Questions from the book.
1. A nurse is assessing a preterm baby with a gestational age of 32 weeks and birth weight of 1,389 grams. Which of the following signs if present would be a possible indication of RDS? A. Expiratory grunting and intercostal retractions B. Respiratory rate of 46 breaths per minute and presence of acrocyanosis C. Mild nasal flaring and heart rate of 140 beats per minute D. Bradycardia and bounding pulse
A
1. Teaching regarding the care of the newborn begins: A. During pregnancy B. Within a few hours after delivery C. Twelve hours after delivery D. The day of discharge
A
2. Your patient gave birth to a 6-pound baby girl 6 hours ago. It was a spontaneous delivery. You note on your assessment of her perineum that there is some edema and slight bruising. She stated that her pain was at 1 on the pain scale. Your nursing action would be to: A. Continue applying ice to the perineum. B. Assist her with a sitz bath. C. Encourage her to keep her bladder empty. D. Administer ibuprofen 800 mg.
A
3. You are assigned to a 21-year-old primipara, who is 36 hours post-birth and breastfeeding her healthy newborn son. During your assessment, you note that there is a small reddened area on the right side of the left areola. Based on this assessment finding, which of the following is the priority nursing action? A. Instruct the woman to change feeding position from cradle hold to football hold. B. Instruct the woman to air-dry her nipples for 15 minutes after each feeding. C. Instruct the woman to apply a lanolin cream to the area after each feeding. D. Instruct the woman to feed from only the right breast for 24 hours.
A
3: The goal of maternal position changes for a prolonged deceleration is: A. Maximizing uterine blood flow B. Increasing uterine contractions C. Maximizing maternal oxygenation D. Increasing maternal movement
A
4. Increased information provided by assessment of uterine contractions with an intrauterine pressure catheter includes: A. Frequency, duration, intensity, and resting tone B. Frequency, duration, and intensity C. Intensity only D. Labor progress
A
5. You are developing a discharge teaching plan for your patient. The newborn is a girl and is full term and healthy. Both the woman and her partner are college educated and have one other healthy child, a boy who is 2 years old. The woman bottle fed her son and plans to breastfeed her daughter. She plans to return to work when her daughter is 3 months old. Based on this information, the three primary learning needs for this couple are: A. Breastfeeding, sibling rivalry, and infant/child safety B. Breastfeeding, storage of breast milk, and bathing C. Safety, colic, and storage of breast milk D. Cord care, breastfeeding, and safety
A
6. Variable decelerations are typically related to: A. Cord compression B. Head compression C. Uteroplacental insufficiency D. Uterine hyperstimulation due to hypovolemia
A
7. Nursing interventions related to late decelerations include all of the following except: A. Initiate pitocin induction B. Initiate IV bolus C. Change maternal position D. Initiate oxygen therapy
A
8. Which of the following treatments is recommended for the infant experiencing drug withdrawal symptoms? A. Morphine B. Diluted formula C. Frequent awakening D. Well-lit room
A
8. You are assigned a hearing impaired first-time mother. When you enter the room, your patient is looking away from you. Which of the following is the most appropriate way to get the woman's attention? A. Flick the overhead lights on and off. B. Make a loud noise as you enter the room. C. Tap the woman on her shoulder. D. Walk to her bed and wave your hand.
A
9. Which is not a risk to the infant of a diabetic mother? A. Hyperglycemia B. Poor feeding C. Macrosomia D. Respiratory distress
A
9. You are assigned a woman who is 2 hours post birth. She had an emergency cesarean section for an abruptio placenta. Based on this history, the woman is at risk for ___________________. Fill in the blank. A. Disseminated intravascular coagulation B. Retained placenta fragments C. Thrombosis D. Subinvolution of the uterus
A
6. The nurse is preparing a woman in the early postpartum period for a fundal check. Select all appropriate nursing actions: A. Provide for privacy. B. Position the woman in high Fowler's position. C. Have the patient empty her bladder. D. Position the patient in the supine position.
A, C, D
7. Which of the following should be included in postpartum discharge teaching regarding risk reduction forcystitis? Select all that apply. A. Drink a minimum of 3,000 mL of fluid per day. B. Change peripads at least every 3-4 hours. C. Eat foods low in acidity. D. Avoid caffeinated fluids.
