Exam 2: NUR230 / NUR 230 (Latest 2026/2027 Update) Concepts of Nursing: The Childbearing/Child Caring Family | Questions & Answers | 100% Correct | Galen

Exam 2: NUR230 / NUR 230 (Latest 2026/2027 Update) Concepts of Nursing: The Childbearing/Child Caring Family | Questions & Answers | 100% Correct | Galen A breastfeeding client is day 4 post Cesarean delivery. Current VS are temp. 99.8, RR 20, HR 88, and BP 118/60. What is the priority in this scenario? A. Massage the fundus B. Notify the physician C. Reassess thr client's temp in 30 minutes D. Assess the client's breasts for engorgement. D During a postpartum assessment, a cluster of hemorrhoids are noted in a G1P1 who delivered vaginally with a superficial perineal laceration. Which of the following would be appropriate for the nurse to include in the women's health teaching? SATA A. The client should use a site bath three times a day for relief. B. The client should apply a topical anesthetic as a relief measure. C. The client should massage the hemorrhoids daily. D. The client should be advised that the hemorrhoids will increase in size and number with each subsequent pregnancy. E. The client can use the side lying position to relieve pressure on the hemorrhoids. F. The client should use witch hazel pads to soothe the area. A, B, E, F Which is the best intervention to help prevent development of postpartum thrombophlebitis after an uncomplicated vaginal delivery? A. Promote adequate oral fluid intake B. Promote early and frequent ambulation C. Place sequential compression devices on all patients D. Administer subcutaneous low molecular weight heparin B A G6 P4114 is 1/2 hour post spontaneous vaginal delivery of a 440 grams baby. Initially, which complication should the nurse monitor considering this patient scenario? A. Maternal hypoglycemia B. Maternal hyperglycemia C. Maternal VTE D. Maternal uterine atony D The nurse is teaching a postpartum mother about changes in the postpartum period. The nurse recognized the mother needs additional teaching when the mother states: SATA A. I need to begin sitz baths within 12 hours of birth if I have an episiotomy or a repaired laceration. B. Tylenol is the preferred pain medication for breastfeeding mothers. C. I should void spontaneously within 6-8 hours after birth. D. I need an additional 1000 kcal/day as a breastfeeding mother. A, B, D Which of the following is NOT a symptom of a vaginal hematoma? A. Normal-apprearing vulva with either no lacerations or normal-appearing, repaired laceration/episiotomy. B. Pain that is greater that expected for the client's circumstances. C. A bluish mass protruding from the vagina. D. Blood loss as indicated by lab results that is greater than expected based on EBL at delivery. C What is the nurse's priority is a vaginal hematoma is suspected? A. Apply ice to the perineum. B. Apply a warm compress to the perineum. C. Monitor the bluish mass to determine whether it is enlarging. D. Notify the provider. D The MOST reliable indicators of impending shock from early postpartum hemorrhage are: SATA A. Blood pressure B. Pulse C. Urinary output D. Level of consciousness B, C, D After completing all of the assessments on a postpartum client (BUBBLE LE), all of which were WDL, the nurse performs orthostatic VS. The blood pressure decreased, and pulse increased by 20%, and the client becomes dizzy and vomits. Temp is 99.3 and RR are 18. The nurse reviews the lab values below. What is the priority in this scenario? Pre delivery values are: hemoglobin: 10 hematocrit: 36% RBC: 5.2 WBC: 18,000 4 hrs after delivery (now): hemoglobin: 7.2 hematocrit: 23% RBC: 4.2 WBC: 20,000 A. Massage the fundus and administer oxytocin. B. Notify the physician and recommend a blood transfusion. C. Assess the client's temp and recommend blood cultures be ordered and drawn D. Start an IV fluid boils with LR and notify HCP D A nurse is estimating blood loss on a postpartum client. The scales read 2.3 kg with a saturated pad and chux. The dry weight of the pad and chux is 500 g. What is the blood loss in ml's? Report the number only. A. 130 B. 1,800 C. 1,300 D. 1.8 B Upon examining a patient on day 2 after spontaneous vaginal delivery, a nurse finds the peri pad to be completely saturated with bright red blood over the last hour. The priority in this scenario is: A. Start a second IV line of normal saline B. Notify the primary health care provider C. Massage the fundus D. Assess vital signs C The nurse takes a newborn to a primipara for a feeding. The mother holds the baby em face, strokes his cheek, and states that this is the first newborn she has ever held. Which of the following assessments is most appropriate? A. Positive bonding and the client requires little teaching. B. Poor bonding and referral to the social worker C. Poor bonding but there is potential for positive mothering D. Positive bonding but teaching related to newborn care is needed D After completing the Ballard Assessment, the nurse determines that infant's weight is at the 95%; height 95%; and head circumference at the 95%. What is the classification and what problem should the nurse anticipate? A. AGA, no apparent problem B. SGA, hyperglycemia C. LGA, hypoglycemia D. Symmetrical IUGR, neurological deficits C Which of the following assessments would alert the nurse to complications associated with hyperbilirubinemia? A. Yellow sclera and head at 18 hours of birth B. Elevated bilirubin level on day 3 C. Yellow skin on day 4 D. Increased sleepiness 12 hours after birth A Which of the following would alert the nurse that an infant is currently experiencing respiratory distress? A. Acrocyanosis B. Intercostal retractions C. Apnea lasting 15 seconds D. Fire rhonchi in the upper lobes B Which of the following characteristics are characteristic with preterm infants? A. Many creases in hands and feet B. Decreased amount of vernix and copious amounts of lanugo C. Large labia minora, small majora D. Well flexed extremities C After completing the Ballard Assessment, the nurse determines that infant's weight is at the 75%; height at the 70%; and head circumference at the 30%. What is the classification of this infant? A. AGA, Asymmetrical growth B. AGA, symmetrical growth C. SGA, Asymmetrical growth D. LGA, symmetrical growth A A nurse notes that an infant has cyanotic hands and feet 8 hours after birth. Which of the following actions is most appropriate: A. Administer oxygen B. Place the infant in the crib C. Assess oxygen saturation D. Notify the physician B A full-term neonate has brown adipose fat tissue stores that were deposited during the latter part of the third trimester. What does the nurse understand in the function of this type of fat? A. To promote melanin production in the neonatal period B. To provide heat production when the baby is hypothermic. C. To protect the bony structures of the body from injury D. To provide calories for neonatal growth B A nurse is visiting a breastfeeding client at home 2 weeks post cesarean delivery of infant boy. The loggia is series with a midline fundus palpated as firm in the symphysis pubis area. Her nipples are cracked. The client is crying and reports her uterine cramping and nippy pain as 6/10. The baby has been crying throughout the visit when the mother suddenly shouts at the baby to stop crying and says "you're getting on my last nerve". What is the nursing priority in this scenario? A. Perform an assessment on the newborn B. Encourage the client to join a postpartum support group. C. Educate the client to take Ibuprofen (Motrin) around the clock D. Evaluate the client's latching on and latching off procedures A Which infant should NOT receive a circumcision today? SATA A. 34 week preterm male B. 39 week male with epispadius C. 40 week male with edematous scrotum from