Maternity Questions- Spring 2022
A nurse is preparing to administer Vitamin K to a newborn. The nurse would administer the drug ________.
intramuscularly
A nurse is assessing a newborn with the parents. The nurse explains that which aspect of newborn behavior is an important indication of neurologic development and function? a) crying response b) voluntary movements c) orientation to surroundings d) reflex
reflex
The nurse is preparing to apply a thermistor probe to a newborn to monitor the newborn's temperature. At which location would the nurse apply the probe? a) lower back b) upper left arm c) right great toe d) right upper abdominal quadrant
right upper abdominal quadrant
The nurse is teaching a new mother about the changes in her newborn's gastrointestinal tract. The nurse determines that additional teaching is needed when the mother makes which statement? a)"The muscle opening that leads into the stomach is not mature." b) "He needs to get food orally to make vitamin K." c) "His stomach can hold approximately 10 ounces." d) "The newborn's gut is sterile at birth."
"His stomach can hold approximately 10 ounces."
New parents are getting ready to go home and have received information to help them learn how best to care for the new infant. Which statement indicates that they need additional teaching about how to soothe their newborn if he becomes upset? a) "We'll hold off on feeding him for a while because he might be too full." b) "We'll swaddle him snuggly to make him feel secure" c) "We'll lightly rub his back as we will talk to him softly" d) "We'll turn the mobile on that's hanging above his head in his crib"
"We'll hold off on feeding him for a while because he might be too full."
A nurse is making a home visit to a new mother with a 5-day-old newborn. The mother tells the nurse that the baby is fussy and she does not know how to calm her. Which suggestions would be most appropriate for the nurse to make? [SATA] 1) "Try shushing her loudly" 2) "Have her lie on your lap on her back" 3) "Try swaddling her nice & snuggly" 4) "Encourage her to suck" 5) "Gently tap her shoulders & back"
1) "Try shushing her loudly" 3) "Try swaddling her nice & snuggly" 4) "Encourage her to suck"
The ability of the nurse to identify irregular findings during a physical assessment aids in rapid diagnosis and treatment of possible complications. The nurse assesses a newborn and notes tachycardia. The nurse notifies the health care provider based on the understanding that further assessment is necessary for which condition? a) hypothermia b) drug withdrawal c) infection d) anemia
drug withdrawal
A nurse is conducting a class for expectant parents about newborns and the changes that they experience after birth. The nurse discusses the neonatal period, describing it as which time frame? a) first 36 days of life b) first 3 weeks of life c) first 2 months of life d) first 28 days of life
first 28 days of life
A new mother is concerned that the infant is not eating enough and will not have enough energy. The nurse explains that storage of which substance will provide energy for the first 24 hours after birth? a. brown fat b. protein c. carbohydrate d. glucose
glucose
One of the nurse's responsibilities is to educate new parents on the best method to prevent infections in the newborn environment. Which method would the nurse identify as best to control infection? a) handwashing b) keeping the infant isolated from others c) instructing visitors to wear face masks d) using antimicrobial soaps
handwashing
Which laboratory test results would the nurse consider as a normal finding in a newborn soon after birth? a) platelets: 600,000/uL b) red blood cells: 3,500,000/uL c) hemoglobin: 17.5 g/dl d) white blood cells: 5,000/mm3
hemoglobin: 17.5 g/dl
When the nurse is describing the events that occur in a newborn when he or she experiences a cold environment, which event would the nurse identify as occurring first? a) increased blood flow through brown fat b) increased cardiac output c) breakdown of triglycerides d) increased release of norepinephrine
increased release of norepinephrine
The nurse is explaining to new parents that a potential complication of a cesarean birth is transient tachypnea. The nurse explains that this is due to which occurrence? a) inadequate suctioning of the mouth & nose of the newborn b) lack of thoracic compressions during birth c) loss of blood volume due to hemorrhage d) prolonged unsuccessful vaginal birth
lack of thoracic compressions during birth
The nurse is aware that the infant's circulatory dynamics during transition can be greatly affected by which action? a) quickly clamping the cord as soon as possible b) giving the infant oxygen as needed c) delayed clamping of the umbilical cord by at least 5 minutes d) late clamping of the umbilical cord after 3 minutes
late clamping of the umbilical cord after 3 minutes
The nurse is preparing a teaching plan for new parents about why newborns experience heat loss. Which information about newborns would the nurse include? a) enhanced shivering ability b) thick skin with deep lying blood vessels c) limited voluntary muscle activity d) expanded stores of glucose & glycogen
limited voluntary muscle activity
The nurse is teaching new parents the best way to prevent hypothermia. Which mechanism would the nurse include when explaining about the newborn's primary method of heat production? a) thermoconduction b) nonshivering thermogenesis c) shivering thermogenesis d) thermoregulation
nonshivering thermogenesis
When the nurse is applying a skin temperature probe to a newborn who is lying on his side, which location would be most appropriate? a) over the liver b) over the opposite hip c) between the scapulae d) in the mediastinal area
over the liver
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. 1) changes in baseline 2) variability 3) rhythm 4) FHR baseline 5) types of decelerations
2) variability 5) types of decelerations
A nurse is assessing a newborn's temperature. Which reading would the nurse document as normal?
