. A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have:

The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a positive sign of pregnancy is:

During a patient’s physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:

The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply.)

The multiple marker test is used to assess the fetus for which condition?

Which nutritional recommendation about fluids is accurate?

Which minerals and vitamins usually are recommended to supplement a pregnant woman’s diet?

A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time?

The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool would be useful in confirming the diagnosis?

A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus?

A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be:

In comparing the abdominal and transvaginal methods of ultrasound examination, nurses should explain to their patients that:

The nurse providing care for the antepartum woman should understand that contraction stress test (CST):

Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring patient with diabetes mellitus, the nurse is aware that she is at a greater risk for:

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?

The nurse recognizes that a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is:

Intrauterine growth restriction (IUGR) is associated with numerous pregnancy-related risk factors. (Select all that apply.)

A laboring woman received an opioid agonist (meperidine) intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate?

A woman in labor has just received an epidural block. The most important nursing intervention is to:

The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is:

Which method of pain management is safest for a gravida 3 para 2 admitted at 8 cm cervical dilation?

Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could you use to raise the patient’s blood pressure? (Select all that apply.)

While developing an intrapartum care plan for the patient in early labor, it is important that the nurse recognize that psychosocial factors may influence a woman’s experience of pain. These include: (Select all that apply.)

he nurse caring for the laboring woman should understand that early decelerations are caused by:

The nurse providing care for the laboring woman realizes that variable fetal heart rate (FHR) decelerations are caused by:

The nurse providing care for the laboring woman should understand that late fetal heart rate (FHR) decelerations are the result of:

The most common cause of decreased variability in the fetal heart rate (FHR) that lasts 30 minutes or less is:

During labor a fetus with an average heart rate of 135 beats/min over a 10-minute period would be considered to have:

A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-lb, 7-ounce boy after augmentation of labor with Pitocin. She puts on her call light and asks for her nurse right away, stating, “I’m bleeding a lot.” The most likely cause of after birth hemorrhage in this woman is:

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse’s first action is to:

If a woman is at risk for thrombus and is not ready to ambulate, nurses may intervene by performing a number of interventions. Which intervention should the nurse avoid?

As relates to rubella and Rh issues, nurses should be aware that:

Rho immune globulin will be ordered after birth if which situation occurs?

The nurse caring for the after birth woman understands that breast engorgement is caused by:

Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early after birth period is:

A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this woman’s fundus?

A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would the nurse expect to find when assessing this woman?

A woman gave birth to a 7-lb, 3-ounce infant boy 2 hours ago. The nurse determines that the woman’s bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate after birth period, the most serious consequence likely to occur from bladder distention is:

With regard to the after birth uterus, nurses should be aware that:

Which finding 12 hours after birth requires further assessment?

The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:

When a woman is diagnosed with postpartum depression (PPD) with psychotic features, one of the main concerns is that she may:

To provide adequate after birth care, the nurse should be aware that postpartum depression (PPD) without psychotic features:

To provide adequate after birth care, the nurse should be aware that postpartum depression (PPD) with psychotic features:

A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:

Which condition is a transient, self-limiting mood disorder that affects new mothers after childbirth?

Medications used to manage postpartum hemorrhage (PPH) include: (Select all that apply.)

A woman gave birth to a healthy 7-lb, 13-ounce infant girl. The nurse suggests that the woman place the infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is effective during the first 30 minutes after birth because this is the:

A patient is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on “high.” The nurse instructs the mother that the fan should not be directed toward the newborn and the newborn should be wrapped in a blanket. The mother asks why. The nurse’s best response is:

In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is:

What are modes of heat loss in the newborn? (Select all that apply.)

A newborn is jaundiced and receiving phototherapy via ultraviolet bank lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method would be to:

The nurse’s initial action when caring for an infant with a slightly decreased temperature is to:

In the classification of newborns by gestational age and birth weight, the appropriate for gestational age (AGA) weight would:

The nurse administers vitamin K to the newborn for which reason?

Pain should be assessed regularly in all newborn infants. If the infant is displaying physiologic or behavioral cues indicating pain, measures should be taken to manage the pain. Examples of nonpharmacologic pain management techniques include: (Select all that apply.)

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization the infant is weighed, and the birth weight is 4550 g (9 lbs, 6 ounces). The nurse’s most appropriate action is to:

An infant was born 2 hours ago at 37 weeks of gestation and weighing 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of:

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetrician’s office revealed a nonreactive tracing. On artificial rupture of membranes, thick, meconium-stained fluid was noted. The nurse caring for the infant after birth should anticipate:

For clinical purposes, preterm and postterm infants are defined as:

Because of the premature infant’s decreased immune functioning, what nursing diagnosis should the nurse include in a plan of care for a premature infant?

A pregnant woman presents in labor at term, having had no prenatal care. After birth her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. On the basis of her infant’s physical findings, this woman should be questioned about her use of which substance during pregnancy?

Which infant would be more likely to have Rh incompatibility?

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs similar to those of preterm infants. Because they are more stable than early-preterm infants, they may receive care that is much like that of a full-term baby. The mother-baby or nursery nurse knows that these babies are at increased risk for: (Select all that apply.)