OB TEST 3

A woman diagnosed with gestational hypertension is at a prenatal appointment. During the assessment, the nurse is concerned that she is developing signs/symptoms that indicate that her gestational hypertension is worsening. What would the nurse have assessed that indicates that the condition is worsening? Select all that apply. -Denial of visual problems -Negative protein on dipstick of urine -Complaints of headache for the last 12 hours -Blood pressure (BP) 165/120 mm Hg

-Complaints of headache for the last 12 hours -Blood pressure (BP) 165/120 mm Hg

Which characteristics would the nurse anticipate in the infant of a suspected or known opioid abuser? Select all that apply. -Hyperactivity -Tremors -Dehydration -Muscle hypotonicity -Prolonged sleep periods

-Hyperactivity -Tremors

An 8-pound 15-ounce baby born at 36 weeks' gestation would be described using which terminology? Select all that apply. -Term -Preterm -Large for gestational age (LGA) -Immature -Normal for gestational age -Postterm

-Preterm -Large for gestational age (LGA)

the charge nurse in the newborn nursery and an unlicensed assistive personnel (UAP) are working together on a shift. under their care are 8 babies rooming in w/ their moms, and 1 infant is in the nursery for the night on tube feedings. there is a new client whose infant will be brought to the nursery in 15 min. Which tasks would the nurse assign to the UAP? SATA -newborn admission -VS on all stable infants -tube feedings -document feedings of infants -record voids/stools -bath and initial feeding for new admission

-VS on all stable infants -document feedings of infants -record voids/stools

what are the goals of antenatal/antepartum testing?

1) to identify compromised fetuses and at risk for death or injury (like a neurological insult/cerebral palsy) 2) to identify babies who are adequately oxygenated to avoid unnecessary interventions

The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse should monitor for which adverse effects of this medication? Select all that apply. 1.Flushing 2.Hypertension 3.Increased urine output 4.Depressed respirations 5.Extreme muscle weakness 6.Hyperactive deep tendon reflexes

1.Flushing 4.Depressed respirations 5.Extreme muscle weakness

no fetal movement in _ hrs should be immediately investigated

12

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which findings are noted on assessment? Select all that apply. 1. Proteinuria of 3+ 2. Urine output of 20 mL in an hour 3. Presence of deep tendon reflexes 4. Respirations of 10 breaths/minute 5. Serum magnesium level of 4 mEq/L (2 mmol/L)

2. Urine output of 20 mL in an hour 4. Respirations of 10 breaths/minute

The nurse reviews the assessment history for a client with a suspected ectopic pregnancy. Which assessment findings predispose the client to an ectopic pregnancy? Select all that apply. 1. Use of diaphragm 2. Use of fertility medications 3. History of Chlamydia 4. Use of an intrauterine device 5. History of pelvic inflammatory disease (PID)

2. Use of fertility medications 3. History of Chlamydia 4. Use of an intrauterine device 5. History of pelvic inflammatory disease (PID)

miscarriage is when a pregnancy ends as a result of natural causes before _ weeks

20

magnesium will continue until...

24 hrs PP

what might be present in a 24 hr urine assessment of a preeclampsia pt?

300 mg of protein

if a pt has mild gestational HTN/mild preeclampsia, she will deliver at _ weeks

37

Five minutes after birth, a newborn is pale; has irregular, slow respirations; has a heart rate of 120 beats/min; displays minimal flexion of the extremities; and has minimal reflex responses. What is this newborn's Apgar score? A. 5 B. 4 C. 6 D. 3

A. 5

Although the newborn was just cleaned and examined, the mother notes a red rash consisting of small papules on the face, chest, and back of the newborn. Which condition would the nurse recognize? A. Erythema toxicum B. Vernix caseosa C. Nevus flammeus D. Harlequin sign

A. Erythema toxicum

It is standard routine to instill the ophthalmic ointment form of which medication into the eyes of a newborn infant as a preventive measure against ophthalmia neonatorum? A. Erythromycin B. Penicillin C. Gentamycin D. Vitamin K

