OB exam three practice questions
a women in labor admits to using heroin during pregnancy. Nurse must be alert for which signs of neonatal abstinence symdrome? A. sleepy B. poor feeding C. bradypnea D. below normal body temp E. high pitched cry F. restlessness
B E D
A nurse is preparing to weight a newborn. Which action should the nurse include as part of the procedure? a. Weigh the newborn at the same time each day for accuracy. b. Place a sterile scale paper on the scale for infection control. c. Keep a hand on the newborn's abdomen for safety. d. Leave its diaper on for comfort.
a
A nurse is working with bereaved parents. What is the most appropriate statement that the nurse can make? a. "You're young and can have other children." b. "I understand how you must feel." c. "I'm sorry." d. "You have an angel in heaven."
c
A nurse is reviewing the concept of injuries occuring to the infant's plexus during labor and birth. Which statement would the nurse identify as being accurate? a. Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves. b. Parents of children with brachial palsy are taught to pick up the child from under the axillae. c. Erb palsy is damage to the lower plexus. d. If the nerves are stretched with no avulsion, they should recover completely in 3 to 6 months.
d
Pre term infants are at risk for cold stress. which signs should the nurse be alert for A. Acrocyanosis B. hypoglycemia C. irritability D. periodic breathing pattern E. Bradycardia F. abdominal distension
B C E F
The nurse is observing a postpartum client who has been bleeding excessively during the first hour, saturating multiple pads. Which interventions would the nurse anticipate that the physician would order? (Select all that apply.) Select all that apply. a. Administer oxygen via nonrebreather mask @ 10 L/minute b. Insert a secondary intravenous line access c. Document findings in the health care record d.Type & screen for 2 units of blood e. Decrease flow rate for intravenous fluid administration
a b
A nurse is caring for an infant with suspected sepsis. Which priority intervention would the nurse implement? a. Electronic monitoring of vital signs b. Intravenous access c. Administration of oxygen d. Recorded intake and output
b
women expresses need to review her L&D experience w nurse who cared for her in labor. what phase is this? a. taking hold b. taking in c. letting go d. postpartum blues
b
A nurse is working with a postpartum client about resumption of menstrual activity following childbirth. Which of the following statements indicate that the client has a correct understanding? a. "My first menstrual cycle will be heavier than normal and then will be light for several months after." b. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." c. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." d. "I will not have a menstrual cycle for 6 months after childbirth."
c
The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? a. Tells visitors how well her son is feeding b. Talks and coos to her son c. Cuddles her son close to her d. Seldom makes eye contact with her son
d
what women is least likely to experience afterpains? A. primipara who is breastfeeding twins who were born at 38wks B. Mulitipara who is breastfeeding 10lb full term C. multipara who is bottle feeding 8 lb baby D. primipara who is bottle feeding 7 lb baby
d
A nurse is caring for an infant whose mother had GD during pregnancy. Infants gestational age is 41 wks and his weight suggests macrocosmic. When assessing infant what should nurse be alert for? A. Fracture of femur B. hypocalcemia C. Blood sugar- 38 D. signs of a heart defect E. pale complexion F. round 'cherubic' face
B C F
A group of nursing students are discussing the condition and reconditioning of the urinary system after childbirth. Which statement should the nursing students identify as correct? a. Fluid loss through perspiration and increased urinary output account for a weight loss of more than 2 kg during the puerperium. b. Kidney function returns to normal a few days after birth. c. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth. d. Diastasis recti abdominis is a common condition that alters the voiding reflex.
a
A mother expresses fear about changing her infant's diaper after he is circumcised. What should the nurse teach the mother about providing caring for the infant upon discharge? a. Cleanse the penis gently with water and put petroleum jelly around the glans after each diaper change. b. Apply constant, firm pressure by squeezing the penis with the fingers for at least 5 minutes if bleeding occurs. c. Cleanse the penis with prepackaged diaper wipes every 3 to 4 hours. d. Wash off the yellow exudate that forms on the glans at least once every day to prevent infection.
a
A nurse is caring for a preterm infant in the nursery setting. Why would the nurse anticpate that a preterm infants would be more likely to become septic? a. IgG level is directly proportional to gestational age. b. Serum complement levels are adequate. c. Immune function is suppressed because of increased IgG levels. d. IgG and IgA levels are adequate at birth.
a
A nurse is performing screening and providing education to parents regarding the treatment of developmental dysplasia of the hip (DDH). Which intervention should the nurse perform? a. Carefully monitor infants for DDH at follow-up visits. b. Explain to the parents the need for serial casting. c. Teach double or triple diapering for added support. d. Be able to perform the Ortolani and Barlow tests.
a
A nurse is providing care for a mother who has abused (or is abusing) alcohol and for her infant. Which statement would the nurse identify as being accurate? a. Alcohol-related neurodevelopmental disorders (ARNDs) not sufficient to meet FAS criteria (learning disabilities, speech and language problems) are often not detected until the child goes to school. b. Two thirds of newborns with fetal alcohol syndrome (FAS) are boys. c. Both the distinctive facial features of the FAS infant and the diminished mental capacities tend toward normal over time. d. The pattern of growth restriction of the fetus begun in prenatal life is halted after birth, and normal growth takes over.
