RN Maternal Newborn Online Practice 2019 A NGN
Which of the following findings should the nurse report to the provider? Select the 3 findings that should be reported 1. uterine contractions 2. fetal heart rate 3. gestational age 4. vaginal examination 5. maternal blood pressure
1. uterine contractions 3. gestational age 4. vaginal examination
A nurse is preparing to administer magnesium sulfate 2g/hr IV to a client who is in preterm labor. Available is 20 g magnesium sulfate in 500 mL of dextrose 5% in water (D5W). The nurse should set the IV infusion pump to administer how many mL/hr?
50 mL/hr
A nurse is caring for a client who is to receive oxytocin to augment her labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider? 1. late decelerations 2. moderate variability of the FHR 3. cessation of uterine dilation 4. prolonged active phase of labor
1. late decelerations
A nurse is assessing a newborn who was born at 26 weeks of gestation using the New Ballard Score. Which of the following findings should the nurse expect? 1. minimal arm recoil 2. popliteal angle of 90 3. creases over the entire foot sole 4. raised areolas with 3-4 mm buds
1. minimal arm recoil
A nurse is assessing a client who is 1 day postpartum and has a vaginal hematoma. Which of the following manifestations should the nurse expect? 1. lochia serosa vaginal discharge 2. vaginal pressure 3. intermittent vaginal pain 4. yellow exudate vaginal discharge
2. vaginal pressure
A nurse in a providers office is reviewing the medical record of a client who is in the first trimester of pregnancy. Which of the following findings should the nurse identify as a risk factor for the development of preeclampsia? 1. Singleton pregnancy 2. BMI 20 3. Maternal age 32 years 4. Pregestational diabetes mellitus
4. Pregestational diabetes mellitus
A nurse is performing a routine assessment on a client who is at 18 weeks of gestation. Which of the following findings should the nurse expect? 1. deep tendon reflexes +4 2. fundal height 14 cm 3. urine protein 2+ 4. FHR 152/min
4. FHR 152/min
Which of the following findings should the nurse report to the provider? Select all that apply 1. abdominal assessment 2. vaginal discharge 3. heart rate 4. temperature 5. dyspareunia 6. condom usage
1. abdominal assessment 2. vaginal discharge 4. temperature 5. dyspareunia 6. condom usage
A nurse is caring for a client who is at 26 weeks of gestation and has epilepsy. The nurse enters the room and observes the client having a seizure. After turning the client's head to one side, which of the following actions should the nurse take immediately after the seizure? 1. monitor FHR 2. assess uterine acitivity 3. administer oxygen via a nonrebreather mask 4. start a bolus of IV fluids
3. administer oxygen via a nonrebreather mask
A nurse is admitting a client who is in labor. The client admits to recent cocaine use. For which of the following complications should the nurse assess? 1. abruptio placenta 2. placenta previa 3. preeclampsia 4.maternal bradycardia
1. abruptio placenta
A nurse is providing teaching about nonpharmacological pain management to a client who is breastfeeding and has engorgement. The nurse should recommend the application of which of the following items? 1. Cold cabbage leaves 2. purified lanolin cream 3. a snug-fitting support bra 4. breast shells
1. cold cabbage leaves
Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is indicated or contraindicated for the newborn 1. educate the parents to begin range of motion exercises on the affected arm after 1 week 2. assess for grasp reflex in affected extremity 3. immobilize the arm across the abdomen by pinning the newborns sleeve to the shirt 4. instruct the parents to limit physical handling for 2 weeks
1. indicated 2. indicated 3. indicated 4. contraindicated
A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take? 1. insert two gloved fingers into the vagina and apply upward pressure to the presenting part 2. wrap the visible corn tightly with sterile, dry gauze 3. apply oxygen to the client at 2 L/min via nasal cannula 4. place the client in the lithotomy position and apply fundal pressure
1. insert two gloved fingers into the vagina and apply upward pressure to the presenting part
A nurse is observing a new parent caring for their crying newborn who is bottle feeding. Which of the following actions by the parent should the nurse recognize as a positive parenting behavior? 1. Lays the newborn across their lap and gently sways 2. Places the newborn in the crib in a prone position 3. offers the newborn a pacifier 4.prepares a bottle of formula mixed with rice cerial
1. lays the newborn across their lap and gently sways
A nurse is creating a plan of care for a client who is postpartum and adheres to traditional Hispanic cultural beliefs. Which of the following cultural practices should the nurse include in the plan of care? 1. protect the client's head and feet from cold air 2. bathe the client within 12 hr following birth 3. ambulate the client within 24 hr following birth 4. offer the client a glass of cold milk with her first meal
1. protect the client's head and feet from cold air
