Maternal and Newborn Health Nursing Review Questions Answers: Chapter 17, Exams of Nursing

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Newborn & Women's Health Nursing 7th

Edition Questions And Answers

1. Immediately after birth, the nurse can anticipate the fundus to be located A. at the umbilicus B. 2cm above the umbilicus C. 1cm below the umbilicus D. midway between the symphysis pubis and umbilicus

• correct answer D. midway between the symphysis pubis and umbilicus

2. When reading the postpartum chart the nurse notices that the patient's fundus is recorded as "u+1." The nurse understands that this means the fundus is A. 1cm above the umbilicus B. 1cm below the umbilicus C. 1in. above the umbilicus D. 1in. below the umbilicus

• correct answer A. 1cm above the umbilicus

3. During the second postpartum day, a woman asks the nurse, "Why are my afterpains so much worse this time

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

than after the birth of my other child?" The best answer by the nurse would be: A. "Most women forget how strong the afterpains can be." B."They should not be strong with you because you are breastfeeding." C."You should not be feeling the pains now; I will notify the physician for you." D. "Afterpains are more severe for women who have already given birth."

• correct answer D. "Afterpains are more severe for women who have already given birth."

4. The nurse is assessing the patient's vaginal discharge. It is red and has about a 2-inch stain on the peripad. The nurse will record this finding as a A. light amount of lochia rubra B. scant amount of lochia alba. C. moderate amount of lochia rubra. D. heavy amount of lochia alba.

• correct answer A. light amount of lochia rubra

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

5. The new mother is complaining of pain at the episiotomy site; however, because she is breastfeeding, she does not want any medication. What other alternatives can the nurse offer this mother to help relieve the pain? A. Ambulation B. Topical Anesthetics C. hot fluids to drink D. stool softeners

• correct answer B. Topical Anesthetics

6. A mother who is 3 days postpartum calls the clinic and complains of "night sweats." She is afraid that she is going into early menopause. The nurse should base her answer on the fact that A. Birth may put some women into early menopause; an appointment is needed to have this checked out. B. night sweats may be an indication of many other problems; an appointment is needed to assess the problem. C. diaphoresis is normal during the postpartum period, and comfort measures can be suggested to the mother.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

D. diaphoresis is normal only if the mother is breastfeeding.

• correct answer C. diaphoresis is normal during the postpartum period, and comfort measures can be suggested to the mother.

7. On the first postpartum day a patient's white blood cell count is 25,000/mm3. The nurse's next action should be to A. notify the physician for an antibiotic order. B. assess the patient's temperature and blood pressure. C. request the count be repeated. D. note the results in the chart.

• correct answer D. note the results in the chart.

8. One nursing measure that can help prevent postpartum hemorrhage and urinary tract infections is A. forcing fluids. B. perineal care. C. encouraging voiding every 2 to 3 hours.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

D. encouraging the use of stool softeners.

• correct answer C. encouraging voiding every 2 to 3 hours.

9. While doing patient teaching, the woman tells the nurse, "I don't have to worry about contraception because I am breastfeeding." The nurse should base her answer on the fact that A. breastfeeding can be considered a reliable system of birth control. B. breastfeeding can be used as a contraceptive method if strict guidelines are followed through C.breastfeeding is not a reliable contraceptive method.

• correct answer C.breastfeeding is not a reliable contraceptive method.

10. A woman was admitted to the ED with her newborn baby. The baby was born 4 days ago at home. The woman had no prenatal care. The nurse is assessing the lab work and sees that the mother has an O-negative blood type, the baby is O-positive, and the Coombs test shows that the mother is not sensitized to the positive blood. The nurse's next action should be

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

A. order Rho(D) immune globulin to be given to the mother. B. order Rho(D) immune globulin to be given to the baby. C. record the findings of the lab work and not plan on any further action at this time.

• correct answer C. record the findings of the lab work and not plan on any further action at this time.

11. The first time a woman ambulates after the birth of the newborn, she has a nursing diagnosis of Risk for injury because of the A. risk for developing orthostatic hypotension. B. development of bradycardia. C. increase in cardiac output. D. increase in circulatory volume

• correct answer A. risk for developing orthostatic hypotension.

