Maternal Newborn Final
Your patient tells you that the date of their last menstrual period (LMP) was May 15, 2020. According to Nagele's Rule, when would be her estimated delivery date? A. February 22, 2021 B. February 8, 2021 C. January 8, 2021 D. March 22, 2021
A
You are assessing a newborn and you turn the baby on his side to assess the back. What are some things you are looking for? Select all that apply. A. The straightness of the spine B. Sacral dimples C. The symmetry of the back D. To see if the baby's back resembles the mom's back E. Whether the baby has a tattoo back there
A, B, C
A nurse on the obstetrical unit is admitting a client who is in labor. The client has a positive HIV status. The nurse is aware that which of the following is contraindicated for this client? (Select all that apply.) A. Episiotomy B. Vacuum extraction C. Forceps D. Cesarean birth E. Internal fetal monitoring
A, B, C, E
Risk factors for uterine atony: A. Magnesium sulfate infusion B. Distended bladder C. Oxytocin infusion D. Prolonged labor E. Small for gestational age newborn
A, B, D
A nurse is assessing a newborn born at 26 weeks gestation who has been diagnosed with hyperbilirubinemia. The newborn's mother was given an epidural and oxytocin during labor, and has a history of diabetes. The mother ingested 800 mg Ibuprofen shortly before going into labor and is blood type O-. The newborn is blood type B+. Which of the following are risk factors for this baby's condition of hyperbilirubinemia? (Select all that apply) A. Premature birth B. Epidural use during labor C. Maternal history of diabetes D. Injection of Ibuprofen shortly before giving birth E. Rh incompatibility
A, C, E
A woman comes in for a doctor visit during her first trimester of pregnancy. She asks you about the potential adverse effects of an epidural block, What education should you include? (select all that apply) A) Hypotension B) Hypertension C) Fever D) Altered mental status E) Fetal bradycardia
A, C, E
Which of the following EBL volumes indicates a post-partum hemorrhage? A. 280 mL after vaginal birth B. 900 mL after c-section birth C. 650 mL after c-section birth D. 725 mL after vaginal birth
D
A nurse is caring for a postpartum client 8 hr after delivery. Which of the following factors places the client at risk for uterine atony? (select all that apply) a. Magnesium sulfate infusion b. Distended bladder c. Oxytocin infusion d. Prolonged labor e. Small for gestational age newborn
a, b, d
A nurse is explaining common first trimester discomforts. What should the nurse include in the teaching? Select all that apply. a. Breast Tenderness b. Urinary Frequency c. Backache d. Cravings e. Dependent Edema
a, b, d
A primary nurse suspects postpartum hemorrhage after her patient begins soaking her peripad with bright red blood in under 15 minutes after a vaginal birth. What interventions should the nurse proceed with? (Select all that apply). a. Massage uterus b. Assess source of bleed c. Lower legs d. IV fluid replacement
a, b, d
What are the signs and symptoms of placenta previa? (Select all that apply) a. Bright red blood b. Painless c. Foul smelling d. Soft uterus
a, b, d
Which of the following conditions put a newborn at risk for hypoglycemia? a. LGA b. SGA c. Rh incompatibility d. Premature e. Pathologic jaundice
a, b, d
Which of the following are part of the five P's? a. Passenger b. Passageway c. Previa d. Powers e. Position f. Physical Response
a, b, d, e
A term newborn who is 12 hours old is experiencing hypoglycemia. Which assessment findings can the nurse expect? Select all that apply. a. Flaccid muscle tone b. Poor feeding c. Loud piercing cry d. Hyperthermia e. Jitters
a, b, e
What are presumptive signs of pregnancy? (Select all the apply) a. Nausea and vomiting b. Urinary frequency c. Fetal heart sounds d. Positive pregnancy test e. Breast changes
