OB Exam II PrepU

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

What measure(s) will the nurse implement to help ensure that a newborn is not misidentified in the hospital? Select all that apply. A) Place an identification band on both the mother and the newborn immediately after birth, before separating them. B) Have identifying data on the newborn's chart and compare information to that in the mother's chart. C) Keep the newborn with the parent 24 hours per day until discharge. D) Ask the parents to look at the newborn each time the newborn is brought to the room to be sure that the newborn is theirs. E) Obtain the newborn and the mother's thumbprint on the mother's chart.

A A) Place an identification band on both the mother and the newborn immediately after birth, before separating them.

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next? A) Check the fetal heart rate. B) Notify the primary care provider immediately. C) Change the linen saver pad. D) Perform a vaginal exam.

A) Check the fetal heart rate.

The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform pelvic floor muscle training or Kegel exercises. The nurse includes this information for which reason? A) improve pelvic floor tone B) promote uterine C) involution D) alleviate perineal pain reduce lochia

A) improve pelvic floor tone

What are common risk factors for developing newborn jaundice? Select all that apply. A) certain drugs B) fetal-maternal blood group incompatibility C) prematurity D) breastfeeding E) maternal gestational diabetes F) too frequent feedings

A, B, C, D, E fetal-maternal blood group incompatibility prematurity breastfeeding certain drugs maternal gestational diabetes

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? Select all that apply. A) Acrocyanosis B) Jaundice C) Vernix caseosa over the abdomen and lower extremities D) Milia E) Lanugo on the back

A, D, E Lanugo on the back Milia Acrocyanosis

A pregnant client at 32 weeks' gestation has been admitted to a health care center reporting decreased fetal movement. Which fetal structure should the nurse determine first before auscultating the fetal heart sounds? A) fetal buttocks B) fetal back C) fetal shoulders D) fetal head

B) fetal back

Which assessment findings indicate a distressed fetus? Select all that apply. A) Moderate fetal heart rate variability B) Persistent bradycardia C) Late deceleration patterns D) Fetal heart rate baseline of 140 E) Absent accelerations

B, C, E

When assessing a 1-day postpartum woman's pulse, what is the first action a nurse should take in response to a rate of 56 beats/min? A) Advise that the client not get out of bed until the nurse returns with assistance. B) Compare the pulse rate with her pulse rate on the first prenatal care visit. C) Do nothing, this is normal. D) Ask the client what she has had to eat today.

C) Do nothing, this is normal.

Which is the most important nursing assessment of the mother during the fourth stage of labor? A) The mother's psyche B) Heart rate C) Hemorrhage D) Blood pressure

C) Hemorrhage

A nurse is explaining to a group of new parents about the changes that occur in the neonate to sustain extrauterine life, describing the cardiac and respiratory systems as undergoing the most changes. Which information would the nurse integrate into the explanation to support this description? A) Breath sounds will have rhonchi for at least the first day of life as fluid is absorbed. B) Heart rate remains elevated after the first few moments of birth. C) Pulmonary vascular resistance (PVR) is decreased as lungs begin to function. D) The cardiac murmur heard at birth disappears by 48 hours of age.

C) Pulmonary vascular resistance (PVR) is decreased as lungs begin to function.

A multigravida woman arrives in the emergency department panting and screaming, "The baby's coming!" Which action should the nurse prioritize? A) Escort to Labor and Delivery. B) Ask medical and obstetrical history. C) Quickly evaluate the perineum. D) Assess maternal and fetal vital signs.

C) Quickly evaluate the perineum.

"2/18/17 0912 vaginal birth of a live male in the vertex presentation, ROA position" The above nurse's note was documented in the client's record by the labor room nurse. In which position was the client born? A) With the right side presenting, and the occiput facing the anterior quadrant B) Rear facing with the occiput facing the posterior quadrant of the pelvis C) With the occiput facing the right anterior quadrant of the pelvis D) With the brow facing the right anterior quadrant of the pelvis

C) With the occiput facing the right anterior quadrant of the pelvis

A nurse is reviewing information about maternal and paternal adaptations to the birth of a newborn. The nurse observes the parents interacting with their newborn physically and emotionally. The nurse documents this as: A) lactation. B) engrossment. C) attachment. D) puerperium.

C) attachment.

The nurse is preparing discharge teaching for a young couple and their infant. Which axillary temperatures should the nurse point out should be reported to the primary care provider? A)less than 96.7° F (35.9° C) or greater than 99.5° F (37.4° C) B) less than 96° F (35.6° C) or greater than 101° F (38.3° C) C) less than 97.7° F (36.5° C) or greater than 100° F (37.8° C) D) less than 97° F (36.1° C) or greater than 100.5° F (38.1° C)

C) less than 97.7° F (36.5° C) or greater than 100° F (37.8° C)

What measures can a nurse take to reduce the risk of hypoglycemia in a newborn? Select all that apply. A) Feed the newborn formula every 4 hours, starting 8 hours after birth. B) Feed only glucose water for the first 24 hours following birth. C) Dry the newborn off immediately after birth to prevent chilling. D) Begin skin-to-skin (kangaroo) care for the newborn. E) Initiate early and frequent breastfeeding.

C, D, E Initiate early and frequent breastfeeding. Dry the newborn off immediately after birth to prevent chilling. Begin skin-to-skin (kangaroo) care for the newborn.

A pregnant client is admitted to the labor and birth unit in the first stage of labor. A nurse reviews a pregnant client's birth plan. Which response from the client would indicate to the nurse that further teaching is indicated? A) "my 6 yr old son will be in the birthing room too" B) "we will hire a doula for our labor support" C) "I would like the babys father to cut the umbilical cord" D) "I will remain in my bed for my labor and birth like last time"

D) "I will remain in my bed for my labor and birth like last time"

Assessment of a woman in labor reveals that the fetus is in a cephalic presentation and engagement has occurred. The nurse interprets this finding to indicate that the presenting part is at which station? A) -1 B) +1 C) -2 D) 0

D) 0

The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is: A) 1 cm below the pubic bone. B) 1 cm below the ischial spines. C) 1 cm above the pubic bone. D) 1 cm above the ischial spines.

D) 1 cm above the ischial spines.

One minute after birth, the neonate's heart rate is 98 beats per minute (bpm), respirations are slow and irregular, arms are flexed, hips are extended, the neonate has no grimace, and the hands/feet are acrocyanotic. What Apgar score should the nurse assign to the neonate? A) 6 B) 7 C) 5 D) 4

D) 4

The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes have ruptured based on which result? A) 5.5 B) 6.0 C) 5.0 D) 6.5

D) 6.5

The parents of a 2-day-old newborn are preparing for discharge from the hospital. Which teaching is most important for the nurse to include regarding sleep? A) The infant may sleep through the night around 2 months of age. B) Caregivers need to sleep while the baby is sleeping. C) Newborns usually sleep for 16 or more hours each day. D) Place the infant on the back when sleeping.

D) Place the infant on the back when sleeping.

Fentanyl has been administered to a client in labor. What assessment should the nurse prioritize? A) Blood pressure B) Level of consciousness C) Maternal heart rate D) Respiratory status

D) Respiratory status

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor? A) The contraction pains have been present for 5 hours, and the patterns are regular. B) After walking for an hour, the contractions have not fully subsided. C) The contraction pains are 2 minutes apart and 1 minute in duration. D) The client reports back pain, and the cervix is effacing and dilating.

D) The client reports back pain, and the cervix is effacing and dilating.

The nurse is assessing an infant's reflexes. While eliciting a rooting reflex, the infant strongly sucks on the nurse's finger. How does the nurse interpret this finding? A) The infant displays a normal rooting reflex. B) The rooting reflex shows a strong sucking response. C) The infant does not have a normal rooting reflex. D) The rooting reflex was tested incorrectly.

D) The rooting reflex was tested incorrectly.

When assessing a postpartum woman, the nurse suspects the woman is experiencing a problem based on which finding? A) elevated white blood cell count B) increased levels of clotting factors C) pulse rate of 60 beats/minute D) acute decrease in hematocrit

D) acute decrease in hematocrit

A nurse working on the postpartum floor is mentoring a new graduate and instructs the new nurse to make sure that clients empty their bladders. A full bladder can lead to which complication? A) fluid volume overload B) permanent urinary incontinence C) ruptured bladder D) increased lochia drainage

D) increased lochia drainage

When performing an assessment on a neonate, which assessment finding is suggestive of hypothermia? A) Shivering B) Metabolic alkalosis C) Bradycardia D) Hyperglycemia

C) Bradycardia

The nurse is caring for a nullipara client at 40 weeks' gestation. After assessing the client, the health care provider states that the fetus is at a -4 station. Which statement by the client requires clarification by the nurse? A) "The health care provider states my labor is imminent." B) "The health care provider will reassess me next week, if I make it." C) "I hope that the end of my pregnancy will be uneventful." D) "I will go home and pack my bag and await the labor process to begin."

A) "The health care provider states my labor is imminent."

A new mother is changing the diaper of her 12-hour-old newborn and asks why the stool is black and sticky. Which response by the nurse would be most appropriate? A) "This is meconium stool and is normal for a newborn." B) "I'll take a sample and check it for possible bleeding." C) "You probably took iron during your pregnancy and that is what causes this type of stool." D)"This is unusual, and I need to report this to your pediatrician."

A) "This is meconium stool and is normal for a newborn."

A client has been discharged from the hospital after a cesarean birth. Which instruction should the nurse include in the discharge teaching? A) "You should be seen by your healthcare provider if you have blurred vision." B) "Call your healthcare provider if you saturate a peri-pad in less than 4 hours." C) "Follow up with your healthcare provider within 3 weeks of being discharged." D) Notify the healthcare provider if your temperature is greater than 99° F (37.2° C)."

A) "You should be seen by your healthcare provider if you have blurred vision."

A nurse is providing care to a neonate and his mother. On reviewing the maternal history, the nurse notes that the mother's glucose level at birth was 102 mg/dL. The nurse would anticipate that the neonate's blood glucose level would be approximately: A) 71 to 82 mg/dL. B) 96 to 108 mg/dL. C) 32 to 44 mg/dL. D) 50 to 66 mg/dL.

A) 71 to 82 mg/dL.

A nurse is assessing a newborn five minutes after birth and notes: HR 110 bpm; a good, strong cry; well flexed extremities; grimacing when slapped on the sole of the foot; and normal pigment in most of the body, with blue hands and feet. What Apgar score will the nurse document for this infant? A) 8 B) 6 C) 9 D) 7

A) 8

At which time is it most important to monitor for umbilical cord prolapse? A) After rupture of membranes B) During transitional labor C) At the onset of labor D) When the fetus is crowning

A) After rupture of membranes

A primigravida client in the second stage of labor has been moaning, screaming, and generally vocal throughout her labor. Her husband is distraught seeing his wife this way and asks the nurse for more pain medication for her. What is the nurse's best response? A) Ask the client to describe the intensity of her pain on a scale of 0 to 10. B) Assist the client with breathing and imagery techniques in an attempt to calm her down. C) Reassure the first-time father that his wife will be fine, and offer to stay with her while he takes a walk. D) Page the obstetrician to evaluate the client's pain, and administer an appropriate increase in her pain medication.

A) Ask the client to describe the intensity of her pain on a scale of 0 to 10.

A nurse is caring for a client administered general anesthesia for an emergency cesarean birth. The nurse notes the client's uterus is relaxed upon massage. What would the nurse do next? A) Continue to massage the client's fundus. B) Administer oxygen to the client. C) Assess the client's vaginal bleeding. D) Continue to monitor the client.

A) Continue to massage the client's fundus.

Which action would be priority for the nurse to complete immediately after the delivery of a 40-week gestation newborn? A) Dry the newborn and place it skin-to-skin on mother. B) Swaddle the infant and place in the bassinet. C) Complete a full head-to-toe assessment. D) Assess the newborn's glucose level.

A) Dry the newborn and place it skin-to-skin on mother.

After the birth of a newborn, which action would the nurse do first to assist in thermoregulation? A) Dry the newborn thoroughly. B) Wrap the newborn in a blanket. C) Check the newborn's temperature. D) Put a hat on the newborn's head.

A) Dry the newborn thoroughly

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: A) Epstein pearls. B) milia. C) thrush. D) vernix caseosa.

A) Epstein pearls.

Which type of anesthesia is anticipated when the delivery of the fetus must be done quickly due to an emergency situation? A) General B) Short acting C) Regional D) Local

A) General

The nurse is explaining to new parents the various injections their newborn will receive before being discharged home. Which injection should the nurse teach the parents about that will help decrease the incidence of hepatic disease later in life? A) Hep B B) HBV immunoglobin C) HiB D) Vitamin K

A) Hep B

The nurse is preparing to administer the vitamin K injection to a newborn. Which action would be correct for this client? A) Injecting the medication into the vastus lateralis B) Injecting 1cc of medication C) Injecting at a 45-degree angle D) Using a 21-gauge needle

A) Injecting the medication into the vastus lateralis

A nurse is caring for a client who has had a vaginal birth. The nurse understands that pelvic relaxation can occur in any woman experiencing a vaginal birth. Which should the nurse recommend to the client to improve pelvic floor tone? A) Kegel exercises B) abdominal crunches C) sitz baths D) urinating immediately when the urge is felt

A) Kegel exercises

Just after birth, a newborn's axillary temperature is 94°F (34.4°C). What action would be most appropriate? A) Rewarm the newborn gradually. B) Notify the primary care provider if the temperature goes lower. C) Assess the newborn's gestational age. D) Observe the newborn every hour.

A) Rewarm the newborn gradually.

Following delivery, a newborn has a large amount of mucus coming out of his mouth and nose. What would be the nurse's first action? A) Using a bulb syringe, suction the mouth then the nose. B) Suction the nose first and then the mouth with a bulb syringe. C) Place the newborn on its stomach with the head down and gently pat its back. D) Suction the mouth and then the nose with a suction catheter.

A) Using a bulb syringe, suction the mouth then the nose.

The nurse is explaining the care the newborn will be receiving right after birth to the parents. The nurse should point out the infant will receive an ophthalmic antibiotic ointment by approximately which time? A) Within one hour B) Within 72 hours C) Any time prior to discharge D) Within 12 hours

A) Within one hour

Which action is a priority when caring for a woman during the fourth stage of labor? A) assessing the uterine fundus B) encouraging the woman to void C) assisting with perineal care D) offering fluids as indicated

A) assessing the uterine fundus

What is the best way for the nurse to assess the newborn's heartbeat? A) auscultating the apical pulse for 60 seconds B) palpating the brachial pulse for 60 seconds C) auscultating the apical pulse for 30 seconds and multiplying by 2 D) palpating the femoral pulse for 30 seconds and multiplying by 2

A) auscultating the apical pulse for 60 seconds

While performing a physical assessment of a newborn boy, the nurse notes diffuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as: A) caput succedaneum. B) microcephaly. C) cephalohematoma. D) molding.

A) caput succedaneum.

The nurse administers Rho(D) immune globulin to an Rh-negative client after birth of an Rh-positive newborn based on the understanding that this drug will prevent her from: A) developing Rh sensitivity. B) becoming pregnant with an Rh-positive fetus. C) developing AB antigens in her blood. D) becoming Rh positive.

A) developing Rh sensitivity.

When developing the plan of care for the parents of a newborn, the nurse identifies interventions to promote bonding and attachment based on the rationale that bonding and attachment are most supported by which measure? A) early parent-infant contact following birth B) grandparent involvement in infant care after birth C) good nutrition and prenatal care during pregnancy D) expert medical care for the labor and birth

A) early parent-infant contact following birth

In an effort to decrease complications for the infant right after birth, the nurse would expect to administer which medication for prophylaxis of potential eye conditions? A) erythromycin ophthalmic ointment B) silver nitrate solution C) gentamicin ophthalmic ointment D) vitamin K

A) erythromycin ophthalmic ointment

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? A) fetal heart rate declining late with contractions and remaining depressed B) variable decelerations, too unpredictable to count C) fetal baseline rate increasing at least 5 mm Hg with contractions D) a shallow deceleration occurring with the beginning of contractions

A) fetal heart rate declining late with contractions and remaining depressed

While assessing a newborn, the nurse notes that half the body appears red while the other half appears pale. The nurse interprets this finding as: A) harlequin sign. B) stork bites. C) erythema toxic. D) Mongolian spots.

A) harlequin sign.

While trying to decide whether to bottle feed or breastfeed her newborn infant, a new mother questions the lactation specialist concerning the greatest benefit of breastfeeding her infant. What would be the best response? A) immunity against many different bacteria B) convenience of breastfeeding C) decreased expense for feedings D) ease of digestion of breast milk

A) immunity against many different bacteria

A nurse teaches a postpartum woman about her risk for thromboembolism. The nurse determines that additional teaching is required when the woman identifies which as a factor that increases her risk? A) increase in red blood cell production B) vessel damage C) increase in clotting factors D) immobility

A) increase in red blood cell production

The nurse is developing a teaching plan for a client who has decided to bottle-feed her newborn. Which information would the nurse include in the teaching plan to facilitate suppression of lactation? A) instructing her to apply ice packs to both breasts every other hour B) telling her to limit the amount of fluids that she drinks C) suggesting that she take frequent warm showers to soothe her breasts D) encouraging the woman to manually express milk

A) instructing her to apply ice packs to both breasts every other hour

When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be: A) less than after a vaginal birth. B) about the same as after a vaginal birth. C) greater than after a vaginal birth. D) saturated with clots and mucus.

A) less than after a vaginal birth.

A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered? A) naloxone B) fentanyl C) promethazine D) butorphanol

A) naloxone

The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation? A) nasal flaring B) acrocyanosis C) abdominal breathing D) respiratory rate of 54 breaths/minute

A) nasal flaring

A nurse is teaching a new mother about breastfeeding. The nurse determines that the teaching was successful when the woman identifies which hormone as responsible for milk let-down? A) oxytocin B) prolactin C) estrogen D) progesterone

A) oxytocin

A nurse is reviewing a postpartum woman's history and labor and birth record. The nurse determines the need to closely monitor this client for infection based on which factor? A) placenta removed via manual extraction B) hemoglobin of 11.5 mg/dl (115 g/L) C) labor less than 3 hours D) multiparity

A) placenta removed via manual extraction

Prior to discharging a 24-hour-old newborn, the nurse assesses the newborn's respiratory status. What would the nurse expect to assess? A) respiratory rate 45 breaths/minute, irregular B) nasal flaring, rate 65 breaths/minute C) crackles on auscultation D) costal breathing pattern

A) respiratory rate 45 breaths/minute, irregular

While waiting for the placenta to deliver during the third stage of labor the nurse must assess the new mother's vital signs every 15 minutes. What sign would indicate impending shock? A) tachycardia and a falling blood pressure B) bradycardia and auscultation of fluid in the base of the lungs C) bradypnea and hypertension D) tachypnea and a widening pulse pressure

A) tachycardia and a falling blood pressure

Which factor in a client's history would alert the nurse to an increased risk for postpartum hemorrhage? A) uterine atony, placenta previa, operative procedures B) prematurity, infection, length of labor C) size of placenta, small baby, operative birth D) multiparity, age of mother, operative birth

A) uterine atony, placenta previa, operative procedures

When teaching new parents about the sensory capabilities of their newborn, which sense would the nurse identify as being the least mature? A) vision B) hearing C) touch D) taste

A) vision

A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply. A) hydramnios B) uterine infection C) prolonged labor D) empty bladder E) early ambulation F) breastfeeding

A, B, C uterine infection prolonged labor hydramnios

A breastfeeding client presents with a temperature of 102.4°F (39°C) and a pulse of 110 bpm. She reports general fatigue and achy joints, and her left breast is engorged, red, and tender. Which instructions would the nurse anticipate being given to this client? Select all that apply. A) Continue breastfeeding on the left side, if the infant is willing to latch on. B) If infant refuses to feed, pump the breast to maintain flow. C) Take prescribed antibiotics until all prescribed doses are completed. D) Use a bottle to feed the infant until the pain and tenderness subside. E) Until antibiotics are completed, pump the left breast and dispose of the milk.

A, B, C Continue breastfeeding on the left side, if the infant is willing to latch on. Take prescribed antibiotics until all prescribed doses are completed. If infant refuses to feed, pump the breast to maintain flow.

The nurse is assessing a client for rupture of membranes. Which findings would confirm the presence of ruptured membranes? Select all that apply. A) a pool of fluid visible in the vagina B) ferning is present C) nitrazine paper turns blue D) the client reports having wet pants E) the cervix is effaced

A, B, C Nitrazine paper turns blue. Ferning is present. A pool of fluid is visible in the vagina.

While assessing a postpartum client who gave birth about 12 hours ago, the nurse evaluates the client's bladder and voiding. The nurse determines that the client may be experiencing bladder distention based on which finding? Select all that apply. A) dullness on percussion over symphysis pubis B) rounded mass over symphysis pubis C) fundus boggy to the right of the umbilicus D) moderate lochia rubra E) elevated oral temperature

A, B, C rounded mass over symphysis pubis dullness on percussion over symphysis pubis fundus boggy to the right of the umbilicus

A new mother delivered 1 week ago and is tearful, anxious, sad, and has no appetite. She is diagnosed with postpartum blues. What factors contribute to this problem? Select all that apply. A) Hormonal changes B) Lack of activity C) Discomfort D) Fatigue E) Disrupted sleep patterns

A, C, D, E Hormonal changes Fatigue Discomfort Disrupted sleep patterns

A nurse is preparing a class on newborn adaptations for a group of soon-to-be parents. When describing the change from fetal to newborn circulation, which information would the nurse include? Select all that apply. A) Onset of respirations leads to a decrease in pulmonary vascular resistance. B) Increase in pressure in the left atrium results from increases in pulmonary blood flow. C) Closure of the ductus venosus eventually forces closure of the ductus arteriosus. D) Decrease in right atrial pressure leads to closure of the foramen ovale. E) Increase in oxygen levels leads to a decrease in systemic vascular resistance.

A, B, C, D Decrease in right atrial pressure leads to closure of the foramen ovale. Onset of respirations leads to a decrease in pulmonary vascular resistance. Increase in pressure in the left atrium results from increases in pulmonary blood flow. Closure of the ductus venosus eventually forces closure of the ductus arteriosus.

A nursing instructor informs students that recent research has shown that delayed cord clamping provides which advantages? Select all that apply. A) increasing blood pressure B) improving the newborn's cardiopulmonary adaptation C) improving oxygen transport D) preventing childhood anemia E) increasing red blood cell flow F) preventing childhood obesity

A, B, C, D, E improving the newborn's cardiopulmonary adaptation preventing childhood anemia increasing blood pressure improving oxygen transport increasing red blood cell flow

A nurse is monitoring a fetal heart rate (FHR) pattern on her client in labor and notes a change from the earlier baseline FHR of 140 bpm to 168 bpm. The nurse is aware that which factors can result in fetal tachycardia? Select all that apply. A) uteroplacental insufficiency B) maternal fever C) fetal movement D) narcotic medication to maternal client E) fetal distress

A, B, C, E fetal movement fetal distress uteroplacental insufficiency maternal fever

The nurse is inspecting a new mother's perineum. What actions would the nurse take for this client? Select all that apply. A) Note any hemorrhoids. B) Gently palpate for any hematomas. C) Palpate the episiotomy for pain. D) Inspect the episiotomy for sutures and to ensure that the edges are approximated. E) Place the patient in Trendelenburg position for inspection.

A, B, D Inspect the episiotomy for sutures and to ensure that the edges are approximated. Note any hemorrhoids. Gently palpate for any hematomas.

A nurse is performing a detailed assessment of a female newborn. Which observations indicate normal findings? Select all that apply. A) swollen genitals B) Mongolian spots C) enlarged fontanelles D) short, creased neck E) low-set ears

A, B, D Mongolian spots swollen genitals short, creased neck

A nurse is completing the assessment of a woman admitted to the labor and birth suite. Which information would the nurse expect to include as part of the physical assessment? Select all that apply. A) contraction pattern B) membrane status C) estimated date of birth D) fundal height measurement E) support system F) current pregnancy history

A, B, D fundal height measurement membrane status contraction pattern

A nurse is developing a teaching plan about sexuality and contraception for a postpartum woman who is breastfeeding. Which information would the nurse most likely include? Select all that apply. A) possible experience of fluctuations in sexual interest B) possibility of increased breast sensitivity during sexual activity C) use of combined hormonal contraceptives for the first three weeks D) use of a water-based lubricant to ease vaginal discomfort E) resumption of sexual intercourse about two weeks after birth

A, B, D possible experience of fluctuations in sexual interest use of a water-based lubricant to ease vaginal discomfort possibility of increased breast sensitivity during sexual activity

The nursing student is preparing a presentation illustrating the effects of hypoglycemia on an infant. Which signs or symptoms should the student be sure to include in the presentation? Select all that apply. A) Jitteriness B) Lethargy C) Hyperthermia D) Bradypnea E) Seizures

A, B, E Jitteriness Lethargy Seizures

The nurse has been asked to conduct a class to teach new mothers how to avoid developing stress incontinence. Which action would the nurse include in the discussion as possible strategies for the new mothers to do? Select all that apply. A) avoiding smoking B) losing weight if obese C) increasing fluid intake D) starting jogging E) performing Kegel exercises

A, B, E performing Kegel exercises avoiding smoking losing weight if obese

What findings should the nurse report to the health care provider for a postpartum client who delivered 12 hours ago? Select all that apply. A) Fundal height level of one fingerbreadth above the umbilicus B) White blood cell count of 28,000/mm3 C) Temperature of 101.8°F (38.8°C) D) Episiotomy appears edematous E) Lochia rubra

A, C Fundal height level of one fingerbreadth above the umbilicus Temperature of 101.8°F (38.8°C)

A nurse is assisting with the gestational age assessment of a newborn. When assessing the newborn's physical maturity, which areas would the nurse likely address? Select all that apply. A) Lanugo B) Square window C) Breast tissue D) Posture E) Arm recoil

A, C Lanugo Breast tissue

The nurse orienting a student to the nursery determines that teaching has been effective when the student states that the signs of neonate respiratory distress include which findings? Select all that apply. A) Chest retractions B) Heart rate of 120 beats per minute C) Respiratory rate of 64 breaths per minute D) Nasal flaring E) Bluish coloration of hands and feet

A, C, D Nasal flaring Respiratory rate of 64 breaths per minute Chest retractions

A nurse is preparing a presentation about changes in the various body systems during the postpartum period and their effects for a group of new mothers. The nurse explains which event as influencing a postpartum woman's ability to void? Select all that apply. A) generalized swelling of the perineum B) need for an episiotomy C) decreased bladder tone from regional anesthesia D) use of oxytocin to augment labor E) use of an opioid anesthetic during labor

A, C, D generalized swelling of the perineum decreased bladder tone from regional anesthesia use of oxytocin to augment labor

A nurse is teaching a woman in her third trimester about Braxton Hicks contractions. When describing these contractions, which information would the nurse likely include? Select all that apply. A) "they often spread downward before they go away" B) "they usually happen in a regular pattern" C) "they go away when you walk around or change position" D) "they typically last for about 3 minutes each time you have them" E) "they usually feel like a tightening across the top of your uterus"

A, C, E "They usually feel like a tightening across the top of your uterus." "They often spread downward before they go away." "They go away when you walk around or change position."

A mother asks the nurse about having her son circumcised. The nurse understands that circumcision is contraindicated under which circumstances? Select all that apply. A) There is a family history of hemophilia. B) The penis is small. C) The father is uncircumcised. D) The infant is at 33 weeks' gestation. E) The newborn was febrile at birth but temperature is now normal.

A, D There is a family history of hemophilia. The infant is at 33 weeks' gestation.

A postpartum woman tells the home care nurse, "My hemorrhoids are really uncomfortable. Is there anything I can do?" Which suggestion(s) by the nurse would be appropriate? Select all that apply. A) "Witch hazel pads can have a cooling effect." B) "You should pour cold water over the area with your peribottle." C) "You might think anesthetic sprays help but they do not." D) "Applying ice to the area can help." E) "I will show you how to use a sitz bath."

A, D, E "Applying ice to the area can help." "Witch hazel pads can have a cooling effect." "I will show you how to use a sitz bath."

Rho(D) immune globulin is administered to which clients? Select all that apply. A) An Rh-negative woman following an ectopic pregnancy B) A newborn with type O-negative blood and a negative Coombs test C) A client who is Rh-positive and gave birth to a 7-pound baby D) An Rh-negative woman who had a spontaneous abortion (miscarriage) yesterday E) A Rh negative woman who gives birth at 32 weeks gestation to a baby with A+ blood

A, D, E An Rh-negative woman who had a spontaneous abortion (miscarriage) yesterday An Rh-negative woman following an ectopic pregnancy A Rh negative woman who gives birth at 32 weeks gestation to a baby with A+ blood

The nurse is conducting a breast exam on a postpartum mother on the second day following delivery. What findings would the nurse determine to be normal? Select all that apply. A) Breasts are non-painful B) Nipples have several cracks on both breasts. C) One reddened area on the left breast 3 cm in size. D) Flattened nipple on the right breast E) Breasts feel slightly firm.

A, D, E Breasts feel slightly firm. Flattened nipple on the right breast Breasts are non-painful

The nurse is monitoring a client at 38 weeks' gestation who is bleeding. Which assessment findings indicate the client is hemodynamically unstable? Select all that apply. A) Fetal heart rate 198 bpm B) Urine output: 20 ml/hr C) Heart rate: 82 bpm D) Blood pressure: 120/78 mm Hg E) Pulse oximeter: 95%

A, N Fetal heart rate 198 bpm Urine output: 20 ml/hr

A newborn's parents ask the nurse how to prevent the newborn from becoming ill. What is the best response by the nurse? A) "Be sure to keep the newborn's umbilical cord stump clean and dry." B) "Always wash your hands before you pick up or provide care to your newborn." C) "Be sure to keep all scheduled doctor appointments for vaccinations." D) "Keep your newborn at home and do not allow visitors for the first month."

B) "Always wash your hands before you pick up or provide care to your newborn."

A nurse is observing a new mother interacting with her newborn. Which statement would alert the nurse to the potential for impaired bonding between mother and newborn? A) "He seems to sleep a lot." B) "He looks like a frog to me." C) "You have your daddy's eyes." D) "Where did you get all that hair?"

B) "He looks like a frog to me."

A nursing instructor is teaching about changes the newborn must make to survive outside of the uterus. The instructor realizes that further teaching is needed when a student makes which statement? A) "The baby's lungs begin to function when the umbilical cord is clamped." B) "The baby takes the first breath when ready to leave the uterus." C) "The baby takes the first breath when stimulated by a slight slap." D) "The baby takes the first breath when the umbilical cord is clamped."

B) "The baby takes the first breath when ready to leave the uterus."

A nurse is teaching a newborn's caregivers how to change a diaper correctly. Which statement by the caregiver best indicates the nurse's teaching was effective? A) "We will apply a moisture barrier cream with every diaper change to prevent diaper rash." B) "We will fold down the front of her diaper under the umbilical cord until it falls off." C) "We should clean the skin with soap and water after each bowel movement." D) "It is best practice to change the diaper every 2 to 4 hours, even during the night."

B) "We will fold down the front of her diaper under the umbilical cord until it falls off."

When a client is counseled about the advantages of epidural anesthesia, which statement made by the counselor would indicate the need for further teaching? A) "You can continuously receive epidural anesthesia until you have the baby, and even afterward if you need it." B) "You have no trouble walking around and using the bathroom after you receive the epidural." C) "If you end up having a cesarean, the epidural can be used for anesthesia during surgery." D) "Epidural anesthesia is more effective than opioid analgesia in providing pain relief."

B) "You have no trouble walking around and using the bathroom after you receive the epidural."

A postpartum woman who is bottle-feeding her newborn asks the nurse, "About how much should my newborn drink at each feeding?" The nurse responds by saying that to feel satisfied, the newborn needs which amount at each feeding? A) 6 to 8 ounces B) 2 to 4 ounces C) 4 to 6 ounces D) 1 to 2 ounces

B) 2 to 4 ounces

The nurse has completed assessing the blood glucose levels of several infants who are 24 hours old. Which result should the nurse prioritize for intervention? A) 90 mg/dl (5.00 mmol/L) B) 30 mg/dl (1.67 mmol/L) C) 50 mg/dl (2.77 mmol/L) D) 70 mg/dl (3.89 mmol/L)

B) 30 mg/dl (1.67 mmol/L)

The nurse performs a quick assessment of an infant who is now 5 minutes old and determines the heart rate is 110 bpm, has a weak cry, acrocyanosis, extremities are held in partial flexion, and a catheter placed in the nose produces grimacing. What Apgar score does the nurse record and what action should the nurse prioritize? A) 4; repeat Apgar scoring in 5 minutes B) 6; repeat Apgar scoring in 10 minutes C) 5; repeat Apgar scoring in 5 minutes D) 7; repeat Apgar scoring in 10 minutes

B) 6; repeat Apgar scoring in 10 minutes

Following the birth, the nurse is responsible for assessing the cord pH. The nurse recognizes that which value would be considered a normal pH? A) 7.4 B) 7.2 C) 7.0 D) 6.8

B) 7.2

During the fourth stage of labor, which mother typically experiences the strongest afterpains? A) A primigravid whose breast milk has not come in B) A multipara who is breast-feeding C) The primigravid who delivers a 6 lb (2,688 g) newborn D) A multigravid with twins who decided to formula feed

B) A multipara who is breast-feeding

A nurse is providing care to a newborn in the immediate newborn period. Which nursing intervention is priority? A) Complete the hearing test. B) Administer aquamephyton. C) Perform the newborn screening. D) Provide hepatitis B vaccination.

B) Administer aquamephyton.

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure? A) Offer a warm sitz bath. B) Apply an ice pack to the site. C) Encourage the woman to void. D) Offer warm blankets.

B) Apply an ice pack to the site.

A postpartum woman has a history of thrombophlebitis. Which action would help the nurse determine if she is developing this postpartum? A) Palpate her feet for tingling or numbness. B) Assess for calf redness and edema. C) Take her temperature every 4 hours. D) Ask her if she feels any warmth in her legs.

B) Assess for calf redness and edema.

Prior to infusing medication into an epidural catheter inserted into a laboring mother, which vital sign is a priority? A) Temperature B) Blood pressure C) Pain level D) Respiratory rate

B) Blood pressure

A 30-minute-old newborn starts crying in a high-pitched manner and cannot be consoled by the mother. Which action should the nurse prioritize if jitteriness is also noted and the infant is unable to breastfeed? A) Place child in a radiant warmer. B) Check blood glucose. C) Assess the baby's temperature. D) Assess for pain source.

B) Check blood glucose.

The nurse is caring for a client experiencing pruritus secondary to opioid medication administration during labor. When reviewing the medication administration record, which medication would the nurse offer the client? A) Meperidine B) Diphenhydramine C) Naloxone D) Nalbuphine

B) Diphenhydramine

A nurse is explaining the benefits of breastfeeding to a client who has just given birth. Which statement correctly explains the benefits of breastfeeding to this mother? A) Breastfeeding provides more iron and calcium for the infant. B) Immunoglobulin IgA in breast milk boosts a newborn's immune system. C) Breastfed infants gain weight faster than formula fed infants after 6 month of age. D) Mothers who breastfeed have increased breast size following nursing.

