Safe Maternity Pediatric Nursing By Care Palmer Coats -Test Bank

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Safe Maternity Pediatric Nursing By Care Palmer Coats -Test Bank

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WITH ANSWERS

Safe Maternity Pediatric Nursing By Care Palmer Coats -Test Bank

Chapter 3: Human Reproduction and Fetal Development

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The nurse is teaching a class about female reproduction for middle school girls. Which statement made by one of the students requires the nurse to correct a misunderstanding?

1) Boys have a penis that gets erect when they are excited, but girls dont have anything like that.
2) Bartholin glands secrete a lubricant to make sexual intercourse more comfortable.
3) The ovaries secrete eggs that, when fertilized, start a baby growing in the womans body.
4) The fallopian tubes are the passageways for eggs to travel to the uterus.

 

 

____    2.   A pregnant woman lives in a community that is experiencing a measles outbreak because of a lack of immunization. The woman says she heard that measles are teratogenic and does not know what that means. Which statement by the nurse best explains this concept?

1) The growing baby can catch measles and get very sick.
2) The measles virus acts as a harmful substance that could hurt the fetus.
3) A teratogen, such as the measles virus, can cause fetal death.
4) It means that a mother exposed to measles will probably miscarry.

 

 

____    3.   The nurse is caring for a young man with testicular cancer who is preparing for removal of the left testicle. The patient asks, Does this mean I wont be able to father a child? Which is the nurses best response?

1) You can arrange with your doctor to have sperm frozen and stored for when you want children.
2) Although your sperm count will be lower, there is still a chance you could father a child. However, it may take longer.
3) This is an important discussion to have with your physician, who can discuss the chances of fathering a child.
4) Removal of one testicle will have no impact on your ability to father a child because the other testicle will function.

 

 

____    4.   An adult womans laboratory studies indicate a lack of estrogen production. As a result, the nurse anticipates the patients history will report which finding?

1) Inability to produce breast milk
2) Small breast size
3) Inability to carry a pregnancy to term
4) Inability to become pregnant

 

 

____    5.   The nurse admits a woman in the second trimester of pregnancy to the obstetric clinic for her regular examination. The patient asks the nurse if it is safe to take acetaminophen for minor pain during pregnancy. Which is the nurses best response?

1) Acetaminophen is a Category A medication, so it is safe to take during pregnancy.
2) The safest thing for the growing fetus is to avoid all medications during pregnancy.
3) What kind of medication have you taken in the past for minor pain?
4) Talk with the provider about the safest medications to take during pregnancy.

 

 

____    6.   The nurse caring for a family shortly after a birth overhears the father of the baby say, Well, you gave me another daughter. I guess you cant produce boys. Which is the nurses best response?

1) It is the father who determines the sex of the baby.
2) Girls are nice, too, and are often closer to their father than boys.
3) It isnt the mothers fault when girls are produced instead of boys.
4) There are scientific methods of producing male children if you are interested.

 

 

____    7.   The newborn nursery nurse admits a baby born with a congenital defect of the digestive tract and recognizes this is due to an anomaly in which layer during cell differentiation?

1) Ectoderm
2) Mesoderm
3) Endoderm
4) Pyloderm

 

 

____    8.   A fetal ultrasound demonstrates a cardiac anomaly in a 22-week fetus. The mother says, My baby is sick, all because I insisted on having a cup of coffee last week. Which statement by the nurse is most appropriate?

1) Caffeine is a stimulant and impacts the baby by speeding up the heartbeat and increasing activity, which can result in metabolic problems.
2) The fetal heart is beating and pumping blood by 4 weeks and is fully formed by 8 weeks, so your actions last week did not affect your babys heart.
3) Whats done is done and cant be undone, but try to follow the doctors advice from this point onward in your pregnancy.
4) Drinking coffee doesnt cause any problem for the fetus, so dont feel bad about what you did last week.

 

 

____    9.   A mother goes into preterm labor and delivers a baby who weighs 435 g and has fused eyelids. The nurse assesses the infant at what stage of gestational development?

1) 4 months
2) 5 months
3) 6 months
4) 7 months

 

 

____  10.   A woman delivers an infant assessed prenatally at 34 weeks gestation. Which nursing assessment indicates the babys gestation is closer to term than anticipated?