a, b, e
What are the signs and symptoms of HELLP syndrome? (Select all that apply) a. Low platelets b. High platelets c. Elevated lipids d. Hemolysis of RBC e. Elevated liver enzymes
a, d, e
When does the mother produce milk? a. 2-3 days after birth b. 8-10 days after birth c. 3-5 days after birth d. 4-7 days after birth
c
Which finding should be reported to the doctor? a. temperature of 36.9 degrees Celsius b. acrocyanosis c. HR of 90 d. Head measuring 35 cm
c
Which of the following is NOT a probable sign of pregnancy? a. Abdominal Enlargement b. Hegar's Sign c. Uterine Enlargement d. Ballottement
c
You are caring for a woman who showed up to your L&D floor with concerns about not being able to feel her baby move. She is attached to FHR monitoring while you interpret the strip. Which of the following FHR patterns are characteristics of a reassuring fetal strip? Select all that apply. A. Accelerations with fetal movement. B. Minimal variability C. FHR of 150 bpm D. Late Decelerations E. Moderate variability
A, C, E
You are caring for a newborn who has an order for phototherapy to address a diagnosis of jaundice. What is something you should do before following this order? A. Make sure the baby's eyes are covered before starting phototherapy B. Make sure the baby has on at least a thin t shirt to protect the skin C. Make sure the baby has not eaten in the last hour D. Give the baby an iron supplement to make sure the phototherapy doesn't cause anemia
A
A newborn presents with acrocyanosis, heart rate of 95, irregular cry, strong grimace and active movement at 1 minute of birth. Calculate the 1-minute Apgar score for the infant. A. 7 B. 5 C. 9 D. 4
A
A nurse is assessing a newborn infant following circumcision and notes that the circumcised area is red with a small amount of bloody drainage. Which of the following nursing actions would be most appropriate? A. Document the findings B. Contact the physician C. Circle the amount of bloody drainage on the dressing and reassess in 30 minutes D. Reinforce the dressing
A
A nurse is caring for a client who is in active labor and reports severe back pain. During assessment, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress? A. Hands and Knees B. Lithotomy C. Trendelenburg C. Supine with a rolled towel under one hip
A
A patient in her third trimester of pregnancy states that her last menstrual period was February 18th 2021. What is the estimated date of delivery using Nägele's rule? A. November 25th, 2021 B. November 5th, 2021 C. September 15th 2021 D. September 25th 2021
A
A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The client's health record includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply.) A. Client has delivered one newborn at term. B. Client has experienced no preterm labor. C. Client has been through active labor. D. Client has had two prior pregnancies. E. Client has one living child.
A, D, E
A nurse is caring for a client who is in labor and has received epidural analgesia. The client's blood pressure is 88/50 mmHg, and the fetal heart tracing shows late decelerations. Which of the following actions should the nurse take? A. Assist the client to the bathroom to empty her bladder B. Increase the rate of the primary IV infusion C. Position the client in a semi-Fowler's position D. Provide glucose via oral hydration IV
B
Which of the following would indicate to the nurse that a patient is experiencing postpartum depression and not just baby blues? A. The patient states that her emotions are like a roller coaster. B. The patient is not bonding with her baby. C. When the patient is asked if she has lost interest or no longer finds pleasure in activities that she used to enjoy, the patient answers "yes." D. The patient is irritable with her family members that are at the bedside.