breech birth D. 39 week male whose mother has eclampsia A, B An infant is acrocyanotic, slightly flexed; HR 90 and decreasing; RR 18 and decreasing; and the infant is not crying. Based on the following APGAR score, the nurse will most likely: A. Chart APGAR score and continue to monitor B. Administer intramuscular Narcan/naloxone C. Assist with intubation and begin chest compressions D. Provide supplemental oxygen and consider bag and mask procedure D Which of the following assessments would alert the nurse that hyperbilirubinemia is at a critical state in a term infant? A. Yellow skin and sclera in a 2-day-old newborn. B. Preterm newborn at 4 days of age with a serum bilirubin level of 8.2 C. Preterm newborn at 36 hours after birth with serum bilirubin of 11.2 D. Term newborn at 12 hours after birth with a serum bilirubin of 12.8 D The best way to prevent hypothermia in the newborn directly after delivery is A. Place the infant under the radiant warmer for 30 minutes B. Bathe the infant while under the radiant warmer C. Place the baby on the mother's chest and dry with warm blankets D. Wrap the baby in 2 warm blankets with a hat on the head. C Which of the following babies is at greatest risk of developing hyperbilirubinemia? A. A Caucasian baby at 39 weeks gestation with cephalohematoma B. Native American baby born at 36 weeks whose mother is having difficulty breastfeeding. C. African American baby born at 40 weeks whose mother is having difficulty breastfeeding. D. Term Asian baby with type B+ blood, mother is O+ and bottle feeding well. B Identity infants who are considered appropriate for gestational age. SATA A. A preterm infant whose height, weight, and head circumference are all at the 9th percentile. B. A term infant whose height, weight are at the 8th percentile, and head circumference is at the 15th percentile. C. A term infant whose height, weight are at the 80th percentile, and head circumference is at the 85th percentile. D. A preterm infant whose height is at the 95th percentile, and weight and head circumference are at the 80th percentile. As long as two or all plots fall between the 10th and 90th percentile, the infant is AGA. If two or three plots fall below the 10th percentile, then the infant is SGA; likewise, when two or three plots are above the 90th percentile, then infant is classified as LGA. After circumcision, the nurse should instruct the neonate's mother to cleanse the circumcision site with which of the following? A. Warm water B. Antimicrobial soap C. Providone-iodine (Betadine) solution D. Diluted hydrogen peroxide. A A nurse is educating a breadt-feeding client on safety for the newborn after discharge. SATA A. Co-bedding is fine after the baby is 6 weeks old. B. A home visit 2 days after discharge will be scheduled. C. Placing the baby on their backs for sleep D. Expect the baby to sleep 6-8 hours at night at 2-4 weeks of age. E. Two to three loose blankets are recommended during sleep time F. Over and under-heating should be avoided B, C, F Four pregnant women indicate to the nurse that they wish to breastfeed their babies. Which mother should be advised to bottle feed her child? A. A mother with a current and active history of heroin use. B. A mother who received the Rubella vaccination. C. A mother who received the RhoGAM injection. D. A mother who plans to smoke outside of the house A A breastfeeding woman has been educated on how to avoid engorgement. Which of the following actions by the mother shows that teaching was effective? A. She pumps her breast's after each feeding. B. She feeds her baby every 2-3 hours. C. She feeds her baby 10 minutes on each side. D. She wears cabbage leaves for 24 hours a day. B A woman is diagnosed with an autosomal recessive disease. Her husband does not have the disease but is a carrier. The nurse can advise the couple that any of their children will have the disease is: SATA A. 50% of the children will express the disease B. 100% of the children will express the disease C. 50% of the children will be carriers for the disease D. 100% of the children will be disease free E. 25% of the children will express the disease F. 75% of the children will express the disease A, C While interacting with a couple, the nurse learns that they are planning to conceive. Which action would help the clients either prepare for or prevent genetic disorders in the newborn? A. Collecting a medical history of the couple and their parents B. Collecting the family history of the couple during the preconception period C. Advising the couple to seek genetic testing during the second trimester D. Advising the couple to seek genetic testing as soon as possible B A client is 22 years old, 5'2", weight 95 lbs., and tells a nurse that her last menstrual periods occurred on Jan 1, Mar 30, and June 30. She has no cramps. Is the client ovulating? Are her periods likely to be light or heavy? A. Yes, light B. Yes, heavy C. No, light D. No, heavy C Which of the following best describes Asherman's syndrome? A. Secondary amenorrhea due to pituitary dysfunction B. Secondary amenorrhea due to hypothalamic dysfunction C. Secondary amenorrhea due to overly-vigorously scraping of the endometrium after surgical procedures. D. Secondary amenorrhea due to ovarian dysfunction. C According to the CDC, which of the following is the most common STI in the US A. Syphillis B. HPV C. Gonorrhea D. Chlamydia B Which of the following statements regarding STIs are TRUE? SATA A. The risk of a woman contracting gonorrhea from a single act of intercourse is 60-90%, compared to 20-30% in men. B. Men are 2-3 times more likely to transmit HIV to women than are women to men C. More than 50% of bacterial STIs and 90% of viral STIs are asymptomatic in women and therefore unlikely to be detected without testing D. All states allow providers to treat the partners of clients who have a STI, even if the partner is not the providers client, through Expedited Partner Therapy. A, B, C Which STI is the most commonly reported in the U.S, according to the CDC A. Chlamydia B. Gonorrhea C. HSV I & II D. HPV D Which STI is the most commonly reported bacterial STI in the U.S, according to the CDC A. Chlamydia B. Gonorrhea C. Syphilis D. HSV A The most common symptom associated with chlamydia in women is: A. Pelvic Inflammatory Disease B. Mucopurulent cervicitis C. Vaginal discharge D. No symptoms D Which nursing instruction is appropriate for a woman who has completed half of the prescribed course of antibiotics to treat a chlamydial infection who reports being completely asymptomatic? A. "You may stop the medication now but be sure to resume treatment if your symptoms come back". B. "You must take all of the prescribed medication, even if you no longer have symptoms". C. "If the symptoms do not come back in the next 3 days, you may stop treatment". D. "Since your symptoms are gone, you may stop taking the medication today". B A nurse is teaching an 18-year-old client with her 2nd STI in 6 months about treatment and screening. The nurse recognizes the need for additional teaching when the client states: A. I need to abstain from intercourse for 7 days after the single-dose of medicine I will receive from the clinic today. B. Abstain from intercourse until all of my partners are also treated C. If one of my partners received a 7-day antibiotic prescription, I need to abstain from intercourse with that partner until competition of the 7-day course of treatment D. I will be screened annually for STIs. D The most common symptom associated with gonorrhea in women is: A. Pelvic Inflammatory Disease B. Irregular bleeding C. Mucopurulent cervicitis D. No symptoms D A nurse is doing a bimanual exam on a client during a physical exam. Her period ended 1 week ago. The client is very uncomfortable