Maternity Practice Questions

What may be happening when a client at 32 weeks gestation experiences changes in strength or frequency of fetal movements?

Fetus is in distress

Which action best explains the main role of surfactant in the neonate?

Helps the lungs remain equally and sufficiently expanded after the initiation of breathing

After instructing primagravid client at 38 weeks gestation about how preeclampsia can affect the client and the growing fetus, the nurse realizes that the client needs additional instruction when she says that preeclampsia can lead to which of the following?

Hydrocephalic infant

A nurse implements a teaching plan for a pregnancy client who is newly diagnosed with gestational diabetes. Which statement if made by the client indicates a need for further education?

I need to avoid exercise because of the negative effects of insulin production

In response to a question from a 40yr old multigravid client with preeclampsia about the cause of the problem, which of the following if stated by the client as an associated condition would indicate the need for additional teaching?

Iron Deficiency

A primagravid client with diabetes at 39 weeks gestation is seen in the high risk clinic. The physician estimates that the baby weighs 4,500g(10lbs). The client asks, " What causes the baby to be so large?" Fetal macrosomia is usually related to the following

Maternal hyperglycemia

A primigravida with preeclampsia has just delivered her baby following a 2-day induction, and has started to hemorrhage. Which of the following medication would you order?

Misoprostol(Cytotec) 1000mcg per rectum

A newborn who is 20 hours old has a RR of 60 , is grunting and has nasal flaring. Temperature is 98F, breathing RA and is pink with acrocyanosis. The mothers had membranes that ruptured 26 hours before birth. Which of the following actions should the nurse include in infant's care?

Place a pulse oximeter and contact the PCP for orders to draw blood culture Worried about sepsis based on prolonged rupture of membranes

What may be happening when a client at 32 weeks gestation experiences bleeding with no pain?

Possible previa or abruption

Grand multip's urine culture reveals 160,000 c/ml of gram negative bacteria. She says she has no symptoms of a UTI. Do you:

Prescribe Bactrim

A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension(PIH). The nurse who is caring for the client is performing assessment every 30 minutes. Which assessment finding would be of most concern to the nurse?

Respiratory rate of 10BPM Normal -urinary output of 20ml since previous assessment -deep tendon reflexes of 2+ -Fetal heart rate of 120BPM

Which neonatal respiratory disorder is usually mild, and runs a self-limiting course?

TTN(transient tachypnea of neonate)

A homecare nurse visits a pregnancy client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension(PIH). Which assessment finding indicates a worsening of the Preeclampsia and need to notify the physician?

The client complains of a headache and blurred vision

T/F TTN occurs among neonates diagnosed with fetal macrosomia( >8lbs 13oz) and babies who prematurely

True

T/F A baby at higher risk of hyperbilirubinemia if they are premature

True

T/F TTN common occurs in neonates born via C/S w/o labor because of lack of thoracic compression that expels fluid during vaginal delivery

True

T/F Transient tachypnea in neonates (TTN) is associated with maternal diabetes?

True

Nurse explains the complications of pregnancy that occurs with diabetes to a primagravid client. Which of the following if stated by the client as a complication indicates the need for additional teaching?

Twin-to-twin transfer

What may be happening when a client at 32 weeks gestation has a pounding headache that doesn't go away?

elevated BP

A neonate is admitted to the NICU for observation with a potential diagnosis of meconium aspiration syndrome(MAS). The neonate weights 10lbs 4oz and is at 41 weeks gestation. What is the primary problem?

impaired gas exchange related to obstruction

What is jaundice caused by

ineffective metabolism of bilirubin due to the immaturity of my baby's liver

Which symptoms would alert you to evaluation for cholestasis?

itching all over the body

What may be happening when a client at 32 weeks gestation experiences leg cramps that are waking her up?

leg veins may increase in size, leg cramps may occur and are associated with calcium supplements