A,B
10. A patient who delivered vaginally and has a third degree laceration is being prepared for discharge. Which of the following instructions should the nurse include in her discharge teaching? Select all that apply. A. Drink at least 2 liters of fluid a day. B. Ambulate several times a day. C. Eat plenty of whole grain foods, and fruits and vegetables. D. Use suppositories to help promote regular, soft bowel movements.
A,B,C
5. Factors that can hamper a couple's transition to parenthood include which of the following? Select all that apply. A. First experience with newborns B. Change of employment C. Adolescent father
A,B,C
4. You are providing discharge teaching to your patient. In addition to her newborn son, she has a 2-year-old daughter. Which of the following will you include in your teaching? Select all that apply. A. Stressing the importance of quality time with her 2-year-old daughter B. Instructing the woman to include the 2-year-old in the care of her baby brother C. Explaining that all children experience some degree of sibling rivalry D. Instructing the woman to explain to her daughter the reasons babies cry
A,B,C,D
7. Which of the following are true statements regarding let-down reflex? Select all that apply. A. Contractions of the myoepithelial cells forces milk into the duct system. B. Oxytocin is released in response to infant suckling and woman's emotions. C. It can occur during sexual arousal. D. It occurs multiple times during feeding session
A,B,C,D
7. Your postpartum assignment includes a 15-year-old firsttime mother who gave birth to a healthy baby girl 6 hours ago. The 16-year-old father of the baby was present for the birth and is present while you are caring for the new mother. Which of the following nursing actions are appropriate for this couple? Select all that apply. A. Include the new father in infant care teaching sessions. B. Ask the new father to tell you about his labor and birth experience. C. Include the new father in teaching session on contraception. D. Include the new father in teaching session on postpartum blues.
A,B,C,D
8. Which of the following factors place a woman at risk for thrombosis? Select all that apply. A. Obesity B. Physiological changes of pregnancy C. Metritis D. Cesarean birth
A,B,C,D what is metritis? Inflamation of the wall of the uterus..I googled it.
5. Signs and symptoms of postpartum depression include which of the following? Select all that apply. A. Sleep and appetite disturbance B. Uncontrolled crying C. Delusions D. Feelings of guilt and/or worthlessness
A,B,D
2. Mrs. Fischer is 4 days post-birth. She calls the clinic and tells the triage nurse that she has a temperature and does not feel well. What additional assessment findings does the triage nurse need to obtain to assist in her nursing assessment? Select all that apply. A. When did she notice an increase in temperature and what is her temperature? B. Is she experiencing pain, and if so, where is it located? C. What is the amount of her fluid intake within the past 24 hours? D. What is the color and amount of her bleeding?
A,B<C,D
5. During your discharge teaching, you are evaluating if your patient needs information on contraception. Select the responses that indicate she needs additional information. A. "I will be breastfeeding for the next 6 months. We will start using a condom after I have my first period." B. "My husband is getting a vasectomy. We will be using condoms until his second semen analysis is negative for sperm." C. "I plan to have an IUD. We will be using condoms until I get an IUD." D. "I used a diaphragm prior to this pregnancy and plan to use my old one."
A,D
A pregnant client in labor is placed on an external fetal monitor. Later, the fetal strip shows late fetal heart decelerations. The nurse should (select all that apply): A.Turn the client to the left side and administer oxygen. B. Start an intravenous line. C. Prep the mother for caesarian section. D. Notify the physician.
Answer: A & D. Late fetal heart rate decelerations are associated with fetal hypoxia and acidosis. Positioning the mother on her left side prevents compression of the vena cava. Oxygen administration increases maternal, then fetal blood levels, thus treating current and preventing further development of hypoxia and acidosis. Failure to recognize fetal monitoring strip abnormalities and failure to report abnormalities to the physician are deviations from the standard of care.
A pregnant client in labor receives an epidural and anesthetic for pain control. The most important, initial nursing action is to: A. Perform a thorough skin prep of the insertion site. B. Obtain the client's consent for the procedure. C. Assure the client that residual effects of the procedure won't be felt. D.Monitor maternal blood pressure.
Answer: D.
