MASTERY MATERNAL QUESTIONS AND
CORRECT ANSWERS
A 34-year-old pregnant woman is in the clinic for her first-trimester checkup. While
assessing the patient's health history, the nurse should be most concerned about which
of the following? - Answer-• Taking over-the-counter medications can be dangerous
during pregnancy. Many common drugs are teratogenic. The fetus is at a high risk of
developing deformities during the first trimester.
A patient comes to the clinic stating that she may be pregnant. The nurse knows that a
pregnancy can be confirmed by - Answer-ultrasound fetal visualization
• There are only three positive signs that are used to confirm pregnancy: fetal heart
sounds heard by doppler ultrasound, ultrasound visualization of the fetus, or fetal
movements palpated by the examiner.
What should the nurse document when a physician places a direct fetal scalp
electrode? - Answer-• This is the most reliable way to measure FHR.
• When a fetal scalp electrode is placed by a physician, the nurse should document the
time of placement, the physician applying the electrode, and the FHR.
A patient at 34 weeks gestation calls the hospital with concerns of leaking vaginal fluid.
The nurse should - Answer-• This woman needs to be assessed for premature rupture
of membranes (PROM).
• If a preterm woman experiences premature rupture of membranes, the fetus is in
serious danger. After rupture, the seal to the fetus is lost and uterine and fetal infection
may occur, as well as increased stress to the fetus due to changes in pressure from
decreased amniotic fluid. It is necessary to report to the hospital immediately for
prophylactic administration of broad-spectrum antibiotics.
• Prophylactic administration of broad-spectrum antibiotics may reduce the risk of
infection in the newborn. Labor may be induced.
• After being assessed by the doctor, the woman may be placed on home bed rest if
labor does not begin and if the fetus is too young to survive outside the uterus.
The nurse cares for a postpartum patient. Which of the following signs suggest
endometritis? - Answer-Foul-Smelling Lochia
Cramping
Uterine tenderness
,• Endometritis is an infection/inflammation of the endometrium (lining of the uterus). It
can occur during pregnancy or after childbirth or it may occur unrelated to pregnancy
(when it is called pelvic inflammatory disease).
• Endometritis may be caused by organisms that are normal inhabitants of the vagina
and cervix; however, organisms such as gonorrhea and chlamydia may be frequently
encountered during pregnancy. If left untreated, these infections may lead to
postpartum endometritis and a potential for maternal and/or neonatal morbidity.
• Major signs and symptoms of endometritis are fever, chills, malaise, lethargy,
anorexia, abdominal pain, and cramping, uterine tenderness, and purulent, foul-smelling
lochia.
• The nurse should expect treatment of the organism according to CDC guidelines if
indicated.
• Constipation and hemorrhoids are common postpartum complications but are
unrelated to endometritis.
Cramping
Constipation
Uterine tenderness
A nurse is preparing to bathe a full-term newborn for the first time since birth. Which of
the following should the nurse do? - Answer-Wait until the newborn's vital signs are
stabilized.
Wait until the newborn's temperature has stabilized, and give the bath under a radiant
heat source.
Wear gloves when handling the newborn until after the bath is given.
• The newborn's vital signs should be stable to prevent complications.
• The newborn's body temperature should be at least 36.5° C (97.7° F), and the sponge
bath should be given under a radiant heat source to prevent excessive heat loss.
• Gloves should be worn when assessing or caring for a newborn before the first bath to
prevent exposure to bloodborne pathogens. Standard Precautions require handwashing
before any infant care, but gloves are to be worn if there is risk of contact with body
fluids (such as with diaper changes or circumcision care).
• Medicated soap and scrubbing can irritate the newborn's skin and cause abrasions.
• The nurse does not need to wait until the newborn's first void.
A newborn less than 3 hours old has a split S2 that is heard on inspiration and a HR of
140 beats/minute. What should the nurse do next? - Answer-• A split S2 on inspiration is
, a normal finding for newborns during the first few hours of life. All the nurse needs to do
at this point is to document the finding.
