TEST BANK MATERNITY AND PEDIATRIC
NURSING CERTIFICATION EVALUATION
EXAMS SOLVED QUESTIONS STUDY GUIDE
GUARANTEED TO PASS
◉ The nurse is preparing a laboring client for an amniotomy.
Immediately after the procedure is completed, it is most important for
the nurse to obtain which information?
A.Maternal blood pressure
B.Maternal temperature
C.Fetal heart rate (FHR)
D.White blood cell count (WBC). Answer: C. Fetal heart rate (FHR)
Rationale:
The FHR should be assessed before and after the procedure to detect
changes that may indicate the presence of cord compression or
prolapse. An amniotomy (artificial rupture of membranes [AROM]) is
used to stimulate labor when the condition of the cervix is favorable.
The fluid should be assessed for color, odor, and consistency. Option
A should be assessed every 15 to 20 minutes during labor but is not
,specific for AROM. Option B is monitored hourly after the
membranes are ruptured to detect the development of amnionitis.
Option D should be determined for all clients in labor.
◉ A nurse receives a shift change report for a newborn who is 12
hours post-vaginal delivery. In developing a plan of care, the nurse
should give the highest priority to which finding?
A.Cyanosis of the hands and feet
B.Skin color that is slightly jaundiced
C.Tiny white papules on the nose or chin
D.Red patches on the cheeks and trunk. Answer: B. Skin color that is
slightly jaundiced
Rationale: Jaundice, a yellow skin coloration, is caused by elevated
levels of bilirubin, which should be further evaluated in a newborn
<24 hours old. Acrocyanosis (blue color of the hands and feet) is a
common finding in newborns; it occurs because the capillary system
is immature. Milia are small white papules present on the nose and
chin that are caused by sebaceous gland blockage and disappear in a
few weeks. Small red patches on the cheeks and trunk are called
erythema toxicum neonatorum, a common finding in newborns.
,◉ A breastfeeding postpartum client is diagnosed with mastitis, and
antibiotic therapy is prescribed. Which instruction should the nurse
provide to this client?
A.Breastfeed the infant, ensuring that both breasts are completely
emptied.
B.Feed expressed breast milk to avoid the pain of the infant latching
onto the infected breast.
C.Breastfeed on the unaffected breast only until the mastitis subsides.
D.Dilute expressed breast milk with sterile water to reduce the
antibiotic effect on the infant.. Answer: A.Breastfeed the infant,
ensuring that both breasts are completely emptied.
Rationale:Mastitis, caused by plugged milk ducts, is related to breast
engorgement, and breastfeeding during mastitis facilitates the
complete emptying of engorged breasts, eliminating the pressure on
the inflamed breast tissue. Option B is less painful but does not
facilitate complete emptying of the breast tissue. Option C will not
relieve the engorgement on the affected side. Option D will not
decrease antibiotic effects on the infant.
◉ A 38-week primigravida who works as a secretary and sits at a
computer 8 hours each day tells the nurse that her feet have begun to
swell. Which instruction will aid in the prevention of pooling of blood
in the lower extremities?
, A.Wear support stockings.
B.Reduce salt in the diet.
C.Move about every hour.
D.Avoid constrictive clothing.. Answer: C.Move about every hour.
Rationale:
Pooling of blood in the lower extremities results from the enlarged
uterus exerting pressure on the pelvic veins. Moving about every hour
will relieve pressure on the pelvic veins and increase venous return.
Option A would increase venous return from varicose veins in the
lower extremities but would be of little help with swelling. Option B
might be helpful with generalized edema but is not specific for
edematous lower extremities. Option D does not address venous
return, and there is no indication in the question that constrictive
clothing is a problem.
◉ Twenty-four hours after admission to the newborn nursery, a full-
term male infant develops localized swelling on the right side of his
head. In a newborn, what is the most likely cause of this accumulation
of blood between the periosteum and skull that does not cross the
suture line?