A. Erythromycin

The nurse must continually assess a preterm infant's temperature and provide appropriate nursing care because, unlike the full-term infant, the preterm infant has which limitation? A. Has a limited supply of brown fat available to provide heat B. Has a limited amount of pituitary hormones with which to control internal heat C. Cannot use shivering to produce heat D. Cannot break down glycogen to glucose

A. Has a limited supply of brown fat available to provide heat

To reduce the risk of sudden infant death syndrome (SIDS) during sleep, how would the nurse instruct the parents to position the 3-day-old infant? A. Supine B. Prone C. Next to an adult in bed for closer monitoring D. Side-lying

A. Supine

Which is the most common complication for which the nurse must monitor preterm infants? A. respiratory distress B. hemorrhage C. aspiration of mucus D. brain damage

A. respiratory distress

A mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How would the nurse best respond? A. "Babies of mothers with diabetes do not have large stores of glucose at birth, so it's difficult for them to maintain the blood glucose level within an acceptable range." B. "Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mother during pregnancy, so the glucose level may drop." C. "A newborn's pancreas produces an increased amount of insulin during the first day of birth, so we're checking to see whether hypoglycemia has occurred." D. "A healthy newborn's glucose level drops after birth, so we're being especially cautious with your baby because of your diabetes."

B. "Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mother during pregnancy, so the glucose level may drop."

How would the nurse suction a term neonate choking on mucus using a bulb syringe? A. By positioning the bulb far into the throat before beginning suctioning B. By suctioning the mouth before the nostrils C. By applying oxygen and then suctioning the pharynx D. By placing the bulb in the mouth, compressing the bulb, and starting suctioning

B. By suctioning the mouth before the nostrils

A herpes simplex virus (HSV) positive mother questions the nurse about if breastfeeding is safe or not. What is the best response from the nurse? A. Yes, breastfeeding is always safe B. Yes, but only if no lesions are present on the breast C. Yes, but only with a nipple shield D. No, breastfeeding is not safe with HSV

B. Yes, but only if no lesions are present on the breast

For a newborn diagnosed with neonatal abstinence syndrome, the nurse should question which order? A. obtain fetal urine drug screen B. administer narcan C. feedings every 2-3 hours D. implement seizure precautions

B. administer narcan

A 38 week gestation neonate born at 5 lb 3 oz was noted to not pass the hearing test and has a small head circumference. Which of the following do you expect this newborn to be experiencing? A. rubella B. cytomegalovirus C. toxoplasmosis D. herpes simplex virus

B. cytomegalovirus

the lab results show that a mother has a blood type of O+ and her infant has the blood type A-. as part of the plan of care, the nurse should assess the infant for which condition? A. breast milk jaundice B. pathologic hyperbilirubinemia C. physiologic hyperbilirubinemia D. Rh incompatibility

B. pathologic hyperbilirubinemia

Following a shoulder dystocia during delivery, a baby is diagnosed with Erb's palsy. Which would be included in the treatment plan? A. no treatment necessary B. range of motion exercises and immobilization C. initiate seizure precautions D. morphine as needed for pain

B. range of motion exercises and immobilization

A mother comes in with a positive Urinalysis for alcohol, which of these would not be expected for the fetus after it is born: A. jitteriness B. sensitivity to noise and other stimuli C. microcephaly D. flat face

B. sensitivity to noise and other stimuli

A nurse assesses a newborn and notices a cephalohematoma. Which of the following should be monitored for? A. necrotizing enterocolitis B. skull fracture C. respiratory distress D. cerebral palsy

B. skull fracture

The nurse has conducted a class for pregnant clients diagnosed with diabetes mellitus about the signs/symptoms of potential complications. The nurse determines that the teaching was effective if a client makes which statement? A. "I should not have ultrasounds done because I am diabetic." B. "I'm glad I don't have to worry about developing hypoglycemia while I am pregnant." C. "I need to watch my weight for any sudden gains because I could develop what they call gestational hypertension." D. "My insulin needs should decrease during the last 2 months because I will be using some of the baby's insulin supply."

