1 MATERNAL AND CHILD NURSINGPOST TESTMATERNAL AND CHILD NURSINGPOST TESTANATOMY AND PHYSIOLOGY1. The hormone responsible for a positive pregnancy test is: A. Follicle Stimulating hormoneB. Human Chorionic GonadotroinC. EstrogenD. ProgesteroneAn!"#r$ Buman chorionic gona!otropin "C#$ is the hormone secrete! by the chorionic villi %hich is the precursor of the placenta. &n the early stage of pregnancy' %hile the placenta is not yet fully !evelope!' the ma(or hormone that sustains the pregnancy is C#.). The most common an! normal site of ni!ation in the uterus is A. U#r ut#rin# ortion *. +i!,uterine area C. -o%er uterine segment D. -o%er cervical segment An!"#r$ %A& U#r ut#rin# ortion The embryo.s normal ni!ation site is the upper portion of the uterus. &f the implantation is in the lo%er segment' this is an abnormal con!ition calle! placenta previa./. 0hich of the follo%ing are signs of ovulation11. +ittelschmer2). Spinnbar3eit/. Thin %atery cervical mucus45. Elevate! bo!y temperature of /.6 !egrees centigra!e A. 1 an! ) *. 1 an! /C. '( ) and * D. 1' )' /' 5 An!"#r$ C+ittelschmer2' spinnabar3eit an! thin %atery cervical mucus are signs of ovulation. 0hen ovulation occurs' the hormone progesterone is release! %hich can cause a slight elevation of temperature bet%een 6.),6.5 !egrees centigra!e an! not 5 !egrees centigra!e.HUMAN SE+UALITY5. 0hich of the follo%ing factors %oul! be most in7uential to the outcome of a class on human se8uality that inclu!es both males an! females ranging in age from a!olescence through mi!!le,age! a!ults1A. Environmental setting %here the class %ill ta3e place*. Availability of %ritten han!outs to reinforce the contentC. Th# nur!#,! com-ort .#/#. in di!cu!!in0 th# !u12#ct matt#rD. Cognitive level of the information to be presente!Ans%er C9ationale: The nurse must !emonstrate comfort %ith human se8uality content to facilitate an e:ective presentation to a class. Although reinforcement of concepts is important' availability of Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i42 MATERNAL AND CHILD NURSINGPOST TEST%ritten han!outs is not the most important aspect to in7uence the outcome of the class. Although cognitive level of the information to be presente! is also an important factor still it is not the best in!icator in the !etermination of the e:ectiveness of the class. The setting for the class presentation facilitates e:ectiveness' but it is not the primary factor in the !etermination of the clients learning outcomes.;. The client begins to n %hat bo!y parts %oul! you e8pecte! chloasma to be observe!1a. :or#h#ad( no!# ch##8!Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i47 MATERNAL AND CHILD NURSINGPOST TESTb. *reast' areola' nipplec. *reast' ab!omen' thighs!. Jec3 an! chest' arms an! legsAns%er: AChloasma' also 3no%n as the Lmas3 of pregnancyM' is an irregular pigmente! area foun! on the face. &t is not seen on the breast' areola' nipples' chest' nec3' ab!omen' arms' an! legs. (Lippincotts Maternal-Newborn Nursing, p 74))5. 0hich of the follo%ing common emotional reactions to pregnancy %oul! the nursing e8pect to occur !uring the thir! trimester1a. ambivalence' fear' fantasies1. a"8"ardn#!!( c.um!in#!!