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Perinatal Nursing is a specialized field focusing on the care of women and their families throughout pregnancy, childbirth, and the immediate postpartum period. This course covers the physiological and psychological changes occurring during the perinatal period, emphasizing assessment, health promotion, risk reduction, and the management of common complications. Students learn evidence-based practices for labor and delivery support, newborn care, and family-centered approaches while developing critical skills in communication, advocacy, and interdisciplinary collaboration. Attention is also given to cultural competence, ethical considerations, and addressing the needs of diverse populations during the perinatal experience.
Recommended Textbook
Foundations of Maternal Newborn and Womens Health Nursing 7th Edition Murray
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Q1) Which of the following statements highlights the nurse's role as a researcher?
A) Reading peer-reviewed journal articles
B) Working as a member of the interdisciplinary team to provide patient care
C) Helping patient to obtain home care postdischarge from the hospital
D) Delegating tasks to unlicensed personnel to allow for more teaching time with patients
Answer: A
Q2) Which statement is true regarding the shortage of nurses in the United States?
A) There are a larger proportion of younger nurses in the workforce as compared with older nurses.
B) As a result of decreased RN-to-patient ratios, there is a decrease in patient mortality in the clinical setting.
C) Nursing programs are turning away qualified applicants.
D) There are adequate classroom and clinical facilities for training RNs.
Answer: C
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Q1) Which situation is most representative of an extended family?
A) It includes adoptive children.
B) It is headed by a single-parent.
C) It contains children from previous marriages.
D) It is composed of children, parents, and grandparents living in the same house.
Answer: D
Q2) Which issue is a major concern among members of lower socioeconomic groups?
A) Practicing preventive health care
B) Meeting health needs as they occur
C) Maintaining an optimistic view of life
D) Maintaining group health insurance for their families
Answer: B
Q3) Which patient may require more help and understanding when integrating the newborn into the family?
A) A primipara from an upper income family
B) A primipara who comes from a large family
C) A multipara (gravida 2) who has a supportive husband and mother
D) A multipara (gravida 6) who has two children younger than 3 years
Answer: D
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Q1) A female patient who has gone through puberty and started menstruating without any problems has developed cessation of periods after 2 years of normal cycles. Which finding would indicate a possible cause for this occurrence?
A) Lag in development of secondary sexual characteristics
B) Overproduction of androgenic hormones
C) Negative pregnancy test
D) Clinical diagnosis of primary amenorrhea
Answer: B
Q2) Which hormonal effect is noted during the menstrual cycle?
A) Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion rise during the ovulatory phase.
B) A negative feedback mechanism is exhibited by the anterior pituitary gland and ovaries.
C) The posterior pituitary gland secretes LH.
D) Estrogen secretion enhances FSH secretion.
Answer: A
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Q1) The nurse is teaching prenatal patients about avoiding substances or conditions that can harm the fetus. Which should the nurse include in the teaching session? (Select all that apply.)
A) Elimination of use of alcohol
B) Avoidance of supplemental folic acid replacement
C) Stabilization of blood glucose levels in a diabetic patient with insulin
D) Avoidance of nonurgent radiologic procedures during the pregnancy
E) Avoidance of maternal hyperthermia to temperatures of 37.8°C (100°F) or higher
Q2) The patient indicates to the clinic nurse that she is trying to become pregnant. The clinic nurse reviews the patient's chart and notes the following laboratory values: Blood type O-, RPR nonreactive, rubella non-immune, HCT 35%. Which laboratory value is most concerning to the nurse?
A) HCT 35%
B) Blood type O-
C) RPR nonreactive
D) Rubella non-immune
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Q1) An expectant mother says to the nurse, "When my sister's baby was born, it was covered in a cheese-like coating. What is the purpose of this coating?" The correct response by the nurse is to explain that the purpose of vernix caseosa is to
A) regulate fetal temperature.
B) protect the fetal skin from amniotic fluid.
C) promote normal peripheral nervous system development.
D) allow the transport of oxygen and nutrients across the amnion.
Q2) The nurse is explaining fetal circulation to a group of nursing students. Which information should be included in the teaching session? (Select all that apply.)
A) After birth the ductus venosus remains open, but the other shunts close.
B) The foramen ovale shunts blood from the right atrium to the left atrium.
C) The ductus venosus shunts blood from the liver to the inferior vena cava.
D) The ductus arteriosus shunts blood from the right ventricle to the left ventricle.
