12/6/2011 Maternal-Newborn Nursing Chapter 06: NCLEX RN® Review Practice Test

You got 17 out of 30 questions correct 1. The client has come to the clinic for her first prenatal visit and tells the nurse that she eats only vegetables. To assess for a problem related to thi s information, the nurse should assess what part of the CBC? You answered correctly: Hemoglobin Rationale: The client who is not eating meat may have a problem with decreased i ron intake which could impact her hemoglobin level. Polymorphonuclear cells, lym phocytes, and platelets are unrelated to iron intake. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: Recall that iron deficiency anemia is a risk for vegetarians. Eliminat e options 2, 3, and 4 because polymorphonuclear cells, lymphocytes, and platelet s are unrelated to iron intake. References: Olds, S., London, M., Ladewig, P., & Davidson, M. (2004). Maternal-N ewborn Nursing & Women's Health Care (7th ed.). Upper Saddle River, N. J.: Pears on Education, Inc. p. 447-448. Kee, J. L. (2005). Laboratory and diagnostic tests with nursing implications (7t h ed.). Upper Saddle River, NJ: Pearson Education, Inc., pp. 718-719. 2. The pregnant client has been diagnosed with toxoplasmosis. The nurse rea lizes that this infection places the fetus at risk for which of the following? S elect all that apply. You answered incorrectly: Central nervous system damage; Microcephaly and hydroc ephalus; Raised, red skin rash The correct answers were: Central nervous system damage; Microcephaly and hydroc ephalus Rationale: Toxoplasmosis can result in fetal convulsions, coma, microcephaly, an d hydrocephalus. Cognitive Level: Application Client Need: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process: Analysis Content Area: Maternal-Newborn Strategy: Knowledge of the complications of toxoplasmosis is essential to answer the question correctly. Reference: Olds, S.B., London, M.L., Ladewig, P.A. & Davidson, M.R. (2004). Mate rnal-Newborn Nursing & Women's Health Care (7th ed.). Upper Saddle River, NJ: Pe arson Education, Inc., p. 514-515. 3. Which of the following would indicate to the nurse a need for client tea ching about avoiding infection with the rubella virus? You answered incorrectly: Rubella titer 1:10 The correct answer was: Rubella titer 1:8 Rationale: Rubella titer of >1:10 is indicative of immunity to rubella. Rubella is a mild illness and the client may or may not be aware of past infection. A r

M.).: Pearso n Education. S. Inc. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: Knowledge of the risks of herpes lesions transmitted at the time of de livery will aid in answering the question. Ladewig. (2004). 517-518. would indicate a need for delivery by Cesarean section? You answered incorrectly: Positive herpes culture at the first prenatal visit..A.). 4.R. J. p.. Maternal-Ne wborn Nursing & Women's Health Care (7th ed. Ladewig. would indic ate to the nurse that the client has an increased risk for exposure to cytomegal ovirus? You answered incorrectly: Caring for a cat and litter box The correct answer was: Working at a day care center Rationale: Day care workers are frequently exposed to the virus. P.).B.B. S. Upper Saddle River. London. N. p. p.R.. Reference: Olds. c lient asymptomatic at the time of delivery The correct answer was: History of genital herpes lesions. a vaginal deliver y is recommended.L.. prodromal symptoms pr esent but no lesions at the time of delivery Rationale: Indications for Cesarean section are presence of a herpes lesion or p rodromal symptoms. Reference: Olds. 515-516. S. P. Inc.ubella titer of 1:8 or less does not demonstrate immunity and avoidance of those with rubella infection is indicated. and treated as indicated. 337. Which of the following.A. Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Integrated Process: Teaching/Learning Content Area: Maternal-Newborn Strategy: Knowledge of the required titer level that indicates immunity is neces sary to answer this question. (2004). M. & Davidson. Cesarean section would be appropriate only if there were s . Mate rnal-Newborn Nursing & Women's Health Care (7th ed. NJ: Pe arson Education. Upper Saddle River. 6. if found during prenatal care. M.. IV drug use increases the risk for HIV or hepatitis. The nurse explains to a pregnant client who is diagnosed with a sexually transmitted disease that follow-up includes which of the following? You answered correctly: Contacting and treating all sexual partners Rationale: All partners have been exposed and should be made aware.. P. 516-517. London. Exposure to cat litter can result in toxoplasmosis exposure.. London. 5. Cognitive Level: Analysis Client Need: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: Knowledge of cytomegalovirus and how it is transmitted will help to an swer this question. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. & Davidson. Ladewig. Upper Saddle River.L. Which of the following. NJ: Pe arson Education. Reference: Olds. tested. Inc. M.. Giving blood does not increase the client's risk. If there are no herpes symptoms or lesions. M. if revealed in a prenatal interview. M.. (2004). & Davidson.

