U-6 Maternal Newborn
Caring for a pt. and her partner who have experienced a fetal death. Which action should be taken? A.Take photos of the newborn to give to the parents. B.Tell the parents that they can consider organ donation. C.Encourage the parents to avoid allowing older children to visit them in the hospital. D.Explain to the parents the need to name the newborn.
A.Take photos of the newborn to give to the parents.
Pt. has hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following findings should the nurse report to the provider?
BUN 25 mg/dL
Reviewing the medical records of a pt. who is postpartum and has preeclampsia. Which lab results should be reported to the MD?
Platelets 50,000/mm3
A nurse is teaching a pt. who is at 10 wks of gestation about nutrition during pregnancy. Which of the following statements by the pt. indicates an understanding? "I should increase my protein intake to 60 grams each day." "I should increase my overall daily caloric intake by 300 calories." "I should take 600 micrograms of folic acid each day." "I should drink 2 liters of water each day."
"I should take 600 micrograms of folic acid each day."
A nurse is teaching a new mother about newborn safety. Which of the following instructions should the nurse include in the teaching? "Check the temperature of your baby's bath water with your hand." "Your baby can nap in her car seat during the daytime." "Cover your baby with a light blanket while she is sleeping." "You can share your room with your baby for the next few weeks."
"You can share your room with your baby for the nxt few wks."
A nurse is caring for a pt. who is anemic at 32 wks of gestation and is in preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the following outcomes should the nurse expect? Decreased uterine contractions An increase in the client's hemoglobin levels A reduction in respiratory distress in the newborn Increased production of antibodies in the newborn
A reduction in respiratory distress in the newborn.
A nurse is reviewing the lab report of a pt. who is 24 hrs postpartum following a vaginal delivery. Which of the following lab results should the nurse identify as an indicator of a postpartum infection? A.Erythrocyte B.Sedimentation Rate (ESR) 26 mm/hr C.C-reactive protein 0.8 mg/dL D.Platelets 300,000/mm3 WBC 9,000/mm3
A.Erythrocyte sedimentation rate (ESR) 26 mm/hr
Pt is 35 wks of gestation and is undergoing a nonstress test that reveals a variable deceleration in the FHR. Appropriate action to take? A.Have the client change position. B.Give the client orange juice. C.Establish IV access. D.Elevate the client's legs.
A.Have the client change positions.
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? A.Remove all clothing from the newborn except the diaper. B.Feed the newborn 1 oz of water every 4 hr. C.Apply lotion to the newborn's skin three times per day. D.Discontinue therapy if the newborn develops a rash.
A.Remove all clothing from the newborn except the diaper.
A nurse is caring for a pt who is in labor and whose fetus is in the right occiput posterior position. The pt. is dilated to 8 cm and reports back pain. Which of the following actions should the nurse take?
Apply sacral counterpressure.
A nurse is reviewing the medical record of a pt. who is one day postpartum. The pt. had a vaginal birth with a 4th-degree perineal laceration. The nurse should contact the provider regarding which of the following prescriptions? Sitz bath two to three times per day as needed for pain Bisacodyl rectal suppository daily as needed for constipation Docusate sodium 100 mg capsule by mouth three times daily Ibuprofen 600 mg by mouth every 6 hr as needed for pain
Bisacodyl rectal suppository daily as needed for constipation.
Assessing a pt. who gave birth vaginally 12 hrs ago and palpates her uterus to the right above the umbilicus. Which of the following interventions should the nurse perform? A.Instruct the client to lie on her right side. B.Reassess the client in 2 hr. C.Assist the client to empty her bladder. D.Administer simethicone.
C.Assist the client to empty her bladder.
A nurse is assesing the newborn of a client who took a selective serotonin reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI? A.Hyperglycemia B.Large for gestational age C.Vomiting D.Bradypnea
C.Vomiting
A nurse is assessing a newborn following a circumcision. Which of the following findings should the nurse identify as an indication that the newborn is experiencing pain. Slowed respirations Decreased heart rate Chin quivering Pinpoint pupils
Chin quivering
A nurse is performing a routine assessment on a pt. who is at 18 wks of gestation. Which of the following findings should be expected? A.Deep tendon reflexes 4+ B.Fundal height 14 cm C.Urine protein 2+ D.FHR 152/min
D.FHR 152/min
A nurse in an antepartal clinic is providing care for a client who is at 26 wks of gestation. Upon reviewing the client's medical record, which of the following findings should the nurse report to the provider? A.1-hr glucose tolerance test B.Hematocrit C.Fetal heart rate (FHR) D.Fundal height measurement
D.Fundal height measurement
A nurse is caring for a pt. becomes unresponsive upon delivery of the placenta. Which of the following actions should the nurse take first?
