PN Maternal Newborn Online Practice 2020 Exam A:

PN Maternal Newborn Online Practice 2020 Exam A: 1. A nurse is caring for a client who is at 11 weeks of gestation and reports frequent vomiting. Which of the following findings should the nurse identify as an indication that the client has hyperemesis gravidarum? a. Ketonuria i. Occurs due to the breakdown of fat secondary to malnutrition or starvation 2. A nurse is collecting data from a client who is at 36 weeks of gestation during a prenatal examination. Which of the following findings should the nurse report to the provider? a. Blurred vision i. An indication that the client might have preeclampsia 3. A nurse is caring for a newborn who has a high-pitched cry and does not respond to consoling efforts. Which of the following neonatal data collection tools should the nurse expect to complete? a. Neonatal abstinence scoring system i. Exhibiting manifestations of opioid withdrawal and should be screened ii. Additional manifestations of withdrawal include restlessness, tremors, increased muscle tone, and an exaggerated Moro reflex 4. A nurse is caring for a newborn who is receiving phototherapy. Which of the following actions should the nurse take? a. Place an opaque mask over the newborn’s eyes i. To prevent damage to the retinas – remove mask for feedings 5. A nurse is assisting in the care of a newborn immediately following birth. Which of the following images should the nurse identify as an indication that the newborn was a myelomeningocele? a. First picture – exposed spinal cord and fluid filled sac, priority intervention is to maintain the integrity of the sac i. Myelomeningocele occurs when the neural tube fails to close, and the meninges and spinal cord herniate 1. Defect most often occurs in the lumbar area and may be covered by a thin membranous sac 6. A nurse is collecting data from a newborn who is 8 hr old. Which of the following findings should the nurse report to the provider? a. Apical heart rate of 90/min while crying i. Is below the expected reference range of 110-160 bpm for a newborn; 80-100 bpm while sleeping; and up to 180 bpm while crying 7. A nurse is caring for a client 6 hr after a vaginal birth who is going to breastfeed her newborn. The client reports perineal pain of 6 on a scale from 0-10. The nurse also notes mild perineal edema and ecchymosis, with a fundus that is 2 cm above the umbilicus with deviation to the right. Which of the following action is the nurse’s priority? a. Help the client ambulate to the toilet i. Greatest risk is postpartum hemorrhage from uterine atony; help client to urinate & completely empty the bladder, which will allow the uterus to contract 8. A nurse is reinforcing teaching with a client who is at 20 weeks of gestation and has gestational diabetes mellitus. Which of the following information should the nurse include in the teaching? a. Consume at least 2000 cal/day This study source was downloaded by from CourseH on :49:36 GMT -06:00 i. Is about 35 cal/kg/day – will ensure adequate glucose intake and prevent hypoglycemia 9. A nurse is reinforcing teaching about risk factors for respiratory distress syndrome (RDS) in newborns with a group of clients who are pregnant. Which of the following risk factors should the nurse include? a. Prematurity i. A newborn who is premature has inadequate surfactant production, which can lead to RDS 10. A nurse is caring for a client who is planning to become pregnant. The client asks the nurse why folic acid supplements are necessary. The nurse should inform the client that the purpose of the folic acid supplement is to do which of the following? a. Prevent certain kinds of birth defects i. Help prevent neural tube defects 11. A nurse is reinforcing discharge teaching about methods to prevent engorgement during lactation suppression with a client who is bottle-feeding her newborn. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. “I will apply cold cabbage leaves to my breasts throughout the day.” i. Frequent application of cold leaves to breasts can prevent engorgement ii. Should also apply ice packs or cold compresses to breasts, take mild analgesics, and wear a well-fitting and supportive bra 12. A nurse is assisting with the care of a client who is at 40 weeks of gestation and is in active labor. Which of the following findings should the nurse report to the charge nurse? a. Prolonged deceleration of FHR i. Can be a manifestation of an emergent condition, such as uterine rupture or umbilical cord prolapse ii. Charge nurse should notify provider about this change 13. A client requests information about the use of a diaphragm for birth control. Which of the following statements should the nurse make? a. “You will need to replace your diaphragm every 2 years.” 14. A nurse is reinforcing teaching with a client who is at 9 weeks of gestation and reports frequent episodes of nausea and vomiting. Which of the following instructions should the nurse include? a. Consume small meals frequently each day i. 5-6 small meals throughout the day – should avoid an empty stomach, as this increases nausea 15. A nurse on a postpartum unit is assisting in the care of a client who is experiencing hypovolemic shock. Which of the following actions should the nurse take? a. Insert an indwelling urinary catheter i. To monitor output closely – decrease kidney perfusion caused by shock can lead to oliguria 16. A nurse is assisting with planning care for a client who is breastfeeding and has mastitis. Which of the following recommendations should the nurse include? a. Instruct the client to apply warm compresses to the affected breast This study source was downloaded by from CourseH on :49:36 GMT -06:00 i. Will decrease inflammation and edema – will enable more effective emptying of the breast to prevent milk stasis, which decreases bacterial growth 17. A nurse is reinforcing teaching about car seat safety with the parent of a newborn. Which of the following client statements indicates an understanding of the teaching? a. “If my baby rides in a car with no back seat, the passenger air bag must be turned off.” i. To prevent potential injuries caused by air bag deployment 18. A nurse is planning to administer terbutaline to a client who is experiencing preterm labor. Which of the following routes of administration should the nurse plan to use? a. Subcutaneous i. Relaxes the smooth muscles and inhibits uterine activity – subcutaneously every 4 hours 19. A nurse is reviewing the laboratory results of a 4-hour-old newborn. Which of the following findings should the nurse report to the provider? a. Platelet count 120,000/mm3 i. Is below the expected reference range of 14-24 g/dL for a newborn 20. A nurse is caring for a client who is at 32 weeks of gestation and has a prescription for nifedipine. Which of the following outcomes should the nurse expect from this medication? a. Cessation of uterine contractions i. A calcium channel blocker used to decrease uterine contractions by relaxing the smooth muscle of the uterus 21. A nurse is reinforcing teaching about food sources that are high in folate with a group of clients who are pregnant. Which of the following foods should the nurse recommend to this group as the best source of folate? a. ½ cup dried peas i. Provides 127 mcg of folate ii. Should consume 400 mcg of folate/day 22. A nurse is reinforcing teaching with a client who has asked about continuing routine exercise during pregnancy. Which of the following responses should the nurse make? a. “Drink plenty of water after exercising.” i. Drink plenty of water during and after exercising to decrease the risk of dehydration from diaphoresis