NUR 2513 Exam 1 Fall 2020- Maternal Child Health; Questions & Answers;Guaranteed A+

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NUR 2513 Exam 1 Fall - Maternal Child Health 1 . Which trend is currently influencing maternal and child healthcare? *A. An expansion of community based services B. Closure of regionalized healthca... re centers C. The availability of additional family support D. A reduction in the number of latch key kids 2. A client with a gestational age of 32 weeks arrives at the clinic for a routine prenatal visit. When measuring fundal height and listening to fetal heart tones, the nurse finds fundal height to be 28 cm and fetal heart tones at 115 bpm, and mother states fetal movements have slowed. What may the nurse conclude with this finding? A. Fetus has stopped growing due to the limited uterine growth. B. The client should return in two weeks to reevaluate the fetal well-being. *C. Possible IUGR and the nurse should identify risk factors and notify the physician. D. Possible macrosomia, the nurse should check blood glucose and notify the physician. 3. A nurse is caring for several clients on a busy floor. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following client? A. A client that is experiencing fetal death at 34 weeks gestation *B. A client who is experiencing preterm labor at 29 weeks gestation C. A client who is experiencing Braxton-Hicks contractions at 37 weeks gestation D. A client who has a post term pregnancy at 41-week gestation 4. The nurse is planning an educational session for community members to address the issue of schoolage child mortality. Which topic should the nurse identify as the highest priority for this population? A. Cancer B. Assault C. Suicide *D. Accidents 5. A nurse is caring for a primiparous woman who is 7 weeks gestation and asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make? A. This will occur in the last trimester of pregnancy *B. This will occur between the sixteenth to twenty weeks of pregnancy C. This will occur at the end of the first trimester of pregnancy D. This will occur when the uterus begins to rise out of the pelvis Type: MR 6. The nurse has noticed a change in the type of care needed to support maternal and child health issues. What does the nurse realize as reasons for the changes in care? Select all that apply. *A. Smaller families B. Less domestic violence *C. More employed mothers D. Stable home environments *E. More single-parent families 7. After assessing a client, a nurse determines that an IUD as a method of contraceptive would be contraindicated based on a history of which finding? A. Smoking B. Hypertension *C. Abnormal uterine shape D. Thromboembolic disease 8. The nurse is teaching a patient on the use of a diaphragm for contraception. Which patient statement indicates that the client needs further teaching? A. “I need to use my finger to remove the diaphragm.” B. “I should remove the diaphragm 6 hours after intercourse.” C. “I should stop using a diaphragm if I get an infection of my cervix.” *D. “I need to have the diaphragm checked if my weight changes by 30 lb.” 9. An Rh-negative woman at 6 weeks' gestation is scheduled for a medically induced termination. Which outcome should the nurse identify as appropriate for this patient? *A. Received Rh o (D) immune globulin B. Denied need for contraceptive counseling C. Avoided strenuous activity for 3 weeks D. Experienced a menstrual cycle in 2 months 10. At 32 weeks gestation a woman experiences preterm labor. The nurse administered tocolytics and the client is placed on bedrest. The client continues to experience regular contractions, her cervix is beginning to dilate and efface. What additional medication should be considered to assist the development of the fetus? A. Pitocin B. Cytotec *C. Betamethasone D. Brethine (terbutaline) 11. A Nurse is caring for a client who is at 42 weeks of gestation and in active labor. Which of the following findings is the fetus at risk for developing? A. Intrauterine growth restriction B. Hyperglycemia *C. Meconium aspiration D. Polyhydramnios 12. A nurse is reviewing a journal article about fetal development and the formation of various body systems. When reading about the development of the digestive system, the nurse finds information related to the developmental abnormality of omphalocele. The nurse demonstrates understanding of this information by identifying which situation as the reason for an omphalocele? A. Fetus suffered a bowel