Maternity Exam 1 Practice Questions With Correct Answers

A woman who have birth 2 hours ago has a temperature of 37.9 *C. Select all of the immediate nursing actions A) Have pt drink 2 glasses of fluid over the next hour B) Explain to the patient that she needs to rest and assist her into a comfortable position C) Medicate pt with 500 mg of acetaminophen as per orders D) Call the patient's physician or midwife to report the elevated temp - A & B Reasoning: A mild temperature elevation within a few hours of birth can be related to dehydration and exhaustion. Acetaminophen is given if temperature remains elevated after the woman has been hydrated and rested. The physician or midwife is notified if temperature remains elevated after initial interventions. 3 hours after a vaginal delivery, the client complains of increased perineal pain. What should the nurse do first? A) Administer analgesia as ordered B) Assess the perineum C) Perform perineal care D) Apply ice to perineum - B A woman gave birth to a 3200 g baby girl with an estimated gestational age of 40 weeks. The baby is 1 hour of age. In preparation of giving the baby an injection of Vitamin K, the nurse will: A) Explain to the parents the action of the medication and answer their questions B) Remove neonate from the room so parents will not be distressed by seeing the injection C) Completely undress the neonate to identify the injection site D) Replace needle with a 21 gauge ⅝ needle - A Reasoning: It is important to always explain to parents wHat and why a procedure is being done on the newborn When assessing a placenta and umbilical cord at delivery, the nurse must know that the normal cord has: A) 1 vein and 2 arteries B) 2 veins and 1 artery C) 1 vein and 1 artery D) 2 veins and 2 arteries - A (AVA) When reviewing a potential cause for postpartum hemorrhage with the student nurse, the nurse is sure to include the finding of a(n) ____________ bladder - FULL/OVERDISTENDED Reasoning: An overdistended bladder, which displaces the uterus above and to the right of the umbilicus, can cause uterine atony and lead to hemorrhage Maddy, a G3 P1 woman, gave birth 12 hrs ago to a 9lb 13 oz daughter. She experiences severe cramps with breastfeeding. The perinatal nurse best describes this condition as: A) Afterpains B) Uterine hypertonia C) Bladder hypertonia D) Rectus abdominis diastasis - A Reasoning Afterpains are intermittent uterine contractions that occur during the process of involution. Afterpains are more pronounced in patients w/ decreased uterine tone due to overdistension, which is associated w/ multiparity and macrosomia. Patients often describe the sensation as a discomfort similar to menstrual cramps What does GTPAL mean? - G: Gravida → # of times a woman has conceived including current pregnancy T: Term Births → # of times a woman has carried a pregnancy to at least 37 weeks and delivered P: Preterm Births → # of births a woman has delivered before 37 weeks gestation but after 20 weeks A: Abortions → # of times a woman has lost a pregnancy, whether it was elective or spontaneous (miscarriage), before 20 weeks gestation L: living children → live births The best way for the nurse to enhance parental confidence is to A) Have the parents watch a video tape of infant care, then discuss it with them B) Demonstrate skills on the newborn while providing care C) Encourage new parents to ask their friends about infant care D) Provide encouragement and positive feedback - D The nurse is teaching the parents of a female baby how to change a baby's diapers. Which of the following should be included in the teaching? A) Always wipe the perineum from front to back B) Remove any vernix caseosa from labia folds C) Put powder on buttocks every time the baby stools D) Weigh every diaper in order to assess for hydration - A Reasoning To decrease risk of infection from bacteria from the rectum, the perineum of female babies should always be cleansed from front to back After birth, the perinatal nurse explains to the new mom that Progesterone is the hormone responsible for stimulating milk production A) True B) False - FALSE A 6 hour infant passes an unformed, black, tar like stool. The nurse should conclude this is a: A) Meconium stool expected at the time of birth B) Transitional stool expected at this time C) Meconium stool expected at this time D) Transitional stool expected later - C A woman's postpartum vaginal discharge is dark red and contains shreds of decidua and epithelial cells. The nurse should describe the discharge in the nurse's notes as: A) Rubra B) Serosa C) Alba