a
A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. Which intervention should the nurse implement? a. Discuss options with the couple, including amniocentesis to determine whether the fetus is affected. b. Refer the couple to a psychologist for emotional support. c. Tell the couple they need to have an abortion within 2 to 3 weeks. d. Explain that the fetus has a 50% chance of having the disorder.
a
A nurse is providing teaching relative to TORCH infections to a group of pregnant women. Which TORCH infection could be contracted by the infant because the mother owned a cat? a. Toxoplasmosis b. Parvovirus B19 c. Varicella-zoster d. Rubella
a
A nurse is reviewing best practice for placing an infant to breast following birth. What timeframe should the nurse identify as representing a Baby-friendly hospital mandate? a. 1 hour b. 30 minutes c. 4 hours d. 2 hours
a
A nurse is reviewing concepts related to infants of diabetic mothers. Which factor would the nurse identified as increasing the risk of complications for infants of diabetic mothers? a. Duration of maternal disease b. Hemoglobin A1c level of 7 prior to pregnancy c. Glycemic control d. Hemoglobin A1c level of 7
a
A nurse is working with a client who is grieving over the loss of a stillborn. Which statement would the nurse identify as correct with regard to the emotional state of grief? a. Time limit for grief experiences is variable among individuals. b. Aspects of grief occur simultaneously across family units. c. It represents a linear process. d. It is a static concept applied to loss.
a
A nurse is working with parents who have a sensory impairment. Which statement should the nurse identify as being inaccurate? a. Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact. b. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities. c. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information. d. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals.
a
A nurse must administer erythromycin ophthalmic ointment to a newborn after birth. Which action shoud the nurse include when administering the medication? a. Cleanse eyes from inner to outer canthus before administration if necessary. b. Flush eyes 10 minutes after instillation to reduce irritation. c. Apply directly over the cornea. d. Instill within 15 minutes of birth for maximum effectiveness.
a
An infant weighing 4.1 kg was born 2 hours ago at 37 weeks of gestation. The infant appears chubby with a flushed complexion and is very tremulous. What would the nurse identify as being the most likely cause of the tremors? a. Hypoglycemia. b. Seizures. c. Birth injury. d. Hypocalcemia.
a
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman 1 day postpartum. What should the nurse identify as an expected finding? a. Little if any change. b. Leakage of milk at let-down. c. Swollen, warm and tender on palpation. d. A few blisters and a bruise on each areola.
a
First sign of puerperal infection most likely is a. elevated temp on 2 successive days of the first 10 PP days, excluding the first 24 hours after birth b. increased WBC count c. foul smelling profuse lochia d. bradycardia
a
Following birth, the nurse assigns an Apgar score of 10 at 1 minute to a newborn. How would the nurse explain this score? a. An infant having no difficulty adjusting to extrauterine life but who should be assessed again at 5 minutes after birth. b. An infant having no difficulty adjusting to extrauterine life and needing no further testing. c. A prediction of a future free of neurologic problems. d. An infant in severe distress that needs resuscitation.
a
Most congenital anomalies of the central nervous system(CNS)result from defects in the closure of the neural tube during fetal development. Which factor would the nurse identify has having themost impact on this process? a. Maternal folic acid deficiency b. Maternal diabetes c. Maternal use of anticonvulsant d. Socioeconomic status
a
The condition hypospadias encompasses a wide range of penile abnormalities. Which information should the nurse provide to the anxious parents of an affected newborn? a. Mild cases involve a single surgical procedure. b. Repair is performed as soon as possible after birth. c. No correlation exists between hypospadia and testicular cancer. d. Infant should be circumcised.
a
The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. What is the nurse's intial action? a. Massage her fundus b. Place her on a bedpan to empty her bladder c. Administer methylergonovine (Methergine), 0.2 mg IM, which has been ordered prn d. Call the physician
a
The nurse is assessing the respiratory system of a newborn. Which statement should the nurse be aware of with regard to the respiratory development of the newborn? a. Crying increases the distribution of air in the lungs. b. Seesaw respirations are no cause for concern in the first hour after birth. c. Newborns must expel the fluid at uterine life from the respiratory system within a few minutes of birth. d. Newborns are instinctive mouth breathers.
a
The nurse is providing discharge instructions related to the baby's respiratory system. Which statement should the nurse not include as part of discharge teaching? a. Don't let the infant sleep on his or her back. b. Avoid loose bedding, waterbeds, and beanbag chairs. c. Prevent exposure to people with upper respiratory tract infections. d. Keep the infant away from secondhand smoke.