1) Fused eyelids
2) Hand grip reflex present
3) Sole creases on the heel of the foot
4) Earlobes that are firm and not easily creased

 

 

____  11.   Which statement indicates a mother understood the information about the function of the placenta taught by the nurse?

1) My blood flows through the placenta into the baby and returns to my body to oxygenate.
2) My body removes wastes and provides nutrients and oxygen to the baby when our blood mixes.
3) The placenta grows and functions because of the production of progesterone from the ovaries.
4) The placenta separates my blood from the babys and produces hormones until delivery.

 

 

____  12.   Which finding is normal when assessing a newborn shortly after birth?

1) The umbilical cord has two arteries and one vein.
2) The umbilical cord has one artery and one vein.
3) The umbilical cord has one artery and two veins.
4) The umbilical cord is 0.25 in. in diameter.

 

 

____  13.   The mother of a premature newborn is crying and tells the nurse the neonatologist said the baby will need surgery to close the patent ductus arteriosus. She asks what this is. Which is the best explanation?

1) It is an opening in the blood vessel that shunts blood away from the liver and needs to close after birth.
2) It is an opening in the aorta that shunts blood away from the lungs, which is normal in the fetus but needs to close after birth.
3) It is a small hole in the atria of the heart that shunts blood from the right atrium to the left atrium, reducing blood flow to the lungs.
4) It is a small hole in the atria of the heart that shunts blood from the left atrium to the right atrium, reducing blood flow to the lungs.

 

 

____  14.   A patient who recently delivered twins has learned that each baby has a different father. How does the nurse interpret this finding?

1) The twins are monozygotic.
2) The twins are dizygotic.
3) There was a mistake in testing because this is not possible.
4) The twins have different gestational ages.

 

 

____  15.   Which finding during a nursing assessment of twins supports the diagnosis of dizygotic twins?

1) Both twins are boys.
2) One twin weighs more than the other.
3) One twin is blonde, the other is brunette.
4) One twin required oxygen at birth.

 

 

____  16.   The nurse receives an order to administer a Category A medication to a pregnant patient. Which is the nurses best action?

1) Holding the medication until verifying the order with the obstetrician
2) Administering the medication as ordered
3) Calling the pharmacist and verifying the safety of this medication
4) Giving the medication only if essential to the womans well-being

 

 

____  17.   The nurse receives an order to administer a Category X medication to a woman of childbearing age who denies pregnancy. Which action will the nurse take before administering this medication?

1) Asking the woman if there is any chance of pregnancy
2) Requesting an order to perform a serum pregnancy test
3) Administering the medication
4) Requesting an order for a different medication

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  18.   The nurse reviews the chart of a man undergoing testing to determine the cause of infertility. Which hormone levels will the nurse review as a possible cause of the patients low sperm count? (Select all that apply.)

1) Follicle-stimulating hormone
2) Luteinizing hormone
3) Testosterone
4) Estrogen
5) Progesterone

 

 

____  19.   The nurse performs a cervical examination on a woman in labor and recognizes that the elasticity of the cervix results from which characteristics of the anatomy? (Select all that apply.)

1) High fibrous content of the supportive tissue
2) Large number of folds in the cervical lining
3) High collagenous content of the supportive tissue
4) Location of the uterosacral ligaments
5) Mucus-secreting glands

 

 

Completion

Complete each statement.

 

  1. Rank these events in the order in which they occur. (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)

1) Secretion of luteinizing hormone

2) Release of an egg

3) Release of progesterone by the corpus luteum

4) Fertilization of the ovum

5) Implantation into the endometrium

 

 

Chapter 3: Human Reproduction and Fetal Development

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  1

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Identify the structures and functions of the female reproductive system.

Chapter page reference: 22

Heading: Internal Organs

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Female Reproduction

Difficulty: Moderate

 

  Feedback
1 The clitoris in the woman also becomes erect during periods of excitation, but it is much smaller than the male penis; so this statement reflects a misunderstanding that needs to be corrected.
2 The statement regarding Bartholin glands is accurate and does not require correction.
3 The statement about the ovaries contains accurate information and does not need to be corrected.
4 The statement about the fallopian tubes is accurate and does not require correction.

 

 

PTS:   1                    CON:  Female Reproduction

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Discuss possible risks to safe fetal development due to possible teratogens in medications, street drugs, foods, and the environment.

