Obstetrics/Maternity Practice Exam
A primigravida at 33-weeks gestation is admitted after being involved in a motor vehicle collision (MVC). The client has no complaints of abdominal pain and no evidence of vaginal bleeding. Which action should the practical nurse (PN) anticipate implementing for the client?
Obtain a biophysical profile.
Which information should the practical nurse (PN) provide the parents about the purpose of instilling erythromycin (Ilotycin) ophthalmic ointment into the newborn's eyes?
Prophylactic treatment for gonorrheal and chlamydia infection.
Which client should the practical nurse (PN) closely monitor for severe afterpains?
A multigravida who is breastfeeding.
A primiparous client asks the practical nurse (PN) how much her newborn baby boy should sleep every day. What information should the PN provide?
A newborn sleeps most of the day and gradually will have increasing periods of wakefulness.
A multiparous client's membranes rupture after 8 hours of labor. Which action should the practical nurse implement at this time?
Assess the fetal heart rate (FHR) and pattern.
A mother who is preparing for discharge begins asking the practical nurse (PN) questions about bottle feeding her infant. What information should the PN reinforce?
Burp the newborn periodically during the feeding.
A primigravida client asks the practical nurse (PN), "How will I know that I will be going into labor soon?" Which sign should the PN provide that is a common sign?
Burst of energy.
The practical nurse (PN) palpates fundal height at the umbilicus of the multiparous client who has just given birth to an 8-pound boy when dark red blood comes from the client's vagina. What action is most important for the PN to implement?
Continue to massage the fundus until firm.
The practical nurse (PN) is discussing aspects of newborn hygiene with the new parents as they prepare for discharge. Which information should the PN provide?
Create a draft-free environment when bathing the baby.
A primigravida client who is at 39-weeks gestation arrives at the clinic and tells the practical nurse (PN) she is having contractions every 5 minutes. The healthcare provider determines she is dilated 3 cm and in early labor. What action should the practical nurse (PN) implement when the client groans with each contraction?
Demonstrate simple relaxation measures.
Which physiological cause(s) for constipation during pregnancy should the practical nurse (PN) explain to a client in the first trimester? (Select all that apply.)
Displacement of the colon. Decrease in peristalsis.
A 14-week gestational client, who weighed 125 pounds before pregnancy, comes into the health clinic for a prenatal appointment. The client's weight today is 129 pounds. What action should the practical nurse (PN) implement?
Document the findings in the medical record.
The practical nurse (PN) quickly moves the crib of a male newborn and notices that his legs flew, arms fan out, and then return toward his midline. What action should the PN implement?
Document the newborn demonstrates a Moro reflex.
A 3-day old newborn who weighed 7 pounds, 8 ounces at birth is breast feeding and now weighs 6 pound and 15 ounces. Which action should the practical nurse take?
Document the weight loss.
Which medication is prescribed for the prevention of ophthalmia neonatorum?
Erythromycin (Ilotycin)
The practical nurse (PN) is assessing a client 2 hours after a vaginal delivery of a 7-pound 3-ounce newborn and determines the client's bladder is distended. Which additional finding should the PN report to the charge nurse?
Excessive bleeding on the perineal pad
What is the most important action by the practical nurse (PN) in preventing neonatal infection?
Hand washing.
Which strategy should the practical nurse (PN) implement to prevent the puerperal infection for a client during the first postpartum week?
Implement strict medical and aseptic technique.
The mother asks the practical nurse (PN) what her infant may need if the phenylketonuria (PKU) test is positive. What type of treatment should the PN tell the mother will be required?
Lifelong dietary management.
A client who took iron supplements during pregnancy delivers an infant by cesarean section. On the second postpartum day, the client reports having a constipated stool that is greenish-black in color. Which action should the practical nurse (PN) implement?
Record color and consistency of the stool.
Which client is a candidate for the administration of human immune globulin (RhoGame) after delivery?
The Rh-negative mother who delivers a Rh-positive baby.
The practical nurse (PN) places a newborn who is 4 hours old with an axillary temperature of 97.2oF under the radiant heat warmer. Which rationale supports the PN's action?
The newborn's thin layer of subcutaneous fat provides poor insulation.
After repeating the vital signs for a newborn who is 4 hours old, the practical nurse (PN) obtains an axillary temperature of 97.2oF and places the newborn under a radiant heat warmer. Which additional finding should the PN observe in the newborn?
Tremors of the hands during crying.
A client who is 5 weeks pregnant calls the clinic to report that her home pregnancy test is positive. She asks what she should be concerned about during the weeks before her first visit. Which signs and symptoms should the practical nurse (PN) tell the client to report immediately to the healthcare provide? (Select all that apply.)
Vaginal bleeding. Membrane rupture. Severe headaches.
Which finding of a 2-week-old infant should the practical nurse (PN) report to the healthcare provider?
Yellowish tinge around the eyes.
An infant who weights 4550 grams is delivers using forceps-assisted vaginal delivery. What action is most important for the practical nurse (PN) to implement?
Monitor for signs of hypoglycemia.
A father expresses concern that his 3-day-old infant looks "yellow." Which information should the practical nurse (PN) provide?
Physiologic jaundice occurs from a normal reduction in red blood cells.
A young adult female comes to the health clinic to confirm a positive home pregnancy test. After determining the client's last menstrual period (LMP) as August 5, what expected date of birth (EDB) should the practical nurse (PN) calculate?
May 12
The practical nurse (PN) is reviewing the informational packets with a client who is at risk for preeclampsia. Which information is most important for the PN reinforce with the client?
Notify the clinic if any vision changes are experienced.
Which interventions should the practical nurse (PN) provide a neonate during hospitalization?
Offer the neonate a pacifier between feedings.