However. & Davidson. N. 518-519. Eliminate options 1. and 4 because rash. London.. 8. and 4 because other factors identified would no t affect the results of the gonorrhea culture.).B. London. Upper Saddle River. The nurse should plan for Group B streptococcus screening if the pregnan t client meets which of the following criteria? You answered correctly: 36-37 weeks gestation Rationale: Carrier status of Group B Streptococcus is variable. However.). Genetic assessment and more th an routine assessment of hematocrit and hemoglobin are not indicated. J. Reference: Olds. S.. Maternal-Ne wborn Nursing & Women's Health Care (7th ed. douching within 24 hours can affect results.L. & Davidson. Eliminate options 3 and 4 because genetic assessment and more than routine assessment of hematocrit and hemoglobin are not indicated. Rash and history of STI do not alter this recommendation. Inc. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: Recall that results of a gonorrhea culture can be affected by menstrua l blood. if revealed prior to collection of a gonorrhea c ulture. M. The correct answer was: Is currently menstruating. Eliminate option 2 because Cesarean section would be appropriate only if there were symptoms of a herpes lesion or prodromal symptoms. (2004).ymptoms of a herpes lesion or prodromal symptoms. Upper Saddle River.. M. 9. P. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. Reference: Olds. M. (2004). would result in postponing specimen collection? The client: You answered incorrectly: Reports douching 3 days ago. 3.R.. Other factors listed here would not affect the results. M. Eliminate options 1. London. Ladewig. 3.). P.. S. douching within 24 h ours can affect results. Inc. M. p.. Ladewig. Which of the following. S. P.A. p. Maternal-Ne wborn Nursing & Women's Health Care (7th ed. the gre atest risk to the fetus is at the time of delivery.. Ladewig. M. Rationale: Menstrual blood can affect the results of a gonorrheal culture. N. 7. NJ: Pe arson Education. Reference: Olds. 112. J. Upper Saddle River.. so identificatio n several weeks before delivery may not identify a woman who is positive at the time of delivery. The nurse would assess which of the following items that would p . p. time of initial prenatal visit and history of STI do not alter the recommendation for screening at 36 to 37 weeks gestation. (2004). Cognitive Level: Application Client Need: Health Promotion and Maintenance Integrated Process: Nursing Process: Implementation Content Area: Maternal-Newborn Strategy: Recall that diagnostic screening and referral for treatment are needed for all partners exposed to a sexually transmitted infection. Inc. The client has come to the prenatal clinic complaining of repeated nause a and vomiting. & Davidson. The current recommendation is screening during the 36-37th wee k of gestation.: Pearso n Education. Cognitive Level: Application Client Need: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process: Planning Content Area: Maternal-Newborn Strategy: Recall that Group B streptococcus screening is time sensitive.. 114.: Pearso n Education.