Chapter page reference: 35

Heading: Environmental Toxins

Integrated processes: Teaching and Learning

Client need: Safety and Infection Control

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Easy

 

  Feedback
1 This statement does not explain the concept of a teratogen and is not an accurate statement.
2 This statement explains in simple terms the meaning of teratogen without frightening the mother unnecessarily.
3 Although this statement is not completely incorrectbecause exposure to measles can cause fetal death if the birth defect is incompatible with lifethe risk is low and would unnecessarily frighten the mother.
4 This statement does not accurately explain the concept of a teratogen and may unnecessarily frighten the mother.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Identify the structures and functions of the male reproductive system.

Chapter page reference: 22-23

Heading: Internal Organs

Integrated processes: Teaching and Learning

Client need: Physiological Adaptation

Cognitive level: Application [Applying]

Concept: Male Reproduction

Difficulty: Moderate

 

  Feedback
1 Although this statement is true, the information is not necessary and is not the best response to the patients question.
2 Removal of one testicle does not reduce sperm count by half.
3 With NCLEX-style questions, the correct answer is rarely to refer the patient to another health-care provider because the nurse is capable of answering the question.
4 Both testicles produce sperm that is stored until ejaculation occurs, and one testicle is capable of producing adequate sperm for impregnating an egg.

 

 

PTS:   1                    CON:  Male Reproduction

 

  1. ANS:  4

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Summarize the actions of the hormones that affect reproductive functioning.

Chapter page reference: 25

Heading: Follicular Phase

Integrated processes: Clinical Problem-Solving Process

Client need: Reduction of Risk Potential

Cognitive level: Analysis [Analyzing]

Concept: Female Reproduction

Difficulty: Difficult

 

  Feedback
1 Low estrogen levels are not associated with the inability to produce breast milk.
2 Small breast size is related to many factors but is not associated with low estrogen levels.
3 Estrogen is not a primary factor in the inability to carry a pregnancy to term.
4 Estrogen stimulates production of the uterine lining for the fertilized egg, so lack of estrogen prevents implantation and results in difficulty becoming pregnant.

 

 

PTS:   1                    CON:  Female Reproduction

 

  1. ANS:  4

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Discuss possible risks to safe fetal development due to possible teratogens in medications, street drugs, foods, and the environment.

Chapter page reference: 33

Heading: Medications

Integrated processes: Communication and Documentation

Client need: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 Although this statement is true, it is not the nurses responsibility to tell the patient which medications can be taken during pregnancy; this response is outside the nurses scope of practice.
2 Although this statement is true, it does not address the patients question.
3 Although it is not wrong to ask this question, it is not the best response because the medication taken by the patient when not pregnant does not indicate what medication is safest during pregnancy.
4 This is the correct response because only the provider should advise the patient regarding the safety of specific medications during pregnancy.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Describe the fertilization process.

Chapter page reference: 27

Heading: Fertilization

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Female Reproduction; Male Reproduction

Difficulty: Moderate

 

  Feedback
1 The female has two identical sex chromosomes, XX, whereas the male has two distinct sex chromosomes, XY; thus, the man determines the sex of the baby depending on which sex chromosome is located on the sperm that fertilizes the egg.
2 The female has two identical sex chromosomes, XX, whereas the male has two distinct sex chromosomes, XY; thus, the man determines the sex of the baby depending on which sex chromosome is located on the sperm that fertilizes the egg.
3 The female has two identical sex chromosomes, XX, whereas the male has two distinct sex chromosomes, XY; thus, the man determines the sex of the baby depending on which sex chromosome is located on the sperm that fertilizes the egg.
4 The female has two identical sex chromosomes, XX, whereas the male has two distinct sex chromosomes, XY; thus, the man determines the sex of the baby depending on which sex chromosome is located on the sperm that fertilizes the egg.

 

 

PTS:   1                    CON:  Female Reproduction | Male Reproduction

 

  1. ANS:  3

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Discuss the stages of embryonic development.

Chapter page reference: 29

Heading: First Trimester

Integrated processes: Clinical Problem-Solving Process

Client need: Physiological Adaptation

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The ectoderm becomes the nervous system, epidermis of the skin, tooth enamel, and lens and cornea of the eye.
2 The mesoderm becomes the connective tissue, skeleton, skeletal muscles, circulatory system, and dermis of the skin.
3 It is the endoderm that gives rise to the digestive tract.
4 There is no such layer as the pyloderm.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Discuss the stages of embryonic development.

