REVIEW WITH KEY MATERNAL AND FETAL CONCEPTS FOR
NURSING STUDENTS
The nurse is caring for a G 3, T 3, P 0, Ab 0,L 3 woman who is one day postpartum following a vaginal
delivery. Which of the following indicates a need for further assessment?
■ 1. Increased hematocrit and hemoglobin.
■ 2. White blood cell (WBC) count of 15,000.
■ 3. Pulse of 60.
■ 4. Temperature of 100.8° F. - CORRECT ANSWER-■ 4. Temperature of 100.8° F.
While making a home visit to a primiparous client and her 3-day-old son, the nurse observes
the mother changing the baby's disposable diaper. Before putting the clean diaper on the neonate,
the mother begins to apply baby powder to the neonate's buttocks. Which of the following
statements about baby powder should the nurse relate to the mother?
■ 1. It may cause pneumonia to develop.
■ 2. It helps prevent diaper rash.
■ 3. It keeps the diaper from adhering to the skin.
■ 4. It can result in allergies later in life. - CORRECT ANSWER-■ 1. It may cause pneumonia to
develop.
After teaching a new mother about the care of her neonate after circumcision with a Gomco clamp,
which of the following statements by the mother indicates to the nurse that the mother needs
additional instructions?
■ 1. "The petroleum gauze may fall off into the
diaper."
■ 2. "A few drops of blood oozing from the site is
normal."
■ 3. "I'll leave the gauze in place for 24 hours."
■ 4. "I'll remove any yellowish crusting gently
with water." - CORRECT ANSWER-■ 4. "I'll remove any yellowish crusting gently
with water."
,The nurse instructs a primiparous client about bottle-feeding her neonate. Which of the
following demonstrates that the mother has understood the nurse's instructions?
■ 1. Placing the neonate on his back after the feeding.
■ 2. Bubbling the baby after 1 oz of formula.
■ 3. Putting three-fourths of the bottle nipple into
the baby's mouth.
■ 4. Pointing the nipple toward the neonate's
palate - CORRECT ANSWER-■ 1. Placing the neonate on his back after the feeding
Approximately 90 minutes after birth, the nurse should encourage the mother of a term neonate
to do which of the following?
■ 1. Feed the neonate.
■ 2. Allow the neonate to sleep.
■ 3. Get to know the neonate.
■ 4. Change the neonate's diaper - CORRECT ANSWER-■ 2. Allow the neonate to sleep.
After the delivery of a neonate, a quick assessment is completed. The neonate is found to
be apneic. After quickly drying the neonate, what should the nurse do next?
■ 1. Assign the fi rst Apgar score.
■ 2. Place the head in a "sniff" position.
■ 3. Administer oxygen.
■ 4. Start cardiac compressions. - CORRECT ANSWER-2. Place the head in a "sniff" position.
A 6-lb, 8-oz neonate was delivered vaginally at 38 weeks' gestation. At 5 minutes of life, the neonate
has the following signs: heart rate 110, intermittent grunting with respiratory rate of 70, fl acid tone,
no response to stimulus, overall pale white in color. The Apgar score is:
■ 1. 2.
■ 2. 3.
■ 3. 4.
■ 4. 6. - CORRECT ANSWER-■ 3. 4.
,A neonate has a large amount of secretions. After vigorously suctioning the neonate, the nurse
should assess for what possible result?
■ 1. Bradycardia.
■ 2. Rapid eye movement.
■ 3. Seizures.
■ 4. Tachycardia. - CORRECT ANSWER-■ 1. Bradycardia.
When reviewing the prenatal history for a newly delivered neonate, the nurse notes that the
mother has neurofi bromatosis. The nurse should further assess the neonate for:
■ 1. Acrocyanosis.
■ 2. Café au lait spots.
■ 3. Port wine nevus.
■ 4. Strawberry hemangiomas. - CORRECT ANSWER-■ 2. Café au lait spots
After explaining to a primiparous client about the causes of her neonate's cranial molding,
which of the following statements by the mother indicates the need for further instruction?
■ 1. "The molding was caused by an overlapping
of the baby's cranial bones during my labor."
■ 2. "The amount of molding is related to the
amount and length of pressure on the head."
■ 3. "The molding will usually disappear in a
couple of days."
■ 4. "Brain damage may occur if the molding
doesn't resolve quickly." - CORRECT ANSWER-■ 4. "Brain damage may occur if the molding
doesn't resolve quickly."
After instructing a mother about normal refl exes of term neonates, the nurse determines that
the mother understands the instructions when she describes the tonic neck refl ex as occurring
when the neonate does which of the following?
■ 1. Steps briskly when held upright near a fi rm,
hard surface.
, ■ 2. Pulls both arms and does not move the chin
beyond the point of the elbows.
■ 3. Turns head to the left, extends left extremities,
and fl exes right extremities.
■ 4. Extends and abducts the arms and legs with
the toes fanning open. - CORRECT ANSWER-■ 3. Turns head to the left, extends left extremities,
and fl exes right extremities.
Metabolic screening of an infant revealed a high phenylketonuria (PKU) level. Which of the following
statements by the infant's mother indicates understanding of the disease and its management?
Select all that apply.
■ 1. "My baby can't have milk-based formulas."
■ 2. "My baby will grow out of this by the age of 2."
■ 3. "This is a hereditary disease, so any future
children will have it, too."
■ 4. " My baby will eventually become retarded
because of this disease."
■ 5. "We have to follow a strict phenylalanine diet."
■ 6. "A dietitian can help me plan a diet that
keeps a safe phenylalanine level but lets my
baby grow." - CORRECT ANSWER-1, 5, 6
Which of the following assessment fi ndings in a term neonate would cause the nurse to notify
the pediatrician?
■ 1. Absence of tears.
■ 2. Unequally sized corneas.
■ 3. Pupillary constriction to bright light.
■ 4. Red circle on pupils with ophthalmoscopic
examination. - CORRECT ANSWER-■ 2. Unequally sized corneas.
At 24 hours of age, assessment of the neonate reveals the following: eyes closed, skin pink, no sign