12. When assessing a woman who gave birth 2 hours ago, the nurse notices a constant trickle of lochia. The uterus is well contracted. The next nursing action should be to

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

A. massage the fundus. B. continue to monitor. C. notify the physician. D. assess the blood pressure and pulse for changes.

• correct answer C. notify the physician.

13. During the early post-cesarean section phase, it is important for the woman to turn, cough, and deep breathe. The rationale for this is to prevent A. pooling of secretions in the airway. B. thrombus formation in the lower legs. C. gas formation in the intestinal tract. D. urinary retention.

• correct answer A. pooling of secretions in the airway.

14. As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is 1 day postpartum. An expected finding would be A. Soft, nontender; colostrum is present. B. Leakage of milk at let-down.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

C. Swollen, warm, and tender on palpation. D. A few blisters and a bruise on each areola.

• correct answer A. Soft, nontender; colostrum is present.

15. A birthing center is trying to balance its budget and needs to cut down on certain services they have been providing. One concern of the staff is the follow-up care for new mothers. Which of the following provides follow- up care at the least cost? A. Longer hospital stays for the mother and newborn B. Home visits after discharge C. Return clinic visits D. Telephone counseling services

• correct answer D. Telephone counseling services

16. The new mother comments that the newborn "has his father's eyes." The nurse recognizes this as A. part of the bonding process termed claiming. B. the mother trying to find signs of the baby's paternity. C. the mother trying to include the father in the bonding process.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

D. part of the letting-go phase of maternal adaptation.

• correct answer A. part of the bonding process termed claiming.

17. A new father of 1 day expresses concern to the nurse that his wife, who is normally very independent, is asking him to make all the decisions. The nurse can best explain this as a(n) A. normal occurrence because the mother is in pain. B. abnormal occurrence that needs to be assessed further. C. normal occurrence because the mother is in the taking- in phase. D. normal occurrence because the mother is frustrated with the care of the newborn.

• correct answer C. normal occurrence because the mother is in the taking-in phase.

18. The day after giving birth, the woman complains that she did not lose all the weight she had gained during the pregnancy. The nurse can best respond to the mother with the knowledge that

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

A. she has lost the most of the weight and the rest will be gone within 1 week. B. she has lost some of the weight and the rest will slowly disappear within 6 weeks. C. it will take about 6 to 12 months for all the weight gained with the pregnancy to disappear. D. most women do not lose all the weight gained with each pregnancy.

• correct answer C. it will take about 6 to 12 months for all the weight gained with the pregnancy to disappear.

19. A nurse is asked to do a home visit on a woman who delivered 2 weeks ago. When assessing the woman, the nurse was not able to locate the fundus. The next action would be A. massage the fundus until firm. B. monitor for bleeding. C. arrange transportation for the woman to the nearest hospital. D. document this normal finding.

• correct answer D. document this normal finding.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

20. The home care nurse is visiting a new mother who delivered 1 week ago. The mother complains about not being able to sleep and that she is tired and cries easily. The best response by the nurse would be: A. "Having a baby is difficult; it will be a long time before you get a good night's sleep." B. "Maybe your mother can come in and help you out." C. "It is normal for this to happen and should go away in 2 weeks. It must be very difficult for you to feel this way with a new baby." D. "The hospital nurses must not have taught you enough information about the changes you will experience during these first 6 weeks."

• correct answer C. "It is normal for this to happen and should go away in 2 weeks. It must be very difficult for you to feel this way with a new baby."

21. The new parents express concern that their 4-year-old son is jealous of the new baby. They are planning on going home tomorrow and are not sure how the preschooler will react when they bring the baby home. Which one of the following suggestions by the nurse will be most helpful?

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

A. Be aware that the child may regress to an earlier stage. B. Have the mother spend time with the child while the father cares for the baby. C. Have the child stay with a grandparent until the parents adjust to the new baby. D. Tell the child that he is a "big boy" now and doesn't need his crib so the new baby will be using it for a while.