Diagnosis Content Area: Diagnostic Tests Strategy: Recall that the presence of ketones may indicate diabetes and hypergly cemia with fatty acid catabolism. & Davidson. NJ: Pearson Education. 3.. Abnormal results include a fasting level greater than 105 mg/dL and a 1-hour level greater than 190 mg/dL. Upper Saddle River.). (2004). Laboratory and diagnostic tests with nursing implications (7t h ed. Kee.rovide information regarding client hydration status? You answered correctly: Urine specific gravity Rationale: Urine specific gravity is a measure of the concentration of particles in the urine. P.. 434. Eliminate options 2. The o ther answers are not related to hydration status. p. London. (2005).. P. p. 11. 10.: Pears on Education. M.).). During a routine prenatal visit. Maternal-N ewborn Nursing & Women's Health Care (7th ed.. References: Olds. J. Upper Saddle River. Cognitive Level: Analysis Client Need: PHYS Integrated Process: Nursing Process. Eliminate option 1 because it c ontains normal assessment findings. NJ: Pearson Education. Inc. Urine gl ucose and assessment of 6-hour glucose levels are not part of this test. Cognitive Level: Analysis Nursing Process: Assessment Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process. the presence of ketones is noted during a dipstick analysis of the client's urine.. References: Olds.. Eliminate options 3 and 4 because urine gluc . Urine specific gravity rises when the client is dehydrated.). S. J. (2004). Upper Saddle River. Upper Saddle River. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Evaluation Content Area: Maternal-Newborn Strategy: Recall that abnormal results include a fasting level greater than 105 mg/dL and a 1-hour level greater than 190 mg/dL. p. Ladewig. Kee. M. M. 787. 433. L. M. Inc.. Presence of ketones may indicate diabetes and hyperglycemia with fatty acid catabolism. ketones are not found in the urine. Laboratory and diagnostic tests with nursing implications (7t h ed. Maternal-N ewborn Nursing & Women's Health Care (7th ed. The client has completed a three-hour oral glucose tolerance test. The n urse interprets that which of the following results would require follow-up for gestational diabetes? You answered correctly: 1-hour level of 210 mg/dL Rationale: A 3-hour oral glucose tolerance test involves assessment of glucose l evels prior to ingestion of glucose followed by 3 assessments at 1-hour interval s after ingestion of 100 gm of oral glucose. London. & Davidson. This finding would indicate to the n urse the possibility of what complication of pregnancy? You answered correctly: Diabetes Rationale: Normally. Inc. p. J. and 4 because urine ke tones are not associated with these conditions. L. N. J. N..: Pears on Education. Assessment Content Area: Maternal-Newborn Strategy: Knowledge of tests to determine hydration status will be necessary to determine the correct answer to the question. (2005). The other answe rs are unrelated to the presence of ketones in the urine. Inc. Ladewig. S. 437-438.

(2004). M.B. "When will I know my blood levels of serum alpha-fetoprotein. P.. & Davidson. & Davidson. 12. M. Mate rnal-Newborn Nursing & Women's Health Care (7th ed.. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Content Area: Maternal-Newborn Strategy: Recall that the triple screen test relies on evaluation of 3 serum mar kers to screen for neural tube defects and chromosomal trisomies.. P. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. NJ: Pe arson Education.. "I am having this test to determine if my baby has D own syndrome. London.B. 547. M. P. Rationale: Amniocentesis done for genetic testing is usually done early in the s econd trimester.L..)." Rationale: The triple screen test determines serum levels of serum alpha-fetopro tein. 13. Upper Saddle River. (2004). and hCG?". Reference: Olds. (2004). S. Elimina te option 3 because amniocentesis is not used to assess TORCH infections.R. 440. not urine. Inc. Eliminate opti ons 1. & Davidson. The correct answer was: Lung maturity. Ladewig.". The client is a 37-year-old gravida one at 38 weeks gestation. and hCG?" The correct answers were: "When will I know my blood levels of serum alpha-fetop rotein. p. being done on a client who has diabetes and is at 38 weeks gestation. Nursing interventions should include which of the following? . markers for neural tube d efects and trisomies 18 and 21 (Down syndrome. A 3-day high carbohydrate diet would be recommended prior to a 3-hour glucose tolerance test.R. Ladewig. M.A.B. Reference: Olds. 553. You answered incorrectly: "I kept my 24-hour urine sample refrigerated and broug ht it with me today.A. Recall that amniocentesis done late i n pregnancy is used to assess fetal lung maturity.. is probably being done to assess lung maturity in anticipation of delivery.). estriol.) Maternal serum. 14. S. A client has been scheduled for an amniocentesis. Cognitive Level: Analysis Client Need: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process: Analysis Content Area: Maternal-Newborn Strategy: This question is time sensitive.). Reference: Olds. Inc. Ladewig.L.R... estriol. is a ssessed in this test. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. M. 3.. London. "I am having this test to determine if my baby has Down s yndrome. This test. A pregnant client has come to the clinic for a triple screen test. and 4 because urine.ose and assessment of 6-hour glucose levels are not part of this test.A. M. Upper Saddle River. and human chorionic gonadotropin (hCG). Eliminate options 1 and 2 bec ause testing for genetic disorders is performed in the second trimester. Inc. p. p.". S. She was d iagnosed with diabetes at age 17 and is scheduled for an amniocentesis. estriol . Which of the following statements by the client indicate the nurse's teaching about t he test has been effective? Select all that apply. diet alterations and sound waves are not part of this test. 349. Upper Saddle River.L. NJ: Pe arson Education. NJ: P earson Education. London. The nurs e interprets that the procedure is probably being done to assess for the presenc e of: You answered incorrectly: Neural tube defects.

