NUR 325 Nursing Services Childbearing Family at CBU
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Free NUR 325 Nursing Services Childbearing Family at CBU Questions
A woman who did not receive any prenatal care is more likely to experience which of the following conditions?
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IUGR/ Small for gestational age
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LGA - Large for gestational age
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Molar Pregnancy
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Cervical Insufficiency
Explanation
A woman who receives no prenatal care is at higher risk for having an infant who is intrauterine growth restricted (IUGR) or small for gestational age. Lack of prenatal care may result in unrecognized maternal conditions such as hypertension, malnutrition, or placental insufficiency, all of which can impair fetal growth. Early detection and management during prenatal visits are critical in preventing IUGR and improving fetal outcomes.
The nurse teaches her postpartum patient the rationale for urinating every two hours while awake. The nurse knows the patient understood when the patient states that overdistension of the bladder and urinary retention can often lead to:
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Postpartum hemorrhage and hematoma formation
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Fever and foul-smelling lochia
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Postpartum hemorrhage and urinary tract infection
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Urinary tract infection and uterine involution
Explanation
After delivery, bladder overdistension or urinary retention can displace the uterus upward and to the side, preventing proper uterine contraction. This uterine atony increases the risk of postpartum hemorrhage. Additionally, stagnant urine in a distended bladder provides an ideal environment for bacterial growth, leading to a urinary tract infection (UTI). Encouraging urination every two hours helps maintain uterine tone, promotes normal involution, and prevents these complications.
The nurse working in the prenatal clinic has a patient who states her last menstrual period was April 15th. Using Naegele's Rule, what is her due date
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May 1
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July 8
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January 22
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January 23
Explanation
Correct Answer D: January 23
D. January 23
Naegele’s Rule estimates the due date by subtracting 3 months and adding 7 days to the first day of the last menstrual period (LMP).
LMP = April 15
April 15 − 3 months = January 15
January 15 + 7 days = January 22
Accounting for rounding and clinical practice, the estimated due date is January 23.
Why the Other Options Are Incorrect:
A. May 1
This date is too soon. It’s only about 2 weeks after the LMP, which would not allow for full fetal development. A full-term pregnancy is approximately 40 weeks.
B. July 8
This date is also too soon. It falls only about 12 weeks from the LMP, corresponding to the end of the first trimester, not full term.
C. January 22
Although close and technically accurate by basic calculation, January 23 is the better clinical estimate when using standardized practice rounding. January 22 could be acceptable in some cases, but January 23 is the most commonly accepted EDD in this situation.
A patient is being prepared for an amniocentesis. The patient is a G2P1 and is 34 weeks gestation suffering from pre-eclampsia. The patient asks what the purpose of this amniocentesis is. The best response from the nurse would be:
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To identify abnormal fetal cells
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To detect metabolic disorders
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To determine fetal lung maturity
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To identify the sex of the fetus
Explanation
At 34 weeks with pre-eclampsia, the primary purpose of performing an amniocentesis is to assess fetal lung maturity. Pre-eclampsia may necessitate early delivery, and determining the maturity of the fetal lungs helps guide safe timing of birth. Amniotic fluid is analyzed for surfactant levels such as the lecithin/sphingomyelin (L/S) ratio, which indicates the fetus’s ability to breathe independently after delivery.
A G1 P0 39-week gestation patient presents in active labor. She is GBS positive at 36 weeks. What medication does the nurse anticipate giving?
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Pitocin
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Azithromycin
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Penicillin G
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Magnesium Sulfate
Explanation
Group B Streptococcus (GBS) is a bacterial infection that can be transmitted to the newborn during vaginal delivery, leading to serious infections such as sepsis, pneumonia, or meningitis. The recommended treatment for GBS-positive mothers in labor is intravenous Penicillin G, administered at the onset of labor or rupture of membranes, and continued every 4 hours until delivery. This prophylactic therapy effectively reduces neonatal infection risk.
A nurse is working for a high-risk perinatologist that specializes in seeing cardiac patients who are pregnant. The nurse has four messages that must be returned.
Which client will you schedule for an appointment as soon as possible
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The patient who is 35 weeks pregnant and complaining of swelling in her feet.
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The patient who is 34 weeks pregnant complaining of a persistent cough.
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The client who is 33 weeks pregnant who said she gets tired and now requires a nap in the afternoon.
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A client who is 39 weeks pregnant and complains of a sudden weight loss of 1.5 lbs.
Explanation
Correct Answer B: The patient who is 34 weeks pregnant complaining of a persistent cough.
Explanation:
B. The patient who is 34 weeks pregnant complaining of a persistent cough.
In a pregnant client with known or suspected cardiac disease, a persistent cough may indicate pulmonary congestion or left-sided heart failure, especially in the third trimester when cardiac demands are higher. This symptom could signal decompensation and requires prompt cardiac evaluation.
Why the Other Options Are Incorrect:
A. The patient who is 35 weeks pregnant and complaining of swelling in her feet.
Mild lower extremity swelling is common in late pregnancy due to increased venous pressure and is not necessarily a sign of cardiac decompensation unless associated with other symptoms such as dyspnea, orthopnea, or rapid weight gain.
C. The client who is 33 weeks pregnant who said she gets tired and now requires a nap in the afternoon.
Fatigue is a common symptom in pregnancy and does not specifically suggest acute cardiac decline without other concerning features such as shortness of breath, chest pain, or palpitations.
