MATERNITY PRACTICE EXAM - 50
NURSING, EVOLVE
OBSTETRICS/MATERNITY QUESTIONS
WITH CORRECT ANSWERS
During a prenatal visit, the nurse discusses with a client the effects that smoking has
on the fetus. Which statement is most characteristic of an infant whose mother
smoked during pregnancy compared to the infant of a nonsmoking mother? -
ANSWER-Lower initial weight documented at birth. Smoking is associated with low-
birth-weight infants . Therefore, mothers are encouraged not to smoke during
pregnancy.
The nurse is teaching care of the newborn to a childbirth preparation class and
describes the need for administering antibiotic ointment into the eyes of the newborn.
An expectant father asks, "What type of disease causes infections in babies that can
be prevented by using this ointment?" Which response by the nurse is accurate? -
ANSWER-Gonorrhea. Erythromycin ointment is instilled into the lower conjunctiva of
each eye within 2 hours after birth to prevent ophthalmica neonatorum, an infection
caused by gonorrhea (C), and inclusion conjunctivitis, an infection caused by
chlamydia. The infant may be exposed to these bacteria when passing through the
birth canal.
An expectant father tells the nurse he fears that his wife "is losing her mind." He
states she is constantly rubbing her abdomen and talking to the baby, and that she
actually reprimands the baby when it moves too much. What recommendation
should the nurse make to this expectant father? - ANSWER-Reassure him that
normal maternal/fetal bonding is occurring.These behaviors are positive signs of
maternal/fetal bonding and do not reflect ambivalence .
A client who is 3 days postpartum and breastfeeding asks the nurse how to reduce
breast engorgement. Which instruction should the nurse provide? - ANSWER-
Breastfeed the infant every 2 hours. The mother should be instructed to attempt
feeding her infant every 2 hours while massaging the breasts as the infant is feeding.
If the infant does not feed adequately and empty the breast, using a breast pump
helps to extract the milk and relieve some of the discomfort.
Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time? - ANSWER-Her arms and hands receive the infant and
she then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in during the first visit with the newborn, which may be at delivery or later.
After the first visit, the mother may exhibit different touching behaviors such as
eagerly reaching for the infant and cuddling the infant close to her
,A mother who is HIV-positive delivers a full-term newborn and asks the nurse if her
baby will become HIV infected. Which explanation should the nurse provide? -
ANSWER-HIV infection is determined at 18 months of age when maternal HIV
antibodies are no longer present.
All newborns of HIV-positive mothers receive passive HIV antibodies from the
mother, so the evaluation of an infant for the HIV virus is determined at 18 months of
age when all the maternal antibodies are no longer in the infant's blood. Passive HIV
antibodies disappear in the infant within 18 months of age .
A client at 30 weeks of gestation is on bedrest at home because of increased blood
pressure. The home health nurse has taught her how to take her own blood pressure
and given her parameters to judge a significant increase in blood pressure. When
the client calls the clinic complaining of indigestion, which instruction should the
nurse provide? - ANSWER-"Take your blood pressure now, and if it is seriously
elevated, go to the hospital."
Checking the blood pressure for an elevation is the best instruction to give at this
time. A blood pressure exceeding 140/90 or increased by 15 mm Hg diastolic and/or
30 mm Hg systolic is indicative of preeclampsia. Epigastric pain can be a sign of an
impending seizure (eclampsia), a life-threatening complication of PIH.
Prior to discharge, what instructions should the nurse give to parents regarding the
newborn's umbilical cord care at home? - ANSWER-Allow the cord to air dry as
much as possible.
Recent studies indicate air drying or plain water application may be equal or more
effective than alcohol in the cord healing process .
The nurse is teaching a new mother about diet and breastfeeding. Which instruction
is most important to include in the teaching plan? - ANSWER-Avoid alcohol because
it is excreted in breast milk. Alcohol should be avoided while breastfeeding because,
when consumed by the mother, it is excreted in breast milk and may cause a variety
of problems, including growth and mental retardation for the infant.