Determine respiratory function.
A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? (select all) Excess vaginal bleeding Flaccid uterus Increased maternal temperature Increased afterbirth cramping Cervical laceration
Flaccid uterus Excessive vaginal bleeding
A nurse is teaching a client who is at 35 wks of gestation about clinical manifestations of potential pregnancy complications to report to the provider. Which of the following manifestations should the nurse include? Braxton Hicks contractions Headache that is unrelieved by analgesia Swelling of feet and ankles at the end of the day Shortness of breath when climbing stairs
Headache that is unrelieved by analgesia
A nurse is assessing a newborn 12 hrs after birth. Which of the following manifestations should the nurse report to the MD? Acrocyanosis Caput succedaneum Jaundice Transient strabismus
Jaundice
A nurse is observing a new mother caring for her crying newborn who is bottle feeding. Which of the following actions by the mother should the nurse recognize as a positive parenting behavior?
Lays the newborn across her lap and gently sways.
A nurse is assessing a newborn who was born at 26 wks of gestation using the New Ballard Score. Which of the following findings should the nurse expect? Raised areolas with 3 to 4 mm buds Minimal arm recoil Popliteal angle of 90° Creases over the entire foot sole
Minimal arm recoil
A nurse is creating a plan of care for a pt. 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? Bathe the client within 12 hr following delivery. Protect the client's head and feet from cold air. Offer the client a glass of cold milk with her first meal. Ambulate the client within 24 hr following delivery.
Protect the client's head and feet from cold air.
A staff nurse on an obstetric unit is caring for a pt. who is scheduled for an induced abortion. The staff nurse informs the nurse manager that she has a moral issue withe the pt's decision. Which of the following actions should the nurse manager take?
Reassign the client to another staff nurse
A charge nurse on a L&D unit is teaching a newly licensed nurse how to perform Leopold maneuvers. Which of the following images indicates the 1st step of Leopold maneuvers.
The nurse palpates the pt's abdomen with her palms to determine which fetal part is in the uterine fundus.
A nurse is demonstrating to a pt. how to bathe her newborn. In which order should the nurse perform the following actions?
Wipe the newborn's eyes from the inner canthus outward Wash the newborn's neck by lifting the newborn's chin Cleanse the skin around the newborn's umbilical cord stump Wash the newborn's legs and feet Clean the newborn's diaper area
A nurse is assessing a pt who is in labor and notes early decelerations on the fetal monitor. Which of the following findings should the nurse identify as a possible cause of the early decelerations?
Fetal head compression
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?
"Ensure that the newborn has been receiving feedings for 24 hrs prior to obtaining the specimen."
A nurse is teaching a pt. who is in preterm labor about terbutaline. Which of the following statements by the pt. indicates an understanding of the teaching? "My blood sugar may be low while I'm on this medication." "My blood pressure may increase while I'm on this medication." "I will have blood tests because my potassium might decrease." "I will get injections of the medication once daily until my labor stops."
"I will have blood tests because my potassium might decrease."
A nurse in a prenatal clinic is caring for a pt. who reports that her menstrual period is 2 wks late. The pt. appears anxious and asks the nurse if she is pregnant. Which of the following responses should the nurse make.
"You can miss your period for several other reasons. Describe your typical menstrual cycle"
A nurse is teaching a pt. who is at 8 wks of gestation about exercise. Which of the following instructions should the nurse include in the teaching? "You should take your pulse every 20 minutes while you are exercising." "You should increase weight-bearing exercises as your pregnancy progresses." "You should exercise for 30 minutes each day." "You should lie on your back to rest for 5 minutes after exercising."
"You should exercise for 30 mins each day."
Family planning for a pt. with a new prescription for a diaphragm. Which of the following statements should be included?
"You should leave the diaphragm in place for at least 6 hrs after intercourse."
