OB Exam 4- Final Questions

The nurse is assessing the Apgar score for a 1-minute-old newborn and notes the following: HR 105 bpm, a pink body with blue feet, a strong cry, sneezing and minimal flexion. Which Apgar score will the nurse document as appropriate for this infant?

8

A baby with developmental dysphasia of the hip is placed in a Pavlik harness. The harness positions the hip in which position?

A flexed, abducted position to press the femur head against the acetabulum

Assessment reveals that a young mother has several risk factors for giving birth to an infant with a neural tube defect. Which lab test would the nurse expect to be used to monitor the fetus for this birth defect?

Alpha-fetoprotein levels

A hep B positive mother delivers a newborn. What precautions would the nurse take in caring for this infant? SATA

B. Bathe the newborn thoroughly soon after birth to remove maternal blood C. Give the newborn the HBV vaccination within 12 hours after birth

A nurse is reviewing the lab results of a neonate. Which finding would be a cause of concern for the nurse? SATA

B. Hematocrit 34% D. RBC 3.2

A nurse is assessing a newborn who is about 4.5 hours old. The nurse would expect this newborn to exhibit which behavior? SATA

B. Interest in environmental stimuli C. passage of meconium

The nurse is teaching a couple about the pros and cons of circumcision for their infant son. The nurse knows teaching has been effective when the couple can identify which contraindications to circumcision? SATA

B. Preterm infant C. Bleeding disorder D. Congenital genitourinary disorder E. Active infection

The nurse is conducting a class for postpartum women about mood disorders. The nurse describes a transient, self-limiting mood disorder that affects mothers after birth. The nurse determines that the women understand the description when they identify the condition as postpartum

Blues

The parents are concerned their newborn appears to be cold all the time. The nurse should point out the infant is best helped by which primary method in the first few days?

Brown fat store usage

The nurse is providing care for a postpartum client who has been diagnosed with a perineal infection and who is being treated with antibiotics. What is the nurse's most appropriate intervention?

Encourage fluid intake

The nurse is inspecting the mouth of a newborn and finds small, white cysts on the gums and hard palate. the nurse documents this finding as:

Epstein's pearls

Two weeks after a vaginal birth, a client presents with low-grade fever. the client also reports a loss of appetite and low energy levels. The HCP suspects an infection of the episiotomy. What sign or symptom is most indicative of an episiotomy infection?

Foul-smelling vaginal discharge

While teaching a newborn nutrition class to a group of pregnant women, the nurse encourages breastfeeding because it is a major source of which immunoglobulin?

IgA

A newborn has been diagnosed with a group B streptococcal infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause?

Mother's birth canal

When caring for a client with postpartum depression (PPD), which assessment findings would confirm the diagnosis? SATA

Sense of isolation Decreased energy Hostility toward others

A 6 week gestation client asks the nurse what foods she should eat to help prevent neural tube disorders in her growing baby. The nurse would recommend which foods?

Spinach, oranges, and beans

what intervention would the nurse recommend for a new breastfeeding mother with mastitis? SATA

b. begin feedings on the unaffected breast c. take prescribed antibiotics for 10 days d. apply warm compress as a comfort measure for her pain

A new mother is diagnosed with a venous thromboembolism in her left calf. Which risk factor is associated with this problem? SATA

b. c section c. obesity

A nurse is assessing a neonate bron approx. 2 hrs ago. The nurse anticipates that the newborn's transition to extrauterine life would be typically accomplished by which time frame?

first 6-10 hours of life

An infant has a grade 3 intraventricular hemorrhage (IVH). The nurse monitors the infant for which complication?

hydrocephalus

The nurse is caring for a small-for-gestational-age infant at 1 hour old, after a difficult birth, with a glucose level of 40 mg/dL. Which nursing action would be the priority

initiate early oral feedings

A nurse is assessing a postpartum client. Which finding would the cause the nurse the greatest concern?

sharp stabbing chest pain with SOB

The nurse is working with a group of parents of children who have congenital heart disorders. Which statement made by the parents should the nurse prioritize for further assessment?

"She gets so tired when she is eating"

The nurse is visiting the parents of a newborn diagnosed with periventricular leukomalacia. Which statement indicates that the parents understand the newborn's health problem?

