VATI Maternal Newborn Health Promotion and Maintenance Quiz

A nurse is teaching a client the correct use a diaphragm as a method of contraception. Which of the following statements is correct?

a. Douche promptly after removing the diaphragm b. Do not use any cream or jelly with the diaphragm c. Insert diaphragm at least 8 hours prior to sexual intercourse d. Leave diaphragm in place for at least 6 hours post coitus CorrectThe diaphragm should be left in place for at least 6 hours post intercourse.

A nurse is educating a parent of a newborn about safety measures. Which of the following statements made by the client would indicate a need for further teaching?

a. "Once my baby begins to roll over it is okay to use a small pillow in the crib." CorrectCORRECT. It is never safe to have a pillow or a soft surface in the crib because of the danger of suffocation. b. "My baby's car seat should be in the back seat facing backwards." c. "I should always support my baby's head when I pick him up." d. "I should never leave my baby unattended with pets or other children."

A client reports awaking from sleep by contractions that are occurring every five minutes and lasting 30-40 seconds. Which of the following questions should the nurse ask to assess for true labor versus false labor?

a. "When did your contractions begin?" b. "Have you noticed any bloody show or fluid coming from your vagina?" CorrectCORRECT. Vaginal discharge of blood or fluid may indicate cervical dilation, and potentially rupture of membranes. False labor is characterized by painless, irregular, and intermittent contractions that decrease in frequency, duration, and intensity with walking or position changes. Contractions are felt in the lower back or above the umbilicus and often stop with comfort measures (like oral hydration). There is usually no vaginal discharge with false labor. c. "What happens to your contractions when you move about?" d. "Have you felt fetal movement over the last 24 hours?" Feedback The correct answer is: "Have you noticed any bloody show or fluid coming from your vagina?"

A nurse is providing a tour of the labor and delivery unit to expectant parents. Which statement made by the mother indicates a need for further education?

a. "When the baby is born, my thumb print will be taken along with the baby's footprint." b. "We will need to remove the baby's ankle identification band during diaper changes." CorrectCORRECT. This statement indicates a need for further education. The mother, newborn, and significant other are identified by plastic identification bands with permanent locks that must be cut to be removed. Per most hospitals' policies, newborns will be provided with both ankle and armband identification. These identification bands should not be removed for any reason until the newborn is discharged from the hospital. c. "We will request to see picture identification badges for all facility staff who care for our baby." d. "When the baby is returned to us from the nursery, we should check the baby's identification band."

A nurse is assessing a client during her first prenatal visit. The client reports that her last normal period began on April 22. Use Nagele's rule to calculate this client's expected date of birth (EDB). Use the MMDD format to enter exactly four numerals, with no spaces or punctuation between the numbers.

a. 0129 CorrectTo use Nagele's rule subtract 3 months and add 7 days to the first day of the client's last normal menstrual period. b. 0122 c. 0729 d. 0722

A nurse is caring for a client who is reporting lower abdominal pain. The client has a positive pregnancy test and is estimated to be 10 weeks pregnant. Which of the following best support a possible ectopic pregnancy?

a. Absence of fetal heart tones and fetal movement. b. Steady bleeding with lower abdominal pain. c. Unilateral stabbing abdominal lower abdominal pain. CorrectAs the fetus develops, it eventually exceeds the diameter of the fallopian tube and ruptures the tube, creating an internal hemorrhage. There may or may not be blood from the vagina. The symptoms may include unilateral stabbing pain and tenderness in the lower abdominal quadrant, and commonly referred shoulder pain from blood irritation of the diaphragm or phrenic nerve. There may be nausea and vomiting, and symptoms of shock. d. Edematous face, hands, and ankles.

A nurse is caring for a client who is 11 weeks pregnant. Which of the following is an appropriate psychological task for the client?

a. Accept the fact that she is pregnant CorrectThe developmental task during the first trimester is to accept the reality of the pregnancy. Accepting the reality of being pregnant allows the client to see a provider and get prenatal care. b. View morning sickness as tolerable c. Verbalize concerns about the health care facility d. Begin to think about names for the baby

A postpartum client is reporting heavy vaginal blood flow. The nurse correctly understands which of the following assessments has the highest priority?

a. Assess episiotomy for bleeding b. Assessing vital signs both lying and sitting c. Assess the fundus for tone and position CorrectThe most common cause of early post-partum bleeding is uterine atony. Even before assessing vital signs, the nurse should determine if the uterus is firm and midline in the abdomen. If it is not, fundal massage is urgently indicated, and if it is not midline, voiding is indicated, as a full bladder will displace the uterus and contribute to uterine atony d. Assess the client's last voiding