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Q1) A pregnant patient comes into the medical clinic stating that her family and friends are telling her that she is always talking about the pregnancy and nothing else. She is concerned that something is wrong with her. What psychological behavior is she exhibiting?
A) Antepartum obsession
B) Ambivalence
C) Uncertainty
D) Introversion
Q2) An expectant patient in her third trimester reports that she developed a strong tie to her baby from the beginning and now is really in tune to her baby's temperament. The nurse interprets this as the development of which maternal task of pregnancy?
A) Learning to give of herself
B) Developing attachment with the baby
C) Securing acceptance of the baby by others
D) Seeking safe passage for herself and her baby
Q3) The capacity of the uterus in a term pregnancy is how many times its prepregnant capacity? Record your answer as a whole number. ______ times
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Q1) A gravida 1 patient at 32 weeks of gestation reports that she has severe lower back pain. What should the nurse's assessment include?
A) Palpation of the lumbar spine
B) Exercise pattern and duration
C) Observation of posture and body mechanics
D) Ability to sleep for at least 6 hours uninterrupted
Q2) Use Nägele's rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.
A) February 19
B) January 19
C) January 21
D) February 7
Q3) Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy?
A) Sexual intercourse two or three times weekly
B) Moderate exercise for 30 minutes daily
C) Working 40 hours a week as a secretary in a travel agency
D) Relaxing in a hot tub for 30 minutes a day, several days a week
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Q1) In order to increase the absorption of iron by a pregnant patient, which beverage should an iron preparation be given with?
A) Tea
B) Milk
C) Coffee
D) Orange juice
Q2) When planning a healthy diet with a pregnant patient, what should the nurse's first action be?
A) Teach the patient about MyPlate.
B) Review the patient's current dietary intake.
C) Instruct the patient to limit the intake of fatty foods.
D) Caution the patient to avoid large doses of vitamins, especially those that are fat-soluble.
Q3) When should iron supplementation during a normal pregnancy begin?
A) Before pregnancy
B) In the first trimester
C) In the third trimester
D) In the second trimester
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Q1) The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks' gestation. The nurse determines that the patient understands the teaching when she states that will be collected for the initial screening process?
A) Urine
B) Blood
C) Saliva
D) Amniotic fluid
Q2) Which factors should be considered a contraindication for transcervical chorionic villus sampling?
A) Rh-negative mother
B) Gestation less than 15 weeks
C) Maternal age younger than 35 years
D) Positive for group B Streptococcus
Q3) What does optimal nursing care after an amniocentesis include?
A) Pushing fluids by mouth
B) Monitoring uterine activity
C) Placing the patient in a supine position for 2 hours
D) Applying a pressure dressing to the puncture site
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Q1) What is the priority nursing intervention for the patient who has had an incomplete abortion?
A) Methylergonovine (Methergine), 0.2 mg IM
B) Preoperative teaching for surgery
C) Insertion of IV line for fluid replacement
D) Positioning of patient in left side-lying position
Q2) A patient has tested HIV-positive and has now discovered that she is pregnant. Which statement indicates that she understands the risks of this diagnosis?
A) "I know I will need to have an abortion as soon as possible."
B) "Even though my test is positive, my baby might not be affected."
C) "My baby is certain to have AIDS and die within the first year of life."
D) "This pregnancy will probably decrease the chance that I will develop AIDS."
Q3) Which disease process improves during pregnancy?
A) Epilepsy
B) Bell's palsy
C) Rheumatoid arthritis
D) Systemic lupus erythematosus (SLE)
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Q1) Which characteristics of fetal alcohol syndrome (FAS) should the nurse expect to assess in affected neonates? (Select all that apply.)
A) Hydrocephaly
B) Low activity
C) Epicanthal folds
D) Short palpebral fissures
E) Flat midface, with a low nasal bridge
Q2) Which is the most dangerous effect on the fetus of a patient who smokes cigarettes while pregnant?
A) Intrauterine growth restriction
B) Genetic changes and anomalies
C) Extensive central nervous system damage
D) Fetal addiction to the substance inhaled
Q3) Which environment can assist a pregnant teen to achieve the task of establishing a stable identity?
A) Home schooling
B) Alternative education program
C) School-based mothers' program
D) Continuing mainstream high school classes
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Q1) Which assessment finding indicates that cervical dilation and/or effacement has occurred?