C. "I need to watch my weight for any sudden gains because I could develop what they call gestational hypertension."

The nurse is caring for a preterm infant with necrotizing enterocolitis (NEC). Which nursing intervention is most important for this infant? A. Diluting the formula mixture as prescribed B. Administering oxygen before the gastric feeding C. Measuring abdominal girth frequently D. Using half-strength formula for tube feeding

C. Measuring abdominal girth frequently

In her 36th week of gestation, a client with type 1 diabetes delivers a 9 lb 10 oz (4366 g) infant via cesarean birth. Which condition is this infant at a high risk for developing? A. Increased intracranial pressure B. Meconium ileus C. Respiratory distress syndrome D. Physiological jaundice

C. Respiratory distress syndrome

The lab results show that a mother has a blood type of O positive and her infant has the blood type of A negative. As part of the plan of care the nurse should assess the infant for which condition A. breast milk jaundice B. Rh incompatibility C. pathologic hyperbilirubinemia D. physiologic hyperbilirubinemia

C. pathologic hyperbilirubinemia

A newborn's birth was prolonged because the fetal shoulders were very wide. Which reflex would the nurse anticipate a problem with? A. Plantar B. Babinski C. Stepping D. Moro

D. Moro

How would the nurse best explain the probable cause of jaundice to the parents of a 3-day-old newborn? A. A temporary bile duct obstruction commonly found in newborns B. An allergic response to the feedings C. The seepage of maternal Rh-negative blood into the neonate's bloodstream D. The body is slow to get rid of the fetal red blood cells that have been destroyed

D. The body is slow to get rid of the fetal red blood cells that have been destroyed

Which of the following is not a risk factor for respiratory distress syndrome? A. male B. C/S C. IUGR D. female

D. female

preeclampsia

HTN and proteinuria OR other systemic symptoms, develops after 20 weeks gestation in a woman who previously had neither condition

chronic HTN

HTN present before pregnancy or diagnosed before 20 weeks gestation

what determines a positive contraction stress test?

LATE DECELS occur w/ 50% or more of contractions

is Maternal Serum Alpha-Fetoprotein (MSAFP) a diagnostic test?

NO, it is a screening test

warning signs of eclampsia

Persistent headache (severe) Epigastric/RUQ pain blurred vision altered mental status

can preeclampsia develop in the PP period?

YES!

a positive contraction stress test shows...

a compromised fetus and we may have to do a c/s and need further monitoring

what determines a nonreactive NST?

a test that does not have 2 accelerations in 20 min

what determines a negative contraction stress test?

at least 3 contractions occur in a 10 min window w/ NO LATE DECELS

when can a maternal serum alpha-fetoprotein test be drawn?

between 15-20 weeks

what is the antidote for magnesium sulfate toxicity?

calcium glutinate

what determines an equivocal/suspicious contraction stress test?

decelerations occur w/ less than 50% of contractions

TX for chronic HTN

labetalol, nifedipine, methyldopa

what is the drug of choice for prevention and tx of seizure activity caused by preeclampsia?

magnesium sulfate

what are the 2 methods for contraction stress testing?

nipple stimulated contraction test and oxytocin stimulated contraction stress test

if someone has hyperactive reflexes, they are at a higher risk for _

seizures

babies of hypertensive moms are usually _

smaller

why might a pt get amniocentesis late in pregnancy?

to assess fetal lung maturity

polyhydramnios

too much amniotic fluid, seen w/ esophageal atresia and fetal GI obstructions, CNS abnormalities, poorly controlled diabetes

following the admission assessment of a neonate born at 42 weeks of gestation, the nurse documents which findings as normal? SATA -3-vessel cord -peeling skin on the feet -absence of sole crease -absence of vernix -cyanosis of the hands and feet -large amounts of frothy oral secretions

-3-vessel cord -peeling skin on the feet -absence of vernix -cyanosis of the hands and feet

S/S of mild preeclampsia

-BP 140/90 1+ proteinuria; 300 mg protein in 24 hrs -possible HA, mild and intermittent