A 26-year-old gravida 2, para 1 client is admitted to the hospital at 28 weeks of
gestation in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25
mg subcutaneously to stop her labor contractions. The nurse plans to monitor for the
primary side effects of terbutaline sulfate, which are: - ANSWER-tachycardia and a
feeling of nervousness.
tachycardia and a feeling of nervousness. Terbutaline sulfate (Brethine), a beta-
sympathomimetic drug, stimulates beta-adrenergic receptors in the uterine muscle to
stop contractions. The beta-adrenergic agonist properties of the drug may cause
tachycardia, increased cardiac output, restlessness, headache,
and a feeling of "nervousness"
The nurse observes an antepartum client, on bedrest for preterm labor, eating ice
rather than the food on her breakfast tray. The client states that she has been
craving ice and then feels too full to eat anything else. What is the best response by
,the nurse? - ANSWER-Notify the healthcare provider. The healthcare provider
should be notified when a client practices pica (craving for and consumption of
nonfood substances). The practice of pica may displace more nutritious foods from
the diet and the client should be evaluated for anemia
Six hours after an oxytocin induction was begun and 2 hours after spontaneous
rupture of the membranes, the nurse notes several sudden decreases in the fetal
heart rate with quick return to baseline, with and without contractions. Based on this
fetal heart rate pattern, which intervention is best for the nurse to implement? -
ANSWER-Place the client in a slight Trendelenburg position. The goal is to relieve
pressure on the umbilical cord and placing the client in a Trendelenburg position is
most likely to relieve that pressure. The FHR pattern is indicative of a variable fetal
heart rate deceleration, which is typically caused by cord compression and can occur
with or without contractions.
A client at 32 weeks of gestation is hospitalized with severe pregnancy-induced
hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms.
Which assessment finding indicates that therapeutic drug levels have been
achieved? - ANSWER-Respiratory rate decreases from 24 to 16. Magnesium sulfate,
a CNS depressant, helps prevent seizures. A decreased respiratory rate indicates
that the drug is effective. However, a respiratory rate below 12 indicates toxic effects.
Urinary output must be monitored when administering magnesium sulfate and should
be at least 30 ml per hour. . The therapeutic level of magnesium sulfate for a PIH
client is 4.8 to 9.6 mg/dl.
A new mother is having trouble breastfeeding her newborn son. He is making frantic
rooting motions and will not grasp the nipple. Which intervention should the nurse
implement? - ANSWER-Encourage the mother to stop feeding for a few minutes and
comfort the infant. The infant is becoming frustrated and so is the mother; both need
a "time-out." The mother should be encouraged to comfort the infant and to relax
herself .
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized swelling on the right side of his head. What is the most likely
cause of this accumulation of blood between the periosteum and skull that does not
cross the suture line in a newborn? - ANSWER-A cephalhematoma, which is caused
by forceps trauma. Cephalhematoma , a slight abnormal variation of the newborn,
usually arises within the first 24 hours after delivery. Trauma from delivery causes
capillary bleeding between the periosteum and the skull.
A 41-week multigravida is receiving oxytocin (Pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal
heart rate increases with each contraction and returns to the baseline after the
contraction. What action should the nurse implement? - ANSWER-Increase the rate
of the Pitocin infusion. The goal of labor augmentation is to produce firm contractions
that occur every 2 to 3 minutes, with a duration of 60 to 70 seconds, and without
evidence of fetal stress. Fetal heart rate accelerations are a normal response to
contractions, so the Pitocin infusion should be increased per protocol to stimulate the
frequency and intensity of contractions.
, . Client teaching is an important part of the perinatal nurse's role. Which factor has
the greatest influence on successful teaching of the pregnant client? - ANSWER-The
client's investment in what is being taught. When teaching any client, readiness to
learn is related to how much the client has invested in what is being taught , or how
important the material is to their particular life. For example, the client with severe
morning sickness in the first trimester may not be "ready to learn" about labor and
delivery, but is probably very "ready to learn" about ways to relieve morning
sickness.