A nurse is assessing a client who has gestational diabetes mellitus and is experiencing hyperglycemia. Which of the following findings should the nurse expect? 1. reports increased urinary output 2. diaphoresis 3. reports blurred vision 4. shallow respirations
1. reports increased urinary output
A nurse is transporting a newborn back to the parent's room following a procedure. Which of the following actions should the nurse take? 1. Verify that the parent's identification band matches the newborns identification band 2. scan the newborns identification band to verify their identity 3. check the newborns security tag number to ensure it matches the newborns medical record 4. match the newborns date and time of birth to the information in the parent's medical record
1. verify that the parent's identification band matches the newborns identification band
A nurse is providing teaching to a client about the physiological changes that occur during pregnancy. The client is at 10 weeks of gestation and has a BMI within the expected reference range. Which of the following client statements indicates an understanding of the teaching? 1. I will gain more than 15 to 20 pounds during my pregnancy 2. I will likely need to use alternative positions for sexual intercourse 3. I'm glad I had a breast reduction years ago, so they will not enlarge with my pregnancy 4. I'm glad I have a light complexion and will not get any stretch marks
2. I will likely need to use alternative positions for sexual intercourse
Which of the following actions are the nurse's priorities? Select the 4 actions that the nurse should take immediately. 1. Assess cervical dilation 2. administer a bolus of IV fluids 3. Insert indwelling urinary catheter 4. reposition the client to the other side 5. apply oxygen at 10 to 12 L/mn via nonrebreather mask 6. Elevate the client's legs 7. Evaluate the client's pain level
2. administer a bolus of IV fluids 4. reposition the client to the other side 5. apply oxygen at 10 to 12 L/min via nonrebreather mas 6. Elevate the client's legs
The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions regarding the newborn should the nurse anticipate? 1. Instruct the mother to discontinue breastfeeding 2. administer scheduled doses of oral morphine 3. give a one-time does of naloxone IM 4. maintain a low stimulus environment 5. initiate neonatal abstinence syndrome (NAS) scoring
2. administer scheduled doses of oral morphine 4. maintain a low stimulus environment 5. initiate neonatal abstinence sydrome (NAS) scoring
A nurse is caring for a client who is at 38 weeks of gestation. Which of the following actions should the nurse take prior to applying an external transducer for fetal monitoring? 1. determine progression of dilation and effacement 2. perform Leopold's maneuvers 3. complete a sterile speculum exam 4. Prepare a Nitrazine paper test
2. perform Leopold's maneuvers
A nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actions should the nurse take? 1. administer antiviral medication 2. schedule an ultrasound examination 3. administer Haemophilus influenzae type b vaccine 4. schedule an indirect Coombs test
2. schedule an ultrasound examination
A nurse is caring for a client who is at 36 weeks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound? 1. To estimate the fetal weight 2. to locate the pocket of fluid 3. to determine multiparity 4. to prescreen for fetal anomalies
2. to locate the pocket of fluid
A nurse is caring for a client who is anemic at 32 weeks of gestation and is in preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the following outcomes should the nurse expect? 1. Decreased uterine contractions 2. An increase in the client's hemoglobin levels 3. A reduction in respiratory distress in the newborn 4. Increased production of antibodies in the newborn
3. A reduction in respiratory distress in the newborn
A nurse in an antepartum clinic is providing care for a client who is at 26 weeks of gestation. Upon reviewing the client's medical record, which of the following findings should the nurse report to the provider? 1. 1-hr glucose tolerance test 2. hematocrit 3. fundal height measurement 4. FHR
3. Fundal height measurement
A nurse is developing a plan of care for a newborn who is to undergo phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan? 1. Feed the newborn 1 oz of water very 4 hr. 2. Apply lotion to the newborn's skin three times per day 3. Remove all clothing from the newborn except the diaper 4. Discontinue therapy if newborn develops a rash
3. Remove all clothing from the newborn except the diaper
A nurse is providing teaching for a client who gave birth 2 hr ago about the facility policy for newborn safety. Which of the following client statements indicates an understanding of the teaching? 1. My sister will be able to carry my baby from the nursery to my room when she arrives 2. The nurse will match my wrist band to my baby's crib card when they bring him to me 3. The person who comes to take my baby's pictures will be wearing a photo ID badge 4. My baby doesn't need to wear the electronic security bracelet when he's in my room
3. The person who comes to take my baby's pictures will be wearing a photo ID badge
