In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy, the nurse recognizes that further teaching is warranted when the patient states:

Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with

In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for

A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 lbs less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. What nursing diagnosis is most appropriate for the woman at this time?

Maternal phenylketonuria (PKU) is an important health concern during pregnancy because

In terms of the incidence and classification of diabetes, maternity nurses should know that

Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand. Nurses should understand that

With regard to the association of maternal diabetes and other risk situations affecting mother and fetus, nurses should be aware that

The nurse providing care for a woman with gestational diabetes understands that a laboratory test for glycosylated hemoglobin Alc

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. She shows the nurse her readings for the past few days. Which one should the nurse tell her indicates a need for adjustment (insulin or sugar)?

A new mother with which of these thyroid disorders would be strongly discouraged from breastfeeding?

When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cardiac decompensation, which include

While providing care in an obstetric setting, the nurse should understand that after birth care of the woman with cardiac disease

A woman with asthma is experiencing a after birth hemorrhage. Which drug would not be used to treat her bleeding because it may exacerbate her asthma?

The use of methamphetamine (meth) has been described as a significant drug problem in the United States. In order to provide adequate nursing care to this patient population the nurse must be cognizant that methamphetamine

Since the gene for cystic fibrosis was identified in 1989, data can be collected for the purposes of genetic counseling for couples regarding carrier status. According to statistics, how often does cystic fibrosis occur in Caucasian live births?

Which heart condition is not a contraindication for pregnancy?

During a physical assessment of an at-risk patient, the nurse notes generalized edema, crackles at the base of the lungs, and some pulse irregularity. These are most likely signs of:

Nurses caring for antepartum women with cardiac conditions should be aware that

As related to the care of the patient with anemia, the nurse should be aware that

The most common neurologic disorder accompanying pregnancy is

With one exception, the safest pregnancy is one in which the woman is drug and alcohol free. For women addicted to opioids, ________________________ treatment is the current standard of care during pregnancy.

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

Which factor is known to increase the risk of gestational diabetes mellitus?

To manage her diabetes appropriately and ensure a good fetal outcome, the pregnant woman with diabetes will need to alter her diet by

When the pregnant diabetic woman experiences hypoglycemia while hospitalized, the nurse should intervene by having the patient

Nursing intervention for the pregnant diabetic patient is based on the knowledge that the need for insulin

In caring for a pregnant woman with sickle cell anemia, the nurse is aware that signs and symptoms of sickle cell crisis include

Congenital anomalies can occur with the use of antiepileptic drugs (AEDs), including: (Select all that apply.)

Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action, insulin secretion, or both. Over time, diabetes causes significant changes in the microvascular and macrovascular circulations. These complications include: (Select all that apply.)

Autoimmune disorders often occur during pregnancy because a large percentage of women with an autoimmune disorder are of childbearing age. Identify all disorders that fall into the category of collagen vascular disease.

Women with hyperemesis gravidarum:

Because pregnant women may need surgery during pregnancy, nurses should be aware that

What laboratory marker is indicative of disseminated intravascular coagulation (DIC)?

In caring for an immediate after birth patient, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder:

In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate?

A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the woman’s latest laboratory test findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit. The nurse notifies the physician because the laboratory results are indicative of:

A woman with preeclampsia has a seizure. The nurse’s primary duty during the seizure is to

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment the nurse finds the following vital signs: temperature of 37.3° C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure (BP) of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The patient complains, “I’m so thirsty and warm.” The nurse

A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the woman and documents the following findings: temperature of 37.1° C, pulse rate of 96 beats/min, respiratory rate of 24 breaths/min, blood pressure (BP) of 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. The nurse calls the physician, anticipating an order for:

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of:

The patient that you are caring for has severe preeclampsia and is receiving a magnesium sulfate infusion. You become concerned after assessment when the woman exhibits:

The nurse caring for pregnant women must be aware that the most common medical complication of pregnancy is:

Nurses should be aware that HELLP syndrome:

Nurses should be aware that chronic hypertension:

In planning care for women with preeclampsia, nurses should be aware that:

Magnesium sulfate is given to women with preeclampsia and eclampsia to:

A woman presents to the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?

The perinatal nurse is giving discharge instructions to a woman after suction curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. The best response from the nurse would be:

The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:

Methotrexate is recommended as part of the treatment plan for which obstetric complication?

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1 is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?