A nurse is assessing a client in the immediate postpartum period. The fundus is boggy and deviated to the left of the umbilicus. Which of the following is the most appropriate intervention?

a. Assess lochia b. Assist client to void CorrectA displaced and boggy uterus most likely indicate a full bladder and assisting the client to void would have the highest priority. c. Reassess client in 30 minutes d. Begin an oxytocin infusion

Thirty minutes following initiation of oxytocin infusion a client's contractions are lasting 95 seconds and coming one minute apart. Late decelerations are observed on the fetal monitor. Which of the following is the correct priority nursing intervention?

a. Assess vital signs and apply O2 via facemask. b. Stop pitocin infusion and assess contractions and fetal heart rate. CorrectIf there are any signs of fetal or maternal distress the priority intervention would be to stop the Pitocin infusion. Pitocin should be discontinued with any of the following: prolonged or excessively strong contractions; signs of any fetal hypoxia and or fetal distress; signs of uterine or placenta abruptio; evidence of an antidiuretic affect; and hypertension c. Stop the pitocin infusion and administer terbutaline 0.25 mg. d. Notify provider and prepare for an emergency cesarean birth

A nurse is collecting data on newborn. Which of the following is an expected finding?

a. Babinski reflex present CorrectThe Babinski reflex is present for the first year of life. The reflex is elicited by stroking the outer edge of the sole of an infant's foot up toward the toes. The infant's toes fan upward and out. b. Decorticate reflex c. Pulse rate 70 to 80/min d. Respirations 21 to 24/min

A nurse is caring for a client diagnosed with pre-eclampsia. The client is receiving magnesium sulfate IV. Which of the following assessment findings is the first sign of magnesium toxicity?

a. Decreased deep tendon reflexes CorrectMagnesium Sulfate reduces striated muscle contractions due to a depressant effect on the CNS. It blocks neuromuscular transmission. Toxic signs of Magnesium sulfate include diminished tendon reflexes, hypotension and prolonged PR intervals. Later signs include absence of reflexes. b. Visual blurring c. Respiratory depression d. Nausea and vomiting

A client at 35 weeks gestation is admitted to the birthing unit with preterm labor. Which of the following assessments would require the nurse to immediately notify the provider?

a. FHR 120 b/min with late decelerations, contractions- every 1-2 minutes CorrectLate decelerations are signs of placental insufficiency which can cause fetal hypoxemia. The nurse should notify PCP immediately. b. FHR 140 b/min: good variability, contractions every 3-4 minutes c. B/P 110/60mmHg, trace protein, contractions every 3-4 minutes d. B/P 138/80mmHg, contractions every 3-4 minutes

A breastfeeding mother develops engorgement on her third postpartum day. Which of the following statements by the client indicates a need for further teaching?

a. I will feed my baby every 2 hours. b. I will apply warm packs to each breast prior to feeding. c. I will use a breast pump if my breasts do not soften. d. I will offer my baby a bottle following each feeding. CorrectBottle feeding while breastfeeding could lead to nipple confusion and interfere with successful breastfeeding. This mother needs further teaching.

The client asks the nurse to explain the difference between true and false labor. Which of the following is an example of true labor?

a. In true labor contractions are felt in the abdomen above the umbilicus b. In true labor the presenting part is engaged c. In true labor walking will cause contractions to slow down d. In true labor the cervix will dilate and efface CorrectProgressive changes in dilation and effacement are the ultimate signs of true labor.

A nurse is positioning a client on the operating room table in preparation for a cesarean birth. Which of the following is the correct position?

a. Left lateral position with a foam wedge between the legs. b. Lithotomy position with a foam wedge behind the shoulders. c. Supine position with foam wedge positioned under one hip. CorrectThe supine position is appropriate for abdominal surgery (cesarean birth), and a wedge under one hip laterally tilts the client and reduces uterine weight on the vena cava and descending aorta. This helps maintain optimal perfusion of oxygenated blood to the fetus during the procedure. d. Modified Trendelenburg position with a foam wedge under the legs. Feedback The correct answer is: Supine position with foam wedge positioned under one hip.

A nurse is caring for a newborn diagnosed with a neonatal infection. Which of the following risk factors is most important to the care of this client?

a. Maternal history of cytomegalovirus. CorrectCytomegalovirus can be transferred via the placenta directly onto the fetal circulatory system and transmitted directly from infected amniotic fluid. b. A decreased number of functional alveoli. c. Increased size of neonate's heart. d. Documented birth trauma.

