Maternity Practice Questions 1
A nurse is caring for 4 newborns. Which of the following newborns is at the greatest risk of hypoglycemia? A) A newborn who is large for gestational age B) A newborn who has an Rh incompatibility C) A newborn who has pathologic jaundice D) A newborn who has fetal alcohol syndrome
A) a newborn who is large for gestational age Explanation: Large for gestational age (LGA) newborns have a weight at or above the 90th percentile. One of the most common etiologies of LGA newborns is a mother who is diabetic. LGA newborns, especially those born to mothers who have diabetes, are at an increased risk of hypoglycemia.
A nurse is teaching about preventing engorgement to a client who is planning to use a formula to feed her newborn. Which of the following instruction should the nurse include? A) Apply ice packs to your breasts B) Hand express milk from your breasts 3 times each day C) Try to avoid wearing a bra as much as possible throughout the day D) Request a prescription for medication to suppress lactation.
A) Apply ice packs to your breasts Explanation: Applying ice packs to the breasts can assist in reducing the discomforts of engoregment.
A nurse is caring for a client who is receiving oxytocin to induce labor. Which of the following actions should the nurse take? A) Perform continuous fetal heart rate monitoring. B) Measure maternal temperature every hour C) Evaluate the maternal contraction pattern every hour. D) Check blood pressure every five minutes.
A) Perform continuous fetal heart rate monitoring Explanation: When oxytocin is administered to an antepartum client, the fetal monitor must be used to monitor the fetal heart rate and maternal contractions continuously. Temperature is not related to oxytocin, it is monitored with risk of infection accompanied prolonged rupture. Oxytocin does not cause fluctuations in blood pressure.
A nurse enters a postpartum client's room and notices many visitors in the room, conversing loudly and taking turns holding the newborn. The newborn intermittently cries attempts to suck on her hands. After a few minutes, the newborn quiets, stares, and turns her head away when someone talks to her. What teaching should the nurse provide for this family? A) The newborn would benefit from skin-to-skin contact in a quiet environment B) The newborn's blanket should be removed so her movements will not be restricted C) The newborn's hat should be removed to avoid overheating D) The newborn should be discouraged from sucking on her hand since this habit can interfere with feeding.
A) The newborn would benefit from skin-to-skin contact in a quiet environment. Explanation: Staring and gaze eversion indicate the newborn is overstimulated and is "switching off" in an attempt to cope with excess stimuli. When this is observed, stimulation should be decreased and supportive measures such as skin-to-skin contact should be increased
A nurse is teaching a client about breastfeeding. Which of the following client statements indicates an understanding of the teaching? A) "I should consume about 700 extra calories a day while breastfeeding." B) "I will introduce bottle feeding of pumped breast milk when the baby is 2 weeks old." C) "I may notice increased cramping when I am feeding my baby." D) "I will place my baby on a strict feeding schedule to help establish a good feeding schedule."
C) "I may notice increased cramping when I am feeding my baby." Explanation: An increase in uterine cramping while breastfeeding can be due to the release of oxytocin. A patient only needs 500 calories a day in breastfeeding. Artificial nipples shouldn't be introduced until 3-4 weeks when breastfeeding is well established. Never keep a newborn on a strict schedule, waiting to eat can cause weight loss.
A nurse is proving teaching about the rubella immunization to a client who is a 24 hours postpartum. Which of the following client statements indicates an understanding of the teaching. A) "I should not breastfeed for at least 3 days after receiving this immunization." B) "I will need a second rubella booster when I see my midwife at 6 weeks postpartum." C) "I should be careful to avoid becoming pregnant within the next month." D) "This vaccine will be given into my arm muscle."
C) "I should be careful to avoid becoming pregnant within the next month." Explanation: The rubella vaccine is a live virus vaccine and it can cause birth defects. They should use abstinence or effective contraception use.
A nurse is teaching a client who is in labor about the use of nitrous oxide analgesia for pain control. Which of the following statements by the client indicates an understanding of the teaching? A) "Nitrous oxide could make my baby sleepy when he is born." B) "I should inhale the nitrous oxide between contraindications." C) "I will feel the effects of the nitrous oxide almost immediately." D) "Nitrous oxide can make me feel disoriented."
C) "I will feel the effects of the nitrous oxide almost immediately." Explanation: The effects of nitrous oxide are felt within 1 minute. It does not affect neonatal sedation, it is used as the contractions begin, and it only decreases pain, not cause disorientation.
A nurse in an outpatient setting is providing education for a client who is pregnant. Which of the following statements should the nurse include in the teaching? A) "During the last trimester, you should sleep mainly on your back." B) "During the second trimester, you will notice increased urinary frequency and urgency." C) "You will probably notice your baby moving when you are around 20 weeks gestation." D) "You should plan to gain 40 to 45 pounds during your pregnancy."
C) "You will probably first notice your baby moving when you are around 20 weeks gestation." Explanation: Fetal movement is typically noted by a pregnant client at 18 to 20 weeks gestation. Multiparous clients might notice the movement earlier.
A nurse is caring for a client who is receiving magnesium sulfate IV. Which of the following medications should the nurse have available as an antidote to magnesium sulfate? A) Betamethasone B) Terbutaline C) Calcium Gluconate D) Indomethacin
C) Calcium Gluconate Explanation: Betamethasone is administered to help mature the lungs of premature infants. Terbutaline is a smooth muscle relaxer administered to inhibit uterine contractions in premature labor. Indomethacin relaxes uterine smooth muscle and is administered to stop preterm labor.
