Advanced Nursing Care of Childbearing Families
Final Exam
Course Introduction
This course focuses on the advanced nursing care of childbearing families, emphasizing the assessment, planning, and implementation of evidence-based interventions for women, infants, and their families during the antepartum, intrapartum, and postpartum periods. Topics include high-risk pregnancy and childbirth, perinatal complications, neonatal transitional care, lactation support, family dynamics, and culturally competent care. Students will refine their clinical decision-making skills and collaborate with interdisciplinary teams to promote optimal health outcomes for diverse populations experiencing the childbirth process.
Recommended Textbook
Foundations of Maternal Newborn and Womens Health Nursing 7th Edition Murray
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27 Chapters
812 Verified Questions
812 Flashcards
Source URL: https://quizplus.com/study-set/168 Page 2
Chapter 1: Maternity and Womens Health Care Today
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/2149
Sample Questions
Q1) The nurse is writing an expected outcome for the nursing diagnosis-acute pain related to tissue trauma, secondary to vaginal birth, as evidenced by patient stating pain of 8 on a scale of 10. Which expected outcome is correctly stated for this problem?
A) Patient will state that pain is a 2 on a scale of 10.
B) Patient will have a reduction in pain after administration of the prescribed analgesic.
C) Patient will state an absence of pain 1 hour after administration of the prescribed analgesic.
D) Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration of the prescribed analgesic.
Answer: D
Q2) In which step of the nursing process does the nurse determine the appropriate interventions for the identified nursing diagnosis?
A) Planning
B) Evaluation
C) Assessment
D) Intervention
Answer: A
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Chapter 2: Social, Ethical, and Legal Issues
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) The clinic nurse often cares for patients who are considering an abortion. Which responsibilities does this nurse have in regard to this issue? (Select all that apply.)
A) Informing the patient about pro-life options
B) Informing the patient about pro-choice support groups
C) Being informed about abortion from a legal standpoint
D) Being informed about abortion from an ethical standpoint
E) Recognizing that this issue may result in confusion for the patient
Answer: C, D, E
Q2) A Vietnamese patient who speaks little English is admitted to the labor and birth unit in early labor. The nurse plans to use an interpreter during an initial assessment. Which should the nurse plan to implement with regard to using an interpreter? (Select all that apply.)
A) Face the interpreter when speaking.
B) Listen carefully to what the patient says.
C) Speak slowly and smile when appropriate.
D) Plan to use a male interpreter, even if a female interpreter is available.
E) Ask the interpreter to explain exactly what is said as much as possible, instead of paraphrasing.
Answer: B, C, E
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Page 4
Chapter 3: Reproductive Anatomy and Physiology
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) The nurse is explaining the function of the male's cremaster muscle to a group of nursing students. Which statement accurately describes the function of the cremaster muscle?
A) Assists with transporting sperm
B) Aids in temperature control of the testicles
C) Aids in voluntary control of excretion of urine
D) Entraps blood in the penis to produce an erection
Answer: B
Q2) Which hormonal effect is noted during the menstrual cycle?
A) Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion rise during the ovulatory phase.
B) A negative feedback mechanism is exhibited by the anterior pituitary gland and ovaries.
C) The posterior pituitary gland secretes LH.
D) Estrogen secretion enhances FSH secretion.
Answer: A
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Chapter 4: Hereditary and Environmental Influences on Childbearing
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) An infant is born with blood type AB. The father is type A and the mother is type B. The father asks why the baby has a blood type different from that of the parents. The nurse's answer should be based on the knowledge that
A) both A and B blood types are dominant.
B) types A and B are recessive when linked together.
C) the baby has a mutation of the parents' blood types. D) type A is recessive and links more easily with type B.
Q2) Testing for the cause of anomalies in a stillborn infant is underway. The mother angrily asks the nurse how long these tests are going to take. The nurse should understand that this mother is
A) exhibiting normal grief behavior.
B) trying to place blame on someone.
C) being impatient and unreasonable.
D) feeling guilty and blaming herself.