A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching? 1. obtain an informed consent prior to obtaining the screening 2. collect at least 1 mL of urine for the test 3. ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen 4. premature newborns may have false negative tests due to immature developing of liver enzymes
3. ensure the newborn has been receiving feedings for 24 hours prior to obtaining the specimen
A nurse is providing education about family bonding to parents who recently adopted a newborn. The nurse should make which of the following suggestions to aid the family's 7-year-old child in accepting the new family member? 1. allow the sibling to hold the newborn during a bath 2. make sure the sibling kisses the newborn each night 3. obtain a gift from the newborn to present to the sibling 4. switch the sibling's room with the nursery
3. obtain a gift from the newborn to present to the sibling
A nurse is assessing a newborn who was delivered vaginally and experienced a tight nuchal cord. Which of the following findings should the nurse expect? 1. Bruising over the buttocks 2. hard nodules on the roof of the mouth 3. Petechiae over the head 4. Bilateral periauricular papilloma's
3. petechiae over the head
A nurse is caring for a client who is at 30 weeks of gestation and has prescription for magnesium sulfate IV to treat preterm labor. The nurse should notify the provider of which of the following adverse effects? 1. client reports nausea 2. urinary output of 40 mL/hr 3.. respiratory rate 10/min 4. client reports feeling flushed
3. respiratory rate 10/min
A nurse is assessing a client who is at 38 weeks of gestation during a weekly prenatal visit. Which of the following finding should the nurse report to the provider? 1. blood pressure 136/88 2. report of insomnia 3. weight gain of 2.2 kg (4.8lb) 4. report of braxton hicks contractions
3. weight gain of 2.2 kg (4.8lb)
A nurse is providing discharge teaching to a client who had a cesarean birth 3 days ago. Which of the following instructions should the nurse include? 1. you can resume sexual activity in 1 week 2. you won't need to do kegel exercises since you had a cesarean 3. you can still become pregnant if you are breastfeeding 4. you are safe to start adding sit-ups to your exercise routine in 2 weeks
3. you can still become pregnant if you are breastfeeding
A nurse is teaching a client who is at 10 weeks of gestation about nutrition during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? 1. I should increase my protein intake to 60 grams each day 2. I should drink 2 liters of water each day 3. I should increase my overall daily caloric intake by 300 calories 4. I should take 600 micrograms of folic acid each day
4. I should take 600 micrograms of folic acid each day
A nurse is assessing four newborns. Which of the following findings should the nurse report to the provider? 1. a newborn who is 26 hr old and has erythema toxicum on his face 2. a newborn who is 32 hr old and has not passed a meconium stool 3. a newborn who is 12 hr old and has pink-tinged urine 4. a newborn who is 18 hr old and has an axillary temperature of 37.7 C (99.9 F)
4. a newborn who is 18 hr old and has an axillary temperature of 37.7 C (99.9 F)
A nurse is admitting a client to the labor and delivery unit when the client states, "my water just broke." Which of the following interventions is the nurse's priority? 1. perform Nitrazine testing 2. assess the fluid 3. check cervical dilation 4. begin FHR monitoring
4. begin FHR monitoring
Which of the following findings should the nurse report to the provider? Select all that apply 1. respiratory findings 2. temperature 3. oxygen saturation 4. central nervous system findings 5. gastrointestinal findings
4. central nervous system findings 5. gastrointestinal findings
A nurse is caring for a client who is 15 weeks of gestation, is Rh-negative, and has just had an amniocentesis. Which of the following interventions is the nurses priority following the procedure? 1. check the client's temperature 2. observe for uterine contractions 3. administer Rh0(D) immune globulin 4. monitor FHR
4. monitor FHR
A nurse is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the nurse use to help minimize the pain of the procedure for the newborn? 1. apply a cool pack for 10 min to the heel prior to the puncture 2. request a prescription for IM analgesic 3. use a manual lance blade to pierce the skin 4. place the newborn skin to skin on the mother's chest
4. place the newborn skin to skin on the mother's chest
A nurse is assessing a client who received carboprost for postpartum hemorrhage. Which of the following findings is an adverse effect of this medication? 1. Hypertension 2. Hypothermia 3. Constipation 4. Muscle weakness
1. Hypertension
The nurse is reviewing the provider's prescriptions in the adolescent's medical chart. Complete the following sentence by using the list of options
providing education on medications administering the ceftriaxone
The nurse is planning care for the adolescent. Which of the following prescriptions should the nurse expect the provider to prescribe?