S/S of severe preeclampsia

-BP of 160/110 or higher -massive proteinuria of 3+ or 4+ or higher; 5,000 mg protein in 24 hr urine -decreased urine output -persistent, more severe HA -visual disturbance -RUQ/epigastric pain -SOB -N/V

The nurse monitoring a preterm newborn infant for manifestations of respiratory distress syndrome (RDS) would assess the infant for which manifestations? Select all that apply. -Grunting -Acrocyanosis -Nasal Flaring -Retractions -Tachypnea

-Grunting -Nasal Flaring -Retractions -Tachypnea

A nurse is caring for a neonate born addicted to opiates in the special care nursery. Click to specify whether each intervention is anticipated, nonessential, or contraindicated for the newborn -administer antibiotics -administer morphine -swaddle and/or provide a pacifier -feed every 2-3 hrs -increase environmental stimuli -encourage parental handling

-administer antibiotics = nonessential -administer morphine = anticipated -swaddle = anticipated -feed = anticipated -increase stimuli = contraindicated -encourage handling = contraindicated

A 37 week neonate is born and displays signs of fetal alcohol syndrome. What are initial findings that the nurse recognizes related to this? Select all that apply -large nose -macrocephaly -bulging eyes -flat face shape -thin upper lip

-flat face shape -thin upper lip

Which of the following signs would indicate that a newborn with hyperbilirubinemia is worsening? Select all that apply -respiratory rate of 50 -hypotonia -bilirubin level greater than 25 -yellow discoloration of the skin -positive Babinski reflex

-hypotonia -bilirubin level greater than 25

The nurse is caring for a primigravida mother who tested positive for Tay-Sachs on a quad screen. What can the nurse do to help? SATA -reassure the mother that everything will be okay -involve the family in the plan of care -prepare the mother for the death of the child -dismiss hopeful questions -give resources for comfort care -provide time for grieving

-involve the family in the plan of care -prepare the mother for the death of the child -give resources for comfort care -provide time for grieving

The newborn is experiencing Acute Bilirubin Encephalopathy, what signs and symptoms indicate the third phase? Select all that apply. -poor suck -shrill cry -fever -hypotonia -apnea

-shrill cry -apnea

The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement? 1. "I will need to increase my insulin dosage during the first 3 months of pregnancy." 2. "My insulin dose will likely need to be increased during the second and third trimesters." 3. "Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy." 4. "My insulin needs should return to prepregnant levels within 7 to 10 days after birth if I am bottle-feeding."

1. "I will need to increase my insulin dosage during the first 3 months of pregnancy."

The nurse is teaching a pregnant client with diabetes about nutrition and insulin needs during pregnancy. The nurse should provide the client with which information? 1. Glucose crosses the placenta 2. Insulin crosses the placenta 3. Increased caloric intake is needed 4. Decreased caloric intake is required

1. Glucose crosses the placenta

The nurse is creating a plan of care for a pregnant client with a diagnosis of severe preeclampsia. Which nursing actions should be included in the care plan for this client? Select all that apply. 1. Keep the room semi-dark. 2. Initiate seizure precautions. 3. Pad the side rails of the bed. 4. Avoid environmental stimulation. 5. Allow out-of-bed activity as tolerated.

1. Keep the room semi-dark. 2. Initiate seizure precautions. 3. Pad the side rails of the bed. 4. Avoid environmental stimulation

The nurse is collecting data from a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which findings are associated with abruptio placentae? Select all that apply. 1. Uterine tenderness 2. Acute abdominal pain 3. A hard, "board-like" abdomen 4. Painless, bright red vaginal bleeding 5. Increased uterine resting tone on fetal monitoring

1. Uterine tenderness 2. Acute abdominal pain 3. A hard, "board-like" abdomen 5. Increased uterine resting tone on fetal monitoring; 4 is incorrect bc it would be PAINFUL, NOT painless

what determines a reactive NST?