Q3) Two healthy parents who carry the same abnormal autosomal recessive gene have what percentage chance of having a child affected with the disorder caused by this gene? Record your answer as a whole number. _____%
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Page 6
Chapter 5: Conception and Prenatal Development
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) The nurse is explaining the process of cell division during the preembryonic period to a group of nursing students. Which statement best describes the characteristics of the morula?
A) Fertilized ovum before mitosis begins
B) Double layer of cells that becomes the placenta
C) Flattened, disk-shaped layer of cells within a fluid-filled sphere
D) Solid ball composed of the first cells formed after fertilization
Q2) An expectant father asks the nurse, "Which part of the mature sperm contains the male chromosome?" What is the correct response by the nurse?
A) X-bearing sperm
B) The tail of the sperm
C) The head of the sperm
D) The middle portion of the sperm
Q3) What is the purpose of the ovum's zona pellucida?
A) Prevents multiple sperm from fertilizing the ovum
B) Stimulates the ovum to begin mitotic cell division
C) Allows the 46 chromosomes from each gamete to merge
D) Makes a pathway for more than one sperm to reach the ovum
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Chapter 6: Maternal Adaptations to Pregnancy
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) Which finding is a positive sign of pregnancy?
A) Amenorrhea
B) Breast changes
C) Fetal movement felt by the woman
D) Visualization of fetus by ultrasound
Q2) Which situation best describes a man trying on fathering behaviors?
A) Reading books on newborn care
B) Spending more time with his siblings
C) Coaching a little league baseball team
D) Exhibiting physical symptoms related to pregnancy
Q3) Which of these findings would indicate a potential complication related to renal function during pregnancy?
A) Increase in glomerular filtration rate (GFR)
B) Increase in serum creatinine level
C) Decrease in blood urea nitrogen (BUN)
D) Mild proteinuria
Q4) The capacity of the uterus in a term pregnancy is how many times its prepregnant capacity? Record your answer as a whole number. ______ times
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8
Chapter 7: Antepartum Assessment, Care, and Education
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) Which complaint made by a patient at 35 weeks of gestation requires additional assessment?
A) Abdominal pain
B) Ankle edema in the afternoon
C) Backache with prolonged standing
D) Shortness of breath when climbing stairs
Q2) What is the gravida and para for a patient who delivered triplets 2 years ago and is now pregnant again?
A) 2, 3
B) 1, 2
C) 2, 1
D) 1, 3
Q3) The nurse is scheduling the next appointment for a healthy primigravida currently at 28 weeks gestation. When will the nurse schedule the next prenatal visit?
A) 1 week
B) 2 weeks
C) 3 weeks
D) 4 weeks
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9
Chapter 8: Nutrition for Childbearing
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) Which patient has correctly increased her caloric intake from her recommended pregnancy intake to the amount necessary to sustain breastfeeding in the first 6 postpartum months?
A) From 1800 to 2200 calories per day
B) From 2000 to 2500 calories per day
C) From 2200 to 2530 calories per day
D) From 2500 to 2730 calories per day
Q2) Which patient would require additional calories and nutrients?
A) A 36-year-old female gravida 2, para 1, in her first trimester of pregnancy
B) An 18-year-old female who delivered a 7-lb baby and is bottle feeding
C) A 23-year-old female who had a cesarean birth and is bottle feeding
D) A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
Q3) The nurse is conducting a prenatal nutrition education class for a group of nursing students. Which statement best describes the condition known as pica?
A) Iron-deficiency anemia
B) Intolerance to milk products
C) Ingestion of nonfood substances
D) Episodes of anorexia and vomiting
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Chapter 9: Assessing the Fetus
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) What point in the pregnancy is the most accurate time to determine gestational age through ultrasound?
A) First trimester
B) Second trimester
C) Third trimester
D) No difference in accuracy among the trimesters
Q2) A pregnant patient's biophysical profile score is 8. The patient asks the nurse to explain the results. What is the nurse's most appropriate response?
A) "The test results are within normal limits."
B) "Immediate birth by cesarean birth is being considered."