( unattracti/#n#!!c. introversion' egocentrism' narcissism!. an8iety' passivity' e8troversionAns%er: *During the Hrst trimester' the common reactions are fear' ambivalence' an8iety. During the secon! trimester' the %oman is e8pecte! to be introvert an! passive' %ith increasing nee! to learn about fetal gro%th an! !evelopment. During the thir! trimester' the %oman becomes a%3%ar!' clumsy an! unattractive an! becomes re7ective of her o%n chil!hoo!. (Lippincotts Maternal-Newborn Nursing, p 74));. &n the later part of the thir! trimester' the mother may e8perience shortness of breath. This complaint maybe e8plaine! as a. The %oman maybe e8periencing complication of pregnancyb. The %oman is having allergic reaction to the pregnancy an! its hormonesc. Th# -undu! o- th# ut#ru! i! hi0h u!hin0 th# diahra0m u"ard!!. A normal occurrence in pregnancy because the fetus is using more o8ygenAns%er: C , The fun!us of the uterus is high pushing the !iaphragm up%ar!s from the /)n! %ee3 of the pregnancy' the fun!us of the enlarge! uterus is pushing the respiratory !iaphragm up%ar!s. Thus' the lungs have re!uce! space for e8pansion conse# is consi!ere! as the minimum fetal age for viability.)E. 0hich of the follo%ing refers to the single cell that repro!uces itself after conception1 A. Chromosome *. *lastocyst C. C30ot# D. Trophoblast Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i48 MATERNAL AND CHILD NURSINGPOST TESTAn!"#r$ CThe2ygoteisthesinglecell that repro!ucesitself after conception. Thechromosomeisthematerial that ma3es up the cell an! is gaine! from each parent. *lastocyst an! trophoblast arelater terms for the embryo after 2ygote. )F. The fontanels are soft spots forme! by the:A. bloo! accumulate! bet%een the bone an! periosteum.*. e!ema of the scalp from birth pressure.C. 2unction o- indi/idua. !8u.. 1on#!.D. pressure of a vacuum e8tractor.An!"#r$ C CHILDBIRTH EDUCATION)G. There are many %ays of chil!birth preparation to ease the stress an! an8iety of the mother !uring labor an! !elivery. The follo%ing are natural chil!birth proce!ures EOCEPT: A. Rit0#nD! man#u/#r*. Dic3,9ea! metho! C. Psychoprophylactic metho!D. -ama2e metho!An!"#r$ A9itgen.s metho! is use! to prevent perineal tearNlaceration !uring the !elivery of the fetal hea!. -ama2e metho! is also 3no%n as psychoprophylactic metho! an! Dic3,9ea! metho! are commonly 3no%n natural chil!birth proce!ures %hich a!vocate the use of non,pharmacologic measures to relieve labor pain.ANTEPARTUM CARE/6. Posie' 1; years ol!' comes to the prenatal clinic because she has misse! three menstrual perio!s. *efore her physical e8amination' she says. @& !onAt 3no% %hat the problem is' but & canAt be pregnant.@ The nurseAs most therapeutic response to this statement %oul! be:A. ;@hat 1rou0ht 3ou to th# r#nata. c.inic th#nE;*. @The !octor %ill let you 3no% shortly.@C. @&f you have ha! intercourse' you are probably pregnant.@D. @+any young %omen are irregular at your age.@Ans%er AE8planation: A. This response points out reality an! allo% the client to elaborate.*. This response %oul! close o: any future communication %ith the client.C. This response soun!s rather critical or (u!gmental an! %oul! probably cut o: further !iscussion %ith the client. D. This may be true statement' but it !oes not allo% for much !iscussion to follo%/1. Bou performe! the -eopol!.s maneuver an! foun! the follo%ing: breech presentation' fetal bac3 at the left si!e of the mother. *ase! on these Hn!ings' you can hear the fetal heart beat "P+&$ *EST in %hich location1 A. -eft lo%er CT$ ta3en !uring pregnancy may cause problems in the ne%born !uring the neonatal perio!. The membranes rupture! ) hours ago is not a cause of concern4 if membranes rupture! over )5 hours before birth' infection may ensue.emophilia a:ects males4 this fetus is 3no%n to be a female may be a carrier but %oul! not have hemophilia. Placenta previa %oul! have been !iagnose! before active labor4 a history of a placenta previa in an earlier pregnancy %oul! not have implication for this ne%born.POSTPARTUM CARE;5. A client %ho is )5 hours postpartum has the follo%ing morning vital signs: Temperature GG.FS F4 *P 1)5NEF4 P9 ;Fbpm4 99 1?cpm. The nurse shoul! !o %hich of the follo%ing1A. R#co0ni4# th# c.i#nt,! /ita. !i0n! ar# norma..