a
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. What clinical finding should the nurse expect? a. Hematoma formation b. Uterine atony c. Constipation d. Bladder distention
a
Which factor would the nurse identify as contributing to depletion of weight and metabolic stores in the high risk newborn? a. Phototherapy b. Frequent breast feedings c. Bathing d. Core temperature within normal range
a
Which of the following findings would raise concern for the nurse who is monitoring a postpartum client who had a spontaneous vaginal delivery (SVD) of a 10-lb baby boy? a. Fundus midline and firm with spurts of bright red blood upon fundal massage b. Lochia rubra with minimal clots expressed on fundal massage c. Fundus midline and firm with nonpalpable bladder d. Client report of mild to moderate cramping and request for pain medication
a
While caring for the newborn, the nurse must be alert for any signs of cold stress. Which finding should the nurse anticpate? a. Increased respiratory rate b. Decreased activity level c. Hyperglycemia d. Shivering
a
With regard to the classification of neonatal bacterial infection, nurses should be aware that: a. Health care-associated infection can be prevented by effective handwashing; early-onset infection cannot. b. Infections occur with about the same frequency in boy and girl infants, although female mortality is higher. c. The clinical sign of a rapid, high fever makes infection easier to diagnose. d. Congenital infection progresses slower than health care-associated infection.
a
A newborn at 5 hrs old wakes from a sound sleep and becomes very active and begins to cry. Which signs, if exhibited by this newborn indicate expected adaptation to extrauterine life? select all a. increased muscle tone b. passage of meconium c. HR of 160 d. R rate of 24bmp and irregular e. fine crackles w auscultation f. expiratory grunting w nasal flaring
a b c
A nurse is reviewing the clinical diagnosis of cleft lip and palate. Which environmental factors would the nurse identify as being causative? (Select all that apply.) Select all that apply. a. Maternal cigarette smoking b. Alcohol consumption c. Antibiotic use in pregnancy d. Use of some anticonvulsant medications e. Female gender
a b c
A nurse is caring for a postpartum client who has a significant bleed. In which clincial situations would the nurse identify the use of Methergine or prostaglandin be contraindicated even if the client was experiencing a postpartum significant bleed? (Select all that apply.) Select all that apply. a. Client's blood pressure postpartum is 180/90. b. Client has delivered twin pregnancies. c. Client has a history of asthma. d. Client has a mitral valve prolapse. e. Client is a grand multip.
a c d
A nurse is reviewing the concept of birth injuries. Which factors would the nurse identify so as to predispose an infant to birth injuries? (Select all that apply.) Select all that apply. a. Vacuum-assisted birth b. Multip between the ages of 25 and 30 c. Vertex presentation d. Application of an internal fetal scalp electrode
a d
A nurse is reviewing the occurrence of hematologic problems in preterm infants. Which of the following processes or findings would the nurse identify as leading to an increase in hematologic problems? (Select all that apply.) Select all that apply. a. Prolonged Prothrombin time (PT)time b. Decrease in size of red blood cells c. Decreased capillary fragility d. Decreased red blood cell survival time e. Decrease in erythropoiesis
a d e
You are a maternal-newborn nurse caring for a mother who just delivered a baby born with Down syndrome. What nursing diagnosis would be the most essential in caring for the mother of this infant? a. Disrupted family processes b. Reduced self-concept c. Anxiety d. Potential for injury
a9
A 3.8-kg infant was delivered vaginally at 39 weeks after a 30-minute second stage. There was a nuchal cord. After birth the infant is noted to have petechiae over the face and upper back. What information should the nurse provide to the parents regarding the presence of petechiae? a. Should always be further investigated. b. Are benign if they disappear within 48 hours of birth. c. Usually occur with forceps delivery. d. Result from increased blood volume.
b
A client tells the nurse about the funeral arrangements for her newborn son. The client is thereby providing the nurse with information about: a. Expression of loss. b. Mourning process. c. Family reaction. d. Grief process.
b
A group of nurses are discussing care options for lesbian partners in childbearing experiences. Which opportunity should the nurses identified as not being able to be provided to male partners? a. Cutting the cord b. Breastfeeding the infant c. Rooming-in during hospitalization d. Labor support
b
A male infant at 26 weeks of gestation arrives from the delivery room intubated. The nurse weighs the infant, places him under the radiant warmer, and attaches him to the ventilator at the prescribed settings. A pulse oximeter and cardiorespiratory monitor are placed. The pulse oximeter is recording oxygen saturation values of 80%. The prescribed saturation value is 92%. What is the most appropriate nursing action? a. Continue with the admission process to ensure that a thorough assessment is completed. b. Listen to breath sounds and ensure the patency of the endotracheal tube, increase oxygen, and notify a physician. c. Notify the parents that their infant is not doing well. d. Continue to observe and make no changes until the saturations are 75%.
b
A nurse administers Vitamin K to the newborn post delivery. The nurse understands that the reason for this medication to be given is? a. Reduce bilirubin levels. b. Enhance the ability of blood to clot. c. Stimulate the formation of surfactant. d. Increase the production of red blood cells.