• Normal HR for newborns is 120 to 160 beats/minute.
• There is no need to notify the physician or inform the parents of a normal finding.
• Assessing the newborn's neurological status is not needed based on the scenario.
A patient has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood
pH of 7.12 and fetal bradycardia is present. Based on these findings, the nurse should
take which action? - Answer-Prepare for a Cesarean Section
• Infants with meconium-stained amniotic fluid may have respiratory difficulties and
bradycardia at birth.
• Based on the assessment, fetal metabolic acidosis is present. These findings pose a
great threat to the newborn's well-being. A cesarean section is required.
• Incorrect: Amnioinfusion is an infusion of sterile isotonic solution into the uterine cavity
during labor to reduce umbilical cord compression. This is also done to dilute meconium
in the amniotic fluid, reducing the risk that the infant will aspirate thick meconium at
birth. This procedure is not sufficient in this scenario.
A patient with mastitis asks the nurse if her infant will be infected if she continues to
breastfeed. Which of the following is the appropriate response by the nurse? -
Answer-"Continue breastfeeding because the bacteria is localized in the breast tissue
and will not enter the breast milk."
"You will want to stop breastfeeding if an abscess forms."
• Breastfeeding is continued because frequent emptying will help prevent the growth of
bacteria. Complete emptying of breasts prevents stasis of milk and engorgement. This
aids in reducing the risk of further infection and pain.
• The organism causing the infection usually enters through cracked or fissured nipples.
The bacteria remain localized in the breast tissue and will not enter the breast milk.
• Discontinue breastfeeding if the breast infection is untreated and forms an abscess.
However, the woman is encouraged to continue to pump breast milk until the abscess
has resolved so she can continue breastfeeding again after treatment.
• The woman, not the infant, will be placed on a broad-spectrum antibiotic.
• Breastfeeding has major physiologic advantages for the infant. Breast milk contains
secretory immunoglobulin A, which provides the infant with additional immunity.
CORRECT ANSWERS
A 34-year-old pregnant woman is in the clinic for her first-trimester checkup. While
assessing the patient's health history, the nurse should be most concerned about which
of the following? - Answer-• Taking over-the-counter medications can be dangerous
during pregnancy. Many common drugs are teratogenic. The fetus is at a high risk of
developing deformities during the first trimester.
A patient comes to the clinic stating that she may be pregnant. The nurse knows that a
pregnancy can be confirmed by - Answer-ultrasound fetal visualization
• There are only three positive signs that are used to confirm pregnancy: fetal heart
sounds heard by doppler ultrasound, ultrasound visualization of the fetus, or fetal
movements palpated by the examiner.
What should the nurse document when a physician places a direct fetal scalp
electrode? - Answer-• This is the most reliable way to measure FHR.
• When a fetal scalp electrode is placed by a physician, the nurse should document the
time of placement, the physician applying the electrode, and the FHR.
A patient at 34 weeks gestation calls the hospital with concerns of leaking vaginal fluid.
The nurse should - Answer-• This woman needs to be assessed for premature rupture
of membranes (PROM).
• If a preterm woman experiences premature rupture of membranes, the fetus is in
serious danger. After rupture, the seal to the fetus is lost and uterine and fetal infection
may occur, as well as increased stress to the fetus due to changes in pressure from
decreased amniotic fluid. It is necessary to report to the hospital immediately for
prophylactic administration of broad-spectrum antibiotics.
• Prophylactic administration of broad-spectrum antibiotics may reduce the risk of
infection in the newborn. Labor may be induced.
• After being assessed by the doctor, the woman may be placed on home bed rest if
labor does not begin and if the fetus is too young to survive outside the uterus.
The nurse cares for a postpartum patient. Which of the following signs suggest
endometritis? - Answer-Foul-Smelling Lochia
Cramping
Uterine tenderness
,• Endometritis is an infection/inflammation of the endometrium (lining of the uterus). It
can occur during pregnancy or after childbirth or it may occur unrelated to pregnancy
(when it is called pelvic inflammatory disease).
