MCH Exam 1 Study Guide PDF

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MCH Exam 1 Modules 1 - 2 (Chapters 1, 2, 5, 8, 9, 10, 11, 12, 13, 20, 21)...

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MOM & BABY TEST 1  Question 1

A nurse is caring for a client who is prescribed Rho immune globulin standard dose IM (Rhogam). The nurse should understand the action of this medication as which of the following? Selected Answer: Rhogam prevents the formation of Rh antibodies in mothers who are Rh negative

 Question 2

Fetal movement that is noted by the mother is a very important assessment factor to determine fetal well being. If the nurse is to ask the client if she has "felt her baby move", when is the best time for a primigravid client to note the first fetal activity? Selected Answer: 18 - 20 weeks.

 Question 3

The nurse is palpating the uterus of a client who is 20 weeks pregnant to measure fundal height. Identify where the nurse will find the uterine fundus? Selected Answer: At or near the umbilicus

 Question 4

A woman asks the nurse: "What protects my baby's umbilical cord from being pinched while the baby's inside". The nurse's best response is? Selected Answer:

"Your baby's umbilical cord is surounded by connective tissue called Wharton's Jelly, which prevents compression of the blood vessels and ensures continued nourishment and oxygen to your baby."

 Question 5

A 20 year -old client calls the clinic to report that she has found a lump in her breast. The nurse's best response to her is which of the following? Selected Answer:

"Many women have benign lumps and bumps in their breasts. However to make sure that it is benign, you should come in for an examination by your physician"

 Question 6

Activity is an important component of prenatal teaching. Activity that is considered safe for a client that states she does not participate in any activity or exercise program at this time would be? Selected Answer: Walking

 Question 7

During her annual gynecologic check up a 17 year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse would document this complaint as? Selected Answer: Dysmenorrhea

 Question 8

Prenatal testing is done to identify health issues that may interfere with the developing fetus. Within the first trimester what lab tests are normally obtained? (select all that apply) Selected Answers: Blood type and Rh factor

Group Beta Strep vaginal culture

Amniocentesis

 Question 9

The normal parameter of Fetal heart tones is 110 - 160 and can be heard by a doppler as early as? Selected Answer: 10-12 weeks gestation

 Question 10

A common discomfort of pregnancy can be managed by changing nutritional intake and some OTC medications. In reviewing information with the patient after her first prenatal visit the nurse is confident that this woman understand the management of constipation when she makes which of the following statements? Selected Answer:

"In addition to increasing my dietary fiber, I can use fiber supplements, drink more water and increase my activity if I have no restrictions"

 Question 11

At 32 weeks of pregnancy a woman experiences preterm labor. Although tocolytics are administered and she is placed on bed rest, she continues to experiences regular contractions and her cervix is beginning to dilate and efface. What additional medication should be considered to assist the development of the fetus?

Selected Answer: Terbutaline (brethine)

 Question 12

A 30 week gestational age pregnant client presents to the labor suite with complaints of contractions and pressure. What medications can the nurse expect the provider to order for administration? (select all that apply) Selected Answers: Terbutaline (Brethine)

Pitocin

Betamethasone

 Question 13

Hormonal shifts in pregnancy and the physiological changes that occur affect every body system. As the nurse which of the following symptoms or presentation would you consider abnormal? Selected Answer: Headaches occurring in the third trimester

 Question 14

A women with the diagnosis of hyperemesis gravidarum requires hospitalization. In addition to her need to be hospitalized what else is significant?

Selected Answer:

She has vomiting severe and persistent enough to cause weight loss, dehydration and electrolyte imbalance.

 Question 15

A woman is 39 weeks gestation with severe abdominal pain that remains constant is being admitted to the labor and delivery unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, has dark red vaginal bleeding and a tense rigid abdomen. What should the nurse suspect at this time? Selected Answer: Placenta abruption

 Question 16

Magnesium sulfate is given to a pregnant client with pre eclampsia and eclampsia for which of the following reasons? Selected Answer: Prevent and treat seizures

 Question 17

A nurse is caring for a client who has a possible ectopic pregnancy at 8 weeks gestation. Which of the following manifestations should the nurse expect to identify as consistent with this diagnosis? Selected Answer: A. Unilateral abdominal pain

 Question 18

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be which of the following? Selected Answer: changes in the pattern of fetal

activity

 Question 19

A nurse instructs a 20 year old female college student about oral contraceptives. After the teaching session, the nurse confirms that the client understands the information when she makes which of the following statements? Selected Answer: Oral contraceptives should be taken the same time each day.

 Question 20

A 34 week pregnant worman is experiencing preterm labor. The nurse will provide the following interventions for her client? (select all that apply) Selected Answers: Place on a fetal monitor

Position the patient in the supine position to facilitate accurate fetal moinitoring

 Question 21

A client with a gestational age of 32 weeks arrives at the clinic for a routine prenatal visit. In identifying fetal well being, the nurse knows she must measure fundal height, fetal heart tones and fetal movement. The nurse finds the fundal height to be 28 cm and fetal heart tones at 115 bpm, and mother relates that fetal movement has slowed. What may the nurse conclude with this finding?

Selected Answer: Possible IUGR and the nurse should identify risk factors and notify the physician.