1. The most critical physiological change required of neonates during the transition from intrauterine to extrauterine life is: A. Initiation and maintenance of cardiac function B. Initiation and maintenance of respiratory function C. Initiation and maintenance of metabolic function D. Initiation and maintenance of hepatic function
B
1. Your patient is a 25-year-old gravida 1 woman who is 2 hours postpartum. You note on assessment that her fundus is firm and midline. She is experiencing a steady stream of blood. The bed linen under her is soaked in blood. Based on these findings and observations, you suspect that she is exhibiting early signs/symptoms of a postpartum hemorrhage related to: A. Uterine atony B. Laceration of the cervical or vaginal area C. Retained placental tissue D. Fibroids
B
10. If a pregnant woman is group beta strep (GBS) positive, prophylactic antibiotics should be administered if: A. She is a planned cesarean section B. The gestational age of her baby is less than 37 weeks C. She has vomiting and diarrhea during labor D. Her baby has a known congenital anomaly
B
10. You are assigned a woman who is 5 hours post-birth. She gave birth to an 8-pound girl and experienced a 4th degree tear of the perineum. During your postpartum assessment, she informed you that she has rectal pressure and severe pain where she tore. Her level of pain is 10 on a pain scale of 0-10. You note her perineum is intact with minimal bruising. Her blood pressure is 100/60 and pulse is 98. Based on this assessment data, select the best initial nursing action. A. Medicate her for pain. B. Notify her physician of your assessment data. C. Place an ice pack on the perineum. D. Assist her in ambulating to the bathroom.
B
2. Your postpartum patient is a 25-year-old, white, single woman who gave birth to a healthy infant. She is 36 hours post-birth. You note that she holds her infant at a distance and refers to her infant as "it." Based on this assessment, your initial nursing actions include: A. Obtain referral for a social worker. B. Ask the woman to tell you about her pregnancy and childbirth experience. C. Teach her the importance of holding her baby close to her body. D. Take her baby to the nursery so she can have some uninterrupted sleep.
B
4. The nurse would expect the stools of a 3-day-old breastfed newborn to be: A. Sticky, thick, and black B. Greenish-brown to greenish-yellow C. Golden yellow and pasty D. Loose and green
B
4. Women who experience mastitis should be instructed to: A. Stop breastfeeding until 48 hours after the start of antibiotic treatment. B. Continue to breastfeed or massage and express milk from the affected breast. C. Wash nipples with antibiotic soap before each feeding session. D. Apply cream to nipples after each feeding until mastitis has resolved.
B
5. Which of the following statements is true regarding hyperbilirubinemia? A. Jaundice covers the entire body in pathological jaundice versus only the face in physiological jaundice. B. Jaundice occurs within the first 24 hours post-birth in pathological jaundice versus after 24 hours in physiological jaundice. C. Kernicterus only occurs in pathological jaundice. D. Jaundice begins to appear in term neonates when the bilirubin level is 3 mg/dL
B
6. Clinical management strategies for prevention of retinopathy of prematurity (ROP) focus on targeting appropriate _____________ ranges for infants at risk. A. Arterial pH B. Oxygen saturation C. Heart rate D. Core temperature
B
7. A nurse is providing discharge teaching to a postpartum patient who is bottle feeding. The patient asks the nurse when she should expect to have her period return. The nurse's best response is: A. "You can expect to have your period in 3-4 weeks." B. "Many women who choose not to breastfeed will have a period in 7-9 weeks after childbirth." C. "Your period will return at about 6 months post-delivery." D. "Bottle feeding suppresses ovulation, so as long as you bottle feed, you will not have a period."
B
8. You observe that a 2-day postpartum woman is having difficulty breastfeeding. Her baby is crying and moving his head from side to side. Your first nursing action is to: ________________. A. Assist the woman into a comfortable position. B. Assist the woman in calming her baby. C. Show the woman how to properly position the baby. D. Tell the woman that her baby is not hungry and to wait a few hours.
B
7. Select all that are true regarding the anterior fontanel of a full term neonate. A. Approximately 0.5-1 cm in size B. Approximately 2.5-4 cm in size C. Diamond shape D. Triangle shape
B,C
10. Which statements are true regarding coparenting? Select all that apply. A. Implies that the parenting roles are equal in the amount of child care responsibilities B. Consists of parental figures supporting each other in the rearing of their child C. Can be affected by the infant's temperament. D. Can be affected by the man's cultural beliefs.