Chapter page reference: 29

Heading: First Trimester

Integrated processes: Clinical Problem-Solving Process

Client need: Physiological Adaptation

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Although caffeine is a stimulant, taken in small, infrequent amounts it does not cause any harm to the growing fetus.
2 Fetal heart development is completed by week 8, and the mothers activity last week, at 21 weeks, was not the cause of the heart defect; thus, it is important to reassure this mother.
3 This statement is cold and uncaring and does not reassure the mother that she did not cause the problem; it is not an appropriate statement for the nurse to make.
4 Although this statement is true, it does not provide the factual information the mother needs to hear to provide genuine reassurance.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Identify significant developmental changes of the fetus at various gestations.

Chapter page reference: 29

Heading: Second Trimester

Integrated processes: Clinical Problem-Solving Process

Client need: Physiological Adaptation

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 Although a 4-month-old fetus will have fused eyelids, it will not weigh this much.
2 A 5-month-old fetus will weigh about 435 g and still have fused eyelids.
3 By 6 months, the fetus weighs about 780 g, and the eyelids are no longer fused.
4 By 7 months, the fetus weighs approximately 1200 g and no longer has fused eyelids.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Identify significant developmental changes of the fetus at various gestations.

Chapter page reference: 29

Heading: Third Trimester

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The eyelids are no longer fused from the seventh month on, so this is not an indicator of being close to term.
2 The hand grip reflex appears in the seventh month, so this finding does not indicate the baby is closer to term.
3 Sole creases appear on the heel in the eighth month, so this does not indicate the baby is closer to term.
4 The earlobe develops more cartilage as the fetus develops, and an ear that is not easily creased indicates the infant is closer to term than anticipated.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  4

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Describe the functions of the placenta, umbilical cord, amniotic membranes, and amniotic fluid.

Chapter page reference: 31-32

Heading: Placenta

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The fetus has its own blood supply, and the mothers blood does not flow into the baby.
2 There is no mixing of the mothers blood with the babys, so this statement is incorrect.
3 Progesterone is secreted by the placenta, so this is an incorrect statement.
4 This statement is correct and indicates the mother understood the teaching.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  1

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Describe the functions of the placenta, umbilical cord, amniotic membranes, and amniotic fluid.

Chapter page reference: 32

Heading: Umbilical Cord

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 This is a normal and expected finding when examining the umbilical cord.
2 This is an abnormal finding and indicates the need for further examination.
3 This is not an expected finding and indicates a potential problem.
4 This is a thin umbilical cord and could indicate the fetus had a poor blood supply in utero.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Describe fetal circulation.

Chapter page reference: 28

Heading: Fetal Circulation

Integrated processes: Teaching and Learning

Client need: Physiological Adaptation

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Easy

 

  Feedback
1 The ductus venosus shunts blood away from the liver in fetal circulation.
2 This statement correctly explains a patent ductus arteriosus.
3 This statement describes the foramen ovale.
4 This statement describes the foramen ovale, but the shunt is from the right to the left.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Contrast the differences between monozygotic twins and dizygotic twins.

Chapter page reference: 33

Heading: Multiple Pregnancy

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Monozygotic twins form when a single fertilized egg splits into two embryos, which is not possible if they have different fathers.
2 Dizygotic twins with different fathers can result when the mother produces two eggs and each egg is fertilized by a different man.
3 There is no indication of an error in testing.
4 There is no indication the twins have different gestational ages.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Contrast the differences between monozygotic twins and dizygotic twins.

Chapter page reference: 33

Heading: Multiple Pregnancy

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 Monozygotic twins are the same sex, so this is not supportive of a diagnosis of dizygotic twins.
2 Weight at birth may differ depending on blood supply to each fetus and is not supportive of dizygotic twins.
3 Monozygotic twins are identical in appearance, so the differing hair color supports the diagnosis of dizygotic twins.
4 Oxygen requirement is often related to the trauma of delivery and does not support a diagnosis of dizygotic twins.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Explain the FDA pregnancy category system for safe medication use in pregnancy.