B, C
Which of the following are signs and symptoms of preeclampsia with severe features: A. +1 proteinuria B. BP greater than 160/110 C. HA or blurred vision D. Metallic taste E. Epigastric pain
B, C, E
A nurse is assessing a client who is postpartum following a vacuum-assisted birth. For which of the following findings should the nurse monitor to identify a cervical laceration? A. Continuous lochia flow and flaccid uterus B. Report of increasing pain and pressure in the perineal area C. Slow trickle of bright vaginal bleeding and a firm fundus D. Gush of rubra lochia when the uterus is massaged
C
A nurse is gathering health history from a client in a Women's clinic. The client states, "I think I may be pregnant, I have not had my period for 2 months, I have been experiencing nausea and have thrown up a lot. I also have to pee a lot throughout the day, and usually have to go right then. I also took a pregnancy test and it was positive." Which of her symptoms indicate a probable sign of pregnancy? A. Nausea and vomiting B. Urinary Frequency C. Positive pregnancy test D. Amenorrhea
C
A nurse is providing education to a patient who is 22 hours postpartum and is inquiring about the impact of breastfeeding on the return of ovulation. Which of the following is the most appropriate response? A. "The modified cradle will be the optimal breastfeeding position if you wish to delay the return of ovulation for the longest period of time." B. "Lactating and nonlactating clients do not differ in the timing of the first ovulation and resumption of menstruation." C. "The return of ovulation is influenced by breastfeeding frequency, the length of each feeding, and the use of supplementation." D. "Now that you have delivered your baby, your first ovulation should occur within the next 4-5 weeks if you choose not to breastfeed your child."
C
A nurse is providing patient education about amniocentesis to a patient scheduled to undergo the procedure. Which of the following statements indicates the patient understands the teaching? A. It is important that I avoid eating foods high in protein before the procedure. B. I should be sure to drink plenty of fluids 30 minutes prior to the procedure. C. I will need to empty my bladder before receiving the procedure. D. The purpose of this procedure is to "break my water" to induce labor.
C
At what age does the permanent eye color develop in infants? A) At birth B) 2-3 months old C) 6-12 months old D) On their 1st birthday
C
When asked about prior pregnancies, a patient states that her youngest child was a vaginal delivery at 33 weeks, but her two other children were scheduled c-sections at 37 weeks. She notes that her last pregnancy ended in miscarriage. She is currently 32 weeks pregnant. Which of the following would correctly indicate this in the documentation A. G4P2113 B. G4P3013 C. G5P2113 D. G5P3114
C
You are assessing a postpartum client and you notice that her peri pad is soaked with blood. What is the first thing you would do? A. Ask the client if she has chosen to begin birth control B. Call the provider immediately C. Ask the client when the last time she changed the pad was D. Massage the fundus
C
You are taking care of a client in active labor that develops that following signs and symptoms; tachypnea, hypotension, pallor and states that she felt a tearing pain. What labor complication is occurring in your patient? A) Precipitous labor B) Dystocia C) Uterine rupture D) Prolapsed umbilical cord
C
A nurse is caring for a patient who is in the fourth stage of labor. Which of the following is an appropriate nursing action during this stage? (Select all that apply) A. Insert an intrauterine pressure catheter inside the uterus to measure intrauterine pressure B. Assess fetal heart rate to determine fetal well being C. Massage the uterine fundus and/or administer oxytocin as prescribed D. Assess fundus and lochia every 15 minutes for the first hour, and then according to facility protocol E. Encourage voiding to prevent bladder distention
C, D, E
A Postpartum woman was just given 600 micrograms of Misoprostol PO. What was the most likely reason for this medication? A) Hypoglycemia B) Cervical ripening C) Hypervolemia D) Hemorrhage
D
A nurse in a delivery room is assisting with the delivery of a newborn infant. After the delivery, the nurse prepares to prevent heat loss in the newborn resulting from evaporation by: A. Warming the crib pad B. Turning on the overhead radiant warmer C. Closing the doors to the room D. Drying the infant in a warm blanket
D
A nurse is assessing a client who is at 26 weeks of gestation and has mild preeclampsia. Which of the following findings should the nurse report to the provider? A. Platelet count 97,000/mm^3 B. Urine protein 1+ C. BUN 22 mg/dL D. Deep tendon reflexes 4+
D
A nurse is reviewing a new prescription for iron supplements with a client who is in the 8th week of gestation and has iron deficiency anemia. The nurse should advise the client to take the iron supplements with which of the following? A. Ice water B. Low-fat or whole milk C. Tea or coffee D. Orange juice
D
A patient is delivering a baby at 42 weeks gestation. What complication is the baby most at risk for developing? A) Hypoglycemia B) Fetal Congenital Heart Block C) Subdural Hematoma D) Meconium Aspiration
D
A woman in her third trimester of pregnancy is experiencing vaginal bleeding. Upon assessment she has a tender, rigid uterus with sharp abdominal pain. What could be the cause of her bleeding? A) Placenta previa B) Gestational trophoblastic disease C) Ectopic pregnancy D) Abruptio Placentae
D
Which of the following is an example of secondary amenorrhea? A. Absence of menses during reproductive years B. Absence of menses at age 14 with absence of development of secondary sexual characteristics C. Absence of menses at age 16 with normal development of secondary sexual characteristics D. Absence of menses in women who have previously menstruated that is related to another condition or disorder
D
True or False Abnormal uterine bleeding is painless prolonged, excessive, and irregular bleeding that is not attributed to underlying structural or systemic disease.