2 accelerations in a 20 min period

The nurse prepares a plan of care for the client with preeclampsia and documents that if the client progresses from preeclampsia to eclampsia, the nurse should take which first action? 1. Administer oxygen by face mask. 2. Clear and maintain an open airway. 3. Administer magnesium sulfate intravenously. 4. Assess the blood pressure and fetal heart rate.

2. Clear and maintain an open airway.

The nurse is caring for a client who has just delivered a newborn following a pregnancy with placenta previa. When reviewing the plan of care, the nurse should prepare to monitor the client for which risk that is associated with placenta previa? 1. Hematoma 2. Hemorrhage 3. Chronic hypertension 4. Disseminated intravascular coagulation

2. Hemorrhage; When a pt has had a previa, when she delivers and is PP, the lower part of the uterus does not have nearly the muscle content that the rest has so they can have problems contracting down They are at a bleeding risk and at a hemorrhage risk

The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the primary health care provider's prescriptions and should question which prescription? 1. Prepare the client for an ultrasound. 2. Obtain equipment for a manual pelvic examination. 3. Prepare to draw a hemoglobin and hematocrit blood sample. 4. Obtain equipment for external electronic fetal heart rate monitoring.

2. Obtain equipment for a manual pelvic examination.

The nurse is performing a prenatal assessment on a pregnant client. The nurse should plan to implement teaching related to risk for abruptio placentae if which information is obtained on assessment? 1. The client is 28 years of age. 2. This is the second pregnancy. 3. The client has a history of hypertension. 4. The client performs moderate exercise on a regular daily schedule.

3. The client has a history of hypertension.

A client arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. The client tells the nurse that a home pregnancy test was positive but that she began to have mild cramps and is now having moderate vaginal bleeding. On physical examination of the client, it is noted that she has a dilated cervix. Which statement, if made by the client, indicates that the client is interpreting the situation correctly? 1. "I will need to remain on bed rest for 2 weeks." 2. "I will need to take a full course of antibiotic treatment." 3. "I will need to take tocolytic medication to halt the labor process." 4. "I will need to prepare myself and my family for the loss of this pregnancy."

4. "I will need to prepare myself and my family for the loss of this pregnancy."

The nurse is counseling a pregnant woman diagnosed with gestational diabetes at 29 weeks' gestation. Which information should the nurse discuss with the client? Select all that apply. 1. Plan induction at 35 weeks. 2. Plan amniocentesis at this time. 3. Schedule a biophysical profile immediately. 4. Plan for weekly nonstress tests at 32 weeks. 5. Obtain nutritional counseling with a dietitian.

4. Plan for weekly nonstress tests at 32 weeks. 5. Obtain nutritional counseling with a dietitian.

A postpartum client with a diagnosis of gestational diabetes is scheduled for discharge. During the discharge teaching, the client asks the nurse, "Do I have to worry about this diabetes anymore?" Which is the most appropriate response by the nurse? A. "You will be at risk for developing gestational diabetes with your next pregnancy and also for developing diabetes mellitus." B. "You will have to worry about the diabetes only if you become pregnant again." C. "Your blood glucose level is within normal limits now, so you will be all right." D. "When you have gestational diabetes, you have diabetes forever, and you must be treated with medication for the rest of your life."

A. "You will be at risk for developing gestational diabetes with your next pregnancy and also for developing diabetes mellitus."

the nurse is providing teaching to the mom of a newborn w/ early jaundice about the condition's progression. The nurse knows that the teaching regarding hyperbilirubinemia was successful when the mom makes which response? A. "kernicterus is a consequence of elevated bilirubin levels and has possible lifelong effects" B. "my baby should not get hyperbilirubinemia if I place him near a window in the sunlight" C. "my baby will be 3 days old at discharge and I will not need to worry ab hyperbilirubinemia" D. "since I'm exclusively BF, the risk of my baby having hyperbilirubinemia is very low"