A nurse is providing teaching about comfort measures to a pt. who is breastfeeding and is experiencing engorgement. Which of the following nonpharmacological measures should the nurse include in the teaching? "You may place breast shells inside your bra." "You should apply a few drops of colostrum to the nipple following the feeding." "You should use cold compresses after each feeding." "You may use a breast binder to relieve the discomfort."
"You should use cold compresses after each feeding."
A pt. who is at 34 wks of gestation asks the nurse how she will know when she is in labor and should go to the hospital. Which of the following responses should the nurse make? "You will feel the contractions primarily in your upper abdomen." "You will notice blood-tinged discharge from your vagina." "Your breasts will begin to excrete colostrum." "You will feel extremely fatigued when your labor starts."
"You will notice blood-tinged discharge from your vagina."
A nurse is preparing to administer hepatitis B immune globulin to a newborn. The prescription states, "Administer 5 mcg IM once today." Available is a 5 mL vial with 10 mcg/mL. How may mL should the nurse administer? (nearest 10th)
0.5 mL
A nurse in a prenatal clinic is assessing a group of pts. Which of the following pts. should the nurse request the provider see first? A client who is at 20 weeks of gestation and reports constipation for the past 4 days A client who is at 8 weeks of gestation and reports having three bloody noses in the past week A client who is at 11 weeks of gestation and reports abdominal cramping A client who is at 15 weeks of gestation and reports tingling and numbness in her right hand
A client who is at 11 wks of gestation and reports abdominal cramping.
A nurse on an antepartum unit is caring for 4 pts. Which of the following pts. should the nurse identify as the priority? A client who is at 28 weeks of gestation and has an Hgb of 10.4 g/dL A client who has gestational diabetes and a fasting blood glucose level of 120 mg/dL A client who is at 39 weeks of gestation and reports urinary frequency and dysuria A client who is at 34 weeks of gestation and reports epigastric pain
A client who is at 34 wks of gestation and reports epigastric pain.
A nurse is performing a physical assessment of a newborn. Which of the following clinical findings should the nurse expect? (select all) Respiratory rate 58/min Weight 2.6 kg (5 lb 12 oz) Length 43 cm (16.9 in) Axillary temperature 36° C (96.8° F) Heart rate 154/min
A heart rate of 154/min Respiratory rate 58/min Weight 2.6 kg (5 lbs 12 oz)
Teaching a pt. who is pregnant about managing N/V. Which instructions should be included in the teaching? A."Eat high-carbohydrate foods." B."Brush your teeth immediately after eating." C."Eat foods served at a warm temperature." D."Drink a glass of water with each meal."
A."Eat high-carbohydrate foods."
A nurse is caring for a pt. who is at 36 wks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests? Cordocentesis Amniocentesis Biophysical profile Kleihauer-Betke test
Biophysical profile
A nurse is planning discharge for a pt. who is 3 days postpartum. Which of the following nonpharmacological interventions should the nurse include in the plan of care for the lactation suppression? Apply cabbage leaves to the breasts. Wear a loose-fitting bra. Put green tea bags on the breasts. Place warm, moist packs on the breasts.
Apply cabbage leaves to the breasts.
A nurse is caring for a pt who is at 26 wks of gestation and has epilepsy. The nurse enters the room and observes the pt having a seizure. After turning the pt's head to one side, which of the following actions should the nurse take next? Assess uterine activity. Monitor the FHR. Start a bolus of IV fluids. Administer oxygen via a nonrebreather mask.
Administer O2 via a nonrebreather mask
A nurse on the postpartum unit is caring for a pt. following a cesarean birth. Which of the following assessments is the nurse's priority. Quality and quantity of urine output Amount of lochia Patency of the IV catheter Parent-child attachment
Amount of lochia
A nurse is teaching a pt. about Rho(D) immune globulin. Which statement by the pt. indicates understanding? A. "I will need a second dose of this medication when my baby is 6 weeks old." B. "I will need this medication if I have an amniocentesis." C. "I will receive this medication when I am in labor." D. "I will receive this medication if my baby is Rh-negative."
B. "I will need this medication if I have an amniocentesis"
A nurse is teaching a new mother about steps the nurses will take to promote the security and safety of the newborn. Which of the following statements should the nurse make? A."Your baby will stay in the nursery while you are asleep." B."Staff members who take care of your baby will be wearing a photo identification badge." C."We will prevent unidentified visitors from entering the unit." D."We will document the relationship of visitors in your medical record."