37.0° C (98.6° F)
A nurse is explaining to new parents how a newborn adapts to extrauterine life. When discussing the physiologic changes that occur, the nurse would explain that this transition usually occurs within the first: a) 8 to 12 hours of life b) 6 to 10 hours of life c) 2 to 4 hours of life d) 4 to 6 hours of life
6 to 10 hours of life
When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voidings per day is a good indicator of adequate fluids? a. 4 to 6 b. 8 to 10 c. 2 to 4 d. 6 to 8
6 to 8
A nurse is reviewing the FHR and notes it to be in the range of 100 to 106 bpm over the past 10 minutes. Which conditions might the nurse suspect as the cause? Select all that apply. 1) effect of maternal analgesia 2) maternal fever 3) fetal hypoxia 4) prematurity 5) prolonged umbilical cord compression
1) effect of maternal analgesia 3) fetal hypoxia 5) prolonged umbilical cord compression
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 c) 6.5 d) 5
6.5 Rationale: amniotic fluid is alkaline, so the membranes are probably ruptured if the pH ranges from 6.5 to 7.5
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) thrush c) vernix caseosa d) milia
Epstein pearls
While teaching a newborn nutrition class to a group of pregnant women, the nurse encourages breastfeeding because it is a major source of which immunoglobulin? a) IgA b) IgG c) IgM d) IgE
IgA
A nurse is aware that the newborn's neuromuscular maturity assessment is typically completed within 24 hours after birth. Which assessment would the nurse be least likely to complete to determine the newborn's degree of maturity? a) scarf sign b) Moro reflex c) popliteal angle d) square window
Moro reflex
A new dad appears very concerned that his newborn's head looks too big. The nurse assures him there is no need for concern, explaining that the head circumference should typically be: a) approximately 1/4 of the abdominal girth b) approximately 1/3 of the length c) approximately 1/2 of the abdominal girth d) approximately 1/4 of the length
approximately 1/4 of the length
Which finding would alert the nurse to suspect that a newborn is experiencing respiratory distress? a. acrocyanosis b. asymmetrical chest movement c. RR of 50 breaths/minute d. short periods of apnea (less than 15 seconds)
asymmetrical chest movement
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) 6.8 b) 7 c) 7.2 d) 7.2
c) 7.2 Rationale: umbilical cord blood acid-base analysis is considered the most reliable indication of fetal oxygenation and acid-base condition at birth. The normal mean pH value range is 7.2 to 7.3
During the assessment of a woman in labor, the nurse explains that certain landmarks are used to determine the progress of the birth. The nurse identifies which area as one of these landmarks? a) ischial tuberosity b) cervical os c) ischial spine d) pubic symphysis
c) ischial spine
A nurse is describing the many changes a newborn will go through during his or her first couple of weeks after birth. The nurse explains how the functions of the placenta are taken over by which organ? a. kidneys b. intestine c. liver d. cardiovascular system
liver
A nurse is assessing a newborn and observes the newborn bringing his hand up to his mouth. The nurse interprets this finding as which behavioral response? a) self-quieting ability b) orientation c) habituation d) motor maturity
motor maturity
A nurse is explaining to new parents about the numerous changes that occur shortly after birth to the newborn. When describing how the ductus arteriosus closes, the nurse explains that which factor is most important to assist in its closure?
oxygen
Circumcision is a very personal decision for parents, and the nurse's major responsibility is to inform the parents of the risks and benefits of the procedure. The nurse needs to recognize that this is mainly which type of decision? a) social decision b) family decision c) difficult decision d) legal decision
social decision
The mother has given birth to a premature infant at 30 weeks. To ensure the alveoli can function properly, the infant needs to be evaluated for: a) hematocrit b) blood flow c) oxygen d) surfactant
surfactant
A newborn develops physiologic jaundice, and the mother asks the nurse why this happened. Which response by the nurse would be most accurate? a) "There is some type of blood incompatibility between you and your baby that's causing the problem." b) "We really don't know why jaundice develops in some babies and not in others. We just know how to treat it." c) "Your baby must have a blocked duct near his liver that's preventing the bilirubin from being excreted." d) "Because his liver is a bit immature, the baby can't break down the bilirubin as fast as needed."