when the nurse gently moves her cervix from side-to-side during the exam. The client says "well, I just finished my period a week ago". What should the nurse do NEXT? A. Continue the examination with more gentle movement. B. Report symptoms to the health care provider immediately C. Ask the woman to breathe deeply and bear down D. Reschedule the bimanual examination for a later date. B Pain with cervical motion may be a sign of cervicitis or PID d/t STI; notify provider Which of the following statements about genital herpes (HSV-II) are TRUE? SATA A Most infections are transmitted by people who don't know they are infected. B. Recurrent infections are usually more severe than initial infections C. HSV-II cannot be cured D. Newborn babies can die from unintentional exposure to infection by HSV during birth. A,C,D Which assessment finding(s) is anticipated for a client diagnosed with HSV-II? SATA A. Inguinal lymphadenopathy B. Painless fleshy vulvar or penile lesions C. Dysuria D. Mucopurulent cervical discharge E. Afebrile F. Edema of the affected area A,C,F Which assessment finding is anticipated for a client diagnosed with external genital warts? SATA A. Inguinal lymphadenopathy B. Painless fleshy vulvar or penile lesions C. Dysuria D. Mucopurulent discharge E. Afebrile F. Edema of the affected area B,E Which assessment finding is anticipated for a patient diagnosed with primary syphilis? A. Firm and painless genital unclear B. Mucous patches in the mouth C. Rash over trunk of body D. Muscle weakness and visual changes A Which assessment finding is anticipated for a patient diagnosed with secondary syphilis? SATA A. Gummas B. Mucous patches in the mouth C. Rash over trunk of body D. Muscle weakness and visual changes B,C Which aspects of STI prevention and detection are appropriate to include during nursing education for every sexually active woman, regardless of infection status? SATA A. Methods of contraception that can prevent STIs B. Circumstances in which testing may be necessary C. Diagnostic and screening tests that can help diagnose STIs D. How STI's may impact future childbearing E. Specific signs and symptoms that require medical attention C. A,B,C,E A nurse is teaching a client about abnormal uterine bleeding. The client displays adequate knowledge of this topic when she identifies possible causes of AUB as all of the following except: A. Menopause B. Menarche C. Uterine Infection D. Coagulopathy E. Uterine cancer D AUB is irregular, sometimes heavy, sometimes light, bleeding. HMB is regular, but always heavy, bleeding. Coagulopathy causes HMB A client tells a nurse that her last menstrual periods occurred on Jan1, Feb 28, May 2, and May 18. Her periods are heavy, requiring double protection, and lasting 9-13 days. She has no cramps. Is the client ovulating? A. Yes B. No B Which of the following are most likely to experience AUB? SATA A. Jenny, age 12; began periods 2 months ago. B. Sally, age 24;coming off birth control pills to become pregnant C. Alisha, age 50, with occasional hot flashes and night sweats. A,C Janey has periods as follows: Jan 1, Feb 12, Mar 1, May 15, and June 7. She only needs to change her pad one time per day for her entire period. Is Janey ovulating? A. Yes B. No B Which statement is consistent with the diagnosis of endometriosis? A. Endometriosis is associated with higher incidence of cervical cancer. B. Endometriosis can be diagnosed with a blood test. C. Endometriosis May cause infertility D. Endometriosis is concentrated in the uterus C Which condition is suspected for a 17-year-old female patient who has not had her first period, displays normal growth, and has developed several secondary sex characteristics? A. Primary amenorrhea B. Secondary amenorrhea C. Primary dysmenorrhea D. Secondary dysmenorrhea A Which condition is associated with a 39-year-old woman experiencing secondary dysmenorrhea? A. Premenstrual syndrome B. Menopause C. Uterine cancer D. Endometriosis D Which condition is suspected in a woman with previously regular menstrual cycles who has not had a period for 6 months and is not pregnant? A. Primary amenorrhea B. Secondary amenorrhea C. Primary dysmenorrhea D. Secondary dysmenorrhea B Which findings must be included for the diagnosis of premenstrual syndrome (PMS), according to the American College of Obstetricians and Gynecologists (ACOG, 2015)? SATA A. Symptoms must end within 4 days after menses begins B. Symptoms must include primary dysmenorrhea C. Symptoms must interfere with some of the woman's normal activities. D. The woman's symptoms must be present 5 days before menses begins. E. At least one of the woman's symptoms must be irritability or labile mood. A,C,D A nurse is teaching a client with PMS about interventions which may help this condition. It is evident that the client needs more education when she states: A. I should eat a diet rich in complex carbohydrates, calcium rich foods, and reduce my intake of fat, salt, and sugar. B. I should consider moderately increasing my caffeine intake to help with fatigue. C. I should eat 6 small meals per day D. Regular aerobic exercise may lessen my PMS symptoms. B A nurse is educating a pregnant client about kick counts. The client demonstrates a need for additional teaching when she states: A. I should begin kick counts at 24 weeks gestation. B. There are a lot of different ways to do kick counts. C. It is normal for babies to love less as they approach term D. I may need a non-stress test if I feel fewer than 3 movements in one hour. C A nurse is leaning about the use of ultrasonography in pregnancy. The nurse had a good understanding of the use of third trimester uses for ultrasonography when he identifies all of the following uses except: A. Determine placental position B. Evaluation of the fetus' other structures during chorionic villus sampling C. Detect congenital abnormalities D. Determine fetal position B A client asks the nurse about my Hal translucency screening. The nurse is correct when she identifies this as: SATA A. an ultrasound measurement of the fluid at the nape of the fetal neck B. Performer between 20-24 weeks gestation C. Identifies increased risk of Trisomy 13, 18, and 21 D. 3mm is considered abnormal A,C,D Which of the following is NOT a maternal or fetal indication for antepartal testing? A. Chronic hypertension B. Post-term pregnancy C. Decreased fetal movement D. Preterm pre-labor rupture of membranes E. Increased fetal activity E All of the following are included in a biophysical profile except: A. Doppler blood flow analysis of the umbilical artery B. Ultrasound measurement of amniotic fluid volume C. Ultrasound evaluation of fetal movements D. Ultrasound determination of fetal tone E. Fetal heart rate reactivity as measured by non-stress test. F. Ultrasound evaluation of fetal breathing movements A Each measurement can get a score of 2 or zero. A score = 8/10 is NORMAL. Less than 8, suspect chronic asphyxia. A nurse is educating a client about amniocentesis. Which of the following statements indicates a need for additional education of the client about this procedure? A. In amniocentesis a needle is passed through the cervix under ultrasonic visualization so a small amount of amniotic fluid can be withdrawn. B. It is possible to perform amniocentesis after 10 weeks gestation. C. It is used to diagnose fetal genetic diseases and fetal lung maturity D. Complications in the mother or fetus from this procedure are rare B It is possible to perform amniocentesis after 14 weeks gestation when the uterus is a pelvic organ and enough amniotic fluid has developed A nurse is educating a client about chorionic villus sampling (CVS). Which of the following statements indicates a need for additional education of the client about this procedure? A. CVS