Maternity Final exam

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Questions and Answers

What is the race that includes infants with the highest mortality rates?

  • Black maternal clients (correct)
  • White maternal clients
  • Hispanic maternal clients
  • Asian maternal clients

At what age does fertility begin to decline in women?

  • At around age 25
  • At around age 30
  • At around age 32 (correct)
  • At around age 35

Which of the following medications is used in a medication-induced abortion?

  • Mifepristone (correct)
  • Ibuprofen
  • Acetaminophen
  • Ciprofloxacin

What are the manifestations of postpartum psychosis?

<p>Hallucinations, delusions, bizarre behavior, and confusion. (A)</p> Signup and view all the answers

Which of the following factors contribute to pregnant clients being at an increased risk for health disparities? (Select all that apply)

<p>Unemployment, low socioeconomic status (A), Mental or physical illness (B)</p> Signup and view all the answers

What review findings in a pregnancy client indicate a risk for polysubstance use disorder? (Select all that apply)

<p>Social Determinants of Health (SDOH) and other commodities (A), Psychiatric and medical conditions (B)</p> Signup and view all the answers

While monitoring a laboring client, the nurse evaluates uterine contractions to assess fetal well-being. What are the key characteristics of uterine contractions that influence fetal oxygenation?

<p>Uterine relaxation between contractions is essential to ensure fetal oxygenation (A)</p> Signup and view all the answers

Which of the following options is a social determinant of health during the prenatal period?

<p>Access to care in the preconception, prenatal, postpartum, and interconception care periods (A)</p> Signup and view all the answers

Which of the following sources of outreach are appropriate for a client who lacks social support? (Select all that apply)

<p>Community outreach programs (B), Support groups (C), Social workers (A)</p> Signup and view all the answers

What is a recommended strategy to promote maternal-infant bonding for a client with an active diagnosis of substance use disorder?

<p>(ESC) Eat, Sleep, Console (A)</p> Signup and view all the answers

What is the most common sex chromosomal abnormality in individuals with two X chromosomes?

<p>Turner syndrome: short stature, infertility/ovarian dysfunction primarily amenorrhea (A)</p> Signup and view all the answers

Which of the following statements is true regarding the fetal inheritance of hemophilia?

<p>Y-Chromosomes cannot pass hemophilia to their children (A)</p> Signup and view all the answers

Which of these factors increase the risk for the client and fetus when undergoing chronic villus sampling (CVS)? (Select all that apply)

<p>Fetus risk of fetal hemolytic disease if the fetus is Rh-positive and the pregnant client is Rh-negative. (B), Clients over the age of 35 and family history of aneuploidy high risk for genetic structural, or chromosomal anomalies in pregnancy (A), Other risks include spontaneous abortion, rupture of membranes, infection, and inconclusive results. (C)</p> Signup and view all the answers

Which of the following statements is true regarding client education for testing for hereditary genetic disorders?

<p>Individuals have the right to decline genetic testing,answer questions and support decisions (A)</p> Signup and view all the answers

What type of data is collected when determining genetic risks in a couple planning to conceive? (Select all that apply)

<p>Both medical history and genetic line (B), Family history including that of the reproductive partner (A)</p> Signup and view all the answers

What is the function of the cervix?

<p>Dilates to birth the fetus (A)</p> Signup and view all the answers

What is the function of testosterone?

<p>Responsible for producing sex characteristics (A)</p> Signup and view all the answers

What is the function of the prostate gland?

<p>To produce prostate fluid, which helps nourish and support sperm cells (A)</p> Signup and view all the answers

What are the care tasks that occur during the initial prenatal visit? (Select all that apply)

<p>Education on prenatal vitamins, preconception and pregnancy (B), Monitor Fetal growth, testing (A), Risk reduction: Yearly flu vaccine, wear seatbelt, car seat safety, wash hands, no alcohol, smoking, illicit drugs (C)</p> Signup and view all the answers

What are healthy lifestyle practices that should be followed during pregnancy? (Select all that apply)

<p>Avoid alcohol (C), Maintain a healthy weight (D), Stop smoking (B)</p> Signup and view all the answers

What is important client education regarding STIs and pregnancy? (Select all that apply)

<p>STIs can prevent pregnancy (A), Postmenopausal women can still get STIs even though they can't get pregnant (B)</p> Signup and view all the answers

Review signs of positive coping from the client during labor.