*. Assess the vital signs hourly instea! of every 5 hours.C. 9eta3e the pulse rate after the client ambulates. Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i415 MATERNAL AND CHILD NURSINGPOST TESTD. 9eport the changes in vital signs to the physician.Ans%er A9ationale: A temperature elevation greater than 166.5S F on any t%o consecutive rea!ings is consi!ere! febrile on the other han! a temperature of GG.FS F re7ects the bo!yAs normal response to tissue !amage or repair an! to slight !ehy!ration from labor. *ecause the clientAs vital signs are%ithin normal limits' there is no in!ication to assess vital signs more fre5 is /6 ccNhr. &f in 5 hours the urine Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i422 MATERNAL AND CHILD NURSINGPOST TESToutput is only 166 cc this is lo% an! can lea! to poor e8cretion of +agnesium %ith a possible cumulative e:ect' %hich can be !angerous to the mother.F). A mother receiving me!ications for pregnancy,in!uce! hypertension shoul! have her !iastolic bloo! pressure maintaine! in the range of G6 to 166 mmg to:A. A/oid cau!in0 -#ta. ano9ia*. Ensure progression of laborC. Prevent premature contractionsD. Present su!!en elevations in pulseAn!"#r$ AF/. A client reports s%elling of her feet an! han!s on arising each morning. A )5,hour !ietary recall reveals a salt inta3e in e8cess of ) gN!ay. 0hich of the follo%ing shoul! the nurse recommen!1A. 9estriction of 7ui! inta3e *. A/oidanc# o- !a.t3 -ood! C. Elimination of all salt from her !ietD. 9e+ is associate! %ith malpresentation an! possibly incompetent cervi8 An!"#r$ BP9>+ can precipitate many potential an! actual problems4 one of the most serious is the fetuslossof an e:ective !efense againstinfection.Thisisthe client.s most imme!iatenee!at thistime. Typically' P9>+ occurs about 1 hour' not 5 hours' before labor begins. Fetal viability an!gestationalage are less imme!iate consi!erations that a:ect the plan of care. +alpresentationan! an incompetent cervi8 may be causes of P9>+. LACERATIONG;. &f the labor perio! lasts only for ) an! 1N) hours' the nurse shoul! suspect that the follo%ing con!itions may occur1. Fetal ano8ia). Cranial hematoma in the fetus/. -aceration of perineal muscles5. -aceration of cervi8A. '( )( *( B*. 1 an! /C. / an! 5 D. )' /' an! 5An!"#r$ Aall the above con!itions can occur follo%ing a precipitate labor an! !elivery of the fetus because there %as little time for the baby to a!apt to the passage%ay. &f the presentation is cephalic' the fetal hea! serves as the main part of the fetus that pushes through the birth canal %hich can lea! to cranial hematoma' an! possible compression of cor! may occur %hich can lea! to less bloo! an! o8ygen to the fetus "hypo8ia$. -i3e%ise the maternal passage%ay "cervi8' vaginal canal an! perineum$ !i! not have enough time to stretch %hich can lea! to laceration.DYS:UNCTIONAL LABORG?. The follo%ing are common causes of !ysfunctional labor. 0hich of these can be manage! using in!epen!ent nursing action1 A. Cervical rigi!ity*. Pelvic bone contractionC. :u.. 1.add#rD. E8tension rather than 7e8ion of the hea!Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i426 MATERNAL AND CHILD NURSINGPOST TESTAn!"#r$ C Full bla!!er can impe!e the !escent of the fetal hea!. The nurse can rea!ily manage this problem by !oing a simple catheteri2ation of the mother.CEASARIAN BIRTHGE. 