Maternal Newborn Alternate Item Format Questions with Complete Solutions

Maternal Newborn Alternate Item Format Questions with Complete Solutions A nurse is educating a client on how to perform Kegel exercise therapy for urinary incontinence. Which of the following points should be included in teaching? Select all that apply. Select one or more: a. While sitting on the toilet, strain down to help identify pelvic muscles. b. Have a designated time and place for completing therapy. c. Complete exercises in only a sitting position. d. Improvement in incontinence may be seen after 6 weeks of exercise therapy. e. During exercises, tighten pelvic muscles for a count of 10 and then relax for a count of 10. b. Have a designated time and place for completing therapy. d. Improvement in incontinence may be seen after 6 weeks of exercise therapy. e. During exercises, tighten pelvic muscles for a count of 10 and then relax for a count of 10. At first, it is helpful to have a designated time and place to do exercises because the client will need to concentrate to do them correctly. Although improvement may take several months, most clients notice a positive change after 6 weeks of exercises. The client should be educated to tighten pelvic muscles for a slow count of 10 and then relax for a slow count of 10. This exercise should be done 15 times while lying down, sitting up, and standing (a total of 45 exercises). The client should then repeat the exercises rapidly contracting and relaxing the pelvic muscles 10 times. This should take no longer than 10 to 12 minutes for all three positions, or 3 to 4 minutes for each set of 15 exercises. A nurse is caring for a client immediately following an amniotomy. Which of the following interventions are appropriate? Select all that apply. Select one or more: a. Assess fetal heart for rate and variable decelerations. Correct b. Observe for the presence of an odor in amniotic fluid. c. Prepare for an intrauterine pressure catheter (IUCP) insertion. d. Assess maternal intake and urinary output. e. Document any unusual color in the amniotic fluid. Correct a. Assess fetal heart for rate and variable decelerations. Correct b. Observe for the presence of an odor in amniotic fluid. e. Document any unusual color in the amniotic fluid. Correct After an amniotomy everything shifts in the uterus and the cord may become compressed. The nurse should immediately assess the fetal heart following the procedure. The presence of a foul odor in maternal fluid can be an important sign of infection. Any color in particular any meconium stained fluid or blood can indicate fetal distress. A nurse is educating a client who is scheduled for a nonstress test (NST). Which of the following statements are correct? Select all that apply. Select one or more: a. The NST is not useful after 38 weeks gestation. b. The NST is a useful in calculating gestational age. c. The NST can easily be performed in an outpatient setting. d. The NST measures the relationship of the fetal heart rate to fetal movement. e. The NST is a primary method of antenatal fetal assessment. c. The NST can easily be performed in an outpatient setting. d. The NST measures the relationship of the fetal heart rate to fetal movement. e. The NST is a primary method of antenatal fetal assessment. In most settings the NST has become an ideal screening test for fetal well being. The NST is a noninvasive test which is easily performed in outpatient settings. The basis of the NST is the principle that the normal fetus will produce characteristic HR patterns in relationship to fetal movement. A nurse is teaching a new mother breastfeeding techniques. Which of the following teaching tips are appropriate to discuss with a new mother who is breastfeeding? Select all that apply. Select one or more: a. Avoid a specific length of time to breastfeed. b. Dark, firm stools are the norm. c. Two to three wet diapers per day are the norm. d. Avoid use of a pacifier to prevent nipple confusion. e. Burp the newborn between each breast. a. Avoid a specific length of time to breastfeed. d. Avoid use of a pacifier to prevent nipple confusion. e. Burp the newborn between each breast. Avoid educating mothers regarding the duration of newborn feedings. Mothers should be instructed to evaluate when the newborn has completed the feeding, including slowing of newborn suckling, a softened breast, or sleeping. Tell the mother to avoid nipple confusion in the newborn by not offering supplemental formula, pacifier, or soothers. Supplementation can be provided using a small feeding or syringe feeding, if needed. Show the mother how to burp the newborn when she alternates breasts. The newborn should be burped either over the shoulder or in an upright position with his chin supported. The mother should gently pat the newborn on his back to elicit a burp. A nurse is providing prenatal education to a group of pregnant women. The nurse is teaching clients