• Endometritis may be caused by organisms that are normal inhabitants of the vagina
and cervix; however, organisms such as gonorrhea and chlamydia may be frequently
encountered during pregnancy. If left untreated, these infections may lead to
postpartum endometritis and a potential for maternal and/or neonatal morbidity.
• Major signs and symptoms of endometritis are fever, chills, malaise, lethargy,
anorexia, abdominal pain, and cramping, uterine tenderness, and purulent, foul-smelling
lochia.
• The nurse should expect treatment of the organism according to CDC guidelines if
indicated.
• Constipation and hemorrhoids are common postpartum complications but are
unrelated to endometritis.
Cramping
Constipation
Uterine tenderness
A nurse is preparing to bathe a full-term newborn for the first time since birth. Which of
the following should the nurse do? - Answer-Wait until the newborn's vital signs are
stabilized.
Wait until the newborn's temperature has stabilized, and give the bath under a radiant
heat source.
Wear gloves when handling the newborn until after the bath is given.
• The newborn's vital signs should be stable to prevent complications.
• The newborn's body temperature should be at least 36.5° C (97.7° F), and the sponge
bath should be given under a radiant heat source to prevent excessive heat loss.
• Gloves should be worn when assessing or caring for a newborn before the first bath to
prevent exposure to bloodborne pathogens. Standard Precautions require handwashing
before any infant care, but gloves are to be worn if there is risk of contact with body
fluids (such as with diaper changes or circumcision care).
• Medicated soap and scrubbing can irritate the newborn's skin and cause abrasions.
• The nurse does not need to wait until the newborn's first void.
A newborn less than 3 hours old has a split S2 that is heard on inspiration and a HR of
140 beats/minute. What should the nurse do next? - Answer-• A split S2 on inspiration is
, a normal finding for newborns during the first few hours of life. All the nurse needs to do
at this point is to document the finding.
• Normal HR for newborns is 120 to 160 beats/minute.
• There is no need to notify the physician or inform the parents of a normal finding.
• Assessing the newborn's neurological status is not needed based on the scenario.
A patient has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood
pH of 7.12 and fetal bradycardia is present. Based on these findings, the nurse should
take which action? - Answer-Prepare for a Cesarean Section
• Infants with meconium-stained amniotic fluid may have respiratory difficulties and
bradycardia at birth.
• Based on the assessment, fetal metabolic acidosis is present. These findings pose a
great threat to the newborn's well-being. A cesarean section is required.
• Incorrect: Amnioinfusion is an infusion of sterile isotonic solution into the uterine cavity
during labor to reduce umbilical cord compression. This is also done to dilute meconium
in the amniotic fluid, reducing the risk that the infant will aspirate thick meconium at
birth. This procedure is not sufficient in this scenario.
A patient with mastitis asks the nurse if her infant will be infected if she continues to
breastfeed. Which of the following is the appropriate response by the nurse? -
Answer-"Continue breastfeeding because the bacteria is localized in the breast tissue
and will not enter the breast milk."
"You will want to stop breastfeeding if an abscess forms."
• Breastfeeding is continued because frequent emptying will help prevent the growth of
bacteria. Complete emptying of breasts prevents stasis of milk and engorgement. This
aids in reducing the risk of further infection and pain.
• The organism causing the infection usually enters through cracked or fissured nipples.
The bacteria remain localized in the breast tissue and will not enter the breast milk.
• Discontinue breastfeeding if the breast infection is untreated and forms an abscess.
However, the woman is encouraged to continue to pump breast milk until the abscess
has resolved so she can continue breastfeeding again after treatment.
• The woman, not the infant, will be placed on a broad-spectrum antibiotic.
• Breastfeeding has major physiologic advantages for the infant. Breast milk contains
secretory immunoglobulin A, which provides the infant with additional immunity.