0hen preparing a client for cesarean !elivery' %hich of the follo%ing 3ey concepts shoul! beconsi!ere! %hen implementing nursing care1 A. &nstruct the mother.s support person to remain in the family lounge until after the !elivery *. Arrange for a sta: member of the anesthesia !epartment to e8plain %hat to e8pectpostoperatively C. Modi-3 r#o#rati/# t#achin0 to m##t th# n##d! o- #ith#r a .ann#d or #m#r0#nc3c#!ar#an 1irth D. E8plain the surgery' e8pecte! outcome' an! 3in! of anesthetics An!"#r$ CA3eypoint toconsi!er %henpreparingtheclient for acesarean!eliveryis tomo!ifythepreoperative teaching to meet the nee!s of either a planne! or emergency cesarean birth' the!epth an! brea!th of instruction %ill !epen! on circumstances an! time available. Allo%ing themother.s support person to remain %ith her as much as possible is an important concept' although!oingso!epen!s onmanyvariables. Arrangingfor necessarye8planations byvarious sta:members to be involve! %ith the client.s care is a nursing responsibility. The nurse is responsiblefor reinforcing the e8planations about the surgery' e8pecte! outcome' an! type of anesthetic tobe use!. The obstetrician is responsible for e8plaining about the surgery an! outcome an! theanesthesiology sta: is responsible for e8planations about the type of anesthesia to be use!. GF. A trial for vaginal !elivery after an earlier caesarean' %oul! li3ely to be given to a gravi!a' %hoha!:A. First lo% transverse cesarean %as for active herpes type ) infections4 vaginal culture at /G %ee3s pregnancy %as positive.*. First an! secon! caesareans %ere for cephalopelvic !isproportion.C. First caesarean through a classic incision as a result of severe fetal !istress.D. :ir!t .o" tran!/#r!# ca#!ar#an "a! -or 1r##ch o!ition. :#tu! in thi! r#0nanc3 i! in a /#rt#9 r#!#ntation.An!"#r$ DThis type of client has no obstetrical in!ication for a caesarean section as she !i! %ith her Hrst caesarean !elivery.PRETERM LABORGG. To prevent preterm labor from progressing' !rugs are usually prescribe! to halt the labor. The !rugs commonly given are: A. Prostaglan!in an! o8ytocin*. De8amethasone an! prostaglan!inC. Progesterone an! estrogen D. Ma0n#!ium !u.-at# and t#r1uta.in#An!"#r$ D+agnesium sulfate acts as a CJS !epressant as %ell as a smooth muscle rela8ant. Terbutaline is a !rug that inhibits the uterine smooth muscles from contracting. >n the other han!' o8ytocin an! prostaglan!in stimulates contraction of smooth muscles.166. 0hich of the follo%ing !rugs can be given to the mother before a preterm birth to help re!uce the severity of respiratory !istress syn!rome1Pr#ar#d 13$ Archi# D. A./i4( R.N.( R.M. 5 mano-!t##.6archi#73ahoo.com5 -ac#1oo8 -an a0#$ SirArchi# D. A./i427 MATERNAL AND CHILD NURSINGPOST TESTA. B#tam#tha!on#*. Dia2epamC. Phenobarbital D. 9ho#A+ An!"#r$ APROLONGED LABOR161. The response that conveys acceptance of the clientAs e8pressions of frustration an! hostility %hen caring for a client %ho is having a prolonge! labor' %oul! be:A. ;I,.. ru1 3our 1ac8N t#.. m# i- it h#.!.;*. @&All leave as you can tal3 to your husban!.@C. @All %omen get %eary an! frustrate! !uring labor.@D. @0oul! you li3e to tal3 about %hatAs bothering you1@Ans%er AE8planation: A. This response provi!es the client %ith a comfort measure %hile giving her an opportunity to get verbali2e her fears about having a prolonge! labor. *. This closes o: communication %ith the client. C. This is of no help to the client4 she is concerne! %ith %hat is happening to her. D. This can be ans%ere! @yes@ or @no@ an! leaves no further avenue for !iscussion.UTERINE IN=ERSION16). Techni