NUR 325 Nursing Services Childbearing Family at CBU

NUR 325 Nursing Services Childbearing Family at CBU

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Free NUR 325 Nursing Services Childbearing Family at CBU Questions

1. A patient is being taught about tests for gestational diabetes. Teaching was effective when the patient states the following:
  • "I will get my A1C checked every visit."
  • "A fasting glucose done in the first trimester of pregnancy will show if I have gestational diabetes."
  • "All women are tested in the second trimester with a three hour glucose tolerance test to determine if they have gestational diabetes."
  • "I will have a one hour glucola test (glucose tolerance test) to screen for gestational diabetes during the second trimester."

Explanation

Gestational diabetes screening is routinely performed during the second trimester (24–28 weeks) using a one-hour oral glucose challenge test (glucola test). This screening determines whether the body effectively metabolizes glucose during pregnancy. If abnormal, a three-hour glucose tolerance test is done for confirmation. This timing corresponds with increased insulin resistance caused by placental hormones. The patient’s statement correctly reflects the standard protocol for gestational diabetes screening.
2.

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

  • If she has had prenatal care.

  • Membrane status and her EDD/EDC.

  • Time of last food intake and fasting blood sugar.

  • Pain level and birth plan.

Explanation

Correct Answer B: Membrane status and her EDD/EDC

B. Membrane status and her EDD/EDC

When a woman presents in labor, the most critical initial assessments include whether her membranes have ruptured and her estimated due date (EDD/EDC). Membrane status is essential for assessing infection risk and potential labor progression, while the EDD helps determine gestational age, influencing care decisions (e.g., term vs. preterm protocols).

Why the Other Options Are Incorrect:

A. If she has had prenatal care.

While important for background information, it is not the most immediate priority during labor admission. Urgent clinical data comes first.

C. Time of last food intake and fasting blood sugar.

This is relevant if anesthesia or surgery is anticipated but is not a top initial priority upon arrival to the intrapartum unit.

D. Pain level and birth plan.

Pain assessment and understanding the birth plan are important for ongoing care and patient-centered management, but they do not supersede determining membrane status and gestational age.


3. A patient is HIV+ and wants to know how this will affect her pregnancy and baby. What should be included in the response to this patient? (Select all that apply.)
  • "Your baby will be treated with prophylactic medications after it is born."
  • "All HIV+ patients should not breastfeed their infants."
  • "The baby might be born with a positive HIV test but this may convert to negative by 6 months of age."
  • "You will be given antibiotics when you are in labor to help protect the baby."
  • "To decrease chances of your baby acquiring HIV you need to take your antiretrovirals as prescribed."

Explanation

A. "Your baby will be treated with prophylactic medications after it is born.":
Newborns of HIV-positive mothers are given antiretroviral prophylaxis, such as zidovudine, to reduce the risk of mother-to-child transmission.
B. "All HIV+ patients should not breastfeed their infants.":
HIV can be transmitted through breast milk, so mothers are advised not to breastfeed. Formula feeding is recommended in settings where it is safe and accessible.
C. "The baby might be born with a positive HIV test but this may convert to negative by 6 months of age.":
HIV antibodies from the mother cross the placenta, causing the baby’s test to show false positive results initially. These maternal antibodies typically disappear by 6–18 months, and follow-up testing determines the infant’s true status.
E. "To decrease chances of your baby acquiring HIV you need to take your antiretrovirals as prescribed.":
Adherence to antiretroviral therapy (ART) during pregnancy dramatically reduces the risk of vertical transmission to less than 1%. Consistent medication use is essential for maternal health and fetal protection.
4. The ovum and sperm are called gametes. After fertilization, when the ovum and sperm join, the single cell is called a:
  • Blastocyst
  • Embryo
  • Zygote
  • Fetus

Explanation

When the male sperm fertilizes the female ovum, they unite to form a single cell known as a zygote. This cell contains a complete set of chromosomes—half from each parent—and represents the very first stage of human development. The zygote undergoes rapid cell division as it travels through the fallopian tube toward the uterus, where implantation and embryonic development begin.
5. The nurse is giving discharge instructions to a woman after a suction curettage to aspirate and evacuate a molar pregnancy. The woman asks why she must not get pregnant for at least a year. The best response from the nurse is:
  • If you get pregnant within one year, you will have another molar pregnancy, but if you wait for 2 years the odds are better to have a normal pregnancy with a better outcome.
  • The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult.
  • The procedure you had causes scarring of your tubes. You should wait for at least a year to get pregnant so that you can avoid an ectopic pregnancy.
  • Birth control will suppress the cancer that grows after a molar pregnancy. Therefore, you need to take oral contraceptives for a year to suppress your periods and decrease your chances of having choriocarcinoma.

Explanation

After a molar pregnancy, there is a risk of developing choriocarcinoma, a malignant tumor associated with persistent trophoblastic tissue. This condition is monitored by measuring serial levels of human chorionic gonadotropin (hCG), the same hormone produced during pregnancy. Becoming pregnant would elevate hCG levels, making it impossible to determine whether they are due to a new pregnancy or a malignant process. Avoiding pregnancy for at least a year allows accurate monitoring and early detection of potential malignancy.
6.