"We will need to plan for special care to help with learning disabilities"

the nurse is teaching nursing students about the risks that late preterm infants may experience. The nurse feels confident learning has taken place when the students make which statement?

A late preterm newborn may have more clinical problems compared with full-term newborns

The nurse reviews the antenatal history and notes of a term newborn, The mother admits to continual daily use of alcohol throughout her pregnancy. For which should the nurse assess the infant? SATA

A. Abnormal smallness of the head B. A flatter groove between the nose and upper lib C. weight below the 10th percentile for gestational age D. inadequate sucking

A new mother is alarmed because her newborn has lost 10 ounces in weight since being born 2 days ago. She believes that she has been breastfeeding properly. Which info would the n nurse include as a likely cause of the phenomenon? SATA

A. Absence of salt and fluid retaining maternal hormones B. The infant's voiding and passing stool C Low calorie content of colostrum

A nurse is conducting an in-service education program for a group of nurses working in the newborn nursery. The nurse has explained the events that occur as fetal circulation transitions to newborn circulation. The nurse determines the session is successful after the participants put the chain of events in which order? All options must be used

A. Birth occurs E. Pulmonary blood flow increases, and pulmonary venous return to the left side of the heart increases B. The foramen ovale closes D. An increase in systemic BP occurs with continued increase in blood flow to the lungs C. The ductus arteriosus closes

Which situation is likely to result in the presence of developmental dysplasia of the hip (DDH) at birth? SATA

A. Breech birth C. Female gender E. Oligohydramnios

A preterm infant is born at risk for normochromic, normocytic anemia. Which nursing action reduces the risk of the infant developing this condition? SATA

A. Coordinate blood draws so they are few as possible B. Delay cord clamping at birth

What are common risk factors for developing newborn jaundice? SATA

A. Fetal-maternal blood group incompatibility B. Prematurity C. Breastfeeding D. Certain drugs E. Maternal gestational diabetes

On postpartum day 4, a client has a temp of 101.4 f. Which findings would be consistent with a diagnosis of endometritis? SATA

A. Foul smelling lochia B. tender uterus

A nurse is explaining the Apgar scoring to new mother and her partner. What should the nurse point out about this scoring method? SATA

A. It is done at 1 and 5 minutes after birth B. the baby is considered vigorous if the 5-minute score is above 7 E. The Apgar score is an immediate assessment of newborn cardiopulmonary adaptation

Upon examination of the skin, which assessment findings would the nurse recognize as normal findings for a full-term newborn at 3 hours of age? SATA

A. Lanugo on the back C. Milia D. Acrocyanosis

An infant is experiencing transient tachypnea of the newborn (TTN). Symptoms that may be seen in this infant include which of the following? SATA

A. Nasal flaring B. Respirations of 60 bpm C. Retractions E. Expiratory grunting

Which nursing interventions promote healthy development of the preterm neonate?

A. Nesting B. Nonnutritive sucking C. Quiet hours D. covering the incubator

Which of the following is a cause of retinopathy of prematurity (ROP)? SATA

A. Oxygen saturation maintained above 95% B. Presence of immature retinal blood vessels

A nurse is assessing a preterm newborn for possible sepsis. The nurse suspects an early onset infection based on which risk factors? SATA

A. Preterm labor B. Prolonged rupture of membranes E. maternal fever

Which postpartum clients would require the nurse to intervene? SATA

A. Primipara with vital signs including temp 100.2, BP 140/86, P 124, RR 12 B. Multipara with vital signs including temp 99, BP 136/84, P 96, RR 32 C. Postpartum client with urine output of 30 mL/h for 2 hours D. First day postpartum client with BP 84/48, P 128, RR 16 F. Primipara with VS including temp 100.2, RR 28, O2 94%

A neonate receiving oxygen at concentrations greater than 70% is at risk for developing which complication? SATA

A. Retinopathy of prematurity B. Pulmonary edema

An infant with a tracheoesophageal fistula is carefully examined to identify other teratogenic effects at the same week in gestation. Which systems need to be examined?