True
A 21 year old female reports increased urinary frequency, abdominal bloating, and chadwicks sign. What type of signs are these? a. Probable b. Presumptive c. Positive d. Definitive
a
A mother is concerned about her teenage daughter's physical and sexual development. Which of the following would be identified as a type of primary amenorrhea? a) Absence of menses by age 14 with absence of development of secondary sexual characteristics b) Absence of menses by age 14 with normal development of secondary sexual characteristics c) Absence of menses by age 16 who previously menstruated that is related to another condition or disorder d)Absence of menses by age 16 with absence of development of secondary sexual characteristics
a
A nurse is assessing a newborn baby at 5 minutes. The babies heart rate is 128, crying loudly, is kicking his arms and legs, has a grimace, and has acrocyanosis. What is the babies APGAR score? a. 9 b. 7 c. 4 d. 2
a
A nurse is caring for a client who reports intestinal gas pain following a cesarean section. Which of the following actions should the nurse take? a. Assist the client to ambulate in the hallway b. Instruct the client to splint the incision with a pillow c. Have the client drink fluids through a straw d. Encourage the client to drink carbonated beverages
a
What is the ideal position for the baby to come out vaginally? a. Occipital Anterior b. Occipital Posterior c. Breeched d. Transverse
a
You are an oncoming nurse on the labor and delivery unit. During report the nurse tells you a patient is in labor. The patient is G5P4105 and the baby is expected to be very large. What does this patient have an increased risk of? a. Hemorrhage b. Placental abruption c. Amniotic embolism d. Postpartum depression
a
A nurse caring for an infant with neonatal abstinence syndrome (NAS). Which actions would the nurse take? Select all that apply a. Administer morphine b. Swaddle the infant c. Avoid eye contact while feeding d. Provide stimulation
a, b, c
A nurse is caring for a woman in labor. While going over her health history, the nurse should identify which of the following as risk factors for uterine rupture? Select all that apply. a. Overdistention of uterus from polyhydramnios b. External fetal version c. Hyperstimulation of the uterus d. Being 24 years old
a, b, c
Which of the following are parts of the Initial Newborn Assessment? (select all) a. apgar scoring b. gestational age assessment c. neuromuscular maturity d. bilirubin testing e. blood glucose
a, b, c
A nurse is caring for a newborn baby girl. Her apgar score is 9. Which of the following are accurate assessments based on her apgar score? Select all that apply. a. Heart rate of 145 bpm b. Good, vigorous cry c. Well-flexed d. Cries promptly when stimulated e. Acrocyanosis f. Absent heart rate g. Flaccid muscle tone
a, b, c, d, e
A nurse is caring for a client who is 8 hr postpartum and is experiencing hemorrhage. Which of the following actions should the nurse implement after notifying the provider? (Select all that apply.) a. Massage the fundus b. give oxygen at 2 L/min via nasal cannula c. Administer oxytocin with IV fluids d. Insert an indwelling urinary catheter e. Place the client in a lateral position with her legs elevated 30*
a,b,c,d
A newborn present with the following manifestations after birth: poor feeding, jitteriness, hypothermia, cyanosis, and apnea may indicate what condition? a. Hyperbilirubinemia b. Hypoglycemia c. Necrotizing Enterocolitis (NEC) d. Respiratory Distress Syndrome (RDS)
b
A nurse is completing an assessment on a newborn one minute after birth and finds that the infant's apgar score is a 6. Which level of adaptation will this newborn be placed into based on its ability to adjust to extrauterine life? a. Minimal or no difficulty b. Moderate difficulty c. Severe distress
b
The nurse is caring for a primilara client at 27 weeks gestation. Which client learning need should the nurse identify as priority at this stage of pregnancy? a. Appropriate nutrition b. Signs of preterm labor c. Fetal teratogens d. Newborn care
b
What is the correct order of the mechanisms of labor for a fetus? a. Engagement, Flexion, Internal Rotation, Descent, External Rotation, Extension, Birth by Expulsion b. Engagement, Descent, Flexion, Internal Rotation, Extension, External Rotation, Birth by Expulsion (correct) c. Engagement, Descent, Extension, External Rotation, Flexion, Internal Rotation, Birth by Expulsion d. Descent, Engagement, Flexion, Internal Rotation, Extension, External Rotation, Birth by Expulsion
b
Which of the following is a sign of postpartum hemorrhage following a vaginal birth? a. Soaking through a peripad in one hour b. Blood loss of >500 mL c. lessening blood flow d. Hypertension
b
A nurse is caring for a patient in their third trimester with iron-deficiency anemia and is reviewing the patient's lab results. Which of the following labs are an expected finding from the following condition? (Select all that apply) a. Hgb between 12 and 16 g/dL b. Hct less than 33% c. Hgb less than 11 g/dL d. Hct above 48%
b, c
Which of the following are appropriate nursing interventions when caring for a client in labor with a suspected Amniotic Fluid Embolism? (select all that apply) a. Lay supine b. Administer Oxygen via a mask at 8-10 L/min c. Administer IV fluids d. Instruct the mother to push e. Assist with intubation and mechanical ventilation as needed
b, c, e
Which of the following measurements are not within normal limits for a newborn? Select all that apply. a) HR 130 b) Resp 26 c) BP 76/48 d) Length 60 cm e) Weight 4400g
b, d, e
A clients membranes spontaneously rupture at 10 cm dilation and +2 station. The nurse notes that the fluid is colored green. What nurse preparation is the priority nursing action? a. Emergency c section b. Immediate high forceps delivery c. Equipment for immediate suctioning of the newborn d. Administration of IV oxytocin
c
A newborn was born one minute ago. Her heart rate is 110, has a slow weak cry, pink body with cyanotic hands and feet, and has well-flexion present, and cries with stimuli. What is the newborn Apgar score? a. 9 b. 8 c. 7 d. 5
c
A nurse administers betamethasone to a client who is at 33 weeks gestation to stimulate fetal lung maturity. When planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this medication? a. hyperthermia b. Decreased blood glucose c. rapid pulse rate d. Irritability
c
A nurse at a prenatal clinic is teaching a client how to perform a kick count. Which of the following statements should the nurse include in the teaching? a. "You will need to drop by the clinic so I can count your baby's kicks" b. "Count fetal kicks once a day for a total of 15 minutes." c. "Before bedtime is a good time to start counting the kicks" d. "Wear baggy clothing when performing the kick count."
c
A nurse is assessing a 4-hour-old newborn who is to breastfeed and notes hands and feet that are cool and slightly blue. Which of the following actions should the nurse take? a. Apply an 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
A nurse is caring for a primipara mother who asks what each of the straps on her abdomen are for. What is the best response the nurse should provide? a. They splint your abdomen to help reduce labor pains. b. They help us know how the baby is doing. We will let you know if there is a problem. c. The higher strap tells us when you are contracting, and the lower strap monitors the baby's heart rate. Together they help us know how your baby is. d. The top strap is a tocodynamometer and the lower strap is a doppler.
c
A patient at 20 weeks gestation is dilating prematurely. The provider performs cervical cerclage in hopes of preventing premature birth. At what week should the stitches from the cerclage be removed? a. 32 weeks b. 34 weeks c. 37 weeks d. 40 weeks
c
A woman in labor wants to use a natural approach to giving birth. Which of the following is not a nonpharmacological measure to help manage pain? a) Massage b) Patterned-paced breathing c) Vomiting d) Acupuncture
c
What is a cause of late decelerations? a. Ruptured membrane b. Uterine contractions c. Uteroplacental insufficiency d. Vaginal exam
c
A Labor and Delivery nurse is caring for a mother who is G3P1102 and is progressing rapidly through labor and is transitioning. The patient is expected to deliver in the next 25 minutes but demands an epidural because she cannot tolerate the pain. Which kind of regional anesthesia is still possible? Select all that apply. a. Epidural b. Opioid analgesics c. Pudendal d. Spinal
c, d
A 21y.o. client has been diagnosed with hydatidiform mole. Which of the following factors is considered a risk factor for developing hydatidiform mole? a. age in 20s or 30s b. Early menopause c. Primigravida d. prior molar gestation
d
A Client who is 4 weeks postpartum asks about expected weight loss. What amount should the nurse recommend? a. 4.4 pounds b. 6.5 pounds c. 3.5 pounds d. 2.2 pounds
d
A client is requesting an intrauterine device (IUD) for contraception. Which of the following in a contraindication? a. Previous pregnancies b. Hypertension c. Polyuria d. Menorrhagia
d
A nurse is assessing a newborn and is giving an APGAR assessment one minute after vaginal delivery. The newborn has a pink body and blue extremities, a heart rate of 140, has minimal response to stimulation, has absent muscle tone, and slow irregular respirations. What is the newborns APGAR score? a. 8 b. 6 c. 3 d. 5
d
A nurse is preparing medications for a woman in preterm labor. Which medication is not used to help delay delivery? a. Nifedipine b. Magnesium Sulfate c. Terbutaline d. Misoprostol
d
A nurse is providing teaching about exercise to a client who is pregnant. Which of the following pieces of information should the nurse include? a. "You can continue participating in whatever sports or activities you did prior to becoming pregnant." b. Intermittent exercise is a great way to stay healthy during pregnancy." c. "You should limit your exercise to walking if you did not exercise prior to becoming pregnant." d. "Vigorous exercises should be limited and should not be performed in hot, humid weather."
d
A nurse is reviewing the EFM tracing of a client in active labor which shows an abrupt decrease in the FHR of 15/min for at least 15 seconds that varies in intensity and timing with the contraction. Which of the following fetal heart rate fluctuations would the nurse include in her charting? a. Early deceleration b. No variability c. Late deceleration d. Variable deceleration
d
A nurse is teaching a client who had a vacuum-assisted vaginal delivery. Which of the following statements should the nurse identify as an indication that the client understands the information? a. "My baby's head will be cone-shaped for about 2 months." b. "My doctor performed this procedure because I didn't dilate past 6 centimeters." c. "The doctor performed this procedure because my hemoglobin was low." d. "My baby has a higher risk of developing jaundice."
d
A pregnant woman who had just been admitted to the labor and delivery room states that her "water just broke". What should the nurse do immediately? a. Confirm that fluid is amniotic fluid with a pH test strip b. Obtain maternal vital signs c. Observe amniotic fluid color d. Check fetal heart rate (FHR) pattern
d