C) "Further testing will be performed to determine the meaning of this score."
D) "An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth."
Q3) The nurse's role in diagnostic testing is to provide which of the following?
A) Advice to the couple
B) Information about the tests
C) Reassurance about fetal safety
D) Assistance with decision making
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Chapter 10: Complications of Pregnancy
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55 Verified Questions
55 Flashcards
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Sample Questions
Q1) Rh incompatibility can occur if the patient is Rh-negative and the A) fetus is Rh-negative.
B) fetus is Rh-positive.
C) father is Rh-positive.
D) father and fetus are both Rh-negative.
Q2) Spontaneous termination of a pregnancy is considered to be an abortion if
A) the pregnancy is less than 20 weeks.
B) the fetus weighs less than 1000 G
C) the products of conception are passed intact.
D) there is no evidence of intrauterine infection.
Q3) Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
A) direct Coombs test of twin A.
B) direct Coombs test of twin B.
C) indirect Coombs test of the mother.
D) transcutaneous bilirubin level for both twins.
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Chapter 11: The Childbearing Family with Special Needs
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which health concern is most likely to be an issue for the older mother?
A) Nutrition and diet planning
B) Exercise and fitness
C) Having enough rest and sleep
D) Effective contraceptive methods
Q2) In planning sex education classes for the middle school age group, more emphasis should be placed on
A) how to set limits for sexual behavior.
B) the inaccuracy of information from peers.
C) the use of oral contraceptives to prevent unwanted pregnancy.
D) the use of condoms to prevent sexually transmitted diseases as well as pregnancy.
Q3) The nurse is seeing a 17-year-old female in the clinic for complaints of acne. The nurse plans on taking advantage of this teachable moment with the teen. Which topics will the nurse include in the teen's teaching plan?
A) Smoking habits, folic acid intake, and heart disease
B) Hyperlipidemia, distracted driving, and menstrual history
C) Sexual activity, contraception, and screening for violence
D) Optimum weight, hypothyroidism, and sexually transmitted diseases
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13
Chapter 12: Processes of Birth
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) Which assessment finding indicates that cervical dilation and/or effacement has occurred?
A) Onset of irregular contractions
B) Cephalic presentation at 0 station
C) Bloody mucus drainage from vagina
D) Fetal heart tones (FHTs) present in the lower right quadrant
Q2) To determine if the patient is in true labor, the nurse would assess for changes in
A) cervical dilation.
B) amount of bloody show.
C) fetal position and station.
D) pattern of uterine contractions.
Q3) The nurse is assessing the duration of a patient's labor contractions. Which method does the nurse implement to assess the duration of labor contractions?
A) Assess the strongest intensity of each contraction.
B) Assess uterine relaxation between two contractions.
C) Assess from the beginning to the end of each contraction.
D) Assess from the beginning of one contraction to the beginning of the next.
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14
Chapter 13: Pain Management During Childbirth
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39 Verified Questions
39 Flashcards
Source URL: https://quizplus.com/quiz/2161
Sample Questions
Q1) Childbirth pain is different from other types of pain in that it is
A) less intense.
B) associated with a physiologic process.
C) more responsive to pharmacologic management.
D) designed to make one withdraw from the stimulus.
Q2) The best time to teach nonpharmacologic pain control methods to an unprepared laboring patient is during which stage?
A) Latent phase
B) Active phase
C) Second stage
D) Transition phase
Q3) While developing an intrapartum care plan for the patient in early labor, it is important that the nurse recognize that psychosocial factors may influence a woman's experience of pain. These include which of the following? (Select all that apply.)
A) Culture
B) Anxiety and fear
C) Support systems
D) Preparation for childbirth
E) Previous experiences with pain
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Page 15
Chapter 14: Intrapartum Fetal Surveillance
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38 Verified Questions
38 Flashcards
Source URL: https://quizplus.com/quiz/2162
Sample Questions
Q1) When evaluating the patient's progress, the nurse knows that four of the five fetal factors that interact to regulate the heart rate are (Select all that apply.)
A) baroreceptors.
