Maternal And Child Health Nursing (Intrapartum And Postpartum)

106 Questions | Total Attempts: 448

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Maternal And Child Health Nursing (Intrapartum And Postpartum)

Welcome to Maternal and Child Health Nursing (HESI EXAMINATION) Prepared by: Jeffrey Viernes The care of childbearing and childrearing families is a major focus of nursing practice, because to have healthy adults you must have healthy children. To have healthy children, it is important to promote the health of the childbearing woman and her family from the time before children are born until they reach adulthood. Both preconceptual and prenatal care are essential contributions to the health of a woman and fetus and to a family’s emo- tional preparation for childbearing and childrearing. As chil- dren grow, families need continued health supervision and support. As children reach maturity and plan for their fam- ilies, a new cycle begins and new


Questions and Answers
  • 1. 
    A client in the 28th week of gestation comes to the emergency department because she thinks that she's in labor. To confirm the diagnosis of PRETERM LABOR, the nurse would expect the physical examinations to reveal: Client's needs category: Physiological integrity Client's need subcategory: Physiological adaptation Cognitive level: Knowledge
    • A. 

      Irregular uterine contractions with no cervical dilation

    • B. 

      Painful contractions with cervical dilation

    • C. 

      Regular uterine dilation with cervical dilation

    • D. 

      Regular uterine contractions without cervical dilation

  • 2. 
    A client in the active phase of labor has a reactive fetal monitor strip and has been encouraged to walk. When she returns to bed for a monitor check, she complains for an urge to push. The nurse notes that the amniotic membranes have ruptured and she can visualize the umbilical cord. What should the nurse do next? Client's needs category: Physiological Integrity Client's needs subcategory: Reduction of risk potential Cognitive level: Analysis
    • A. 

      Put the client in a knee-to-chest position

    • B. 

      Call the physician or midwife because it is emergent

    • C. 

      Push down on the uterine fundus

    • D. 

      Arrange for fetal blood sampling to assess for fetal acidosis

  • 3. 
    A client is attempting to deliver vaginally despite the fact that her previous delivery was by cesarean delivery. Her contractions are 2 to 3 minutes apart, lasting from 75 to 100 seconds. Suddenly, the client complains of intense abdominal pain, and the fetal monitor stops picking up contractions. The nurse recognizes that which of the following events may have occured? Client's needs category: Physiological Integrity Cognitive level: Application
    • A. 

      Abruptio placentae

    • B. 

      Prolapsed cord

    • C. 

      Partial placenta previa

    • D. 

      Complete uterine rupture

  • 4. 
    A client with gravida 3 para 2 at 40 weeks' gestation is admitted with spontaneous contractions. The physician performs an amniotomy to augment her labor. The PRIORITY nursing action is to: Client's needs category: Physiological Integrity Cognitive level: Knowledge
    • A. 

      Explain the rationale for the amniotomy to the patient

    • B. 

      Monitor fetal heart tones after the amniotomy

    • C. 

      Ambulate the client to strengthen the contraction pattern

    • D. 

      Position the client in a lithotomy position to administer perineal care

  • 5. 
    What is the most IMPORTANT determinant of fetal maturity for extrauterine survival? Cognitive level: Application and Knowledge
    • A. 

      An L/S ratio of 2:1

    • B. 

      The presence of IgG antibodies on the fetal bloodstream

    • C. 

      An L/S ratio of 1:2

    • D. 

      The presence of well functioning CNS, cardiovascular and respiratory system

  • 6. 
    The characteristics of the HELLP syndrome are: Select all that apply. Cognitive level: Analysis and Knowledge
    • A. 

      Hemolysis (blood destruction)

    • B. 

      Elevated liver enzyme

    • C. 

      Hypertension and generalized edema

    • D. 

      Low platelet count

    • E. 

      Proteinuria

    • F. 

      It is usually occurring before the 37th weeks' gestation

  • 7. 
    What are the manifestations of Hypertension in pregnancy (Preeclampsia)? Select all that apply.
    • A. 

      Systolic blood pressure greater than 140 or diastolic blood pressure greater than 90

    • B. 

      Proteinuria

    • C. 

      Weight gain

    • D. 

      Decreased urine output

    • E. 

      Presence of HELLP syndrome

    • F. 

      Headaches, blurred vision, hyperreflexia, nausea, vomiting

  • 8. 
    A 36 years old pregnant patient (is on her 36th weeks of gestation) has been diagnosed with hypertension with a blood pressure of 140/90 for the past two weeks has been admitted to the labor and delivery department. Suddenly within the first 24 hours of her stay, the patient described a bright red bleeding on her drape. The nurse ask about her pain level, the patient rated her pain as 1 out of 10. What are the necessary nursing intervention you need to provide for this patient? Select all that apply. 
    • A. 

      Monitor maternal Vital Signs, including uterine activity

    • B. 

      Monitor signs of infection

    • C. 

      Monitor fetal heart rate

    • D. 

      Obtain a blood glucose from the patient

    • E. 

      Provide vitamin K because the patient is bleeding severely

    • F. 

      Administer 2 Tylenol as needed order

  • 9. 
    Older adults are vulnerable to diseases because of decreased physiologic reserve, less flexible homeostatic processes, and less effective body defenses. What are the most common physiologic changes that is related to aging? Select all that apply.
    • A. 

