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Maternity NCLEX Questions and Answers Graded A+
Prior to discharging a 24 - hour-old newborn, the nurse assesses her respiratory status. Which of the following would the nurse expect to assess? A) Respiratory rate 45, irregular B) Costal breathing pattern C) Nasal flaring, rate 65 D) Crackles on auscultation The nurse encourages the mother of a healthy newborn to put the newborn to the breast immediately after birth for which reason? A) To aid in maturing the newborn's sucking reflex B) To encourage the development of maternal antibodies C) To facilitate maternal-infant bonding D) To enhance the clearing of the newborn's respiratory passages When making a home visit, the nurse observes a newborn sleeping on his back in a bassinet. In one corner of the bassinet is a soft stutted animal and at the other end is a bulb syringe. The nurse determines that the mother needs additional teaching because of which of the following? A) The newborn should not be sleeping on his back. B) Stutted animals should not be in areas where infants sleep. C) The bulb syringe should not be kept in the bassinet. D) This newborn should be sleeping in a crib. Assessment of a newborn reveals a heart rate of 180 beats/minute. To determine whether this finding is a
A
Typically, respirations in a 24 - hour-old newborn are sym- metric, slightly irregular, shallow, and unlabored at a rate of 30 to 60 breaths/minute. The breathing pattern is primarily diaphragmatic. Nasal flaring, rates above 60 breaths per minute, and crackles suggest a problem. C Breast-feeding can be initiated immediately after birth. This immediate mother-newborn contact takes advantage of the newborn's natural alertness and fosters bonding. This contact also reduces maternal bleeding and stabi- lizes the newborn's temperature, blood glucose level, and respiratory rate. It is not associated with maturing the sucking reflex, encouraging the development of maternal antibodies, or aiding in clearing of the newborn's respira- tory passages. B The nurse should instruct the mother to remove all flutty bedding, quilts, stutted animals, and pillows from the crib to prevent suttocation. Newborns and infants should be placed on their backs to sleep. Having the bulb syringe nearby in the bassinet is appropriate. Although a crib is the safest sleeping location, a bassinet is appropriate initially.
Maternity NCLEX Questions and Answers Graded A+
common variation rather than a sign of distress, what else does the nurse need to know? A) How many hours old is this newborn? B) How long ago did this newborn eat? C) What was the newborn's birthweight? D) Is acrocyanosis present? Just after delivery, a newborn's axillary temperature is 94 degrees F. What action would be most appropriate? A) Assess the newborn's gestational age. B) Rewarm the newborn gradually. C) Observe the newborn every hour. D) Notify the physician if the temperature goes lower. The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parents' findings by observ- ing the newborn, which of the following actions would be most appropriate? A) Notify the health care provider immediately. B) Assess the newborn for signs of respiratory distress. C) Reassure the parents that this is an expected pattern. D) Tell the parents not to worry since his color is fine.
A
The typical heart rate of a newborn ranges from 120 to 160 beats per minute with wide fluctuation during activity and sleep. Typically heart rate is assessed every 30 minutes un- til stable for 2 hours after birth. The time of the newborn's last feeding and his birthweight would have no ettect on his heart rate. Acrocyanosis is a common normal finding in newborns. B A newborn's temperature is typically maintained at 36. to 37.5 degrees C (97.7 to 99.7 degrees F). Since this newborn's temperature is significantly lower, the nurse should institute measures to rewarm the newborn gradu- ally. Assessment of gestational age is completed regard- less of the newborn's temperature. Observation would be inappropriate because lack of action may lead to a further lowering of the temperature. The nurse should notify the physician of the newborn's current temperature since it is outside normal parameters. B Although periods of apnea of less than 20 seconds can occur, the nurse needs to gather additional information about the newborn's respiratory status to determine if this finding is indicative of a developing problem. Therefore, the nurse would need to assess for signs of respiratory distress. Once this information is obtained, then the nurse can notify the health care provider or explain that this finding is an expected one. However, it would be inappro- priate to tell the parents not to worry, because additional information is needed. Also, telling them not to worry ignores their feelings and is not therapeutic.