Which of the following statement by a mother whose infant has been diagnosed with a neonatal jaundice indicates need for further teaching?

my baby will not need to be monitored because most jaundice clears on its own in a few days

A primagravid client's baseline blood pressure at her initial visit at 12 weeks gestation was 110/70. During an assessment at 38 weeks, which of the following data would indicate mild preeclampsia?

weight gain of 2lb in the last week

After reinforcing the danger signs to report with a client at 32 weeks gestation with an elevated blood pressure, which client statements would demonstrate her understanding of when to call the physician's office? Select all that apply

- " If I see any bleeding, even if I have no pain" -If I have a pounding headache that doesn't go away" - If baby seems to be less active than usual

A nurse implements a teaching plan for a pregnancy client who is newly diagnosed with gestational diabetes. Which statement if made by the client indicates they understand their plan of care?

- I need to stay on a diabetic diet -I will perform glucose monitoring at home -I need to be aware of any infections and report signs of infection immediately to my health care provider

Possible Risk for Preeclampsia

-Multifetal pregnancy -Diabetes Mellitus -Age >/= 35yrs

A nurse should suspect Transient tachypnea of the newborn (TTN) to occur in which of the following cases?

-Neonate delivered by c/s w/o labor -neonate weighing 10lbs 2oz -neonate born to a diabetic mother -premature neonate

Preeclampsia can lead to

-abruptio placentae -intrauterine growth restriction -poor placental perfusion

A neonate has been diagnosed with caput succedaneum. Which statement is correct about this condition?

-it usually resolves w/in first few weeks of life -it involves swelling of tissue over the presenting part of the head -It crosses suture lines and is described as "boggy"

Which of the following would alert you to need for blood glucose monitoring in a newborn?

-jitteriness, irritability, and lethargy -the newborn has not yet been breastfed by hour 2 of life -the baby is large for gestational age

What are potential causes of postpartum hemorrhage?

-retained placenta fragments -long induction with Pitocin -Chorioamnionitis

client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education?

A: I will maintain strict bedrest throughout the remainder of pregnancy correct facts - I will avoid sexual intercourse until the bleeding has stopped and for 2 weeks following the last evidence of bleeding - I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad - I will watch for the evidence of the passage of tissue

Nurse would recognize the need for further teaching if a pregnancy patient made which of the following statements about smoking during pregnancy?

A: Smoking may cause baby to be larger than it should be Correct Facts 1. Smoking during pregnancy is a risk factor for preterm labor 2. smoking during pregnancy can cause my baby to be born too early 3. smoking during pregnancy may make the placenta separate from the womb too early

A pregnancy client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for

A: any bleeding such as in the gums, petechiae, and purpura

Which observation during a newborn assessment would suggest a birth injury?

Asymmetrical moro reflex"startle reflex"

Neonate born at 38 weeks via C/S after prolonged rupture of membranes and a maternal oral temperature of 102F is being observed for s/sx of infection. Which of the following should be reported to the PCP?

Behavioral changes s/sx of infection in neonates include subtle behavioral changes like lethargy and irritability, as well as color changes, temperature instability, poor feeding, and apnea

A nurse is caring for a pregnancy client with Preeclampsia. The nurse prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to enclampsia, the nurse's first action is to

Clean and maintain an open airway

Several pregnancy clients are waiting to be seen in the triage area of the obstetrical unit. Which client is the highest priority?

Client at 32 weeks gestation who has preeclampsia and +3 proteinuria who is returning for evaluation of epigastric pain Other patients -client at 13 weeks gestation experiencing nausea and vomitting 3x per day with +1 ketones in her urine -client at 37 wks gestation who is an insulin dependent diabetic and experiencing 3-4 fetal movements per day -primigravida at 17 wks gestation complaining of not feeling her baby move at this point of pregnancy

A nurse monitoring a pregnancy client with pregnancy induced hypertension who is at risk for Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia?

Elevated blood pressure, facial edema