 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

  • Postpartum hemorrhage and hematoma formation.

  • Fever and foul smelling lochia.

  • Postpartum hemorrhage and urinary tract infection.

  • Urinary tract infection and uterine involution.

Explanation

Correct Answer C: Postpartum hemorrhage and urinary tract infection

Explanation:

C. Postpartum hemorrhage and urinary tract infection

A distended bladder can displace the uterus, preventing it from contracting effectively, which increases the risk of postpartum hemorrhage. Additionally, urinary stasis due to retention promotes bacterial growth, leading to urinary tract infections. Encouraging regular urination helps prevent both complications.

Why the Other Options Are Incorrect:

A. Postpartum hemorrhage and hematoma formation

While bladder distention can lead to hemorrhage, it is not a typical cause of hematomas, which are usually due to birth trauma or vascular injury.

B. Fever and foul smelling lochia

These symptoms suggest infection, but bladder distention is not a direct cause of foul-smelling lochia or uterine infection.

D. Urinary tract infection and uterine involution

Uterine involution refers to the uterus shrinking back to pre-pregnancy size, which can be delayed by bladder distention, but this choice pairs an infection with a normal physiological process, making it an imprecise statement.


7. A woman who is gravida 3 para 2 enters the intrapartum unit. The most important initial nursing assessments are:
  • If she has had prenatal care
  • Membrane status and her EDD/EDC
  • Time of last food intake and fasting blood sugar
  • Pain level and birth plan

Explanation

For a gravida 3 para 2 woman entering the intrapartum unit, the priority assessments are determining membrane status and estimated date of delivery (EDD/EDC). These findings help establish how far along labor may be and whether there is a risk of infection if membranes are ruptured. Knowing gestational age also guides interventions for fetal well-being and readiness for birth, ensuring immediate and appropriate obstetric care.
8. When caring for a laboring mother, late decelerations are noted on the fetal heart rate monitor. What actions should the nurse take? (Select all that apply.)
  • Turn the patient to her side
  • Provide 2–3 liters of oxygen via mask
  • Notify the health care provider
  • Stop the oxytocin

Explanation

A. Turn the patient to her side:
Repositioning the mother to her side relieves pressure on the inferior vena cava and aorta, improving uteroplacental blood flow. This helps increase oxygen delivery to the fetus and may reduce or eliminate late decelerations caused by decreased perfusion.
B. Provide 2–3 liters of oxygen via mask:
Administering oxygen enhances maternal oxygenation, thereby increasing the oxygen available to the fetus. This intervention helps correct fetal hypoxia and stabilizes the fetal heart rate pattern.
C. Notify the health care provider:
Late decelerations are a sign of potential fetal distress. The nurse must notify the provider immediately so further medical interventions, such as intrauterine resuscitation or expedited delivery, can be initiated to prevent fetal complications.
D. Stop the oxytocin:
Oxytocin increases uterine contractions, which can further compromise placental blood flow. Discontinuing oxytocin allows the uterus to relax, improving oxygen exchange between mother and fetus and preventing worsening of late decelerations.
9. Which of the following ideas would the nurse not include in a teaching plan on preconception health?
  • Taking prenatal vitamins with 400 mcg of folic acid
  • Normalizing HgA1c levels, if diabetic, prior to conception
  • Consuming a nutritional diet with 300 kcal more than normal
  • Going to the dentist for a routine check-up and cleaning

Explanation

A woman planning pregnancy should focus on a balanced diet but does not need to increase calorie intake before conception. The recommendation to consume an additional 300 calories per day applies after pregnancy begins, particularly during the second and third trimesters, to support fetal growth. Preconception care emphasizes folic acid supplementation, managing chronic conditions such as diabetes, and maintaining overall health—including dental care—to prepare for a healthy pregnancy.
10.

The nursery nurse is assessing a newborn that was just admitted to the nursery. The nursery nurse notices a cephalohematoma upon assessment of the head. The nursery knows that this infant is at risk for which condition

  • Hypoxemia

  • Hypoglycemia

  • Hyperbilirubinemia

  • Hyperglycemia

Explanation

Correct Answer C: Hyperbilirubinemia

Explanation

C. Hyperbilirubinemia

A cephalohematoma is a collection of blood between the skull and the periosteum caused by birth trauma, such as from forceps or vacuum delivery. As the hematoma resolves, the breakdown of red blood cells releases bilirubin, increasing the newborn’s risk for hyperbilirubinemia (jaundice).

Why the Other Options Are Incorrect:

A. Hypoxemia

Cephalohematoma is not associated with oxygen deprivation or respiratory compromise. Hypoxemia would be more related to pulmonary or cardiac issues.

B. Hypoglycemia

Though common in newborns under certain conditions (e.g., infants of diabetic mothers, preterm), hypoglycemia is not directly related to cephalohematoma.

D. Hyperglycemia

Newborns rarely experience hyperglycemia, and it is not related to birth trauma or cephalohematoma.


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