MATERNITY PRACTICE EXAM -
NURSING, EVOLVE
OBSTETRICS/MATERNITY QUESTIONS
WITH CORRECT ANSWERS
A 41-week multigravida is receiving oxytocin (Pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal
heart rate increases with each contraction and returns to the baseline after the
contraction. What action should the nurse implement? - ANSWER-Increase the rate
of the Pitocin infusion. The goal of labor augmentation is to produce firm contractions
that occur every 2 to 3 minutes, with a duration of 60 to 70 seconds, and without
evidence of fetal stress. Fetal heart rate accelerations are a normal response to
contractions, so the Pitocin infusion should be increased per protocol to stimulate the
frequency and intensity of contractions.
. Client teaching is an important part of the perinatal nurse's role. Which factor has
the greatest influence on successful teaching of the pregnant client? - ANSWER-The
client's investment in what is being taught. When teaching any client, readiness to
learn is related to how much the client has invested in what is being taught , or how
important the material is to their particular life. For example, the client with severe
morning sickness in the first trimester may not be "ready to learn" about labor and
delivery, but is probably very "ready to learn" about ways to relieve morning
sickness.
A mother who is breastfeeding her baby receives instructions from the nurse. Which
instruction is most effective in preventing nipple soreness? - ANSWER-Ensure that
the baby is positioned correctly for latch-on. The most common cause of nipple
soreness is incorrect positioning of the infant on the breast for latch-on. The baby's
body is in alignment with ears, shoulders, and hips in a straight line with nose,
cheeks, and chin touching the breast. This helps prevent chafing and nonbinding
support aids in prevention of discomfort
from the stretching of Cooper's ligament.
what does it mean when a fundus is boggy? - ANSWER-Fundus is boggy when it is
not firm, may indicate hemorrhage.
Indicative of uterine atony (loss of uterine musculature), if not corrected, results in
PP hemorrhage.
Massage the boggy fundus to stimulate it to become firm again, or give patient
Pitocin, or have the patient breastfeed.
What're you going to do for hemorrhoids? - ANSWER-Lay on her side.
Tighten buttocks when sitting down to reduce contact of the perineum with the seat
and avoid prolonged sitting.
Maintain high-fiber diet, high fluids.
Begin moderate exercise such as walking.
,How much weight do you expect to lose right after delivery? - ANSWER-10-12 lbs
initially- infant, placenta, fluid
additional 5 lbs d/t PP diuresis.
How do you assess the healing of a placental site? what're you looking for? how can
you tell as a nurse if the placental site is healing? - ANSWER-Placental site takes up
to 6-7 weeks to completely heal.
Heals by a process of exfoliation.
Evaluate lochia- type, amount, and consistency- lochia rubra (2-3 days PP) Lochia
serosa (3-10 days PP) Lochia alba (1-2 weeks PP)
Trend toward a lighter color and bleeding gets lighter
What is a Homan's sign? - ANSWER-An indication of incipient or established
thrombosis in the leg veins in which slight pain occurs at the back of the knee or calf
when, with the knee bent, the ankle is slowly and gently dorsiflexed
What does it mean if a fundus is not at midline? know what that is/ what would you
do? - ANSWER-Means the patient has a full bladder
characteristics: bulging of the lower abdomen, spongy feeling mass between the
fundus and pubis, displaced uterus from the midline, usually to the right, increased
lochia flow
Full bladders may actually cause PP hemorrhage because it prevents the uterus
from contracting appropriately
Have the patient void
What would it mean if there's a steady trickle of blood? - ANSWER-Could mean
there's lacerations that still need sutures.
Know about rubella vaccines - ANSWER-should receive rubella vaccine early PP,
administer right after childbirth.
What is RhoGAM? - ANSWER-Vaccine to prevent Rh negative mothers from forming
antibodies against their Rh positive babies. All Rh negative mothers with Rh positive
babies need to get RhoGAM prior to discharge.
Interventions for breastfeeding mothers? - ANSWER-Feeding requirement: 140-160
ml/kg/day
Caloric requirement: 100-115 kcal/kg/day
Observation of breastfeeding technique
weight check
maternal assessment
infant assessment
infant feeding history
provide breast pump instructions- collection and storage
engorgement, what do you do for that? what do you do if there's redness? -
ANSWER-Engorgement is when the breast is not being emptied enough d/t baby not
nursing rigorously enough, separation from baby, not nursing enough.
Milk builds up and swelling occurs- breasts become hard, skin is taut and shiny-
extremely tender and painful, may fun a low-grade fever and become achy.
,Alveoli can become atrophied and may decrease milk production.