<p>Moaning (A), Rhythmic movements and breathing (B), Relaxed between contractions (C)</p> Signup and view all the answers

A client in labor is experiencing severe pain and requests alternatives to pain medication. What non-pharmacological techniques can be used to manage pain during labor? (Select all that apply)

<p>Positioning for maternal satisfaction (D), Touch massage - effleurage (B), Relaxation and breathing (Lamaze), Positioning for maternal satisfaction (C)</p> Signup and view all the answers

What is the appropriate treatment for respiratory depression due to fentanyl administration for pain management?

<p>Naloxone (D)</p> Signup and view all the answers

What are the risk factors associated with using a diaphragm with spermicide for birth control?

<p>Increase risk of UTI (A)</p> Signup and view all the answers

What are the hormones included in a combination birth control?

<p>Synthetic estrogen and progesterone (A)</p> Signup and view all the answers

What is the procedure of Hysteroscopic sterilization?

<p>A physical barrier in the Fallopian tubes, prevents egg from reaching uterus (A)</p> Signup and view all the answers

What medication would be given to a pregnant client complaining of nausea?

<p>Anti emetics - Ondansetron (A)</p> Signup and view all the answers

What are the potential causes of amenorrhea? (Select all that apply)

<p>Dysfunction of pituitary gland (B), Dysfunction of hypothalamus, thyroid, ovaries, uterus, vagina (A)</p> Signup and view all the answers

Which findings are consistent with premenstrual syndrome?

<p>Body aches, bloating, mood swings, weight gain (A)</p> Signup and view all the answers

Which of the following are potential causes of dysmenorrhea? (Select all that apply)

<p>Endometriosis (B), Uterine fibroids (C), Prostaglandin secretions (A)</p> Signup and view all the answers

Which of the following is a potential cause of ovarian hyper stimulation syndrome (OHSS)?

<p>Gonadotropin therapy: increases the risk for ovarian hyperstimulation syndrome (OHSS). (A)</p> Signup and view all the answers

What labor positions can help reduce pain and promote comfort during contractions? (Select all that apply)

<p>Ambulation (A), High-fowler's position (B), Squatting (C)</p> Signup and view all the answers

What are the contraindications for a client having a home birth

<p>Needs to be Safety and quick access to a hospital (B), High risk birth (A)</p> Signup and view all the answers

A client asks about risk factors for placental abruption. (Select all that apply)

<p>Hypertension, maternal age &gt;35 (B), Smoking, cocaine (C), Polyhydramnios (A)</p> Signup and view all the answers

What changes in lab values and blood volume are expected after vaginal birth? (Select all that apply)

<p>Hemoglobin and hematocrit decrease first and then gradually increase (A), WBCs can increase to about 25,000. (B), Platelets significantly decrease, while Clotting factors fibrinogen is elevated (@)</p> Signup and view all the answers

A nurse assesses a postpartum client’s cervix. What cervical changes occur after birth? (Select all that apply)

<p>External os becomes a transverse slit (A), Heals within a few weeks postpartum (B)</p> Signup and view all the answers

A provider suspects a client may have placenta accreta. What risk factors contribute to placenta accreta? (Select all that apply)

<p>Uterine Atony - Uterine Fibroids (C), Primigravida - Maternal age &gt; 35 (A), History of endometriosis, smoking (B)</p> Signup and view all the answers

What are the findings that can increase a client's risk for postpartum shock? (Select all that apply)

<p>BMI &gt; 40 (B), History of hemorrhage following previous birth (A)</p> Signup and view all the answers

What are the potential complications for clients receiving heparin for postpartum deep vein thrombosis?

<p>Increased risk of bleeding (A)</p> Signup and view all the answers

What are the risk factors for postpartum hemorrhage that can lead to shock? (Select all that apply)

<p>Hypotension, Tachycardia (A), Delayed cap refill (B), Decrease urine output (C)</p> Signup and view all the answers

In postpartum hemorrhage management, what does the "T" stand for in the acronym Emotive?