obstruction at an early point in life B. Fetal abdomen formed with a smaller internal cavity than normal C. Intestines formed without sufficient nerve innervation for contraction *D. Intestines failed to return to the abdominal cavity during intrauterine development 13. Assessment for surfactant level is a primary estimation of fetal maturity. When asked, which statement by the nurse indicates understanding? *A. Prevents alveoli from collapsing on expiration B. Increase lung resistance on inspiration C. Encourages immunologic competence of lung tissue D. Promotes the maturation of lung alveoli Type: MR 14. The nurse is planning to instruct a patient who is 12 weeks pregnant on interventions to stop smoking. What should the nurse include in these instructions? Select all that apply. A. Purchase nicotine chewing gum *B. Follow a smoking cessation plan *C. Ask a friend to help with smoking cessation actions D. Apply a nicotine patch when the cravings become sever *E. Ask the physician if a smoking cessation medication can be used 15. The nurse is teaching a patient in the first trimester of pregnancy about the importance of folic acid in the diet and how folic acid supplements might be beneficial. For which reason is the nurse teaching the patient about this vitamin? A. Maintains energy throughout the pregnancy B. Controls the risk of hypertension while pregnant *C. Prevents neural tube disorders in the developing fetus D. Sustains a slow and steady weight gain while pregnant 16. The nurse is evaluating the fetal heart rate rhythm strip and determines that the heart rate amplitude varies with a rate 15 to 20 beats/min. What does this assessment finding indicate to the nurse about variability? A. Variability is absent B. Variability is minimal *C. Variability is normal D. Variability is marked 17. The nurse determines that a fetal nonstress test is nonreactive for over 20 minutes. The nurse interprets this result as suggesting which situation? A. The patient may be sleeping. *B. The patient may be is hypoglycemic. C. The patient may be working too much. D. The patient may be is exercising too much. 18. A pregnant patient is concerned that the baby is going to drown in the uterus because of the fluid. How should the nurse respond about fetal respiration? A. “You are breathing for the baby.” B. “The baby's breathing is very minor until delivery.” C. “The baby's lungs can accommodate all of the fluid.” *D. “Oxygen is provided to the baby through the placenta.” 19. The nurse is teaching a pregnant client about fetal circulation. Which of the following responses shows that the teaching on fetal circulation has been effective. A. Supine with knees bent to prevent strain on lower back B. Prone, supported with pillows to decrease muscle rigidity of mother *C. Left side lying to promote placental perfusion D. High fowlers to improve respiratory status of fetus and mother 20 . Which picture depicts the ideal presentation for a vaginal delivery? A. 1 *B. 2 C. 3 D. 4 21. If a woman is three months pregnant, which finding related to breast changes would the nurse expect to assess? A. Slack, soft breast tissue B. Deeply fissured nipples C. Enlarged lymph nodes *D. Darkened breast areolae 22 . By the second trimester of pregnancy, frequent urination results mainly from which cause? *A. Pressure on the bladder from the uterus B. Increased concentration of urine C. Addition of fetal urine to maternal urine D. Decreased glomerular selectivity 23. A screening at 24 weeks gestation reveals that a pregnant woman has gestational diabetes mellitus. In planning her care the nurse and the woman mutually agree that an expected outcome is to prevent fetal injury as a result of GDM. What does the nurse identify as the greatest risk for the fetus? A. Preterm birth *B. Macrosomia C. Low birth weight D. Congenital anomalies Type: MR 24. A newly wed young adult patient tells the nurse that she hopes to become pregnant soon. What should the nurse recommend to this patient to support the 2020 National Health Goals for pregnancy? Select all that apply. *A. Stop smoking B. Limit recreational drug use *C. Eat a healthy diet D. Reduce work hours *E. Avoid alcohol intake 25. A client at her prenatal visit complains of episodes of dizziness when sitting up after lying in a supine position. Which response by the nurse explains this change during pregnancy? A. "This is due to an increase of blood volume." B. "This is due to fluctuations in cardiac output." C. "This is due to pressure