomas as which of the following? A) Cysts B) Pelvic organ
prolapse C) Fistula D) Fibroid 21.A nurse is assessing a female client and
suspects that the client may have endometrial polyps based on which of the
following? A) Bleeding after intercourse B) Vaginal discharge Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 53
C) Bleeding between menses D) Metrorrhagia 22.After teaching a group of
students about ovarian cysts, the instructor determines that the teaching was
successful when the students identify which type of cyst as being associated
with hydatiform mole? A) Theca-lutein cyst B) Corpus luteum cyst C) Follicular
cyst D) Polycystic ovarian syndrome 23.A nurse is reading a journal article
about care of the woman with pelvic organ prolapse. The nurse would expect to
find information related to which of the following? (Select all that apply.) A)
Rectocele B) Fecal incontinence C) Cystocele D) Urinary incontinence E)
Enterocele 24.A nurse is reviewing the medical record of a client. Which of the
following would lead the nurse to suspect that the client is experiencing
polycystic ovarian syndrome? (Select all that apply.. A) Decreased androgen
levels B) Elevated blood insulin levels C) Anovulation D) Waist circumference
of 32 inches E) Triglyceride level of 175 mg/dL F) High-density lipoprotein
level of 40 mg/dL 25.A group of students are preparing a class presentation
about polyps. Which of the following would the students most likely include in
the presentation? Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 54 A) Polyps are rarely the result of an
infection. B) Endocervical polyps commonly appear after menarche. C) Cervical
polyps are more common than endocervical polyps. D) Endocervical polyps are
most common in women in their 50s. Chapter 08: Cancers of the Female
Reproductive Tract 1. The nurse would refer a client, age 54, for follow-up for
suspected endometrial carcinoma if she reports which of the following? A)Use of
oral contraceptives between ages 18 and 25 B) Onset of painless, red postmenopausal
bleeding C) Menopause occurring at age 46 D)Use of intrauterine device for 3
years 2. Which of the following instructions would the nurse include when
preparing a woman for a Pap smear? A) Refrain from sexual intercourse for 1
week before the test. B) Wear cotton panties on the day of the test. C) Avoid
taking any medications for 24 hours. D) Do not douche for 48 hours before the
test. 3. A woman comes to the clinic for a routine checkup. A history of
exposure to which of the following would alert the nurse that she is at
increased risk for cervical cancer? A)Hepatitis B) Human papillomavirus C)
Cytomegalovirus D)Epstein-Barr virus 4. A client is scheduled to have a Pap
smear. After the nurse teaches the client about the Pap smear, which of the
following client statements indicates successful teaching? A)I need to douche
the night before with a mild vinegar solution. B) I will take a bath first
thing that morning to make sure I'm clean. C) I will not engage in sexual
intercourse for 48 hours before the test. D)I will get a clean urine specimen
when I first wake up the morning of the test. Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 57 5. Which
finding obtained during a client history would the nurse identify as increasing
a clients risk for ovarian cancer? A)Multiple sexual partners B) Consumption of
a high-fat diet C) Underweight D)Grand multiparity (more than five children) 6.
A client is scheduled for cryosurgery to remove some abnormal tissue on the
cervix. The nurse teaches the client about this treatment, explaining that the
tissue will be removed by which method? A)Freezing B) Cutting C) Burning
D)Irradiating 7. Which of the following statements best indicates that a client
has taken self-care measures to reduce her risk for cervical cancer? A)Ive
really cut down on the amount of caffeine I drink every day. B) Ive thrown out
all my bubble baths and just use soap and water now. C) Every time I have
sexual intercourse, I douche. D)My partner always uses a condom when we have
sexual intercourse. 8. A client is suspected of having endometrial cancer. The
nurse would most likely prepare the client for which procedure to confirm the
diagnosis? A)Transvaginal ultrasound B) Colposcopy C) Pap smear D)Endometrial
biopsy 9. Which of the following descriptions would the nurse include when
teaching a client about her scheduled colposcopy? Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 58 A)A gel will be
applied to your abdomen and a microphone-like device will be moved over the
area to identify problem areas. B) A solution will be wiped on your cervix to
identify any abnormal cells, which will be visualized with a magnifying
instrument. C) Scrapings of tissue will be obtained and placed on slides to be
examined under the microscope. D)After you receive anesthesia, a small device
will be inserted into your abdomen near your belly button to obtain tissue
samples. 10.The nurse is preparing a presentation for a local women's group
about ways to reduce the risk of reproductive tract cancers. Which of the
following would the nurse include? A) Blood pressure evaluation every 6 months
B) Yearly Pap smears starting at age 40 C) Yearly cholesterol screening
starting at age 45 D) Consumption of two to three glasses of red wine per day
11.The daughter of a woman who has been diagnosed with ovarian cancer asks the
nurse about screening for this cancer. Which response by the nurse would be
most appropriate? A) Currently there is no reliable screening test for ovarian
cancer. B) A Pap smear is almost always helpful in identifying this type of
cancer. C) Theres a blood test for a marker, CA-125, that if elevated indicates
cancer. D) A genetic test for two genes, if positive, will identify the ovarian
cancer. 12.Which of the following would the nurse be least likely to suggest
when teaching a group of young women how to reduce their risk for ovarian
cancer? A) Pregnancy B) Oral contraceptives C) Feminine hygiene sprays D)
Breast-feeding 13.A woman is diagnosed with adenocarcinoma of the endometrium
in situ. The nurse interprets this as indicating which of the following about
the cancer? A) Spread to the uterine muscle wall Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 59 B) Found on the
endometrial surface C) Spread to the cervix D) Invaded the bladder 14.When
preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects
that the lesion would most likely be located at which area? A) Labia majora B) Labia
minora C) Clitoris D) Prepuce 15.When describing the various types of
reproductive tract cancers to a local women's group, which of the following
would the nurse identify as the least common type? A) Vulvar B) Vaginal C)
Endometrial D) Ovarian 16.When assessing a female client for the possibility of
vulvar cancer, which of the following would the nurse most likely expect the
client to report? (Select all that apply.) A) Abnormal vaginal bleeding B)
Persistent vulvar itching C) History of herpes simplex D) Lesion on the cervix
E) Abnormal Pap smear 17.A nurse is reviewing the medical record of a woman
diagnosed with vulvar cancer. Which of the following would the nurse identify
as a risk factor for this cancer? (Select all that apply.) A) Age under 40 years
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 60 B) HPV 16 exposure C) Monogamous sexual partner D) Hypertension E)
Diabetes 18.A nurse is assisting with the collection of a Pap smear. When
collecting the specimen, which of the following is done first? A) Insertion of
the speculum B) Swabbing of the endocervix C) Spreading of the labia D)
Insertion of the cytobrush 19.The plan of care for a woman diagnosed with a
suspected reproductive cancer includes a nursing diagnosis of disturbed body
image related to suspected reproductive tract cancer and impact on sexuality as
evidenced by the clients statement that she is worried that she won't be the
same. Which of the following would be an appropriate outcome for this client?
A) Client will verbalize positive statements about self and sexuality. B)
Client will demonstrate understanding of the condition and associated
treatment. C) Client will exhibit positive coping strategies related to
diagnosis. D) Client will identify misconceptions related to her diagnosis.
20.During a routine health check-up, a young adult woman asks the nurse about
ways to prevent endometrial cancer. Which of the following would the nurse most
likely include? (Select all that apply.) A) Eating a high-fat diet B) Having
regular pelvic exams C) Engaging in daily exercise D) Becoming pregnant E)
Using estrogen contraceptives 21.After teaching a group of students about
cervical cancer, the instructor determines that the teaching was successful
when the students identify which of the following as the area included with a
cone biopsy? Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 61 A) Clitoris B) Uterine fundus C) Ovarian follicle D)
Transformation zone 22.A woman is scheduled for diagnostic testing to evaluate
for endometrial cancer. The nurse would expect to prepare the woman for which
of the following? A) CA-125 testing B) Transvaginal ultrasound C) Pap smear D)
Mammography 23.A nurse is conducting a class for a local woman's group about
recommendations for a Pap smear. One of the participants asks, At what age
should a woman have her first Pap smear? The nurse responds by stating that a
woman should have her first Pap smear at which age? A) 18 B) 21 C) 25 D) 28 24.An
instructor is describing the development of cervical cancer to a group of
students. The instructor determines that the teaching was successful when the
students identify which area as most commonly involved? A) Internal cervical os
B) Junction of the cervix and fundus C) Squamous-columnar junction D) External
cervical os 25.A client has an abnormal Pap smear that is classified as ASC-US.
Based on the nurses understanding of this classification, the nurse would
expect which of the following? A) Immediate colposcopy Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 62 B) Testing
for HPV C) Repeat Pap smear in 4 to 6 months D) Cone biopsy Chapter 09:
Violence and Abuse 1. The nurse is presenting a class at a local community
health center on violence during pregnancy. Which of the following would the
nurse include as a possible complication? A)Hypertension of pregnancy B)
Chorioamnionitis C) Placenta previa D)Postterm labor 2. Which approach would be
most appropriate when counseling a woman who is a suspected victim of violence?
A)Offer her a pamphlet about the local battered women's shelter. B) Call her at
home to ask her some questions about her marriage. C) Wait until she comes in a
few more times to make a better assessment. D)Ask, Have you ever been
physically hurt by your partner? 3. When describing an episode, the victim
reports that she attempted to calm her partner down to keep things from
escalating. This behavior reflects which phase of the cycle of violence? A)Battering
B) Honeymoon C) Tension-building D)Reconciliation 4. A battered pregnant woman
reports to the nurse that her husband has stopped hitting her and promises
never to hurt her again. Which of the following is an appropriate response?
A)Thats great. I wish you both the best. B) The cycle of violence often repeats
itself. C) He probably didn't mean to hurt you. D)You need to consider leaving
him. Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing
(4th Edition) 65 5. Which of the following nursing actions would be least
helpful for a client who is a victim of violence? A) Assist the client to
project her anger. B) Provide information about a safe home and crisis line. C)
Teach her about the cycle of violence. D) Discuss her legal and personal
rights. 6. When describing the cycle of violence to a community group, the
nurse explains that the first phase usually is: A)Somehow triggered by the
victims behavior B) Characterized by tension-building and minor battery C)
Associated with loss of physical and emotional control D)Like a honeymoon that
lulls the victim 7. Which of the following statements would be most appropriate
to empower victims of violence to take action? A)Give your partner more time to
come around. B) Remember, children do best in two-parent families. C) Change
your behavior so as not to trigger the violence. D)You are a good person and
you deserve better than this. 8. When a nurse suspects that a client may have
been abused, the first action should be to: A) Ask the client about the
injuries and if they are related to abuse. B) Encourage the client to leave the
batterer immediately. C) Set up an appointment with a domestic violence
counselor. D) Ask the suspected abuser about the victims injuries. 9. Which of
the following would the nurse describe as a characteristic of the second phase
of the cycle of violence? A)The batterer is contrite and attempts to apologize
for the behavior. Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 66 B) The physical battery is abrupt and
unpredictable. C) Verbal assaults begin to escalate toward the victim. D)The
victim accepts the anger as legitimately directed at her. 10.In addition to
providing privacy, which of the following would be most appropriate initially
in situations involving suspected abuse? A) Allow the client to have a good cry
over the situation. B) Tell the client, Injuries like these don't usually
happen by accident. C) Call the police immediately so they can question the
victim. D) Ask the abuser to describe his side of the story first. 11.When the
nurse is alone with a client, the client says, It was all my fault. The house
was so messy when he got home and I know he hates that. Which response would be
most appropriate? A) It is not your fault. No one deserves to be hurt. B) What
else did you do to make him so angry with you? C) You need to start to clean
the house early in the day. D) Remember, he works hard and you need to meet his
needs. 12.When developing a presentation for a local community organization on
violence, the nurse is planning to include statistics on intimate partner abuse
and its effects on children. In what percentage of the cases in which a parent
is abused are the children battered also? A) 50% to 75% B) 25% to 50% C) 10% to
25% D) Less than 5% 13. The primary goal when working with victims of intimate
partner violence is to: A) Convince them to leave the abuser soon B) Help them
cope with their life as it is Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 67 C) Empower them to regain control of
their life D) Arrest the abuser so he or she can't abuse again 14. Teaching for
victims who are recovering from abusive situations must focus on ways to: A)
Enhance their personal appearance and hairstyle B) Develop their creativity and
work ethic C) Improve their communication skills and assertiveness D) Plan more
nutritious meals to improve their own health 15.During a follow-up visit to the
clinic, a victim of sexual assault reports that she has changed her job and
moved to another town. She tells the nurse, I pretty much stay to myself at
work and at home. The nurse interprets these findings to indicate that the
client is in which phase of rape recovery? A) Disorganization B) Denial C)
Reorganization D) Integration 16.A nurse is assessing a rape survivor for
post-traumatic stress disorder. The nurse asks the woman, Do you feel as though
you are reliving the trauma? The nurse is assessing for which of the following?
A) Physical symptoms B) Intrusive thoughts C) Avoidance D) Hyperarousal 17.A
group of students are preparing a class discussion about rape and sexual
assault. Which of the following would the students include as being most
accurate? (Select all that apply.) A) Most victims of rape tell someone about
it. B) Few women falsely cry rape. C) Women have rape fantasies desiring to be
raped. D) A rape victim feels vulnerable and betrayed afterwards. Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 68
E) Medication and counseling can help a rape victim cope. 18.After teaching a
class on date rape, the instructor determines that the teaching was successful
when the class identifies which of the following as the most common date rape
drug? A) Gamma hydroxybutyrate B) Liquid ecstasy C) Ketamine D) Rohypnol 19.A
nurse is caring for a woman who was recently raped. The nurse would expect this
woman to experience which of the following first? A) Denial B) Disorganization
C) Reorganization D) Integration 20.A group of nurses are researching
information about risk factors for intimate partner violence in men. Which of
the following would the nurses expect to find related to the individual person?
(Select all that apply.) A) Dysfunctional family system B) Low academic achievement
C) Victim of childhood violence D) Heavy alcohol consumption E) Economic stress
21.A nurse is working with a victim of intimate partner violence and helping
her develop a safety plan. Which of the following would the nurse suggest that
the woman take with her? (Select all that apply.) A) Drivers license B) Social
security number C) Cash Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 69 D) Phone cards E) Health insurance
cards 22.A nurse is presenting a discussion on sexual violence at a local
community college. When describing the incidence of sexual violence, the nurse
would identify that a woman has which chance of experiencing a sexual assault
in her lifetime? A) One in three B) One in six C) Two in 15 D) Three in 20
23.After teaching a class on sexual violence, the instructor determines that
the teaching was successful when the class identifies which of the following as
a type of sexual violence. (Select all that apply.) A) Female genital cutting
B) Bondage C) Infanticide D) Human trafficking E) Rape 24.A nurse is reading a
journal article about sexual abuse. Which age range would the nurse expect to
find as the peak age for such abuse? A) 710 years B) 812 years C) 1418 years D)
1822 years 25.After teaching a group of students about sexual abuse and
violence, the instructor determines that the teaching was successful when the
students describe incest as involving which of the following? A) Sexual
exploitation by blood or surrogate relatives B) Sexual abuse of individuals
over age 18 Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 70 C) Violent aggressive assault on a person D) Consent
between perpetrator and victim. Chapter 10: Fetal Development and Genetics 1.
While talking with a pregnant woman who has undergone genetic testing, the
woman informs the nurse that her baby will be born with Down syndrome. The
nurse understands that Down syndrome is an example of: A)Multifactorial
inheritance B) X-linked recessive inheritance C) Trisomy numeric abnormality
D)Chromosomal deletion 2. A nurse is describing advances in genetics to a group
of students. Which of the following would the nurse least likely include?
A)Genetic diagnosis is now available as early as the second trimester. B)
Genetic testing can identify presymptomatic conditions in children. C) Gene
therapy can be used to repair missing genes with normal ones. D)Genetic agents
may be used in the future to replace drugs. 3. After teaching a group of
students about fetal development, the instructor determines that the teaching
was successful when the students identify which of the following as providing
the barrier to other sperm after fertilization? A)Zona pellucida B) Zygote C)
Cleavage D)Morula 4. A nurse is teaching a class on X-linked recessive
disorders. Which of the following statements would the nurse most likely
include? A)Males are typically carriers of the disorders. B) No male-to-male
transmission occurs. C) Daughters are more commonly affected with the disorder.