A laboring woman with no known risk factors suddenly experiences spontaneous rupture of membranes (ROM). The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. There is no change in uterine resting tone. The fetal heart rate begins to decline rapidly after the ROM. The nurse should suspect the possibility of:

A woman arrives for evaluation of her symptoms, which include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination the nurse notices an ecchymotic blueness around the woman’s umbilicus and recognizes this assessment finding as:

As related to the care of the patient with miscarriage, nurses should be aware that:

Which condition would not be classified as a bleeding disorder in late pregnancy?

In providing nutritional counseling for the pregnant woman experiencing cholecystitis, the nurse would:

Which maternal condition always necessitates delivery by cesarean section?

Spontaneous termination of a pregnancy is considered to be an abortion if:

An abortion in which the fetus dies but is retained within the uterus is called a(n):

A placenta previa in which the placental edge just reaches the internal os is more commonly known as:

Which condition indicates concealed hemorrhage when the patient experiences an abruptio placentae?

The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to:

A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs are an indication of:

Which order should the nurse expect for a patient admitted with a threatened abortion?

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on the knowledge that:

Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. Which is the most common cause of spontaneous abortion?

The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment to involve:

A patient who has undergone a dilation and curettage for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that vital signs are stable, bleeding has been controlled, and the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, discharge teaching should include: (Select all that apply.)

The reported incidence of ectopic pregnancy in the United States has risen steadily over the past two decades. Causes include the increase in STDs accompanied by tubal infection and damage. The popularity of contraceptive devices such as the IUD has also increased the risk for ectopic pregnancy. The nurse who suspects that a patient has early signs of ectopic pregnancy should be observing her for symptoms such as: (Select all that apply.)

A new mother asks the nurse when the “soft spot” on her son’s head will go away. The nurse’s answer is based on the knowledge that the anterior fontanel closes after birth by _____ months.

When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:

When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother’s right side close to midline. What is the likely position of the fetus?

The nurse has received report regarding her patient in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. The nurse’s interpretation of this assessment is that:

To care for a laboring woman adequately, the nurse understands that the __________ stage of labor varies the most in length?

The nurse would expect which maternal cardiovascular finding during labor?

The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:

The slight overlapping of cranial bones or shaping of the fetal head during labor is called:

Which presentation is described accurately in terms of both presenting part and frequency of occurrence?

With regard to factors that affect how the fetus moves through the birth canal, nurses should be aware that:

As relates to fetal positioning during labor, nurses should be aware that:

Which basic type of pelvis includes the correct description and percentage of occurrence in women?

In relation to primary and secondary powers, the maternity nurse comprehends that:

While providing care to a patient in active labor, the nurse should instruct the woman that:

Which description of the four stages of labor is correct for both definition and duration?

With regard to the turns and other adjustments of the fetus during the birth process, known as the mechanism of labor, nurses should be aware that:

In order to evaluate the condition of the patient accurately during labor, the nurse should be aware that:

The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products:

Which statement is the best rationale for assessing maternal vital signs between contractions?

In order to care for obstetric patients adequately, the nurse understands that labor contractions facilitate cervical dilation by:

To teach patients about the process of labor adequately, the nurse knows that which event is the best indicator of true labor?

Which occurrence is associated with cervical dilation and effacement?

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be:

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth?

Signs that precede labor include: (Select all that apply.)

Which factors influence cervical dilation? (Select all that apply.)

The nurse recognizes that a woman is in true labor when she states:

The nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates the woman’s understanding of the instructions when she states, “True labor contractions will:

When a nulliparous woman telephones the hospital to report that she is in labor, the nurse initially should:

When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman’s risk for _________________________ has increased.

Which action is correct when palpation is used to assess the characteristics and pattern of uterine contractions?

When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective would be:

The nurse who performs vaginal examinations to assess a woman’s progress in labor should:

A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. The nurse’s initial response would be to:

A nulliparous woman who has just begun the second stage of her labor would most likely:

The nurse knows that the second stage of labor, the descent phase, has begun when:

When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include:

Through vaginal examination the nurse determines that a woman is 4 cm dilated, and the external fetal monitor shows uterine contractions every 3.5 to 4 minutes. The nurse would report this as:

The most critical nursing action in caring for the newborn immediately after birth is:

When assessing a multiparous woman who has just given birth to an 8-lb boy, the nurse notes that the woman’s fundus is firm and has become globular in shape. A gush of dark red blood comes from her vagina. The nurse concludes that:

The nurse expects to administer an oxytocic (e.g., Pitocin, Methergine) to a woman after expulsion of her placenta to:

After an emergency birth, the nurse encourages the woman to breastfeed her newborn. The primary purpose of this activity is to:

A pregnant woman is in her third trimester. She asks the nurse to explain how she can tell true labor from false labor. The nurse would explain that “true” labor contractions:

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse’s best response is:

For the labor nurse, care of the expectant mother begins with any or all of these situations, with the exception of:

Nurses can help their patients by keeping them informed about the distinctive stages of labor. Which description of the phases of the first stage of labor is accurate?