B) adrenal glands.
C) chemoreceptors.
D) uterine activity.
E) autonomic nervous system.
Q2) Which nursing action is correct when initiating electronic fetal monitoring?
A) Lubricate the tocotransducer with an ultrasound gel.
B) Securely apply the tocotransducer with a strap or belt.
C) Inform the patient that she should remain in the semi-Fowler position.
D) Determine the position of the fetus before attaching the electrode to the maternal abdomen.
Q3) A nurse documents that the fetal heart rate variability is marked. This indicates that the range is greater than how many beats per minute? Record your answer as a whole number. _____ bpm
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Chapter 15: Nursing Care During Labor and Birth
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50 Verified Questions
50 Flashcards
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Sample Questions
Q1) The nurse thoroughly dries the infant immediately after birth primarily to A) reduce heat loss from evaporation.
B) stimulate crying and lung expansion.
C) increase blood supply to the hands and feet.
D) remove maternal blood from the skin surface.
Q2) At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is 110 bpm, and the infant is crying vigorously with the limbs flexed. The infant's trunk is pink and the hands and feet are blue. The Apgar score for this infant is A) 7.
B) 8.
C) 9.
D) 10.
Q3) Which assessment finding is an indication of hemorrhage in the recently delivered postpartum patient?
A) Elevated pulse rate
B) Elevated blood pressure
C) Firm fundus at the midline
D) Saturation of two perineal pads in 4 hours
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Chapter 16: Intrapartum Complications
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) A pregnant patient who has had a prior obstetric history of preterm labors is pregnant with her third child. The physician has ordered a fetal fibronectin test. Which instructions should be given to the patient regarding this clinical test?
A) Patient must be NPO prior to testing.
B) Blood work will be drawn every week to help confirm the start of preterm labor.
C) Patient should refrain from sexual activity prior to testing.
D) A urine specimen will be collected for testing.
Q2) A patient who has had two previous cesarean births is in active labor when she suddenly complains of pain between her scapulae. Which should be the nurse's priority action?
A) Notify the health care provider promptly.
B) Observe for abnormally high uterine resting tone.
C) Decrease the rate of nonadditive intravenous fluid.
D) Reposition the patient with her hips slightly elevated.
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18
Chapter 17: Postpartum Adaptations and Nursing Care
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45 Verified Questions
45 Flashcards
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Sample Questions
Q1) The postpartum nurse is observing a patient holding the baby she delivered less than 24 hours ago. The partner is watching his wife and asking questions about newborn care. The 4-year-old big brother is punching his mother on the back. What should the nurse do next?
A) Report the incident to the social services department.
B) Advise the parents that the older son needs to be reprimanded.
C) No action; this is a normal family adjusting to family change.
D) Report to oncoming staff that the mother is probably not a good disciplinarian.
Q2) To assess fundal contraction 6 hours after cesarean birth, which technique should the nurse utilize?
A) Assess lochial flow rather than palpating the fundus.
B) Palpate forcefully through the abdominal dressing.
C) Place hands on both sides of the abdomen and press downward.
D) Gently palpate, applying the same technique used for vaginal deliveries.
Q3) The postpartum nurse is administering ibuprofen (Advil) to a patient with episiotomy discomfort. The prescribed order is 400 mg of Advil by mouth every 6 to 8 hours PRN for discomfort. The Advil sent by the pharmacy is 200 mg/tablet. How many tablet(s) should the nurse administer to the patient? Record your answer as a whole number. _____ tab(s)
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Page 19
Chapter 18: Postpartum Maternal Complications
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36 Verified Questions
36 Flashcards
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Sample Questions
Q1) A positive sign of thrombophlebitis includes
A) visible varicose veins.
B) positive Homans sign.
C) pedal edema in the affected leg.
D) local tenderness, heat, and swelling.
Q2) The nurse suspecting a uterine infection in a postpartum patient should assess the A) episiotomy site.
B) odor of the lochia.
C) abdomen for distention.
D) pulse and blood pressure.