D) Erythra - A Which of the following statements indicates that a new mom needs additional teaching? A) I will need to supervise my cat when she is in the same room as my baby B) I will place by baby on her back when she is sleeping C) I will not leave my baby on an elevated flat surface after she is able to turn over on her own D) I have asked my husband to install safety latches on the lower cabinets - C Reasoning: Newborns/infants should never be left on an elevated flat surface because they may roll or wiggle & fall off The perinatal nurse explains to the student nurse that the growing embryo is called a ___________ at the end of 8 weeks of gestational age A) Neonate B) Fetus C) Zygote D) Gamete - B Reasoning - Zygote = fertilization - 2nd week - Embryo = end of 2nd week - 8th week - Fetus = end of 8th week - birth A mother refused to allow her son to receive the vitamin K injection at birth. Which of the following s/s might the nurse observe in the baby as a result? A) Skin color is dusky B) Vitals signs are labile C) Glucose levels are subnormal D) Circumcision site oozes blood - D Reasoning The circumcision site may ooze blood due to lack of Vitamin K, which is required for the hepatic synthesis of blood coagulation factors II, VII, and X The nurse is assessing a client 24 hrs after delivery and finds the fundus to be slightly boggy and 2 centimeters above the umbilicus. What should the nursing priority intervention be? A) Document this expected finding B) Notify the physician C) Gently massage the fundus until firm D) Assess mom's vital signs - C During a postpartum assessment, the nurse notes that the uterus is midline and boggy. The immediate nursing action is: A) To notify the patient's midwife or physician B) Massage the fundus until firm and reevaluate within 30 minutes C) Give syntocinon as per orders D) Assist the patient to the bathroom and ask her to void - B Reasoning The first nursing action for a boggy uterus = massage the fundus A perinatal nurse assesses the skin condition of a newborn, which is characterized by a yellow coloration of the skin, sclera, and oral mucous membranes. What condition is most likely the cause of this symptom? A) Hypoglycemia B) Physiologic anemia of infancy C) Low glomerular filtration rate D) Jaundice - D Reasoning Jaundice is a condition characterized by a yellow (icteric) coloration of the skin, sclera, and oral mucous membranes and results from the accumulation of bile pigments associated with an excessive amount of bilirubin in the blood The perinatal nurse teaches the student nurse that deep breathing exercises following a cesarean birth are critical to the prevention of: select all that apply A) Pneumonia B) Atelectasis C) Abdominal distension D) Increased tidal volume - A & B Reasoning Incisional pain and abdominal distension often cause patients to adopt shallow breathing patterns haht can lead to decreased gas exchange and a reduced tidal volume. To facilitate adequate lung functions, patients should be taught how to perform pulmonary exercises. Expectoration of secretions and deep breathing help prevent common complications including atelectasis and pneumonia. Abdominal distension and gas pains are common after abdominal surgery and result from delayed peristalsis The nurse assesses the postpartum patient who has not had a bowel movement by the 3rd postpartum day. Which nursing intervention would be appropriate? A) Encourage the new mother to be patient, saying "it will happen soon" B) Obtain an order for a stool softener C) Decrease fluid intake D) Instruct patient to eat a low fiber diet - B When assessing the apical pulse of the neonate, the stethoscope should be placed at the A) First or second intercostal space B) Second or third intercostal space C) Third or fourth intercostal space D) Fourth or fifth intercostal space - C A postpartum woman, who gave birth 12 hours ago, is breastfeeding her baby. She tells her nurse that she is concerned that her baby is not getting enough food since her milk has not come in. The best response for this patient is: A) I understand your concern, but your baby will be okay until your milk comes in B) Your baby seems content, so you should not worry about him getting enough to heat C) Milk normally comes in around the third day. Prior to that, he is getting colostrum, which is high in protein and immunoglobulins which are important for your baby's health D) You can bottle feed until your milk comes in - C Reasoning This response provides info on the stages of milk production to help the woman understand her newborn's nutritional needs