B,C,D
6. Factors that influence a man's transition to fatherhood include which of the following? Select all that apply. A. Educational level B. Cultural expectations C. Socioeconomic status D. Support from partner
B,C,D
10. The American Dental Association recommends that parents can decrease the risk of tooth decay in infants by _______________. Select all that apply. A. Preparing juice bottles with one part juice and two parts water B. Cleaning the infant's gums with a wet, clean gauze after feedings C. Rinsing the infant's mouth with sterile water after each feeding D. Beginning regular dental checkups by 1 year of age
B,D
1. Your postpartum patient is 10 hours post-birth. She experienced an uncomplicated labor and birth and her newborn is full term with Apgar scores of 9 at 1 minute and 9 at 5 minutes. During your assessment, you note that she was hungry and very interested in telling you about her birth experience. You had to remind her to change her baby's diaper and to feed her baby. Based on this assessment you determine that she is: A. Having difficulty bonding with her baby B. Not concerned about her baby's needs C. In the taking-in phase D. In the taking-hold phase
C
10. The initial bathing of the neonate should occur ____________. A. within 30 minutes of the birth B. before applying eye ointment C. after temperature has stabilized D. 3 hours after the birth
C
2. During a feeding session, your 19-year-old primipara who is 12 hours post-birth, asks you how she can tell if her baby girl is getting any milk when nursing. Your best response is: A. "Your baby is getting colostrum. Your milk will come in around 2-3 days." B. "When your baby falls asleep while nursing." C. "You will hear swallowing noises from your baby as she suckles." D. "Your baby will refuse to latch-on."
C
2. The primary risk factor for necrotizing enterocolitis (NEC) is: A. Early oral feedings with formula B. Passage of meconium during labor C. Prematurity D. Low birth weight
C
2: Potential causes of late decelerations include: A. Maternal fever B. Umbilical cord compression C. Uteroplacental insufficiency D. Fetal activity
C
3. Heat loss through evaporation can be reduced by: A. Closing the door to the room B. Using warming equipment on the neonate C. Drying the neonate D. Placing the crib near a warm wall
C
3. To decrease the risk of orthostatic hypotension during the first few hours after the birth, the nurse should: A. Assist the patient to the bathroom by using a wheelchair. B. Break open an ammonia ampule and have the patient take a deep breath before getting up. C. Have the patient sit on the side of the bed for a few minutes before standing. D. Check the patient blood pressure before assisting her to the bathroom.
C
4. When gavage feeding a preterm neonate, the nurse should: A. Measure the tube before insertion from the mouth to the sternum. B. Check for placement by injecting a small amount of sterile water into the feeding tube and listen for a gurgling noise. C. Instill formula over a 20-minute period of time. D. Flush the tube at the end of feeding with dextrose water.
C
4. You are assigned a 16-year-old primipara, who is bottle feeding her healthy full-term baby boy. She asks you why the other nurse told her to tilt the baby's bottle when feeding. Your best response is: A. "I will go and get the other nurse so she can clarify the instruction she gave you." B. "By tilting the bottle, the nipple is in a more comfortable placement in your baby's mouth." C. By tilting the bottle, you keep the nipple full of formula and decrease the amount of air your baby swallows." D. "The tilted position provides greater pressure coming from the bottle and makes it easier for your baby to take in the formula."
C
5. In the birth suite during the initial newborn assessment, the new father seems concerned and asks why his baby girl is so hairy. The best response is: A. "Over the next few months the hair on the back will fall out." B. "This is a normal characteristic of newborns, so no need to be concerned." C. "This is called lanugo, which covered the baby while inside the mother. It will fall out in a few months." D. "You seem overly concerned about this. Do you want to talk about your feelings?"
C
6. Contraindications for breastfeeding include which of the following? Select all that apply. A. Woman is using cocaine. B. Woman is being treated for mastitis. C. Woman is receiving chemotherapy for lymphoma. D. Infant has thrush.
C
7. A neonate born at 37 weeks' gestation is determined to be small for gestational age (SGA). The most common immediate problem for this infant would be: A. Anemia B. Hypovolemia C. Hypoglycemia D. Hypocalcemia
C
8. A patient who delivered 20 hours ago reports a transient increase in her lochia when she ambulated to the bathroom to void this morning after sleeping for a few hours. The nurse performs an assessment and documents scant rubra, lochia with no clots, fundus firm 1 cm below the umbilicus. Which of the following nursing actions are appropriate at this time? A. Report this finding to the patient's health care provider immediately. B. Begin weighing and counting pads. C. Reassure the patient that this is normal. D. Obtain a physician's order to administer oxytocin.