b
A nurse examining a newborn infant notes that the infant is jaundiced. Which observation would lead the nurse to continue to monitor but not to intervene and contact the physician? a. Infant is being bottle fed and within the first 24 hours of life. b. Jaundice appeared on the third day of life. c. Jaundice appeared within the first 24 hours of life. d. Preterm infant who is 12 hours old.
b
A nurse has provided client teaching to a breastfeeding mother. Which action if observed by the nurse would indicate the need for further instruction? a. Puts her finger into newborn's mouth before removing breast. b. Leans forward to bring breast toward the baby. c. Holds breast with four fingers along bottom and thumb at top. d. Stimulates the rooting reflex and then inserts nipple and areola into newborn's open mouth.
b
A nurse is assisting a breastfeeding mother with positioning of the baby. Which finding should the nurse be aware of? a. While supporting the head, the mother should push gently on the occiput. b. Whatever the position used, the infant is held in direct skin with the mother. c. Women with perineal pain and swelling prefer the modified cradle position. d. The cradle position is usually preferred by mothers who had a cesarean birth.
b
A nurse is providing instruction to a postpartum client regarding perineal care technique. When evaluating the postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman: a. Uses soap and warm water to wash the vulva and perineum. b. Uses the peribottle to rinse upward into her vagina. c. Washes from symphysis pubis back to the episiotomy. d. Changes her perineal pad every 2 to 3 hours.
b
A nurse is providing umbilical cord care to a newly delivered infant. What information should the nurse be aware of? a. The cord clamp is removed at cord separation. b. The stump can easily become infected. c. The average cord separation time is 5 to 7 days. d. A nurse noting bleeding from the vessels of the cord should immediately call for assistance.
b
A nurse is reviewing concepts of hemolytic disease of the newborn. Which statement would the nurse identify as being most accurate? a. ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia. b. The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth. c. Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother. d. Exchange transfusions are frequently required in the treatment of hemolytic disorders.
b
A nurse is reviewing lab results related to Rh factor. Which infant would the nurse identify as being most likely to express Rh incompatibility? a. Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor b. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor c. Infant who is Rh negative and a mother who is Rh negative d. Infant who is Rh positive and a mother who is Rh positive
b
A nurse is reviewing the concept of lochia. Which statement should the nurse identify as correct? a. Will usually decrease with ambulation and breastfeeding. b. should smell like normal menstrual flow unless an infection is present. c. Is similar to a light menstrual period for the first 6 to 12 hours. d. Is usually greater after cesarean births.
b
A nurse is reviewing the concept of weaning with regard to infant care. Which statement should the nurse identify as correct? a. Abrupt weaning is easier than gradual weaning. b, Weaning can be mother or infant initiated. c. Weaning should proceed from breast to bottle to cup. d. The feeding of most interest should be eliminated first.
b
A nurse is reviewing types of accretas that occur during pregnancy. Which of the following would the nurse identify as the most common kind of placental adherence? a. Increta b. Accreta c. Placenta previa d. Percreta
b
A nurse is taking care of a newborn who was diagnosed with a diaphragmatic hernia. Which nursing diagnosis would the nurse identify as being the most appropriate? a. Potential for infection b. Potential for reduced gas exchange c. Potential for attachment problems d. Inadequate nutrition
b
A nurse is working with a postpartm client who is experiencing after birth pains. Which statement should the nurse identify as being accurate with regard to afterbirth pains? a. Alleviated somewhat when the mother breastfeeds. b. They are caused by mild, continual contractions for the duration of the postpartum period. c. More common in first-time mothers. d. More noticeable in births in which the uterus was overdistended.
b
A nurse providing care to preterm infants should understand that nasogastric and orogastric tubes are used to: a. Provide oxygen and ventilation. b. Feed the infants. c. Help maintain body temperature. d. Replace surfactants
b
A nursing student is reviewing concepts related to infant feeding. Which statement should the nurse identify as being correct concerning tandem feeding? a. Supplementing breastfeeding with bottle feeding to maintain adequate weight gain. b. Breastfeeding an infant and an older sibling during the same period. c. Using both breasts to nurse the baby. d. Adequate nutritional stores for the mother and infant.
b
A pregnant client who is at term has been informed that her fetus has died and has been admited to the obstetric unit. When developing a plan of care, the nurse would focus on which priority measure? a. Providing the client with phone numbers so as to make funeral arrangements. b. Incorporating perinatal palliative care into the client's plan of care. c. Including case management to participate in the client's care when she is admitted to the hospital. d. Referral to a perinatologist.
b
Methylergonovine 0.2 mg is ordered for a women who gave birth vaginally 1 hour ago. it is to be administered IM to treat profuse lochial flow with clots. Her fundus is boggy and does not respond well to massage. She is being treated with pre-eclapsia with IV Mag a 1g/hour. Her BP 5 min ago was 155/98. In fulfilling this order the nurse should a. measure BP 5 min after administration b. question order bc of high BP c. administer bc it is the best choice to counteract possible uterine relaxation effects of mag infusion d. tell the women it will lead to uterine cramping.