Milk ducts can swell shut- leading to mastitis and plugged duct.
Apply moist heat, cold compress, wear a supportive bra , may need antibiotics.
Contraception for breastfeeding moms/ what would you tell them? - ANSWER-
pregnancy can occur before the first menstruation period.
Progestin-only hormonal contraceptives are a good idea. No estrogen+ progestin b/c
it will decrease milk production.
Birth control, implants, and shot of progestin.
Normal vitas for newborn? - ANSWER-Resp rate: 30-60
HR: 120-160
Systolic: 70-100
Diastolic: 50-65
Weight in lbs: 4.5-7
Temp: 97.7-98.9
Heat loss- what's the most common form of heat loss in babies, how do you avoid it,
what're you going to do to prevent it? - ANSWER-radiation: body heat transferred to
cooler surfaces- walls of a room, walls of an incubator.
Convection: warm body surface to cooler air currents- air conditioned room,
unwarmed O2 by mask, removal of infant from a incubator for procedures.
Evaporation: loss of heat when water converted to vapor- baths.
Conduction: loss of heat to a cooler surface by direct skin contact- chilled hands,
cool scales, cold exam tables.
hyperbilirubinemia- what is it? what's bilirubin? - ANSWER-accelerated destruction of
fetal RBCs.
impaired conjugation of bilirubin.
increased bili reabsorption from intestines.
Bilirubin aids in digestion of fats, green- processed and removed by liver.
jaundice will develop when a baby's liver is not efficient enough to remove the bili
from the bloodstream- once baby begins to mature and RBCs diminish, jaundice will
subside- usually 1-2 weeks after birth
know about patient teaching for jaundice? what does it mean? - ANSWER-daylight
assists in early recognition- press on abd/ forehead/ nose- check icterus.
Nursing care: hydration/ promote feedings/ phototherapy/ possible supplement with
formula if BF/ parental support- they'll be upset.
six factors: increased amounts of bili delivered to liver, defective uptake of bili from
plasma, defective conjugation of the bili, defect in bili excretion, inadequate hepatic
circulation, increased reabsorption of bili from intestines.
28 year old client in active labor complains of cramps in her leg.What intervention
should the nurse implement.
A. massage the calf and foot
B. extend the leg and dorsiflex the foot
C. lower the leg off the side of the bed
D. elevate the leg above the heart. - ANSWER-B. Extend the leg and dorsiflex the
foot.
, The nurse instructs a laboring client to use accelerated blow breathing. The client
begins to complain of tingling finger and dizziness. What action should the nurse
take?
a. administer o2 by face mask
b. notify the HCP for the client's syndrome
c. have the client breathe into her cupped hands
d. check the client's BP and fetal HR/ - ANSWER-c. have the client breathe into her
cupped hands.
When assessing a client who is at 12 week gestation, the nurse recommends that
she and her husband consider attending childbirth preparation classes. When is the
best time for the couple to attend these classes?
A. at 16 weeks gestation
B.at 20 weeks gestation
C. at 24 weeks gestation
D. at 30 weeks gestation - ANSWER-D. At 30 weeks gestation.
In developing a teaching plan for expectant parents the nurse plans to include
formation about when the parents can expect the infants fontanels to close. The
nurse bases the explanation on knowledge that for the normal newborn, the
A. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first
week.
B. anterior fontanel closes at 5 to 7 months and the posterior by the end of the
second week.
C. anterior fontanel closes at 8 to 11 months and the posterior by the end of the first
month.
D. anterior fontanel closes at 12 to 18 months and the posterior by the end of the
second month - ANSWER-D. anterior fontanel closes at 12 to 18 months and the
posterior by the end of the second month
A 42 week gestational client is receiving an intravenous infusion of oxytocin(Pitocin)
to augment early labor. The nurse should discontinue the oxytocin infusion for with
pattern of contractions?
A. transition labor with contractions every 2 mins, lasting 90 seconds each.
B. early labor with contractions every 5 min, lasting 40 seconds each.
C. Active labor with contractions every 31 mins, lasting 60 seconds each.
D. Active labor with contraction every 2 to 3 mins, lasting 70 to 80 seconds each. -
ANSWER-A. transition labor with contractions every 2 mins, lasting 90 seconds
each.
What action should the nurse implement to decrease the client's risk for hemorrhage
after c-section.
A. Monitor urinary output via an indwelling catheter.
B. assess the abdominal dressings for drainage.
C. Give the Ringer's lactated infusion at 125ml
D. Check the firmness of the uterus every 15mins. - ANSWER-D. Check the
firmness of the uterus every 15mins.