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 73 D)Both sons and daughters have a 50% risk of the disorder. 5. A
pregnant woman undergoes maternal serum alpha-fetoprotein (MSAFP) testing at 16
to 18 weeks gestation. Which of the following would the nurse suspect if the
woman's level is decreased? A)Down syndrome B) Sickle-cell anemia C) Cardiac
defects D)Open neural tube defect 6. The nurse is developing a presentation for
a community group of young adults discussing fetal development and pregnancy.
The nurse would identify that the sex of offspring is determined at the time
of: A)Meiosis B) Fertilization C) Formation of morula D)Oogenesis 7. When
describing amniotic fluid to a pregnant woman, the nurse would include which of
the following? A) This fluid acts as transport mechanism for oxygen and
nutrients. B) The fluid is mostly protein to provide nourishment to your baby.
C) This fluid acts as a cushion to help to protect your baby from injury. D)
The amount of fluid remains fairly constant throughout the pregnancy. 8.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be
alert for the development of which of the following? A)Maternal diabetes B)
Placental insufficiency C) Neural tube defects D)Fetal gastrointestinal
malformations 9. A couple comes to the clinic for preconception counseling and
care. As part of the visit, the nurse teaches the couple about fertilization
and initial development, stating that the zygote formed by the union of the Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 74 ovum and sperm consists of how many chromosomes? A)22 B) 23 C) 44
D)46 10.A woman just delivered a healthy term newborn. Upon assessing the
umbilical cord, the nurse would identify which of the following as normal?
(Select all that apply.) A) One vein B) Two veins C) One artery D) Two arteries
E) One ligament F) Two ligaments 11.After teaching a pregnant woman about the
hormones produced by the placenta, the nurse determines that the teaching was
successful when the woman identifies which hormone produced as being the basis
for pregnancy tests? A) Human placental lactogen (hPL) B) Estrogen (estriol) C)
Progesterone (progestin) D) Human chorionic gonadotropin (hCG) 12.After the
nurse describes fetal circulation to a pregnant woman, the woman asks why her
fetus has a different circulation pattern than hers. In planning a response,
the nurse integrates understanding of which of the following? A) Fetal blood is
thicker than that of adults and needs different pathways. B) Fetal circulation
carries highly oxygenated blood to vital areas first. C) Fetal blood has a
higher oxygen saturation and circulates more slowly. Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 75 D) Fetal heart
rates are rapid and circulation time is double that of adults. 13.When
describing genetic disorders to a group of childbearing couples, the nurse
would identify which as an example of an autosomal dominant inheritance
disorder? A) Huntingtons disease B) Sickle cell disease C) Phenylketonuria D)
Cystic fibrosis 14.Prenatal testing is used to assess for genetic risks and to
identify genetic disorders. In explaining to a couple about an elevated
alpha-fetoprotein screening test result, the nurse would discuss the need for:
A) Special care needed for a Down syndrome infant B) A more specific
determination of the acidbase status C) Further, more definitive evaluations to
conclude anything D) Immediate termination of the pregnancy based on results
15.A nursing instructor is preparing a teaching plan for a group of nursing
students about the potential for misuse of genetic discoveries and advances.
Which the following would the instructor most likely include? A) Gene replacement
therapy for defective genes B) Individual risk profiling and confidentiality C)
Greater emphasis on the causes of diseases D) Slower diagnosis of specific
diseases 16.After teaching a class on the stages of fetal development, the
instructor determines that the teaching was successful when the students
identify which of the following as a stage? (Select all that apply.) A)
Placental B) Preembryonic C) Umbilical D) Embryonic E) Fetal Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 76
17.A nurse is discussing fetal development with a pregnant woman. The woman is
12 weeks pregnant and asks, Whats happening with my baby? Which of the
following would the nurse integrate into the response? (Select all that apply.)
A) Continued sexual differentiation B) Eyebrows forming C) Startle reflex
present D) Digestive system becoming active E) Lanugo present on the head
18.After teaching a group of students about fetal development, the instructor
determines that the teaching was successful when the students identify which of
the following as essential for fetal lung development? A) Umbilical cord B)
Amniotic fluid C) Placenta D) Trophoblasts 19.During a prenatal class for a
group of new mothers, the nurse is describing the hormones produced by the
placenta. Which of the following would the nurse include? (Select all that
apply.) A) Prolactin B) Estriol C) Relaxin D) Progestin E) Human chorionic
somatomammotropin 20.When describing the structures involved in fetal
circulation, the nursing instructor describes which structure as the opening
between the right and left atrium? A) Ductus venosus B) Foramen ovale C) Ductus
arteriosus Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 77 D) Umbilical artery 21.A group of students are
reviewing information about genetic inheritance. The students demonstrate
understanding of the information when they identify which of the following as
an example of an autosomal recessive disorder? (Select all that apply.) A) Cystic
fibrosis B) Phenylketonuria C) Tay-Sachs disease D) Polycystic kidney disease
E) Achondroplasia 22.A nurse is assessing a child with Klinefelters syndrome.
Which of the following would the nurse expect to assess? (Select all that
apply.) A) Gross mental retardation B) Long arms C) Profuse body hair D)
Gynecomastia E) Enlarged testicles 23.A woman is scheduled to undergo fetal
nuchal translucency testing. Which of the following would the nurse include
when describing this test? A) A needle will be inserted directly into the
fetuss umbilical vessel. B) Youll have an intravaginal ultrasound to measure
fluid in the fetus. C) The doctor will take a sample of fluid from your bag of
waters. D) A small piece of tissue from the fetal part of the placenta is taken.
Chapter 11: Maternal Adaptation During Pregnancy 1. During a vaginal exam, the
nurse notes that the cervix has a bluish color. The nurse documents this
finding as: A)Hegars sign B) Goodells sign C) Chadwicks sign D)Ortolanis sign
2. The nurse teaches a primigravida client that lightening occurs about 2 weeks
before the onset of labor. The mother will most likely experience which of the
following at that time? A)Dysuria B) Dyspnea C) Constipation D)Urinary
frequency 3. A gravida 2 para 1 client in the 10th week of her pregnancy says
to the nurse, Ive never urinated as often as I have for the past three weeks.
Which response would be most appropriate for the nurse to make? A)Having to
urinate so often is annoying. I suggest that you watch how much fluid you are
drinking and limit it. B) You shouldn't be urinating this frequently now; it
usually stops by the time youre eight weeks pregnant. Is there anything else
bothering you? C) By the time you are 12 weeks pregnant, this frequent
urination should no longer be a problem, but it is likely to return toward the
end of your pregnancy. D)Women having their second child generally don't have
frequent urination. Are you experiencing any burning sensations? 4. In a
clients seventh month of pregnancy, she reports feeling dizzy, like I'm going
to pass out, when I lie down flat on my back. The nurse integrates which of the
following in to the explanation? A)Pressure of the gravid uterus on the vena
cava B) A 50% increase in blood volume Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 80 C) Physiologic anemia due
to hemoglobin decrease D)Pressure of the presenting fetal part on the diaphragm
5. A primiparous client is being seen in the clinic for her first prenatal
visit. It is determined that she is 11 weeks pregnant. The nurse develops a
teaching plan to educate the client about what she will most likely experience
during this period. Which of the following would the nurse include? A)Ankle
edema B) Urinary frequency C) Backache D)Hemorrhoids 6. A pregnant client in
her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets
this as indicating which of the following? A)Iron-deficiency anemia B) A
multiple gestation pregnancy C) Greater-than-expected weight gain D)Hemodilution
of pregnancy 7. The nurse is discussing the insulin needs of a primaparous
client with diabetes who has been using insulin for the past few years. The
nurse informs the client that her insulin needs will increase during pregnancy
based on the nurses understanding that the placenta produces: A)hCG, which
increases maternal glucose levels B) hPL, which deceases the effectiveness of
insulin C) Estriol, which interferes with insulin crossing the placenta
D)Relaxin, which decreases the amount of insulin produced 8. When teaching a
pregnant client about the physiologic changes of pregnancy, the nurse reviews
the effect of pregnancy on glucose metabolism. Which of the following would the
nurse include as the underlying reason for the effect? A)Pancreatic function is
affected by pregnancy. B) Glucose is utilized more rapidly during a pregnancy.
C) The pregnant woman increases her dietary intake. Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 81 D)Glucose moves
through the placenta to assist the fetus. 9. When assessing a woman in her
first trimester, which emotional response would the nurse most likely expect to
find? A)Ambivalence B) Introversion C) Acceptance D)Emotional lability 10.The
nurse is assessing a pregnant woman in the second trimester. Which of the
following tasks would indicate to the nurse that the client is incorporating
the maternal role into her personality? A) The woman demonstrates concern for
herself and her fetus as a unit. B) The client identifies what she must give up
to assume her new role. C) The woman acknowledges the fetus as a separate
entity within her. D) The client demonstrates unconditional acceptance without
rejection. 11.A woman comes to the prenatal clinic suspecting that she is
pregnant, and assessment reveals probable signs of pregnancy. Which of the
following would be included as part of this assessment? (Select all that
apply.) A) Positive pregnancy test B) Ultrasound visualization of the fetus C)
Auscultation of a fetal heart beat D) Ballottement E) Absence of menstruation
F) Softening of the cervix 12.The nurse is teaching a pregnant woman about
recommended weight gain. The woman has a prepregnancy body mass index of 26.
The nurse determines that the teaching was successful when the woman states
that she should gain no more than which amount during pregnancy? A) 35 to 40
pounds Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing
(4th Edition) 82 B) 25 to 35 pounds C) 28 to 40 pounds D) 15 to 25 pounds 13.A
nurse strongly encourages a pregnant client to avoid eating swordfish and
tilefish because these fish contain which of the following? A) Excess folic
acid, which could increase the risk for neural tube defects B) Mercury, which
could harm the developing fetus if eaten in large amounts C) Lactose, which
leads to abdominal discomfort, gas, and diarrhea D) Lowquality protein that
does not meet the woman's requirements 14.Which of the following changes in the
musculoskeletal system would the nurse mention when teaching a group of
pregnant women about the physiologic changes of pregnancy? A) Ligament
tightening B) Decreased swayback C) Increased lordosis D) Joint contraction
15.Assessment of a pregnant woman reveals a pigmented line down the middle of
her abdomen. The nurse documents this as which of the following? A) Linea nigra
B) Striae gravidarum C) Melasma D) Vascular spiders 16.A nurse is assessing a
pregnant woman on a routine checkup. When assessing the woman's
gastrointestinal tract, which of the following would the nurse expect to find?
(Select all that apply.) A) Hyperemic gums B) Increased peristalsis C)
Complaints of bloating Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 83 D) Heartburn E) Nausea 17.A woman
suspecting she is pregnant asks the nurse about which signs would confirm her
pregnancy. The nurse would explain that which of the following would confirm
the pregnancy? A) Absence of menstrual period B) Abdominal enlargement C)
Palpable fetal movement D) Morning sickness 18.A nurse is developing a teaching
plan about nutrition for a group of pregnant women. Which of the following
would the nurse include in the discussion? (Select all that apply.) A) Keep
weight gain to 15 lb B) Eat three meals with snacking C) Limit the use of salt
in cooking D) Avoid using diuretics E) Participate in physical activity
19.Assessment of a pregnant woman reveals that she compulsively craves ice. The
nurse documents this finding as which of the following? A) Quickening B) Pica
C) Ballottement D) Linea nigra 20.A woman in her second trimester comes for a
follow-up visit and says to the nurse, I feel like I'm on an emotional
roller-coaster. Which response by the nurse would be most appropriate? A) How
often has this been happening to you? B) Maybe you need some medication to
level things out. Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 84 C) Mood swings are completely normal during
pregnancy. D) Have you been experiencing any thoughts of harming yourself?
21.While talking with a woman in her third trimester, which behavior indicates
to the nurse that the woman is learning to give of oneself? A) Showing concern
for self and fetus as a unit B) Unconditionally accepting the pregnancy without
rejection C) Longing to hold infant D) Questioning ability to become a good
mother 22.A group of students are reviewing the signs of pregnancy. The
students demonstrate understanding of the information when they identify which
as presumptive signs? (Select all that apply.) A) Amenorrhea B) Nausea C)
Abdominal enlargement D) Braxton-Hicks contractions E) Fetal heart sounds 23.A
nursing instructor is teaching a class to a group of students about pregnancy,
insulin, and glucose. Which of the following would the instructor least likely
include as opposing insulin? A) Prolactin B) Estrogen C) Progesterone D)
Cortisol 24. A woman is at 20 weeks gestation. The nurse would expect to find
the fundus at which of the following? A) Just above the symphysis pubis B)
Mid-way between the pubis and umbilicus C) At the level of the umbilicus Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 85 D) Mid-way between the umbilicus and xiphoid process 25.A pregnant
woman comes to the clinic and tells the nurse that she has been having a
whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis based on
which assessment finding? A) Fever B) Vaginal itching C) Urinary frequency D)
Incontinence Chapter 12: Nursing Management During Pregnancy 1. A woman in the
34th week of pregnancy says to the nurse, I still feel like having intercourse
with my husband. The woman's pregnancy has been uneventful. The nurse responds
based on the understanding that: A)It is safe to have intercourse at this time.
B) Intercourse at this time is likely to cause rupture of membranes. C) There
are other ways that the couple can satisfy their needs. D)Intercourse at this
time is likely to result in premature labor. 2. On the first prenatal visit,
examination of the woman's internal genitalia reveals a bluish coloration of
the cervix and vaginal mucosa. The nurse records this finding as: A)Hegars sign
B) Goodells sign C) Chadwicks sign D)Homans sign 3. When describing perinatal
education to a pregnant woman and her partner, the nurse emphasizes that the
primary goal of these classes is to: A)Equip a couple with the knowledge to
experience a pain-free childbirth B) Provide knowledge and skills to actively
participate in birth and parenting C) Eliminate anxiety so that they can have
an uncomplicated birth D)Empower the couple to totally control the birth
process 4. When assessing a woman at follow-up prenatal visits, the nurse would
anticipate which of the following to be performed? A)Hemoglobin and hematocrit
B) Urine for culture C) Fetal ultrasound D)Fundal height measurement Test Bank
- Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 88
5. During a routine prenatal visit, a client, 36 weeks pregnant, states she has
difficulty breathing and feels like her pulse rate is really fast. The nurse
finds her pulse to be 100 beats per minute (increased from baseline readings of
70 to 74 beats per minute. and irregular, with bilateral crackles in the lower
lung bases. Which nursing diagnosis would be the priority for this client?
A)Ineffective tissue perfusion related to supine hypotensive syndrome B)
Impaired gas exchange related to pulmonary congestion C) Activity intolerance
related to increased metabolic requirements D)Anxiety related to fear of
pregnancy outcome 6. When preparing a woman for an amniocentesis, the nurse
would instruct her to do which of the following? A)Shower with an antiseptic
scrub. B) Swallow the preprocedure sedative. C) Empty her bladder. D)Lie on her
left side. 7. A client who is 4 months pregnant is at the prenatal clinic for
her initial visit. Her history reveals she has 7-year-old twins who were born
at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a
spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method,
the nurse would document her obstetric history as: A)3 2 1 0 3 B) 3 1 2 2 3 C)
4 1 1 1 3 D)4 2 1 3 1 8. A clients last menstrual period was April 11. Using
Nageles rule, her expected date of birth (EDB. would be: A)January 4 B) January
18 C) January 25 D)February 24 Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 89 9. During a nonstress test, when
monitoring the fetal heart rate, the nurse notes that when the expectant mother
reports fetal movement, the heart rate increases 15 beats or more above the
baseline. The nurse interprets this as: A)Variable decelerations B) Fetal
tachycardia C) A nonreactive pattern D)Reactive pattern 10.A clients maternal
serum alpha-fetoprotein (MSAFP. level was unusually elevated at 17 weeks. The
nurse suspects which of the following? A) Fetal hypoxia B) Open spinal defects
C) Down syndrome D) Maternal hypertension 11.When assessing a pregnant woman in
her last trimester, which question would be most appropriate to use to gather
information about weight gain and fluid retention? A) Whats your usual dietary
intake for a typical day? B) What size maternity clothes are you wearing now?
C) How puffy does your face look by the end of a day? D) How swollen do your
ankles appear before you go to bed? 12.A pregnant woman in the 36th week of
gestation complains that her feet are quite swollen at the end of the day.
After careful assessment, the nurse determines that this is an expected finding
at this stage of pregnancy. Which intervention would be most appropriate for
the nurse to suggest? A) Limit your intake of fluids. B) Eliminate salt from
your diet. C) Try elevating your legs when you sit. D) Wear Spandex-type
full-length pants. 13.A pregnant woman needs an update in her immunizations.