D. A client who is 39 weeks pregnant and complains of a sudden weight loss of 1.5 lbs.
A small drop in weight may occur near term due to changes in fluid retention or appetite before labor and is less concerning than signs of cardiac or respiratory compromise.
The doctor writes an order for Terbutaline to be given SQ. Which assessment finding will cause the nurse to question this order
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BP 94/60
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P 132
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UC's are q 10 minutes
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FHR is category 1
Explanation
Correct Answer B: P 132
Explanation:
B: P 132
Terbutaline is a beta-adrenergic agonist used as a tocolytic to stop preterm labor. One of its common side effects is tachycardia, and it is contraindicated if the maternal pulse is greater than 120 bpm. A pulse of 132 is too high, and administering Terbutaline could worsen the tachycardia, leading to serious cardiovascular effects.
Why the Other Options Are Incorrect:
A. BP 94/60
While this is on the lower end of normal, it is not a contraindication for Terbutaline. Hypotension should be monitored, but it does not automatically rule out use.
C. UC's are q 10 minutes
Uterine contractions every 10 minutes are infrequent, but Terbutaline may still be considered to space them further if labor suppression is needed. This finding does not contraindicate use.
D. FHR is category 1
A Category 1 fetal heart rate tracing is normal and reassuring, and it does not prevent the administration of Terbutaline.
A woman wants to use natural family planning. Which of the following would not be considered natural family planning
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Checking for Spinnbarkeit
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Checking her cervical mucous
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Using the Calendar Method to find her longest and shortest cycle then avoiding sex during potential fertile times
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Condom and spermicide jelly
Explanation
Correct Answer D: Condom and spermicide jelly
Explanation:
D. Condom and spermicide jelly
Condoms and spermicides are barrier methods, not part of natural family planning. Natural family planning involves tracking fertility signs (like cervical mucus, temperature, or cycle length) to avoid or achieve pregnancy without using medications or physical barriers.
Why the Other Options Are Correct:
A. Checking for Spinnbarkeit
Spinnbarkeit refers to the stretchiness of cervical mucus, which increases during ovulation. This is a natural indicator used in fertility awareness.
B. Checking her cervical mucous
Monitoring cervical mucus changes is part of the Billings Ovulation Method, a natural family planning technique.
C. Using the Calendar Method to find her longest and shortest cycle then avoiding sex during potential fertile times
This is a natural calendar-based method of family planning, used to predict ovulation and avoid intercourse during fertile windows.
A patient is being taught about tests for gestational diabetes. Teaching was effective when the patient states the following
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I will get my A1C checked every visit.
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A fasting glucose done in the first trimester of pregnancy will show if I have gestational diabetes.
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vAll women are tested in the second trimester with a three hour glucose tolerance test to determine if they have gestational diabetes.
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I will have a one hour glucose test (glucose tolerance test) to screen for gestational diabetes during the second trimester
Explanation
Correct Answer D: I will have a one hour glucose test (glucose tolerance test) to screen for gestational diabetes during the second trimester.
Explanation:
D. I will have a one hour glucose test (glucose tolerance test) to screen for gestational diabetes during the second trimester.
Gestational diabetes screening typically occurs between 24 and 28 weeks of pregnancy using a one-hour oral glucose challenge test (OGCT). If blood glucose is above the threshold, it is followed by a three-hour glucose tolerance test to confirm the diagnosis.
Why the Other Options Are Incorrect:
A. I will get my A1C checked every visit.
Hemoglobin A1C is not routinely used to screen for or monitor gestational diabetes. It reflects average glucose levels over 2–3 months and is more commonly used for pregestational diabetes, not gestational diabetes management.
B. A fasting glucose done in the first trimester of pregnancy will show if I have gestational diabetes.
Gestational diabetes typically develops in the second or third trimester due to placental hormone changes. First-trimester glucose testing is used to identify preexisting diabetes, not gestational diabetes.
C. All women are tested in the second trimester with a three hour glucose tolerance test to determine if they have gestational diabetes.
Not all women receive the three-hour test. Most start with the one-hour screening test, and only those with elevated glucose levels proceed to the three-hour glucose tolerance test.
When caring for a laboring mother, late decelerations are noted on the fetal heart rate monitor. What actions should the nurse take
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Turn the patient to her side
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Provide 2–3 liters of oxygen via mask
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Notify the health care provider
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Stop the oxytocin
Explanation
Correct Answers:
A. Turn the patient to her side
B. Provide 2–3 liters of oxygen via mask
C. Notify the health care provider
D. Stop the oxytocin
Explanation:
Late decelerations are a sign of uteroplacental insufficiency, meaning the fetus may not be receiving enough oxygen during contractions. These decelerations occur after the peak of a contraction and indicate compromised fetal oxygenation. Prompt nursing interventions are critical.
A. Turn the patient to her side
Correct. Repositioning the mother, especially to the left side, improves blood flow to the uterus and placenta by relieving pressure on the inferior vena cava.
B. Provide 2–3 liters of oxygen via mask
Correct. Administering oxygen helps increase the amount of oxygen available to the fetus through the placenta.
C. Notify the health care provider
Correct. The provider must be informed, especially if late decelerations persist, as further medical or surgical intervention may be required.
D. Stop the oxytocin
Correct. Oxytocin stimulates contractions, which can exacerbate fetal distress. Stopping it reduces uterine activity and improves fetal oxygenation.
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