Questions And Answers
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This Test Consists Of 55 Questions And Answers
1. At 10 weeks gestation, a high-risk multiparous client with a family historyof
Down syndrome is admitted for observation following a chorionic villavilla
sampling (CVS) procedure. What assessment finding requires immediate in-
tervention?
A. Uterine cramping.
B. Intermittent nausea.
C. Systolic blood pressure < 100 mmHg.
,D. Abdominal tenderness
Answer>> A. Uterine cramping.
2. A client states, "During the three months I've been pregnant, it seems like
I have had to go to the bathroom every five minutes." Which explanation
should the nurse provide to this client?
A. The client may have a bladder or kidney infection.
B. Bladder capacity increases during pregnancy.
C. During pregnancy a woman is especially sensitive to body functions.
D. The growing uterus is putting pressure on the bladder
Answer>> D. The growing uterusis putting pressure on the bladder.
3. The nurse assesses a male newborn and determines that he has the
following vital signs: axillary temperature 95.1 F, heart rate 136 beats/minute
and a respiratory rate of 48 breaths/minute. Based on these findings, which
action should the nurse take first?
A. Notify the pediatrician of the infant's vital signs.
B. Encourage the infant to take the breast or sugar water.
C. Assess the infant's blood glucose level.
,D. Check the infant's arterial blood gases
Answer>> C. Assess the infant's blood glucoselevel.
4. An infant in respiratory distress is placed on pulse oximetry. The oxygen
saturation indicates 85%. What is the priority nursing intervention?
A. Evaluate the blood pH.
B. Begin humidified oxygen via hood.
C. Place the infant under a radiant warmer.
D. Stimulate infant crying
Answer>> B. Begin humidified oxygen via hood.
5. When assessing a newborn infant's heart rate, which technique is most
important for the nurse to use?
A. Count the heart rate for at least one full minute.
,B. Quiet the infant before counting the heart rate.
C. Palpate the umbilical cord.
D. Listen at the apex of the heart
Answer>> A. Count the heart rate for at least one fullminute.
6. The nurse prepares to administer an injection of vitamin K to a newborn
infant. The mother tells the nurse, "Wait! I don't want my baby to have a shot."
Which response would be best for the nurse to make?
A. Inform the mother that the injection was prescribed by the healthcare
provider.
B. Explore the mother's concern about the infant receiving an injection of
vitamin K.
C. Remind the mother that all babies receive the shot and it is relatively
painless.
D. Explain that vitamin K is required by state law and compliance is mandato-
ry
Answer>> B. Explore the mother's concern about the infant receiving an injection of
vitaminK.
7. The nurse is teaching a new mother about diet and breastfeeding. Which
,instruction is most important to include in the teaching plan?
A. Double prenatal milk intake to improve vitamin D transfer to the infant.
B. Increase caloric intake by approximately 500 calories/day.
C. Avoid spicy foods to prevent infant colic.
D. Avoid alcohol because it is excreted in breast milk
Answer>> D. Avoid alcohol becauseit is excreted in breast milk.
8. Which nursing intervention best enhances maternal-infant bonding dur-
ing the fourth stage of labor?
A. Brighten the lighting so the mother can view the infant.
B. Provide positive reinforcement for maternal care of infant.
C. Complete a newborn assessment as quickly as possible.
D. Encourage early initiation of breast or formula feeding
Answer>> D. Encourage earlyinitiation of breast or formula feeding.
9. A client at 8-weeks gestation ask the nurse about the risk for congenital
heart defect (CHD) in her baby. Which response best explains when a CHD
may occur?
A. They usually occur in the first trimester pregnancy.
, B. The heart develops in the third to fifth weeks after conception.