Which of the following vaccinations would the nurse ensure that the woman
receives? Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 90 A) Measles B) Mumps C) Rubella D) Hepatitis B 14.A
pregnant woman is flying across the country to visit her family. After teaching
the woman about traveling during pregnancy, which statement indicates that the
teaching was successful? A) I'll sit in a window seat so I can focus on the sky
to help relax me. B) I won't drink too much fluid so I don't have to urinate so
often. C) I'll get up and walk around the airplane about every 2 hours. D) I'll
do some upper arm stretches while sitting in my seat. 15.Which of the following
would the nurse include when teaching a pregnant woman about chorionic villus
sampling? A) The results should be available in about a week. B) Youll have an
ultrasound first and then the test. C) Afterwards, you can resume your exercise
program. D) This test is very helpful for identifying spinal defects. 16.A pregnant
woman is scheduled to undergo percutaneous umbilical blood sampling. When
discussing this test with the woman, the nurse reviews what can be evaluated
with the specimens collected. Which of the following would the nurse include?
(Select all that apply.) A) Rh incompatibility B) Fetal acidbase status C)
Sex-linked disorders D) Enzyme deficiencies E) Coagulation studies 17.A
biophysical profile has been completed on a pregnant woman. The nurse
interprets which score as normal? Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 91 A) 9 B) 7 C) 5 D) 3 18.After
teaching a group of students about the discomforts of pregnancy, the students
demonstrate understanding of the information when they identify which as common
during the first trimester? (Select all that apply.) A) Urinary frequency B)
Breast tenderness C) Cravings D) Backache E) Leg cramps 19.A nurse is reviewing
the medical record of a pregnant woman and notes that she is gravid II. The
nurse interprets this to indicate the number of: A) Deliveries B) Pregnancies
C) Spontaneous abortions D) Pre-term births 20.A nurse measures a pregnant
woman's fundal height and finds it to be 28 cm. The nurse interprets this to
indicate which of the following? A) 14 weeks gestation B) 20 weeks gestation C)
28 weeks gestation D) 36 weeks gestation 21.A pregnant woman has a rubella
titer drawn on her first prenatal visit. The nurse explains that this test
measures which of the following? Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 92 A) Platelet level B) Rh status C)
Immunity to German measles D) Red blood cell count 22.A nurse is working with a
pregnancy woman to schedule follow-up visits for her pregnancy. Which statement
by the woman indicates that she understands the scheduling? A) I need to make
visits every 2 months until I'm 36 weeks pregnant. B) Once I get to 28 weeks, I
have to come twice a month. C) From now until I'm 28 weeks, I'll be coming once
a month. D) I'll make sure to get a day off every 2 weeks to make my visits.
23.A nursing instructor is describing the various childbirth methods. Which of
the following would the instructor include as part of the Lamaze method? A)
Focus on the pleasurable sensations of childbirth B) Concentration on
sensations while turning on to own bodies C) Interruption of the
fear-tensionpain cycle D) Use of specific breathing and relaxation techniques
24.After teaching a group of students about the different perinatal education
methods, the instructor determines that the teaching was successful when the
students identify which of the following as the Bradley method? A)
Psychoprophylactic method B) Partner-coached method C) Natural childbirth
method D) Mind prevention method 25.A pregnant woman in her second trimester
tells the nurse, Ive been passing a lot of gas and feel bloated. Which of the
following suggestions would be helpful for the woman? A) Watch how much beans
and onions you eat. Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 93 B) Limit the amount of fluid you drink with
meals C) Try exercising a little more. D) Some say that eating mints can help.
E) Cut down on your intake of cheeses. Chapter 13: Labor and Birth Process 1. A
woman in her 40th week of pregnancy calls the nurse at the clinic and says shes
not sure whether she is in true or false labor. Which statement by the client
would lead the nurse to suspect that the woman is experiencing false labor?
A)I'm feeling contractions mostly in my back. B) My contractions are about 6
minutes apart and regular. C) The contractions slow down when I walk around.
D)If I try to talk to my partner during a contraction, I cant. 2. Which of the
following would indicate to the nurse that the placenta is separating? A) Uterus
becomes globular B) Fetal head is at vaginal opening C) Umbilical cord shortens
D) Mucous plug is expelled 3. When assessing cervical effacement of a client in
labor, the nurse assesses which of the following characteristics? A)Extent of
opening to its widest diameter B) Degree of thinning C) Passage of the mucous
plug D)Fetal presenting part 4. A woman calls the health care facility stating
that she is in labor. The nurse would urge the client to come to the facility
if the client reports which of the following? A)Increased energy level with
alternating strong and weak contractions B) Moderately strong contractions
every 4 minutes, lasting about 1 minute C) Contractions noted in the front of
abdomen that stop when she walks D)Pinktinged vaginal secretions and irregular
contractions lasting about 30 seconds Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 96 5. A woman is in the first
stage of labor. The nurse would encourage her to assume which position to
facilitate the progress of labor? A)Supine B) Lithotomy C) Upright D)Kneechest
6. A client has not received any medication during her labor. She is having
frequent contractions every 1 to 2 minutes and has become irritable with her
coach and no longer will allow the nurse to palpate her fundus during
contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets
these findings as indicating: A)Latent phase of the first stage of labor B)
Active phase of the first stage of labor C) Transition phase of the first stage
of labor D)Pelvic phase of the second stage of labor 7. The fetus of a
nulliparous woman is in a shoulder presentation. The nurse would most likely
prepare the client for which type of birth? A)Cesarean B) Vaginal C)
Forceps-assisted D)Vacuum extraction 8. Assessment of a woman in labor reveals
cervical dilation of 3 cm, cervical effacement of 30%, and contractions
occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines
that this client is in: A)Latent phase of the first stage B) Active phase of
the first stage C) Transition phase of the first stage D)Perineal phase of the
second stage Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 97 9. A client is admitted to the labor and birthing
suite in early labor. On review of her medical record, the nurse determines
that the clients pelvic shape as identified in the antepartal progress notes is
the most favorable one for a vaginal delivery. Which pelvic shape would the
nurse have noted? A)Platypelloid B) Gynecoid C) Android D)Anthropoid 10.A woman
telephones her health care provider and reports that her water just broke.
Which suggestion by the nurse would be most appropriate? A) Call us back when
you start having contractions. B) Come to the clinic or emergency department
for an evaluation. C) Drink 3 to 4 glasses of water and lie down. D) Come in as
soon as you feel the urge to push. 11.After teaching a group of students about
the maternal bony pelvis, which statement by the group indicates that the
teaching was successful? A) The bony pelvis plays a lesser role during labor
than soft tissue. B) The pelvic outlet is associated with the true pelvis. C)
The false pelvis lies below the imaginary linea terminalis. D) The false pelvis
is the passageway through which the fetus travels. 12. A fetus is assessed at 2
cm above the ischial spines. The nurse would document fetal station as: A) +4
B) +2 C) 0 D) 2 13.Assessment of a fetus identifies the buttocks as the
presenting part, with the legs extended upward. The nurse identifies this as
which type of breech presentation? Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 98 A) Frank B) Full C)
Complete D) Footling 14.A woman in her third trimester comes to the clinic for
a prenatal visit. During assessment the woman reports that her breathing has
become much easier in the last week but she has noticed increased pelvic
pressure , cramping and lower back pain. The nurse determines that which of the
following has most likely occurred? A) Cervical dilation B) Lightening C)
Bloody show D) Braxton-Hicks contractions 15.After teaching a group of students
about the factors affecting the labor process, the instructor determines that
the teaching was successful when the group identifies which of the following as
a component of the true pelvis? (Select all that apply.) A) Pelvic inlet B)
Cervix C) Mid pelvis D) Pelvic outlet E) Vagina F) Pelvic floor muscles 16. A
nurse is documenting fetal lie of a woman in labor. Which term would the nurse
most likely use? A) Flexion B) Extension C) Longitudinal D) Cephalic Test Bank
- Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 99
17.The nurse is reviewing the medical record of a woman in labor and notes that
the fetal position is documented as LSA. The nurse interprets this information
as indicating which of the following is the presenting part? A) Occiput B) Face
C) Buttocks D) Shoulder 18.A nurse is preparing a class for pregnant women
about labor and birth. When describing the typical movements that the fetus
goes through as it travels through the passageway, which of the following would
the nurse most likely include? (Select all that apply.) A) Internal rotation B)
Abduction C) Descent D) Pronation E) Flexion 19.The nurse is reviewing the
monitoring strip of a woman in labor who is experiencing a contraction. The
nurse notes the time the contraction takes from its onset to reach its highest
intensity. The nurse interprets this time as which of the following? A)
Increment B) Acme C) Peak D) Decrement 20.A nurse is assessing a woman in
labor. Which finding would the nurse identify as a cause for concern during a
contraction? A) Heart rate increase from 76 bpm to 90 bpm B) Blood pressure
rise from 110/60 mm Hg to 120/74 C) White blood cell count of 12,000 cells/mm3
D) Respiratory rate of 10 breaths /minute Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 100 21.When describing the
stages of labor to a pregnant woman, which of the following would the nurse
identify as the major change occurring during the first stage? A) Regular
contractions B) Cervical dilation C) Fetal movement through the birth canal D)
Placental separation 22.A nurse is caring for several women in labor. The nurse
determines that which woman is in the transition phase of labor? A)
Contractions every 5 minutes, cervical dilation 3 cm B) Contractions every 3
minutes, cervical dilation 5 cm C) Contractions every 2 minutes, cervical
dilation 7 cm D) Contractions every 1 minute, cervical dilation 9 cm 23.A nurse
is preparing a presentation for a group of pregnant women about the labor
experience. Which of the following would the nurse most likely include when
discussing measures to promote coping for a positive labor experience? (Select
all that apply.) A) Presence of a support partner B) View of birth as a
stressor C) Low anxiety level D) Fear of loss of control E) Participation in a
pregnancy exercise program 24.During a follow-up prenatal visit, a pregnant
woman asks the nurse, How long do you think I will be in labor? Which response
by the nurse would be most appropriate? A) Its difficult to predict how your
labor will progress, but well be there for you the entire time. B) Since this
is your first pregnancy, you can estimate it will be about 10 hours. C) It will
depend on how big the baby is when you go into labor. D) Time isn't important;
your health and the babys health are key. Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 101 25.A nurse is describing
how the fetus moves through the birth canal. Which of the following would the
nurse identify as being most important in allowing the fetal head to move
through the pelvis? A) Sutures B) Fontanelles C) Frontal bones D) Biparietal
diameter 26.Assessment of a pregnant woman reveals that the presenting part of
the fetus is at the level of the maternal ischial spines. The nurse documents
this as which station? A) 2 B) 1 C) 0 D) +1 Chapter 14: Nursing Management
During Labor and Birth 1. A woman in labor who received an opioid for pain
relief develops respiratory depression. The nurse would expect which agent to
be administered? A)Butorphanol B) Fentanyl C) Naloxone D)Promethazine 2. A
clients membranes spontaneously ruptured, as evidenced by a gush of clear fluid
with a contraction. Which of the following would the nurse do next? A)Check the
fetal heart rate. B) Perform a vaginal exam. C) Notify the physician
immediately. D)Change the linen saver pad. 3. A woman has just entered the
second stage of labor. The nurse would focus care on which of the following?
A)Encouraging the woman to push when she has a strong desire to do so B)
Alleviating perineal discomfort with the application of ice packs C) Palpating
the woman's fundus for position and firmness D)Completing the identification
process of the newborn with the mother 4. The nurse notes persistent early
decelerations on the fetal monitoring strip. Which of the following would the
nurse do next? A)Continue to monitor the FHR because this pattern is benign. B)
Perform a vaginal exam to assess cervical dilation and effacement. C) Stay with
the client while reporting the finding to the physician. D)Administer oxygen
after turning the client on her left side. Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 104 5. A woman is admitted to
the labor and birthing suite. Vaginal examination reveals that the presenting
part is approximately 2 cm above the ischial spines. The nurse documents this
finding as: A)+2 station B) 0 station C) 2 station D)Crowning 6. The nurse is
performing Leopolds maneuvers to determine fetal presentation, position, and
lie. Which action would the nurse do first? A)Feel for the fetal buttocks or
head while palpating the abdomen. B) Feel for the fetal back and limbs as the
hands move laterally on the abdomen. C) Palpate for the presenting part in the
area just above the symphysis pubis. D)Determine flexion by pressing downward
toward the symphysis pubis. 7. A client states, I think my waters broke! I felt
this gush of fluid between my legs. The nurse tests the fluid with Nitrazine
paper and confirms membrane rupture if the paper turns: A)Yellow B) Olive green
C) Pink D)Blue 8. A woman in labor is to receive continuous internal electronic
fetal monitoring. The nurse reviews the woman's medical record to ensure which
of the following as being required? A)Intact membranes B) Cervical dilation of
2 cm or more C) Floating presenting fetal part D)A neonatologist to insert the
electrode 9. When assessing fetal heart rate, the nurse finds a heart rate of
175 bpm, accompanied by a decrease in variability and late decelerations. Which
of the following would the nurse do next? Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 105 A)Have the woman change
her position. B) Administer oxygen. C) Notify the health care provider.
D)Continue to monitor the pattern every 15 minutes. 10.A woman in labor has
chosen to use hydrotherapy as a method of pain relief. Which statement by the
woman would lead the nurse to suspect that the woman needs additional teaching?
A) The warmth and buoyancy of the water has a nice relaxing effect. B) I can
stay in the bath for as long as I feel comfortable. C) My cervix should be
dilated more than 5 cm before I try using this method. D) The temperature of
the water should be at least 105 F. 11.A woman in labor received an opioid
close to the time of birth. The nurse would assess the newborn for which of the
following? A) Respiratory depression B) Urinary retention C) Abdominal
distention D) Hyperreflexia 12.When applying the ultrasound transducers for
continuous external electronic fetal monitoring, at which location would the
nurse place the transducer to record the FHR? A) Over the uterine fundus where
contractions are most intense B) Above the umbilicus toward the right side of
the diaphragm C) Between the umbilicus and the symphysis pubis D) Between the
xiphoid process and umbilicus 13.After describing continuous internal
electronic fetal monitoring to a laboring woman and her partner, which of the
following would indicate the need for additional teaching? A) This type of
monitoring is the most accurate method for our baby. B) Unfortunately, I'm
going to have to stay quite still in bed while it is in place. Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 106
C) This type of monitoring can only be used after my membranes rupture. D)
Youll be inserting a special electrode into my babys scalp. 14.When planning
the care of a woman in the active phase of labor, the nurse would anticipate
assessing the fetal heart rate at which interval? A) Every 2 to 4 hours B)
Every 45 to 60 minutes C) Every 15 to 30 minutes D) Every 10 to 15 minutes 15.
Which of the following is a priority when caring for a woman during the fourth
stage of labor? A) Assessing the uterine fundus B) Offering fluids as indicated
C) Encouraging the woman to void D) Assisting with perineal care 16.When
palpating the fundus during a contraction, the nurse notes that it feels like a
chin. The nurse interprets this finding as indicating which type of
contraction? A) Intense B) Strong C) Moderate D) Mild 17.A nurse palpates a
woman's fundus to determine contraction intensity. Which of the following would
be most appropriate for the nurse to use for palpation? A) Finger pads B) Palm
of the hand C) Finger tips D) Back of the hand Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 107 18.A woman's
amniotic fluid is noted to be cloudy. The nurse interprets this finding as
which of the following? A) Normal B) Possible infection C) Meconium passage D)
Transient fetal hypoxia 19.After teaching a group of students about fetal heart
rate patterns, the instructor determines the need for additional teaching when
the students identify which of the following as indicating normal fetal
acidbase status? (Select all that apply.) A) Sinusoidal pattern B) Recurrent
variable decelerations C) Fetal bradycardia D) Absence of late decelerations E)
Moderate baseline variability 20.A nurse is reviewing the fetal heart rate
pattern and observes abrupt decreases in FHR below the baseline, appearing as a
U-shape. The nurse interprets these changes as reflecting which of the
following? A) Early decelerations B) Variable decelerations C) Prolonged
decelerations D) Late decelerations 21.A nurse is explaining the use of
therapeutic touch as a pain relief measure during labor. Which of the following
would the nurse include in the explanation? A) This technique focuses on
manipulating body tissues. B) The technique requires focusing on a specific
stimulus. C) This technique redirects energy fields that lead to pain. D) The
technique involves light stroking of the abdomen with breathing. Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 108 22.A group
of nursing students are reviewing the various medications used for pain relief
during labor. The students demonstrate understanding of the information when
they identify which agent as the most commonly used opioid? A) Butorphanol B)
Nalbuphine C) Fentanyl D) Meperidine 23.A nurse is describing the different
types of regional analgesia and anesthesia for labor to a group of pregnant
women. Which statement by the group indicates that the teaching was successful?