Q3) The visiting nurse must be aware that women who have had a postpartum hemorrhage are subject to a variety of complications after discharge from the hospital. These include which of the following? (Select all that apply.)
A) Anemia
B) Dehydration
C) Exhaustion
D) Postpartum infection
E) Failure to attach to her infant
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Chapter 19: Normal Newborn: Processes of Adaptation
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) The nurse is explaining how a newly delivered baby initiates respirations. Which statement explains this process most accurately?
A) Drying off the infant
B) Chemical, thermal, and mechanical factors
C) An increase in the PO2 and a decrease in the PCO2
D) The continued functioning of the foramen ovale
Q2) In the newborn nursery, you are reviewing the maternal medication list to ascertain if there is any significant risk to the newborn. Which medications would pose a potential risk to the newborn in terms of clotting ability? (Select all that apply.)
A) Carbamazepine
B) Phenytoin (Dilantin)
C) Phenobarbital
D) INH (Isoniazid)
E) Prenatal vitamins with iron
Q3) Which of the following organs are nonfunctional during fetal life?
A) Eyes and ears
B) Lungs and liver
C) Kidneys and adrenals
D) Gastrointestinal system
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Page 21
Chapter 20: Assessment of the Normal Newborn
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) The nurse is performing a gestational age assessment on a newborn. Which characteristic indicates the greatest gestational maturity?
A) The infant's arms and legs are extended.
B) There is some peeling and cracking of the skin.
C) There are few rugae on the scrotum and the testes are high in the scrotum.
D) The arm can be positioned with the elbow beyond the midline of the chest.
Q2) The hips of a newborn are examined for developmental dysplasia. Which clinical finding indicates an incomplete development of the acetabulum?
A) Negative Barlow test
B) Equal knee heights
C) Negative Ortolani sign
D) Thigh and gluteal creases are asymmetric.
Q3) An infant at term was born at 0105 hours. The nurse is developing a plan of care for the newborn. During which time range will the nurse plan on performing the assessment to determine a Ballard score?
A) 0115 to 0130
B) 0200 to 0600
C) 1400 to 1800
D) 2000 to 2300
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Page 22
Chapter 21: Care of the Normal Newborn
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) Which intervention will be most helpful to parents in identifying problems with an infant car seat?
A) Questioning the parents about the instructions
B) Providing the parents with current laws on infant and child safety
C) Asking the parents to demonstrate how to secure the infant in the car seat
D) Allowing the parents to ask questions and express feelings about infant restraint
Q2) An infant who eats very rapidly may experience problems with swallowing excessive air. What should the mother be instructed to do?
A) Use a nipple with a smaller hole.
B) Place the infant on the abdomen after feeding.
C) Provide the infant with water between feedings.
D) Begin the feeding before the infant becomes too hungry.
Q3) Most newborns receive a prophylactic injection of vitamin K soon after birth. Which site is optimal for the newborn?
A) Deltoid muscle
B) Gluteal muscle
C) Rectus femoris muscle
D) Vastus lateralis muscle
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Chapter 22: Infant Feeding
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28 Flashcards
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Sample Questions
Q1) A new mother is preparing for discharge. She plans on bottle feeding her baby. Which statement indicates to the nurse that the mom needs more information about bottle feeding?
A) "I should encourage my baby to consume the entire amount of formula prepared for each feeding."
B) "I can make up a 24-hour supply of formula and refrigerate the bottles so I am ready to feed my baby."
C) "I will hold my baby in a cradle hold and alternate sides from left to right when I feed my baby."
D) "I will generally feed my baby every 3 to 4 hours or more often as signs of hunger are displayed."
Q2) Which hormone is essential for milk production?
A) Estrogen
B) Prolactin
C) Progesterone
D) Lactogen
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Chapter 23: High-Risk Newborn: Complications Associated with Gestational Age and Development
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Sample Questions
Q1) Which is the most useful factor in preventing premature birth?
A) High socioeconomic status
B) Adequate prenatal care
C) Aid to Families with Dependent Children
D) Women, Infants, and Children (WIC) nutritional program
Q2) A preterm infant is on a ventilator, with intravenous lines and other medical equipment. When the parents come to visit for the first time, what is the most important action by the nurse?