b
The birth weight of a breastfed newborn was 8 lb, 4 oz. On the third day the newborn's weight is 7 lb, 12 oz. Which action should the nurse take based on this finding? a. Notify the physician because the newborn is being poorly nourished. b. Encourage the mother to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs. c. Suggest that the mother switch to bottle feeding because breastfeeding is ineffective in meeting newborn needs for fluid and nutrients. d. Refer the mother to a lactation consultant to improve her breastfeeding technique.
b
The nurse is assigned a home care visit of a 5-day-old infant for the treatment of jaundice. A thorough assessment is completed, and a health history is obtained. Which sign or symptom if observed by the nurse indicates that the infant may be displaying the initial phase of encephalopathy? a. Fever and seizures b. Hypotonia, lethargy, and poor suck c. High-pitched cry d. Severe muscle spasms (opisthotonos)
b
The nurse is instructing a family how to care for their infant in a Pavlik harness to treat Developmental Dysplasia of the Hip (DDH). What information should the nurse include in the teaching? a. Apply lotion or powder to minimize skin irritation. b. Return to the clinic every 1 to 2 weeks. c. Place a diaper over the harness, preferably using an absorbent disposable diaper. d. Remove the harness several times a day to prevent contractures.
b
When caring for a preterm infant at 30 wks, the primary nursing diagnosis is A. risk for infection related to decreased immune response B. ineffective breathing pattern related to surfactant deficiency and weak respiratory muscle effort C. ineffective thermoregulation related to immature thermoregulation center D. imbalanced nutrition: less than body requirements related to ineffective suck and swallow
b
Which nursing action is least effective in facilitating parental attachment to the new infant a. referring couple to lactation specialist to ensure successful breastfeeding b. keeping baby in nursery as much as possible so mother can rest c. extending visiting hours to womens partner as the couple desires d. providing guidance and support as the parents care for the baby's nutrition and hygiene needs
b
Which statement regarding Postpartum Depression (PPD) is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis? a. PPD symptoms are consistently severe. b. PPD can easily go undetected. c. Only mental health professionals should teach new parents about this condition. d. This syndrome affects only new mothers.
b
A nurse is reviewing metabolic functions occuring during the postpartum period. Which of the following changes would the nurse identify as being consistent with that timeframe? (Select all that apply.) Select all that apply. a. Mildly increased T3 and T4 levels for the first several weeks postpartum b. Increased BMR in the immediate postpartum period c. Secretion of insulinase d. Decrease in estrogen and cortisol levels e. Moderate hyperglycemia
b c d
A nurse is reviewing phases of maternal postpartum adjustment. Which behaviors should the nurse identify as being exhibited during the letting-go phase of maternal role adaptation? (Select all that apply.) Select all that apply. a. Being talkative and excited about becoming a mother b. Sexual intimacy relationship continuing c. Emergence of family unit d. Defining one's individual roles e. Dependent behaviors
b c d
A nurse is working with clients who have experienced a perinatal loss. Which statements would not be advisable for the nurse to use as a basis for therapeutic discussion? (Select all that apply.) Select all that apply. a. "You wanted a boy anyway, so now you have another chance" b. "I'm sorry" c. "I am sad for you" d. "This must be hard for you" e. "You're young, you can have other children"
b c d
A nurse is reviewing possible etiologies for hyperbilirubinemia in the newborn. Which findings would the nurse expect to lead to increased bilirubin levels in the newborn? (Select all that apply.) Select all that apply. a. Cord clamped immediately following delivery of newborn b. Initiation of newborn feedings delayed following birth c. Twin-to-twin transfusion syndrome d. Hyperglycemia e. Meconium passed after 24 hours
b c e
Following a vaginal delivery, the client tells the nurse that she intends to breastfeed her infant but she is very concerned about returning to her prepregnancy weight. On the basis of this interaction, the nurse would advise the client that: (Select all that apply.) Select all that apply. a. She should join Weight Watchers as soon as possible to ensure adequate weight loss. b. Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period. c. If breastfeeding, she should regulate her fluid consumption in response to her thirst level. d. If she decreases her calorie intake by 100-200 calories a day she will lose weight more quickly. e. Weight loss diets are not recommended for women who breastfeed.