can be performed in the 1st or 2nd trimester, ideally between 10-13 weeks gestation. B. CVS can be done transcervically or transabdominally. C. It takes a small sample of the placenta to evaluate fetal DNA. D. The pregnancy loss rate is 2 times higher with CVS compared to amniocentesis. D The pregnancy loss rate of CVS and amino are EQUAL A nurse is educating a client about Percutaneous Umbilical Blood Sampling (PUBS). Which of the following statements indicates a need for additional education of the client about this procedure? A. PUBS is also known as Cordocentesis. B. PUBS may be conducted in all trimesters C. PUBS can be used for fetal blood sampling or fetal transfusion. D. CVS has replaced PUBS in many centers because improvements in diagnostic testing no longer require fetal blood. B PUBS may be conducted in only the 2nd and 3rd trimesters Which of the following statements regarding maternal serum alpha-fetoprotein (MSAFP) tests is false? A. MSAFP is used as a screening tool for chromosomal abnormalities in pregnancy. B. MSAFP screening should occur between 15-20 weeks gestation, ideally between 16-18 weeks. C. If MSAFP levels are elevated, the next step is a Level III ultrasound. D. Inaccurate EDC, multifetal pregnancy, and inaccurately recorded maternal age, race, weight, and presence of IDDM can cause false positive results on the MSAFP. A MSAFP is used as a screening tool for neural tube defects in pregnancy Which of the following statements regarding the Coombs tests are true? SATA A. The Coombs test is for Rh incompatibility B. The indirect Coombs test is a test of the mother's blood; the direct Coombs test is a test of the newborn baby's or fetal blood. C. If the maternal Coombs test is positive, it will give a tiger for Rh antibodies in the maternal blood. A tiger of 1:8 indicates a need for fetal evaluation. D. Fetal middle cerebral artery Doppler flow studies are used to determine the severity of fetal hemolytic anemia. All of the above The nurse is teaching a prenatal client about cell-free DNA (cf-DNA) screening of maternal blood. Which of the following statements indicates a need for additional education of the client about this test? A. cf-DNA testing is a screening test for fetal aneuploidy. B. It is a non-invasive prenatal test (NIPT) that requires a maternal blood sample between 10-12 weeks gestation. C. The detection accuracy of cf-DNA is 99% for trisomy 21 and 18, and 80% for trisomy 13 D. This test is now offered to all pregnant women. D Test is only offered to women who are at greater risk of chromosomal abnormalities: age 35, abnormal MSAFP, abnormal U/S screens. Less accurate in obese women. Reactive non stress test 2 accelerations in a 20 minute period, each lasting at least 15 seconds and peaking at least 15 bpm above the baseline. Before 32 weeks gestation an acceleration is defined as lasting at least 10 seconds and peaking at least 10 non above the baseline. Non reactive to stress test A test that does not demonstrate 2 20-second accelerations in a 20-min period. Which of the following statements about the contraction stress test (CST) (oxytocin challenge test) is false? A. The CST provides an earlier warning of fetal compromise than the NST and produces fewer false positives. B. It should not be performed on women for whom labor is contraindicated at the time the test is done C. The CST may occur via nipple stimulation or through the IV administration of oxytocin D. CST results are reported as reactive, non reactive, suspicious, or equivocal. D A nurse is administering a magnesium sulfate bonus to client diagnosed with pre-eclampsia at 32 weeks. Which finding(s) are expected at this time? SATA A. DTRs will decrease and clonus will resolve in 15 minutes. B. Nausea and vomiting. C. Decrease in blood pressure by about 20%. D. Flushing and feeling hot E. Increase in uterine output F. The nurse informs the client that he will return in 15 minutes. B, D In order to be eligible to discharge home with a diagnosis of pre-eclampsia, the client must meet all of the following criteria except? A. Have access to reliable transportation and phone B. The last seizure was 24 hours ago C. Be able to perform and monitor kick counts D. Be able to monitor weight and blood pressure and return if symptoms worsen B A client diagnosed with pre-eclampsia receiving mag. sulfate at 2 grams/hour exhibits the following trending data. What is the nursing priority? 2 hours ago: BP 144/85, DTR/Clonus 3+, No HA/Scotoma/Epigastric pain, urine output 200ml 1 hour ago: BP 155/82, DTR/Clonus 2+/1BB, client reports scotoma and a H/A Tylenol administered with RUQ pain, urine output 150ml Now: BP 138/70, DTR/Clonus 3+/2BB, client reports increased pain level with H/A and has scotoma with RUQ pain, urine output 100ml A. Discontinue mag. sulfate B. Send a serum mag. level C. Notify HCP and recommend a 1-gram bonus of mag. and increase the hourly rate to 2.5 gram/hour D. Notify the HCP and recommend decreasing the hourly rate of mag. to 1 gram/hour C A client has been diagnosed with severe pre-eclampsia at 29 weeks. The client is admitted for delivery. The SVE is 3cm/70/-2. Which orders and nursing interventions are appropriate for this client? SATA A. Foley catheter B. Magnesium bolts 6 grams over 30 minutes C. Celestine/ Betamethasone 12 mg IM now and repeat in 24 hours. D. Continuous FHR monitoring E. Type and hold, hemoglobin (CBC), OB panel, and magnesium level. F. Artificial rupture of membranes B,D,E A nurse is monitoring a client's DTR's who has been on magnesium sulfate for 12 hours. Which finding is expected? A. Bilateral DTR's noted as 2+/0 B. Bilateral DTR's noted as 4+/2 beats of bilateral Clonus C. Client reports pain and soreness during the DTR exam D. Clonus is elicited when the DTR's are assessed A The priority intervention for a client experiencing magnesium toxicity is A. Administer calcium gluconate B. Notify the HCP C. Discontinue the magnesium sulfate D. Use an ammonia capsule under the client's nostrils C Which finding is most concerning if exhibited by a client diagnosed with preeclampsia at 30 weeks gestation? A. Heartburn with nausea and vomiting, client denies RUQ pain B. BP ranging from 130-150s/70-90s C. DTR's 3+/0 Clonus D. Fundal height measurement of 24cm for the last two weeks D A nurse is caring for a pre-eclampsia postpartum client receiving magnesium sulfate at 2 gram/hour. A Foley catheter is in place. The nurse evaluated the clients findings below and contacts the HCP. What is the priority recommendation or action in this scenario? Delivery (2 hours ago): BP 155/80, protein dip 1+, serum mag level 5.4, DTR's 2+, Client denies x2, reports a frontal headache at 5/10: Tylenol administered, urine output 50ml One hour ago: BP 148/78, protein dip 1+, serum mag level not done, DTR's 1+, client reports headache as a 3/10, urine output 75ml Now: BP 145/82, protein dip 1+, serum mag level not done, DTR's 1+, client denies headache/scotoma/epigastric pain x3, urine output 100ml A. Discontinue the magnesium and continue to monitor the client B. Leave the magnesium at the prescribed rate and continue to monitor the client C. Recommend that the continuous IVF be decreased to 50 ml/hour D. Discontinue B Are there any complications for the mother and baby as a result exposure to pre-eclampsia and/or magnesium sulfate? SATA A. "This is not a concern, we have caught the disease before it had an opportunity to cause long term problems." B. "Infants who are exposed to Magnesium sulfate during pregnancy are more likely to develop cerebral palsy." C. "All women who are exposed to pre-eclampsia are more likely to experience Diabetes Mellitus in the future." D. "Pre-eclampsia increase your risk for developing chronic HTN and CVD." E. "Mag sulfate exposure during pregnancy