when to contact their provider. Which of the following should be included? Select all that apply. Select one or more: a. Evening lower extremity edema. b. Severe continuous headaches c. Chloasma d. Dimming vision e. Epigastric pain b. Severe continuous headaches d. Dimming vision e. Epigastric pain All are possible symptoms of pregnancy induced hypertension. A severe and continuous headache along with visual changes could indicate CNS irritability and possible onset of seizures. Epigastric pain could indicate impending HELLP syndrome. A nurse is caring for a neonate who is 34 weeks gestation. The nurse correctly understands which of the following are consistent with prematurity? Select all that apply. Select one or more: a. Large amount of vernix present b. Abundant lanugo c. Mongolian spots on shoulders d. Prominent clitoris and labia minora e. Inner eye canthus level with pina a. Large amount of vernix present b. Abundant lanugo d. Prominent clitoris and labia minora Large amounts of vernix are noted with prematurity. Abundant lanugo is noted in abundant amounts with a premature newborn. Prominent clitoris and labia minora are seen with prematurity. A laboring client reports suddenly feeling something in her vagina. Upon assessment, the nurse identifies a prolapsed umbilical cord. Place the following interventions in the correct order that they should be performed for this client. A. Prepare the client for a cesarean birth. B. Administer oxygen at 8-10L via face mask. C. Notify primary care provider of the prolapsed cord. D. Reposition the client in either a knee-ches or Trendelenburg position. E. Using a sterile glove insert two fingers into the vagina to reduce pressure off the cord. Select one: a. A, D, B, E, C b. B, C, D, A, E c. C, D, E, B, A d. B, A, D, C, E c. C, D, E, B, A C. Notifying the health care provider and staff is the first priority and facilitates readiness for further interventions. D. Next step will be to remove pressure from the cord by repositioning client. E. Inserting fingers into the vagina and applying finger pressure to the fetal presenting part reduces pressure on the umbilical cord and provides oxygenation to the fetus. B. Administration of supplemental oxygen will further improve fetal oxygenation. A Emergent care of the client and fetus is priority and if all other measures fail, the client should be prepared for a cesarean birth. A nurse is administering magnesium sulfate to a client diagnosed with preeclampsia. Which of the following signs and symptoms would indicate possible magnesium toxicity? Select all that apply. Select one or more: a. Prolonged PR interval b. Hypertension c. Hypotension d. Diminished tendon reflexes e. Hyperactive tendon reflexes a. Prolonged PR interval c. Hypotension d. Diminished tendon reflexes Magnesium 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. A nurse is caring for a client diagnosed with hyperemesis gravidarum. Which of the following are expected findings for this client? Select all that apply Select one or more: a. Ketosis b. Persistent diarrhea c. Dehydration d. Increased blood pressure e. Weight loss a. Ketosis c. Dehydration e. Weight loss Hyperemesis gravidarum is excessive nausea and vomiting (related to elevated hCG levels) that is prolonged past 12 weeks of gestation and results in a 5% weight loss from prepregnancy weight, electrolyte imbalance, acetonuria, and ketosis. Dehydration would lead to a decrease in blood pressure and increase in pulse. A nurse is caring for a newborn client who is experiencing severe hyperbilirubinemia. Which of the following are symptoms of kernicterus? Select all that apply. Select one or more: a. Temperature instability b. Low birth weight c. Lethargy d. Backward arching of the neck and trunk e. Hypotonic c. Lethargy d. Backward arching of the neck and trunk e. Hypotonic Kernicterus (bilirubin encephalopathy) can result from untreated hyperbilirubinemia with bilirubin levels at or higher than 25 mg/dL. It is a neurological syndrome caused by bilirubin depositing in brain cells. Survivors may develop cerebral palsy, epilepsy, or mental retardation. They may have minor effects such as learning disorders or perceptual-motor disabilities. Symptoms can inlcude letheragy, hyoptonia, high-ptiched cry and tonic motions such as backwards arching of the next and trunk. Low birth weight and temperature instabilty are not symptoms associated with kernicterus. What are characteristics of the fetus that are reviewed to determine the biophysical profile (BPP) during an ultrasound? Select all that apply. Select one or more: a. Fetal tone b. Reactive FHR c. Qualitative amniotic fluid volume d. Fetal tidal volume e. Fine body movement a. Fetal tone b. Reactive FHR c. Qualitative amniotic fluid volume Fetal tone, relative FHR, fetal breathing movements, gross body movements, fetal tone and qualitative amniotic fluid volume are physical and physiological characteristics of the BPP.