Maternity NCLEX Questions and Answers Graded A+
The nurse interprets this finding as: A) Milia B) Mongolian spots C) Stork bites D) Birth trauma While making rounds in the nursery, the nurse sees a 6 - hour-old baby girl gagging and turning bluish. What would the nurse do first? A) Alert the physician stat and turn the newborn to her right side. B) Administer oxygen via facial mask by positive pressure. C) Lower the newborn's head to stimulate crying. D) Aspirate the oral and nasal pharynx with a bulb syringe. While performing a physical assessment of a newborn boy, the nurse notes dittuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as: A) Molding B) Microcephaly C) Caput succedaneum D) Cephalhematoma Assessment of a newborn reveals uneven gluteal (but- tocks) skin creases and a "clunk" when Ortolani's maneu- ver is performed. Which of the following would the nurse suspect? A) Slipping of the periosteal joint pear on the lower back and buttocks of newborns. Milia are unopened sebaceous glands frequently found on a newborn's nose. Stork bites are superficial vascular areas found on the nape of the neck and eyelids and between the eyes and upper lip. Birth trauma would be manifested by bruising, swelling, and possible deformity. D The nurse's first action would be to suction the oral and nasal pharynx with a bulb syringe to maintain airway patency. Turning the newborn to her right side will not alleviate the blockage due to secretions. Administering oxygen via positive pressure is not indicated at this time. Lowering the newborn's head would be inappropriate. C Caput succedaneum is localized edema on the scalp, a poorly demarcated soft tissue swelling that crosses the suture lines. Molding refers to the elongated shape of the fetal head as it accommodates to the passage through the birth canal. Microcephaly refers to a head circumference that is 2 standard deviations below average or less than 10% of normal parameters for gestational age. Cephal- hematoma is a localized ettusion of blood beneath the periosteum of the skull. B A "clunk" indicates the femoral head hitting the acetabu- lum as the head reenters the area. This, along with uneven gluteal creases, suggests developmental hip dysplasia. These findings are not a normal variation and are not as-
Maternity NCLEX Questions and Answers Graded A+
B) Developmental hip dysplasia C) Normal newborn variation D) Overriding of the pelvic bone The nurse strokes the lateral sole of the newborn's foot from the heel to the ball of the foot when evaluating which reflex? A) Babinski B) Tonic neck C) Stepping D) Plantar grasp The nurse administers vitamin K intramuscularly to the newborn based on which of the following rationales? A) Stop Rh sensitization B) Increase erythopoiesis C) Enhance bilirubin breakdown D) Promote blood clotting When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes? A) Gastrointestinal and hepatic B) Urinary and hematologic C) Respiratory and cardiovascular D) Neurological and integumentary A new mother reports that her newborn often spits up after feeding. Assessment reveals regurgitation. The nurse sociated with slipping of the periosteal joint or overriding of the pelvic bone. A The Babinski reflex is elicited by stroking the lateral sole of the newborn's foot from the heel toward and across the ball of the foot. The tonic neck reflex is tested by having the newborn lie on his back and then turn his head to one side. The stepping reflex is elicited by holding the newborn upright and inclined forward with the soles of the feet on a flat surface. The plantar grasp reflex is elicited by placing a finger against the area just below the newborn's toes. D Vitamin K promotes blood clotting by increasing the syn- thesis of prothrombin by the liver. RhoGAM prevents Rh sensitization. Erythropoietin stimulates erythropoiesis. Phototherapy enhances bilirubin breakdown. C Although all the body systems of the newborn undergo changes, respiratory gas exchange along with circulato- ry modifications must occur immediately to sustain ex- trauterine life. D The cardiac sphincter and nervous control of the stomach is immature, which may lead to uncoordinated peristaltic
