RN_Maternal_Newborn_A_practice_question.docx

RN Maternal Newborn A Practice questions A nurse is planning discharge for a client who is 3 days postpartum.Which of the following non pharmacological interventions should the nurse include in the plan of care for lactation suppression? A) Place warm, moist packs on the breast. B) Apply cabbage leaves to the breast. C) Wear a loose- fitting bra. D) Put green tea bags on the breasts. - B) Apply cabbage leaves to the breasts. A nurse is performing a physical assessment of a newborn. Which of the following clinical findings should the nurse expect? ( Select all that apply). Heart Rate 154/min Axillary temperature 96.8 F Respiratory rate 58/min Length 43 cm (16.9in) Weight 5lb 12 oz - Heart rate Respiratory Weight A nurse is caring for a client and her partner who have experienced a fetal death. Which of the following actions should the nurse take? A) Take photos of the newborn to give to the parents. B) Tell the parents that they can consider organ donations. C) Encourage the parents to avoid allowing older children to visit them in the hospital. D) Explain to the parents the need to name the newborn. - Take photos of the newborn to give to the parents. A nurse is caring for a client who is 36 weeks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound? A) to estimate fetal weight B) to locate a pocket of fluid C) to determine multiparity D) to pre-screen for fetal anomalies - B) to locate a pocket of fluid A nurse in the antepartum clinic is assessing a client's adaptation to pregnancy. The client states that she is, ''happy one min and crying the next.'' The nurse should interpret the client's statement as an indication of which of the following? A) Emotional lability B) Focusing phase C) Cognitive restructuring D) Couvade syndrome - A) Emotional lability A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching? A) Obtain an informed consent prior to obtaining the specimen B) Collect at least milliliter of the urine for the test C) Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen. D) Premature newborns may have false negative tests due to immature development of liver enzymes. - C) Ensure that the newborn has been receiving feedings for 24 hrs prior to obtaining the specimen. A nurse is assessing a newborn 12 hr after birth. Which of the following manifestations should the nurse report to the provider? A) Acrocyanosis B) Transient strabismus C) Jaundice D) Caput succedaneum - c) jaundice A nurse is assessing the newborn of a client who took a selective serotonin reuptake inhibitor ( SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI? A) Large for gestational age B) Hyperglycemia C) Bradypnea D) Vomiting - D) Vomiting A nurse is assessing a newborn following a circumcision. Which of the following should the nurse identify as an indication that the newborn is experiencing pain ? A) Decreased heart rate B) Chin quivering C) Pinpoint pupils D) Slowed respirations - B) Chin quivering A nurse is demonstrating to a client how to bathe her newborn. In which order should the nurse perform the following actions? ( Use all the steps and list them in order) A) Clean the newborn's diaper area B) Wash the newborn's neck by lifting the newborn's chin. C) Wipe the newborn's eyes from the inner canthus outward. D) Cleanse the skin around the newborn's umbilical cord stump. E) Wash the newborn's legs and feet. - C,B,D,E,A A nurse is assessing a client who is at 30 wks gestation during a routine prenatal visit. Which of the following findings should the nurse report to the provider? A) swelling of the face B) varicose veins in the calves C) nonpitting 1+ ankle edema D) Hyperpigmentation - A) swelling of the face A nurse is caring for a client who is in active labor and has had no cervical change in the last 4 hr. Which of the following statements should the nurse make? A) Let me help you into a comfortable pushing position so you can begin bearing down. B) I am going to call the doctor to get a prescription for medication to ripen your cervix. C) I will give you some IV pain medicine to strengthen your contractions. D) Your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions. - D) Your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions. A nurse in a prenatal clinic who reports that her menstrual period is 2 wks late. The client appears anxious and asks the nurse if she is pregnant. Which of the following responses should the nurse make? A) You can miss your period for several other reasons, describe your typical menstrual cycle. B) If you have been sexually active and havent used protection, it is likely that you are pregnant. C) Lets check to see if you have any other signs of pregnancy, have you noticed any abdominal enlargement yet? D) Because you have missed your period, you should try taking a home pregnancy test before you start worrying. - A) You can miss your period for several other reasons, describe your typical menstrual cycle. A nurse is caring for a client who is anemic at 32 wks of gestation and is in preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the following outcomes should the nurse expect? A) decreased uterine contractions B) an increase in the clients hemoglobin levels C) a reduction in respiratory distress in the newborn D) increased production of antibodies in the newborn - C) a reduction in respiratory distress in the newborn A nurse is caring for a client who is pregnant and is at the end of her first trimester. The nurse should place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones (FHT) ? A) just above the umbilicus B) just above the symphysis pubis