A mother who is breastfeeding her baby receives instructions from the nurse. Which
instruction is most effective in preventing nipple soreness? - ANSWER-Ensure that
the baby is positioned correctly for latch-on. The most common cause of nipple
soreness is incorrect positioning of the infant on the breast for latch-on. The baby's
body is in alignment with ears, shoulders, and hips in a straight line with nose,
cheeks, and chin touching the breast. This helps prevent chafing and nonbinding
support aids in prevention of discomfort
from the stretching of Cooper's ligament.
what does it mean when a fundus is boggy? - ANSWER-Fundus is boggy when it is
not firm, may indicate hemorrhage.
Indicative of uterine atony (loss of uterine musculature), if not corrected, results in
PP hemorrhage.
Massage the boggy fundus to stimulate it to become firm again, or give patient
Pitocin, or have the patient breastfeed.
What're you going to do for hemorrhoids? - ANSWER-Lay on her side.
Tighten buttocks when sitting down to reduce contact of the perineum with the seat
and avoid prolonged sitting.
Maintain high-fiber diet, high fluids.
Begin moderate exercise such as walking.
How much weight do you expect to lose right after delivery? - ANSWER-10-12 lbs
initially- infant, placenta, fluid
additional 5 lbs d/t PP diuresis.
How do you assess the healing of a placental site? what're you looking for? how can
you tell as a nurse if the placental site is healing? - ANSWER-Placental site takes up
to 6-7 weeks to completely heal.
Heals by a process of exfoliation.
Evaluate lochia- type, amount, and consistency- lochia rubra (2-3 days PP) Lochia
serosa (3-10 days PP) Lochia alba (1-2 weeks PP)
Trend toward a lighter color and bleeding gets lighter
What is a Homan's sign? - ANSWER-An indication of incipient or established
thrombosis in the leg veins in which slight pain occurs at the back of the knee or calf
when, with the knee bent, the ankle is slowly and gently dorsiflexed
What does it mean if a fundus is not at midline? know what that is/ what would you
do? - ANSWER-Means the patient has a full bladder
NURSING, EVOLVE
OBSTETRICS/MATERNITY QUESTIONS
WITH CORRECT ANSWERS
During a prenatal visit, the nurse discusses with a client the effects that smoking has
on the fetus. Which statement is most characteristic of an infant whose mother
smoked during pregnancy compared to the infant of a nonsmoking mother? -
ANSWER-Lower initial weight documented at birth. Smoking is associated with low-
birth-weight infants . Therefore, mothers are encouraged not to smoke during
pregnancy.
The nurse is teaching care of the newborn to a childbirth preparation class and
describes the need for administering antibiotic ointment into the eyes of the newborn.
An expectant father asks, "What type of disease causes infections in babies that can
be prevented by using this ointment?" Which response by the nurse is accurate? -
ANSWER-Gonorrhea. Erythromycin ointment is instilled into the lower conjunctiva of
each eye within 2 hours after birth to prevent ophthalmica neonatorum, an infection
caused by gonorrhea (C), and inclusion conjunctivitis, an infection caused by
chlamydia. The infant may be exposed to these bacteria when passing through the
birth canal.
An expectant father tells the nurse he fears that his wife "is losing her mind." He
states she is constantly rubbing her abdomen and talking to the baby, and that she
actually reprimands the baby when it moves too much. What recommendation
should the nurse make to this expectant father? - ANSWER-Reassure him that
normal maternal/fetal bonding is occurring.These behaviors are positive signs of
maternal/fetal bonding and do not reflect ambivalence .
A client who is 3 days postpartum and breastfeeding asks the nurse how to reduce
breast engorgement. Which instruction should the nurse provide? - ANSWER-
Breastfeed the infant every 2 hours. The mother should be instructed to attempt
feeding her infant every 2 hours while massaging the breasts as the infant is feeding.
If the infant does not feed adequately and empty the breast, using a breast pump
helps to extract the milk and relieve some of the discomfort.
Which maternal behavior is the nurse most likely to see when a new mother receives
her infant for the first time? - ANSWER-Her arms and hands receive the infant and
she then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors
described in during the first visit with the newborn, which may be at delivery or later.