S. is done under guidance of ultrasound visualization. M. It flows out into the amnioti c fluid where we can measure it to determine lung maturity. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. The client is positioned on her back with a wedge under her left hip to avoid hypotension from pressure of the uterus on the vena cava. Ladewig.).R. Mate rnal-Newborn Nursing & Women's Health Care (7th ed.. She seems upset and says that she doesn't understand how this test cou ld tell if a baby's lungs are mature...You answered correctly: Arrange for access to an ultrasound machine for use duri ng the procedure. 15. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. M. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Communication and Documentation Content Area: Maternal-Newborn Strategy: Knowledge of the procedure and what it is used for will aid in choosin g the correct answer. 553. The nurse's best response is: You answered correctly: "A chemical called lecithin is made by the fetal lungs. Ladewig.). S.).. S. Inc. Eliminate option 1 b ecause the client does not need to be NPO for the procedure. The test is done without anesthetic or with a local a nesthetic. 547. M. M. The nurse would choose which of the following as an appropriate nursing diagnosis for a client about to undergo an amniocentesis? You answered correctly: Anxiety related to concern for fetal well-being Rationale: Most women view invasive antenatal testing with anxiety because of th e reason for the test. p.L. Reference: Olds.A. NJ: Pe arson Education. (2004).B." Rationale: The amount of lecithin increases as the fetal lungs mature. NJ: Pe arson Education. Reference: Olds. London.R. (2004). (2004). Ladewig.A.. Reference: Olds. NJ: Pe .A. & Davidson. 547-550. London. Cognitive Level: Analysis Client Need: Psychosocial Integrity Integrated Process: Nursing Process: Diagnosis Content Area: Maternal-Newborn Strategy: Recall that an amniocentesis is an invasive test commonly accompanied by client anxiety related to the procedure or the findings. and concern about maternal and fet us complications. Eliminate option 2 because only local anesthesia is used. Eliminate option 3 because a supine positi on is avoided to reduce the risk of vena cava syndrome. M. & Davidson. The amount of it increases as gestation continues.. P. Rationale: The test. Eliminate option 4 because only a small a mount of amniotic fluid is removed for assessment.B. London.L. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Planning Content Area: Maternal-Newborn Strategy: Eliminate options 1 and 4 because amniocentesis is an outpatient proce dure performed with the client awake. Upper Saddle River. The other answers are incorrect. Inc. The client is scheduled to have an amniocentesis for assessment of lung maturity.. M. completed on an outpatient basis. The ratio of lecithin to sphingomyelin is used to assess lung maturity. P. pp. The other diagnosis are not necessarily related to undergoing an amniocentesis. Upper Saddle River. & Davidson.L. Upper Saddle River.. P.R.B. the impending results. 16.