C) the right lower quadrant D) the left lower quadrant - B) just above the symphysis A nurse is caring for a postpartum client who is receiving heparin via a continuous IV infusion for thrombophlebitis in her left calf. Which of the following actions should the nurse take? A) administer aspirin for pain B) maintain the client on bed rest C) massage the affected leg every 12hr D) apply cold compresses to the affected calf - B) maintain the client on bed rest A nurse is planning care for a client who is to undergo a nonstress test. Which of the following actions should the nurse include in the plan of care? A) maintain the client NPO throughout the procedure B) place client in a supine position C) instruct the client to massage the abdomen to stimulate fetal movement D) Instruct the client to press the provided button each time fetal movement is detected - D) Instruct the client to press the provided button each time fetal movement is detected A nurse is providing discharge teaching to a client who is postpartum and was taking insulin for gestational diabetes mellitus. Which of the following instructions should the nurse include in the teaching? A) you should get a 2 hour oral gluscose tolerance test in 6-12 wks B) you should avoid using low dose oral contraceptives for birth control C) you will need to monitor your blood glucose levels daily at home for 2-3 wks D) you will need to take a lower dose of insulin than you took during your pregnancy - A) you should get a 2 hour oral glucose tolerance test in 6-12 wks A nurse in a prenatal clinic is assessing a group of clients. Which of the following clients should the nurse request the provider see first? A) A client who is at 11 wks of gestation and reports abdominal cramping B) A client who is at 15 weeks of gestation and reports tingling and numbness in her right hand C) A client who is at 20 wks of gestation and reports constipation for the past 4 days D) A client who is at 8 wks of gestation and reports having three bloody noses in the past week - A) A client who is at 11 wks of gestation and reports abdominal cramping A nurse is teaching a client who is at 10 wks gestation about nutrition during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? A) I should increase my protein to 60 grams daily B) I should drink 2 L of water each day C) I should increase my overall daily caloric intake by 300 calories D) I should take 600 micrograms of folic acid each day - D) I should take 600 micrograms of folic acid each day A nurse is teaching a client who is pregnant about managing nausea and vomiting. Which of the following instructions should the nurse include in the teaching? A) Brush your teeth immediately after eating B) Eat foods served at a warm temp C) Drink a glass of water with each meal D) Eat high carb foods - D) eat high carb foods A nurse is reviewing the lab report of a client who is 24 hr postpartum following a vaginal delivery. Which of the following lab results should the nurse identify as an indication of a postpartum infection? a) Platelets 300,000/mmm^3 b) WBC 9,000/mm^3 c) Erythrocyte sedimentation rate (ESR) 26mm/hr d) C-reactive protein 0.8mg/dl - c) Erythrocyte sedimentation rate (ESR) 26mm/hr A nurse is caring for a client who is at 35 wks of gestation and is undergoing a nonstress test that reveals a variable deceleration in the FHR. Which of the following actions should the nurse take? A) give the client orange juice B) Elevate the clients legs C) Have the client change position D) Establish IV access - C) Have the client change position A client who is at 34 weeks of gestation asks the nurse how she will know when she is in labor and should go to the hospital. Which of the following responses should the nurse make? a) you will feel the contractions primarily in your upper abdomen b) you will feel extremely fatigued when your labor starts c) your breasts will begin to excrete colostrum d) you will notice blood-tinged discharge from your vagina - d) you will notice blood-tinged discharge from your vagina A nurse is planning care for a client who is in labor and is to have an amniotomy. Which of the following assessments should the nurse identify as the priority? A) O2 saturation b) temp c) bp d) urinary output - b) temp A nurse is reviewing the medical record of a client who is postpartum and has preeclampsia. Which of the following lab results should the nurse report to the provider? A) Hct 39% b) serum albumin 4.5 g/dl c) WBC 9,000/mm^3 d) Platelets 50,000/mm^3 - d) Platelets 50,000/mm^3 A nurse on the postpartum unit is caring for a client following a cesarean birth.Which of the following assessments is the nurses priority? a) parent child attachement b) amount of lochia C) patency of the IV catheter D) quality and quantity of urine output - b) amount of lochia A nurse is providing teaching about comfort measures to a client who is breastfeeding and is experiencing engorgement. Which of the following nonpharm measures should the nurse include in the teaching? A) you may use a breast binder to relieve discomfort B) you should use cold compresses after each feeding C) you should apply a few drops of colostrum to the nipple following the feeding D) you may place breast shells inside your bra - B) you should use cold compresses after each feeding A nurse is caring for a prenatal client who has parvovirus B19 ( fifth disease). Which of the following actions should the nurse take? a) administer antiviral medication b) schedule an ultrasound examination C) administer haemophilus influenzae type b vaccine d) schedule an indirect coombs' test - b) schedule an ultrasound examination