After the first visit, the mother may exhibit different touching behaviors such as
eagerly reaching for the infant and cuddling the infant close to her
,A mother who is HIV-positive delivers a full-term newborn and asks the nurse if her
baby will become HIV infected. Which explanation should the nurse provide? -
ANSWER-HIV infection is determined at 18 months of age when maternal HIV
antibodies are no longer present.
All newborns of HIV-positive mothers receive passive HIV antibodies from the
mother, so the evaluation of an infant for the HIV virus is determined at 18 months of
age when all the maternal antibodies are no longer in the infant's blood. Passive HIV
antibodies disappear in the infant within 18 months of age .
A client at 30 weeks of gestation is on bedrest at home because of increased blood
pressure. The home health nurse has taught her how to take her own blood pressure
and given her parameters to judge a significant increase in blood pressure. When
the client calls the clinic complaining of indigestion, which instruction should the
nurse provide? - ANSWER-"Take your blood pressure now, and if it is seriously
elevated, go to the hospital."
Checking the blood pressure for an elevation is the best instruction to give at this
time. A blood pressure exceeding 140/90 or increased by 15 mm Hg diastolic and/or
30 mm Hg systolic is indicative of preeclampsia. Epigastric pain can be a sign of an
impending seizure (eclampsia), a life-threatening complication of PIH.
Prior to discharge, what instructions should the nurse give to parents regarding the
newborn's umbilical cord care at home? - ANSWER-Allow the cord to air dry as
much as possible.
Recent studies indicate air drying or plain water application may be equal or more
effective than alcohol in the cord healing process .
The nurse is teaching a new mother about diet and breastfeeding. Which instruction
is most important to include in the teaching plan? - ANSWER-Avoid alcohol because
it is excreted in breast milk. Alcohol should be avoided while breastfeeding because,
when consumed by the mother, it is excreted in breast milk and may cause a variety
of problems, including growth and mental retardation for the infant.
A 26-year-old gravida 2, para 1 client is admitted to the hospital at 28 weeks of
gestation in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25
mg subcutaneously to stop her labor contractions. The nurse plans to monitor for the
primary side effects of terbutaline sulfate, which are: - ANSWER-tachycardia and a
feeling of nervousness.
tachycardia and a feeling of nervousness. Terbutaline sulfate (Brethine), a beta-
sympathomimetic drug, stimulates beta-adrenergic receptors in the uterine muscle to
stop contractions. The beta-adrenergic agonist properties of the drug may cause
tachycardia, increased cardiac output, restlessness, headache,
and a feeling of "nervousness"
The nurse observes an antepartum client, on bedrest for preterm labor, eating ice
rather than the food on her breakfast tray. The client states that she has been
craving ice and then feels too full to eat anything else. What is the best response by
,the nurse? - ANSWER-Notify the healthcare provider. The healthcare provider
should be notified when a client practices pica (craving for and consumption of
nonfood substances). The practice of pica may displace more nutritious foods from
the diet and the client should be evaluated for anemia
Six hours after an oxytocin induction was begun and 2 hours after spontaneous
rupture of the membranes, the nurse notes several sudden decreases in the fetal
heart rate with quick return to baseline, with and without contractions. Based on this
fetal heart rate pattern, which intervention is best for the nurse to implement? -
ANSWER-Place the client in a slight Trendelenburg position. The goal is to relieve
pressure on the umbilical cord and placing the client in a Trendelenburg position is
most likely to relieve that pressure. The FHR pattern is indicative of a variable fetal
heart rate deceleration, which is typically caused by cord compression and can occur
with or without contractions.
A client at 32 weeks of gestation is hospitalized with severe pregnancy-induced
hypertension (PIH), and magnesium sulfate is prescribed to control the symptoms.
Which assessment finding indicates that therapeutic drug levels have been
achieved? - ANSWER-Respiratory rate decreases from 24 to 16. Magnesium sulfate,
a CNS depressant, helps prevent seizures. A decreased respiratory rate indicates
that the drug is effective. However, a respiratory rate below 12 indicates toxic effects.
Urinary output must be monitored when administering magnesium sulfate and should
be at least 30 ml per hour. . The therapeutic level of magnesium sulfate for a PIH
client is 4.8 to 9.6 mg/dl.