A) Onset of irregular contractions
B) Cephalic presentation at 0 station
C) Bloody mucus drainage from vagina
D) Fetal heart tones (FHTs) present in the lower right quadrant
Q2) Pregnant patients can usually tolerate the normal blood loss associated with childbirth because of which physiologic adaptation to pregnancy?
A) A higher hematocrit
B) Increased leukocytes
C) Increased blood volume
D) A lower fibrinogen level
Q3) The nurse is planning care for a patient during the fourth stage of labor. Which interventions should the nurse plan to implement? (Select all that apply.)
A) Offer the patient a warm blanket.
B) Place an ice pack on the perineum.
C) Massage the uterus if it is boggy.
D) Delay breastfeeding until the patient is rested.
E) Explain to the patient that the lochia will be light pink in color.
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Q1) The nurse is administering fentanyl (Sublimaze) to a patient in labor. The health care provider's prescription reads fentanyl (Sublimaze), 100 mcg IV stat. The medication vial reads fentanyl (Sublimaze), 50 mcg/mL. The nurse should prepare how many milliliters to administer the correct dose? Record your answer as a whole number. _____ mL
Q2) A woman with a known heroin habit is admitted in early labor. Which drug is contraindicated with opiate-dependent patients?
A) Nalbuphine (Nubain)
B) Hydroxyzine (Vistaril)
C) Promethazine (Phenergan)
D) Diphenhydramine (Benadryl)
Q3) To improve placental blood flow immediately after the injection of an epidural anesthetic, the nurse should
A) give the woman oxygen.
B) turn the woman to the right side.
C) decrease the intravenous infusion rate.
D) place a wedge under the woman's right hip.
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Q1) The nurse is instructing a nursing student on the application of fetal monitoring devices. Which method of assessing the fetal heart rate requires the use of a gel?
A) Doppler
B) Fetoscope
C) Scalp electrode
D) Tocodynamometer
Q2) A nurse documents that the fetal heart rate variability is marked. This indicates that the range is greater than how many beats per minute? Record your answer as a whole number. _____ bpm
Q3) Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
A) Unruptured membranes
B) Cervix dilated to 4 cm
C) Fetus has known heart defect
D) Maternal HIV
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Q1) A woman who is gravida 3, para 2 enters the intrapartum unit. The most important nursing assessments include
A) contraction pattern, amount of discomfort, and pregnancy history.
B) fetal heart rate, maternal vital signs, and the woman's nearness to birth.
C) last food intake, when labor began, and cultural practices the couple desires.
D) identification of ruptured membranes, the woman's gravida and para, and access to a support person.
Q2) Which breech presentation should the nurse recognize as being favorable for an external cephalic version?
A) 36-week gestation with low-lying placenta
B) 38-week gestation with one previous cesarean
C) 37-week gestation with fetal weight of 7 lb
D) 40-week gestation with several uterine fibroids
Q3) The nurse in the birth room receives an order to give a newborn 0.3 mg of naloxone (Narcan) intramuscularly. The medication vial reads naloxone (Narcan), 0.4 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Fill in the blank and record your answer using two decimal places. _____ mL
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Q1) Which technique is least effective for the patient with persistent occiput posterior position?
A) Squatting
B) Lying supine and relaxing
C) Sitting or kneeling, leaning forward with support
D) Rocking the pelvis back and forth while on hands and knees
Q2) A pregnant woman develops hypertension. The nurse monitors the patient's blood pressure closely at subsequent visits because the nurse is aware that hypertension is associated with which complication?
A) Abruptio placentae
B) Cardiac abnormalities in the neonate
C) Neonatal jaundice
D) Reduced placental blood flow
Q3) Which is the priority nursing assessment for the patient undergoing tocolytic therapy with terbutaline (Brethine)?
A) Intake and output
B) Maternal blood glucose level
C) Internal temperature and odor of amniotic fluid
D) Fetal heart rate, maternal pulse, and blood pressure
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Q1) If the patient's white blood cell (WBC) count is 25,000/mm³ on her second postpartum day, which action should the nurse take?
A) Document the finding.
B) Inform the health care provider.
C) Begin antibiotic therapy immediately.
D) Have the laboratory draw blood for reanalysis.
Q2) The nurse is teaching a non-breastfeeding patient measure to suppress lactation. Which information should the nurse include in the teaching session? (Select all that apply.)
A) Avoid massaging the breasts.
B) Allow warm shower water to run over the breasts.