 Question 22

A client who is 32 weeks pregnant is being monitored in the Antepartum unit for pregnancy induced hypertension (gestational hypertension). She suddenly complains of continuous abdominal pain and vaginal bleeding. Which of the following nursing interventions should be included in the care of this

client? (select all that apply) Selected Answers: Evaluate vital signs

Monitor the amount of vaginal bleeding

Evaluate fetal heart tones

 Question 23 The clinic nurse reviews the complete blood count results of a 30-year-old woman who is now 33 weeks’ gestation. The patient’s hemoglobin value is 11.2 g/dL and her hematocrit is 38%. How does the clinic nurse interprets these findings? Selected Answer: D. normal pregnancy values for the third trimester.  Question 24 A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods. (Natural family planning, FAM’s) What is the nurse's most appropriate response? Selected Answer: A. "They can be effective for many couples, but they require motivation.”  Question 25 The student nurse is learning that is is recommended to screen for domestic violence in the first prenatal visit for all clients. The instructor has explained how to communicate and ask questions that are personal, so which question would be the best stated for t he student nurse t o ask ? Selected Answer:

A. “This is something that we ask everyone. Do you feel safe in your current living environment and relationships?”

 Question 26 The prenatal clinic nurse meets with a 30-year-old woman who is experiencing her first pregnancy. The patient’s quadruple marker screen result is positive or abnormal at 17 weeks of gestation and her provider recommends an amniocentesis. The nurse explains that the patient needs a referral to o ne of the following. Selected Answer: C. Genetics counselor/specialist.  Question 27 Management of primary dysmenorrhea often requires a multifaceted approach. What is the optimal pharmacological therapy for pain relief when caring for a client with this condition?:

Selected Answer: C. Non-steroidal anti- inflammatory drugs ( NSAIDS)  Question 28 Screening at 24 weeks 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. What does the nurse identify as the greatest risk for the fetus? Selected Answer: D. Macrosomia  Question 29 The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been effective when the client reports that she has been sleeping in what position? Selected Answer: D. In a side-lying position

 Question 30 A woman is at 14 weeks gestation. The nurse would expect to palpate the fundus at which level? Selected Answer: B. Slightly above the symphysis pubis  Question 31 Which o f the following s igns and symptoms should a woman report immediately to her health care provider? Choose all that apply: Selected Answers: B. Headaches that do not respond to usual therapy. C. Rupture of membranes D. Vaginal bleeding  Question 32 A woman’s obstetrical history indicates that she is pregnant for the 4th 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? Selected Answer: D. 4-1-2-04  Question 33 Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? Selected Answer: B. Increased pulse rate

 Question 34 A woman arrives at the clinical for a pregnancy test. The first day of her last menstrual period (LMP) was February 14. Her expected date of birth (EDB) would be? Selected Answer: A. November 21  Question 35

A pregnant client at 32 weeks gestation has mild pre-eclampsia. She is discharged home with instructions to remain on bedrest. She should also be instructed to call her provider if she experiences which of the following symptoms? (select all that apply) Selected Answers: Blurred vision

Headache not relieved with over the counter medication

Epigastric pain

 Question 36

 Question 37

Intrauterine growth restriction is the result of poor placental perfusion. What pregnancy risk factors may contribute to intrauterine growth restriction? (select all that apply) Selected Answers: Drug abuse

Hypertension

Smoking

A 25-year-old single female comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the client has human papillomavirus (HPV). The client asks, "What is that? Can you get rid of it?" What is your best response?

Selected Answer:

"HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer."

Question 38 The amniotic fluid has many functions and we know that amniotic fluid is necessary for fetal well- being. Please select the purpose of the fluid for fetal well -being. Select all that apply. Selected Answers: A. provides oxygen to the lungs B. cushioning of the baby from minor trauma C. temperature control D. nutrition for the baby E. permits free movement of the baby Question 39 A pregnant woman experiencing nausea and vomiting. What action can she take? Selected Answer: D. eat small, frequent meals (every 2 to 3 hours)

 Question 40

A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The client's health record includes this data: G3, T1, P0, A1, L1. How should the nurse interpret this information? (select all that apply) Selected Answers: A. Client has been through active labor B. Client has one living child C. Client has had two prior pregnancies D. Client has experienced no preterm labor

E. Client has delivered one newborn at term  Question 41

A nurse in a clinic is teaching a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency? Selected Answer: Neural tube defects

Question 42

A nurse is caring for a client who is receiving IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if magnesium sulfate toxicity is suspected? Selected Answer: Calcium gluconate

 Question 43

A nurse is instructing a client who is taking an oral contraceptive about danger signs to report to her provider. The nurse determines the client understands the teaching when the client states the need to report which of the following? Selected Answer: Shortness of breath

 Question 44

A client in the prenatal clinic is complaining of episodes of dizziness when sitting up after lying supine for some time. Which response by the nurse explains this change during pregnancy? Selected Answer: "This is due to an increase of blood volume."

 Question 45

A nurse is reviewing a prescription for ferrous sulfate (iron supplementation) with a client who is at 12 weeks gestation. Which of the following statements by the client indicates understanding of the teaching? Selected Answer: "I plan to drink more orange juice while taking this pill."

 Question 46

As a nurse working in a prenatal clinic it is important to obtain both maternal and fetal assessments. While obtaining fetal assessments, which of the following should the nurse complete for fetal well being? Selected Answer: Fetal heart tones, Fetal movement, and Fundal height

 Question 47

A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagnosis? Selected Answer: Painless red vaginal bleeding

 Question 48

A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client’s newborn at risk for which of the following complications? Selected Answer: Intrauterine growth restriction

 Question 49

A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider’s orders. Which of the following orders requires clarification? Selected Answer: Ambulate twice daily.

 Question 50

A student nurse asks the faculty about the importance of preconception counseling. Which response by the faculty is best?

Selected Answer: “It is the best time to find any conditions that could have a negative effect on a pregnancy.”...