It is paramount for the obstetric nurse to understand the regulatory procedures and criteria for admitting a woman to the hospital labor unit. Which guideline is an important legal requirement of maternity care?

Leopold maneuvers would be an inappropriate method of assessment to determine:

In documenting labor experiences, nurses should know that a uterine contraction is described according to all these characteristics except:

Because the risk for childbirth complications may be revealed, nurses should know that the point of maximal intensity (PMI) of the fetal heart tone (FHT) is:

With regard to a woman’s intake and output during labor, nurses should be aware that:

If a woman complains of back labor pain, the nurse could best suggest that she:

Which description of the phases of the second stage of labor is accurate?

Nurses alert to signs of the onset of the second stage of labor can be certain that this stage has begun when:

A means of controlling the birth of the fetal head with a vertex presentation is:

Which collection of risk factors most likely would result in damaging lacerations (including episiotomies)?

Concerning the third stage of labor, nurses should be aware that:

For women who have a history of sexual abuse, a number of traumatic memories may be triggered during labor. The woman may fight the labor process and react with pain or anger. Alternately, she may become a passive player and emotionally absent herself from the process. The nurse is in a unique position of being able to assist the patient to associate the sensations of labor with the process of childbirth and not the past abuse. The nurse can implement a number of care measures to help the patient view the childbirth experience in a positive manner. Which intervention would be key for the nurse to use while providing care?

As the United States and Canada continue to become more culturally diverse, it is increasingly important for the nursing staff to recognize a wide range of varying cultural beliefs and practices. Nurses need to develop respect for these culturally diverse practices and learn to incorporate these into a mutually agreed on plan of care. Although it is common practice in the United States for the father of the baby to be present at the birth, in many societies this is not the case. When implementing care, the nurse would anticipate that a woman from which country would have the father of the baby in attendance?

A patient whose cervix is dilated to 5 cm is considered to be in which phase of labor?

The primary difference between the labor of a nullipara and that of a multipara is the:

A woman who is gravida 3 para 2 enters the intrapartum unit. The most important nursing assessments are:

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be:

A laboring woman is lying in the supine position. The most appropriate nursing action at this time is to:

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth?

At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is 110 bpm, and the infant is crying vigorously with the limbs flexed. The infant’s trunk is pink, but the hands and feet are blue. What is the correct Apgar score for this infant?

The nurse thoroughly dries the infant immediately after birth primarily to:

In planning for home care of a woman with preterm labor, which concern must the nurse address?

The nurse providing care for a woman with preterm labor who is receiving terbutaline would include which intervention to identify side effects of the drug?

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects?

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to:

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. What finding indicates that preterm labor is occurring?

A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman’s labor?

Which assessment is least likely to be associated with a breech presentation?

A woman is having her first child. She has been in labor for 15 hours. Two hours ago her vaginal examination revealed the cervix to be dilated to 5 cm and 100% effaced, and the presenting part was at station 0. Five minutes ago her vaginal examination indicated that there had been no change. What abnormal labor pattern is associated with this description?

In evaluating the effectiveness of oxytocin induction, the nurse would expect:

A pregnant woman’s amniotic membranes rupture. Prolapsed umbilical cord is suspected. What intervention would be the top priority?

Prepidil (prostaglandin gel) has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes that this medication will be administered to:

The nurse, caring for a patient whose labor is being augmented with oxytocin, recognizes that the oxytocin should be discontinued immediately if there is evidence of:

Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance:

With regard to the care management of preterm labor, nurses should be aware that:

As relates to the use of tocolytic therapy to suppress uterine activity, nurses should be aware that:

With regard to dysfunctional labor, nurses should be aware that:

Nurses should be aware that the induction of labor:

While caring for the patient who requires an induction of labor, the nurse should be cognizant that:

With regard to the process of augmentation of labor, the nurse should be aware that it:

The exact cause of preterm labor is unknown and believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Select the type of infection that has not been linked to preterm births.

The standard of care for obstetrics dictates that an internal version may be used to manipulate the:

The nurse practicing in a labor setting knows that the woman most at risk for uterine rupture is: