CORRECT WELL DETAILED
ANSWERS|LATEST!!!!2025/2026|GUARANTEED
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's
blood pressure drops from 120/80 to 90/60. What action will the nurse take?
A. Notify the healthcare provider or anesthesiologist immediately
B. Continue to assess the blood pressure q5 minutes
C. Place the woman in a lateral position
D. Turn off the continuous epidural - ANSWER C. Place the woman in a lateral position
These symptoms are suggestive of hypotension which is a side effect of epidural anesthesia.
Raising the foot of the bed will increase venous return and provide blood to the vital areas.
Increasing the IV fluid rate using a balanced non-dextrose solution and ensuring that the
client is in a lateral position are also appropriate interventions, and then checking the
patients blood pressure.
A newborn infant is brought to the nursery from the birthing suite. The nurse notices that
the infant is breathing satisfactorily but appears dusky. What action should the nurse take
first?
A. Notify the pediatrician immediately
B. Suction the infant's nares, then the oral cavity
C. Check the infant's oxygen saturation rate
D. Position the infant on the right side - ANSWER C. Check the infant's oxygen
saturation rate
When possible, the nurse should first obtain measurable objective data; an oxygen
saturation rate provides such information.
1
,FYI. The pediatrician should be notified if the oxygen saturation rate is below 90%
The nurse is teaching breastfeeding to prospective parents in a childbirth education class.
Which instruction should the nurse include as content in the class?
A. Begin as soon as your baby is born to establish a four-hour feeding schedule
B. Resting helps with milk production. Ask that your baby be fed at night in the nursery
C. Feed your baby every 2 to 3 hours or on demand, whichever comes first
D. Do not allow your baby to nurse any longer than the prescribed number of minutes -
ANSWER C. Feed your baby every 2 to 3 hours or on demand, whichever comes first
Breastfeeding infants should be kept in the room with the mother and fed every 2 to 3 hours
or on demand--whichever comes first.
A client is admitted with the diagnosis of total placenta previa. Which finding is most
important for the nurse to report to the healthcare provider immediately?
A. Heart rate of 100 beats/minute
B. Variable fetal heart rate
C. Onset of uterine contractions
D. Burning on urination - ANSWER C. Onset of uterine contractions
Total (complete) placenta previa involves the placenta covering the entire cervical os
(opening). The onset of uterine contractions places the client at risk for dilation and
placental separation, which causes painless hemorrhaging.
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 which pattern of
contractions?
A. Transition labor with contractions every 2 minutes, lasting 90 seconds each
B. Early labor with contractions every 5 minutes, lasting 40 seconds each
2
,C. Active labor with contractions every 31 minutes, lasting 60 seconds each
D. Active labor with contractions every 3 to 3 minutes, lasting 70 to 80 seconds each -
ANSWER A. Transition labor with contractions every 2 minutes, lasting 90 seconds
each
When oxytocin causes uterine hyperstimulation as evidence by inadequate resting time
between contractions, the oxytocin infusion should be discontinued because placental
perfusion is impeded
Twenty-four hours after admission to the newborn nursery, a full-term male infant develops
localized edema on the right side of his head. The nurse knows that, in the newborn, an
accumulation of blood between the periosteum and skull which does not cross the suture
line is a newborn variation known as
A. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks
B. a subarachnoid hematoma, which requires immediate drainage to prevent further
complications
C. molding, caused by pressure during labor and will disappear withing 2 to 3 days
D. a subdural hematoma which can result in lifelong damage - ANSWER A. a
cephalhematoma, caused by forceps trauma and may last up to 8 weeks
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within the first
24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and the skull.
The nurse is assessing a 3-day old infant with a cephalohematoma in the newborn nursery.
Which assessment finding should the nurse report to the healthcare provider?
A. Yellowish tinge to the skin
B. Babinski reflex present bilaterally
C. Pink papular rash on the face
D. Moro reflex noted after a loud noise - ANSWER A. Yellowish tinge to the skin
3
, Cephalohematomas are characterized by bleeding between the bone and its covering, the
periosteum. Due to the breakdown of the red blood cells within a hematoma, the infant is at
a greater risk for jaundice, so a yellowish tinge to the skin should be reported.
After each feeding, a 3-day-old newborn is spitting up large amounts of Enfamil Newborn
Formula, a nonfat cow's milk formula. The pediatric healthcare provider changes the
neonate's formula to Simialc Soy Isomil formula, a soy protein isolate based infant formula.
What information should the nurse provide to the mother about the newly prescribed
formula?
A. The new formula is a coconut milk formula used with babies with impaired fat absorption
B. enfamil Formula is a demineralized whey formula that is needed with diarrhea
C. The new formula is a casein protein source that is low in phenylalanine
D. Similac Soy Isomil Formula is a soy-based formula that contains sucrose -
ANSWER D. Similac Soy Isomil Formula is a soy-based formula that contains sucrose
The nurse should explain that the newborn's feeding intolerance may be related to the
lactose found in cow's milk formula and is being replaced with the soy-based formula that
contains sucrose, which is well-tolerated in infants with milk allergies and lactose
intolerance.
A full term infant is transferred to the nursery from labor and delivery. Which information is
most important for the nurse to receive when planning immediate care for the newborn?
A. Length of labor and method of delivery
B. Infant's condition at birth and treatment received
C. Feeding method chosen by the parents
D. History of drugs given to the mother during labor - ANSWER B. Infant's condition at
birth and treatment received
Immediate care is most dependent on the infant's current status (i.e., Apgar scores at 1 and
5 minutes) and any treatment or resuscitation that was indicated.