<p>Tranexamic Acid (Controls bleeding) (A)</p> Signup and view all the answers

What are the physician orders for a client who has excessive bleeding after birth and hypotension? (Select all that apply)

<p>Administration of uterotonics (A), Laboratory and diagnostic testing (B), Frequent assessment of SI (shock index) (C)</p> Signup and view all the answers

What manifestations regarding vital signs indicate an infection in a postpartum client? (Select all that apply)

<p>Fever 100.4 (A), Increase in HR could indicate an infection (B)</p> Signup and view all the answers

What signs indicate that shoulder dystocia is occurring during birth?

<p>&quot;Turtle sign&quot; - Fetal head emerges and then retracts (A)</p> Signup and view all the answers

What are the priority nursing actions for a client about to receive repair for a 3rd degree perineal laceration? (Select all that apply)

<p>Inspection, Pain management (A), Education (B), Stool softener, Sitz bath (C)</p> Signup and view all the answers

What are the complications of delayed cord clamping after birth? (Select all that apply)

<p>Increase risk of jaundice (A), Increase hemoglobin and iron stores (B)</p> Signup and view all the answers

Why are Apgar scores used in newborns?

<p>Assess newborns' transition to extrauterine life (D)</p> Signup and view all the answers

What happens during an overt prolapsed cord?

<p>Cord slips through dilated cervix and becomes compressed by fetal presenting part (A)</p> Signup and view all the answers

What happens to the tissue when a uterine rupture occurs?

<p>3 muscular layers of the uterus tear apart (B)</p> Signup and view all the answers

What does a nurse feel when palpating a breech presentation during Leopold's maneuvers?

<p>Soft mass above symphysis pubis (A)</p> Signup and view all the answers

What are the organisms that represent a common cause of Pelvic Inflammatory disease? (Select all that apply)

<p>N. Gonorrhoeae (A), C. Trachomatis (B)</p> Signup and view all the answers

What findings put a pregnant client at risk for complications related to toxoplasmosis? (Select all that apply)

<p>TORCH infections that can be passed to the fetus (A), Syphilis, Zika virus, varicella-zoster virus (B), Immunocompromised clients (C)</p> Signup and view all the answers

Which of the following are clinical manifestations of trichomonas? (Select all that apply)

<p>Vulvar burning and itching (A), Malodorous discharge (B), Dysuria (C)</p> Signup and view all the answers

Which client occupations can lead to an increased risk of birth defects?

<p>Factory and airport workers (A)</p> Signup and view all the answers

What are some manifestations that could lead a client to suspect pregnancy? (Select all that apply)

<p>Fatigue (C), Felt by client (A), Amenorrhea, breast tenderness (B)</p> Signup and view all the answers

What position would the client's fundus be in at 8 hours postpartum?

<p>The fundus rises to at or below the umbilicus (C)</p> Signup and view all the answers

What would you see in a client's vital signs that would be considered indicative of postpartum hemorrhage? (Select all that apply)

<p>Decrease Blood pressure (A), Increase Heart Rate (B)</p> Signup and view all the answers

What are the manifestations that are consistent with deep vein thrombosis? (Select all that apply)

<p>Calf pain, redness, warmth in legs, swelling (A), Unexplained fever (B), Changes in sensation (C)</p> Signup and view all the answers

Review client education about receiving the varicella vaccine postpartum. Which of the following statements are correct? (Select all that apply)

<p>1st dose given after birth and prior to discharge (A), 2nd dose given 4-8 weeks later at primary physician visit (B)</p> Signup and view all the answers

Which clients are the highest priority to be vaccinated against tetanus-diphtheria-acellular pertussis?