      Chronic illness becomes more prevalent as one ages

    • B. 

      Resistance to stressors diminishes as one ages

    • C. 

      Decreased absorption of vitamins B1 and B2

    • D. 

      Decreased peristalsis and impaired absorption contribute to constipation problems

    • E. 

      Increased thirst sensation

    • F. 

      Increased hunger sensation

  • 10. 
    An 86 years old patient has been admitted into the Long Term Care facility. She has an admitting diagnosis of Hypertensio, diabetes mellitus, and she has a history of falls at home. Last night, the patient was trying to climb the rails and suddenly she fell with her face first on the floor. No blood was found on the scene. the physician ordere a MRI to check f there is internal bleeding on the patient. When the nurse assessed the patient's level of consciousness, she cannot identify her name and time. The patient is currently taking Atenolol 200 mg PO to control her blood pressure. The physician diagnosed a Transient Ischemic Attack for the patient. As a nurse, you know that TIA has the following hallmark signs and symptoms. Select all that apply.
    • A. 

      Weakness

    • B. 

      Persistent nausea and vomiting

    • C. 

      Blackouts

    • D. 

      Presence or leakage of CSF

    • E. 

      Difficulty speaking

    • F. 

      Tremors

  • 11. 
    What are the ways to help prevent or decrease the occurence of falls in the older adult? Select all that apply.
    • A. 

      Remove throw rugs

    • B. 

      Paint the edges of stairs red color

    • C. 

      Administer his antihypertensive medications during the night

    • D. 

      Ambulate the patient with a gait belt

    • E. 

      Ensure adequate lighting

    • F. 

      Wear proper footwear that supports the foot

  • 12. 
    What is the condition called whereby the placenta is implanted in the lower uterine segment. It can be classified as partially, totally, or marginal.?
  • 13. 
    It is th partial or complete premature detachment of the placenta from its site of implantation in the uterus. It is usually occuring in the late third trimester or in labor.
  • 14. 
    What the do you call the procedure whereby the OB/GYN physician removes amniotic fluid sample from the uterus during 14th to 16 th weeks of gestation?
  • 15. 
    What is the procedure called whereby the physician removes a small piece of villi between 8 to 12 weeks' gestation under ultrasound guidance?
  • 16. 
    If there is a decrease of alpha-fetoprotein in the amniotic fluid, it would signify what disease is the fetus risk for?
  • 17. 
    If there is an INCREASE in alpha-fetoprotein 
  • 18. 
    The LPN is helping the RN to complete the necessary assessment data on the Biophysical Profile (BPP) to detect if the fetus is healthy and well. What are the necessary components of this profile?
    • A. 

      Fetal breathing movement

    • B. 

      Fetal tone

    • C. 

      Gross body movement

    • D. 

      L/S ratio

    • E. 

      Reactivity of fetal heart rate

    • F. 

      Amniotic fluid volume

    • G. 

      Presence of alpha-fetoprotein

  • 19. 
    Infection that occurs during pregnancy is very compromising for the fetus. A 12 weeks pregant Asian female is asking the LPN what TORCH disease is. As a knowledgable LPN, you know that TORCH disease includes:  
    • A. 

      Rubella

    • B. 

      Cytomegalovirus

    • C. 

      Tuberculosis

    • D. 

      Influenza

    • E. 

      Chlamydia

    • F. 

      Human papilloma virus

    • G. 

      Herpes Simplex

  • 20. 
    What are the normal physical responses of a pregnant woman who is on a Latent Phase of the First Stage of Labor?
    • A. 

      Able to continue usual activities

    • B. 

      Contractions mild, initially 10 to 20 minutes apart

    • C. 

      Contractions moderate to severe, 2 to 3 minutes apart

    • D. 

      Nausea, hiccups

  • 21. 
    An LPN is watching a nurse practitioner performs an abdominal palpation that is used to determine fetal presentatio, lie, postion, and engagement. As an LPN, you know that this is procedure is called:
  • 22. 
    A nursing student is discussing the normal findings in labor to a 39 weeks pregnant patient. What are the normal findings common to laboring client and the fetus? Select all that apply.
    • A. 

      FHR of 130

    • B. 

      maternal blood pressure of 139/89

    • C. 

      Maternal pulse of 100

    • D. 

      Maternal temperature of 100.4

    • E. 

      Dehydration due to work of labor

    • F. 

      Leukorrhea

  • 23. 
    Which of the following characteristics of contractions would the nurse expect to find in a client experiencing true labor?
    • A. 

      Occurring at irregular intervals

    • B. 

      Starting mainly in the abdomen

    • C. 

      Gradually increasing intervals

    • D. 

      Increasing intensity with walking

  • 24. 
    During which of the following stages of labor would the nurse assess “crowning”?
    • A. 

      First stage

    • B. 

      Second stage

    • C. 

      Third stage

    • D. 

      Fourth stage

  • 25. 
    Barbiturates are usually not given for pain relief during active labor for which of the following reasons?
    • A. 

      The neonatal effects include hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days.

    • B. 

      These drugs readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection.

    • C. 

      They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.

    • D. 

      Adverse reactions may include maternal hypotension, allergic or toxic reaction or partial or total respiratory failure

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