can lead to spasticity of muscles and contractions." D A nurse is caring for a client who is being induced with preeclampsia. What finding supports the placement of a Foley catheter? A. The clients DTRs are 1+/0 Clonus and the client reports feeling weak. B. The client's total urine output over the last 8 hours was 175ml C. The magnesium protocol requires that the client not ambulate D. The client needs assistance with getting on the bedpan every 2-3 hours. B A client begins to experience an eclampsia seizure. What is the nursing priority? A. Administer Valium (diazepam) IV B. Suction the client's PO secretions C. Place the client on the external fetal monitor D. Protect the client's head and displace her uterus to the left D A 25-year-old client is admitted at 12 weeks gestation for vaginal bleeding, no fetal heartbeat is seen on ultrasound. The client is experiencing what type of loss and what is an appropriate treatment? A. Incompetent cervix, cer late placement B. Missed abortion, amniocentesis C. Inevitable abortion, dilation and curettage D. Incomplete abortion, cytotec (misoprostil) induction C A client is one-hour status post dilation and curettage. Which finding would warrant immediate assessment and intervention? A. The client reports uterine pain as a 4 on a numeric 0-10 scale B. Half of the peri pad is saturated with bright red blood. C. BP is 108/68 and pulse is 88 D. The client reports extreme sadness over the situation and crying silently B A pregnant woman is being discharged from the hospital after placement of cer late due to a history of recurrent pregnancy loss secondary to an incompetent cervix. Discharge teaching should emphasize that: A. She will need to make arrangements so that she can be on strict bed rest at home. B. She will need to deliver via C-section C. The patient will be placed on antibiotics throughout the remainder of her pregnancy D. The presence of any uterine cramping or low back pain should reported to her health provider D A client at 14 weeks is status post cer large placement in the recovery room. Which finding is most concerning? A. Temperature of 97.6 and the client reports feeling cold B. The fetal heart rate is 125 and the client denies feeling any movement C. The client reports some mild lower abdominal cramping D. There is a 1cm size spot of pinkish-red discharge on her pad. C A woman G40210 is admitted at 12 weeks gestation for cer late placement. Which of the following long-term outcomes is appropriate for this patient? A. The patient will gain less than 25 pounds during the pregnancy. B. The baby will be classified as appropriate for gestational age at birth. C. The patient will deliver as close to term as possible D. The patient will now have a normal pregnancy. C The nurse is discharging a client after delivery and resolution of a molar pregnancy. The most important aspect teaching to impart to this client is: A. Avoid conception/pregnancy for 3-6 months B. Using sunscreen while taking Doxycycline/Targadox C. Follow-up with an ultrasound in 6 months D. Follow-up with serial lab values weekly D A woman has been diagnosed with ruptured ectopic pregnancy. What is priority? A. Administer Methotrexate IM B. Bills the intravenous line with 500-1000ml of crystal loud fluid C. Assess the abdomen for a Cullen sign D. Perform orthostatic signs B Crystal loud solutions are mainly used to increase the intravascular volume when it is reduced. The reduction could be caused by hemorrhage, dehydration or loss of fluid during surgery. The most frequently used crystalloid fluid is sodium chloride 0.9% (normal saline 0.9%). A patient at 18 weeks gestation has been diagnosed with gestational trophoblastic disease. In addition to vaginal bleeding, what symptom would the nurse expect to see? A. Sever unilateral pain B. Hypermedia gravidarum C. Fetal heart tones via D. Chronic HTN B A client has received methotrexate IM for resolution of ectopic pregnancy. What is the most important follow-up information to impart to this client? A. If you experience sharp unilateral abdominal pain pain, seek medical care immediately B. Be a certain to avoid pregnancy for a year by taking oral contraceptives. C. Be sure to consume a balanced diet with no restrictions. D. Take your prenatal vitamins and iron for 6 weeks A A patient is admitted to the labor and delivery unit with vaginal bleeding. To differentiate between placenta previa and placental abruption, the nurse will assess? A. Abdominal pain B. Fetal heart rate pattern C. Pad counts D. Hgb and Hct counts A There are many associated risk factors in the development of placenta previa. SATA A. Jogger with low BMI B. First time mother who smokes 2PPD C. Registers nurse who works 3 busy 12 hour shifts a week on a med-surf floor. D. A client who delivered at 32 weeks SVD with her last pregnancy due to pre-eclampsia E. Client pregnant with triplets F. A client who has a history of two previous C-sec B,E,F Risk Factors for previa Previous C/section, maternal age 35 years, multiparity, smoking, prior suction cruettage, previous hx. placenta previa, induced abortion Risk factors for placental abruption HTN, cocaine use, blunt force trauma (MVA, Domestic Violence), smoking, previous hx abruption, preterm ROM, multiple gestation A client at 24 weeks of gestation is admitted to the emergency department after sustaining severe internal injuries during a MVA. The nurse suspects internal bleeding and placental abruption. The suspicion is supported by which finding? A. Early decelerations are noted on the EFM B. Kleihauer Berkeley is positive C. Late decelerations are noted on the EFM D. The BP was 110/58 an hour ago and is now 108/56 C Which of the following signs/symptoms would the nurse expect to see in the woman with placental abruption? A. Pain-free vaginal bleeding B. Increasing abdominal girth C. Fetal heart rate accelerations D. BP 110/60, pulse 80 B A client is in labor with a diagnosis of HELLP and DIC. The nurse notes the PT and PTT times are prolonged. Fibrinogen is decreased. What symptom will the nurse expect to see in this client. A. Variable decelerations B. Petechiae C. Positive Cullen sign D. Patellar reflexes 2+/0 Clonus B In order to be eligible to be discharged home with a diagnosis of placenta previa at 28 weeks gestation, the client must meet all of the following criteria. SATA A. Biophysical profile score 8/8 B. NST appropriate for gestational age C. There is a 3cm area of bright red blood on the peri pad D. The hemoglobin and hematocrit are stable E. The client reports mild pain with her F. The client has access to reliable transportation and a telephone A,B,D,F A nurse is evaluating the findings below on a client at 30 weeks diagnosed with a 10% placental abruption who is receiving magnesium sulfate at 2 gram/hour. The HCP is notified. What is the priority recommendation? 