<p>Individuals who are closest to newborns (A)</p> Signup and view all the answers

What are the psychophysiological features of preeclampsia with severe features? (Select all that apply)

<p>Unexpected placental implantation and inadequate blood flow to the placenta (A), Elevated BP causes auto regulation dysfunction of the cerebral vasculature (B), SBP greater or equal to 160 mmHg or DBP greater or equal to 110 mmHg on 2 occasions at least 4 hours apart (C), Persistent headache not responding to treatment, with visual changes (D)</p> Signup and view all the answers

What factors place a client at a higher risk for developing preeclampsia? (Select all that apply)

<p>Maternal age 35 and older - multiple gestations (A), Gestational hypertension (B), Chronic conditions (C)</p> Signup and view all the answers

What are the risk factors for eclampsia? (Select all that apply)

<p>Age 35 and older - Multiple gestations (A), Neurological diagnosis - BMI &gt;30 (B), Use of reproductive technology - Nulliparity (C)</p> Signup and view all the answers

What are the primary clinical manifestations of HELLP syndrome? (Select all that apply)

<p>Abdominal pain in upper right quadrant (A), General fatigue (B), Nausea and vomiting (C)</p> Signup and view all the answers

What are the nursing actions after a client has a first-time blood pressure reading that is considered high? (Select all that apply)

<p>Check BP cuff is correct size - recheck on opposite arm (A), Recheck BP after 10 minutes (B)</p> Signup and view all the answers

What are the nursing interventions for a pregnant client with eclampsia post-seizure? (Select all that apply)

<p>Maternal post-seizure testing - head imaging (A), Fetal continuous fetal monitoring (B)</p> Signup and view all the answers

What is the reason why blood transfusions are used as a treatment for HELLP syndrome?

<p>Hemolytic anemia (A)</p> Signup and view all the answers

What is the nursing intervention for a pregnant client receiving magnesium sulfate who has absent deep tendon reflexes? (Select all that apply)

<p>Monitor fetal heart rate and maternal respiratory rate (A), Assess urine output (B), Check patellar reflexes and uterine activity (C)</p> Signup and view all the answers

What hormone levels contribute to hyperemesis gravidarum? (Select all that apply)

<p>Elevated HCG (A), Estradiol increase due to elevated HCG (B)</p> Signup and view all the answers

What are the potential causes of hyperthyroidism? (Select all that apply)

<p>Hashimoto disease (autoimmune disease) (A), Thyroiditis (B), Congenital - surgical or pharmacological (C)</p> Signup and view all the answers

What are the risk factors for fetal mortality in relation to type 1 diabetes?

<p>Higher risk for maternal and fetal morbidity and mortality than other types of diabetes (A)</p> Signup and view all the answers

What are the risk factors for type 2 diabetes? (Select all that apply)

<p>Genetic - familial history (A), Lifestyle - BMI greater than 25 (B), Sedentary lifestyle - High carbohydrate consumption (C)</p> Signup and view all the answers

What are the risk factors for hyperthyroidism? (Select all that apply)

<p>African American, female, multiparous (A), Surgical procedures, history of autoimmune disorder (B), Age, BMI (C)</p> Signup and view all the answers

What are the possible effects of Type 1 and Type 2 pregestational diabetes on a developing fetus? (Select all that apply)

<p>Congenital malformations- birth injury (A), Large gestational measurements (LGA) (B), Hypoglycemia following birth (C)</p> Signup and view all the answers

What is the impact of hyperemesis gravidarum on clients' psychosocial health? (Select all that apply)

<p>Psychological disorders may occur due to effect on quality of life (A), Confusion, anger, depression, or PTSD (B), Delayed medical assistance (C)</p> Signup and view all the answers

What are the cardiovascular physiologic adaptations that promote fetal oxygenation? (Select all that apply)

<p>Increase in cardiac output promotes fetal oxygenation (A), Increased oxygen carrying capacity supports fetal oxygenation (D)</p> Signup and view all the answers

Regarding the fetal station, what is the designation for when the fetus is closest to the vaginal opening?

<p>Fetal station +5 (C)</p> Signup and view all the answers

How can dehydration in a pregnant client lead to fetal tachycardia?

<p>Reduced blood volume which decreases the oxygen to the placenta (B)</p> Signup and view all the answers

What is the best pain management option for perineal laceration repair after birth?