B) Immunoglobulin IgA in breast milk boosts a newborn's immune system.

There are advantages and disadvantages to any kind of method used to control pain during labor and birth. What is an advantage of opioid administration? A) It can be given frequently without risk to the fetus. B) It can be administered by the nurse. C) It is generally given PO D) Fetal monitoring can be safely discontinued.

B) It can be administered by the nurse.

The multigravida client is moving into the transition phase and asks for a narcotic, stating she doesn't remember the pain being this bad before. Which response from the nurse will be best? A) "Rather than use a narcotic, let's ask for a different type of pain medication." B) "Pain medication can affect the baby's breathing; let's try to focus and breathe." C) "You are so close to birth; don't you want to have natural birth?" D) "I will page the provider and ask for your pain medication."

B) Pain medication can affect the baby's breathing; let's try to focus and breathe."

The nurse has completed assessing the vital signs of several clients who are from 36 to 48 hours postpartum. For which set of vital signs should the nurse prioritize for interaction? A) Temp: 100.2° F (38° C), HR 65, RR 22, BP 130/78 B) Temp: 98.6° F (37° C), HR 74, RR 16, BP 150/85 C) Temp: 97.0° F (36.1° C), HR 80, RR 20, BP 120/72 D) Temp: 99.4° F (37.4° C), HR 90, RR 18, BP 112/67

B) Temp: 98.6° F (37° C), HR 74, RR 16, BP 150/85

The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which? A) The client is fully effaced. B) The fetus is in the true pelvis and engaged. C) The fetus is floating high in the pelvis. D) The fetus has descended down the birth canal.

B) The fetus is in the true pelvis and engaged.

A nurse is preparing a client for rhythm strip testing. She places the woman into a semi-Fowler position. What is the appropriate rationale for this measure? A) To prevent the woman from falling out of bed B) To prevent supine hypotension syndrome C) To aid the woman as she pushes during labor D) To decrease the heart rate of the fetus

B) To prevent supine hypotension syndrome

If the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first? A) Help the woman to sit up in a semi-Fowler's position. B) Turn her or ask her to turn to her side. C) Ask her to pant with the next contraction. D) Administer oxygen at 3 to 4 L by nasal cannula.

B) Turn her or ask her to turn to her side.

Upon assessing the newborn's respirations, which finding would cause the nurse to notify the primary care provider? A) short periods of apnea that last 10 seconds in a pink newborn B) a respiratory rate of 15 breaths per minute with nasal flaring C) coughing and sneezing in the newborn D) a respiratory rate of 45 breaths per minute with acrocyanosis

B) a respiratory rate of 15 breaths per minute with nasal flaring

The nurse determines that the fetal heart rate averages approximately 140 beats per minute over a 10-minute period. The nurse identifies this as: A) short-term variability. B) baseline FHR. C) fetal bradycardia. D) baseline variability.

B) baseline FHR.

While making a follow-up home visit to a client in her first week postpartum, the nurse notes that she has lost 5 pounds. Which reason for this loss would be the most likely? A) nausea B) diuresis C) lactation D) blood loss

B) diuresis

A nurse is making a home visit to a postpartum woman who gave birth to a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as: A) involution. B) engorgement. C) engrossment. D) mastitis.

B) engorgement.

A client receives an epidural anesthetic. Which medication would the nurse anticipate the primary care provider will prescribe if the client develops moderate hypotension? A) methylergonovine B) ephedrine C) betamethasone D) atropine

B) ephedrine

The nurse is assessing the skin of a newborn and notes a rash on the newborn's face and chest. The rash consists of small papules and is scattered with no pattern. The nurse interprets this finding as: A) harlequin sign. B) erythema toxicum. C) nevus flames. D) port wine stain.

B) erythema toxicum.

When doing a health assessment, at which location would the nurse expect to palpate the fundus in a woman on the second postpartum day and how should it feel? A) fundus two fingerbreadths above symphysis pubis and hard B) fundus two fingerbreadths below umbilicus and firm C) fundus height 4 cm below umbilicus and midline D) fundus 4 cm above symphysis pubis and firm

B) fundus two fingerbreadths below umbilicus and firm

The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which phase? A) decrement B) increment C) peak D) acme

B) increment

A client expresses concern that her 2-hour-old newborn is sleepy and difficult to awaken. The nurse explains that this behavior indicates: A) probable hypoglycemia. B) normal progression of behavior. C) inadequate oxygenation. D) physiological abnormality.

B) normal progression of behavior.

When palpating for fundal height on a postpartum woman, which technique is preferable? A) resting both hands on the fundus B) placing one hand at the base of the uterus, one on the fundus C) palpating the fundus with only fingertip pressure D) placing one hand on the fundus, one on the perineum

B) placing one hand at the base of the uterus, one on the fundus

A nurse is reviewing the laboratory test results of a newborn. Which result would the nurse identify as a cause for concern? A) hemoglobin 19 g/dL B) platelets 75,000/uL C) white blood cells 20,000/mm3 D) hematocrit 52%

B) platelets 75,000/uL

A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor? A) shortening of the upper uterine segment B) restoration of blood flow to uterus and placenta C) effacement and dilation of the cervix D) reduction in length of the cervical canal

B) restoration of blood flow to uterus and placenta

A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus and documents which finding as normal? A) two fingerbreadths above the umbilicus B) two fingerbreadths below the umbilicus C) four fingerbreadths below the umbilicus D) at the level of the umbilicus

B) two fingerbreadths below the umbilicus

A postpartum client reports urinary frequency and burning. What cause would the nurse suspect? A) uterine atony B) urinary tract infection C) stress incontinence D) subinvolution

B) urinary tract infection

A nurse is caring for a client who has had a cesarean birth with general anesthesia. The nurse would assess the woman closely for which possible complication? A) pruritus B) uterine atony C) maternal hypotension D) inadequate pain block

B) uterine atony

A nurse is reviewing the fetal heart rate pattern and observes abrupt decreases in FHR below the baseline, appearing as a U-shape. The nurse interprets these changes as reflecting which type of deceleration? A) early decelerations B) variable decelerations C) prolonged decelerations D) late decelerations

B) variable decelerations

A woman delivered her infant 24 hours ago by cesarean section. Which assessment findings should be reported to the assigned nurse? Select all that apply. A) Fundal height is one fingerbreadth below the umbilicus. B) The client reports breakthrough pain level of 7-8. C) Uterus feels boggy. D) Bleeding is noted on the abdominal dressing 2 x 5 cm in size. E) The client's abdomen is mildly distended and bowel sounds are hypoactive.

B, C Uterus feels boggy. The client reports breakthrough pain level of 7-8.

Which physical findings would the nurse observe in a newborn that would indicate that the newborn is full-term? Select all that apply. A) Labia minora are prominent upon observation. B) Pinnae are flexible with rapid recoil. C) Creases on the feet cover 2/3 of the bottom of the feet. D) Fingernails are present and extend to the end of the fingers. E) The newborn has a relaxed posture.

B, C, D Fingernails are present and extend to the end of the fingers. Pinnae are flexible with rapid recoil. Creases on the feet cover 2/3 of the bottom of the feet.

The nursery head nurse is conducting a staff in-service on prevention of hypoglycemia. What information would she share with this group? Select all that apply. A) Offer glucose feedings to all newborns at 1 hour of age. B) Keep the newborns warm in the nursery and covered with a blanket. C) Encourage breastfeeding mothers to nurse immediately after delivery. D) If a newborn becomes lethargic or sleepy, draw a heel stick blood glucose. E) Initiate early feedings for all bottle-fed newborns.

B, C, E Encourage breastfeeding mothers to nurse immediately after delivery. Keep the newborns warm in the nursery and covered with a blanket. Initiate early feedings for all bottle-fed newborns.

An Rh-negative mother delivered an Rh-positive infant. What information would the nurse need to gather prior to administering Rho (D) immune globulin injection? Select all that apply. A) What was the birth weight of the infant? B) Has the mother ever been sensitized to Rh-positive blood? C) Has the mother experienced any miscarriages or abortions? D) Has she delivered by cesarean section or vaginally? E) Has the mother had any previous pregnancies?

B, C, E Has the mother ever been sensitized to Rh-positive blood? Has the mother had any previous pregnancies? Has the mother experienced any miscarriages or abortions?