NURSING, EVOLVE
OBSTETRICS/MATERNITY QUESTIONS
WITH CORRECT ANSWERS
A 41-week multigravida is receiving oxytocin (Pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal
heart rate increases with each contraction and returns to the baseline after the
contraction. What action should the nurse implement? - ANSWER-Increase the rate
of the Pitocin infusion. The goal of labor augmentation is to produce firm contractions
that occur every 2 to 3 minutes, with a duration of 60 to 70 seconds, and without
evidence of fetal stress. Fetal heart rate accelerations are a normal response to
contractions, so the Pitocin infusion should be increased per protocol to stimulate the
frequency and intensity of contractions.
. Client teaching is an important part of the perinatal nurse's role. Which factor has
the greatest influence on successful teaching of the pregnant client? - ANSWER-The
client's investment in what is being taught. When teaching any client, readiness to
learn is related to how much the client has invested in what is being taught , or how
important the material is to their particular life. For example, the client with severe
morning sickness in the first trimester may not be "ready to learn" about labor and
delivery, but is probably very "ready to learn" about ways to relieve morning
sickness.
A mother who is breastfeeding her baby receives instructions from the nurse. Which
instruction is most effective in preventing nipple soreness? - ANSWER-Ensure that
the baby is positioned correctly for latch-on. The most common cause of nipple
soreness is incorrect positioning of the infant on the breast for latch-on. The baby's
body is in alignment with ears, shoulders, and hips in a straight line with nose,
cheeks, and chin touching the breast. This helps prevent chafing and nonbinding
support aids in prevention of discomfort
from the stretching of Cooper's ligament.
what does it mean when a fundus is boggy? - ANSWER-Fundus is boggy when it is
not firm, may indicate hemorrhage.
Indicative of uterine atony (loss of uterine musculature), if not corrected, results in
PP hemorrhage.
Massage the boggy fundus to stimulate it to become firm again, or give patient
Pitocin, or have the patient breastfeed.
What're you going to do for hemorrhoids? - ANSWER-Lay on her side.
Tighten buttocks when sitting down to reduce contact of the perineum with the seat
and avoid prolonged sitting.
Maintain high-fiber diet, high fluids.
Begin moderate exercise such as walking.
,How much weight do you expect to lose right after delivery? - ANSWER-10-12 lbs
initially- infant, placenta, fluid
additional 5 lbs d/t PP diuresis.
How do you assess the healing of a placental site? what're you looking for? how can
you tell as a nurse if the placental site is healing? - ANSWER-Placental site takes up
to 6-7 weeks to completely heal.
Heals by a process of exfoliation.
Evaluate lochia- type, amount, and consistency- lochia rubra (2-3 days PP) Lochia
serosa (3-10 days PP) Lochia alba (1-2 weeks PP)
Trend toward a lighter color and bleeding gets lighter
What is a Homan's sign? - ANSWER-An indication of incipient or established
thrombosis in the leg veins in which slight pain occurs at the back of the knee or calf
when, with the knee bent, the ankle is slowly and gently dorsiflexed
What does it mean if a fundus is not at midline? know what that is/ what would you
do? - ANSWER-Means the patient has a full bladder
characteristics: bulging of the lower abdomen, spongy feeling mass between the
fundus and pubis, displaced uterus from the midline, usually to the right, increased
lochia flow
Full bladders may actually cause PP hemorrhage because it prevents the uterus
from contracting appropriately
Have the patient void
What would it mean if there's a steady trickle of blood? - ANSWER-Could mean
there's lacerations that still need sutures.
Know about rubella vaccines - ANSWER-should receive rubella vaccine early PP,
administer right after childbirth.
What is RhoGAM? - ANSWER-Vaccine to prevent Rh negative mothers from forming
antibodies against their Rh positive babies. All Rh negative mothers with Rh positive
babies need to get RhoGAM prior to discharge.
Interventions for breastfeeding mothers? - ANSWER-Feeding requirement: 140-160
ml/kg/day
Caloric requirement: 100-115 kcal/kg/day
Observation of breastfeeding technique
weight check
maternal assessment
infant assessment
infant feeding history
provide breast pump instructions- collection and storage
engorgement, what do you do for that? what do you do if there's redness? -
ANSWER-Engorgement is when the breast is not being emptied enough d/t baby not
nursing rigorously enough, separation from baby, not nursing enough.
Milk builds up and swelling occurs- breasts become hard, skin is taut and shiny-
extremely tender and painful, may fun a low-grade fever and become achy.
,Alveoli can become atrophied and may decrease milk production.