A) We can get up and walk around after receiving combined spinalepidural
analgesia. B) Higher anesthetic doses are needed for patient-controlled
epidural analgesia. C) A pudendal nerve block is highly effective for pain
relief in the first stage of labor. D) Local infiltration using lidocaine is an
appropriate method for controlling contraction pain. 24.A nurse is completing
the assessment of a woman admitted to the labor and birth suite. Which of the
following would the nurse expect to include as part of the physical assessment?
(Select all that apply.) A) Current pregnancy history B) Fundal height
measurement C) Support system D) Estimated date of birth E) Membrane status F)
Contraction pattern 25.A pregnant woman admitted to the labor and birth suite
undergoes rapid HIV testing and is found to be HIV-positive. Which of the
following would the nurse expect to include when developing a plan of care for
this women? (Select all that apply.) A) Administration of penicillin G at the
onset of labor B) Avoidance of scalp electrodes for fetal monitoring C)
Refraining from obtaining fetal scalp blood for pH testing Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 109
D) Adminstering zidovudine at the onset of labor. E) Electing for the use of
forceps-assisted delivery 26.Which position would be most appropriate for the
nurse to suggest as a comfort measure to a woman who is in the first stage of
labor? (Select all that apply.) A) Walking with partner support B) Straddling
with forward leaning over a chair C) Closed kneechest position D) Rocking back
and forth with foot on chair E) Supine with legs raised at a 90-degree angle
27.Which of the following would be most appropriate for the nurse to suggest
about pushing to a woman in the second stage of labor? A) Lying flat with your
head elevated on two pillows makes pushing easier. B) Choose whatever method
you feel most comfortable with for pushing. C) Let me help you decide when it
is time to start pushing. D) Bear down like youre having a bowel movement with
every contraction. 28.A nurse is assessing a woman after birth and notes a
second-degree laceration. The nurse interprets this as indicating that the tear
extends through which of the following? A) Skin B) Muscles of perineal body C)
Anal sphincter D) Anterior rectal wall 29.A nurse is assisting with the
delivery of a newborn. The fetal head has just emerged. Which of the following
would be done next? A) Suctioning of the mouth and nose B) Clamping of the
umbilical cord C) Checking for the cord around the neck Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 110 D) Drying
of the newborn 30.A nurse is providing care to a woman during the third stage
of labor. Which of the following would alert the nurse that the placenta is
separating? (Select all that apply.) A) Boggy, soft uterus B) Uterus becoming
discoid shaped C) Sudden gush of dark blood from the vagina D) Shortening of
the umbilical cord Chapter 15: Postpartum Adaptations 1. A primipara client
gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates
the clients fundus, expecting it to be at which location? A)Two finger-breadths
above the umbilicus B) At the level of the umbilicus C) Two finger-breadths
below the umbilicus D)Four finger-breadths below the umbilicus 2. When caring
for a mother who has had a cesarean birth, the nurse would expect the clients
lochia to be: A) Greater than after a vaginal delivery B) About the same as
after a vaginal delivery C) Less than after a vaginal delivery D) Saturated
with clots and mucus 3. The nurse is developing a teaching plan for a client
who has decided to bottle feed her newborn. Which of the following would the
nurse include in the teaching plan to facilitate suppression of lactation?
A)Encouraging the woman to manually express milk B) Suggesting that she take
frequent warm showers to soothe her breasts C) Telling her to limit the amount
of fluids that she drinks D)Instructing her to apply ice packs to both breasts
every other hour 4. The nurse is making a follow-up home visit to a woman who
is 12 days postpartum. Which of the following would the nurse expect to find
when assessing the clients fundus? A)Cannot be palpated B) 2 cm below the
umbilicus C) 6 cm below the umbilicus D)10 cm below the umbilicus Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 113
5. A client who is breast-feeding her newborn tells the nurse, I notice that
when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why
am I having contractions now? Which response by the nurse would be most
appropriate? A)Your uterus is still shrinking in size; thats why youre feeling
this pain. B) Let me check your vaginal discharge just to make sure everything
is fine. C) Your body is responding to the events of labor, just like after a
tough workout. D)The babys sucking releases a hormone that causes the uterus to
contract. 6. When the nurse is assessing a postpartum client approximately 6
hours after delivery, which finding would warrant further investigation? A)Deep
red, fleshy-smelling lochia B) Voiding of 350 cc C) Heart rate of 120
beats/minute D)Profuse sweating 7. A postpartum client who is bottle feeding
her newborn asks, When should my period return? Which response by the nurse
would be most appropriate? A)Its difficult to say, but it will probably return
in about 2 to 3 weeks. B) It varies, but you can estimate it returning in about
7 to 9 weeks. C) You won't have to worry about it returning for at least 3
months. D)You don't have to worry about that now. It'll be quite a while. 8.
The nurse interprets which of the following as evidence that a client is in the
taking-in phase? A) Client states, He has my eyes and nose. B) Client shows
interest in caring for the newborn. C) Client performs self-care independently.
D) Client confidently cares for the newborn. 9. Which of the following would
the nurse interpret as being least indicative of paternal engrossment? A)
Demonstrating pleasure when touching or holding the newborn Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 114
B) Identifying imperfections in the newborns appearance C) Being able to
distinguish his newborn from others in the nursery D) Showing feelings of pride
with the birth of the newborn 10.A postpartum client comes to the clinic for
her 6-week postpartum checkup. When assessing the clients cervix, the nurse
would expect the external cervical os to appear: A) Shapeless B) Circular C)
Triangular D) Slit-like 11.The nurse develops a teaching plan for a postpartum
client and includes teaching about how to perform Kegel exercises. The nurse
includes this information for which reason? A) Reduce lochia B) Promote uterine
involution C) Improve pelvic floor tone D) Alleviate perineal pain 12.A father
of a newborn tells the nurse, I may not know everything about being a dad, but
I'm going to do the best I can for my son. The nurse interprets this as
indicating the father is in which stage of adaptation? A) Expectations B)
Transition to mastery C) Reality D) Taking-in 13.A postpartum client is
experiencing subinvolution. When reviewing the woman's labor and birth history,
which of the following would the nurse identify as being least significant to
this condition? A) Early ambulation B) Prolonged labor Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 115 C) Large
fetus D) Use of anesthetics 14.Which of the following would lead the nurse to
suspect that a postpartum woman is experiencing a problem? A) Elevated white
blood cell count B) Acute decrease in hematocrit C) Increased levels of
clotting factors D) Pulse rate of 60 beats/minute 15.A woman who gave birth 24
hours ago tells the nurse, Ive been urinating so much over the past several
hours. Which response by the nurse would be most appropriate? A) You must have
an infection, so let me get a urine specimen. B) Your body is undergoing many
changes that cause your bladder to fill quickly. C) Your uterus is not
contracting as quickly as it should. D) The anesthesia that you received is
wearing off and your bladder is working again. 16.A group of students are
reviewing the process of breast milk production. The students demonstrate
understanding when they identify which hormone as responsible for milk
let-down? A) Prolactin B) Estrogen C) Progesterone D) Oxytocin 17.A nurse is
making a home visit to a postpartum woman who delivered a healthy newborn 4
days ago. The woman's breasts are swollen, hard, and tender to the touch. The
nurse documents this finding as which of the following? A) Involution B)
Engorgement C) Mastitis Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 116 D) Engrossment 18.A nurse is assessing
a postpartum woman's adjustment to her maternal role. Which of the following
would the nurse expect to occur first? A) Reestablishing relationships with
others B) Demonstrating increasing confidence in care of the newborn C)
Assuming a passive role in meeting her own needs D) Becoming preoccupied with
the present 19.The partner of a woman who has given birth to a healthy newborn
says to the nurse, I want to be involved, but I'm not sure that I'm able to
care for such a little baby. The nurse interprets this as indicating which of
the following stages? A) Expectations B) Reality C) Transition to mastery D)
Taking-hold 20.A group of nursing students are reviewing information about
maternal and paternal adaptations to the birth of a newborn. The nurse observes
the parents interacting with their newborn physically and emotionally. The
nurse documents this as which of the following? A) Puerperium B) Lactation C)
Attachment D) Engrossment 21.After teaching a group of nursing students about
the process of involution, the instructor determines that additional teaching
is needed when the students identify which of the following as being involved?
A) Catabolism B) Muscle fiber contraction C) Epithelial regeneration D)
Vasodilation Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 117 22.A nurse is visiting a postpartum woman who
delivered a healthy newborn 5 days ago. Which of the following would the nurse
expect to find? A) Bright red discharge B) Pinkish brown discharge C) Deep red
mucus-like discharge D) Creamy white discharge 23.A nurse teaches a postpartum
woman about her risk for thromboembolism. Which of the following would the
nurse be least likely to include as a factor increasing her risk? A) Increased
clotting factors B) Vessel damage C) Immobility D) Increased red blood cell
production 24.A nursing student is preparing a class presentation about changes
in the various body systems during the postpartum period and their effects.
Which of the following would the student include as influencing a postpartum
woman's ability to void? (Select all that apply.) A) Use of an opioid
anesthetic during labor B) Generalized swelling of the perineum C) Decreased
bladder tone from regional anesthesia D) Use of oxytocin to augment labor E)
Need for an episiotomy 25.A postpartum woman who has experienced diastasis
recti asks the nurse about what to expect related to this condition. Which
response by the nurse would be most appropriate? A) Youll notice that this will
fade to silvery lines. B) Exercise will help to improve the muscles. C) Expect
the color to lighten somewhat. D) Youll notice that your shoe size will
increase. Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 118 26.A group of nursing students are reviewing
respiratory system adaptations that occur during the postpartum period. The
students demonstrate understanding of the information when they identify which
of the following as a postpartum adaptation? A) Continued shortness of breath
B) Relief of rib aching C) Diaphragmatic elevation D) Decrease in respiratory
rate 27.A woman who delivered a healthy newborn several hours ago asks the
nurse, Why am I perspiring so much? The nurse integrates knowledge that a
decrease in which hormone plays a role in this occurrence? A) Estrogen B) hCG
C) hPL D) Progesterone Chapter 16: Nursing Management During the Postpartum
Period 1. A woman who is 12 hours postpartum had a pulse rate around 80 beats
per minute during pregnancy. Now, the nurse finds a pulse of 60 beats per
minute. Which of these actions should the nurse take? A)Document the finding,
as it is a normal finding at this time. B) Contact the physician, as it
indicates early DIC. C) Contact the physician, as it is a first sign of
postpartum eclampsia. D)Obtain an order for a CBC, as it suggests postpartum
anemia. 2. To decrease the pain associated with an episiotomy immediately after
birth, which action by the nurse would be most appropriate? A)Offer warm
blankets. B) Encourage the woman to void. C) Apply an ice pack to the site.
D)Offer a warm sitz bath. 3. A postpartum client has a fourth-degree perineal
laceration. The nurse would expect which of the following medications to be
ordered? A)Ferrous sulfate (Feosol) B) Methylergonovine (Methergine) C) Docusate
(Colace) D)Bromocriptine (Parlodel) 4. Which statement would alert the nurse to
the potential for impaired bonding between mother and newborn? A)You have your
daddys eyes. B) He looks like a frog to me. C) Where did you get all that hair?
D)He seems to sleep a lot. Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 121 5. After a normal labor and birth, a
client is discharged from the hospital 12 hours later. When the community
health nurse makes a home visit 2 days later, which finding would alert the
nurse to the need for further intervention? A)Presence of lochia serosa B)
Frequent scant voidings C) Fundus firm, below umbilicus D)Milk filling in both
breasts 6. A primipara client who is bottle feeding her baby begins to
experience breast engorgement on her third postpartum day. Which instruction
would be most appropriate to aid in relieving her discomfort? A)Express some
milk from your breasts every so often to relieve the distention. B) Remove your
bra to relieve the pressure on your sensitive nipples and breasts. C) Apply ice
packs to your breasts to reduce the amount of milk being produced. D)Take
several warm showers daily to stimulate the milk let-down reflex. 7. The nurse
administers RhoGAM to an Rh-negative client after delivery of an Rh-positive
newborn based on the understanding that this drug will prevent her from:
A)Becoming Rh positive B) Developing Rh sensitivity C) Developing AB antigens
in her blood D)Becoming pregnant with an Rh-positive fetus 8. Which of the
following factors in a clients history would alert the nurse to an increased
risk for postpartum hemorrhage? A)Multiparity, age of mother, operative
delivery B) Size of placenta, small baby, operative delivery C) Uterine atony,
placenta previa, operative procedures D)Prematurity, infection, length of labor
9. After teaching parents about their newborn, the nurse determines that the
teaching was successful when they identify the development of a close emotional
attraction to a newborn by parents during the first 30 to 60 minutes after
birth as which of the following? Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 122 A)Reciprocity B) Engrossment C)
Bonding D)Attachment 10.A nurse is working as part of a committee to establish
policies to promote bonding and attachment. Which practice would be least
effective in achieving this goal? A) Allowing unlimited visiting hours on
maternity units B) Offering roundthe-clock nursery care for all infants C)
Promoting rooming-in D) Encouraging infant contact immediately after birth
11.When developing the plan of care for the parents of a newborn, the nurse
identifies interventions to promote bonding and attachment based on the
rationale that bonding and attachment are most supported by which measure? A)
Early parentinfant contact following birth B) Expert medical care for the labor
and birth C) Good nutrition and prenatal care during pregnancy D) Grandparent
involvement in infant care after birth 12.A postpartum woman is having difficulty
voiding for the first time after giving birth. Which of the following would be
least effective in helping to stimulate voiding? A) Pouring warm water over her
perineal area B) Having her hear the sound of water running nearby C) Placing
her hand in a basin of cool water D) Standing her in the shower with the warm
water on 13.The nurse is assisting a postpartum woman out of bed to the
bathroom for a sitz bath. Which of the following would be a priority? A)
Placing the call light within her reach Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 123 B) Teaching her how the
sitz bath works C) Telling her to use the sitz bath for 30 minutes D) Cleaning
the perineum with the peri-bottle 14.A nurse is reviewing the medical record of
a postpartum client. The nurse identifies that the woman is at risk for a
postpartum infection based on which of the following? (Select all that apply.)
A) History of diabetes B) Labor of 12 hours C) Rupture of membranes for 16
hours D) Hemoglobin level 10 mg/dL E) Placenta requiring manual extraction 15.A
nurse is completing a postpartum assessment. Which finding would alert the
nurse to a potential problem? A) Lochia rubra with a fleshy odor B) Respiratory
rate of 16 breaths per minute C) Temperature of 101 F D) Pain rating of 2 on a
scale from 0 to 10 16.The nurse is assessing a postpartum clients lochia and
finds that there is about a 4-inch stain on the perineal pad. The nurse
documents this finding as which of the following? A) Scant B) Light C) Moderate
D) Large 17.When reviewing the medical record of a postpartum client, the nurse
notes that the client has experienced a third-degree laceration. The nurse
understands that the laceration extends to which of the following? A)
Superficial structures above the muscle Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 124 B) Through the perineal
muscles C) Through the anal sphincter muscle D) Through the anterior rectal
wall 18.A nurse is observing a postpartum client interacting with her newborn
and notes that the mother is engaging with the newborn in the en face position.