A nurse is caring for a client in her third stage of labor. The nurse would predict the placenta is separating from the uterus based on which assessment findings? Select all that apply. A) falling downward of uterus in the abdomen B) fresh gushing of blood from the vagina C) umbilical cord descending lower down D) a relaxed and distended uterus E) a globular shaped uterus

B, C, E fresh gushing of blood from the vagina umbilical cord descending lower down a globular shaped uterus

A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which information? Select all that apply. A) labor of 12 hours B) placenta requiring manual extraction C) hemoglobin level 10 mg/dL D) rupture of membranes for 16 hours E) history of diabetes

B, C, E history of diabetes hemoglobin level 10 mg/dL placenta requiring manual extraction

A nurse is conducting a class for a group of nurses who are newly hired for the labor and birth unit. After teaching the group about fetal heart rate patterns, the nurse determines the need for additional teaching when the group identifies which finding as indicating normal fetal acid-base status? Select all that apply. A) absence of late decelerations B) sinusoidal pattern C) recurrent variable D) decelerations E) fetal bradycardia F) moderate baseline variability

B, C, E sinusoidal pattern recurrent variable decelerations fetal bradycardia

Which nursing interventions align with the outcome of preventing maternal and fetal injury in the latent phase of the first stage of labor? Select all that apply. A) Have a client remain on bed rest with bathroom privileges only. B) Monitor maternal and fetal vital statistics every hour. C) Position client on the left side throughout the labor process. D) Report an elevated temperature over 38℃ (100.4℉). E) Answer questions and encourage verbalization of fears.

B, D, E Monitor maternal and fetal vital statistics every hour. Report an elevated temperature over 38℃ (100.4℉). Answer questions and encourage verbalization of fears.

Which interventions would the nurse take to reduce the incidence of infection in a postpartum woman? Select all that apply. A) Recommend that the mother change her peripads every 12 hours. B) Teach proper positioning of the infant for breastfeeding. C) Have the mother maintain a low activity level to allow the perineum to heal. D) Wash her hands before and after caring for the client. E) Encourage intake of fluids following delivery and after discharge.

B, D, E Teach proper positioning of the infant for breastfeeding. Encourage intake of fluids following delivery and after discharge. Wash her hands before and after caring for the client.

A nurse is caring for a newborn with hypoglycemia. For which symptoms of hypoglycemia should the nurse monitor the newborn? Select all that apply. A) skin rashes B) lethargy C) low-pitched cry D) jitteriness E) cyanosis

B, D, E lethargy cyanosis jitteriness

A newborn is experiencing cold stress. Which findings would the nurse expect to assess? Select all that apply. A) decreased oxygen needs B) jaundice C) metabolic alkalosis D) hypoglycemia E) respiratory distress

B, D, E respiratory distress hypoglycemia jaundice

A nurse is discussing the advantages and disadvantages of intermittent and continuous fetal heart rate monitoring with a colleague. What would the nurse cite as being able to be detected when using continuous monitoring but not intermittent monitoring? Select all that apply. A) changes in baseline B) types of decelerations C) rhythm D) FHR baseline E) variability

B, E types of decelerations variability

A nurse receives the shift report on four infants. 1--Baby A is 16 hours old, HR 117, RR 32, axillary temperature 98oF (36.6oC), BP 72/43 mm Hg, bilirubin 3.5 mg/dL rooming in with mother 2--Baby B is 8 hours old, HR 152, RR 48, axillary temperature 97.7oF (36.5oC), BP 60/40 mm Hg, bilirubin 3 mg/dL, returning to nursery for night 3--Baby C is 19 hours old, HR 140, RR 45, axillary temperature 98.6oF (37oC), BP 68/45 mm Hg, bilirubin 4 mg/dL, rooming in with mother 4--Baby D is 4 hours old, HR 160, RR 60, axillary temperature 98.6oF (37oC), BP 80/45 mm Hg, bilirubin 2 mg/dL, returning to nursery for night. Which baby would the nurse assess first?

Baby C

A nurse is making an initial call on a new mother who gave birth to her third baby 5 days ago. The woman says, "I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother? A) "Tell me, are you seeing things that aren't there, or hearing voices?" B) "It sounds like you need to make an appointment with a counselor. You may have postpartum depression." C) "It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two." D) "Every baby is different with their own temperament. Maybe this one just isn't ready to sleep when you want him to."

C) "It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two."

A new mother asks the nurse why newborns receive an injection of vitamin K after delivery. What will be the best response from the nurse? A) "Newborns are given vitamin K and erythromycin ointment to help prevent ophthalmia neonatorum." B) This vitamin substitutes for vitamin C for newborns to strengthen their immune systems." C) "Newborns lack the intestinal flora needed to produce vitamin K, so it is given to prevent bleeding episodes." D) "Newborns are given vitamin K to help with the digestion to help them absorb fat-soluble vitamins."

C) "Newborns lack the intestinal flora needed to produce vitamin K, so it is given to prevent bleeding episodes."

The nurse is assessing the respirations of several newborns. The nurse would notify the health care provider for the newborn with which respiratory rate at rest? A) 54 breaths per minute B) 38 breaths per minute C) 68 breaths per minute D) 46 breaths per minute

C) 68 breaths per minute

A woman is in labor with her second child. She knows that she will want epidural anesthesia, and she has already signed her consent form. What must the nurse do before the woman receives the epidural? A) Review the woman's medical history and laboratory results, and interview her to confirm all information is accurate and up to date. B) Place the woman in the fetal position on the table, and keep her steady so that she won't move during the procedure. C) Administer a fluid bolus through the IV line to reduce the risk of hypotension. D) Prepare a sterile field with the supplies and medications that will be needed.

C) Administer a fluid bolus through the IV line to reduce the risk of hypotension

The nurse notes persistent early decelerations on the fetal monitoring strip. Which action should the nurse take in this situation? A) Administer oxygen after turning the client on her left side. B) Stay with the client while reporting the finding to the health care provider. C) Continue to monitor the fetal heart rate because this pattern is benign. D) Perform a vaginal examination to assess cervical dilation (dilatation) and effacement.

C) Continue to monitor the fetal heart rate because this pattern is benign.

The nurse is caring for a client who is a gravida 2 para 1 and had a previous cesarean section. The client has had no complications with the pregnancy and prefers to have this delivery vaginally. Which monitoring system best assesses for the ability to delivery vaginally? A) Continuous external monitoring of uterine contractions B) Intermittent fetal heart rate auscultation C) Continuous internal monitoring of uterine contractions D) Intermittent monitoring of the uterine resting tone

C) Continuous internal monitoring of uterine contractions

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 66 beats per minute. Which of these actions should the nurse take? A) Obtain a prescription for a CBC, as it suggests postpartum anemia. B) Contact the primary care provider, as it indicates early DIC. C) Document the finding, as it is a normal finding at this time. D) Contact the primary care provider, as it is a first sign of postpartum eclampsia.

C) Document the finding, as it is a normal finding at this time.

While changing a female newborn's diaper, the nurse observes a mucus-like, slightly bloody vaginal discharge. Which action would the nurse do next? A) Notify the primary care provider immediately. B) Obtain a culture of the discharge. C) Document this as pseudo menstruation. D) Inspect for engorgement.

C) Document this as pseudo menstruation.

The nurse is caring for a client who is gravida 3 para 2. The obstetric history reveals that all labors were uncomplicated with two vaginal deliveries. The client is 6 cm dilated and effaced. Which is the minimal acceptable amount of monitoring? A) No monitoring needed B) Fetal scalp sampling C) Intermittent fetal heart rate auscultation D) Continuous external fetal monitor

C) Intermittent fetal heart rate auscultation

During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse interprets this finding as: A) birth trauma. B) stork bites. C) Mongolian spots. D) milia.

C) Mongolian spots.

The nurse is assisting with the circumcision of a male infant. Which nursing intervention is priority immediately after the procedure? A) Assess the newborn for infection. B) Administer acetaminophen orally. C) Monitor the site for bleeding. D) Apply a petrolatum gauze dressing

C) Monitor the site for bleeding.

The nurse is teaching new parents how to clear the secretions from their infant's mouth and nose. The nurse determines they are prepared when they correctly perform which initial step? A) Position the newborn on side with head slightly below body; use a bulb syringe to clear nose. B) Position the newborn on side, and suction with a bulb syringe. C) Position the newborn on side with head slightly below body; use a bulb syringe to clear mouth. D) Position the newborn on side with head slightly below body; use a small suction catheter to clear nose.

C) Position the newborn on side with head slightly below body; use a bulb syringe to clear mouth.

A nurse is caring for the client who gave birth a week ago. The client informs the nurse that she experiences painful uterine contractions when breastfeeding the baby. Which should the nurse do next? A) Have the client stop breastfeeding. B) Instruct the client to take a warm shower. C) Tell the client to take an NSAID orally. D) Ask how often the client is breastfeeding.

C) Tell the client to take an NSAID orally.

Which client should the postpartum nurse assess first after receiving shift report? A) The 1-day postpartum client who has a respiratory rate of 20 breaths/minute. B) The 12-hour postpartum client who has a temperature of 100.4° F (38° C). C) The 2-day postpartum client who has a blood pressure of 138/90 mm Hg. D)The 3-day postpartum client who has a pulse of 50 bpm.