A nurse is performing a routine assessment on a client who is 18 wks of gestation, which of the following findings should the nurse expect? a) deep tendon reflexes 4+ b) fundal height 14 cm c) urine protein 2+ d) FHR 152/ min - d) FHR 152/min A nurse is teaching a client who is at 35wks gestation about clinical manifestations of potential pregnancy complications to report to the provider.Which of the following manifestations should the nurse include? a) shortness of breath when climbing stairs b) swelling of feet and ankles at the end of the day C) headache that is unrelieved by analgesia D) braxton hicks contractions - c) headache that is unrelieved by analgesia A nurse is observing a new mother caring for her crying newborn who is bottle feeding. Which of the following actions by the mother should the nurse recognize as a positive parenting behavior? a) lays the newborn across her lap and gently sways b) places the newborn in the crib in a prone position c) offers the newborn a pacifier dipped in formula d) prepares a bottle of formula mixed with rice cereal - a) lays the newborn across her lap and gently sways A nurse is calculating a clients expected DOB using Naegele's rule. The client tells the nurse her last menstrual cycle started November 27th. Which of the following dates is the clients expected DOB? A) Sept 3rd b) Sept 20th c) august 3rd D) august 20th - A) sept 3rd A nurse is reviewing the medical record of a client who is one day postpartum. The client had a vaginal birth with a fourth degree perineal laceration. The nurse should contact the provider regarding which of the following prescriptions? A) docusate sodium 100 mg capsule po by mouth 3x daily B) sitz bath 2-3 x a day prn for pain C) bisacodyl rectal suppository daily prn for constipation d) ibuprofen 600 mg by mouth every 6 hr prn for pain - C) bisacodyl rectal suppository daily prn for constipation A nurse is preparing to administer hep B immune globulin to a newborn. The prescription states, administer 5 mcg IM once today. Available is 5 mL vial with 10 mcg/mL. How many mL should the nurse administer? - 0.5 mL A nurse is caring for a client following an amniocentesis at 18 weeks of gestation. Which of the following findings should the nurse report to the provider as a potential complication? a) increased fetal mvmnt b) leakage of fluid from the vagina c) upper abdominal discomfort d) urinary frequency - B) leakage of fluid from the vagina A nurse is an antepartal clinic providing care for a client who is at 26 wks of gestation. Which of the following findings should the nurse report to the provider? a) 1-hr glucose tolerance test B) hematocrit C) fundal height measurement d) fetal heart rate - c) fundal height measurement A nurse is teaching a mother about steps the nurse will take to promote the security and safety of the newborn. Which of the following statements should the nurse make? A) we will prevent unidentified visitors from entering the unit b) we will document the relationship of visitors in your medical record C) your baby will stay in the nursery while you are asleep D) staff members who take care of your baby will be wearing a photo identification badge - d) staff members will wear a photo id badge A nurse is caring for a full term newborn immediately following birth? Which of the following actions should the nurse take first? A) assign apgar scores to the newborn b) weigh the newborn C) place id bracelets on the newborn d) dry the newborn - d) dry the newborn A nurse is teaching a client who is in preterm labor about terbutaline. Which of the following statements by the client indicates an understanding of the teaching? A) I will get injections of the medication once daily until my labor stops b) my blood sugar may be low while I'm on this medication c) I will have blood tests because my potassium might decrease d) my bp may increase while I'm on this medication - C) I will have blood tests because my potassium might decrease A nurse is caring for a client who is at 38 wks of gestation, Which of the following actions should the nurse take prior to applying an external transducer for fetal monitoring? A) determine progression of dilation and effacement b) perform leopold maneuvers c) complete a sterile specimen exam d) prep a Nitrazine paper test - B) perform leopold maneuvers A nurse an an antepartum unit is caring for four clients. Which of the following clients should the nurse identify as the priority? A) A client who has gestational diabetes and a fasting blood glucose level of 120 mg/dl B) A client who is at 34 wks gestation and reports epigastric pain C) a client who is at 28 wks gestation and has a Hgb of 10.4 g/dl D) A client who is at 39 wks of gestation and reports urinary frequency and dysuria - B) A client who is at 34 wks gestation and reports epigastric pain A nurse on a postpartum unit is caring for a client who is experiencing hypovolemic shock. After notifying the provider, which of the following actions should the nurse take next? a) massage the clients fundus B) insert an indwelling urinary catheter C) administer oxygen at 10 L/ min D) Elevate the clients right hip - A) massage the clients fundus A nurse is teaching a client who is at 8 wks gestation about exercise. Which of the following instructions should the nurse include in the teaching? A) you should increase weight bearing exercises as your pregnancy progresses B) you should lie on your back to rest for 5 mins after exercising C) you should take your pulse every 20 mins while your are exercising D) you should exercise for 30 mins every day - D) you should exercise for 30 mins every