Milk ducts can swell shut- leading to mastitis and plugged duct.
Apply moist heat, cold compress, wear a supportive bra , may need antibiotics.
Contraception for breastfeeding moms/ what would you tell them? - ANSWER-
pregnancy can occur before the first menstruation period.
Progestin-only hormonal contraceptives are a good idea. No estrogen+ progestin b/c
it will decrease milk production.
Birth control, implants, and shot of progestin.
Normal vitas for newborn? - ANSWER-Resp rate: 30-60
HR: 120-160
Systolic: 70-100
Diastolic: 50-65
Weight in lbs: 4.5-7
Temp: 97.7-98.9
Heat loss- what's the most common form of heat loss in babies, how do you avoid it,
what're you going to do to prevent it? - ANSWER-radiation: body heat transferred to
cooler surfaces- walls of a room, walls of an incubator.
Convection: warm body surface to cooler air currents- air conditioned room,
unwarmed O2 by mask, removal of infant from a incubator for procedures.
Evaporation: loss of heat when water converted to vapor- baths.
Conduction: loss of heat to a cooler surface by direct skin contact- chilled hands,
cool scales, cold exam tables.
hyperbilirubinemia- what is it? what's bilirubin? - ANSWER-accelerated destruction of
fetal RBCs.
impaired conjugation of bilirubin.
increased bili reabsorption from intestines.
Bilirubin aids in digestion of fats, green- processed and removed by liver.
jaundice will develop when a baby's liver is not efficient enough to remove the bili
from the bloodstream- once baby begins to mature and RBCs diminish, jaundice will
subside- usually 1-2 weeks after birth
know about patient teaching for jaundice? what does it mean? - ANSWER-daylight
assists in early recognition- press on abd/ forehead/ nose- check icterus.
Nursing care: hydration/ promote feedings/ phototherapy/ possible supplement with
formula if BF/ parental support- they'll be upset.
six factors: increased amounts of bili delivered to liver, defective uptake of bili from
plasma, defective conjugation of the bili, defect in bili excretion, inadequate hepatic
circulation, increased reabsorption of bili from intestines.
28 year old client in active labor complains of cramps in her leg.What intervention
should the nurse implement.
A. massage the calf and foot
B. extend the leg and dorsiflex the foot
C. lower the leg off the side of the bed
D. elevate the leg above the heart. - ANSWER-B. Extend the leg and dorsiflex the
foot.
, The nurse instructs a laboring client to use accelerated blow breathing. The client
begins to complain of tingling finger and dizziness. What action should the nurse
take?
a. administer o2 by face mask
b. notify the HCP for the client's syndrome
c. have the client breathe into her cupped hands
d. check the client's BP and fetal HR/ - ANSWER-c. have the client breathe into her
cupped hands.
When assessing a client who is at 12 week gestation, the nurse recommends that
she and her husband consider attending childbirth preparation classes. When is the
best time for the couple to attend these classes?
A. at 16 weeks gestation
B.at 20 weeks gestation
C. at 24 weeks gestation
D. at 30 weeks gestation - ANSWER-D. At 30 weeks gestation.
In developing a teaching plan for expectant parents the nurse plans to include
formation about when the parents can expect the infants fontanels to close. The
nurse bases the explanation on knowledge that for the normal newborn, the
A. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first
week.
B. anterior fontanel closes at 5 to 7 months and the posterior by the end of the
second week.
C. anterior fontanel closes at 8 to 11 months and the posterior by the end of the first
month.
D. anterior fontanel closes at 12 to 18 months and the posterior by the end of the
second month - ANSWER-D. anterior fontanel closes at 12 to 18 months and the
posterior by the end of the second month
A 42 week gestational client is receiving an intravenous infusion of oxytocin(Pitocin)
to augment early labor. The nurse should discontinue the oxytocin infusion for with
pattern of contractions?
A. transition labor with contractions every 2 mins, lasting 90 seconds each.
B. early labor with contractions every 5 min, lasting 40 seconds each.
C. Active labor with contractions every 31 mins, lasting 60 seconds each.
D. Active labor with contraction every 2 to 3 mins, lasting 70 to 80 seconds each. -
ANSWER-A. transition labor with contractions every 2 mins, lasting 90 seconds
each.
What action should the nurse implement to decrease the client's risk for hemorrhage
after c-section.
A. Monitor urinary output via an indwelling catheter.
B. assess the abdominal dressings for drainage.
C. Give the Ringer's lactated infusion at 125ml
D. Check the firmness of the uterus every 15mins. - ANSWER-D. Check the
firmness of the uterus every 15mins.