C) The 2-day postpartum client who has a blood pressure of 138/90 mm Hg.

The nurse is caring for four clients in labor. Which client would the nurse anticipate having continuous internal electronic fetal monitoring? A) The client who has had a previous cesarean section B) The client who is having an uncomplicated labor C) The client who is very restless and is moving around in the bed D) The client who is having back labor and desires to lay on her side

C) The client who is very restless and is moving around in the bed

What assessment finding would suggest to the care team that the pregnant client has completed the first stage of labor? A) The client has contractions once every two minutes. B) The client experiences her first full contraction. C) The client's cervix is fully dilated. D) The infant is born.

C) The client's cervix is fully dilated.

Which reason explains why women should be encouraged to perform Kegel exercises after birth? A) They promote the return of normal bowel function. B) They assist the woman in burning calories for rapid postpartum weight loss. C) They promote blood flow, enabling healing and muscle strengthening. D) They assist with lochia removal.

C) They promote blood flow, enabling healing and muscle strengthening.

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent? A) Second B) Fourth C) Third D) First

C) Third

A woman's amniotic fluid is noted to be cloudy. The nurse interprets this finding as: A) transient fetal hypoxia. B) meconium passage. C) a possible infection. D) normal.

C) a possible infection.

A client states, "I think my water broke! I felt this gush of fluid between my legs." The nurse tests the fluid with nitrazine paper and confirms membrane rupture if the swab turns: A) pink. B) olive green. C) blue. D) yellow.

C) blue.

A new dad is alarmed at the shape of his newborn's head. When responding to the dad, the nurse reminds him this is due to: A) prolonged labor. B) extreme pressure in the vaginal vault. C) cranial bones overlapping at the suture lines. D) a congenital defect.

C) cranial bones overlapping at the suture lines.

The nurse has just administered morphine 2 mg IV to a laboring client. Which change in the fetal heart rate pattern would the nurse prioritize? A) late decelerations B) increased variability C) decreased variability D) early decelerations

C) decreased variability

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which medication to be prescribed? A) methylergonovine B) ferrous sulfate C) docusate D) bromocriptine

C) docusate

When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation? A) dilation (dilatation) B) molding C) effacement D) crowning

C) effacement

A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A) full B) complete C) frank D) footling

C) frank

The nurse is reviewing the laboratory test results of a client in labor. Which finding would the nurse consider normal? A) increased blood glucose levels B) increased blood coagulation time C) increased white blood cell count D) decreased plasma fibrinogen levels

C) increased white blood cell count

The nurse assesses a postpartum woman's perineum and notices that her lochial discharge is moderate in amount and red. The nurse would record this as what type of lochia? A) lochia serosa B) lochia alba C) lochia rubra D) lochia normalia

C) lochia rubra

A nurse is assessing a woman after birth and notes a second-degree laceration. The nurse interprets this as indicating that the tear extends through which area? A) skin B) anal sphincter C) muscles of perineal body D) anterior rectal wall

C) muscles of perineal body

A client in labor has been admitted to the labor and birth suite. The nurse assessing the woman notes that the fetus is in a cephalic presentation. Which description should the nurse identify by the term presentation? A) relation of the fetal presenting part to the maternal ischial spine B) relationship of the presenting part to the maternal pelvis C) part of the fetal body entering the maternal pelvis first D) relation of the different fetal body parts to one another

C) part of the fetal body entering the maternal pelvis first

Which factor might result in a decreased supply of breast milk in a postpartum client? A) maternal diet high in vitamin C B) an alcoholic drink C) supplemental feedings with formula D) frequent feedings

C) supplemental feedings with formula

A nurse is describing how the fetus moves through the birth canal. Which component would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A) frontal bones B) fontanelles C) sutures D) biparietal diameter

C) sutures

When reviewing the medical record of a postpartum client, the nurse notes that the client has experienced a third-degree laceration. The nurse understands that the laceration extends to which area? A) through the perineal muscles B) superficial structures above the muscle C) through the anal sphincter muscle D) through the anterior rectal wall

C) through the anal sphincter muscle

A nurse is caring for a client with postpartum hemorrhage. What should the nurse identify as the significant cause of postpartum hemorrhage? A) hemorrhoid B) diuresis C) uterine atony D) iron deficiency

C) uterine atony

At what point should the nurse expect a healthy newborn to pass meconium? A) by 12 to 18 hours of life B) within 1 to 2 hours of birth C) within 24 hours after birth D) before birth

C) within 24 hours after birth

A nurse is explaining the various methods of pain control used during labor and birth. When explaining why general anesthesia is rarely used, which information would the nurse include? Select all that apply. A) In an emergency situation, it takes too long to administer. B) Malignant hypothermia is a common side effect in pregnant women. C) General anesthesia readily crosses the placenta. D) A pregnant woman has a risk for vomiting and aspiration. E) Physiologic changes make it more difficult to intubate a pregnant woman.

C, D A pregnant woman has a risk for vomiting and aspiration. General anesthesia readily crosses the placenta.

A nurse is meeting with a group of pregnant clients who are in their last trimester to teach them the signs that may indicate they are going into labor. The nurse determines the session is successful after the clients correctly choose which signs as an indication of starting labor? Select all that apply. A) weight gain B) constipation C) lightening D) bloody show E) backache

C, D, E lightening bloody show backache

A hepatitis B positive mother delivers a newborn. What precautions would the nurse take in caring for this infant? Select all that apply. A) Give the mother a one-time dose of hepatitis B immunoglobulin within 12 hours after delivery. B) The newborn will need to stay in the hospital for several extra days for additional IV medications to treat the infection. C) Bathe the newborn thoroughly soon after birth to remove maternal blood. D) Tell the mother that she cannot breastfeed her newborn due to the infection. E) Give the newborn the HBV vaccination within 12 hours after birth.

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

Which occurs as a result of contraction decrement? Select all that apply. A) the mother feels a gush of water in the perineal area B) the fetus is pushed down the birth canal C) fetal heart rate should return to baseline D) the mother feels the contraction intensifying E) blood flow to the fetus improves

C, E Blood flow to the fetus improves. Fetal heart rate should return to baseline.

When assessing the episiotomy site of a postpartum client that delivered 3-hours ago, the nurse would document which findings as expected? Select all that apply. A) Redness B) Bleeding C) Slight bruising D) Discharge E) Edema

C, E Edema Slight bruising

Which suggestion by the nurse about pushing would be most appropriate to a woman in the second stage of labor? A) "Bear down like you're having a bowel movement with every contraction." B) "Let me help you decide when it is time to start pushing." C) "Lying flat with your head elevated on two pillows makes pushing easier." D) "Choose whatever method you feel most comfortable with for pushing."

D) "Choose whatever method you feel most comfortable with for pushing."

A nurse is caring for a female client in the postpartum phase. The client reports "afterpains." Which intervention should the nurse complete first? A) Assess client vital signs. B) Assist the client in emptying her bladder. C) Encourage the client to stop breastfeeding until the pains stop. D) Administer pain medications.

D) Administer pain medications.

Which intervention would be the best way for the nurse to prevent heat loss in a newborn while bathing? A) Postpone breastfeeding until after the initial bath. B) Limit the bathing time to 5 minutes. C) Bathe the baby in water between 90 and 93 degrees. D) Bathe the baby under a radiant warmer.

D) Bathe the baby under a radiant warmer.

A nurse is caring for an infant with an elevated bilirubin level who is under phototherapy. What evaluation data would best indicate that the newborn's jaundice is improving? A) Reticulocyte count is 6%. B) Hematocrit is 38. C) Skin looks less jaundiced. D) Bilirubin level went from 15 to 11.

D) Bilirubin level went from 15 to 11.

A primigravida has an office appointment at 39 weeks' gestation. Which assessment data is most definitive of the onset of labor? A) Expulsion of the mucus plug. B) The mother reports frequent urination. C) The fetal head is engaged in the pelvis. D) Cervical ripening is noted on examination.

D) Cervical ripening is noted on examination.

The nurse cares for a pregnant client in labor and determines the fetus is in the right occiput anterior (ROA) position. Which action by the nurse is best? A) Auscultate fetal heart rate (FHR) in the left upper quadrant. B) Educate the client this fetal position may result in a longer labor. C) Prepare the client for cesarean birth of the fetus. D) Continue to monitor the progress of labor.

D) Continue to monitor the progress of labor.

Which consideration is a priority when caring for a mother with strong contractions 1 minute apart? A) Maternal request for pain medication B) The station in which the fetus is located C) Maternal heart rate and blood pressure D) Fetal heart rate in relation to contractions

D) Fetal heart rate in relation to contractions

A woman delivered her infant 2 hours ago and calls to tell the nurse that she needs to go to the bathroom. When the nurse arrives, the mother is getting out of bed alone. What should the nurse do? A) Assist the client to the bathroom. B) Ask the client to lie back down and get her a bedpan. C) Suggest catheterizing her this time to prevent the possibility of fainting. D) Have the client sit dangling her legs off the side of the bed for 5 minutes

D) Have the client sit dangling her legs off the side of the bed for 5 minutes

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority? A) Check and inspect the lochia, and document all findings. B) Notify the primary care provider, and document the findings. C) Assess a full set of vital signs. D) Have the client void, and then massage the fundus until it is firm.