Inc. London.L. and post term pregnancy are all indications for completing a contraction stress test. S. Reference: Olds. M. Eliminate options 1.B. the nurse would recognize wh ich of the following as a risk factor for contraction of sexually transmitted di sease? You answered incorrectly: Use of oral contraceptives The correct answer was: Report of anal intercourse Rationale: Because it frequently involves tissue trauma that facilitates invasio n of pathogens. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. P.. In taking a history from a pregnant client. 550. pp. Intrauterine growth restriction. M. Ladewig. 538.. and 4 are normal findings and would receive scores of 2 respectively. & Davidson.. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Communication and Documentation Content Area: Maternal-Newborn Strategy: The core issue of the question is determining when contractions would present an increased risk to client or fetal safety.. & Davidson. diabetes mellitus. and post term pregnancy are all indications for completing a contraction stress test. (2004). NJ: Pe arson Education. S. Upper Saddle River. Eliminate options 2. and 3 bec ause intrauterine growth restriction. Upper Saddle River. NJ: Pe arson Education. anal intercourse is considered a high-risk sexual behavior. Findings in options 2. this abnormal finding would result in a score of 0 for this crite rion of the test. p. The nurse would report which of the following assessment findings in a p regnant client as a contraindication for conducting a contraction stress test? You answered correctly: Marginal abruptio placentae Rationale: Contractions elicited during the test could cause increased bleeding if an abruption is present. London. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Evaluation Content Area: Maternal-Newborn Strategy: Recall that decreased fetal movement is an abnormal finding on a bioph ysical profile.. Cognitive Level: Analysis Client Need: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: Recall that anal intercourse increases the risk of tissue trauma and p .B. The nurse notes that which of the following findings on a biophysical pr ofile would result in a decrease in the score? You answered correctly: 1 episode of body movement in a 30-minute time period Rationale: Normal findings would include 3 or more discrete body/limb movements in 30 minutes. Inc.A.). Recall that contractions co uld increase placental abruption and bleeding. p. Inc. 17.). and 4 because they are normal findings a nd would receive scores of 2 respectively. P.R. The other factors listed here do not increase the client's risk for contractions of a sexually transmitted infection.R.L. 18. 19.. 3. Reference: Olds. diabetes mellitus. Ladewig.arson Education. 3. 541-542.A. M.. 2. M. (2004).

NJ: Pe arson Education.). M.athogen invasion.B. London. London. In interviewing a pregnant client concerning sexually transmitted infect ions. Ladewig. P. & Davidson. Inc.B. the nurse should recognize which of the following as a barrier to client d isclosure? You answered correctly: Use of only yes or no questions Rationale: Use of open-ended questions. J. 118. S. Maternal-Ne wborn Nursing & Women's Health Care (7th ed.). M. Ladewig. (2004).L. The other choices are inappropriate and do not meet t he criterion of being noninvasive. 20.R.: Pearso n Education. P. 22. p. p. . M.. reliable screen for cocaine use in the pregnant clien t? You answered correctly: Urine Rationale: Cocaine metabolites may be present in the urine of a pregnant woman f or 4-7 days following use. 115. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. grayish -pink. The nurse anticipates that the client should have diagnostic testing for which of the following sexually tr ansmitted infections? You answered correctly: Human papilloma virus Rationale: The client's symptoms suggest an infection of human papilloma virus o n her vulva. M.). N.. & Davidson. 3. Upper Saddle River.. 21. Ladewig. Inc. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: The critical word in the question is noninvasive. The nurse expects that which of the following specimens will be obtained to provide a noninvasive. (2004). London. Reference: Olds." This indicates that you are looking for an answer that will discourage the client from elaborating.R. 112.. P.A... S.. Upper Saddle River. Upper Saddle River.. & Davidson. M. Cognitive Level: Application Client Need: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Maternal-Newborn Strategy: Key words are "barrier to client disclosure. NJ: P earson Education.. Eliminate options 2. (2004). cauliflower-like lesions in her genital area. Reference: Olds. Cognitive Level: Analysis Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Planning Content Area: Maternal-Newborn Strategy: Knowledge of the diagnostic tests used to determine human papilloma vi rus will be necessary to choose the correct answer. A biopsy is needed for a definitive diagnosis. A female client seeks medical care after noticing multiple soft. Thus the yes and no answers to questions would be the correct response. Eliminate options 2. framed in a culturally sensitive and non judgmental approach. Asking only questions with a yes and no response do no elicit information but may close the conversation.A. and 4 because these factors do not inc rease the client's risk for acquiring a sexually transmitted infection. Mate rnal-Newborn Nursing & Women's Health Care (7th ed. p. Reference: Olds. M. tends to establish a trusting and open relationship for inf ormation exchange. Inc. S.L.

