HESI PN MATERNAL NEWBORN PROCTORED EXAM

HESI PN MATERNAL NEWBORN PROCTORED EXAM

VERSION 17

The nurse is assessing a new mother's efforts to bond with her newly born infant. Identify three (3) factors that can impact effective bonding between mother and infant?

• Holds the infant face-to-face (en face position) maintaining eye

contact

• Identifies the infant’s unique characteristics and relates them to

those of other family members

• Provides physical care for the infant, such as feeding and diapering

A nurse is providing community education regarding risk factors for ovarian cancer. Identify five (5) risk factors associated with the development of ovarian cancer. (Review the Med Surg RM)  Age greater than 40 years  Nulliparity/first pregnancy after 30 years of age  Family history of ovarian, breast, or genetic mutation for hereditary nonpolypolyposis colon cancer (HNPCC)  BRCA1 or BRCA2 gene mutations  Diabetes mellitus  Early menarche/late menopause  History of dysmenorrhea/heavy bleeding  Endometriosis  High-fat diet  Hormone replacement therapy  Use of infertility medications  Older adult clients following surgery for cancer

The client enters the obstetrical clinic for birth control information on using a diaphragm. What five (5) instructions would be provided by the nurse to explain use of the diaphragm? 1 / 2

 Client should be properly fitted with a diaphragm by provider  Replaced every 2 years and refitted for a 20% weight fluctuation, after abdominal/pelvic surgery, and after every pregnancy  Requires proper insertion and removal. Prior to coitus, the diaphragm is inserted vaginally over the cervix with spermicidal jelly/cream, that is applied to the cervical side of the dome and around the rim. The diaphragm can be inserted up to 6 hours before intercourse but for no more than 24 hours. Spermicide must be reapplied with each act of coitus  A client should empty her bladder prior to insertion of the diaphragm  Diaphragm should be washed with mild soap and warm water after each use

What are risks/possible complications/contraindications for the use of intrauterine contraceptive devices? Best used by women in a monogamous relationship due to the risks of STIs  Can cause irregular menstrual bleeding  Risk of bacterial vaginosis, uterine perforation, or uterine expulsion  Active pelvic infection  Abnormal uterine bleeding  Severe uterine distortion  For copper IUD- Wilson’s diseases and copper allergy

A nurse is caring for a client who is considering use of a hormonal intrauterine system. What information regarding the advantages of an Intrauterine Device (IUD) should the nurse provide? IUD can maintain effectiveness for 1 to 10 years (hormonal IUD 3-5 years, copper IUD 10 years)  Can be inserted immediately after abortion, miscarriage, childbirth, and while breastfeeding  Contraception can be reversed with immediate return to fertility  Doesn’t interfere with spontaneity

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