A) Have a smaller body surface compared to body mass B) Lose more body heat when they sweat than adults C) Have an abundant amount of subcutaneous fat all over D) Are unable to shiver ettectively to increase heat produc- tion A new mother is changing the diaper of her 20 - hour-old newborn and asks why the stool is almost black. Which response by the nurse would be most appropriate? A) "You probably took iron during your pregnancy." B) "This is meconium stool, normal for a newborn." C) "I'll take a sample and check it for possible bleeding." D) "This is unusual and I need to report this." A client expresses concern that her 2 - hour-old newborn is sleepy and diflcult to awaken. The nurse explains that this behavior indicates which of the following? A) Normal progression of behavior B) Probable hypoglycemia C) Physiological abnormality D) Inadequate oxygenation After the birth of a newborn, which of the following would the nurse do first to assist in thermoregulation? A) Dry the newborn thoroughly. B) Put a hat on the newborn's head. C) Check the newborn's temperature. D) Wrap the newborn in a blanket. Assessment of a newborn reveals rhythmic spontaneous movements. The nurse interprets this as indicating:
D
Newborns have diflculty maintaining their body heat through shivering and other mechanisms. They have a large body surface area relative to body weight and have limited sweating ability. Additionally, newborns lack sub- cutaneous fat to provide insulation. B Meconium is greenish-black and tarry and usually passed within 12 to 24 hours of birth. This is a normal finding. Iron can cause stool to turn black, but this would not be the case here. The stool is a normal occurrence and does not need to be checked for blood or reported. A From 30 to 120 minutes of age, the newborn enters the second stage of transition, that of sleep or a decrease in activity. More information would be needed to determine if hypoglycemia, a physiologic abnormality, or inadequate oxygenation was present. A Drying the newborn immediately after birth using warmed blankets is essential to prevent heat loss through evapora- tion. Then the nurse would place a cap on the baby's head and wrap the newborn. Assessing the newborn's temper- ature would occur once these measures were initiated to prevent heat loss. B Motor maturity is evidenced by rhythmic, spontaneous
A) Habituation B) Motor maturity C) Orientation D) Social behaviors When teaching new parents about the sensory capabili- ties of their newborn, which sense would the nurse iden- tify as being the least mature? A) Hearing B) Touch C) Taste D) Vision The nurse places a warmed blanket on the scale when weighing a newborn to minimize heat loss via which mechanism? A) Evaporation B) Conduction C) Convection D) Radiation Which of the following would alert the nurse to the pos- sibility of respiratory distress in a newborn? A) Symmetrical chest movements movements. Habituation is manifested by the newborn's ability to respond to the environment appropriately. Ori- entation involves the newborn's response to new stimuli, such as turning the head to a sound. Social behaviors involve cuddling and snuggling into the arms of a parent. D Vision is the least mature sense at birth. Hearing is well developed at birth, evidenced by the newborn's response to noise by turning. Touch is evidenced by the newborn's ability to respond to tactile stimuli and pain. A newborn can distinguish between sweet and sour by 72 hours of age. B Using a warmed cloth diaper or blanket to cover any cold surface, such as a scale, that touches a newborn directly helps to prevent heat loss through conduction. Drying a newborn and promptly changing wet linens, clothes, or diapers help reduce heat loss via evaporation. Keeping the newborn out of a direct cool draft, working inside an isolette as much as possible, and minimizing the opening of portholes help prevent heat loss via convection. Keeping cribs and isolettes away from outside walls, cold windows, and air conditioners and using radiant warmers while transporting newborns and performing procedures will help reduce heat loss via radiation. D Sternal retractions, cyanosis, tachypnea, expiratory grunt- ing, and nasal flaring are signs of respiratory distress in a newborn. Symmetrical chest movements and a respiratory rate between 30 to 60 breaths/minute are typical new-
C) Outward-to-inward D) Distal-caudal A client at 28 weeks gestation is admitted to the labor and birth unit. Which test would most likely be used to assess the client's comprehensive fetal status? a) Ultrasound for physical structure b) Nonstress test (NST) c) Biophysical profile (BPP) d) Amniocentesis A prenatal client in her second trimester is admitted to the maternity unit with painless, bright red vaginal bleeding. What test might the physician order? a) Alpha-fetoprotein (AFP) b)Contraction stress test (CST) c)Amniocentesis d)Ultrasound The nurse is preparing a prenatal client for a transvaginal ultrasound. What nursing action should the nurse include in the preparations? Select all that apply.
C.