b c e
Preterm infants are at an increased risk for developing respiratory distress. The nurse should asses for signs that would indicate that the newborn is having difficulty breathing. Signs to asses for: A. Use of abdominal muscles to breathe B. expiratory grunting C. Periodic breathing pattern D. Suprasternal retraction E. nasal flaring F. acrocynaosis
b d e
A breast feed full term newborn is 12 hrs old and is being discharged. if present, which assesment findings could delay discharge a. dark green- black thick stool b. yellowish tinge in sclera and face c. swollen breasts d. blood tinged vaginal discharg e e. blood glucose of 35 f. acrocyanosis
b e
The nurse is caring for an infant with Developmental Dysplasia of the Hip (DDH). Which clinical manifestations should the nurse expect to observe? (Select all that apply.) Select all that apply. a. Telescoping of the affected limb b. Positive Ortolani click c. Negative Babinski sign d. Trendelenburg sign e. Unequal gluteal folds
b e
A group of nurses are discussing postpartum hemorrahge (PPH). Which PPH conditions would the nurses consider as medical emergencies that require immediate treatment? a. Uterine atony and disseminated intravascular coagulation (DIC). b. Subinvolution of the uterus and idiopathic thrombocytopenic purpura (ITP) c. Inversion of the uterus and hypovolemic shock d. Hypotonic uterus and coagulopathies
c
A nurse is assesing a client who is 12 hours postpartum. Which finding would be a source of concern if observed by the nurse? a. Bradycardia—pulse rate of 55 beats/min b. Postural hypotension c. Pain in left calf with dorsiflexion of left foot d. Temperature of 38° C
c
A nurse is caring for a client who is bottlefeeding but has engorged breasts. What action should the nurse implement? a. Allow warm water to soothe the breasts during a shower. b. Express milk from breasts occasionally to relieve discomfort. c. Wear a snug, supportive bra. d.m Place absorbent pads with plastic liners into her bra to absorb leakage.
c
A nurse is caring for a postpartum client who is experiecing profuse postpartum bleeding. What is the priority intervention to be performed by the nurse? a. Call the woman's primary health care provider. b. Administer the standing order for an oxytocic. c. Palpate the uterus and massage it if it is boggy. d. Assess maternal blood pressure and pulse for signs of hypovolemic shock.
c
A nurse is caring is administering a gavage feeding to an infant. What should the nurse document each time? a. The infant's suck and swallow coordination b. The infant's heart rate and respirations c. The infant's response to the feeding d. The infant's abdominal circumference after the feeding
c
A nurse is discussing with an obese client potential long-term consequences of infant feeding practices. Which method should the nurse identify to the client as having a decreased risk for the development of childhood obesity for the infant? a. Lower-calorie infant formula. b. An on-demand feeding schedule. c. Breastfeeding. d. Smaller, more frequent feedings.
c
A nurse is examining a newborn male, who is estimated to be 39 weeks of gestation. Which physical finding should the nurse anticipate to be present? a. Abundant lanugo over his entire body. b. Ability to move his elbow past his sternum. c. Testes descended into the scrotum. d. Extended posture when at rest.
c
A nurse is making a home visit to a postpartum woman 1 week after childbirth. Which client observation should the nurse expect? a. Exhibit a reduced attention span, limiting readiness to learn. b. Have reestablished her role as a spouse or partner. c. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. d. Express a strong need to review the events and her behavior during the process of labor and birth.
c
A nurse is observing a premature infant's breathing pattern who is exhibiting a compensatory rapid respirations. How would the nurse intepret this finding? a. Trying to maintain a neutral thermal environment. b. Suffering from sleep or wakeful apnea. c. Breathing in a respiratory pattern common to premature infants. d. Experiencing severe swings in blood pressure.
c
A nurse is placing a newborn under a radiant heat warmer for temperature stabilization. Which action should the nurse include during this procedure? a. Cover the probe with a nonreflective material. b. Recheck temperature by periodically taking a rectal temperature. c. Perform all examinations and activities under the warmer. d. Place the thermistor probe on the left side of the chest.
c
A nurse is preparing to educate a group of postpartum clients. Which description of postpartum restoration or healing times should the nurse identify as being accurate? a. Most episiotomies heal within a week. b. Hemorrhoids usually decrease in size within 2 weeks of childbirth. c. Rugae reappear within 3 to 4 weeks. d. The cervix shortens, becomes firm, and returns to form within a month postpartum.
c
A nurse is reviewing concepts of small-for-gestational age (SGA) infants and intrauterine growth restriction (IUGR). Which statement would the nurse identify as being accurate? a. Symmetric IUGR occurs in the later stages of pregnancy. b. In the first trimester, diseases or abnormalities result in asymmetric IUGR. c. Infants with asymmetric IUGR have the potential for normal growth and development. d. In asymmetric IUGR, weight is slightly more than SGA, whereas length and head circumference are somewhat less than SGA
c
A nurse is reviewing intrapartum risk factors that would lead to the development of neonatal sepsis. Which of the following would the nurse not consider to be a factor? a. Meconium aspiration b. Mechanical ventilation c. Chorioamnionitis d. Galactosemia
c
A nurse is reviewing the concept of breastfeeding. Which statement should the nurse identify as being accurate as it relates to the effect of breastfeeding on the family or society at large? a. Breastfeeding benefits the environment. b. Breastfeeding requires fewer supplies and less cumbersome equipment. c. Breastfeeding costs employers in terms of time lost from work. d. Breastfeeding saves families money.
c
A nurse is reviewing the concept of complicated bereavement. Which statement would the nurse identify as being accurate? a. Occurs when, in multiple births, one child dies and the other or others live. b/ Is felt by the family of adolescent mothers who lose their babies. c. Is an extremely intense grief reaction that persists for a long time. d. Is a state in which the parents are ambivalent, as with an abortion.