Which of the following would the nurse be observing? A) Mother placing the
newborn next to bare breast. B) Mother making eye-to-eye contact with the
newborn C) Mother gently stroking the newborns face D) Mother holding the
newborn upright at the shoulder 19.After teaching a group of students about
risk factors associated with postpartum hemorrhage, the instructor determines
that the teaching was successful when the students identify which of the
following as a risk factor? (Select all that apply.) A) Prolonged labor B)
Placenta previa C) Null parity D) Hydramnios E) Labor augmentation 20.A
postpartum woman who is breast-feeding tells the nurse that she is experiencing
nipple pain. Which of the following would be least appropriate for the nurse to
suggest? A) Use of a mild analgesic about 1 hour before breast-feeding B)
Application of expressed breast milk to the nipples C) Application of glycerin-based
gel to the nipples D) Reinstruction about proper latching-on technique 21.A
nurse is developing a teaching plan for a postpartum woman who is breastfeeding
about sexuality and contraception. Which of the following would the nurse most
likely include? (Select all that apply.) A) Resumption of sexual intercourse
about two weeks after delivery Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 125 B) Possible experience of
fluctuations in sexual interest C) Use of a waterbased lubricant to ease
vaginal discomfort D) Use of combined hormonal contraceptives for the first
three weeks E) Possibility of increased breast sensitivity during sexual
activity 22.After teaching a postpartum woman about breast-feeding, the nurse
determines that the teaching was successful when the woman states which of the
following? A) I should notice a decrease in abdominal cramping during
breast-feeding. B) I should wash my hands before starting to breast-feed. C)
The baby can be awake or sleepy when I start to feed him. D) The babys mouth
will open up once I put him to my breast. 23.A postpartum woman who is
bottle-feeding her newborn asks the nurse, About how much should my newborn
drink at each feeding? The nurse responds by saying that to feel satisfied, the
newborn needs which amount at each feeding? A) 1 to 2 ounces B) 2 to 4 ounces
C) 4 to 6 ounces D) 6 to 8 ounces 24.A nurse is observing a postpartum woman
and her partner interact with the their newborn. The nurse determines that the
parents are developing parental attachment with their newborn when they
demonstrate which of the following? (Select all that apply.) A) Frequently ask
for the newborn to be taken from the room B) Identify common features between
themselves and the newborn C) Refer to the newborn as having a monkey-face D)
Make direct eye contact with the newborn E) Refrain from checking out the
newborns features 25.After reviewing information about postpartum blues, a
group of students demonstrate understanding when they state which of the
following about this condition? Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 126 A) Postpartum blues is a long-term
emotional disturbance. B) Sleep usually helps to resolve the blues. C) The
mother loses contact with reality. D) Extended psychotherapy is needed for
treatment. Chapter 17: Newborn Transitioning 1. When explaining how a newborn
adapts to extrauterine life, the nurse would describe which body systems as
undergoing the most rapid changes? A)Gastrointestinal and hepatic B) Urinary
and hematologic C) Respiratory and cardiovascular D)Neurological and
integumentary 2. A new mother reports that her newborn often spits up after
feeding. Assessment reveals regurgitation. The nurse responds integrating
understanding that this most likely is due to which of the following? A)Placing
the newborn prone after feeding B) Limited ability of digestive enzymes C)
Underdeveloped pyloric sphincter D)Relaxed cardiac sphincter 3. After teaching
a class about hepatic system adaptations after birth, the instructor determines
that the teaching was successful when the class identifies which of the
following as the process of changing bilirubin from a fat-soluble product to a
water-soluble product? A)Hemolysis B) Conjugation C) Jaundice
D)Hyperbilirubinemia 4. Twenty minutes after birth, a baby begins to move his
head from side to side, making eye contact with the mother, and pushes his
tongue out several times. The nurse interprets this as indicating which of the
following? A)A good time to initiate breast-feeding B) The period of decreased
responsiveness preceding sleep C) The need to be alert for gagging and vomiting
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 129 D)Evidence that the newborn is becoming chilled 5. The nurse
institutes measure to maintain thermoregulation based on the understanding that
newborns have limited ability to regulate body temperature because they: A)Have
a smaller body surface compared to body mass B) Lose more body heat when they
sweat than adults C) Have an abundant amount of subcutaneous fat all over D)Are
unable to shiver effectively to increase heat production 6. A new mother is
changing the diaper of her 20-hour-old newborn and asks why the stool is almost
black. Which response by the nurse would be most appropriate? A)You probably
took iron during your pregnancy. B) This is meconium stool, normal for a
newborn. C) I'll take a sample and check it for possible bleeding. D)This is
unusual and I need to report this. 7. A client expresses concern that her
2-hour-old newborn is sleepy and difficult to awaken. The nurse explains that
this behavior indicates which of the following? A)Normal progression of
behavior B) Probable hypoglycemia C) Physiological abnormality D)Inadequate
oxygenation 8. After the birth of a newborn, which of the following would the
nurse do first to assist in thermoregulation? A)Dry the newborn thoroughly. B)
Put a hat on the newborns head. C) Check the newborns temperature. D)Wrap the
newborn in a blanket. 9. Assessment of a newborn reveals rhythmic spontaneous
movements. The nurse interprets this as indicating: Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 130 A)Habituation
B) Motor maturity C) Orientation D)Social behaviors 10.After teaching new
parents about the sensory capabilities of their newborn, the nurse determines
that the teaching was successful when they identify which sense as being the
least mature? A) Hearing B) Touch C) Taste D) Vision 11.The nurse places a
warmed blanket on the scale when weighing a newborn. The nurse does so to
minimize heat loss via which mechanism? A) Evaporation B) Conduction C)
Convection D) Radiation 12. Which of the following would alert the nurse to the
possibility of respiratory distress in a newborn? A) Symmetrical chest
movements B) Periodic breathing C) Respirations of 40 breaths/minute D) Sternal
retractions 13.A nurse is counseling a mother about the immunologic properties
of breast milk. The nurse integrates knowledge of immunoglobulins, emphasizing
that breast milk is a major source of which immunoglobulin? A) IgA B) IgG Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 131 C) IgM D) IgE 14.The nurse is teaching a group of students about
the similarities and differences between newborn skin and adult skin. Which
statement by the group indicates that additional teaching is needed? A) The
newborns skin and that of an adult are similar in thickness. B) The lipid
composition of the skin of a newborn and adult is about the same. C) Skin
development in the newborn is complete at birth. D) The newborn has more
fibrils connecting the dermis and epidermis. 15.A nurse is developing a
teaching plan for the parents of a newborn. When describing the neurologic
development of a newborn to his parents, the nurse would explain that the
development occurs in which fashion? A) Head-to-toe B) Lateral-to-medial C)
Outward-to-inward D) Distal-to-caudal 16.The nurse is assessing the
respirations of several newborns. The nurse would notify the health care
provider for the newborn with which respiratory rate at rest? A) 38 breaths per
minute B) 46 breaths per minute C) 54 breaths per minute D) 68 breaths per
minute 17.A new mother asks the nurse, Why has my baby lost weight since he was
born? The nurse integrates knowledge of which of the following when responding
to the new mother? A) Insufficient calorie intake B) Shift of water from
extracellular space to intracellular space C) Increase in stool passage Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 132 D) Overproduction of bilirubin 18.The nurse observes the stool of
a newborn who has begun to breast-feed. Which of the following would the nurse
expect to find? A) Greenish black, tarry stool B) Yellowish-brown, seedy stool
C) Yellow-gold, stringy stool D) Yellowish-green, pasty stool 19.A nurse is
assessing a newborn who is about 4 hours old. The nurse would expect this
newborn to exhibit which of the following? (Select all that apply.) A) Sleeping
B) Interest in environmental stimuli C) Passage of meconium D) Difficulty
arousing the newborn E) Spontaneous Moro reflexes 20.A nurse is assessing a
newborn and observes the newborn moving his head and eyes toward a loud sound.
The nurse interprets this as which of the following? A) Habituation B) Motor
maturity C) Social behavior D) Orientation 21.A newborn is experiencing cold
stress. Which of the following would the nurse expect to assess? (Select all
that apply.) A) Respiratory distress B) Decreased oxygen needs C) Hypoglycemia
D) Metabolic alkalosis Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 133 E) Jaundice 22.A group of nursing
students are reviewing the changes in the newborns lungs that must occur to
maintain respiratory function. The students demonstrate understanding of this
information when they identify which of the following as the first event? A)
Expansion of the lungs B) Increased pulmonary blood flow C) Initiation of
respiratory movement D) Redistribution of cardiac output 23.A nurse is
reviewing the laboratory test results of a newborn. Which result would the
nurse identify as a cause for concern? A) Hemoglobin 19 g/dL B) Platelets
75,000/uL C) White blood cells 20,000/mm3 D) Hematocrit 52% 24.A nursing
instructor is preparing a class on newborn adaptations. When describing the
change from fetal to newborn circulation, which of the following would the
instructor most likely include? (Select all that apply.) A) Decrease in right
atrial pressure leads to closure of the foramen ovale. B) Increase in oxygen
levels leads to a decrease in systemic vascular resistance. C) Onset of
respirations leads to a decrease in pulmonary vascular resistance. D) Increase
in pressure in the left atrium results from increases in pulmonary blood flow.
E) Closure of the ductus venosus eventually forces closure of the ductus
arteriosus. 25.A nursing student is preparing a presentation on minimizing heat
loss in the newborn. Which of the following would the student include as a
measure to prevent heat loss through convection? A) Placing a cap on a newborns
head B) Working inside an isolette as much as possible. Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 134 C) Placing
the newborn skin-to-skin with the mother D) Using a radiant warmer to transport
a newborn 26.After teaching a group of nursing students about a neutral thermal
environment, the instructor determines that the teaching was successful when
the students identify which of the following as the newborns primary method of
heat production? A) Convection B) Nonshivering thermogenesis C) Cold stress D)
Bilirubin conjugation 27.While observing the interaction between a newborn and his
mother, the nurse notes the newborn nestling into the arms of his mother. The
nurse identifies this behavior as which of the following? A) Habituation B)
Self-quieting ability C) Social behaviors D) Orientation Chapter 18: Nursing
Management of the Newborn 1. Prior to discharging a 24-hour-old newborn, the
nurse assesses her respiratory status. Which of the following would the nurse
expect to assess? A)Respiratory rate 45, irregular B) Costal breathing pattern
C) Nasal flaring, rate 65 D)Crackles on auscultation 2. The nurse encourages
the mother of a healthy newborn to put the newborn to the breast immediately
after birth for which reason? A)To aid in maturing the newborns sucking reflex
B) To encourage the development of maternal antibodies C) To facilitate
maternalinfant bonding D)To enhance the clearing of the newborns respiratory
passages 3. When making a home visit, the nurse observes a newborn sleeping on
his back in a bassinet. In one corner of the bassinet is a soft stuffed animal
and at the other end is a bulb syringe. The nurse determines that the mother
needs additional teaching because of which of the following? A)The newborn
should not be sleeping on his back. B) Stuffed animals should not be in areas
where infants sleep. C) The bulb syringe should not be kept in the bassinet.
D)This newborn should be sleeping in a crib. 4. Assessment of a newborn reveals
a heart rate of 180 beats/minute. To determine whether this finding is a common
variation rather than a sign of distress, what else does the nurse need to
know? A)How many hours old is this newborn? B) How long ago did this newborn
eat? C) What was the newborns birth weight? Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 137 D)Is
acrocyanosis present? 5. Just after delivery, a newborns axillary temperature
is 94 C. What action would be most appropriate? A) Assess the newborns
gestational age. B) Rewarm the newborn gradually. C) Observe the newborn every
hour. D) Notify the physician if the temperature goes lower. 6. The parents of
a newborn become concerned when they notice that their baby seems to stop
breathing for a few seconds. After confirming the parents findings by observing
the newborn, which of the following actions would be most appropriate? A)Notify
the health care provider immediately. B) Assess the newborn for signs of
respiratory distress. C) Reassure the parents that this is an expected pattern.
D)Tell the parents not to worry since his color is fine. 7. When assessing a
newborn 1 hour after birth, the nurse measures an axillary temperature of 95.8
F, an apical pulse of 114 beats/minute, and a respiratory rate of 60
breaths/minute. Which nursing diagnosis takes highest priority? A)Hypothermia
related to heat loss during birthing process B) Impaired parenting related to
addition of new family member C) Risk for deficient fluid volume related to
insensible fluid loss D)Risk for infection related to transition to
extrauterine environment 8. The nurse places a newborn with jaundice under the
phototherapy lights in the nursery to achieve which goal? A)Prevent cold stress
B) Increase surfactant levels in the lungs C) Promote respiratory stability
D)Decrease the serum bilirubin level Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 138 9. The nurse completes
the initial assessment of a newborn. Which finding would lead the nurse to
suspect that the newborn is experiencing difficulty with oxygenation?
A)Respiratory rate of 54 breaths/minute B) Abdominal breathing C) Nasal flaring
D)Acrocyanosis 10.During a physical assessment of a newborn, the nurse observes
bluish markings across the newborns lower back. The nurse documents this
finding as which of the following? A) Milia B) Mongolian spots C) Stork bites
D) Birth trauma 11.While making rounds in the nursery, the nurse sees a
6-hour-old baby girl gagging and turning bluish. Which of the following would
the nurse do first? A) Alert the physician stat and turn the newborn to her
right side. B) Administer oxygen via facial mask by positive pressure. C) Lower
the newborns head to stimulate crying. D) Aspirate the oral and nasal pharynx
with a bulb syringe. 12.While performing a physical assessment of a newborn
boy, the nurse notes diffuse edema of the soft tissues of his scalp that
crosses suture lines. The nurse documents this finding as: A) Molding B)
Microcephaly C) Caput succedaneum D) Cephalhematoma 13.Assessment of a newborn
reveals uneven gluteal (buttocks. skin creases and a clunk when Ortolanis
maneuver is performed. Which of the following would the nurse suspect? Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 139 A) Slipping of the periosteal joint B) Developmental hip dysplasia
C) Normal newborn variation D) Overriding of the pelvic bone 14.The nurse
strokes the lateral sole of the newborns foot from the heel to the ball of the
foot when evaluating which reflex? A) Babinski B) Tonic neck C) Stepping D)
Plantar grasp 15.The nurse administers vitamin K intramuscularly to the newborn
based on which of the following rationales? A) Stop Rh sensitization B)
Increase erythopoiesis C) Enhance bilirubin breakdown D) Promote blood clotting
16.The nurse is assessing the skin of a newborn and notes a rash on the
newborns face, and chest. The rash consists of small papules and is scattered
with no pattern. The nurse interprets this finding as which of the following?
A) Harlequin sign B) Nevus flammeus C) Erythema toxicum D) Port wine stain
17.After teaching a group of nursing students about variations in newborn head
size and appearance, the instructor determines that the teaching was successful
when the students identify which of the following as a normal variation?
(Select all that apply.) A) Cephalhematoma Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 140 B) Molding C) Closed
fontanels D) Caput succedaneum E) Posterior fontanel diameter 1.5 cm 18.The
nurse is assessing a newborns eyes. Which of the following would the nurse
identify as normal? (Select all that apply.) A) Slow blink response B) Able to
track object to midline C) Transient deviation of the eyes D) Involuntary
repetitive eye movement E) Absent red reflex 19.Assessment of a newborns head
circumference reveals that it is 34 cm. The nurse would suspect that this
newborns chest circumference would be: A) 30 cm B) 32 cm C) 34 cm D) 36 cm
20.The nurse is auscultating a newborns heart and places the stethoscope at the
point of maximal impulse at which location? A) Just superior to the nipple, at
the midsternum B) Lateral to the midclavicular line at the fourth intercostal
space C) At the fifth intercostal space to the left of the sternum D) Directly
adjacent to the sternum at the second intercostals space 21.The nurse is
inspecting the external genitalia of a male newborn. Which of the following
would alert the nurse to a possible problem? A) Limited rugae Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 141
B) Large scrotum C) Palpable testes in scrotal sac D) Absence of engorgement
22.When assessing a newborns reflexes, the nurse strokes the newborns cheek and
the newborn turns toward the side that was stroked and begins sucking. The
nurse documents which reflex as being positive? A) Palmar grasp reflex B) Tonic
neck reflex C) Moro reflex D) Rooting reflex 23.A nurse is teaching new parents
about bathing their newborn. The nurse determines that the teaching was
successful when the parents state which of the following? A) We can put a tiny
bit of lotion on his skin and then rub it in gently. B) We should avoid using
any kind of baby powder. C) We need to bathe him at least four to five times a
week. D) We should clean his eyes after washing his face and hair. 24.A new
mother who is breast-feeding her newborn asks the nurse, How will I know if my
baby is drinking enough? Which response by the nurse would be most appropriate?
A) If he seems content after feeding, that should be a sign. B) Make sure he
drinks at least 5 minutes on each breast. C) He should wet between 6 to 12
diapers each day. D) If his lips are moist, then hes okay. 25.A nurse is
teaching postpartum client and her partner about caring for their newborns
umbilical cord site. Which statement by the parents indicates a need for
additional teaching? A) We can put him in the tub to bathe him once the cord
falls off and is healed. B) The cord stump should change from brown to yellow.
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 142 C) Exposing the stump to the air helps it to dry. D) We need to
call the doctor if we notice a funny odor. 26.While changing a female newborns
diaper, the nurse observes a mucuslike, slightly bloody vaginal discharge.