2 hours ago: BP 100/48, P 88, RR 18, Temp 98.6, FHR 135 reactive no decels, contractions occasional mild to palpation, DTR 2+, pad count none, pain 3/10 1 hour ago: BP 102/50, P 92, RR 16, Temp 98.2, FHR 140 reactive no decels, contractions 2 (mild to palpation), DTR 1+, pad count 2cm brown spot, pain 2/10 Now: BP 101/49, P 94, RR 17, Temp 98.9, FHR 145 non-reactive no decels, contractions every 10 mins moderate palpation, DTR 1+, pad count 3cm pinkish-red spot, pain 6/10 A. Come and evaluate the client B. Increase the magnesium C. Administer 0.25 mg of SQ terbutaline D. Send labs for a coomb's tiger and blood cultures A Nurse knows this is a 10% abruption by the amount of clot covering the placenta after birth A patient presents to the emergency department c/o abdominal discomfort. The obstetrician performs an ultrasound and diagnoses a 10-week fetus with positive heart tones located in the ampulla region of the Fallopian tube. The nurse understands that the best plan of care for this patient is: A. Surgical removal of the pregnancy B. Dilation and curettage procedure C. Methotrexate administration. D. Dilation and extraction procedure A How is medical management determined for the patient experiencing a miscarriage Medical management and/or surgery depends on classification of miscarriage. Threatened, inevitable, incomplete, complete, missed What discharge instructions are paramount after a miscarriage/dilation and curettage procedure? No tub baths or tampons for 2 weeks, monitor for S&S of infection, eat foods high in iron and protein, refer to support group if appropriate How would a patient with cervical insufficiency present? Early dilation of the cervical os, prolapsing fetal membranes, abnormally short cervix, loss usually occurs around 16 weeks What are the nursing considerations concerning a cer package patient? Monitor for PTL, SROM, infection. Amount of activity determined by HCP What should nurses impart to the patient with a prophylactic cerclage? Placed at 12-14 weeks to prevent premature cerclage dilation. Removed at 36 weeks. What should the nurse impart to the patient with emergency cerclage? Rescue cerclage placed between 14-23 weeks for women with s/s of cervical insufficiency, removed at 36 weeks What is a molar (AKA hydatidiform mole) pregnancy? Chorionic villi of placenta develop into transparent grape-like vesicles from an abnormally fertilized egg. Usually no fetus present. In a complete molar pregnancy, an empty egg is fertilized by one or two sperm, and all of the genetic material is from the father. In this situation, the chromosomes from the mother's egg are lost or inactivated and the father's chromosomes are duplicated. In a partial or incomplete molar pregnancy, the mother's chromosomes remain but the father provided two sets of chromosomes. As a result, the embryo has 69 chromosomes instead of 46. This most often occurs when two sperm fertilize an egg, resulting in an extra copy of the father's genetic material. What is the follow up for patients s/p delivery of a molar (gestational trophoblastic disease) pregnancy? Follows with serial hCG levels, asked to avoid pregnancy for a year Why is follow-up for delivery of molar pregnancy so important? These patients have a higher risk of developing choiriocarcinoma (CC). CC creates high hCG levels, monitor for rising levels. Difficult to distinguish CC in presence of pregnancy since rising hCG levels of pregnancy may mask CC. How do patients with ectopic pregnancy present? Pain, bleeding, + pregnancy test, menses may be delayed How do we medically manage ectopic pregnancy? DX with quant hCG and U/S, methotrexate = 6 weeks (unruptured mall mass, 3.5cm), salpingostomy/salpingectomy (if tubal) 6 weeks What are the nursing considerations concerning methotrexate administration? •hemodynamically stable •normal LFTs & kidney function •serial hCG levels until undetectable (up to 6 weeks) •RhoGAM prn When is a patient with a placenta previa considered stable enough to be discharged home? When condition is stable; no bleeding for 48 hours; able to be on BR w/BRP at home; live within a short distance of the hospital; have constant access to transportation; and verbalize understanding of risks associated w/placenta previa. Normal BPP/NST How would a patient with placental abruption present? Sudden onset intense, localized uterine pain, with or without vaginal bleeding. How would the contraction pattern of a placental abruption appear? As the myometrium becomes engorged with blood the contractions become irregular and eventually stop. FHR tracings? What are the nursing actions? Late decels, UNCOIL What does UNCOIL stand for? U Ndo what you're doing Change position Oxygen on, oxytocin off IV fluids Lower head How is DIC (Disseminated Intravascular Coagulation) likely to present? Premature separation of the placenta causes a massive increase in thrombin to create a clot at the placental bleeding site as the body tries to stop the bleeding. Increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive and massive bleeding. May see bruising, petechiae, vaginal bleeding What is the significance of a Cullen sign? When is the Cullen sign likely to present? A Cullen sign is a hemorrhagic discoloration of the umbilical area due to intraperitoneal hemorrhage from any cause. It appears after abruption, pancreatitis Abruption symptoms Bleeding: absent-moderate Color: dark red Coagulapathy: none to frequent DIC Uterine tonicity: normal to "board-like" Pain: absent to agonizing Shock: none-profound Previa Bleeding: minimal to life-threatening Color: bright red Coagulapathy: none Uterine tonicity: normal Pain: absent Shock: uncommon the nurse is teaching a bottle-feeding mother how to manage engorgement when she gets home. which of the following statements indicates a lack of understanding by the mother on this topic running warm water over my breasts or expressing milk will help if my breasts get overly full reliable indicators of impending shock from early postpartum hemorrhage include all of the following EXCEPT blood pressure if a postpartum woman complains of extreme perineal pain, especially after having received pain medication, the FIRST action by the nurse should be assess the perineum upon examining a patient on day 2 after spontaneous vaginal delivery, a nurse finds the perineal pad to be completely saturated with bright red blood over the last 15 minutes. the priority in this scenario is massage the fundus blood loss of delivery is replenished by all of the following EXCEPT reduction of intravascular fluid through dehydration in labor which of the following information regarding postpartum women's bladder and bowel patterns is FALSE rectal suppositories and enemas may be safely used by all clients in the postpartum period which of the following types of birth control are contraindicated after hospital discharge for the breastfeeding mother in the early postpartum period oral contraceptives, mirena IUD the nurse recognizes all of the following PP changes are normal EXCEPT WBC of 40,000/mm^3 the nurse is teaching a postpartum mother about skin changes in the postpartum period. the nurse recognizes the mother needs additional teaching when the mother states i will have some hair loss for the first 12 months postpartum which postpartum clients require Rhogam mother who is A- infant is A+, mother who is AB- infant is unknown and father is B-, mother who is B- status post miscarriage at 8 weeks a nurse receives report on four mother and baby couplets. which client should the nurse assess first a mother who calls out stating that an employee without the MBU ID badge is going to take her newborn for an X ray with the completion of the THIRD stage of labor and beginning of the FOURTH stage, there are many necessary nursing interventions. SATA massage the fundus, assist the mother with breastfeeding, administer IV oxytocin/pitocin rapidly per institution protocol related to uterine involution, the nurse recognizes all of the following statements are true EXCEPT the uterus should not be palpable abdominally after 2 days a nurse is caring for a postpartum client. she notices the mother saying to the father, "she has your beautiful eyes" this is a specific example of which of the following claiming a couple is concerned that their four year old infant will have problems once their new baby delivers in 6 weeks. what is the best recommendation for this couple encourage the parents to take their 4 year old to sibling classes a nursery nurse is caring for a newborn infant. she has just bathed a baby boy who is laying quietly under the warmer. the nurse uses an animated, high pitched voice and softly says, "what a big boy you are! you are so handsome! and so