A nurse is caring for a client at 35 weeks gestation who has severe preeclampsia. Which of the following assessments provides the most accurate information regarding the client's fluid and electrolyte status? A) Blood Pressure B) Intake and Output C) Daily Weight D) Severity of Edema
C) Daily Weight Explanation: Daily weights is shown to be the most accurate assessment for fluid and electrolyte status according to evidenced based practice.
A nurse is assessing a 4-hour-old newborn prior to breastfeeding and notes that his hands and feet are cool and slightly blue. Which of the following actions should the nurse take? A) Apply and oxygen hood over the newborn's head and neck. B) Check the newborn's temperature using a temporal thermometer. C) Place the naked newborn on the mother's bare chest and cover both with a blanket. D) Give the newborn glucose water between feedings.
C) Place the naked newborn on the mother's bare chest and cover both with a blanket Explanation: Exposure to a cool environment causes vasoconstriction, which results in cool extremities with a bluish discoloration. Placing the newborn skin-to-skin with the mother helps stabilize the newborn's temperature and promotes bonding.
A nurse is caring for a client who is in labor. The client asks the nurse, "Why are you pressing on my abdomen?" Which of the following responses should the nurse make? A) "I can determine your baby's heart rate." B) "I can confirm that you have sufficient fluid around your baby." C) "I can confirm that your baby moves with simulation." D) "I can determine the position of your baby."
D) I can determine the position of your baby. Explanation: Palpation of the abdomen can determine which fetal part is in the uterine fundus and where the back of the fetus is. Palpating the lower abdomen will help determine whether the fetus's head is down or if another extremity is the presenting part.
A nurse is teaching about mastitis to a client who is postpartum and breastfeeding her newborn. Which of the following statements by the client indicates an understanding of the teaching? A) I will limit breastfeeding to five minutes per breast. B) I will not breastfeed if I start to have flu-like symptoms. C) I will shop for an underwire nursing bra today. D) I will avoid any of my family members who are ill.
D) I will avoid any of my family members who are ill. Explanation: The client should avoid ill family members to decrease the risk of mastitis.
A nurse is caring for a preterm infant in the NICU. Which of the following actions by the nurse will promote the infant's optimal development? A) Avoiding swaddling B) Placing the infant in the supine position C) Providing physical care at short, frequent intervals D) Reducing ambient noise and lighting
D) Reducing ambient noise and lighting Explanation: Important in promoting optimal development. Lighting should be diminished at night, and blankets should be placed over the incubators during the daylight hours. Noise levels should always be kept to a minimum.
A nurse is talking with a client at 20 weeks of gestation who is scheduled for a sonogram. The client states, "I am here to have my regular prenatal checkup, but I do not want any pictures taken of my baby." Which of the following responses should the nurse make? A) "Do not worry. We can do the sonogram without showing you the sex of your baby." B) "I would like to hear more about why you do not want the sonogram, including any cultural reasons." C) "I think you should reconsider because the sonogram is an important part of the baby's check-up." D) " You have the right to tell the doctor that you do not want the sonogram."
B) "I would like to hear ore about why you do not want the sonogram, including any cultural reasons." Explanation: The nurse should be culturally sensitive to all clients and respect and recognize a client who is refusing care for cultural or religious reasons. Collecting more information about why she doesn't want the sonogram is important so the nurse can better advocate for the patient. You shouldn't persuade the client or pass judgement. Also do not minimize the client's concerns. Respect the client's right to choose, but you need to communicate the client's concerns to the doctor.
A nurse is assessing a newborn. Which of the following findings suggest the newborn is post-mature? A) Pale, translucent skin B) Nails extending over the fingers C) Weak gag reflex D) Thin covering of fine hair on shoulders and back
B) Nails extending over the fingers Explanation: This is an expected finding for a post-term infant. Thin, pale skin is common in preterm infants. Under-developed reflexes is common in preterm infants. Lanugo, or fine hair on the shoulders and back, is common in preterm infants.
A nurse is assisting with the care of a client who is in labor. The nurse observes late decelerations on the fetal monitor. Which of the following actions should the nurse take? A) Decrease the rate of the client's maintenance IV fluid. B) Place the client in a left lateral position. C) Apply oxygen at 2 L/min via nasal cannula. D) Prepare the client for an amniocentesis.
B) Place the client in the left lateral position Explanation: A late deceleration of the FHR has a onset beginning after a contraction has started and persists beyond the end of the contraction. It indicates an interruption in fetal oxygenation. A lateral position improves blood flow to the uterus and intervillous spaces. Repositioning the client is a component o intrauterine resuscitation.
A nurse is caring for a client who had a cesarean birth 36 hours ago and is experiencing pain due to gas. Which of the following strategies should the nurse recommend? A) Sip a carbonated beverages throughout the day. B) Rock in a rocking chair C) Lie flat in the bed with the legs extended D) Use a straw when drinking fluids
B) Rock in a rocking chair Explanation: The nurse should recommend that the client rocks in a rocking chair, ambulates in the hallways, and lies o her left side to assist with intestinal motility and to expel flatulence
A nurse is teaching the guardian of a newborn about caring for the newborn's umbilical cord. For which of the following reasons should the nurse instruct the guardian to avoid using antimicrobial agents on the cord? A) They can cause increased pain from the cord B) They can cause delayed cord separation C) They can cause swelling of the surrounding tissue D) They can cause skin discoloration
B) They can cause delayed cord separation. Explanation: There is no evidence that antimicrobial preparations are of any benefit in the process of drying and detachment of the umbilical cord stump. Keeping the cord moist with any kind of preparation prevents drying and separation of the cord, as well as increases the risk for infection.