Which of the following would the nurse do next? A) Document this as pseudomenstruation
B) Notify the practitioner immediately C) Obtain a culture of the discharge D)
Inspect for engorgement 27.A nursing instructor is describing the advantages
and disadvantages associated with newborn circumcision to a group of nursing
students. Which statement by the students indicates effective teaching? A)
Sexually transmitted infections are more common in circumcised males. B) The
rate of penile cancer is less for circumcised males. C) Urinary tract
infections are more easily treated in circumcised males. D) Circumcision is a
risk factor for acquiring HIV infection. 28.A newborn is scheduled to undergo a
screening test for phenylketonuria (PKU). The nurse prepares to obtain the
blood sample from the newborns: A) Finger B) Heel C) Scalp vein D) Umbilical
vein 29.Assessment of a newborn reveals transient tachypnea. The nurse reviews
the newborns medical record. Which of the following would the nurse be least
likely to identify as a risk factor for this condition? A) Cesarean birth B)
Shortened labor C) Central nervous system depressant during labor D) Maternal
asthma Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing
(4th Edition) 143 30.A nurse is providing teaching to a new mother about her
newborns nutritional needs. Which of the following would the nurse be most
likely to include in the teaching? (Select all that apply.) A) Supplementing
with iron if the woman is breast-feeding B) Providing supplemental water intake
with feedings C) Feeding the newborn every 2 to 4 hours during the day D)
Burping the newborns frequently throughout each feeding E) Using feeding time
for promoting closeness Chapter 19: Nursing Management of Pregnancy at Risk-
Pregnancy 1. After teaching a woman who has had an evacuation for a hydatidiform
mole (molar pregnancy. about her condition, which of the following statements
indicates that the nurses teaching was successful? A)I will be sure to avoid
getting pregnant for at least 1 year. B) My intake of iron will have to be
closely monitored for 6 months. C) My blood pressure will continue to be
increased for about 6 more months. D)I won't use my birth control pills for at
least a year or two. 2. Which of the following findings on a prenatal visit at
10 weeks might lead the nurse to suspect a hydatidiform mole? A)Complaint of
frequent mild nausea B) Blood pressure of 120/84 mm Hg C) History of bright red
spotting 6 weeks ago D)Fundal height measurement of 18 cm 3. A client is
diagnosed with gestational hypertension and is receiving magnesium sulfate. Which
finding would the nurse interpret as indicating a therapeutic level of
medication? A)Urinary output of 20 mL per hour B) Respiratory rate of 10
breaths/minute C) Deep tendons reflexes 2+ D)Difficulty in arousing 4. Upon
entering the room of a client who has had a spontaneous abortion, the nurse
observes the client crying. Which of the following responses by the nurse would
be most appropriate? A)Why are you crying? B) Will a pill help your pain? C)
I'm sorry you lost your baby. D)A baby still wasn't formed in your uterus. Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 146 5. Which of the following data on a clients health history would
the nurse identify as contributing to the clients risk for an ectopic pregnancy?
A)Use of oral contraceptives for 5 years B) Ovarian cyst 2 years ago C)
Recurrent pelvic infections D)Heavy, irregular menses 6. In a woman who is
suspected of having a ruptured ectopic pregnancy, the nurse would expect to
assess for which of the following as a priority? A)Hemorrhage B) Jaundice C)
Edema D)Infection 7. Which of the following findings would the nurse interpret
as suggesting a diagnosis of gestational trophoblastic disease? A)Elevated hCG
levels, enlarged abdomen, quickening B) Vaginal bleeding, absence of FHR,
decreased hPL levels C) Visible fetal skeleton on ultrasound, absence of
quickening, enlarged abdomen D)Gestational hypertension, hyperemesis
gravidarum, absence of FHR 8. It is determined that a clients blood Rh is
negative and her partners is positive. To help prevent Rh isoimmunization, the
nurse anticipates that the client will receive RhoGAM at which time? A)At 34
weeks gestation and immediately before discharge B) 24 hours before delivery
and 24 hours after delivery C) In the first trimester and within 2 hours of
delivery D)At 28 weeks gestation and again within 72 hours after delivery 9.
The nurse is developing a plan of care for a woman who is pregnant with twins.
The nurse includes interventions focusing on which of the following because of
the woman's increased risk? Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 147 A)Oligohydramnios B) Preeclampsia C)
Post-term labor D)Chorioamnionitis 10.A woman hospitalized with severe
preeclampsia is being treated with hydralazine to control blood pressure. Which
of the following would the lead the nurse to suspect that the client is having
an adverse effect associated with this drug? A) Gastrointestinal bleeding B)
Blurred vision C) Tachycardia D) Sweating 11.After reviewing a clients history,
which factor would the nurse identify as placing her at risk for gestational
hypertension? A) Mother had gestational hypertension during pregnancy. B)
Client has a twin sister. C) Sister-in-law had gestational hypertension. D)
This is the clients second pregnancy. 12.A client with hyperemesis gravidarum
is admitted to the facility after being cared for at home without success.
Which of the following would the nurse expect to include in the clients plan of
care? A) Clear liquid diet B) Total parenteral nutrition C) Nothing by mouth D)
Administration of labetalol 13.The nurse is reviewing the laboratory test
results of a pregnant client. Which one of the following findings would alert
the nurse to the development of HELLP syndrome? A) Hyperglycemia Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 148
B) Elevated platelet count C) Leukocytosis D) Elevated liver enzymes 14.Which
of the following would the nurse have readily available for a client who is
receiving magnesium sulfate to treat severe preeclampsia? A) Calcium gluconate
B) Potassium chloride C) Ferrous sulfate D) Calcium carbonate 15. Which
assessment finding would lead the nurse to suspect infection as the cause of a
clients PROM? A) Yellow-green fluid B) Blue color on Nitrazine testing C)
Ferning D) Foul odor 16.While assessing a pregnant woman, the nurse suspects
that the client may be at risk for hydramnios based on which of the following?
(Select all that apply.) A) History of diabetes B) Complaints of shortness of
breath C) Identifiable fetal parts on abdominal palpation D) Difficulty
obtaining fetal heart rate E) Fundal height below that for expected
gestataional age 17.After teaching a group of nursing students about the
possible causes of spontaneous abortion, the instructor determines that the
teaching was successful when the students identify which of the following as
the most common cause of first trimester abortions? A) Maternal disease B)
Cervical insufficiency Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 149 C) Fetal genetic abnormalities D)
Uterine fibroids 18.A pregnant woman is admitted with premature rupture of the
membranes. The nurse is assessing the woman closely for possible infection.
Which of the following would lead the nurse to suspect that the woman is
developing an infection? (Select all that apply.) A) Fetal bradycardia B)
Abdominal tenderness C) Elevated maternal pulse rate D) Decreased C-reactive
protein levels E) Cloudy malodorous fluid 19.A nurse is teaching a pregnant
woman with preterm premature rupture of membranes who is about to be discharged
home about caring for herself. Which statement by the woman indicates a need
for additional teaching? A) I need to keep a close eye on how active my baby is
each day. B) I need to call my doctor if my temperature increases. C) Its okay
for my husband and me to have sexual intercourse. D) I can shower but I
shouldn't take a tub bath. 20.A nurse is assessing a pregnant woman with
gestational hypertension. Which of the following would lead the nurse to
suspect that the client has developed severe preeclampsia? A) Urine protein 300
mg/24 hours B) Blood pressure 150/96 mm Hg C) Mild facial edema D)
Hyperreflexia 21.A nurse suspects that a pregnant client may be experiencing
abruption placenta based on assessment of which of the following? (Select all
that apply.) A) Dark red vaginal bleeding Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 150 B) Insidious onset C)
Absence of pain D) Rigid uterus E) Absent fetal heart tones 22.The health care
provider orders PGE2 for a woman to help evacuate the uterus following a
spontaneous abortion. Which of the following would be most important for the
nurse to do? A) Use clean technique to administer the drug. B) Keep the gel
cool until ready to use. C) Maintain the client for hour after administration.
D) Administer intramuscularly into the deltoid area. 23.A nursing student is
reviewing an article about preterm premature rupture of membranes. Which of the
following would the student expect to find as factor placing a woman at high
risk for this condition? (Select all that apply.) A) High body mass index B)
Urinary tract infection C) Low socioeconomic status D) Single gestations E)
Smoking 24.A woman with placenta previa is being treated with expectant
management. The woman and fetus are stable. The nurse is assessing the woman
for possible discharge home. Which statement by the woman would suggest to the
nurse that home care might be inappropriate? A) My mother lives next door and
can drive me here if necessary. B) I have a toddler and preschooler at home who
need my attention. C) I know to call my health care provider right away if I
start to bleed again. D) I realize the importance of following the instructions
for my care. 25.A woman with hyperemesis gravidarum asks the nurse about
suggestions to minimize nausea and vomiting. Which suggestion would be most
appropriate for the nurse to make? Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 151 A) Make sure that
anything around your waist is quite snug. B) Try to eat three large meals a day
with less snacking. C) Drink fluids in between meals rather than with meals. D)
Lie down for about an hour after you eat 26.A woman with gestational
hypertension experiences a seizure. Which of the following would be the
priority? A) Fluid replacement B) Oxygenation C) Control of hypertension D)
Delivery of the fetus 27.A woman is receiving magnesium sulfate as part of her
treatment for severe preeclampsia. The nurse is monitoring the woman's serum
magnesium levels. Which level would the nurse identify as therapeutic? A) 3.3
mEq/L B) 6.1 mEq/L C) 8.4 mEq/L D) 10.8 mEq/L Chapter 20: Nursing Management of
the Pregnancy at Risk 1. The nurse is teaching a pregnant woman with type 1
diabetes about her diet during pregnancy. Which client statement indicates that
the nurses teaching was successful? A)I'll basically follow the same diet that
I was following before I became pregnant. B) Because I need extra protein, I'll
have to increase my intake of milk and meat. C) Pregnancy affects insulin
production, so I'll need to make adjustments in my diet. D)I'll adjust my diet
and insulin based on the results of my urine tests for glucose. 2. A nurse is
developing a program for pregnant women with diabetes about reducing
complications. Which factor would the nurse identify as being most important in
helping to reduce the maternal/fetal/neonatal complications associated with
pregnancy and diabetes? A)Stability of the woman's emotional and psychological
status B) Degree of glycemic control achieved during the pregnancy C)
Evaluation of retinopathy by an ophthalmologist D)Blood urea nitrogen level
(BUN. within normal limits 3. Because a pregnant clients diabetes has been
poorly controlled throughout her pregnancy, the nurse would be alert for which
of the following in the neonate at birth? A)Macrosomia B) Hyperglycemia C) Low
birth weight D)Hypobilirubinemia 4. A woman with diabetes is considering
becoming pregnant. She asks the nurse whether she will be able to take oral
hypoglycemics when she is pregnant. The nurses response is based on the
understanding that oral hypoglycemics: A)Can be used as long as they control
serum glucose levels B) Can be taken until the degeneration of the placenta
occurs C) Are usually suggested primarily for women who develop gestational
diabetes Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 154 D)Show promising results but more studies are needed
to confirm their effectiveness 5. A 10-week pregnant woman with diabetes has a
glycosylated hemoglobin (HbA1C. level of 13%. At this time the nurse should be
most concerned about which of the following possible fetal outcomes?
A)Congenital anomalies B) Incompetent cervix C) Placenta previa D)Abruptio
placentae 6. After teaching a group of students about the use of antiretroviral
agents in pregnant women who are HIV-positive, the instructor determines that
the teaching was successful when the group identifies which of the following as
the underlying rationale? A)Reduction in viral loads in the blood B) Treatment
of opportunistic infections C) Adjunct therapy to radiation and chemotherapy D)Can
cure acute HIV/AIDS infections 7. Assessment of a pregnant woman and her fetus
reveals tachycardia and hypertension. There is also evidence suggesting
vasoconstriction. The nurse would question the woman about use of which
substance? A)Marijuana B) Alcohol C) Heroin D)Cocaine 8. When teaching a class
of pregnant women about the effects of substance abuse during pregnancy, which
of the following would the nurse most likely include? A)Low-birth-weight
infants B) Excessive weight gain C) Higher pain tolerance D)Longer gestational
periods Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 155 9. A client who is HIV-positive is in her second
trimester and remains asymptomatic. She voices concern about her newborns risk
for the infection. Which of the following statements by the nurse would be most
appropriate? A)Youll probably have a cesarean birth to prevent exposing your
newborn. B) Antibodies cross the placenta and provide immunity to the newborn.
C) Wait until after the infant is born and then something can be done.
D)Antiretroviral medications are available to help reduce the risk of
transmission. 10.When assessing a pregnant woman with heart disease throughout
the antepartal period, the nurse would be especially alert for signs and
symptoms of cardiac decompensation at which time? A) 16 to 20 weeks gestation
B) 20 to 24 weeks gestation C) 24 to 28 weeks gestation D) 28 to 32 weeks
gestation 11.When preparing a schedule of follow-up visits for a pregnant woman
with chronic hypertension, which of the following would be most appropriate? A)
Monthly visits until 32 weeks, then bi-monthly visits B) Bi-monthly visits
until 28 weeks, then weekly visits C) Monthly visits until 20 weeks, then
bimonthly visits D) Bi-monthly visits until 36 weeks, then weekly visits 12.
Which medication would the nurse question if ordered to control a pregnant
woman's asthma? A) Budesonide B) Albuterol C) Salmeterol D) Oral prednisone
13.After teaching a pregnant woman with iron deficiency anemia about her
prescribed iron supplement, which statement indicates successful teaching? Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 156 A) I should take my iron with milk. B) I should avoid drinking
orange juice. C) I need to eat foods high in fiber. D) I'll call the doctor if
my stool is black and tarry. 14.A nurse is providing care to several pregnant
women at the clinic. The nurse would screen for group B streptococcus infection
in a client at: A) 16 weeks gestation B) 28 week gestation C) 32 weeks
gestation D) 36 weeks gestation 15.The nurse is assessing a newborn of a woman
who is suspected of abusing alcohol. Which newborn finding would provide
additional evidence to support this suspicion? A) Wide large eyes B) Thin upper
lip C) Protruding jaw D) Elongated nose 16.After teaching a group of nursing
students about the impact of pregnancy on the older woman, the instructor
determines that the teaching was successful when the students state which of
the following? A) The majority of women who become pregnant over age 35
experience complications. B) Women over the age of 35 who become pregnant
require a specialized type of assessment. C) Women over age 35 and are pregnant
have an increased risk for spontaneous abortions. D) Women over age 35 are more
likely to have substance abuse problems. 17.A group of students are reviewing
information about sexually transmitted infections and their effect on
pregnancy. The students demonstrate understanding of the information when they
identify which infection as being responsible for ophthalmia neonatorum? A)
Syphilis Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 157 B) Gonorrhea C) Chlamydia D) HPV 18.A nurse is
preparing a presentation for a group of young adult pregnant women about common
infections and their effect on pregnancy. When describing the infections, which
infection would the nurse include as the most common congenital and perinatal
viral infection in the world? A) Rubella B) Hepatitis B C) Cytomegalovirus D)
Parvovirus B19 19.A pregnant woman asks the nurse, I'm a big coffee drinker.
Will the caffeine in my coffee hurt my baby? Which response by the nurse would
be most appropriate? A) The caffeine in coffee has been linked to birth defects.
B) Caffeine has been shown to cause growth restriction in the fetus. C)
Caffeine is a stimulant and needs to be avoided completely. D) If you keep your
intake to less than 300 mg/day, you should be okay. 20.A neonate born to a
mother who was abusing heroin is exhibiting signs and symptoms of withdrawal.
Which of the following would the nurse assess? (Select all that apply.) A) Low
whimpering cry B) Hypertonicity C) Lethargy D) Excessive sneezing E) Overly
vigorous sucking F) Tremors 21.A nurse has been invited to speak at a local
high school about adolescent pregnancy. When developing the presentation, the
nurse would incorporate information related to which of the following? (Select
all that apply.) Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 158 A) Peer pressure to become sexually active B)
Rise in teen birth rates over the years. C) Latinas as having the highest teen
birth rate D) Loss of self-esteem as a major impact E) Majority of teen
pregnancies in the 1517-year-old age group 22.A nurse is counseling a pregnant
woman with rheumatoid arthritis about medications that can be used during
pregnancy. Which drug would the nurse emphasize as being contraindicated at
this time? A) Hydroxychloroquine B) Nonsteroidal anti-inflammatory drug C)
Glucocorticoid D) Methotrexate 23.A nurse is preparing a teaching program for a
group of pregnant women about preventing infections during pregnancy. When
describing measures for preventing cytomegalovirus infection, which of the
following would the nurse most likely include? A) Frequent handwashing B)
Immunization C) Prenatal screening D) Antibody titer screening 24.A pregnant
woman tests positive for HBV. Which of the following would the nurse expect to
administer? A) HBV immune globulin B) HBV vaccine C) Acylcovir D) Valacyclovir
25.After teaching a pregnant woman with iron deficiency anemia about nutrition,
the nurse determines that the teaching was successful when the woman identifies
which of the following as being good sources of iron in her diet? (Select all
that apply.) Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 159 A) Dried fruits B) Peanut butter C) Meats D) Milk E)
White bread 26.A group of nursing students are preparing a presentation for
their class about measures to prevent toxoplasmosis. Which of the following
would the students be least likely to include? Select all that apply. A)
Washing raw fruits and vegetables before eating them B) Cooking all meat to an
internal temperature of 140 F C) Wearing gardening gloves when working in the
soil D) Avoiding contact with a cats litter box. 27.A pregnant woman with
gestational diabetes comes to the clinic for a fasting blood glucose level.