Biophysical profile is a comprehensive test that would be used to assess the client's fetal status at 28 weeks gestation. Ultrasound for physical structure is limited to identifying the growth and development of the fetus, and does not assess for other parameters of fetal well-being. Women with a high-risk factor will probably begin having NSTs at 30-32 weeks gestation and at frequent intervals for the remainder of the pregnancy. Amniocentesis late in pregnancy is used to test for lung maturity, not overall fetal status in labor, and when performed earlier it is used to test for specific disorders. D. An ultrasound for placenta location to rule out placenta previa would be ordered for a client who presents with painless, bright red vaginal bleeding. The ability to see the lower portion of the uterus and cervix with ultrasound is particularly important when vaginal bleeding is noted and placenta previa is the suspected cause. Alpha-fetoprotein (AFP) is a test used to screen for neural tube defects. A contraction stress test is ordered in the third trimester to evaluate the respiratory function of the placenta. Amnio- centesis is a procedure used for genetic diagnosis or, in later pregnancy, for lung maturity studies. D After having the client void, assist her to a lithotomy posi-
a)Advise the client to empty her bladder. b)Encourage the client to drink 1.5 quarts of fluid. c) Apply transmission gel over the client's abdomen. d) Place client in lithotomy position. A pregnant client asks why ultrasound is used so frequent- ly during pregnancy. The nurse's response is based on her knowledge that the advantages of ultrasound include which of the following? Select all that apply. a) "It is noninvasive and painless." b) "It can be used to estimate gestational age." c) "Results are immediate." d) "The ultrasound is the only test to determine gender." The physician orders an ultrasound for a prenatal client prior to an amniocentesis. The nurse explains to the client that the purpose of the ultrasound is to: a) Determine the gestational sac volume. b) Measure the fetus's crown-rump length. c) Locate the placenta. d) Measure the fetus's biparietal diameter. The nurse is reviewing four prenatal charts. Which client would be an appropriate candidate for a contraction stress test (CST)? tion for a transvaginal ultrasound. Preparation for a trans- abdominal ultrasound includes encouraging the client to drink 1.5 quarts of fluid, maintaining a full bladder, and applying transmission gel over the client's abdomen. A, B, C The ability to establish fetal age accurately by ultrasound is lost in the third trimester because fetal growth is not as uniform as it is in the first two trimesters; however, ultrasound can be used to approximate gestational age within 1 - 3 weeks' accuracy during the third trimester. A comprehensive ultrasound is used to detect anatomical defects, not gestational age. Ultrasound is not used to determine gender. C During an amniocentesis, the physician scans the uterus using ultrasound to identify the fetal and placental posi- tions and to identify adequate pockets of amniotic fluid. Determination of the gestational sac volume, measuring the crown-rump length, and measuring the biparietal di- ameter are aspects of assessing fetal well-being (biophys- ical profile, or BPP), and may or may not be done prior to the amniocentesis, depending on gestational age. A A contraction stress test (CST) is indicated for a client with intrauterine growth retardation (IUGR), because it will as- sess the respiratory function of the placenta, which may be adversely attected by the conditions causing IUGR. The
a) Intrauterine infection b) Rupture of membranes c) Maternal hypertension d)Spontaneous abortion A prenatal client at 35 weeks gestation is scheduled for an amniocentesis to determine fetal lung maturity. The nurse expects the lecithin/sphingomyelin (L/S) ratio to be: a)0.5: b)1: c) 2: d) 3: A pregnant client is concerned about a blow to the ab- domen if she continues to play basketball during her pregnancy. The nurse's response is based upon her knowledge of which of the following facts concerning amniotic fluid? a) The total amount of amniotic fluid during pregnancy is 300 mL. b) Amniotic fluid functions as a cushion to protect against mechanical injury. c) The fetus does not contribute to the production of amniotic fluid. d) Amniotic fluid is slightly acidic. A client states that she had a spontaneous abortion 12 months ago. The client asks if her hormones may have contributed to the loss of the pregnancy. The nurse's trauterine infection, maternal tissue contamination of the specimen, and Rh alloimmunization. CVS testing has a higher rate of spontaneous abortion than amniocentesis. Other complications include fetal limb defects and abnor- malities of the fetal face and jaw. C Early in pregnancy, the sphingomyelin concentration in amniotic fluid is greater than the concentration of lecithin, and so the L/S ratio is low (lecithin levels are low and sphingomyelin levels are high). At about 32 weeks ges- tation, sphingomyelin levels begin to fall and the amount of lecithin begins to increase. By 35 weeks gestation, an L/S ratio of 2:1 (also reported as 2.0) is usually achieved in the normal fetus. B During pregnancy, the amniotic fluid protects against in- jury. After 20 weeks of pregnancy, fluid volume ranges from 700-1000 mL. Some of the amniotic fluid is con- tributed by the fetus's excreting urine. Amniotic fluid is slightly alkaline. C