Eliminate opt ion 1 because urine toxicology is used to screen for drug use. p. Mat ernal-Newborn Nursing & Women's Health Care (7th ed.. the nurse discovers that the client frequently eats undercooked meat. Reference: Olds. Inc. 518. The pregnant client. If a culture were desired. is usually transmitted to the fetus during labor and delivery and can result i n neonatal sepsis.. Reference: Olds. Which of the following would best be used as a diagnostic tool when th e client is asked to come into the office to be seen? You answered correctly: Indirect florescent antibody test Rationale: Toxoplasmosis can be diagnosed by indirect florescent antibody test. & Davidson. The VDRL is a test for syphilis. P. M. cultures of toxoplasmosis are difficult to obtain. P. Eliminate option 4 because it does not focus on an infectious process. Eliminate option 3 because the VDRL is a test for syphilis. M. considered normal vaginal flora for many women . and 4 as they require invasive testing.. Inc. Upper Saddle River. M. S. 25. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Content Area: Maternal-Newborn Strategy: Recall that the Group B streptococcus is a bacteria with risk for infe ction in the fetus.B.. Ladewig. Urine t oxicology is used to screen for drug use. London. . Inc.. (2004).A. & Davidson.B. The nurse suspects that the client might have contracted toxop lasmosis. Mat ernal-Newborn Nursing & Women's Health Care (7th ed.R. (2004). A priority nursing diagnosis for the client would be: You answered correctly: Risk for ineffective heath maintenance related to lack o f knowledge about ways in which a pregnant woman can contract toxoplasmosis. London. M.).3. Eliminate options 1 and 3 because this organism does not cau se these maternal infections. M. Meat consumption would increase iron intake. S.R. NJ: P earson Education.L..L. has called the office complaining of f lu-like symptoms. Rationale: Group B streptococcus. In talking with her. 24. p. however. The other answers do not provide correct information about di seases that can result from this organism. Ladewig. NJ: P earson Education.B. pp.A. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. 385. Reference: Olds. & Davidson. S. NJ: P earson Education. Ladewig. 514-515. M. London.. a cat owner.. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Planning Content Area: Maternal-Newborn Strategy: The core issue of the question is a diagnostic test for toxoplasmosis.). A client has come to the clinic for her first prenatal visit.A. The nurse explains to a pregnant client that maternal screening for Grou p B streptococcus is important because the microorganism can result in: You answered correctly: Neonatal sepsis. Eliminate option 4 because a cervical culture would not be specific for this di sease. Rationale: Toxoplasmosis can be contracted by eating undercooked and infected me at.. (2004). There is no indication that she is consuming too many calories or that other family members will need to change their eating habits. it would be obtained from blood. Upper Saddle River. P. 23.R.). Upper Saddle River.L.

If elevated. Eliminate options 1 and 4 because there is no indication that the client is consuming too many calories or that other family members will need to change their eating habits..). Ladewig.. Eliminate option 2 because it contains a finding of fetal lung immaturity.L. S. London. 27. S.. P. pp. Reference: Olds. (2004).R. There are false positive results. M. 514-515. Cognitive Level: Analysis Client Need: Physiological Integrity: Physiological Adaptation Integrated Process: Nursing Process: Assessment Content Area: Maternal-Newborn Strategy: The core focus of the question is a normal assessment finding for feta l lung maturity.L. Inc. Optical density is used to assess bilirubin concentrations. "I understand that this tes t will be done on amniotic fluid.R. You answered incorrectly: "I understand that if this test is normal I won't have to worry about having a baby with a birth defect. toxoplasmosis. London. M.A. 26.B.". & Davidson..B. Which of the following statements by the cli ent would indicate a need for further teaching? Select all that apply. "I understand that this test will be done on amniotic fluid. Eliminate option 2 because meat consumption would increase iron intake. & Davidson.. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. M. P. (2004).. and does not rule out or prove that an in fant has a neural tube defect. M." The correct answers were: "I understand that if this test is normal I won't have to worry about having a baby with a birth defect. Ladewig. The client is 37 weeks pregnant. Mat . M. the nu rse notes that an amniocentesis was performed to assess fetal lung maturity. 545-547.B. P. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. The nurse has just completed teaching a client who is to have a maternal serum alpha-fetoprotein screening. when present in amniotic fluid. Upper Saddle River." Rationale: Maternal serum alpha-fetoprotein is a screening test not a diagnostic test that uses a maternal blood test. (2004). London.A.A.R.Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Integrated Process: Nursing Process: Analysis Content Area: Maternal-Newborn Strategy: The focus of the question is client risk from eating undercooked meat. Hu man chorionic gonadotrophin is part of the triple screen used to assess for cert ain birth defects. S. pp. Ladewig.L. "I understand that this tes t will let us know if my baby has Down Syndrome. Upper Saddle River. NJ: P earson Education. Eliminate options 3 and 4 because they are not findings related to l ung maturity. & Davidson. Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Evaluation Content Area: Maternal-Newborn Strategy: Knowledge of the use of maternal serum alpha-fetoprotein screening tes t will aid in choosing the correct answer. Inc. In reviewing the client's chart. it is an indicator that further testing is warranted to establish a diagnosis.. M. Reference: Olds. An L/S ratio of 2:1 indicat es lung maturity. is associated w ith very low risk for respiratory distress syndrome. NJ: P earson Education. Whi ch of the following findings would indicate that the fetus's lungs are mature? You answered incorrectly: L/S ratio 1:1 The correct answer was: Phosphatidylglycerol Rationale: Phosphatidylglycerol."."..). Reference: Olds.