strong! arent you just a cutie pie!" as she says this, the baby's eyes widen, his head turns towards her voice, and his arms and legs begin actively moving. this is an example of entrainment a client is 6 hours postpartum. in an ideal world, what should nursing care focus on at this time - using reva rubin's theory as a guide providing pain medication, encouraging rest, and keeping the mother clean, dry, and comfortable which of the following is not a maternal or fetal indication for antepartal testing increased fetal activity a nurse is educating a pregnant client about kick counts. the client demonstrates a need for additional teaching when she states it is normal for babies to move less as they approach term a nurse is learning about the use of the ultrasonography in pregnancy. the nurse has a good understanding of the use of first trimester uses for ultrasonography when he identifies all of the following except visualization of the fetus and other structures during amniocentesis a nurse is learning about the use of ultrasonography in pregnancy. the nurse has a good understanding of the use of third trimester uses for ultrasonography when he identifies all of the following except visualization of the fetus other structures during chorionic villus sampling a client asks the nurse about nuchal translucency screening. the nurse is correct when she identifies this as an ultrasound measurement of the fluid at the nape of the fetal neck, identifies increased risk of trisomy 13/18/21, 3mm is considered abnormal all of the following are included in a biophysical profile except doppler blood flow analysis of the umbilical artery a nurse is educating a client about amniocentesis. which of the following statements indicates a need for additional education of the client about this procedure in amniocentesis, a needle is passed through the cervix under ultrasonic visualization so a small amount of amniotic fluid can be withdrawn, it is possible to perform amniocentesis after 10 weeks gestation (after 14 weeks when uterus is pelvic organ) a nurse is educating a client about chorionic villus sampling. which of the following statements indicates a need for additional education of the client about this procedure the pregnancy loss rate is 2 times higher with CVS compared to amniocentesis a nurse is educating a client about percutaneous umbilical blood sampling. which of the following statements indicates a need for additional education of the client about this procedure PUBS may be conducted in all trimesters (only 2nd and 3rd) which of the following statements regarding maternal serum alpha fetoprotein tests is false MSAFP is used as a screening tool for chromosomal abnormalities in pregnancy which of the following statements regarding the coombs test are true the coombs test is a test for Rh incompatibility, the indirect coombs test is a test of the mothers blood and the direct coombs test is a test of the newborn baby's or fetal blood, if the maternal coombs test is positive it will give a titer for Rh antibodies in the maternal blood (1:8 indicates need for fetal evaluation), fetal middle cerebral artery doppler flow studies are used to determine the severity of fetal hemolytic anemia the nurse is teaching a prenatal client about cell-free DNA screening of maternal blood. which of the following statements indicates a need for additional education of the client about this test this test is now offered to all pregnant women which of the following statements about the contraction stress test is false CST results are reactive, nonreactive, suspicious, or equivocal a pregnant mother's blood type is A-. the father of the baby's blood type is B+. what is the likelihood that her infant will be Rh factor +? Rh- factor is autosomal recessive (dd) and Rh+ is homozygous autosomal dominant (DD) 100% chance the infant will be Rh+ all cases of full monosomy are lethal except turner syndrome which statement most accurately describes dominant genetic disorders the risk factor remains the same no matter how many affected children are already in the family a client asks the nurse "did my baby inherit his cleft palate and cleft lip from me? no one in my family has ever had this" the best response by the nurse is most of the common malformations that babies are born with - like cleft palate and cleft lip - result from a combination of genetic and environmental factors after completing all of the BUBBLEHER assessments and noting that all are WDL, the nurse reviews the laboratory findings on the postpartum mother. (H&H are low) what is the priority in this scenario? assess the client's orthostatic vital signs after completing all of the assessments on a postpartum client and noting that all were WDL, the nurse reviews the laboratory findings on a client. orthostatic BP and P are performed and no changes are noted. (H&H still low) what is the priority in this scenario push fluids by mouth and notify the HCP a nurse assesses a formula feeding client's breast on day 4 post cesarean section. the breasts are firm and warm to touch. what is the priority in this scenario apply cold compresses to the breast and axillae areas after completing the BUBBLEHER assessments and noting that all are WDL, the nurse reviews the laboratory findings on the postpartum cesarean section mother. (H&H still low) the nurse then assesses orthostatic vital signs and notes a 20% increase in pulse and 20% decrease in BP. the client becomes dizzy and nauseated. the client is placed back in the bed. the HCP is notified. what is the priority in this scenario recommend the client be cross-matched for 2 units of RBCs, bolus the client with 500 mL of normal saline, administer an IV antiemetic with the completion of the third stage of labor/beginning of the fourth stage, there are many necessary nursing interventions. SATA massage the fundus, assist the mother with breastfeeding, administer IV oxytocin/pitocin rapidly per institution protocol a nurse is estimating blood loss on a postpartum client. the scale reads 1.8 kg with a saturated pad and chux. the dry weight of the pad and chux is 300 g. what is the blood loss in mL which of the following findings indicates respiratory distress in the newborn when all are present simultaneously respiratory rate 70, intercostal retractions, grunting, nasal flaring a 2 day old infant's blood values are blood type O-, negative direct Coomb's titer, glucose level 45, bilirubin 8.5mg/dL. the mother's blood type is A+ what is the nursing priority continue to monitor a nurse notes that an infant has cyanotic hands and feet 8 hours after birth. which of the following actions is most appropriate place the infant in the crib at birth, what are the priorities for the healthy term newborn directly after delivery dry the infant off, apgar scores at 1 and 5 minutes, stimulate the infant by stroking the feet, place the infant on the mother's chest for skin to skin which of the following assessments would alert the nurse hyperbilirubinemia is at a critical state in a term infant bilirubin level of 14, 2 hours after delivery what is the rationale for vitamin K administration in newborns the neonatal gut is sterile at birth and inadequate in synthesizing vitamin K view the findings below (temp 97.3, glucose 42, jitteriness in hands). what is the priority for this newborn place the infant under the radiant warmer which infants would require that a circumcision should be delayed infant born at 32 weeks, term infant with ambiguous genitalia, term infant with a hypospadias, term infant with an epispadias what are some risks for neonatal hyperbilirubinemia Rh sensitization, poor feeding, cephalohematoma, prematurity a nurse is visiting a breastfeeding client at home 2 weeks post-delivery of a full-term infant boy via cesarean