A nurse is caring for a neonate who exhibits abstinence syndrome and demonstrates clinical manifestations of the condition. Which assessment finding is associate with this condition?

a. Negative Startle reflex b. Diminished tendon reflexes c. Hypothermia CorrectCorrect - Thermal regulation issues are noted with this condition, such as hypothermia or hyperthermia. d. Increased drowiness

Thirty minutes after admission to the nursery an infant appeared jittery and exhibits a weak, high pitched cry. Which of the following would be the nurse's priority action?

a. Perform a heel stick to check serum glucose. CorrectThe priority action is to confirm the serum glucose before proceeding. A blood glucose level less than 40-45 mg/dL by heel stick is an urgent situation requiring therapy with glucose - generally orally. b. Feed the infant oral feeding. c. Obtain an order for a drug screening blood test. d. Hold and comfort the infant to stop the crying.

A client in the early postpartum period is talkative and enjoys recounting the details of her labor and birth. The nurse recognizes that the behaviors must likely indicate which of the following?

a. Postpartum role transition. b. Positive mother-infant bonding. c. The taking-hold phase of maternal psychosocial adaptation. d. The taking-in phase of maternal postpartum adjustment. CorrectThe taking-in phase begins immediately following birth and lasts a few hours to a couple of days. It is characterized by the mother being excited and talkative, reliving her birthing experience, and focusing on her own needs and the overall health of her newborn.

A client with gestational diabetes gave birth to a 9 pound neonate 12 hours ago. The neonate is presenting with a high pitched cry and jitteriness. Which of the following is the nurse's priority intervention?

a. Provide oxygen via oxyhood b. Offer the neonate breast milk or formula CorrectA neonate of a diabetic mother is at risk for hypoglycemia. High glucose loads are present in the infant in utero. When maternal blood glucose via the placenta abruptly stops at birth, the neonate experiences a rapid drop in blood sugar. Signs of hypoglycemia in the neonate are jitteriness, lethargy, poor muscle tone, apnea, high pitched cry, and vomiting. Nursing interventions should focus on monitoring for sign of complications associated with hypoglycemia. c. Place the neonate under a radiant warmer d. Administer subcutaneous insulin

A nurse is caring for a client who has been prescribed magnesium sulfate for pregnancy induced hypertension. On admission the client's B/P is 160/90 mm Hg and urine output is 25mL/hr. Following initiation of magnesium sulfate, which of the following symptoms should be reported to the provider?

a. The client is voiding 40 mL/hr b. The client reports feeling flushed and warm c. The client is drowsy and difficult to rouse CorrectIf the client is sleepy and difficult to rouse she may be experiencing symptoms of magnesium sulfate toxicity. This should be immediately reported to the provider. d. The client's blood pressure is 130/70 mm Hg

A nurse is performing a fundal assessment on the client's second postpartum day. Which of the following should the nurse expect if the client is experiencing normal involution?

a. The fundus will be two centimeters below the umbilicus. b. The fundus will be at the level of the umbilicus. c. The fundus will be one centimeter above the umbilicus. d. The fundus will be one centimeter below the umbilicus. Feedback The correct answer is: The fundus will be one centimeter below the umbilicus.

The client who is scheduled for a nonstress test (NST) asks the nurse to explain the purpose of the test. Which of the following is the correct response?

a. The purpose of the NST is to determine fetal breathing. b. The purpose of the NST is to assess the fetal CNS. CorrectThis is the primary purpose of a NST. The test monitors the response of the FHR to fetal movement. This allows the nurse to assess the FHR in relationship to the fetal movement c. The purpose of the NST is to determine fetal lie. d. The purpose of the NST helps to determine gestational age. Feedback The correct answer is: The purpose of the NST is to assess the fetal CNS.

A client in the early postpartum period is talkative and enjoys recounting the details of her labor and birth. The nurse recognizes that these behaviors likely indicate which of the following?

a. The taking-in phase of maternal postpartum adjustment. CorrectThe taking-in phase begins immediately following birth and lasts a few hours to a couple of days. It is characterized by the mother being excited and talkative, reliving her birthing experience, and focusing on her own needs and the overall health of her newborn. b. The taking-hold phase of maternal psychosocial adaptation. c. Positive mother-infant bonding. d. Postpartum role transition.