Chapter page reference: 33-34

Heading: Medications

Integrated processes: Clinical Problem-Solving Process

Client need: Reduction of Risk Potential

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Easy

 

  Feedback
1 There is no need to hold this medication, so this is an incorrect answer.
2 This is a Category A medication, meaning it is safe to take during pregnancy, so the nurse can administer it as ordered.
3 There is no need to call the pharmacist if the nurse knows it is a Category A medication.
4 The nurse does not have the option of deciding whether the medication is essential to the womans well-being, so this is an incorrect response.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  2

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Explain the FDA pregnancy category system for safe medication use in pregnancy.

Chapter page reference: 33-34

Heading: Medications

Integrated processes: Clinical Problem-Solving Process

Client need: Reduction of Risk Potential

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Difficult

 

  Feedback
1 If the woman has already denied being pregnant, questioning if there is any chance of pregnancy is not likely to yield a different answer.
2 Because of the extreme risk to the fetus of Category X medications, a serum pregnancy test, which is more sensitive than a urine test, will help to ensure that the woman is not pregnant before administering the medication.
3 Administering the medication could result in serious harm to the fetus if the woman is in the early stage of pregnancy, so this is not the best action.
4 An order for a different medication is needed only if the woman is pregnant.

 

 

PTS:   1                    CON:  Pregnancy

 

MULTIPLE RESPONSE

 

  1. ANS:  1, 2, 3

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Discuss the female and male reproductive cycles.

Chapter page reference: 26-27

Heading: The Male Reproductive Cycle

Integrated processes: Clinical Problem-Solving Process

Client need: Reduction of Risk Potential

Cognitive level: Analysis [Analyzing]

Concept: Male Reproduction

Difficulty: Difficult

 

  Feedback
1. Follicle-stimulating hormone is one of the hormones responsible for regulating sperm production, so this is an important level to check.
2. Luteinizing hormone is one of the hormones responsible for regulating sperm production, so this is an important level to check.
3. Because testosterone influences maturation of spermatozoa, a change in this level could impact fertility and should be reviewed.
4. Estrogen is not involved in male fertility, so it should not be reviewed by the nurse.
5. Progesterone is not involved in male fertility, so it should not be reviewed by the nurse.

 

 

PTS:   1                    CON:  Male Reproduction

 

  1. ANS:  1, 2, 3

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Identify the structures and functions of the female reproductive system.

Chapter page reference: 25-26

Heading: Internal Organs

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Easy

 

  Feedback
1. The high fibrous content allows the cervix to be highly elastic.
2. The large number of folds in the cervical lining contributes to the elasticity of the cervix.
3. The high collagenous content of the supportive tissue contributes to the cervical elasticity.
4. The uterosacral ligaments contribute to cervical dilation during childbirth but do not contribute to the elasticity of the cervix.
5. Mucus-secreting glands in the cervical canal have many functions but do not contribute to cervical elasticity.

 

 

PTS:   1                    CON:  Pregnancy

 

COMPLETION

 

  1. ANS:

12345

Chapter number and title: 3: Human Reproduction and Fetal Development

Chapter learning objective: Discuss the female and male reproductive cycles.

Chapter page reference: 25

Heading: Female Reproductive Cycle

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Easy

 

  Feedback
1. Leuteinizing hormone is secreted first, stimulating release of the egg. Next, the corpus luteum releases progesterone. The ovum is fertilized, and only after traveling through the fallopian tube can the fertilized egg implant in the endometrium of the uterus.
2. Leuteinizing hormone is secreted first, stimulating release of the egg. Next, the corpus luteum releases progesterone. The ovum is fertilized, and only after traveling through the fallopian tube can the fertilized egg implant in the endometrium of the uterus.
3. Leuteinizing hormone is secreted first, stimulating release of the egg. Next, the corpus luteum releases progesterone. The ovum is fertilized, and only after traveling through the fallopian tube can the fertilized egg implant in the endometrium of the uterus.
4. Leuteinizing hormone is secreted first, stimulating release of the egg. Next, the corpus luteum releases progesterone. The ovum is fertilized, and only after traveling through the fallopian tube can the fertilized egg implant in the endometrium of the uterus.
5. Leuteinizing hormone is secreted first, stimulating release of the egg. Next, the corpus luteum releases progesterone. The ovum is fertilized, and only after traveling through the fallopian tube can the fertilized egg implant in the endometrium of the uterus.