4
ANSWERS|LATEST!!!!2025/2026|GUARANTEED
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's
blood pressure drops from 120/80 to 90/60. What action will the nurse take?
A. Notify the healthcare provider or anesthesiologist immediately
B. Continue to assess the blood pressure q5 minutes
C. Place the woman in a lateral position
D. Turn off the continuous epidural - ANSWER C. Place the woman in a lateral position
These symptoms are suggestive of hypotension which is a side effect of epidural anesthesia.
Raising the foot of the bed will increase venous return and provide blood to the vital areas.
Increasing the IV fluid rate using a balanced non-dextrose solution and ensuring that the
client is in a lateral position are also appropriate interventions, and then checking the
patients blood pressure.
A newborn infant is brought to the nursery from the birthing suite. The nurse notices that
the infant is breathing satisfactorily but appears dusky. What action should the nurse take
first?
A. Notify the pediatrician immediately
B. Suction the infant's nares, then the oral cavity
C. Check the infant's oxygen saturation rate
D. Position the infant on the right side - ANSWER C. Check the infant's oxygen
saturation rate
When possible, the nurse should first obtain measurable objective data; an oxygen
saturation rate provides such information.
1
,FYI. The pediatrician should be notified if the oxygen saturation rate is below 90%
The nurse is teaching breastfeeding to prospective parents in a childbirth education class.
Which instruction should the nurse include as content in the class?
A. Begin as soon as your baby is born to establish a four-hour feeding schedule
B. Resting helps with milk production. Ask that your baby be fed at night in the nursery
C. Feed your baby every 2 to 3 hours or on demand, whichever comes first
D. Do not allow your baby to nurse any longer than the prescribed number of minutes -
ANSWER C. Feed your baby every 2 to 3 hours or on demand, whichever comes first
Breastfeeding infants should be kept in the room with the mother and fed every 2 to 3 hours
or on demand--whichever comes first.
A client is admitted with the diagnosis of total placenta previa. Which finding is most
important for the nurse to report to the healthcare provider immediately?
A. Heart rate of 100 beats/minute
B. Variable fetal heart rate
C. Onset of uterine contractions
D. Burning on urination - ANSWER C. Onset of uterine contractions
Total (complete) placenta previa involves the placenta covering the entire cervical os
(opening). The onset of uterine contractions places the client at risk for dilation and
placental separation, which causes painless hemorrhaging.
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 which pattern of
contractions?
A. Transition labor with contractions every 2 minutes, lasting 90 seconds each
B. Early labor with contractions every 5 minutes, lasting 40 seconds each
2
,C. Active labor with contractions every 31 minutes, lasting 60 seconds each
D. Active labor with contractions every 3 to 3 minutes, lasting 70 to 80 seconds each -
ANSWER A. Transition labor with contractions every 2 minutes, lasting 90 seconds
each
When oxytocin causes uterine hyperstimulation as evidence by inadequate resting time
between contractions, the oxytocin infusion should be discontinued because placental
perfusion is impeded
Twenty-four hours after admission to the newborn nursery, a full-term male infant develops
localized edema on the right side of his head. The nurse knows that, in the newborn, an
accumulation of blood between the periosteum and skull which does not cross the suture
line is a newborn variation known as
A. a cephalhematoma, caused by forceps trauma and may last up to 8 weeks
B. a subarachnoid hematoma, which requires immediate drainage to prevent further
complications
C. molding, caused by pressure during labor and will disappear withing 2 to 3 days
D. a subdural hematoma which can result in lifelong damage - ANSWER A. a
cephalhematoma, caused by forceps trauma and may last up to 8 weeks
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within the first
24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and the skull.
The nurse is assessing a 3-day old infant with a cephalohematoma in the newborn nursery.
Which assessment finding should the nurse report to the healthcare provider?
A. Yellowish tinge to the skin
B. Babinski reflex present bilaterally
C. Pink papular rash on the face
D. Moro reflex noted after a loud noise - ANSWER A. Yellowish tinge to the skin
3
, Cephalohematomas are characterized by bleeding between the bone and its covering, the
periosteum. Due to the breakdown of the red blood cells within a hematoma, the infant is at
a greater risk for jaundice, so a yellowish tinge to the skin should be reported.
After each feeding, a 3-day-old newborn is spitting up large amounts of Enfamil Newborn
Formula, a nonfat cow's milk formula. The pediatric healthcare provider changes the
neonate's formula to Simialc Soy Isomil formula, a soy protein isolate based infant formula.
What information should the nurse provide to the mother about the newly prescribed
formula?
A. The new formula is a coconut milk formula used with babies with impaired fat absorption
B. enfamil Formula is a demineralized whey formula that is needed with diarrhea
C. The new formula is a casein protein source that is low in phenylalanine
D. Similac Soy Isomil Formula is a soy-based formula that contains sucrose -
ANSWER D. Similac Soy Isomil Formula is a soy-based formula that contains sucrose
The nurse should explain that the newborn's feeding intolerance may be related to the
lactose found in cow's milk formula and is being replaced with the soy-based formula that
contains sucrose, which is well-tolerated in infants with milk allergies and lactose
intolerance.
A full term infant is transferred to the nursery from labor and delivery. Which information is
most important for the nurse to receive when planning immediate care for the newborn?
A. Length of labor and method of delivery
B. Infant's condition at birth and treatment received
C. Feeding method chosen by the parents
D. History of drugs given to the mother during labor - ANSWER B. Infant's condition at
birth and treatment received
Immediate care is most dependent on the infant's current status (i.e., Apgar scores at 1 and
5 minutes) and any treatment or resuscitation that was indicated.
4