response is based upon her knowledge of which of the following facts? a) Implantation occurs when progesterone levels are low. b) hCG reaches a maximum level at 4 weeks gestation. c) Progesterone decreases the contractility of the uterus. d) Progesterone is only produced by the corpus luteum during pregnancy. A nurse is teaching a group of student nurses about amni- otic fluid. Which of the following statements by the student nurse reflects an understanding of the fetus's contribution to the quality of amniotic fluid? Select all that apply. a) "The fetus contributes to the volume of amniotic fluid by excreting urine." b) "Approximately 400 mL of amniotic fluid flows out of the fetal lungs each day." c) "The fetus swallows about 600 mL of the fluid in 24 hours." d) "A fetus can move freely and develop normally, even if there is no amniotic fluid." The nurse is preparing an educational workshop on fetal development. Which statement by the student would re- quire the nurse to explain further? a) "True knots are usually associated with a cord that is too long." b) "The average cord length at term is 22 inches." c) "The umbilical cord normally contains two veins and one artery." Progesterone decreases the contractility of the uterus, thus preventing uterine contractions that might cause spontaneous abortion. Progesterone must be present in high levels for implantation to occur. After 10 weeks, the placenta takes over the production of progesterone. hCG reaches its maximum level at 50-70 days gestation. A, B, C "The fetus contributes to the volume of amniotic fluid by excreting urine." Approximately 400 mL of amniotic fluid flows out of the fetal lungs each day. The fetus swallows about 600 mL of the fluid in 24 hours. A normal volume of amniotic fluid is necessary for good fetal movement. Normal movement is necessary for good musculoskeletal development. C Umbilical cords appear twisted or spiraled. This is most likely caused by fetal movement. A true knot in the um- bilical cord rarely occurs; if it does, the cord is usually long. More common are so-called false knots, caused by the folding of cord vessels. A nuchal cord is said to exist when the umbilical cord encircles the fetal neck. A normal umbilical cord contains one large vein and two smaller arteries. A specialized connective tissue known as Wharton's jelly
titioner, would indicate a positive, or diagnostic sign of pregnancy? a) Positive pregnancy test b) Goodell's sign c) Uterine enlargement and amenorrhea d) Fetal heartbeat with at Doppler at 11 weeks gestation The nurse in the prenatal clinic assesses a 26-year-old client at 13 weeks gestation. Which presumptive (subjec- tive) signs and symptoms of pregnancy should the nurse anticipate? a) Hegar's sign and quickening b) Ballottement and positive pregnancy test c) Chadwick's sign and uterine souffle d) Excessive fatigue and urinary frequency The nurse is teaching a group of students about the ditter- ences between a full-term newborn and a preterm new- born. The nurse determines that the teaching is ettective when the students state that the preterm newborn has: A) Fewer visible blood vessels through the skin B) More subcutaneous fat in the neck and abdomen C) Well-developed flexor muscles in the extremities D) Greater surface area in proportion to weight When assessing a postterm newborn, which of the fol- lowing would the nurse correlate with this gestational age Doppler device as early as weeks 10-12 of pregnancy. Pregnancy tests detect the presence of hCG in the mater- nal blood or urine. These are not considered a positive sign of pregnancy because other conditions can cause el- evated hCG levels. Physical changes, like Godell's sign and uterine enlargement, can also have other causes and do not confirm pregnancy. The subjective changes of preg- nancy, like amenorrhea, are the symptoms the woman experiences and reports. Because they can be caused by other conditions, they cannot be considered proof of pregnancy. D Excessive fatigue and urinary frequency both are pre- sumptive (subjective) signs and symptoms of pregnan- cy. Hegar's sign, ballottement, a positive pregnancy test, Chadwick's sign, and uterine souffle are probable (objec- tive) signs or symptoms of pregnancy. D Preterm newborns have large body surface areas com- pared to weight, which allows an increased transfer of heat from their bodies to the environment. Preterm new- borns often have thin transparent skin with numerous visible veins, minimal subcutaneous fat, and poor muscle tone.