A. "kernicterus is a consequence of elevated bilirubin levels and has possible lifelong effects"

A home care nurse is monitoring a 16-year-old primigravida who is at 36 weeks' gestation and has gestational hypertension. Her blood pressure during the past 3 weeks has been averaging 130/90 mm Hg. She has had some swelling in the lower extremities and has had mild proteinuria. Which statement by the woman should alert the nurse to the worsening of gestational hypertension? A. "my vision for the past 2 days has been really fuzzy" B. "the swelling in my hands and ankles has gone down" C. "I had heartburn yesterday after I ate some spicy foods" D. "I had a HA yesterday, but I took some acetaminophen and it went away"

A. "my vision for the past 2 days has been really fuzzy"

A nonstress test is performed on a client, and the results are documented in the chart as no accelerations during a 40-minute observation. The nurse interprets these findings as which result? A. A nonreactive nonstress test B. Equivocal C. A reactive nonstress test D. Unsatisfactory

A. A nonreactive nonstress test

The nurse is caring for a client diagnosed with preeclampsia. When the client's condition progresses from preeclampsia to eclampsia, what would the nurse's first action be? A. Prepare to maintain an open airway B. Administer an intravenous infusion of magnesium sulfate C. Prepare to administer oxygen via face mask D. Assess the maternal blood pressure and fetal heart tones

A. Prepare to maintain an open airway

Which symptom is not associated with a fractured clavicle? A. fever B. unilateral movement of the arms C. crepitus over the bone D. absence of moro reflex

A. fever

A newborn is experiencing apnea and presents with microcephaly and seizures. Which would you expect to be included in the treatment plan? A. give newborn acyclovir and provide supportive measures B. administer HepB immune globulin to the newborn C. no treatment necessary D. give one dose of rocephin to newborn at birth

A. give newborn acyclovir and provide supportive measures

A baby presents with an apgar of 2, green stained skin, respiratory rate of 28, and rales upon auscultation. Which of the following should the nurse expect to be the diagnosis? A. meconium aspiration syndrome B. respiratory distress syndrome C. chorioamnionitis D. sepsis

A. meconium aspiration syndrome

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The primary health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? A. normal test result B. an abnormal test result C. a high risk for fetal demise D. the need for a C/S

A. normal test result

the nurse is caring for a family that is grieving the loss of their newborn. which tokens of remembrance would be appropriate to provide? SATA A. picture of the newborn B. certificate of death C. footprints D. lock of hair

A. picture of the newborn C. footprints D. lock of hair

The nurse is teaching the mother of a preterm neonate about how to reduce the risk of necrotizing enterocolitis. Which statement indicates that the mother understands the teaching? A. "I will not swaddle my infant to prevent GI upset." B. "I will provide breastmilk to feed my infant while in the NICU." C. "My baby will only receive TPN feedings." D. "Pain is not common with this diagnosis."

B. "I will provide breastmilk to feed my infant while in the NICU."

The nurse is caring for a newborn of a primiparous woman w/ insulin-dependent diabetes. When the mother visits the neonate at 1 hr after birth, the nurse explains to the mom that the neonate is being closely monitored for S/S of hypoglycemia bc of which reason? A. increased use of glucose stores during a difficult labor and birth process B. interrupted supply of maternal glucose and continued high neonatal insulin production C. a normal response that occurs during transition from intrauterine to extrauterine life D. increased pancreatic enzyme production caused by decreased glucose stores

B. interrupted supply of maternal glucose and continued high neonatal insulin production

the nurse is assigned to care for 4 mothers and their term newborns. which mother and newborn couplet requires the nurse's attention 1st? A. mom: fundus firm 2 cm below umbilicus, minimal lochia rubra. infant: color is pink on room air, RR 67, bilateral crackles on auscultation B. mom: fundus is firm 3 cm above umbilicus and to the right, moderate rubra lochia. infant: color is pink when active, currently dusky while quiet, RR 70 C. mom: fundus is firm 1 cm above umbilicus, small amount lochia rubra. infant: color is pink w/ acrocyanosis, RR 68 and intermittent expiratory grunting D. mom: fundus is firm at umbilicus, small amount of lochia rubra. infant: pale pink, quiet alert, RR 65, periodic breathing noted

B. mom: fundus is firm 3 cm above umbilicus and to the right, moderate rubra lochia. infant: color is pink when active, currently dusky while quiet, RR 70