C) If the breasts become engorged, pumping is recommended.
D) Ice packs or cabbage leaves can be applied to the breasts to relieve discomfort.
E) Wear a sports bra 24 hours a day until the breasts become soft.
Q3) Which situation would require the administration of Rho(D) immune globulin?
A) Mother Rh-negative, baby Rh-positive
B) Mother Rh-negative, baby Rh-negative
C) Mother Rh-positive, baby Rh-positive
D) Mother Rh-positive, baby Rh-negative
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Q1) If the nurse suspects a complication of a low forceps birth labor, she should immediately
A) administer a strong oral analgesic.
B) assess the perineal and vaginal areas.
C) assess the position of the uterine fundus.
D) review the labor record for duration of second stage.
Q2) The nurse suspecting a uterine infection in a postpartum patient should assess the A) episiotomy site.
B) odor of the lochia.
C) abdomen for distention.
D) pulse and blood pressure.
Q3) Nursing measures that help prevent postpartum urinary tract infection include
A) forcing fluids to at least 3000 mL/day.
B) promoting bed rest for 12 hours after birth.
C) encouraging the intake of grapefruit juice and carbonated beverages.
D) discouraging voiding until the sensation of a full bladder is present.
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Q1) A nursing student is helping the mother-baby nurse with morning vital signs. A baby born 10 hours ago via cesarean birth is found to have moist lung sounds. Which is the best interpretation of this information?
A) This is an emergency situation.
B) The neonate must have aspirated surfactant.
C) If this baby was born vaginally, it could indicate a pneumothorax.
D) The lungs of a baby delivered by cesarean birth may sound moist for 24 hours after birth.
Q2) The nurse is preparing to administer a vitamin K injection to the infant shortly after birth. Which statement is important to understand regarding the properties of vitamin K?
A) It is necessary for the production of platelets.
B) It is important for the production of red blood cells.
C) It is not initially synthesized because of a sterile bowel at birth.
D) It is responsible for the breakdown of bilirubin and the prevention of jaundice.
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Q1) The nurse is conducting a body system assessment of the newborn. Which are abnormal findings that the nurse should report? (Select all that apply.)
A) Low-set ears
B) Yellow sclera
C) A doll's eye sign
D) Edema of the eyelids
E) Absence of the grasp reflex
Q2) The nurse is assessing a newborn delivered 24 hours ago for jaundice. What is the best way to evaluate for this finding?
A) Depress the tip of the nose.
B) Stroke the outer aspect of the foot.
C) Place a finger in the palm of the hand.
D) Rotate the hips in an upward and outward direction.
Q3) Which assessment finding of a newborn requires prompt action by the nurse?
A) Respiratory rate of 50 breaths per minute
B) Cyanosis of the extremities
C) Pause in breathing lasting 20 seconds
D) Pause in breathing for 15 seconds followed by rapid respirations
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Q1) Which information should the nurse teach to new parents regarding the use of a bulb syringe?
A) Use it only once per day.
B) Suction the back of the throat vigorously.
C) Insert the syringe into the sides of the mouth.
D) Always suction the mouth before suctioning the nose.
Q2) A yellow crust has formed over the circumcision site. The mother calls the hotline at the local hospital 5 days after her son was circumcised. She is very concerned. Which response by the nurse is most appropriate?
A) The yellow crust should not be removed.
B) This yellow crust is an early sign of infection.
C) Discontinue the use of petroleum jelly to the tip of the penis.
D) After circumcision, the diaper should be changed frequently and fastened snugly.
Q3) Which intervention should be included in the home care of a high-risk infant?
A) Feeding the infant on a strict schedule
B) Keeping the infant in the supine or prone position
C) Providing continued respiratory support and oxygen
D) Cleaning the umbilical cord several times daily with alcohol
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Q1) Which is the first step in assisting the breastfeeding mother to nurse her infant?
A) Assess the woman's knowledge of breastfeeding.
B) Provide instruction on the composition of breast milk.
C) Discuss the hormonal changes that trigger the milk-ejection reflex.
D) Help her obtain a comfortable position and place the infant to the breast.
Q2) A mother conveys concern over the fact that she is not certain if her newborn is receiving enough nutrients from breastfeeding. This is the baby's first clinic visit after birth. What information can you provide that will help alleviate her fears regarding nutrient status for her newborn?
A) Monitor the infant's output; as long as at least six or more diapers are changed in a 24-hour period, the baby is receiving sufficient intake.