A) Encourage the parents to touch their infant.
B) Reassure the parents that the infant is progressing well.
C) Discuss the care they will give their infant when the infant goes home.
D) Suggest that the parents visit for only a short time to reduce their anxiety.
Q3) What will the nurse note when assessing an infant with asymmetric intrauterine growth restriction?
A) All body parts appear proportionate.
B) The extremities are disproportionate to the trunk.
C) The head seems large compared with the rest of the body.
D) One side of the body appears slightly smaller than the other.
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Chapter 24: High-Risk Newborn: Acquired and Congenital Conditions
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Sample Questions
Q1) Which newborn should the nurse recognize as being at the greatest risk for developing respiratory distress syndrome?
A) A 35-week-gestation male baby born vaginally to a mother addicted to heroin.
B) A 35-week-gestation female baby born vaginally 72 hours after the rupture of membranes.
C) A 36-week-gestation male baby born by cesarean birth to a mother with insulin-dependent diabetes.
D) A 35-week-gestation female baby born vaginally to a mother who has pregnancy-induced hypertension.
Q2) The nurse present at the birth is reporting to the nurse who will be caring for the neonate after the delivery. Prior to birth there was meconium present in the amniotic fluid. The infant presented with depressed respirations and weak muscle tone. Which information should be included in the report for this infant?
A) The parents spent an hour bonding with the baby after birth.
B) An IV was started immediately after birth to treat dehydration.
C) The infant required warmed humidified oxygen.
D) The infant was placed skin to skin with the mother.
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Page 26
Chapter 25: Family Planning
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Sample Questions
Q1) A woman who has a successful career and a busy lifestyle will most likely look for which type of contraceptive?
A) Requires extensive education to use
B) Is the easiest and most convenient to use
C) Costs the least
D) Is permanent
Q2) When instructing a patient in the use of spermicidal foam or gel, it is important to include the information that
A) effectiveness is about 85%.
B) douching should be avoided for at least 6 hours.
C) it should be inserted 1 to 2 hours before intercourse.
D) one application is effective for several hours.
Q3) A nurse is leading a discussion regarding options for birth control. Which of the following methods is considered the most reliable?
A) Coitus interruptus
B) Breastfeeding
C) Natural family planning
D) Intrauterine device
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Chapter 26: Infertility
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Sample Questions
Q1) Which situation best describes secondary infertility in a couple?
A) Never conceived.
B) Had repeated spontaneous abortions.
C) Not conceived after 1 year of unprotected intercourse.
D) Has one child but cannot conceive a second time.
Q2) A patient has been diagnosed with an incompetent cervix (the cervix will not remain closed). What treatment option will be incorporated into the plan of care for this patient?
A) Bed rest throughout the pregnancy
B) Wait and see approach to determine if the patient goes into preterm labor
C) Preparation for cerclage procedure at 32 weeks' gestation
D) More frequent ultrasounds to assess progression of pregnancy
Q3) A woman who is undergoing infertility testing states, "My husband won't discuss this with me. I don't think he cares about or wants a baby." The nurse's ideal response is
A) "You should confront him about this."
B) "He probably doesn't understand your concern."
C) "Men are sometimes less eager to have children."
D) "It may be harder for him to express his feelings."
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Chapter 27: Womens Health
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) Which concern is included in the plan of care for the patient who receives HPV (human papillomavirus) vaccine?
A) It is available in oral form.
B) It involves a series of two injections.
C) Injections should be given over a 3-month period.
D) The vaccine (Gardasil) should not be given to any patient with a sensitivity to yeast.
Q2) Which sexually transmitted disease can be treated and eradicated?
A) Herpes
B) AIDS
C) Chlamydia
D) Venereal warts
Q3) The drug of choice to treat a gonorrhea infection is
A) penicillin G (Pfizerpen).
B) tetracycline (Achromycin).
C) ceftriaxone (Rocephin).
D) acyclovir (Zovirax).
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