C
8. The point of maximal impulse (PMI) is located at __________________. A. the 1st or 2nd intercostal space B. the 2nd or 3rd intercostal space C. the 3rd or 4th intercostal space D. the 4th or 5th intercostal space
C
9. You observe a new father gently touching his newborn son and spending time gazing at his son. These behaviors are characteristics of ______________. A. Entrainment B. Attachment C. Engrossment D. Bonding
C
9. Your discharge teaching for a couple with an uncircumcised boy should include which of the following? A. Beginning at 1 month of age, gently retract the foreskin each day during the infant's bath. B. Beginning at 6 months of age, clean the area between the foreskin and glans each day with a cotton swab. C. Gently wash the penis when bathing and with each diaper change. D. Retract the foreskin when there is a yellowish discharge.
C
3. Foul-smelling lochia occurs: A. When beta-hemolytic Streptococcus is the primary organism associated with metritis B. Within the first 24 hours post-birth related to metritis C. When the entire endometrium is infected D. During the normal involution process
C what a lame question. What if half of the endometrium is infected?
6. Which of the following measurements fall above or below the normal range for a newborn born at 40 weeks gestation? Select all that apply. A. Head circumference: 34 cm B. Chest circumference: 32 cm C. Weight: 4, 250 grams D. Length: 43 cm
C,D
2. You are caring for a newborn girl who weighs 3,800 grams with an estimated gestational age of 41 weeks. During your assessment at 1 hour of age, you note that the newborn is jittery and irritable. Your first nursing action is: A. Increase the temperature of the warmer B. Feed the infant formula C. Transfer the infant to the NICU D. Assess the blood glucose level
D
3. A common characteristic of a premature infant is: A. Absence of lanugo B. Dry skin C. Increased flexion of arms and legs D. Transparent and red skin
D
3. Which 2-day postpartum woman has an abnormal finding that requires intervention? A. A 23-year-old Arabic woman who plans to breastfeed but wants to bottle feed her newborn until her milk comes in B. A 28-year-old Chinese woman who refuses to take a shower C. A 20-year-old Japanese woman who has her mother care for her baby D. A 19-year-old Caucasian woman who requests that her baby stay in the nursery so she can sleep
D
5. Fetal heart rate should be assessed in a low-risk woman in active labor: A. Every 5 minutes B. Every 10 minutes C. Every 15 minutes D. Every 30 minutes
D
6. During a six-week postpartum clinic visit, your patient tells you she is concerned about her husband. She tells you that he either stays late at work or goes out after work with his friends. When he is home, he is usually drinking beer while watching sports on TV. Which of the following is the most appropriate response? A. "These are common behaviors of men as they process the meaning of fatherhood. You just need to give him time to work through this life change." B. "These behaviors can indicate that your husband does not want to take on the responsibilities of being a father. You need to talk to him about his feelings regarding fatherhood." C. "These behaviors indicate that your husband is concerned about the added cost of having a newborn. You and your husband need to sit down and set up a budget." D. These behaviors might indicate that your husband is depressed. You need to encourage him to see a mental health professional."
D
9. The nurse assists a patient who delivered vaginally 6 hours ago to the bathroom to void for the first time since delivery. The patient voids 65 mL of urine. The nurse's initial action is to: A. Document this as a normal finding. B. Encourage the patient to try to void again within the next 4-6 hours. C. Insert an indwelling Foley catheter. D. Palpate for bladder distention.
D
9. Which of the following assessment data of a 12 hours of age neonate needs additional evaluation? Select all that apply. A. Localized soft tissue edema of the scalp B. Transient cyanosis around the mouth C. A 10 cm flat bluish area on the buttock D. Jaundice that is limited to the face
D
1. Your patient, who gave birth to a 7-pound baby boy 24 hours ago, is complaining of uterine cramping (afterpains). This is her second baby and she is breastfeeding. Your assessment reveals a firm fundus at midline at 1 cm below the umbilicus. Select all of your initial nursing actions. A. Instruct the patient to bottle-feed for 36 hours or until the cramping has stopped. B. Place a warm blanket on her abdomen. C. Explain that these are normal for second-time mothers to experience. D. Offer the patient acetaminophen with codeine so she can continue to breastfeed.
b,c
4. Select the statements that are true regarding primary engorgement. A. Only women who are lactating will experience primary engorgement. B. It is caused by an increase in the vascular and lymphatic system of the breast. C. The breasts become large, firm, and warm to touch. D. It subsides within 24-36 hours.
b,c,d