When reviewing the results, the nurse determines that which result indicates
good glucose control? A) 90 mg/dL B) 100 mg/dL C) 110 mg /dL D) 120 mg/dL
Chapter 21: Nursing Management of Labor and Birth at Risk 1. After spontaneous
rupture of membranes, the nurse notices a prolapsed cord. The nurse immediately
places the woman in which position? A)Supine B) Side-lying C) Sitting
D)Kneechest 2. A primigravida whose labor was initially progressing normally is
now experiencing a decrease in the frequency and intensity of her contractions.
The nurse would assess the woman for which condition? A)A low-lying placenta B)
Fetopelvic disproportion C) Contraction ring D)Uterine bleeding 3. The nurse
would be alert for possible placental abruption during labor when assessment
reveals which of the following? A)Macrosomia B) Gestational hypertension C)
Gestational diabetes D)Low parity 4. Assessment of a woman in labor who is
experiencing hypertonic uterine dysfunction would reveal contractions that are:
A)Well coordinated B) Poor in quality C) Rapidly occurring D)Erratic Test Bank
- Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition)
162 5. A woman in labor is experiencing hypotonic uterine dysfunction.
Assessment reveals no fetopelvic disproportion. Which group of medications
would the nurse expect to administer? A)Sedatives B) Tocolytics C) Oxytocins
D)Corticosteroids 6. The fetus of a woman in labor is determined to be in
persistent occiput posterior position. Which of the following would the nurse
identify as the priority intervention? A)Position changes B) Pain relief
measures C) Immediate cesarean birth D)Oxytocin administration 7. A woman gave
birth to a newborn via vaginal delivery with the use of a vacuum extractor. The
nurse would be alert for which of the following in the newborn? A)Asphyxia B)
Clavicular fracture C) Caput succedaneum D)Central nervous system injury 8. A
pregnant client undergoing labor induction is receiving an oxytocin infusion.
Which of the following findings would require immediate intervention? A)Fetal
heart rate of 150 beats/minute B) Contractions every 2 minutes, lasting 45
seconds C) Uterine resting tone of 14 mm Hg D)Urine output of 20 mL/hour 9. A
woman with a history of crack cocaine abuse is admitted to the labor and birth
area. While caring for the client, the nurse notes a sudden onset of fetal
bradycardia. Inspection of the abdomen reveals an irregular wall contour. The
client also complains of acute abdominal pain that is continuous. Which of the
following Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 163 would the nurse suspect? A)Amniotic fluid embolism B)
Shoulder dystocia C) Uterine rupture D)Umbilical cord prolapse 10.When
assessing several women for possible VBAC, which woman would the nurse identify
as being the best candidate? A) One who has undergone a previous myomectomy B)
One who had a previous cesarean birth via a low transverse incision C) One who
has a history of a contracted pelvis D) One who has a vertical incision from a
previous cesarean birth 11.A woman is to undergo an amnioinfusion. Which
statement would be most appropriate to include when teaching the woman about
this procedure? A) Youll need to stay in bed while youre having this procedure.
B) Well give you an analgesic to help reduce the pain. C) After the infusion,
youll be scheduled for a cesarean birth. D) A suction cup is placed on your
babys head to help bring it out. 12.Which finding would indicate to the nurse
that a woman's cervix is ripe in preparation for labor induction? A) Posterior
position B) Firm C) Closed D) Shortened 13.A woman with preterm labor is
receiving magnesium sulfate. Which finding would require the nurse to intervene
immediately? A) Respiratory rate of 16 breaths per minute Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 164
B) Diminished deep tendon reflexes C) Urine output of 45 mL/hour D) Alert level
of consciousness 14.A woman who is 42 weeks pregnant comes to the clinic. Which
of the following would be most important? A) Determining an accurate
gestational age B) Asking her about the occurrence of contractions C) Checking
for spontaneous rupture of membranes D) Measuring the height of the fundus
15.After teaching a couple about what to expect with their planned cesarean birth,
which statement indicates the need for additional teaching? A) Holding a pillow
against my incision will help me when I cough. B) I'm going to have to wait a
few days before I can start breast-feeding. C) I guess the nurses will be
getting me up and out of bed rather quickly. D) I'll probably have a tube in my
bladder for about 24 hours or so. 16.The nurse is providing care to several
pregnant women who may be scheduled for labor induction. The nurse identifies
the woman with which Bishop score as having the best chance for a successful
induction and vaginal birth? A) 11 B) 8 C) 6 D) 3 17.After teaching a group of
nursing students about risk factors associated with dystocia, the instructor
determines that the teaching was successful when the students identify which of
the following as increasing the risk? (Select all that apply.) A) Pudendal
block anesthetic use B) Multiparity Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 165 C) Short maternal stature
D) Maternal age over 35 E) Breech fetal presentation 18.A nurse is preparing an
inservice education program for a group of nurses about dystocia involving
problems with the passenger. Which of the following would the nurse most likely
include as the most common problem? A) Macrosomia B) Breech presentation C)
Persistent occiput posterior position D) Multifetal pregnancy 19.After teaching
a group of nursing students about tocolytic therapy, the instructor determines
that the teaching was successful when they identify which drug as being used
for tocolysis? (Select all that apply.) A) Nifedipine B) Terbutaline C)
Dinoprostone D) Misoprostol E) Indomethacin 20.A nurse is assessing a pregnant
woman who has come to the clinic. The woman reports that she feels some
heaviness in her thighs since yesterday. The nurse suspects that the woman may
be experiencing preterm labor based on which additional assessment findings? A)
Dull low backache B) Malodorous vaginal discharge C) Dysuria D) Constipation
21.A nurse is teaching a pregnant woman at risk for preterm labor about what to
do if she experiences signs and symptoms. The nurse determines that the
teaching was successful when the woman states that if she experiences any
symptoms, she will do which of the following? A) I'll sit down to rest for 30
minutes. Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 166 B) I'll try to move my bowels. C) I'll lie down with
my legs raised. D) I'll drink several glasses of water. 22.A nurse is
describing the risks associated with prolonged pregnancies as part of an
inservice presentation. Which of the following would the nurse be least likely
to incorporate in the discussion as an underlying reason for problems in the
fetus? A) Aging of the placenta B) Increased amniotic fluid volume C) Meconium
aspiration D) Cord compression 23.A group of nursing students are reviewing
information about methods used for cervical ripening. The students demonstrate
understanding of the information when they identify which of the following as a
mechanical method? A) Herbal agents B) Laminaria C) Membrane stripping D)
Amniotomy 24.The nurse notifies the obstetrical team immediately because the
nurse suspects that the pregnant woman may be exhibiting signs and symptoms of
amniotic fluid embolism. Which findings would the nurse most likely assess?
(Select all that apply.) A) Significant difficulty breathing B) Hypertension C)
Tachycardia D) Pulmonary edema E) Bleeding with bruising 25.A group of nursing
students are reviewing information about cesarean birth. The students
demonstrate understanding of the information when they identify which of the
following as an appropriate indication? (Select all that apply.. Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 167
A) Active genital herpes infection B) Placenta previa C) Previous cesarean
birth D) Prolonged labor E) Fetal distress 26.A pregnant woman is receiving
misoprostol to ripen her cervix and induce labor. The nurse assesses the woman
closely for which of the following? A) Uterine hyperstimulation B) Headache C)
Blurred vision D) Hypotension Chapter 22: Nursing Management of the Postpartum
Woman at Risk 1. Review of a primiparous woman's labor and birth record reveals
a prolonged second stage of labor and extended time in the stirrups. Based on
an interpretation of these findings, the nurse would be especially alert for
which of the following? A)Retained placental fragments B) Hypertension C)
Thrombophlebitis D)Uterine subinvolution 2. As part of an inservice program, a
nurse is describing a transient, selflimiting mood disorder that affects
mothers after childbirth. The nurse correctly identifies this as postpartum:
A)Depression B) Psychosis C) Bipolar disorder D)Blues 3. A woman who is 2 weeks
postpartum calls the clinic and says, My left breast hurts. After further
assessment on the phone, the nurse suspects the woman has mastitis. In addition
to pain, the nurse would assess for which of the following? A)An inverted
nipple on the affected breast B) No breast milk in the affected breast C) An
ecchymotic area on the affected breast D)Hardening of an area in the affected
breast 4. A group of students are reviewing the causes of postpartum
hemorrhage. The students demonstrate understanding of the information when they
identify which of the following as the most common cause? A)Labor augmentation
B) Uterine atony C) Cervical or vaginal lacerations Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 170 D)Uterine inversion
5. After presenting a class on measures to prevent postpartum hemorrhage, the
presenter determines that the teaching was successful when the class states
which of the following as an important measure to prevent postpartum hemorrhage
due to retained placental fragments? A)Administering broad-spectrum antibiotics
B) Inspecting the placenta after delivery for intactness C) Manually removing
the placenta at delivery D)Applying pressure to the umbilical cord to remove
the placenta 6. A multipara client develops thrombophlebitis after delivery.
Which of the following would alert the nurse to the need for immediate
intervention? A)Dyspnea, diaphoresis, hypotension, and chest pain B) Dyspnea,
bradycardia, hypertension, and confusion C) Weakness, anorexia, change in level
of consciousness, and coma D)Pallor, tachycardia, seizures, and jaundice 7. A
client experienced prolonged labor with prolonged premature rupture of
membranes. The nurse would be alert for which of the following in the mother
and the newborn? A)Infection B) Hemorrhage C) Trauma D)Hypovolemia 8. When
assessing the postpartum woman, the nurse uses indicators other than pulse rate
and blood pressure for postpartum hemorrhage based on the knowledge that:
A)These measurements may not change until after the blood loss is large B) The
bodys compensatory mechanisms activate and prevent any changes C) They relate
more to change in condition than to the amount of blood lost D)Maternal anxiety
adversely affects these vital signs Test Bank - Essentials of Maternity,
Newborn, and Women's Health Nursing (4th Edition) 171 9. The nurse is assessing
a woman with abruption placentae who has just given birth. The nurse would be
alert for which of the following? A)Severe uterine pain B) Board-like abdomen
C) Appearance of petechiae D)Inversion of the uterus 10. A nurse is assessing a
postpartum woman. Which finding would cause the nurse to be most concerned? A)
Leg pain on ambulation with mild ankle edema B) Calf pain with dorsiflexion of
the foot. C) Perineal pain with swelling along the episiotomy D) Sharp stabbing
chest pain with shortness of breath 11.A woman experiencing postpartum
hemorrhage is ordered to receive a uterotonic agent. Which of the following
would the nurse least expect to administer? A) Oxytocin B) Methylergonovine C)
Carboprost D) Terbutaline 12. Which of the following would be most appropriate
when massaging a woman's fundus? A) Place the hands on the sides of the abdomen
to grasp the uterus. B) Use an up-and-down motion to massage the uterus. C) Wait
until the uterus is firm to express clots. D) Continue massaging the uterus for
at least 5 minutes. 13.After teaching a woman with a postpartum infection about
care after discharge, which client statement indicates the need for additional
teaching? A) I need to call my doctor if my temperature goes above 100.4 F.
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 172 B) When I put on a new pad, I'll start at the back and go forward.
C) If I have chills or my discharge has a strange odor, I'll call my doctor. D)
I'll point the spray of the peribottle so the water flows front to back. 14.A
nurse suspects that a postpartum client is experiencing postpartum psychosis.
Which of the following would most likely lead the nurse to suspect this
condition? A) Delirium B) Feelings of anxiety C) Sadness D) Insomnia 15.A
postpartum woman is diagnosed with metritis. The nurse interprets this as an
infection involving which of the following? (Select all that apply.) A)
Endometrium B) Decidua C) Myometrium D) Broad ligament E) Ovaries F) Fallopian
tubes 16.A group of nursing students are reviewing information about mastitis
and its causes. The students demonstrate understanding of the information when
they identify which of the following as the most common cause? A) E. coli B) S.
aureus C) Proteus D) Klebsiella 17.A home health care nurse is assessing a
postpartum woman who was discharged 2 days ago. The woman tells the nurse that
she has a low-grade fever and feels lousy. Which of the following findings
would lead the nurse to suspect metritis? (Select all that apply.) Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 173
A) Lower abdominal tenderness B) Urgency C) Flank pain D) Breast tenderness E) Anorexia
18.A postpartum client comes to the clinic for her routine 6-week visit. The
nurse assesses the client and suspects that she is experiencing subinvolution
based on which of the following? A) Nonpalpable fundus B) Moderate lochia
serosa C) Bruising on arms and legs D) Fever 19.Assessment of a postpartum
client reveals a firm uterus with bright-red bleeding and a localized bluish
bulging area just under the skin at the perineum. The woman also is complaining
of significant pelvic pain and is experiencing problems with voiding. The nurse
suspects which of the following? A) Hematoma B) Laceration C) Bladder
distention D) Uterine atony 20.A postpartum woman is ordered to receive
oxytocin to stimulate the uterus to contract. Which of the following would be most
important for the nurse to do? A) Administer the drug as an IV bolus injection.
B) Give as a vaginal or rectal suppository. C) Piggyback the IV infusion into a
primary line. D) Withhold the drug if the woman is hypertensive. 21.Assessment
of a postpartum woman experiencing postpartum hemorrhage reveals mild shock.
Which of the following would the nurse expect to assess? (Select all that
apply.) Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 174 A) Diaphoresis B) Tachycardia C) Oliguria D) Cool
extremities E) Confusion 22.A group of students are reviewing risk factors
associated with postpartum hemorrhage. The students demonstrate understanding
of the information when they identify which of the following as associated with
uterine tone? (Select all that apply.) A) Rapid labor B) Retained blood clots
C) Hydramnios D) Operative birth E) Fetal malpostion 23.A nurse is massaging a
postpartum clients fundus and places the nondominant hand on the area above the
symphysis pubis based on the understanding that this action: A) Determines that
the procedure is effective B) Helps support the lower uterine segment C) Aids
in expressing accumulated clots D) Prevents uterine muscle fatigue 24.A nurse
is developing a plan of care for a woman who is at risk for thromboembolism.
Which of the following would the nurse include as the most cost-effective
method for prevention? A) Prophylactic heparin administration B) Compression
stocking C) Early ambulation D) Warm compresses 25.A postpartum woman who
developed deep vein thrombosis is being discharged on anticoagulant therapy.
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 175 After teaching the woman about this treatment, the nurse
determines that additional teaching is needed when the woman states which of
the following? A) I will use a soft toothbrush to brush my teeth. B) I can take
ibuprofen if I have any pain. C) I need to avoid drinking any alcohol. D) I
will call my health care provider if my stools are black and tarry. 26.The
nurse is developing a discharge teaching plan for a postpartum woman who has
developed a postpartum infection. Which of the following would the nurse most
likely include in this teaching plan? (Select all that apply.) A) Taking the
prescribed antibiotic until it is finished B) Checking temperature once a week
C) Washing hands before and after perineal care D) Handling perineal pads by
the edges E) Directing peribottle to flow from back to front 27.A nurse is
assessing a postpartum client who is at home. Which statement by the client
would lead the nurse to suspect that the client may be developing postpartum
depression? A) I just feel so overwhelmed and tired. B) I'm feeling so guilty
and worthless lately. C) It's strange, one minute I'm happy, the next I'm sad.
D) I keep hearing voices telling me to take my baby to the river. Chapter 23:
Nursing Care of the Newborn With Special Needs 1. The nurse is teaching a group
of students about the differences between a fullterm newborn and a preterm
newborn. The nurse determines that the teaching is effective when the students
state that the preterm newborn has: A)Fewer visible blood vessels through the
skin B) More subcutaneous fat in the neck and abdomen C) Well-developed flexor
muscles in the extremities D)Greater surface area in proportion to weight 2.