D) Have the client void, and then massage the fundus until it is firm.

The parents are bonding with their newborn when the nurse notes the infant's axillary temperature is 97.2oF (36.2oC) an hour after birth. Which intervention should the nurse prioritize for this family? A) Place the infant under a radiant warmer. B) Administer a warm bath with temperature slightly higher than usual. C) Place a second stockinette on the baby's head. D) Help the mother provide kangaroo care.

D) Help the mother provide kangaroo care.

The nurse is preparing a client for an epidural block. Which intervention is a priority before the epidural anesthesia is started? A) Increase oral fluids B) Monitor maternal apical pulse C) Monitor temperature D) IV fluid bolus

D) IV fluid bolus

The nurse is assisting with the admission of a newborn to the nursery. The nurse notes what appears to be bruising on the left upper outer thigh of this dark-skinned newborn. Which documentation should the nurse provide? A) Birth trauma noted on left upper outer thigh. B) Mottling noted on left upper outer thigh. C) Harlequin sign noted on left upper outer thigh. D) Mongolian spot noted on left upper outer thigh.

D) Mongolian spot noted on left upper outer thigh.

The nurse is caring for a client who is sent to the obstetric unit for evaluation of fetal well-being. At which location is the nurse correct to place the tocodynamometer? A) On the right side of the abdomen B) At the level of the umbilicus C) Midline but low on the abdomen D) On the uterine fundus

D) On the uterine fundus

The nurse is preparing new parents and their infant for discharge by answering questions and presenting basic discharge instruction. Which explanation should the nurse provide when questioned about the infant's yellow hue? A) It's a mild reaction to the vitamin K injection. B) The infant needs to be in the sunlight to clear the skin. C) Yellow is the normal color for some newborns. D) The tint is due to jaundice.

D) The tint is due to jaundice.

The nurse discovers that the FHM is now recording late decelerations in a client who is in labor. The nurse predicts this is most likely related to which event? A) Cord compression B) Maternal hypotension C) Maternal fatigue D) Uteroplacental insufficiency

D) Uteroplacental insufficiency

A mother asks the nurse why her newborn is getting a Vitamin K injection in the birth room. The nurse explains that the injection is necessary because: A) Vitamin K aids in protein metabolism. Newborns have defective protein metabolism until 24 hours of life. B) Newborns are prone to hypoglycemia, and vitamin K helps maintain a steady blood glucose level. C) The mother was febrile at the time of birth and prophylactic vitamin K is necessary. D) Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the few days following birth.

D) Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the few days following birth.

Twenty minutes after birth, a baby begins to move his head from side to side, making eye contact with the mother, and pushes his tongue out several times. The nurse interprets this as: A) evidence that the newborn is becoming chilled. B) a sign that the infant is being overstimulated. C) the period of decreased responsiveness preceding sleep. D) a good time to initiate breastfeeding.

D) a good time to initiate breastfeeding

A 19-year-old woman presents to the emergency department in the late stages of active labor. Assessment reveals she received no prenatal care. As part of her examination, a rapid HIV screen indicates she is HIV positive. To reduce the perinatal transmission to her infant, which intravenous medication would the nurse anticipate administering? A) antibiotic B) benzodiazepine C) ataractic D) antiretroviral

D) antiretroviral

The five "Ps" of labor are: A) passenger, position, powers, presentation, psych. B) passenger, position, presentation, pushing, psych. C) passenger, posture, position, presentation, psych. D) passageway, passenger, position, powers, psych.

D) passageway, passenger, position, powers, psych.

The nurse institutes measures to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they: A) have a smaller body surface compared to body mass. B) have an abundant amount of subcutaneous fat all over. C) lose more body heat when they sweat than adults. D) are unable to shiver effectively to increase heat production.

D) are unable to shiver effectively to increase heat production.

Which finding would alert the nurse to suspect that a newborn is experiencing respiratory distress? A) short periods of apnea (less than 15 seconds) B) respiratory rate of 50 breaths/minute C) acrocyanosis D) asymmetrical chest movement

D) asymmetrical chest movement

The nurse is assessing a client who has given birth within the past hour. The nurse would expect to find the woman's fundus at which location? A) 2 cm above the umbilicus B) one fingerbreadth below the umbilicus C) between the umbilicus and symphysis pubis D) at the level of the umbilicus

D) at the level of the umbilicus

On an Apgar evaluation, how is reflex irritability tested? A) dorsiflexing a foot against pressure resistance B) raising the infant's head and letting it fall back C) tightly flexing the infant's trunk and then releasing it D) flicking the soles of the feet and observing the response

D) flicking the soles of the feet and observing the response

Screening for this most common birth defect is required by law in most states. Each nurse should know the law for his or her state and the requirements for screening. The nurse would expect a newborn to be screened for which defect as the most common? A) vision B) genetic-linked C) skeletal malformations D) hearing

D) hearing

When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which condition? A) cervical laceration B) thromboembolism C) hemorrhoids D) hemorrhage

D) hemorrhage

A nurse is teaching a postpartum client how to do muscle-clenching exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response? A) alleviates perineal pain B) promotes uterine involution C) reduces lochia D) improves pelvic floor tone

D) improves pelvic floor tone

A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility? A) potential placenta previa B) potential rapid birth of fetus C) increased risk of breech presentation D) increased risk of infection

D) increased risk of infection

Prior to discharge is an appropriate time to evaluate the client's status for preventative measures such as immunizations and Rh status. Which test would the nurse ensure has been conducted to evaluate the Rh negative mother? A) titer screen B) ANA C) CBC with differential D) indirect Coombs' test

D) indirect Coombs' test

A new mother asks the nurse, "Why has my baby lost weight since he was born?" The nurse integrates knowledge of which cause when responding to the new mother? A) overproduction of bilirubin B) increase in stool passage C) shift of water from extracellular space to intracellular space D) insufficient calorie intake

D) insufficient calorie intake

The nurse is auscultating a newborn's heart and places the stethoscope at the point of maximal impulse at which location? A) directly adjacent to the sternum at the second intercostals space B) at the fifth intercostal space to the left of the sternum C) just superior to the nipple, at the midsternum D) lateral to the midclavicular line at the fourth intercostal space

D) lateral to the midclavicular line at the fourth intercostal space

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? A) brow B) shoulders C) buttocks D) occiput

D) occiput

During the birth, the primary care provider performed an episiotomy. The client is now reporting discomfort. To reduce this discomfort and increase hygiene to the perineum, the nurse would encourage the client to use which intervention? A) alcohol wipes B) moist cloths C) baby wipes D) peribottle and warm water

D) peribottle and warm water

When assessing a postpartum woman, the nurse would find which factor to be most significant in identifying possible postpartum hemorrhage? A) hematocrit B) cardiac output C) blood pressure D) pulse rate

D) pulse rate

A woman in labor received an opioid close to the time of birth. The nurse would assess the newborn for which effect? A)abdominal distention B)urinary retention C) hyperreflexia D) respiratory depression

D) respiratory depression

A nurse is assessing a newborn. Which finding would alert the nurse to the possibility of respiratory distress in a newborn? A) symmetrical chest movements B) periodic breathing C) respirations of 40 breaths/minute D) sternal retractions

D) sternal retractions

Which is the best place to perform a heel stick on a newborn? A) the calcaneus B) the vascularized flat surface of the foot C) the front of the heel (the outer arch) D) the fat pads on the lateral aspects of the foot

D) the fat pads on the lateral aspects of the foot

The nurse encourages the mother of a healthy newborn to put the newborn to the breast immediately after birth for which reason? A) to encourage the development of maternal antibodies B) to enhance the clearing of the newborn's respiratory passages C) to aid in maturing the newborn's sucking reflex D) to facilitate maternal-infant bonding

D) to facilitate maternal-infant bonding

What treatments would the nurse perform in caring for a newly circumcised newborn? Select all that apply. A) Apply talc powder to the diaper area with each diaper change. B) Report if there is a bleeding spot the size of a dime on the diaper. C) Notify the doctor if the newborn does not void after 4 hours. D) Wash the penis with warm water at each diaper change. E) Fasten the diaper loosely to prevent unnecessary friction as irritation.

D, E Wash the penis with warm water at each diaper change. Fasten the diaper loosely to prevent unnecessary friction as irritation.

A nurse is assessing a term neonate and notes transient tachypnea. When reviewing the mother's history, which conditions would the nurse most likely find as contributing to this finding? Select all that apply. A) prolonged labor B) use of forceps at birth C) epidural anesthesia D) cesarean birth E) use of heavy sedation during labor

D, E cesarean birth use of heavy sedation during labor