ceftriaxone and doxycycline
A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following findings should the nurse report to the provider? 1. BUN 25 mg/dL 2. Serum creatinine 0.8 mg/dL 3. Urine output of 280 mL within 8 hr 4. Urine negative for ketones
1. BUN 25 mg/dL
A nurse is caring for a client who is at 36 weeks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests? 1. Biophysical profile (BPP) 2. Amniocentesis 3. Cordocentesis 4. Kleihauer-Betke test
1. Biophysical profile (BPP)
A nurse is caring for a client who is experiencing preeclampsia and has a new prescription for IV magnesium sulfate. Which of the following medications should the nurse anticipate administering if the client develops magnesium toxicity? 1. Calcium gluconate 2. Hydralazine 3. Medroxyprogesterone acetate 4. Methylergonovine
1. Calcium gluconate
A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverse effect of this medication? 1. Depression 2. Polyuria 3. Hypotension 4. Urticaria
1. Depression
A nurse is reviewing the prenatal laboratory results for a client who is at 12 weeks of gestation following an initial prenatal visit. Which of the following laboratory findings should the nurse report to the provider? 1. Hemoglobin 10 g/dL 2. WBC 10,000/mm 3. Platelets 250,000/mm 4. Fasting blood glucose 90 mg/dL
1. Hemoglobin 10 g/dL
A nurse is providing teaching to a client who is at 40 weeks of gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching? 1. I can administer oxytocin 4 hours after the insertion of the medication 2. you will need a full bladder prior to the insertion of the medication 3. remain in a side-lying position for 15 minutes after the medication is inserted 4. an antacid will be given 20 minute prior to the insertion of the medication
1. I can administer oxytocin 4 hours after the insertion of the medication
A nurse is caring for a client who is at 24 weeks of gestation and has a suspected placental abuption. Which of the following laboratory tests should the nurse expect the provider to prescribe? 1. Kleihauer-Betke test 2. progesterone serum level 3. lecithin/sphingomyelin (L/S) ratio 4. maternal Alpha-fetoprotein (AFP)
1. Kleihauer-Betke test
A nurse is demonstrating to a client how to bathe their newborn. In which order should the nurse perform the following actions?
1. Wipe the newborn's eyes from the inner canthus outward 2. Wash the newborns neck by lifting the newborns chin 3. Cleanse the skin around the newborn's umbilical cord stump 4. Wash the newborn's legs and feet 5. Clean the newborns diaper area
A nurse is performing a physical assessment of a newborn upon admission to the nursery. Which of the following manifestations should the nurse expect? (Select all that apply.) 1. yellow sclera 2. acrocyanosis 3. posterior fontanel larger than the anterior fontanel 4. positive Babinski reflex 5. two umbilical arteries visible
2. acrocyanosis 4. positive Babinksi reflex 5. two umbilical arteries visible
A nurse is assessing a newborn 12 hr after birth. Which of the following manifestations should the nurse report to the provider? 1. acrocyanosis 2. transient strabismus 3. jaundice 4. caput succedaneum
3. jaundice
A nurse is assessing a client who is receiving morphine via IV bolus for pain following a cesarean birth. The nurse notes a respiratory rate of 8/min. Which of the following medications should the nurse administer? 1. fentanyl 2. butorphanol 3. naloxone 4. meperidine
3. naloxone
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address the condition, and 2 parameters the nurse should monitor to assess the client's progess.
Endometritis Obtain a culture of vaginal fluid using a sterile swab Plan to administer IV antibiotics Monitor temperature and lochia amount and odor
A charge nurse on a labor and delivery unit is teaching a newly licensed nurse how to perform Leopold maneuvers. Which of the following images indicates the first step of Leopold maneuvers?
Hands on the top of the fundus
The nurse has just reviewed discharge instructions with the adolescent. Which of the following indicates whether the adolescent understand the teaching or requires further teaching?
I should continue taking all my medications even if I don't show any symptoms--understanding If I continue to get this type of infection, it can affect my ability to have kids in the future--understanding I should go to the emergency room if my urine turns dark--further education as long as I keep my IUD, I don't need to use condoms--further education I'm more likely to get a sunburn while taking these medications--understanding
The nurse is reviewing the adolescent's medical record. Which of the following conditions is the client most likely developing?
PID C-reactive protein
Which of the following conditions should the nurse identify as being consistent with the adolescent's assessment findings?
abdominal pain--gonorrhea greenish discharge-trichomoniasis and gonorrhea diabetes-candidiasis pain on urination-trichomoniasis, gonorrhea and candidiasis absence of condom use-trichomoniasis and gonorrhea
A nurse is assessing a late preterm newborn. Which of the following manifestations is an indication of hypoglycemia? 1. hypertonia 2. increased feeding 3. hyperthermia 4. respiratory distress
4. respiratory distress
A nurse is a prenatal clinic assessing a group of clients. Which of the following clients should the nurse see first? 1. a client who is at 11 weeks of gestation and reports abdominal cramping 2. a client who is at 15 weeks of gestation and reports tingling and numbness in right hand 3. a client who is at 20 weeks of gestation and reports constipation for the past 4 days 4. a client who is at 8 weeks of gestation and reports having three bloody noses in the past week
1. a client who is at 11 weeks gestation and reports abdominal cramping