When assessing a postterm newborn, which of the following would the nurse
correlate with this gestational age variation? A)Moist, supple, plum skin
appearance B) Abundant lanugo and vernix C) Thin umbilical cord D)Absence of
sole creases 3. The parents of a preterm newborn being cared for in the
neonatal intensive care unit (NICU. are coming to visit for the first time. The
newborn is receiving mechanical ventilation and intravenous fluids and
medications and is being monitored electronically by various devices. Which
action by the nurse would be most appropriate? A)Suggest that the parents stay
for just a few minutes to reduce their anxiety. B) Reassure them that their
newborn is progressing well. C) Encourage the parents to touch their preterm
newborn. D)Discuss the care they will be giving the newborn upon discharge. 4.
When performing newborn resuscitation, which action would the nurse do first?
A) Intubate with an appropriate-sized endotracheal tube. B) Give chest
compressions at a rate of 80 times per minute. C) Administer epinephrine
intravenously. Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 178 D) Suction the mouth and then the nose. 5. The nurse
frequently assesses the respiratory status of a preterm newborn based on the
understanding that the newborn is at increased risk for respiratory distress
syndrome because of which of the following? A)Inability to clear fluids B)
Immature respiratory control center C) Deficiency of surfactant D)Smaller
respiratory passages 6. The nurse prepares to assess a newborn who is
considered to be large for gestational age (LGA). Which of the following would
the nurse correlate with this gestational age variation? A)Strong, brisk motor
skills B) Difficulty in arousing to a quiet alert state C) Birth weight of 7 lb
14 oz D)Wasted appearance of extremities 7. An LGA newborn has a blood glucose
level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which of the
following would the nurse do next? A)Administer intravenous glucose
immediately. B) Feed the newborn 2 ounces of formula. C) Initiate blow-by
oxygen therapy. D)Place the newborn under a radiant warmer. 8. A group of
pregnant women are discussing high-risk newborn conditions as part of a
prenatal class. When describing the complications that can occur in these
newborns to the group, which would the nurse include as being at lowest risk?
A)Small-for-gestational-age (SGA. newborns B) Large-for-gestational-age (LGA.
newborns C) Appropriate-for-gestational-age (AGA. newborns D)Low-birth-weight
newborns Test Bank - Essentials of Maternity, Newborn, and Women's Health
Nursing (4th Edition) 179 9. While caring for a preterm newborn receiving
oxygen therapy, the nurse monitors the oxygen therapy duration closely based on
the understanding that the newborn is at risk for which of the following?
A)Retinopathy of prematurity B) Metabolic acidosis C) Infection D)Cold stress
10. When planning the care for an SGA newborn, which action would the nurse
determine as a priority? A) Preventing hypoglycemia with early feedings B)
Observing for respiratory distress syndrome C) Promoting bonding between the
parents and the newborn D) Monitoring vital signs every 2 hours 11.A woman
gives birth to a newborn at 36 weeks gestation. She tells the nurse, I'm so
glad that my baby isn't premature. Which response by the nurse would be most
appropriate? A) You are lucky to have given birth to a term newborn. B) We
still need to monitor him closely for problems. C) How do you feel about
delivering your baby at 36 weeks? D) Your baby is premature and needs
monitoring in the NICU. 12.Which of the following would be most appropriate for
the nurse to do when assisting parents who have experienced the loss of their
preterm newborn? A) Avoid using the terms death or dying. B) Provide
opportunities for them to hold the newborn. C) Refrain from initiating
conversations with the parents. D) Quickly refocus the parents to a more
pleasant topic. 13.Which of the following, if noted in the maternal history,
would the nurse identify as possibly contributing to the birth of an LGA
newborn? A) Drug abuse Test Bank - Essentials of Maternity, Newborn, and
Women's Health Nursing (4th Edition) 180 B) Diabetes C) Preeclampsia D)
Infection 14. Which of the following would alert the nurse to suspect that a
preterm newborn is in pain? A) Bradycardia B) Oxygen saturation level of 94% C)
Decreased muscle tone D) Sudden high-pitched cry 15.When describing newborns with
birth-weight variations to a group of nursing students, the instructor
identifies which variation if the newborn weighs 5.2 lb at any gestational age?
A) Small for gestational age B) Low birth weight C) Very low birth weight D)
Extremely low birth weight 16.A nurse is assessing a newborn who has been
classified as small for gestational age. Which of the following would the nurse
expect to find? (Select all that apply.) A) Wasted extremity appearance B)
Increased amount of breast tissue C) Sunken abdomen D) Adequate muscle tone
over buttocks E) Narrow skull sutures 17.The nurse is reviewing the medical
record of a newborn born 2 hours ago. The nurse notes that the newborn was
delivered at 35 weeks gestation. The nurse would classify this newborn as which
of the following? A) Preterm B) Late preterm Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 181 C) Full term
D) Postterm 18.A nursing instructor is describing common problems associated
with preterm birth. When describing the preterm newborns risk for perinatal
asphyxia, the instructor includes which of the following as contributing to the
newborns risk? (Select all that apply.) A) Surfactant deficiency B) Placental
deprivation C) Immaturity of the respiratory control centers D) Decreased
amounts of brown fat E) Depleted glycogen stores 19.After determining that a
newborn is in need of resuscitation, which of the following would the nurse do
first? A) Dry the newborn thoroughly B) Suction the airway C) Administer ventilations
D) Give volume expanders 20.A nurse is developing a plan of care for a preterm
infant experiencing respiratory distress. Which of the following would the
nurse be least likely to include in this plan? A) Stimulate the infant with
frequent handling. B) Keep the newborn in a warmed isolette. C) Administer
oxygen using a oxygen hood. D) Give gavage or continous tube feedings. 21.A
nurse suspects that a preterm newborn is having problems with thermal
regulation. Which of the following would support the nurses suspicion? (Select
all that apply.) A) Shallow, slow respirations B) Cyanotic hands and feet Test
Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 182 C) Irritability D) Hypertonicity E) Feeble cry 22.The nurse is assessing
a preterm newborns fluid and hydration status. Which of the following would
alert the nurse to possible overhydration? A) Decreased urine output B)
Tachypnea C) Bulging fontanels D) Elevated temperature 23.The nurse is
assessing a preterm newborn who is in the neonatal intensive care unit (NICU.
for signs and symptoms of overstimulation. Which of the following would the
nurse be least likely to assess? A) Increased respirations B) Flaying hands C)
Periods of apnea D) Decreased heart rate 24.A group of nursing students are
reviewing the literature in preparation for a class presentation on newborn
pain prevention and management. Which of the following would the students be
most likely to find about this topic? A) Newborn pain is frequently recognized and
treated B) Newborns rarely experience pain with procedures C) Pain is
frequently mistaken for irritability or agitation D) Newborns may be less
sensitive to pain than adult. 25.A nurse is developing a plan of care for a
preterm newborn to address the nursing diagnosis of risk for delayed
development. Which of the following would the nurse include? (Select all that
apply.) A) Clustering care to promote rest B) Positioning newborn in extension
Test Bank - Essentials of Maternity, Newborn, and Women's Health Nursing (4th
Edition) 183 C) Using kangaroo care D) Loosely covering the newborn with
blankets E) Providing nonnutritive sucking 26.A nurse is assisting the anxious
parents of a preterm newborn to cope with the situation. Which statement by the
nurse would be least appropriate? A) I'll be here to help you all along the
way. B) What has helped you to deal with stressful situations in the past? C)
Let me tell you about what you will see when you visit your baby. D) Forget
about whats happened in the past and focus on the now. Chapter 24: Nursing
Management of the Newborn at Risk 1. A newborn with severe meconium aspiration
syndrome (MAS. is not responding to conventional treatment. Which of the
following would the nurse anticipate as possibly necessary for this newborn?
A)Extracorporeal membrane oxygenation (ECMO) B) Respiratory support with a
ventilator C) Insertion of a laryngoscope for deep suctioning D)Replacement of
an endotracheal tube via x-ray 2. Which of the following would the nurse expect
to assess in a newborn who develops sepsis? A) Increased urinary output B)
Interest in feeding C) Hypothermia D) Wakefulness 3. Which of the following
would the nurse include in the plan of care for a newborn receiving
phototherapy? A)Keeping the newborn in the supine position B) Covering the
newborns eyes while under the bililights C) Ensuring that the newborn is
covered or clothed D)Reducing the amount of fluid intake to 8 ounces daily 4. A
newborn has been diagnosed with a Group B streptococcal infection shortly after
birth. The nurse understands that the newborn most likely acquired this
infection from which of the following? A)Improper handwashing B) Contaminated
formula C) Nonsterile catheter insertion D)Mothers birth canal 5. Which action
would be most appropriate for the nurse to take when a newborn has an
unexpected anomaly Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 186 at birth? A)Show the newborn to the parents as
soon as possible while explaining the defect. B) Remove the newborn from the
birthing area immediately. C) Inform the parents that there is nothing wrong at
the moment. D)Tell the parents that the newborn must go to the nursery
immediately. 6. The nurse prepares to administer a gavage feeding for a newborn
with transient tachypnea based on the understanding that this type of feeding
is necessary for which reason? A)Lactase enzymatic activity is not adequate. B)
Oxygen demands need to be reduced. C) Renal solute lead must be considered.
D)Hyperbilirubinemia is likely to develop. 7. Which of the following would the
nurse include when teaching a new mother about the difference between
pathologic and physiologic jaundice? A)Physiologic jaundice results in
kernicterus. B) Pathologic jaundice appears within 24 hours after birth. C)
Both are treated with exchange transfusions of maternal O- blood. D)Physiologic
jaundice requires transfer to the NICU. 8. When planning the care of a newborn
addicted to cocaine who is experiencing withdrawal, which of the following would
be least appropriate to include? A)Wrapping the newborn snugly in a blanket B)
Waking the newborn every hour C) Checking the newborns fontanels D)Offering a
pacifier 9. A newborn is suspected of having fetal alcohol syndrome. Which of
the following would the nurse expect to assess? A)Bradypnea Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 187
B) Hydrocephaly C) Flattened maxilla D)Hypoactivity 10.After teaching the
parents of a newborn with periventricular hemorrhage about the disorder and
treatment, which statement by the parents indicates that the teaching was
successful? A) Well make sure to cover both of his eyes to protect them. B) Our
newborn could develop a learning disability later on. C) Once the bleeding
ceases, there won't be any more worries. D) We need to get family members to
donate blood for transfusion. 11. A newborn has an Apgar score of 6 at 5
minutes. Which of the following is the priority? A) Initiating IV fluid therapy
B) Beginning resuscitative measures C) Promoting kangaroo care D) Obtaining a
blood culture 12.While reviewing a newborns medical record, the nurse notes
that the chest x-ray shows a ground glass pattern. The nurse interprets this as
indicative of: A) Respiratory distress syndrome B) Transient tachypnea of the
newborn C) Asphyxia D) Persistent pulmonary hypertension 13.A newborn is
suspected of developing persistent pulmonary hypertension. The nurse would
expect to prepare the newborn for which of the following to confirm the suspicion?
A) Chest x-ray B) Blood cultures C) Echocardiogram Test Bank - Essentials of
Maternity, Newborn, and Women's Health Nursing (4th Edition) 188 D) Stool for
occult blood 14. Which of the following would alert the nurse to suspect that a
newborn has developed NEC? A) Irritability B) Sunken abdomen C) Clay-colored
stools D) Bilious vomiting 15.Which of the following would not be considered a
risk factor for bronchopulmonary dysplasia (chronic lung disease)? A) Preterm
birth (less than 32 weeks) B) Female gender C) White race D) Sepsis 16.A group
of nursing students are reviewing the different types of congenital heart
disease in infants. The students demonstrate a need for additional review when
they identify which of the following as an example of increased pulmonary blood
flow (left-to-right shunting)? A) Atrial septal defect B) Tetralogy of Fallot
C) Ventricular septal defect D) Patent ductus arteriosus 17.After teaching the
parents of a newborn with retinopathy of prematurity (ROP. about the disorder and
treatment, which statement by the parents indicates that the teaching was
successful? A) Can we schedule follow-up eye examinations with the pediatric
ophthalmologist now? B) We can fix the problem with surgery. C) Well make sure
to administer eye drops each day for the next few weeks. D) I'm sure the baby
will grow out of it. Test Bank - Essentials of Maternity, Newborn, and Women's
Health Nursing (4th Edition) 189 18.The nurse is assessing the newborn of a
mother who had gestational diabetes. Which of the following would the nurse
expect to find? (Select all that apply.) A) Pale skin color B) Buffalo hump C)
Distended upper abdomen D) Excessive subcutaneous fat E) Long slender neck
19.The nurse is assessing a newborn who is large for gestational age. The
newborn was born breech. The nurse suspects that the newborn may have
experienced trauma to the upper brachial plexus based on which assessment
findings? A) Absent grasp reflex B) Hand weakness C) Absent Moro reflex D)
Facial asymmetry 20.The nurse is assessing a newborn and suspects that the
newborn was exposed to drugs in utero because the newborn is exhibiting signs
of neonatal abstinence syndrome. Which of the following would the nurse expect
to assess? (Select all that apply.) A) Tremors B) Diminished sucking C)
Regurgitation D) Shrill, high-pitched cry E) Hypothermia F) Frequent sneezing
21.A nurse is developing a plan of care for a newborn with omphalocele. Which
of the following would the nurse include? A) Placing the newborn into a sterile
drawstring bowel bag B) Using clean technique for dressing changes Test Bank -
Essentials of Maternity, Newborn, and Women's Health Nursing (4th Edition) 190
C) Preparing the newborn for incision and drainage D) Instituting gavage
feedings 22.A nurse is explaining to the parents of a child with bladder
exstrophy about the care their infant requires. Which of the following would
the nurse include in the explanation? (Select all that apply.) A) Covering the
area with a sterile, clear, nonadherent dressing B) Irrigating the surface with
sterile saline twice a day C) Monitoring drainage through the suprapubic
catheter D) Administering prescribed antibiotic therapy E) Preparing for
surgical intervention in about 2 weeks 23.A nursing student is preparing a
presentation for the class on clubfoot. The student determines that the
presentation was successful when the class states which of the following? A)
Clubfoot is a common genetic disorder. B) The condition affects girls more
often than boys. C) The exact cause of clubfoot is not known. D) The intrinsic
form can be manually reduced. 24.Assessment of newborn reveals a large
protruding tongue, slow reflexes, distended abdomen, poor feeding, hoarse cry,
goiter and dry skin. Which of the following would the nurse suspect? A) Phenylketonuria
B) Galactosemia C) Congenital hypothyroidism D) Maple syrup urine disease 25.A
group of students are reviewing information about the effects of substances on
the newborn. The students demonstrate understanding of the information when
they identify which drug as not being associated with teratogenic effects on
the fetus? A) Alcohol B) Nicotine Test Bank - Essentials of Maternity, Newborn,
and Women's Health Nursing (4th Edition) 191 C) Marijuana D) Cocaine 26.A nurse
is teaching the mother of a newborn diagnosed with galactosemia about dietary
restrictions. The nurse determines that the mother has understood the teaching
when she identifies which of the following as needing to be restricted? A)
Phenylalanine B) Protein C) Lactose D) Iodine 27.A newborn was diagnosed with a
congenital heart defect and will undergo surgery at a later time. The nurse is
teaching the parents about signs and symptoms that need to be reported. The
nurse determines that the parents have understood the instructions when they
state that they will report which of the following? (Select all that apply.) A)
Weight loss B) Pale skin C) Fever D) Absence of edema E) Increased respiratory
rate 28.When developing the plan of care for a newborn with an acquired
condition, which of the following would the nurse include to promote
participation by the parents? A) Use verbal instructions primarily for
explanations B) Assist with decision making process C) Provide personal views
about their decisions D) Encourage them to refrain from showing emotions 29.A
nurse is assisting in the resuscitation of a newborn. The nurse would expect to
stop resuscitation efforts when the newborn has no heartbeat and respiratory
effort after which time frame? A) 5 minutes B) 10 minutes Test Bank - Essentials
of Maternity, Newborn, and Women's Health Nursing (4th Edition) 192 C) 15
minutes D) 20 minutes 30.A newborn is diagnosed with meconium aspiration
syndrome. When assessing this newborn, which of the following would the nurse
expect to find? (Select all that apply.) A) Pigeon chest B) Prolonged tachypnea
C) Intercostal retractions D) High blood pH level E) Coarse crackles on
auscultation
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