A.Cephalhematoma, which is caused by forceps trauma
NURSING CERTIFICATION EVALUATION
EXAMS SOLVED QUESTIONS STUDY GUIDE
GUARANTEED TO PASS
◉ The nurse is preparing a laboring client for an amniotomy.
Immediately after the procedure is completed, it is most important for
the nurse to obtain which information?
A.Maternal blood pressure
B.Maternal temperature
C.Fetal heart rate (FHR)
D.White blood cell count (WBC). Answer: C. Fetal heart rate (FHR)
Rationale:
The FHR should be assessed before and after the procedure to detect
changes that may indicate the presence of cord compression or
prolapse. An amniotomy (artificial rupture of membranes [AROM]) is
used to stimulate labor when the condition of the cervix is favorable.
The fluid should be assessed for color, odor, and consistency. Option
A should be assessed every 15 to 20 minutes during labor but is not
,specific for AROM. Option B is monitored hourly after the
membranes are ruptured to detect the development of amnionitis.
Option D should be determined for all clients in labor.
◉ A nurse receives a shift change report for a newborn who is 12
hours post-vaginal delivery. In developing a plan of care, the nurse
should give the highest priority to which finding?
A.Cyanosis of the hands and feet
B.Skin color that is slightly jaundiced
C.Tiny white papules on the nose or chin
D.Red patches on the cheeks and trunk. Answer: B. Skin color that is
slightly jaundiced
Rationale: Jaundice, a yellow skin coloration, is caused by elevated
levels of bilirubin, which should be further evaluated in a newborn
<24 hours old. Acrocyanosis (blue color of the hands and feet) is a
common finding in newborns; it occurs because the capillary system
is immature. Milia are small white papules present on the nose and
chin that are caused by sebaceous gland blockage and disappear in a
few weeks. Small red patches on the cheeks and trunk are called
erythema toxicum neonatorum, a common finding in newborns.
,◉ A breastfeeding postpartum client is diagnosed with mastitis, and
antibiotic therapy is prescribed. Which instruction should the nurse
provide to this client?
A.Breastfeed the infant, ensuring that both breasts are completely
emptied.
B.Feed expressed breast milk to avoid the pain of the infant latching
onto the infected breast.
C.Breastfeed on the unaffected breast only until the mastitis subsides.
D.Dilute expressed breast milk with sterile water to reduce the
antibiotic effect on the infant.. Answer: A.Breastfeed the infant,
ensuring that both breasts are completely emptied.
Rationale:Mastitis, caused by plugged milk ducts, is related to breast
engorgement, and breastfeeding during mastitis facilitates the
complete emptying of engorged breasts, eliminating the pressure on
the inflamed breast tissue. Option B is less painful but does not
facilitate complete emptying of the breast tissue. Option C will not
relieve the engorgement on the affected side. Option D will not
decrease antibiotic effects on the infant.
◉ A 38-week primigravida who works as a secretary and sits at a
computer 8 hours each day tells the nurse that her feet have begun to
swell. Which instruction will aid in the prevention of pooling of blood
in the lower extremities?
, A.Wear support stockings.
B.Reduce salt in the diet.
C.Move about every hour.
D.Avoid constrictive clothing.. Answer: C.Move about every hour.
Rationale:
Pooling of blood in the lower extremities results from the enlarged
uterus exerting pressure on the pelvic veins. Moving about every hour
will relieve pressure on the pelvic veins and increase venous return.
Option A would increase venous return from varicose veins in the
lower extremities but would be of little help with swelling. Option B
might be helpful with generalized edema but is not specific for
edematous lower extremities. Option D does not address venous
return, and there is no indication in the question that constrictive
clothing is a problem.
◉ Twenty-four hours after admission to the newborn nursery, a full-
term male infant develops localized swelling on the right side of his
head. In a newborn, what is the most likely cause of this accumulation
of blood between the periosteum and skull that does not cross the
suture line?
A.Cephalhematoma, which is caused by forceps trauma