"Because his liver is a bit immature, the baby can't break down the bilirubin as fast as needed."
A woman is in the fourth stage of labor. During the first hour of this stage, the nurse would assess the woman's fundus at which frequency? a) 15 minutes b) 10 minutes c) 5 minutes d) 20 minutes
a) 15 minutes
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) antiretroviral b) benzodiazepine c) ataractic d) antibiotic
a) antiretroviral Rationale: women who are HIV-positive are given a combination of antiretroviral drugs
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) baseline FHR b) fetal bradycardia c) short-term variability d) baseline variability
a) baseline FHR
The health care provider is evaluating a high-risk woman for a continuous internal monitoring. Which criterion would need to be met for this type of monitoring? a) the presenting fetal part not visible b) rupture of membranes c) cervical dilation of 1 cm d) insertion by any staff
b) rupture of membranes
When assessing fetal heart rate patterns, which finding would alert the nurse to a possible problem? a) early decelerations b) variable decels c) prolonged decels d) accelerations
c) prolonged decels Rationale: prolonged decels are associated with prolonged cord compression, placental abruption, cord prolapse, supine maternal position, maternal seizures, regional anesthesia, or uterine rupture
A nurse is reviewing the history and physical examination findings of a postpartum woman and her female neonate. The neonate was healthy at birth but is now exhibiting signs of jaundice. Which factor(s) would the nurse assess to help identify the neonate suffers from jaundice? Select all that apply. 1) maternal gestational diabetes 2) Eastern European ethnicity 3) Maternal TORCH infection 4) use of oxytocin during labor 5) female gender of neonate
1) maternal gestational diabetes 3) Maternal TORCH infection 4) use of oxytocin during labor
A nurse practitioner is conducting an in-service education program for a group of nurses working in the labor and birth unit. The program is focusing on interpreting FHR patterns. The nurse practitioner determines that the teaching was successful when the group identifies which patterns as indicating abnormal fetal acid-base status? Select all that apply. 1) recurrent late decelerations 2) fetal bradycardia 3) fetal tachycardia 4) sinusoidal pattern 5) minimal variability
1) recurrent late decelerations 2) fetal bradycardia 4) sinusoidal pattern
A nurse is teaching new parents about keeping follow-up appointments and calling their health care provider if they notice signs of illness in their newborn. The nurse determines that the teaching was successful when the parents identify which signs as needing to be reported? Select all that apply. 1) refuse feeding 2) abdominal distention 3) approximately 8 wet diapers a day 4) general fussiness 5) temperature of 38.3° C (101° F) or higher
1) refuse feeding 2) abdominal distention 5) temperature of 38.3° C (101° F) or higher
The nurse encourages a woman in labor to ambulate based on the understanding that ambulating does what? Select all that apply. 1) encourages rotation of the fetus 2) enhances the effectiveness of contractions 3) helps the fetus line up with the angle of the pelvis 4) enlists the aid of gravity to move the fetus 5) widens one side of the pelvis 6) increases the urge to push during the second stage
1, 2, 3, 4, 6
A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as: a) effleurage b) therapeutic touch c) patterned breathing d) acupressure
a) effleurage Rationale: effleurage is a light, stroking, superficial touch of the abdomen in rhythm with breathing during contractions
A woman in labor who is receiving an opioid for pain relief is to receive promethazine. The nurse determines that this drug is effective when the woman demonstrates which finding? a) less anxiety b) decreased sedation c) increased feelings of control d) increased cervical dilation
a) less anxiety
The client wants to avoid an episiotomy. What other technique would the nurse suggest the client try? a) give birth to the infant while lying on her back b) massage the perineum daily during the last trimester c) apply warm compresses to the perineum d) practice Kegel exercises during pregnancy
c) apply warm compresses to the perineum Rationale: apply warm compresses & continual massage with oil have been successful in stretching the perineal area to prevent an episiotomy