Which statement from the parents of a neonate with a fractured clavicle indicates the teaching was effective? A. My baby will be on pain medication to promote comfort B. I should burp my baby aggressively throughout feedings C. I should gently handle the baby during diaper changes and feedings D. My baby will require intensive treatment

C. I should gently handle the baby during diaper changes and feedings

A mother brings her newborn baby boy in for his 1 week checkup. She tells the nurse that he does not seem to be moving his right arm as much as his left. The nurse would observe for A. crying B. positive ortolani sign C. limited ROM during the Moro reflex The nurse suspects the newborn has A. facial palsy B. a fractured clavicle C. a dislocated hip

C. limited ROM during the Moro reflex B. a fractured clavicle

A mother just delivered vaginally a 42 week post-term infant. Which of the following is NOT a symptom of hypoglycemia in the infant? A. bluish color, pale skin B. respiratory rate of 74 C. low birth weight D. tremors

C. low birth weight

Upon delivery an infant presents with rhonchi, APGAR score of 4 and 5. The nurse notices meconium stains on the infants skin. What should be the nurses PRIORITY action? A. provide oxygen B. place the infant in an incubator C. suction the mouth D. vigorously dry the infant

C. suction the mouth

2 hrs ago, a neonate at 38 weeks gestation and weighing 3175 g was born to a primiparous client who tested positive for beta-hemolytic streptococcus. which finding would alert the nurse to notify the HCP? A. alkalosis B. increased muscle tone C. temperature instability D. positive babinski's reflex

C. temperature instability

The nurse developing a plan of care for a postterm small-for-gestational-age (SGA) newborn would identify which assessment as the priority to monitor? A. Hemoglobin and hematocrit B. Urinary output C. Total bilirubin levels D. Blood glucose levels

D. Blood glucose levels

The nurse is caring for a pregnant client with preeclampsia who is receiving a prescribed intravenous (IV) infusion of magnesium sulfate. To provide a safe environment, the nurse would ensure that which priority item is available? A. Reflex hammer B. Potassium chloride injection C. Tongue blade D. Calcium gluconate injection

D. Calcium gluconate injection

The nurse is caring for a newly delivered breastfeeding infant. Which nursing intervention would best prevent jaundice in this infant? A. Encouraging the mother to breastfeed and supplement with formula B. Keeping the infant NPO until it is 12 hours of life C. Initiating the infant under phototherapy D. Encouraging the mother to breastfeed every 2 to 3 hours

D. Encouraging the mother to breastfeed every 2 to 3 hours

The nurse in the newborn nursery is planning for the admission of a large for gestational age (LGA) infant whose mother has gestational diabetes. In preparing to care for this infant, the nurse would obtain equipment to perform which diagnostic test? A. Serum insulin levels B. Indirect and direct bilirubin levels C. Rh and ABO blood typing D. Heel stick blood glucose

D. Heel stick blood glucose

A primigravida is receiving magnesium sulfate for the treatment of gestational hypertension. The nurse who is caring for the client is performing assessments every 30 minutes. Which finding would be of most concern to the nurse? A. urinary output of 20 mL B. deep tendon reflexes of 2+ C. fetal HR of 120 BPM D. RR of 10 breaths/min

D. RR of 10 breaths/min

The nurse is teaching umbilical cord care to a new mother. What information would the nurse provide to the mother related to cord care? A. Cord care is done only at birth to control bleeding. B. It takes at least 21 days for the cord to dry up and fall off. C. Alcohol is the only agent to use to clean the cord. D. The process of keeping the cord clean and dry will decrease bacterial growth.