c
A nurse is talking to parents about the adjustment of a new baby to the family unit. Which parent action should the nurse identify as facilitating the adjustement of other children to the new baby? a. Emphasizing activities that keep the new baby and other children together. b. Having the mother carry the new baby into the home so she can show the other children the baby. c. Having children at home choose or make a gift to give the new baby on his or her arrival home. d. Reducing stress on the other children by limiting their involvement and care of the new baby.
c
A nurse observes a postpartum client to have excessive blood loss. Which cause should the nurse identify as being the most common cause for this finding? a. Unrepaired lacerations of the vagina or cervix. b. Vaginal or vulvar hematomas. c. Failure of the uterine muscle to contract firmly. d. Retained placental fragments.
c
A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. What does the nurse identify as being the most serious complication based on this finding? a. Urinary tract infection. b. A ruptured bladder. c. Excessive uterine bleeding. d. Bladder wall atony.
c
After giving birth to a stillborn infant, the woman turns to the nurse and says, "I just finished painting the baby's room. Do you think that caused my baby to die?" What is the nurse's bestresponse? a. Silence. b. "That's not likely. Paint is associated with elevated pediatric lead levels." c. "I can understand your need to find an answer to what caused this. What else are you thinking about?" d. "That's an old wives' tale; lots of women are around paint during pregnancy, and this doesn't happen to them."
c
For diagnostic and treatment purposes, nurses should know the birth weight classifications of high risk infants. What description would the nurse identify for an infant who was categorized as an extremely low birth weight (ELBW)infant? a. Dependent on the gestational age. b. Less than 1500 g. c. Less than 1000 g. d. Less than 2000 g.
c
Nurses are getting ready for bedside reporting at change of shift. What benefit do the nurses identify for this type of change of shift report? a. Information is transparent so that the nurses and clients are aware of all pertinent data and delivery of care aspects. b. Clients can ask questions of the nurses during change of shift report so that they can better direct the delivery of their health care. c. Nurses are able to visualize their client's directly at the time of report leading to better client satisfaction. d. There is no need for additional information to be exchanged as the client is right there to answer questions and voice concerns.
c
The nurse is assessing a newbown and discovers unequal movement or uneven gluteal skinfolds during the Ortolani maneuver. What should be the priority action taken by the nurse? a. Informs the parents and physician that molding has not taken place. b. Tells the parents that one leg may be longer than the other, but they will equal out by the time the infant is walking. c. Alerts the physician that the infant has a dislocated hip. d. Suggests that if the condition does not change, surgery to correct vision problems might be needed.
c
The nurse is reviewing concepts related to healthy-parent infants bonding. The nurse recognizes that the process in which the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics is called: a. Claiming. b. Acquaintance. c. Mutuality. d. Bonding.
c
The nurse is reviewing the clinical diagnosis of necrotizing enterocolitis (NEC). What would the nurse indicate as being a generalized sign associated with NEC? a. Hypertonia, tachycardia, and metabolic alkalosis. b. Scaphoid abdomen, no residual with feedings, and increased urinary output. c. Abdominal distention, temperature instability, and grossly bloody stools. d. Hypertension, absence of apnea, and ruddy skin color.
c
To explain hemolytic disorders in the newborn to new parents, the nurse who cares for the newborn population must be aware of the physiologic characteristics related to these conditions. What would the nurse identify as being the most common cause of pathologic hyperbilirubinemia? a. Postmaturity b. Hepatic disease c. Hemolytic disorders d. Congenital heart defect
c
Which priority action implemented by the nurse would be most beneficial in helping a couple deal with fetal loss following the delivery of a stillborn? a. Provide a quiet environment for the couple for several hours restricting any visitors or family members. b. Allow all family members to come in immediately after the delivery to console the couple. c. Allow the parents to hold and view the baby following delivery if they so request. d. Take a photograph of the stillborn prior to the client's discharge to use as a keepsake.
c
A group of nurses are discussing congenital anomalies of the cardiovascular and respiratory systems. Which statement would the nurses identify as being accurate? a. Screening for congenital anomalies of the respiratory system need only be performed for infants experiencing respiratory distress. b. Choanal atresia can be corrected with the use of a suction catheter to remove the blockage. c. Congenital diaphragmatic hernias are diagnosed and treated after birth. d. Cardiac disease may demonstrate signs and symptoms of respiratory illness.
d
A group of nursin gstudents are reviewing the process of bathing for a newborn. Which statement should the nursing students identify as being incorrect? a. Tub baths may be given before the infant's umbilical cord falls off and the umbilicus is healed. b. Only plain warm water should be used to preserve the skin's acid mantle. c. Powders are not recommended because the infant can inhale powder. d. Newborns should be bathed every day, for the bonding as well as the cleaning.
d
A nurse caring for a newborn should be aware that the sensory system least mature at the time of birth is: a. Hearing. b. Taste. c. Smell. d. Vision.