variation? A) Moist, supple, plum skin appearance B) Abundant lanugo and vernix C) Thin umbilical cord D) Absence of sole creases The parents of a preterm newborn being cared for in the neonatal intensive care unit (NICU) are coming to visit for the first time. The newborn is receiving mechanical ventilation and intravenous fluids and medications and is being monitored electronically by various devices. Which action by the nurse would be most appropriate? A) Suggest that the parents stay for just a few minutes to reduce their anxiety. B) Reassure them that their newborn is progressing well. C) Encourage the parents to touch their preterm new- born. D) Discuss the care they will be giving the newborn upon discharge. When performing newborn resuscitation, which action would the nurse do first? A) Intubate with an appropriate-sized endotracheal tube. B) Give chest compressions at a rate of 80 times per minute. C) Administer epinephrine intravenously. D) Suction the mouth and then the nose. The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syn-
C
A postterm newborn typically exhibits a thin umbilical cord; dry, cracked, wrinkled skin; limited vernix and lanu- go; and creases covering the entire soles of the feet. C The NICU environment can be overwhelming. Therefore, the nurse should address their reactions and explain all the equipment being used. On entering the NICU, the nurse should encourage the parents to touch, in- teract, and hold their newborn. Doing so helps to ac- quaint the parents with their newborn, promotes self-con- fidence, and fosters parent-newborn attachment. The par- ents should be allowed to stay for as long as they feel comfortable. Reassurance, although helpful, may be false reassurance at this time. Discussing discharge care can be done later once the newborn's status improves and plans for discharge are initiated. D After placing the newborn's head in a neutral position, the nurse would suction the mouth and then the nose. This is followed by ventilation, circulation (chest compressions), and administration of epinephrine. C A preterm newborn is at increased risk for respiratory dis- tress syndrome (RDS) because of a surfactant deficiency.
B) Large-for-gestational-age newborns C) Appropriate-for-gestational-age newborns D) Low-birthweight newborns While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen level and duration closely based on the understanding that the newborn is at risk for which of the following? A) Retinopathy of prematurity B) Metabolic acidosis C) Infection D) Cold stress When planning the care for a SGA newborn, which action would the nurse determine as a priority? A) Preventing hypoglycemia with early feedings B) Observing for respiratory distress syndrome C) Promoting bonding between the parents and the new- born D) Monitoring vital signs every 2 hours A woman gives birth to a newborn at 36 weeks' gesta- tion. She tells the nurse, "I'm so glad that my baby isn't premature." Which response by the nurse would be most appropriate? A) "You are lucky to have given birth to a term newborn." B) "We still need to monitor him closely for problems." C) "How do you feel about delivering your baby at 36 weeks?" est risk for any problems. The other categories all have an increased risk of complications. A Oxygen therapy has been implicated in the pathogenesis of retinopathy of prematurity (ROP). Therefore, the nurse monitors the newborn's oxygen therapy closely. Metabolic acidosis may occur due to anaerobic metabolism used for heat production. Infection may occur for numerous reasons, but they are unrelated to oxygen therapy. Cold stress results from problems due to the preterm new- born's inadequate supply of brown fat, decreased muscle tone, and large body surface area. A With the loss of the placenta at birth, the newborn must now assume control of glucose homeostasis. This is achieved by early oral intermittent feedings. Observing for respiratory distress, promoting bonding, and monitoring vital signs, although important, are not the priority for this newborn. B A baby born at 36 weeks' gestation is considered a late-preterm newborn. These newborns face similar chal- lenges as those of preterm newborns and require similar care. Telling the mother that close monitoring is neces- sary can prevent any misconceptions that she might have and prepare her for what might arise. The baby is not considered a term newborn, nor is the baby considered premature. The decision for care in the NICU would de- pend on the newborn's status. Asking the woman how
D) "Your baby is premature and needs monitoring in the NICU." Which of the following would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn? A) Avoid using the terms "death" or "dying." B) Provide opportunities for them to hold the newborn. C) Refrain from initiating conversations with the parents. D) Quickly refocus the parents to a more pleasant topic. Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of a LGA newborn? A) Drug abuse B) Diabetes C) Preeclampsia D) Infection Which of the following would alert the nurse to suspect that a preterm newborn is in pain? she feels about the delivery demonstrates caring but does not address the woman's lack of understanding about her newborn. B When dealing with grieving parents, nurses should pro- vide them with opportunities to hold the newborn if they desire. In addition, the nurse should provide the parents with as many memories as possible, encouraging them to see, touch, dress, and take pictures of the newborn. These interventions help to validate the parents' sense of loss, relive the experience, and attach significance to the meaning of loss. The nurse should use appropriate terminology, such as "dying," "died," and "death," to help the parents accept the reality of the death. Nurses need to demonstrate empathy and to respect the parents' feel- ings, responding to them in helpful and supportive ways. Active listening and allowing the parents to vent their frustrations and anger help validate the parents' feelings and facilitate the grieving process. B Maternal factors that increase the chance of having an LGA newborn include maternal diabetes mellitus or glu- cose intolerance, multiparity, prior history of a macro- somic infant, postdates gestation, maternal obesity, male fetus, and genetics. Drug abuse is associated with SGA newborns and preterm newborns. A maternal history of preeclampsia and infection would be associated with preterm birth.