 

 

PTS:   1                    CON:  Pregnancy

 

Chapter 13: Physiological and Behavioral Adaptations During the Postpartum Period

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The nurse examines a postpartum woman who is 1 day postdelivery. Which finding does the nurse consider abnormal?

1) Fundus 1 cm below the umbilicus
2) Bright red lochia
3) Dilated cervix
4) Reduced fibrinogen levels

 

 

____    2.   While reviewing laboratory values, the nurse sees a postpartum patients white blood cell count is 26,699 mg/dL, and her neutrophil count is also elevated. Which is the nurses priority action?

1) Assessing the episiotomy for signs of infection
2) Notifying the RN and/or provider
3) Continuing to monitor laboratory findings
4) Obtaining STAT vital signs

 

 

____    3.   When does the nurse expect to be unable to palpate the uterus in a postpartum patient?

1) Immediately after delivery
2) 5 days postdelivery
3) 1 week postdelivery
4) 2 weeks postdelivery

 

 

____    4.   Which events after delivery of the placenta cause the uterus to contract and begin shrinking to nonpregnant size?

1) Reduced estrogen and progesterone levels
2) Reduced estrogen and oxytocin levels
3) Reduced progesterone and oxytocin levels
4) Estrogen, progesterone, and oxytocin levels decline.

 

 

____    5.   The nurse examines a womans lochia and notices excessive bleeding. Which is the nurses priority action?

1) Assessing for a full bladder
2) Placing the patient in the Trendelenburg position
3) Massaging the uterus
4) Encouraging the woman to breastfeed

 

 

____    6.   A woman reports she has not urinated since delivering 8 hours ago and says she has no urge to void despite drinking adequate fluids postpartum. The nurse attributes this to what?

1) The woman was dehydrated and has not fully hydrated yet to produce urine.
2) The womans bladder tone is reduced, and she does not feel the urge to urinate.
3) The bladder has more room to expand and can hold more urine because of a smaller uterus.
4) The woman is experiencing a release of epinephrine, causing absence of bladder sensation.

 

 

____    7.   The nurse is caring for a woman who delivered her third child 2 days ago and who says, I am having pain; it feels like labor pain. I never experienced this with my other children, and it is worse when I breastfeed. Which is the nurses priority response?

1) Further assess the pains location, intensity, and frequency
2) Explain the purpose of afterpains and reassure the patient
3) Immediately obtain vital signs and monitor vital signs every 15 minutes
4) Administer a narcotic analgesic to control pain

 

 

____    8.   Which patient does the nurse anticipate is most likely to experience afterpains?

1) The woman who had a precipitous delivery
2) The woman who delivered a preterm infant
3) The primipara who had a difficult pregnancy
4) The multipara who delivered her fifth child

 

 

____    9.   The nurse working in a womens clinic admits a patient who is almost 6 weeks postpartum and describes a yellow-white vaginal drainage. The nurse interprets this as indicating what?

1) Bacterial infection
2) Retained placenta
3) Expected lochia progression
4) Fungal infection

 

 

____  10.   The ICU nurse is caring for a postpartum patient who experienced complications. Which color of lochia does the nurse expect to find on the fifth day postpartum?

1) Bright red
2) Dark red
3) Pink
4) Yellow-white

 

 

____  11.   A breastfeeding mother says, One good thing about breastfeeding is that I wont have to worry about getting pregnant till I stop. Which information will the nurse provide to this patient?

1) Ovulation and menstruation may be delayed by breastfeeding, but not always.
2) Ovulation will resume as early as 27 days after delivery.
3) Ovulation will resume within 30 days of stopping breastfeeding.
4) By breastfeeding even once a day, she can delay ovulation.

 

 

____  12.   Which statement by a postpartum patient indicates teaching regarding menses and contraception has been understood?

1) I dont have to worry about getting pregnant until I get my first menstrual period.
2) Because I am breastfeeding, I dont have to worry about getting pregnant until I quit.
3) I should resume using my diaphragm as soon as I resume sexual activity.
4) I should use a contraceptive when I resume sexual activity to avoid pregnancy.

 

 

____  13.   The nurse is making a home-care visit when the newborn starts to cry. The new mother smiles and says, Thats his hungry cry. The nurse interprets this as indicating the mother is in which phase of maternal role attainment?