A new mother is having trouble breastfeeding her newborn son. He is making frantic
rooting motions and will not grasp the nipple. Which intervention should the nurse
implement? - ANSWER-Encourage the mother to stop feeding for a few minutes and
comfort the infant. The infant is becoming frustrated and so is the mother; both need
a "time-out." The mother should be encouraged to comfort the infant and to relax
herself .
Twenty-four hours after admission to the newborn nursery, a full-term male infant
develops localized swelling on the right side of his head. What is the most likely
cause of this accumulation of blood between the periosteum and skull that does not
cross the suture line in a newborn? - ANSWER-A cephalhematoma, which is caused
by forceps trauma. Cephalhematoma , a slight abnormal variation of the newborn,
usually arises within the first 24 hours after delivery. Trauma from delivery causes
capillary bleeding between the periosteum and the skull.
A 41-week multigravida is receiving oxytocin (Pitocin) to augment labor. Contractions
are firm and occurring every 5 minutes, with a 30- to 40-second duration. The fetal
heart rate increases with each contraction and returns to the baseline after the
contraction. What action should the nurse implement? - ANSWER-Increase the rate
of the Pitocin infusion. The goal of labor augmentation is to produce firm contractions
that occur every 2 to 3 minutes, with a duration of 60 to 70 seconds, and without
evidence of fetal stress. Fetal heart rate accelerations are a normal response to
contractions, so the Pitocin infusion should be increased per protocol to stimulate the
frequency and intensity of contractions.
, . Client teaching is an important part of the perinatal nurse's role. Which factor has
the greatest influence on successful teaching of the pregnant client? - ANSWER-The
client's investment in what is being taught. When teaching any client, readiness to
learn is related to how much the client has invested in what is being taught , or how
important the material is to their particular life. For example, the client with severe
morning sickness in the first trimester may not be "ready to learn" about labor and
delivery, but is probably very "ready to learn" about ways to relieve morning
sickness.
A mother who is breastfeeding her baby receives instructions from the nurse. Which
instruction is most effective in preventing nipple soreness? - ANSWER-Ensure that
the baby is positioned correctly for latch-on. The most common cause of nipple
soreness is incorrect positioning of the infant on the breast for latch-on. The baby's
body is in alignment with ears, shoulders, and hips in a straight line with nose,
cheeks, and chin touching the breast. This helps prevent chafing and nonbinding
support aids in prevention of discomfort
from the stretching of Cooper's ligament.
what does it mean when a fundus is boggy? - ANSWER-Fundus is boggy when it is
not firm, may indicate hemorrhage.
Indicative of uterine atony (loss of uterine musculature), if not corrected, results in
PP hemorrhage.
Massage the boggy fundus to stimulate it to become firm again, or give patient
Pitocin, or have the patient breastfeed.
What're you going to do for hemorrhoids? - ANSWER-Lay on her side.
Tighten buttocks when sitting down to reduce contact of the perineum with the seat
and avoid prolonged sitting.
Maintain high-fiber diet, high fluids.
Begin moderate exercise such as walking.
How much weight do you expect to lose right after delivery? - ANSWER-10-12 lbs
initially- infant, placenta, fluid
additional 5 lbs d/t PP diuresis.
How do you assess the healing of a placental site? what're you looking for? how can
you tell as a nurse if the placental site is healing? - ANSWER-Placental site takes up
to 6-7 weeks to completely heal.
Heals by a process of exfoliation.
Evaluate lochia- type, amount, and consistency- lochia rubra (2-3 days PP) Lochia
serosa (3-10 days PP) Lochia alba (1-2 weeks PP)
Trend toward a lighter color and bleeding gets lighter
What is a Homan's sign? - ANSWER-An indication of incipient or established
thrombosis in the leg veins in which slight pain occurs at the back of the knee or calf
when, with the knee bent, the ankle is slowly and gently dorsiflexed
What does it mean if a fundus is not at midline? know what that is/ what would you
do? - ANSWER-Means the patient has a full bladder
