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CMS Maternal Newborn Practice B Questions with Solved Solutions
1. A nurse in a clinic is collecting data from a client who is at 12 weeks of gestation. Which of
the following actions should the nurse take?
a. Use an ultrasound stethoscope to listen to fetal heart tones.
b. Obtain a blood sample for the maternal serum alpha-fetoprotein (MSAFP) screen.
c. Collect a vaginal and an anal specimen for group B streptococcus (GBS)
d. Measure fundal height for gestational age.: a. Use an ultrasound stethoscope to listen to fetal heart
tones.
2. A nurse is assisting in the care of a client during the active phase of labor. Which of the following
actions should the nurse take to promote the client's comfort?
a. prepare the client for a pudendal nerve block
b. administer a sedative to the client
c. encourage the client to push
d. have the client perform relaxing breathing techniques: d. have the client perform relaxing
breathing techniques
3. A nurse is reinforcing teaching with a client who requests hydrotherapy for pain management
during labor. Which of the following statements should the nurse include?
a.You must be at least at 37 weeks of gestation before you can use hydrother- apy.
b. you will receive an injection of sterile water into your lower back during hydrotherapy
c. you can continue to use hydrotherapy as long as you do not develop a fever greater than 101
degrees Fahrenheit
d. You should keep the water temperature above 100 degrees Fahrenheit during hydrotherapy.: a. You
must be at least at 37 weeks of gestation before you can use hydrotherapy.
4. A nurse is reinforcing teaching about newborn umbilical cord care with a client who is postpartum.
Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. I will report any drainage from my baby's umbilical cord b. I will wash my baby's umbilical cord with soapy water. c. I will expect my baby's umbilical cord to fall off in 2-3 days. d. I will secure the diaper over my baby's umbilical cord: a. I will report any drainage from my baby's umbilical cord
5. A nurse is reinforcing discharge teaching about home care with the parent of a newborn. Which of
the following instructions should the nurse include?
a. Dress your newborn with two extra layers for the first week at home.
b. Give your newborn a bath once a day in the morning
c. cover your newborn with a lightweight blanket during naps.
d. Ensure the water temperature during your newborn's bath is maintained at 100 degrees
Fahrenheit: d. Ensure the water temperature during your newborn's bath is maintained at 100 degrees Fahrenheit
6. A nurse is assisting with the admission of a newborn who has respiratory distress. While
collecting data, which of the following should the nurse report to the provider? select all that apply.
9. A nurse is assisting with the neuromuscular assessment of a newborn by eliciting primitive
reflexes. which of the following images indicates a charac- teristics response of the tonic neck reflex?
a. newborn's head is quickly turned to one side, the arm and leg on the same side extend, while the
arm and leg on the opposite side flex.
b. newborn is placed on the abdomen
c. newborn pushes against the examiner's hands when pressure is applied to the soles of the
newborn's feet
d. newborn hears a loud noise, they abduct then extend the arms with the fingers widely open and
the thumb and index finger form a "C" shape. lower
extremities might also extend then abduct toward the abdomen.: a. newborn's head is quickly turned to one side, the arm and leg on the same side extend, while the arm and leg on the opposite side flex.
10. A nurse is collecting data from client who is primigravida and has hyper- thyroidism. Which of
the following findings should the nurse expect?
a. lethargy
b. hoarseness
c. diaphoresis
d. cold intolerance: c. diaphoresis
11. A nurse is reinforcing teaching about a non stress test with a client who is at 33 weeks of
gestation. Which of the following statements should the nurse include?
a. you will receive IV fluids throughout the test
b. you will press a button when you feel the baby move
c. you will need to avoid eating for 4 hours prior to the test
d. you will be prompted to massage your nipples for the test: b. you will press a button when you
feel the baby move
12. A nurse is assisting with the care of a client who is postpartum and is receiving lactated Ringer's
1,500 mL IV to infuse over 10 hr. The nurse should verify that the IV pump's settings will deliver how many mL/hr?: 150
13. A nurse is reinforcing discharge teaching with a client who has mastitis of the left breast. Which
of the following instructions should the nurse include?
a. use a nipple shell on the unaffected breast
b. vaginal bleeding
c. temperature of 39 FC
d. leakage of amniotic fluid: a. FHR 120/min
17. A nurse is contributing to the plan of care for a client who has hyperemesis gravidarum. Which of
the following interventions should the nurse recom- mend?