1) Taking-in phase
2) Taking-hold phase
3) Letting-go phase
4) Transitioning from taking-in to taking-hold phase

 

 

____  14.   Which observed behavior arouses the nurses concern as an indication the mother is not bonding with her baby?

1) The mother expresses fear she will hurt the baby because she doesnt know what to do.
2) The mother stares at the babys face and touches it only with her fingertips.
3) The mother does not want to hold the infant and asks to keep the baby in the nursery.
4) The mother asks many questions about self-care and newborn care.

 

 

____  15.   Which behavior observed by the nurse indicates a new mother is beginning to bond with her newborn?

1) Takes the en face position
2) Tells the nurse about her labor experience
3) Needs reassurance of her ability to be a good mother
4) Asks to keep the baby in the nursery overnight so she can sleep

 

 

____  16.   The nurse enters a postpartum patients room and finds the father staring at the newborn in the bassinet with a contemplative look on his face. How should the nurse interpret this behavior?

1) The father may be a danger to the baby.
2) The father feels resentful toward the baby.
3) The father is uncertain about being a father.
4) The father is bonding with the baby.

 

 

____  17.   Which is the best intervention for the nurse to use to promote eye contact between the mother and newborn?

1) Pointing out characteristics of the newborn such as eye color, milia, and other facial features
2) Encouraging the mother to change the babys diaper
3) Encouraging the mother to hold the baby
4) Taking the baby to the nursery and allowing the mother to rest

 

 

____  18.   It is time for a newborn to have blood collected for the newborn screening. How does the nurse turn this into a bonding opportunity for the mother?

1) Perform the test in the mothers room and encourage her to comfort the newborn afterward
2) Take the baby to the nursery for the test to avoid upsetting the mother
3) Explain the bandage on the babys foot when returning the baby to the mothers room
4) Perform the test without mentioning it to the mother to reduce anxiety

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  19.   A new mother asks the nurse what she can do to foster attachment between the newborn and her 8-year-old daughter. Which recommendations should the nurse make? (Select all that apply.)

1) Have the child visit in the hospital
2) Let the child help care for the baby as he or she is able
3) Have Mom spend some time alone with the child
4) Keep the baby away from the child as much as possible
5) Anticipate unpredictable and uncomplimentary statements about the baby

 

 

____  20.   Which behaviors observed by the nurse indicate that a postpartum patient is in the taking-in phase? (Select all that apply.)

1) Introduces information about her labor into every conversation
2) Strokes the baby with just the tips of her fingers
3) Asks the nurse to keep the baby in the nursery so she can sleep
4) When caring for the newborn, often asks the nurse, Did I do that right?
5) Spontaneously begins to cry with no explanation for why she is crying

 

Chapter 13: Physiological and Behavioral Adaptations During the Postpartum Period

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  4

Chapter number and title: 13: Physiological and Behavioral Adaptations During the Postpartum Period

Chapter learning objective: Identify the normal physiological changes following childbirth in the reproductive, integumentary, gastrointestinal, cardiovascular, respiratory, urinary, and musculoskeletal systems.

Chapter page reference: 193

Heading: Cardiovascular System

Integrated processes: Clinical Problem-Solving Process

Client need: Physiological Adaptation

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

  Feedback
1 The fundus drops 1 cm per day starting at the umbilicus immediately after a birth, so a fundus 1 cm below the umbilicus on the first day after delivery is a normal finding.
2 Lochia is bright red for 1 to 3 days after delivery, so this is not an abnormal finding.
3 The cervix closes slowly over 2 weeks, so the continued dilation is not an abnormal finding.
4 Fibrinogen levels normally increase for several days after delivery, so this is an abnormal finding that should be reported to the registered nurse (RN) or provider.

 

 

PTS:   1                    CON:  Pregnancy

 

  1. ANS:  3

Chapter number and title: 13: Physiological and Behavioral Adaptations During the Postpartum Period

Chapter learning objective: Identify the normal physiological changes following childbirth in the reproductive, integumentary, gastrointestinal, cardiovascular, respiratory, urinary, and musculoskeletal systems.

Chapter page reference: 193

Heading: Lab and Diagnostics

Integrated processes: Clinical Problem-Solving Process

Client need: Reduction of Risk Potential

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

 

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