from the uterus on the diaphragm." *D. “This due to the weight of the uterus on the vena cava." 26. A father is preparing a 4-year-old son for the arrival of a new baby. Which statement should the nurse suggest the father use to explain this to the child? A. “Mother will need to spend a lot of time with the new baby.” B. “It will be fun to have a sister or brother to give your old toys to.” C. “The new baby will need your bed so we're buying you a new one.” *D. “A new baby will make our family bigger but not change our love for you.” 27. During a routine prenatal examination, a pregnant patient's urine is found to contain glucose. What does this finding indicate to the nurse? *A. The patient should have further testing for gestational diabetes. B. The patient should have a liver enzyme panel completed. C. The patient is eating excessive calories. D. It is because of a decrease in glomerular filtration rate. 28. A pregnant patient has been counseled by her physician to have an amniocentesis. For which genetic condition should the nurse instruct the patient that this diagnostic test will detect? A. Impetigo *B. Trisomy 21 (Down syndrome) C. Diabetes mellitus D. Breast cancer 29. A woman who is 32 week’s gestation is experiencing preterm labor. The nurse will provide all except the following interventions for her client? *A. Allow the client to ambulate for comfort B. IV fluid with a 500 ml bolus C. Initiate fetal monitoring D. Obtain a urine specimen 30. What is the most effective way for a nurse to assess a woman's usual food intake during her pregnancy? A. Assess a list she makes describing a good diet. B. Ask her to describe her total intake for a week. C. Assess her skin for hydration and color. *D. Ask her to describe her intake for the last 24 hours. 31. A nurse is measuring the fundal height of a client who is at 21 weeks of gestation. At which location should the nurse expect to palpate the fundus? A. 3 cm above the umbilicus *B. Slightly above the umbilicus C. 3 cm below the umbilicus D. Half way between the symphysis pubis and umbilicus 32 . A woman who professes to be a strict vegan voices concerns about her ability to meet the nutritional needs of her fetus. Which concerns should be addressed in this session? A. Her diet will need to have an increase in fruits and vegetables to meet the nutritional requirements of her baby. *B. The supplementation of Vitamin B 12 should be addressed. C. There are not special concerns for vegans as they can easily meet the dietary requirements without violating their “no meat” rules. D. She should be advised to forgo her beliefs during the pregnancy to adequately provide the nutritional requirements for her pregnancy. 33. A woman who is 4 months pregnant has pyrosis (heartburn). Which suggestion would the nurse give her? A. Take 30 mL of milk of magnesia after every meal. *B. Eat small meals and do not lie down after meals. C. Try to include complex carbohydrates in meals. D. Increase vitamin intake by adding more citrus fruit. 34. The nurse caring for a laboring woman notes a variable deceleration of the fetal heart rate on the electronic fetal monitor strip. What should the nurse’s priority intervention be? A. Administer oxygen B. Notify the physician C. Start an IV fluid bolus *D. Change the maternal position Type: MR 35. The nurse is planning a prenatal educational program for a community health center. What information should the nurse include that supports the 2020 National Health Goals for nutrition in pregnancy? Select all that apply. A. Avoid foods high in fats and calories. *B. Take prenatal vitamins as prescribed. *C. Ensure a daily intake of foods with folic acid. D. Limit the intake of foods high in simple carbohydrates. *E. Maintain adequate nutrition before becoming pregnant. 36. The nurse provides instructions to a patient with hyperemesis gravidarum. Which outcome indicates that teaching has been effective? A. Patient has vomiting episodes only in the morning. B. Patient is able to tolerate soft foods after episodes of vomiting. C. Patient is able to ingest clear liquids between episodes of vomiting. *D. Patient is able to ingest a regular diet after progressing through clear liquids and soft foods. Type: MR 37. The labor nurse assesses the fetal heart rate pattern below immediately following an epidural procedure. In response to her assessment, which of the following actions would be appropriate? Select all that apply. *A. Turn the client to her left side B. Administer