• correct answer B. Have the mother spend time with the child while the father cares for the baby.

22. A newborn is rooming-in with his teenage mother, who is watching TV. The nurse notes that the baby is awake and quiet. The best nursing action is to A. pick the baby up and point out his alert behaviors to the mother. B. tell the mother to pick up her baby and talk with him while he is awake. C. focus care on the mother, rather than the infant so she can recuperate. D. encourage the mother to feed the infant before he begins crying.

• correct answer A. pick the baby up and point out his alert behaviors to the mother.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

23. When making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically A. express a strong need to review events and her behavior during the process of labor and birth. B. exhibit a reduced attention span, limiting readiness to learn C. attempt to meet the needs of the infant and is eager to learn about infant care. D. have reestablished her role as a spouse and partner.

• correct answer C. attempt to meet the needs of the infant and is eager to learn about infant care.

24. Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. The nurse should A. tell the woman she can rest after she feeds her baby. B. recognize this as a behavior of the taking-hold stage. C. record the behavior as ineffective maternal-newborn attachment.

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

D. take the baby back to the nursery, reassuring the woman that her rest is a priority at this time

• correct answer D. take the baby back to the nursery, reassuring the woman that her rest is a priority at this time

25. A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment following birth. The nurse, recognizing women's needs during this stage, should A. foster an active role in the baby's care B. provide time for the mother to reflect on the events of the childbirth. C. recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session now. D. promote maternal independence by encouraging her to meet her own hygiene and comfort needs.

• correct answer B. provide time for the mother to reflect on the events of the childbirth.

26. After a cesarean birth, the woman needs to be assessed routinely. Select all the assessments necessary for this woman. (Select all that apply.)

Newborn & Women's Health Nursing 7th

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A. Vital Signs B. Return of motion and sensation C. Abdominal dressing D. Pupil dilation E. Uterine firmness and position F. Urine output G. Deep tendon reflexes H. IV infusion

• correct answer A B C E F H

27. Constipation is a common problem during the postpartum period. Select all the reasons for constipation during this period. (Select all that apply.) A. Diminished bowel tone B. Overhydration during labor

Newborn & Women's Health Nursing 7th

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C. Episiotomy that causes the fear of pain with elimination D. Iron supplementation E. Some pain medications

• correct answer A C D E

28. When assessing the perineum, episiotomy site, or surgical site, the nurse should assess for specific signs. Select all the signs that are appropriate when assessing a surgical site. (Select all that apply.) A. Redness B. Edema C. Ecchymosis D. Discharge E. Asymetry

• correct answer A B C

Newborn & Women's Health Nursing 7th

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D

29. To promote bonding during the first hour after birth, the nurse can do which of the following? (Select all that apply.) A. Delay procedures if appropriate. B. Allow the father to hold the newborn. C. demonstrate proper bottle feeding techniques. D. Allow as much contact with the newborn as possible. E. Use the time to do parent teaching on newborn characteristics.

• correct answer A B D

30. Nursing measures to promote bonding and attachment include which of the following? (Select all that apply.) A. Assist the parents in unwrapping the baby to inspect. B. Point out that the infant grasping the mother's or father's finger is a natural reflex.

Newborn & Women's Health Nursing 7th

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C. Explain the physical changes in the newborn, such as molding, as being normal. D. Encourage the mother to let the infant stay in the nursery as much as possible so the mother can rest. E. Position the infant in a face to face position with the mother.

• correct answer A E

31. The placental site heals by a process of _______________.

• correct answer Exfoliation

32. Ice causes vasoconstriction and is most effective if applied soon after the birth to the perineal area to prevent ______________.

• correct answer Edema

33. The development of a strong emotional tie of a parent to a newborn is called _____________.

• correct answer Bonding

34. The maternal adaptation phase in which the mother relinquishes her previous role as being childless and her

Newborn & Women's Health Nursing 7th

Edition Questions And Answers

old lifestyle is called the _______________ phase.

• correct answer Letting go When the father develops a bond with the new infant and has an intense interest in how the infant looks and responds, this is called ________________.
• correct answer Engrossment