D. The process of keeping the cord clean and dry will decrease bacterial growth.

A 2 week old neonate is admitted to the hospital w/ a diagnosis of possible sepsis. Based on the info in the EHR, which order would the nurse question? EHR: 1. acetaminophen, 2. ampicillin, 3. D545 NS IV @ 30 mL/hr, 4. mom may BF ad lib, 5. draw blood cultures times 3 in AM, 6. send urine culture in AM A. acetaminophen 10 mg/kg per rectum, every 4-6 hrs PRN pain B. ampicillin 200 mg/kg IV every 6 hrs C. mom may breastfeed ad lib D. draw blood cultures times 3 in the AM

D. draw blood cultures times 3 in the AM

a neonate born by C/S at 42 weeks, weight 4100 g, w/ APGAR scores of 8 and 9 after birth, develops an increased RR and tremors of the hands and feet 2 hrs PP. what is the priority problem for this neonate? A. ineffective airway clearance B. hyperthermia C. decreased cardiac output D. hypoglycemia

D. hypoglycemia

A 20 day old baby presents to the pediatrician with signs of sepsis. The nurse confers the baby has most likely developed this infection from: A. chorioamnioitis B. maternal GBS positive C. maternal fever onset during labor D. maternal derived infection at home taking care of the infant

D. maternal derived infection at home taking care of the infant

A baby presents with a HR of 180, decreased muscle tone, RR of 72, and the use of intercostal muscles when breathing. What does the nurse anticipate to educate the mother about? A. sepsis B. facial paralysis C. intraventricular hemorrhage D. respiratory distress syndrome

D. respiratory distress syndrome

a preterm neonate admitted to the NICU at about 30 weeks' gestation is placed in an oxygenated isolate. the neonate's mom tells the nurse that she was planning to BF the neonate. which instructions about breastfeeding would be most appropriate? A. BF is not recommended bc the neonate needs increased fat in the diet B. once the neonate no longer needs oxygen and continuous monitoring, BF can be done C. BF is contraindicated bc the neonate needs a high-calorie formula q 2 hrs D. tube feedings using breast milk can be given until the neonate can coordinate sucking and swallowing

D. tube feedings using breast milk can be given until the neonate can coordinate sucking and swallowing

chromosome abnormalities

advanced maternal age can be a risk factor for chromosome abnormalities, mom w/ hx of prior baby w/ chromosome defects can be a risk, some ultrasound findings are associated w/ chromosome abnormalities (ex: absent nasal bone on ultrasound - could be associated w/ down syndrome), some maternal blood tests and genetic screenings, if we have positive genetic screen, that's a risk factor for chromosome abnormalities

who is the quad screen offered to?

all women as part of their routine prenatal care

what are the 5 markers that the biophysical profile evaluates?

amniotic fluid volume, fetal breathing movements, fetal movement, fetal tone, and the reactivity on a 20 min tracing

Maternal causes for IUGR

diabetes w/ vascular involvement, hypertensive disorders, thrombophilia, cyanotic heart disease, chronic renal disease, lupus, smoking, alcohol, illicit drug use, poor weight gain

when a pt starts to seize, the most imp thing is to....

ensure a patent airway and making safety a priority; protect her from injury and maintain an open and patent airway; do NOT leave bedside and call for help

what determines an unsatisfactory contraction stress test?

fewer than 3 contractions in a 10 min period or unable to maintain continuous fetal monitoring

HELLP syndrome

hemolysis, elevated liver enzymes, low platelets

contraction stress test

identifies a fetus who is jeopardized under stress, but is stable at rest

When is the quad screen offered, and what does it include?

it is offered between 15-20 weeks and includes MSAFP, hCG, inhibin A, and estriol

gestational hypertension

onset of HTN without proteinuria or other systemic findings, after 20 weeks gestation

eclampsia

onset of seizure activity or coma in a woman with preeclampsia who has no history of preexisting seizures

oligohydramnios

renal issues/abnormalities in fetus - part of amniotic fluid is urine so lower urine could indicate renal issue, maternal hypertensive disorders - chronic HTN, gestational HTN, preeclampsia, uteroplacental insufficiency, severely growth restricted fetuses (IUGR) that aren't growing well, prolonged pregnancy (if placenta isn't functioning well, the amniotic fluid can be affected) fluid level is an indicator of fetal well being, fluid level dropping below normal may be a s/s of fetus in jeopardy; oligohydramnios is concerning esp if there is no other reason for it occurring