<p>Pudendal nerve block (A)</p> Signup and view all the answers

What potential complications of an epidural could affect the newborn? (Select all that apply)

<p>Respiratory depression (A)</p> Signup and view all the answers

What are the nursing interventions for a client who has placenta previa at 36 weeks gestation? (Select all that apply)

<p>Monitor Fetal Heart Rate (B), Start IV - Monitor Maternal vital signs (A), Turn client on their side (C)</p> Signup and view all the answers

What is the most common cause of spontaneous abortion?

<p>Fetal length greater than 7mm with absence of fetal heart tones (A)</p> Signup and view all the answers

What is the best way to determine if a client is experiencing placenta previa? (Select all that apply)

<p>CBC, coagulation studies (A), Ultrasound to rule out condition, not a digital exam (B)</p> Signup and view all the answers

What is the client education regarding future pregnancies after a molar pregnancy? (Select all that apply)

<p>Future pregnancies monitored closely (A), The Risk for gestational trophoblastic neoplasia (B)</p> Signup and view all the answers

What are the nursing priorities when a client has acute abruption with hemorrhage? (Select all that apply)

<p>Blood type and screen in case a transfusion is needed and start IV (C), The client may require supplemental oxygen (D), Monitor for hypovolemia, such as tachycardia and hypotension (A), Monitor I&amp;O, including bleeding and measure blood loss by weight (B)</p> Signup and view all the answers

What are the different types of spontaneous abortion, focusing on characteristics of each?

<p>Inevitable abortion – Products of conception have not passed through the client’s dilated cervix; abortion is unavoidable. (D), Threatened abortion – Products of conception are threatened with expulsion through uterine cramping and bleeding. The embryo continues to be viable, and the cervix remains closed. (A), Complete abortion – All products of conception have been completely expelled. (B), Incomplete abortion – A partial passing of the products of conception from the cervical os. (C), Missed abortion – Vaginal bleeding and possible passage of some products of conception. The cervix is closed, but there is no fetal cardiac activity. (@), Septic abortion – Occurs when products of conception are retained and become infected. (@)</p> Signup and view all the answers

Which of the following findings increase a client’s risk for complications in ectopic pregnancy? (Select all that apply)

<p>Endometriosis - Smoking (B), Conditions that affect Fallopian tubes - Age &gt;35 (A), Pelvic Inflammatory Disease (PID) (C)</p> Signup and view all the answers

What are the findings of a marginal placenta previa in a client?

<p>If the placenta does not migrate up by the third trimester and is located near or covering the cervix, it is known as placenta previa. (A)</p> Signup and view all the answers

What is the primary role of the yolk sac during embryonic development?

<p>Yolk sac is responsible for providing nutrition and gas exchange. (A)</p> Signup and view all the answers

At what gestational age is the fetal cardiovascular system considered fully developed?

<p>Week 6, heart is developed and pumping blood (A)</p> Signup and view all the answers

Which of the following physical findings are typical for a full-term newborn?

<p>Full term, long fingernails, hair thicker and may be coarse (A)</p> Signup and view all the answers

What should the nurse do first when a client becomes unresponsive?

<p>Call for a rapid response (A)</p> Signup and view all the answers

What are the normal hemoglobin levels for a pregnant client during each trimester? (Select all that apply)

<p>11 g/dl = first and 3rd trimesters (B), 10.5 g/dl = 2nd trimester (A)</p> Signup and view all the answers

Which of the following accurately describes cardiovascular changes during pregnancy? (Select all that apply)

<p>Maternal heart rate 20% above baseline (A)</p> Signup and view all the answers

What is the normal fetal heart rate range?

<p>110-160 bpm (B)</p> Signup and view all the answers

Which of the following are considered probable signs of pregnancy? (Select all that apply)

<p>Softening of cervix/uterus (C), Positive pregnancy test (A), Ballottement - Blue discoloration (B)</p> Signup and view all the answers

Which of the following risk factors are associated with the highest complications during pregnancy? (Select all that apply)

<p>Lifestyle factors (B), Advanced maternal age (C), Alcohol and substance abuse (A)</p> Signup and view all the answers

Flashcards

Capital of France (example flashcard)

Paris

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