Oxytocin *C. Administer Oxygen *D. Administer an IV fluid bolus 38. A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission? A. Performing a vaginal examination to assess the extent of bleeding B. Helping the woman remain ambulatory to reduce bleeding *C. Assessing fetal heart tones by use of an external monitor D. Assessing uterine contractions by an internal pressure gauge 39. A pregnant client has a Rh-negative blood type. Following the birth of the client's B-positive blood type infant, the nurse administers her Rho(D) immune globulin. The purpose of this is to: A. Promote maternal D antibody formation. *B. Prevent maternal D antibody formation. C. Stimulate maternal D immune antigens. D. Prevent fetal Rh blood formation. 40 . A woman develops HELLP syndrome. During labor, which provider’s order would the nurse question? *A. Prepare her for epidural anesthesia. B. Assess her blood pressure every 15 minutes. C. Assess the urine output every hour. D. Urge her to lie on her left side during labor. Type: MR 41. A perinatal nurse is caring for a woman that desires an unmedicated birth. Which of the following are options for non-pharmacologic methods of pain control in labor? Select all that apply. A. Epidural *B. Hydrotherapy *C. Massage *D. Birthball E. Pudendal block *F. Breathing patterns 42. The nurse is identifying nursing diagnoses for a patient with gestational hypertension. Which diagnosis would be the most appropriate for this patient? A. Risk for injury related to fetal distress B. Imbalanced nutrition related to decreased sodium levels C. Ineffective tissue perfusion related to poor heart contraction *D. Ineffective tissue perfusion related to vasoconstriction of blood vessels 43. A pregnant patient is being admitted for severe preeclampsia. In which room location should the nurse place this patient? A. Near the nursery B. Next to the elevator *C. In the back private room D. Across from the noisy nurse's station 44. A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information? *A. Sickle cell anemia is recessively inherited. B. Sickle cell anemia has more than one polygenic inheritance pattern. C. Sickle cell anemia is dominantly inherited. D. Sickle cell anemia is not inherited; it occurs following a malaria infection. 45. The nurse encourages a woman with gestational diabetes to maintain an active exercise plan during pregnancy. Prior to exercising the nurse would advise her to take which action? A. Inject a bolus of insulin. B. Eat a high-carbohydrate snack. *C. Eat a sustaining-carbohydrate snack. D. Add a bolus of long-acting insulin. 46. A patient makes an appointment at the prenatal clinic because she thinks she might be pregnant. Which assessment is a positive sign of pregnancy? A. Amenorrhea *B. Audible fetal heart tones with a doppler C. Nausea and vomiting D. A positive pregnancy test 47. The nurse is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy terminated by elective abortion at 9 weeks; a live/healthy delivery at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client’s current status? A. 3-0-2-0-2 *B. 4-0-1-2-1 C. 2-0-0-2-0 D. 4-2-0-2-2 48. A nurse on the labor and delivery floor admits a patient who is 38 weeks of gestation and reports heavy, red vaginal bleeding. The bleeding started spontaneously in the morning and is not accompanied by contractions. The client is not in distress and she states that she can "feel the baby moving." An ultrasound is scheduled stat. The nurse should explain to the client that the purpose of the ultrasound is to determine which of the following? *A. Placenta placement B. Fetal viability C. Fetal lung maturity D. Fetal measurement for dating 49. A clinical nurse is caring for a client who asks what her estimated date of delivery will be if her last menstrual period was May 4, 2020. Which of the following is the appropriate response by the nurse? *A. February 11, 2021 B. February 26, 2021 C. July 1, 2021 D. April 26, 2021 50. A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been “eating for two” so the baby is healthy. How should the nurse respond to the patient? A. “Elevated blood glucose levels cause low birth weights in infants.” B. “Elevated blood glucose levels ensure the baby has mature lungs at birth.” C. “Elevated blood glucose levels hasten the development of the fetus in utero.” *D. “Elevated blood glucose levels in the first trimester have been linked to congenital anomalies.” [Show More]

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