a. Encourage fluids with meals
b. obtain a specimen for a uric acid level
c. initiate a high-fat and low-protein diet
d. monitor intake and output: d. monitor intake and output
18. A nurse is contributing to the plan of care for a client who is pregnant and has intermittent
constipation. Which of the following interventions should the nurse recommend in the plan?
a. take 2 decussate calcium capsules each evening
b. use a hypertonic enema when episodes occur
c. consume 10 mL (2 tsp) of mineral oil each morning.
d. Drink 2 L of water per day: d. Drink 2 L of water per day
19. A nurse is planning to reinforce discharge teaching about formula feeding with the guardian of a
newborn. Which of the following instructions should the nurse plan to include?
a. provide the newborn with 6-8 feedings during a 24-hr period
b. Ensure that the newborn receives 45-60 mL of formula per feeding during the first 48 hr.
c. offer water to the newborn between feedings.
d. delay burping the newborn until the feeding is complete.: a. provide the newborn with 6-
feedings during a 24-hr period
20. A nurse is reinforcing teaching about car seat safety with the guardian of a newborn. Which of
the following statements by the guardian indicates an understanding of the teaching? a. I will place the baby's car seat in a rear-facing position until she is 1 year old. b. I will position the retainer clip at the level of the baby's armpits. c. I will place the shoulder harness straps in a slot 2 inches above the baby's shoulders.
c. the water used to prepare the formula must be sterile
d. formula left in the bottle can be given at the next feeding: b. over diluted formula can result in
inadequate growth
24. A nurse is reinforcing teaching about breastfeeding with a client who has a 12-hr-old newborn.
Which of the following statements should the nurse identify as an identification that the client understands the instructions. a. I will wipe the colostrum off my nipple before my baby feeds
b. I should wake up my baby to feed during the night
c. Since I am breastfeeding, I won't need to give my baby iron supplements until he's a year old
d. I should start to pump my breasts after each feeding when I get home: b. I should wake up my
baby to feed during the night
25. A nurse is reinforcing teaching with a client who is at 8 weeks of gestation. Which of the
following responses by the client indicates an understanding of the teaching? a. I should feel fetal movements by 12 weeks of pregnancy b. I should expect my pregnancy to start showing after the 20th week. c. I should report occasional nausea and vomiting to the doctor immediately. d. I should expect to have white vaginal discharge during pregnancy.: d. I should expect to have white vaginal discharge during pregnancy.
26. A nurse is planning to perform a blood collection via heel stick on a newborn. After
performing hand hygiene and donning gloves, which of the following actions should the nurse plan to take next?
a. Cleanse the newborn's heel with antiseptic and allow it to dry
b. Wrap the newborn's heel with a cloth moistened with warm water
c. cuddle and comfort the newborn
d. Apply pressure to the newborn's heel by using a dry gauze square: b. Wrap the newborn's heel
with a cloth moistened with warm water
27. A nurse is reinforcing teaching with a client who is pregnant and will undergo a 1-hr oral glucose
tolerance test. Which of the following instructions should the nurse include?
a. provide a urine sample at the start of the test.
b. Fast for 12 hr before the test
c. avoid caffeine the morning of the test
d. eat a low-carbohydrate diet 24 hr prior to the test: c. avoid caffeine the morning of the test
28. A nurse is reinforcing teaching about preventing urinary tract infections with a client who is at
25 weeks of gestation. Which of the following instruc- tions should the nurse include?
a. you should perform Kegel exercises four times per day
b. you should empty your bladder before you go to bed at night
c. you should wipe from back to front after urinating
d. you should wear underwear made from nylon: b. you should empty your bladder before you
go to bed at night
29. A nurse is caring for a client who is 48 hr postpartum following a vaginal birth. Which of the
following findings should the nurse report to the provider?
a. warm, tender area on the calf
priority immediately following a seizure?
a. initiate an IV line with an 18-gauge needle
b. insert an indwelling urinary catheter
c. Administer oxygen via facemask at 10L/min
d. monitor the client during magnesium sulfate therapy: c. Administer oxygen via facemask at
10L/min
31. A nurse is collecting data from a client who is receiving magnesium sulfate IV for preeclampsia.
The nurse should identify which of the following findings as an indication of toxicity to report to the provider?