day A nurse is providing teaching about family planning to a client who has a new prescription for a diaphragm. Which of the following statements should the nurse include in the teaching? A) you should replace the diaphragm every 5 years B) you should leave the diaphragm in place for at least 6 hrs after intercourse C) you should use an oil based lubricant when inserting the diaphragm D) you should use the diaphragm when your bladder is full - B) you should leave the diaphragm in place for at least 6 hrs after intercourse A nurse is caring for a client who becomes unresponsive upon delivery of the placenta. Which of the following actions should the nurse take first? a) Determine resp function B) increase the IV fluid rate C) access emergency medications from cart D) collect a maternal blood sample for coagulopathy studies - A) determine resp function A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? Select all that apply. A) flaccid uterus B) Cervical laceration C) excess vaginal bleeding D) increased afterbirth cramping E) increased maternal temp - A, C, A nurse is caring for a client who is 26 wks of gestation and has epilepsy. She enters the room and observes the client is having a seizure. After turning the clients head to one side , which action should the nurse take? A) Monitor the FHR B) assess uterine activity C) administer oxygen via a nonrebreather mask D) start a bolus of IV fluids - C) administer oxygen via nonrebreather mask A nurse is assessing a client who is in labor and notes early decelerations on the fetal monito. Which of the following findings should the nurse identify as a possible cause of the early decelerations? A) prolapsed umbilical cord B) placenta previa C) fetal head compression D) maternal hypotension - C) fetal head compression A nurse is assessing a newborn who was born at 26 wks of gestation using the New Ballard score. Which of the following findings should the nurse expect? A) minimal arm recoil b) popliteal angle of 90 degrees C) creases over the entire foot sole D) raised areolas with 3-4 mm buds - A) minimal arm recoil A staff nurse on an obstetric unit is caring for a client who is scheduled for an induced abortion. The staff informs the nurse manager that she has a moral issue with the clients decision. Which of the following actions should the nurse manager take? A) inform the staff nurse that she is required to care for the client B) advise the staff nurse that she will likely receive disciplinary action C) reassign the client to another staff nurse D) advise the staff nurse to transfer to another unit - c) reassign the client to another staff nurse A nurse is teaching a new mother about newborn safety. Which of the following instructions should the nurse include in the teaching? A) you can share your room with your baby for the next few weeks B) cover your baby with light blanket while she is sleeping C) Check the temp of your baby's bath water with your hand D) your baby can nap in her car seat during the daytime - A) you can share your room with your baby for the next few weeks A nurse is caring for a client who is at 36 weeks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests? A) biophysical profile b) amniocentesis C) cordocentesis D) Kleihauer-Betke test - A) Biophysical profile A nurse is creating a plan of care for a client who is postpartum and adheres to traditional Hispanic cultural beliefs. Which of the following cultural practices should the nurse include in the plan of care? A) protect the clients head and feet from cold air B) bathe the client within 12 hr following delivery C) ambulate the client within 24 hr following delivery D) offer the client a glass of cold milk with her meal - A) Protect the clients head and feet from cold air A nurse is developing a plan of care for a newborn who is to undergo phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan? A) feed the newborn 1 oz of water every 4 hr B) Apply lotion to the newborn's skin three times per day C) Remove all clothing from the newborn except the diaper D) Discontinue therapy if the newborn develops a rash - C) Remove all clothing from the newborn except the diaper A nurse is caring for a client who is in labor and whose fetus is in the right occiput posterior position. The client dilated to 8cm and reports back pain. Which of the following actions should the nurse take? A) Apply sacral counterpressure B) Perform transcutaneous electrical nerve stimulation (TENS) C) initiate slow-paced breathing D) assist with biofeedback - A) apply sacral counterpressure A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following findings should the nurse report to the provider? A) BUN 25mg/dl B) Serum creatinine 0.8 mg/dl C) Urine output of 280 mL within 8 hr D) Urine negative for ketones - A) BUN 25 mg/dl A nurse is assessing a client who gave birth vaginally 12 hr ago and palpates her uterus to the right above the umbilicus. Which of the following interventions should the nurse perform? A) Reassess the client in 2 hr B) Administer simethicone C) Assist the client to empty her bladder D) Instruct the client to lie on her right side - C) Assist the client to empty her bladder A nurse is teaching a client about RHo(D) immune globulin. Which of the following statements by the client indicates an understanding of the teaching? A) I will receive this medication if my baby is Rh-negative B) I will receive this medication when I am in labor C) I will need a second dose of this medication when my baby id 6wks old D) I will need this medication if I have an amniocentesis - D) I will need this medication if I have an amniocentesis