Choice A: Copious vaginal bleeding is not a typical sign of ectopic pregnancy. It may occur in some cases, but it is more likely to indicate a miscarriage, placenta previa, or placental abruption.

Choice B: Pelvic pain is the most common symptom of ectopic pregnancy. It usually occurs on one side of the lower abdomen and may be sharp, dull, or crampinG. The pain may worsen with movement or pressurE.

Choice C: Severe nausea and vomiting are not specific to ectopic pregnancy. They may occur in any pregnancy, especially in the first trimester. They may also be caused by other conditions, such as gastroenteritis, food poisoning, or appendicitis.

Choice D: Uterine enlargement greater than expected for gestational age is not a sign of ectopic pregnancy. It may indicate a multiple pregnancy, a molar pregnancy, or a large fibroiD. Ectopic pregnancy usually causes a smaller-than-normal uterus, because the embryo is not implanted in the uterine cavity.

Choice A: I am a terrible mother and should give my child up for adoption. This is a false and harmful statement that reflects low self-esteem, guilt, and hopelessness. These are common symptoms of perinatal mood and anxiety disorder, but they do not reflect the reality or the potential of the patient. The patient needs support, counseling, and possibly medication to overcome these negative thoughts.

Choice B: This is just normal baby blues and I will be fine in a few days. This is a false and minimizing statement that denies the severity and duration of perinatal mood and anxiety disorder. Baby blues are mild and transient mood changes that occur in the first two weeks after delivery. Perinatal mood and anxiety disorder is a more serious and persistent condition that can affect the mother's mental health, bonding with the baby, and daily functioninG. The patient needs to recognize the signs and symptoms of perinatal mood and anxiety disorder and seek professional help.

Choice C: I will have to be on medications the rest of my lifE. This is a false and pessimistic statement that assumes that perinatal mood and anxiety disorder is a chronic and incurable condition. Medications are one of the treatment options for perinatal mood and anxiety disorder, but they are not the only onE. Psychotherapy, peer support, lifestyle changes, and alternative therapies are also effective ways to manage perinatal mood and anxiety disorder. The patient needs to have a realistic and hopeful outlook on the recovery process and the possibility of remission.

Choice D: I am not alone, I am not to blame, I will get better with help. This is a true and empowering statement that reflects the key messages of perinatal mood and anxiety disorder education and awareness. The patient needs to know that perinatal mood and anxiety disorder is a common and treatable condition that affects many women around the worlD. The patient needs to understand that perinatal mood and anxiety disorder is not caused by personal weakness, failure, or fault. The patient needs to believe that perinatal mood and anxiety disorder can be overcome with the help of health care providers, family, friends, and support groups.

Choice A: Elevated liver function tests indicate liver damage, which is a complication of preeclampsia with severe features.

Choice B: Unremitting headache is a sign of increased intracranial pressure, which can result from cerebral edema or hemorrhage caused by preeclampsia with severe features.

Choice C: Rising protein in sequential 24-hour urine reflects the degree of glomerular damage and renal impairment caused by preeclampsia with severe features.

Choice D: Increased urine output is not a sign of preeclampsia with severe features. In fact, oliguria (decreased urine output) may occur due to reduced renal perfusion and acute kidney injury.

Choice E: Pain in the left upper quadrant is a sign of splenic rupture or subcapsular hematoma, which are rare but life-threatening complications of preeclampsia with severe features.

Choice F: BP > 160/110 is one of the diagnostic criteria for preeclampsia with severe features, as it indicates severe hypertension and increased risk of maternal and fetal complications.

Choice A: Amniotic fluid in the vaginal vault indicates that the client's membranes have ruptured, which is a sign of labor. The fluid should be clear and odorless. The nurse should assess the fetal heart rate and monitor for signs of infection or cord prolapsE.

Choice B: Pain just above the navel is not a sign of labor. It may indicate other conditions such as gastritis, gallstones, or pancreatitis. The pain of labor is usually felt in the lower back and abdomen and radiates to the thighs.

Choice C: Cervical dilation is a sign of labor. It indicates that the cervix is opening and thinning to allow the passage of the fetus. The nurse should measure the cervical dilation in centimeters and document the progress of labor.

Choice D: Contractions every 3 to 4 minutes are a sign of labor. They indicate that the uterus is contracting and pushing the fetus downwarD. The nurse should assess the frequency, duration, and intensity of the contractions and monitor the fetal responsE.

Choice A: Massaging a firm fundus is not necessary, as it indicates that the uterus is contracting well and preventing excessive bleedinG. Massaging a firm fundus may cause discomfort and increase the risk of infection.

Choice B: Determining whether the fundus is midline is an important action, as it indicates that the uterus is in the correct position and not displaced by a full bladder or hematomA. A deviated fundus may cause uterine atony and hemorrhagE.

Choice C: Observing the lochia during palpation of fundus is an important action, as it indicates the amount and type of vaginal discharge after delivery. The nurse should assess the color, odor, consistency, and quantity of lochia and report any abnormal findings.

Choice D: Documenting fundal height is an important action, as it indicates the involution of the uterus after delivery. The nurse should measure the distance from the symphysis pubis to the top of the fundus in centimeters and compare it with the expected findings.

Choice E: Administering terbutaline if the fundus is boggy is not an appropriate action, as terbutaline is a tocolytic agent that relaxes the uterine muscles and may worsen the bleedinG. The nurse should massage a boggy fundus until it becomes firm and notify the provider.

Choice A: Explaining to the client what is happening over the next few minutes in detail and asking for teach back from the spouse is not the first action, as it may delay the urgent intervention and increase the anxiety of the client and the spousE. The nurse should provide brief and clear information and reassurance after taking the first action.