section. the lochia is serosa with a midline fundus palpated as firm in the symphysis pubis area. her nipples are cracked. the client is crying and reports her uterine cramping and nipple pain as a 6 out of 10. the infant begins to cry and the client yells at the baby and throws a toy at the window. what is the nursing priority in this scenario perform a head to toe assessment on the newborn what information should a nurse include when teaching post circumcision care to parents of a neonate before discharge from the hospital the neonate must void before being discharged home, petroleum jelly should be applied to the glans of the penis with each diaper change, the circumcision will require care for 2-4 days after discharge after completing the ballard assessment, the nurse determine that the infant's weight is at the 95%, height at the 85%, and head circumference at the 50%. based on this the nurse would classify the infant as AGA which criteria best fits the criteria for having a dubowitz/gestational age assessment/ballard exam and will provide the most accurate examination a 39 week baby at 3 hours post birth a newborn infant's gestatinoal age assessment is as follows: length at 40%, head circumference at 85%, and weight at 30%. what is the most accurate classification of this infant AGA, asymmetrical growth erythromycin eye ointment is administered to newborns within 1-2 hours of delivery in order to... prevent conjunctivitis, prevent complications associated with gonorrhea, prevent neonatal blindness a nurse is teaching new parents about signs of infection in newborns and young infants. the nurse recognizes more teaching is needed when the parents identify which of the following temperature 101F newborns in open bassinets are wrapped in blankets, and their heads covered in caps, to prevent heat loss by ___ which is loss of body heat to cooler ambient air convection which of the following statements regarding newborn vital signs are FALSE body temperature is evaluated by electronic thermometer using the rectum a baby is born at 36 2/7 weeks gestation. how should this infant be classified late preterm a baby is born at 41 2/7 weeks gestation. how should this infant be classified late term the nurse is teaching a new mother about physiologic jaundice. which statement by the mother indicates a need for additional teaching physiologic jaundice occurs within 24 hours after birth nursing care of the infant receiving phototherapy includes all of the following except dressing the baby in only a diaper, short-sleeve shirt, and mask to cover the baby's eyes which of the following is least at risk for hypoglycemia infant born by repeat c/section which vaccine does the newborn receive before discharge hepatitis B which of the following statements about infant feeding is false breast milk contains all vitamins required for infant nutrition; vitamin d is added to formula which of the following statements are true regarding colostrum it is high in protein/vitamins/minerals, colostrum helps protect the newborns GI tract from infection, colostrum provides a laxative effect that speeds the passage of meconium a nurse is educating bottle-feeding parents about cow's milk based formula. the nurse recognizes the need for more parent education when the parents state cow's milk based formulas should be used in infants with food protein intolerances which of the following factors have been found to influence the decision to breastfeed support and encouragement from family and friends, prenatal education for family members about breastfeeding, support from health care providers advantages of breastfeeding include all of the following except reduced risk of hypertension and kidney disease which of the following statements regarding sexually transmitted infections are true the risk of a woman contracting gonorrhea from a single act of intercourse is 60-90% in men, compared to 20-30% in men; men are 2-3 times more likely to transmit HIV to women than are women to men; more than 50% of bacterial STIs and 90% of viral STIs are asymptomatic in women and therefore unlikely to be detected without testing which sexually transmitted infection is the most commonly reported in the United States, according to the CDC human papilloma virus which sexually transmitted infection is the most commonly reported bacterial STI in the united states, according to the CDC chlamydia the most common symptom associated with chlamydia in women is no symptoms which nursing instruction is appropriate for a woman who has completed half of the prescribed course of antibiotics to treat a chlamydial infection who reports being completely asymptomatic you must take all of the prescribed medication, even if you no longer have symptoms a nurse is teaching an 18 year old client with her 2nd STI in 6 months about treatment and screening. the nurse recognizes the need for additional teaching when the client states i will be screened annually for STIs the most common symptom associated with gonorrhea in women is no symptoms a nurse is doing a bimanual exam on a client during a physical exam. her period ended 1 week ago. the client is very uncomfortable when the nurse gently moves her cervix from side to side during the exam. the client says "well I just finished my period a week ago." what should the nurse do next report symptoms to the health care provider immediately which of the following statements about genital herpes (HSV-II) are true most infections are transmitted by people who don't know they are infected; HSV-II cannot be cured; newborn babies can die from unintentional exposure to and infection by HSV during birth which assessment finding is anticipated for a client diagnosed with HSV-II inguinal lymphadenopathy, dysuria, edema of the affected area which assessment finding is anticipated for a client diagnosed with external genital warts painless fleshy vulvar or penile lesions, which assessment finding is anticipated for a patient diagnosed with primary syphilis firm and painless genital ulcer which assessment finding is anticipated for a patient diagnosed with secondary syphilis mucous patches in the mouth, rash over trunk of body which aspects of sexually transmitted infection prevention and detection are appropriate to include during nursing education for every sexually active woman, regardless of infection status methods of contraception that can prevent STIs, circumstances in which testing may be necessary, diagnostic and screening tests that can help diagnose STIs, specific signs and symptoms that require medical attention a nurse is teaching a client about abnormal uterine bleeding. the client displays adequate knowledge of this topic when she identifies possible causes of AUB as all of the following except coagulopathy a client tells a nurse that her last menstrual periods occurred on Jan 1, Feb 28, May 2, and May 18. her periods are heavy, requiring double protection, and lasting 9-13 days. she has no cramps. is the client ovulating no which of the following are most likely to experience AUB jenny age 12 began periods 2 months ago; alisha age 50 with occasional hot flashes and night sweats janey has periods as follows: Jan 1, Feb 12, Mar 1, May 15, and June 7. she only needs to change her pad one time per day for her entire period. is janey ovulating no which statement is consistent with the diagnosis of endometriosis endometriosis may cause infertility which condition is suspected for a 17 year old female patient who has not had her first period, displays normal growth, and has developed several secondary sex characteristics primary amenorrhea which condition is associated with a 39 year old woman experiencing secondary dysmenorrhea endometriosis which condition is suspected in a woman with previously regular menstrual cycle