a. tinnitus
b. proteinuria 3+
c. increased urine output
d. respiratory rat 10/min: d. respiratory rat 10/min
32. A nurse is reinforcing teaching with a client who has a new prescription for
medroxyprogesterone acetate injection for contraception. Which of the following statements by the client indicates understanding of the teaching? a. I should not receive this medication while I am breastfeeding b. I will need monthly injections of this medication c. I am likely to gain weight while taking this medication d. I should limit my calcium intake while taking this medication: c. I am likely to gain weight while taking
this medication
33. A nurse is assisting with the care of a client who is pregnant and has preeclampsia. While
the nurse is collecting data, the client has a seizure. Which of the following actions should the nurse take first?
a. monitor fetal heart tones
b. Measure the client's blood pressure.
c. Insert indwelling urinary catheter
d. turn the client on their side: d. turn the client on their side
34. A nurse is reinforcing education about the prevention of newborn abduc- tion with a client who
recently gave birth. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
a. I can carry my baby back to the nursery in my arms.
b. An alarm will sound if someone removes my baby's safety device
c. The nurse is not required to show their identification when taking my baby back to the nursery
d. I can leave my baby in the bassinet while I take a shower.: b. An alarm will sound if someone
removes my baby's safety device
35. A nurse in a postpartum unit is caring for a client who has endometritis and is 48 hr postpartum
following a cesarean birth. Which of the following findings should the nurse anticipate?
a. WBC 8,000/mm
b. Erythrocyte sedimentation rate
umbilicus
39. A nurse is reinforcing teaching with a client who is trying to become pregnant. Which of the
following foods should the nurse recommend as the best source of folate? a. 1 cup cooked spinach
b. one medium apple
c. 240 mL (8 oz) 2% milk
d. one large hard-boiled egg: a. 1 cup cooked spinach
40. A nurse is assisting with the care of a client who is in the active phase of the first stage of labor.
Which of the following findings should the nurse report to the charge nurse?
a. FHR 155/min
b. uterine contractions 70 seconds in duration
c. green fluid from the vagina
d. early declarations: c. green fluid from the vagina
41. A nurse is contributing to the plan of care for a newborn following a vaginal birth. Which of
the following information should the nurse include when helping to develop the newborn's plan of care? Select all that apps.
a. maternal group B streptococcus (GBS) status
b. Apgar score
c. maternal urinary output
d. type of birth
e. maternal weight: a. maternal group B streptococcus (GBS) status
b. Apgar score d. type of birth
42. A nurse is caring for a client who delivered vaginally 6 hr ago. Which of the following findings
should the nurse report to the provider?
a. labial edema
b. fundus firm at the umbilicus
c. WBC count 15,000/mm
d. perineal pad soaked in 15 mins: d. perineal pad soaked in 15 mins
43. A nurse is contributing to the plan of care for a client who is at 18 weeks gestation and has just
learned that the fetus has trisomy 21. Which of the following resources should the nurse recommend for the client?
a. physical therapy
b. occupational therapy
c. palliative services
d. genetic counseling: d. genetic counseling
44. A nurse is assisting with the care of a client who is at 39 weeks of gestation. Which of the
following statements should alert the nurse as a sign of a potential complication?
a. I have pain in my upper right abdomen
b. my feet and ankles are swollen
c. I feel like I can't breathe when I'm lying down
48. A nurse is collecting data from a client who is 1 day postpartum. Which of the following findings
should the nurse identify as an indication of infection?
a. BUN 15 mg/dL
b. WBC 35,000/mm
c. Urine specific gravity 1.
d. Hgb 10g/dL: b. WBC 35,000/mm
49. A nurse is caring for a client who is in preterm labor and is receiving betamethasone.
Which of the following actions should the nurse take?
a. check the client's blood pressure every 15 min for 1 hr after administration
b. monitor the client's magnesium level
c. inject the medication into the client's vests laterals muscle
d. inform the client that the medication can cause dizziness: c. inject the medication into the
client's vests laterals muscle
50. A nurse on postpartum unit is contributing to the discharge teaching plan for a client. Which of
the following instructions should the nurse suggests for the plan?
a. apply powder to the newborn's skin after baths
b. use a firm mattress in the newborn's crib
c. cover the newborn with a crib comforter
d. place the newborn on their stomach to sleep: b. use a firm mattress in the newborn's crib