Choice B: Placing the client in a knee-chest or Trendelenburg position and raising the presenting part off the cord with your hand is the first and most important action, as it relieves the pressure on the cord and prevents cord compression and fetal hypoxiA. The nurse should maintain this position until the delivery.

Choice C: Covering the cord with a sterile, moist saline dressing is a secondary action, as it prevents the cord from drying and reduces the risk of infection. The nurse should perform this action after taking the first action.

Choice D: Preparing the client for an emergency cesarean birth is a tertiary action, as it is the definitive treatment for cord prolapse and ensures the safety of the mother and the fetus. The nurse should perform this action after taking the first and second actions.

Choice A: Massaging a firm fundus is not necessary, as it indicates that the uterus is contracting well and preventing excessive bleedinG. Massaging a firm fundus may cause discomfort and increase the risk of infection.

Choice B: Determining whether the fundus is midline is an important action, as it indicates that the uterus is in the correct position and not displaced by a full bladder or hematomA. A deviated fundus may cause uterine atony and hemorrhagE.

Choice C: Observing the lochia during palpation of fundus is an important action, as it indicates the amount and type of vaginal discharge after delivery. The nurse should assess the color, odor, consistency, and quantity of lochia and report any abnormal findings.

Choice D: Documenting fundal height is an important action, as it indicates the involution of the uterus after delivery. The nurse should measure the distance from the symphysis pubis to the top of the fundus in centimeters and compare it with the expected findings.

Choice E: Administering terbutaline if the fundus is boggy is not an appropriate action, as terbutaline is a tocolytic agent that relaxes the uterine muscles and may worsen the bleedinG. The nurse should massage a boggy fundus until it becomes firm and notify the provider.

Choice A: Do not use even soft lullaby music or cuddler therapy for this neonate as it will increase stimuli is not a correct option, as it contradicts the evidence-based practice of providing a calm and quiet environment for the neonate with neonatal abstinence syndromE. Music and cuddler therapy can help soothe the neonate and reduce the need for pharmacological agents.

Choice B: Use only pharmacological agents for withdrawal is not a correct option, as it ignores the non-pharmacological interventions that can help the neonate with neonatal abstinence syndromE. Non-pharmacological interventions include swaddling, breastfeeding, skin-to-skin contact, and rooming-in with the mother.

Choice C: Keep the baby and mother together, promoting bonding and providing support and resources for discharge is the correct option, as it supports the family-centered care and the recovery of the mother and the neonate with neonatal abstinence syndromE. Keeping the baby and mother together can improve the maternal-infant attachment, facilitate breastfeeding, and reduce the length of hospital stay and the need for pharmacological agents.

Choice D: Separate the baby from the mother and tell the social worker to contact child protection services is not a correct option, as it violates the ethical and legal principles of nursing practice and the rights of the mother and the neonate with neonatal abstinence syndromE. Separating the baby from the mother can increase the stress and anxiety of both parties and interfere with the bonding and breastfeedinG. The nurse should collaborate with the social worker and other health care professionals to provide a safe and supportive environment for the mother and the neonatE.

Choice A: Delayed bonding with maternal newborn dyad is not a benefit of immediate skin to skin contact. On the contrary, immediate skin to skin contact promotes bonding and attachment between the mother and the newborn by stimulating the release of oxytocin and enhancing the maternal-infant interaction.

Choice B: Decreased breastfeeding exclusivity is not a benefit of immediate skin to skin contact. On the contrary, immediate skin to skin contact facilitates breastfeeding initiation and duration by supporting the newborn's innate feeding behaviors and increasing the mother's confidence and milk production.

Choice C: Regulation of blood sugar is a benefit of immediate skin to skin contact. Immediate skin to skin contact helps prevent hypoglycemia in the newborn by increasing the glucose uptake from the mother's skin and reducing the stress hormone levels that inhibit insulin secretion.

Choice D: Stabilization of temperature is a benefit of immediate skin to skin contact. Immediate skin to skin contact helps maintain the newborn's body temperature by providing a warm and insulated environment and reducing heat loss through convection, radiation, and evaporation.

Choice E: Transfer of good bacteria from amniotic fluid and vernix is a benefit of immediate skin to skin contact. Immediate skin to skin contact helps colonize the newborn's skin and gut with beneficial microorganisms from the mother's amniotic fluid and vernix, which can protect the newborn from infections and enhance the immune system development.

Choice F: Improvement of lung and heart function is a benefit of immediate skin to skin contact. Immediate skin to skin contact helps improve the newborn's respiratory and cardiovascular status by stimulating the vagal nerve and increasing the oxygen saturation and blood pressurE.

Choice A: Increasing IV fluid rate is a secondary action, as it helps restore the blood volume and improve the blood pressure and the fetal perfusion. The nurse should perform this action after taking the first action.

Choice B: Elevating the legs is a tertiary action, as it helps increase the venous return and the cardiac output and improve the blood pressure and the fetal perfusion. The nurse should perform this action after taking the first and second actions.

Choice C: Notifying the provider is a quaternary action, as it helps communicate the situation and obtain further orders and interventions. The nurse should perform this action after taking the first, second, and third actions.

Choice D: Placing the client in a lateral position to relieve pressure on the inferior vena cava is the first and most important action, as it helps prevent or correct the hypotension and the fetal bradycardia caused by the epidural anesthesia block. The epidural anesthesia block can block the sympathetic nerve fibers and cause vasodilation and pooling of blood in the lower extremities, which can reduce the blood pressure and the placental perfusion. The pressure of the gravid uterus on the inferior vena cava can also reduce the venous return and the cardiac output, which can worsen the hypotension and the fetal bradycardiA. By placing the client in a lateral position, the nurse can reduce the pressure on the inferior vena cava and improve the blood flow and the oxygen delivery to the fetus.