A. Vertebral B. Cardiac C. Anal D. Legs

A community health nurse is teaching a group of clients about the zika virus. Which statements by the clients indicate to the nurse that the teaching was effective? SATA

A. Zika can be transmitted by mosquitoes, sexual activity, and blood exposure B. A pregnant woman with zika may have a baby with microcephaly and other congenital abnormalities C. It is best for men who have been exposed to zika to wit 6 months before attempting conception E. There is no treatment for newborns with zika, but they will have supportive care based on the defects

the administration of caffeine has become common in NICU infants with apnea of prematurity. The NICU nurse explains the advantages of this medication to the parents and knows the parents understood when they make which statements? SATA

A. caffeine stimulates the breathing center of the preterm infant's brain B. caffeine has a superior safety profile with fewer side effects than theophylline C. Caffeine improves the rate of recovery when used in conjunction with CPAP D. The neonate can be discharge home while taking caffeine, as it can be given orally

At birth an infant is below average in weight, height, and length and head circumference and has high hematocrit level. Which problem would the nurse assess for in this infant? SATA

A. low glucose level B. high bilirubin level C. prolonged acrocyanosis D. cold stress

The nurse needs to conduct a procedure on a preterm newborn. Which measures would be most effective in reducing pain? SATA

A. swaddling the newborn closely B. offering a pacifier prior to a procedure C. encouraging kangaroo care during procedures

A mother who is 4 days postpartum and is breastfeeding expresses to the nurse that her breast seems to be tender and engorged. Which suggestions should the nurse give to the mother to relieve breast engorgement? SATA

A. take warm-to-hot showers to encourage milk release C. Express some milk manually breastfeeding E. Apply warm compresses to the breasts prior to nursing

Which actions should the nurses advocate to help the nation achieve the 2020 National health goals? SATA

A. teaching about folic supplementation prior to conception B. obtaining early prenatal care C. providing support after the diagnosis of a fetal disorder

During the birth of a poster infant, the nurse suspects that meconium aspiration may have occurred in utero. what findings correlate with this suspicion? SATA

A. the newborn has green staining of the fingernails C. The newborn has labored abdominal respirations D. The newborn makes bearing down movements F. Green amniotic fluid is present at birth

A preterm infant with enteral tube feedings is being monitored for weight gain. What would be priorities for the nurse to include in the infants plan of care? SATA

A. weigh daily b. measure daily I&O d. assess serum electrolytes f. assess for dehydration g. measure abdominal girth AC

The NICU nurse is caring for a preterm neonate with respiratory distress syndrome on mechanical ventilation. Which assessment data would alert the nurse that a pneumothorax might have developed? SATA

B. The neonate's respiratory rate is 68 D. Neonate is exhibiting nasal flaring and grunting E. Chest radiography reveals low lung volume and a ground glass appearance

What treatments would the nurse perform in caring for a newly circumcised newborn? SATA

B. Wash the penis with warm water at each diaper change C. Fasten the diaper loosely to prevent unnecessary friction as irritation

A female client who has very recently given birth arrives at a health care center complaining of painful urination. Assessment also reveals that the client has a temp of 102 F. The physician suspects the client has pyelonephritis. Which of the following would the. nurse expect to assess? SATA

C. Flank pain D. chills E. anorexia

A jaundiced neonate must have heel sticks to assess bilirubin levels. Which assessment findings would indicate that the neonate is in pain? SATA

C. Heart rate is 180 bpm D. Oxygen saturation level is 88% E. The infant has facial grimacing and quivering chin

A nurse is caring for a postpartum client who has a history of thrombosis during pregnancy and is at high risk of developing a pulmonary embolism. For which sign or symptom should the nurse monitor the client to prevent the occurrence of pulmonary embolism?

Calf swelling

For which potential neonatal infection does the nurse anticipate using ophthalmic erythromycin?

Chlamydia trachomatis

Which factors in a maternal birth record are risks for fetal growth restriction?

Congenital malformations, infections, or placental insufficiency

When assessing an infant born at 32 weeks' gestation, which finding would lead the nurse to suspect that the newborn has a patent ductus arteriosus (PDA)?

Continuous murmur on auscultation

When caring for a term newborn, the nurse observes yellow discoloration of the newborn's skin. Which of the following would indicate to the nurse the the jaundice is physiologic in nature?