" Rationale: Chorionic villus sampling.). Which of the following statements by the client to the nurse would ind icate understanding of the information? You answered incorrectly: "This test will be done when I am between 16 and 18 we eks pregnant. Inc. 552-553. S. P. Cognitive Level: Analysis Client Need: PHYS Integrated Process: Nursing Process. this test can cause fetal limb redu ction defects. & Davidson.ernal-Newborn Nursing & Women's Health Care (7th ed. Inc. & Davidson. The nurse is assessing the fetal heart monitor strip of a client having a contraction stress test. Rationale: The contraction stress test is an assessment of the respiratory funct ion of the placenta. NJ: P earson Education.R. M. A client.). London." The correct answer was: "In very rare cases. pp. NJ: P earson Education. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. M. A negative test indicates that uteroplacental function is a dequate to allow the fetus to withstand the stress of labor at this time. S. Eliminate options 2 and 3 because late decelerations ar e present. who is 28 weeks pregnant. Evaluation Content Area: Diagnostic Tests Strategy: Knowledge of the contraction stress test and the interpretation of the results will aid in choosing the correct answer.L.B. has completed her teaching session concerning the test and its potential compl ications.. pp. usually completed between 10 and 12 weeks gestation. 538. (2004).L. Upper Saddle River. NJ: P earson Education. Ladewig.. 550-551. Ladewig..A. M. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. (2004).R. M... Reference: Olds. 540-541. if noted by the nurse. The correct answer was: No late decelerations after any contractions on a strip with three contractions within a 10-minute time frame. Reference: Olds.A. who is to have transcervical chorionic villus sampling (CVS) . Cognitive Level: Application Client Need: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process: Evaluation Content Area: Maternal-Newborn Strategy: Knowledge of the use of CVS and the procedure will enable the selectio n of the correct answer.B. p. would indicate a negative test? You answered incorrectly: Late decelerations after one contraction on a strip wi th three contractions within a 10-minute time frame. 29. 30.. Which of the following. 28. Inc. The nurse interprets that the client will need to be carefully mo nitored for which of the following? You answered incorrectly: Insufficient maternal oxygen levels The correct answer was: Inadequate fetal growth Rationale: An abnormal Doppler blood flow indicates impaired uteroplacental or u mbilical blood flow and places the infant at risk for intrauterine growth restri . Eliminate option 4 because accelerations are described. can rarely result in loss of a portion of the fetus's finger or toe. has had an abnormal Doppler blood fl ow assessment.. London. Upper Saddle River. The client. P.). Recall that a negative test ha s no late decelerations. Upper Saddle River. Transcervical sampling is done with the use of a catheter that is inserted throu gh the endocervix not through the abdomen.

. Inc. 542-543. P. 3. M. Cognitive Level: Application Client Need: PHYS Integrated Process.ction. Assessment Content Area: Diagnostic Tests Strategy: The core focus of the question is blood flow. . S. Mat ernal-Newborn Nursing & Women's Health Care (7th ed. London.A. pp. & Davidson. Upper Saddle River. The correct answer woul d be the option that contains a true statement about the risk of uteroplacental insufficiency.R. (2004).). Eliminate options 1.. Nursing Process. NJ: P earson Education.L. The other answers are incorrect. Ladewig.B. M.. Reference: Olds. and 4 because they are not related to ute roplacental blood flow.

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