d
A nurse is caring for a first-time mother who is breastfeeding. Which postpartum infection would the nurse identify as being most often contracted by this client type? a. Urinary tract infections (UTIs) b. Wound infections c. Endometritis d. Mastitis
d
A nurse is caring for a postpartum client experiencing hemorrhagic shock. Which indicator would lead the nurse to suspect that the client is getting worse? a. Client statement that she sees "stars" b. Restoration of blood pressure levels to normal range c. Capillary refill brisk d. Client complaint of headache and increased reaction time to questioning
d
A nurse is monitoring a healthy newborn's blood glucose level 90 minutes after birth. Which result should the nurse anticipate in terms of mg/dL? a. 80 to 100 b. 60 to 70 c. Less than 40 d. 55 to 60
d
A nurse is monitoring an obstetrical client. Which test result would provide evidence to the nurse that there is fetal blood in maternal circulation? a. Negative Coombs test result b. Positive Fern test result c. Positive Coombs test result d. Positive Kleihauer-Betke test result
d
A nurse is reviewing types of thrombosis. Which thromboembolic condition would the nurse identify as not being associated with postpartum period? a. Pulmonary embolism b. Superficial venous thrombosis c. Deep vein thrombosis d. Amniotic fluid embolism (AFE)
d
A nurse is taking care of an infant born with myelomeningocele. What is the highest priority nursing intervention that the nurse should perform? a. Assess for cyanosis. b. Prepare the parents for closure of the sac when the child is approximately 2 years of age. c. Prepare the parents for the child's paralysis from the waist down. d. Protect the sac from injury.
d
A nurse is working with a Hispanic client. Which statement accurately reflects an after childbirth ritual? a. No restrictions are placed on the mother during this ritual period. b. The ritual is limited to preparing the woman to become a good mother. c. Breastfeeding is started immediately after birth. d. Naming of the child can not be done until the 40 day period has been met.
d
A woman is diagnosed with having a stillborn. At first she appears stunned by the news, cries a little, and then asks the nurse to call her mother. What phase of bereavement does the nurse identify that the woman is experiencing? a. Grief. b. Reorganization. c. Intense grief. d. Acute distress.
d
During rounds, a nurse suspects that a client who has recently delivered via vaginal route is having excessive postpartum bleeding. Which intervention would be the priority action taken by the nurse at this time? a. Increase the rate of intravenous fluids. b. Monitor pad count and perform catheterization. c. Call the physician. d. Massage the uterine fundus.
d
During the final stage of claiming process 0f a new born, a mother might say a. "she has her grandfathers nose" b. his ears lie nice and flat against his head, not like mine and my sisters" c. "she gave me nothing but trouble during pregnancy and now she is so stubborn she wont wake up to breast feed" d. " he has such a sweet disposition and pleasant expression. I have never seen a baby quite like him before"
d
In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which of the following should the nurse identify as a facilitating behavior? a. The parents have difficulty naming the infant. b. The parents make no effort to interpret the actions or needs of the infant. c. The parents do not move from fingertip touch to palmar contact and holding. d. The parents hover around the infant, directing attention to and pointing at the infant.
d
Nurse is assessing a client that gave birth 12 hours ago. which findings would require further assessment? A. bright red uterine discharge B. midline epioptomy- approximated, moderate edema, slight erythema, absense of ecchymosis C. protrusion of abdomen with slight separation of abdominal wall muscles D. fundus firm above the umbillicus and to the right of the midline
d
On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the first action to be taken by the nurse? a. Call the woman's primary health care provider. b. Begin an IV infusion of Ringer's lactate solution. c. Assess the woman's vital signs. d. Massage the woman's fundus.
d
The nurse helps a breastfeeding mother change the diaper of her 16-hour-old newborn after the first bowel movement. The mother expresses concern because the large amount of thick, sticky stool is very dark green, almost black. She asks the nurse whether something is wrong. Which of the following would be the bestresponse offered by the nurse? a. Telling the mother not to worry because all breastfed babies have this type of stool. b. Asking the mother what she ate for her last meal. c. Suggesting to the mother that she ask her pediatrician to explain normal newborn stooling patterns to her. d. Explaining to the mother that this stool is called meconium and is expected for the first few bowel movements of all newborns.
d
The nurse taught new parents the guidelines to follow regarding the bottle feeding of their newborn who will be using formula from a can of concentrate. Which action if observed by the nurse would indicate that the parents correctly understand the nurse's instruction? a. Warm formula in a microwave oven for a couple of minutes prior to feeding. b. Add some honey to sweeten the formula and make it more appealing to a fussy newborn. c. Adjust the amount of water added according to weight gain pattern of the newborn. d. Wash the top of can and can opener with soap and water before opening the can.
d
While evaluating the reflexes of a male newborn, the nurse notes that with a loud noise, the newborn symmetrically abducts and extends his arms, his fingers fan out and form a "C" with the thumb and forefinger, and he has a slight tremor. The nurse documents this finding as a positive: a. Glabellar (Myerson) reflex response b. Babinski reflex response c. Tonic neck reflex response d. Moro reflex response
d