B) Tell the mother that if a baby is satisfied with feeding, she or he will be content and not fussy.
C) Tell the mother that breast milk contains everything required for the infant and not to worry about nutrition.
D) Provide nutrition information in the form of pamphlets for the mother to take home with her so that she uses them as a point of reference.
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Q1) Following a traumatic birth of a 10-lb infant, the nurse should evaluate
A) gestational age status.
B) flexion of both upper extremities.
C) infant's percentile on growth chart.
D) blood sugar to detect hyperglycemia.
Q2) A characteristic of a post-term infant who weighs 7 lb, 12 oz, and who lost weight in utero, is
A) soft and supple skin.
B) a hematocrit level of 55%.
C) lack of subcutaneous fat.
D) an abundance of vernix caseosa.
Q3) A newborn assessment finding that would support the nursing diagnosis of postmaturity would be
A) loose skin.
B) ruddy skin color.
C) presence of vernix.
D) absence of lanugo.
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Q1) The nurse should be alert to a blood group incompatibility if
A) both mother and infant are O-positive.
B) mother is A-positive and infant is A-negative.
C) mother is O-positive and infant is B-negative.
D) mother is B-positive and infant is O-negative.
Q2) When a cardiac defect causes the mixing of arterial and venous blood in the right side of the heart, the nurse might expect to find
A) cyanosis.
B) diuresis.
C) signs of congestive heart failure.
D) increased oxygenation of the tissues.
Q3) Newborns whose mothers are substance abusers frequently exhibit which of the following behaviors?
A) Hypothermia, decreased muscle tone, and weak sucking reflex
B) Excessive sleep, weak cry, and diminished grasp reflex
C) Circumoral cyanosis, hyperactive Babinski reflex, and constipation
D) Decreased amounts of sleep, hyperactive Moro reflex, and difficulty feeding
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Q1) The most appropriate statement for introducing the topic of family planning in the postpartum setting is
A) "What are your plans for future pregnancies?"
B) "Do you plan on being sexually active in the future?"
C) "Let's talk about birth control, because breastfeeding is not 100% effective for preventing pregnancy."
D) "Here are some pamphlets on available methods of birth control. I'll come back later and discuss them with you."
Q2) You are teaching a group of adolescents regarding myths and facts related to contraception. Which statement indicates that additional teaching is needed for this group?
A) Adolescents are more likely to become pregnant even if they use available contraception methods correctly.
B) The withdrawal technique provides a higher likelihood that a teen will not get pregnant.
C) Pregnancy can occur in the presence or absence of orgasm.
D) Pregnancy can occur even if a teen is menstruating at the time of coitus.
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Q1) A woman undergoing evaluation of infertility states, "At least when we're through with all of these tests, we will know what is wrong." The nurse's best response is
A) "I know the test will identify what is wrong."
B) "I'm sure that once you finish these tests, your problem will be resolved."
C) "Even with diagnostic testing, infertility remains unexplained in about 20% of couples."
D) "Once you've identified your problem, you may want to look at the option of adoption."
Q2) Large amounts of leukocytes in the seminal fluid suggest a clinical finding of A) inadequate fructose.
B) inflammation of the testes.
C) an infection of the genital tract.
D) an obstruction in the vas deferens.
Q3) The procedure in which ova are removed by laparoscopy, mixed with sperm, and the embryo(s) returned to the woman's uterus is
A) in vitro fertilization (IVF).
B) tubal embryo transfer (TET).
C) therapeutic insemination (IUI).
D) gamete intrafallopian transfer (GIFT).
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Q1) The physician diagnoses a 3-cm cyst in the ovary of a 28-year-old patient. You expect the initial treatment to include
A) initiating hormone therapy.
B) scheduling a laparoscopy to remove the cyst.
C) examining the patient after her next menstrual period.
D) aspirating the cyst and sending the fluid to pathology.
Q2) Which concern is included in the plan of care for the patient who receives HPV (human papillomavirus) vaccine?
A) It is available in oral form.
B) It involves a series of two injections.
C) Injections should be given over a 3-month period.
D) The vaccine (Gardasil) should not be given to any patient with a sensitivity to yeast.
Q3) A benign breast condition that includes dilation and inflammation of the collecting ducts is known as A) fibroadenoma.
B) ductal ectasia.
C) intraductal papilloma.
D) chronic cystic disease.
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