Cord blood bilirubin concentration of 2.5 mg/dl

A nurse is assessing a newborn's gestational age. When determining neuromuscular maturity, which parameters would the nurse assess? SATA

D. Arm recoil E. Scarf sign

Why are newborns born to diabetic mothers prone to hypoglycemia

Elevated insulin production metabolized glucose faster

A nurse discovers a perineal hematoma in a woman who has recently given birth. Which interventions should the nurse make in this case? SATA

Estimate the size of the hematoma and report it Administer a mild analgesic as prescribed Apply an ice pack to the site

A newborn with severe meconium aspiration syndrome (MAS) is not responding to conventional treatment. Which measure would the nurse anticipate as possibly necessary for this newborn>

Extracorporeal membrane oxygenation (ECMO)

A laboring woman with a history of a previous cesarean birth suddenly begins to exhibit manifestations of hypovolemic shock. Suspecting either complete of partial uterine rupture, which priority interventions should the nurse implement first? SATA

Increase IV fluids immediately Prepare to administer IV oxytocin to assist with uterine contraction

A nurse finds that a client is bleeding excessively after a vaginal birth. Which assessment finding would indicate retained placental fragments as a cause of bleeding?

Large uterus with painless dark red blood mixed with clots

A perinatal nurse is providing care for a large for gestational age neonate admitted to the observational unit after a complicated vaginal birth resulting in shoulder dystocia. Which assessment would be a priority for the nurse to perform?

Moro assessment

A neonate born addicted to cocaine is now being treated with medication for acute neonatal abstinence syndrome. Which medication will be prescribed to relieve withdrawal symptoms?

Morphine sulphate

A premature infant in the neonatal intensive care unit exhibits worsening respiratory distress and is noted to have abdominal distention, absent bowel sounds, and frequent diarrhea stools that are positive for hem occult. What diagnosis would be most likely to correlate with the symptoms?

Necrotizing enterocolitis

Which intervention should a nurse implement to promote thermal regulation in a preterm newborn?

Observe for clinical signs of cold stress such as weak cry

Which post-op goal is most important following surgical repair of a cleft lip and palate?

Relieving surgical pain

A nurse is caring for a postpartum client whose most recent assessment reveals a large, purple area of edema on the left side of her perineum. What is the nurse's best action?

Report the finding promptly to the primary care provider

A newborn is suspected of having gastroschisis at birth. How would the nurse differentiate this problem from other congenital defects?

The intestines appear reddened and swollen and have no sac around them

Which type of nutrition would the nurse expect to administer to a preterm infant who was born at 34 weeks' gestation and has developed necrotizing enterocolitis (NEC)?

Total parenteral nutrition(TPN)

A mother is experiencing postpartum hemorrhage shortly after delivery of her infant. which nursing interventions would be appropriate for this client? SATA

a. encourage the mother to breast-feed her infant if she is breast-feeding c. turn the mother on her side and inspect the area under her buttocks for blood d. encourage increased fluid intake e. monitor vitals every 15 min

A nurse is caring for a client with idiopathic thrombocytopenic purport (ITP). Which intervention should the nurse perform first?

administration of platelet transfusions as prescribed

A nurse receives the shift report on four infants. Baby A 16 hours. Baby B 8 hours. Baby C 19 hours. Baby D 4 hours

baby c

A nurse is assigned to care for a client experiencing early postpartum hemorrhage. The nurse is required to administer the prescribed methylergonovine maleate intramuscularly to the client. Which condition would the nurse identify as necessitating the cautious administration of this drug?

cardiovascular disease

the nurse is helping her client to recognize signs of hunger in her newborn. The nurse knows that her client needs additional teaching when she states that which sign is one of the early signs of hunger

crying

What is a risk factor for developing a postpartum infection? SATA

diabetes type 1 prolonged labor c section

Congenital myelomeningocele is commonly associated with which condition?

hydrocephalus

A nurse is caring for a client in the postpartum period. When observing the client's condition, the nurse notices that the client tends to speak incoherently. The client's thought process is disoriented, and she frequently indulges in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition?

postpartum psychosis