B."Staff members who take care of your baby will be wearing a photo identification badge."
A nurse is caring for a pt. who is in active labor and has had no cervical change in the last 4 hrs. Which of the following statements should the nurse make? A."I am going to call the doctor to get a prescription for medication to ripen your cervix." B."Your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions." C."Let me help you into a comfortable pushing position so you can begin bearing down." D."I will give you some IV pain medicine to strengthen your contractions."
B."Your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions."
A nurse is caring for a full-term newborn immediately following birth. Which of the following actions should the nurse take first? A.Weigh the newborn. B.Dry the newborn. C.Assign Apgar scores to the newborn. D.Place identification bracelets on the newborn.
B.Dry the newborn
A nurse is caring for a pt. following an amniocentesis at 18 wks of gestation. Which of the following findings should the nurse report to the provider as a potential complication? A.Urinary frequency B.Leakage of fluid from the vagina C.Upper abdominal discomfort D.Increased fetal movement
B.Leakage of fluid from the vagina.
A nurse is assessing a pt. who is at 30 wks of gestation during a routine prenatal visit. Which of the following findings should the nurse report to the provider? A. Nonpitting 1+ ankle edema B. Hyperpigmentation of the cheeks C. Swelling of the face D. Varicose veins in the calves
C. Swelling of the face
A nurse is providing discharge teaching to a pt. who is postpartum and was taking insulin for gestational diabetes mellitus. Which of the following instructions should the nurse include in the teaching? A."You should avoid using low-dose oral contraceptives for birth control." B."You will need to take a lower dose of insulin than you took during your pregnancy." C."You should get a 2-hour oral glucose tolerance test in 6 to 12 weeks." D."You will need to monitor your blood glucose levels daily at home for 2 to 3 weeks."
C."You should get a 2-hr oral glucose tolerance test in 6-12 wks."
A nurse in the antepartum clinic is assessing a pt's adaption to pregnancy. The pt. states that she is, "happy one minute and crying the next." The nurse should interpret the pt's statement as indication of which of the following? Emotional lability Couvade syndrome Focusing phase Cognitive restructuring
Emotional lability
A nurse is planning care for a pt. who is to undergo a nonstress test. Which of the following actions should the nurse include in the plan of care? Instruct the client to massage the abdomen to stimulate fetal movement. Instruct the client to press the provided button each time fetal movement is detected. Place the client in a supine position. Maintain the client NPO throughout the procedure.
Instruct the client to press the provided button each time fetal movement is detected.
A nurse is caring for a pt who is pregnant and is at the end of her 1st trimester. The nurse should place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones (FHT) ? The right lower quadrant Just above the symphysis pubis The left lower quadrant Just above the umbilicus
Just above the symphysis pubis
A nurse is caring for a postpartum pt who is receiving heparin via a continuous IV infusion for thrombophlebitis in her left calf. Which of the following actions should the nurse take?
Maintain the client on best rest.
A nurse on a postpartum unit is caring for a pt. who is experiencing hypovolemic shock. After notifying the provider, which of the following actions should the nurse take next? Elevate the client's right hip. Massage the client's fundus. Insert an indwelling urinary catheter. Administer oxygen at 10 L/min.
Massage the client's fundus
A nurse is caring for a pt. who is at 38 wks of gestation. Which of the following actions should the nurse take prior to applying an external transducer for fetal monitoring? Complete a sterile speculum exam. Perform Leopold maneuvers. Determine progression of dilatation and effacement. Prepare a Nitrazine paper test.
Perform Leopold maneuvers
A nurse is caring for a prenatal pt who has parvovirus B19 (5th disease). Which of the following actions should the nurse take?
Schedule an ultrasound examination.
A nurse is calculating a pt's expected date of birth using Naegele's rule. The pt. tells the nurse that her last menstrual cycle started on November 27th. Which of the following dates is the pt's expected date of birth? September 20th August 20th September 3rd August 3rd
September 3rd
A nurse is planning care for a pt who is in labor and is to have an amniotomy. Which of the following assessments should the nurse identify as the priority? Urinary output Blood pressure O2 saturation Temperature
Temperature
A nurse is caring for a client who is at 36 wks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound? To determine multiparity To prescreen for fetal anomalies To locate a pocket of fluid To estimate the fetal weight
To locate a pocket of fluid.