Download RN Maternal Newborn Final Quiz: Answers and Explanations and more Exams Nursing in PDF only on Docsity!
RN Maternal Newborn Final Quiz
A nurse is planning care for a client who is pregnant and is Rh-negative. In which of the following situations should the nurse administer Rh(D) Immune Globulin? While the client is in labor Following an episode of influenza during pregnancy Prior to a blood transfusion At 28 weeks of gestation At 28 weeks of gestion The nurse should administer Rh(D) Immune Globulin to a client who is pregnant and has Rh-negative blood at 28 weeks of gestation. Rh(D) Immune Globulin consists of passive antibodies against the Rh factor, which will destroy any fetal RBCs in the maternal circulation and block maternal antibody production. A nurse is caring for a newborn whose mother received magnesium sulfate to treat preterm labor. Which of the following clinical manifestations in the newborn indicates toxicity due to the magnesium sulfate therapy? Respiratory depression Hypothermia Hypoglycemia Jaundice Respiratory depression Magnesium sulfate can cause respiratory and neuromuscular depression in the newborn. The nurse should monitor the newborn for clinical manifestations of respiratory depression. A nurse is assessing a client on the first postpartum day. Findings include fundus firm and one fingerbreadth above and to the right of the umbilicus, moderate lochia rubra with small clots, temperature 37.3 C (99.2 F), and pulse rate 52/min. Which of the following actions should the nurse take? Ask the client when she last voided Because the muscles supporting the uterus have been stretched during pregnancy, the fundus is easily displaced when the bladder is full. The fundus should be found firm at midline. A deviated, firm fundus indicates a full bladder. The nurse should assist the client to void. A nurse is preparing to administer naloxone to a newborn. Which of the following conditions can require administration of this medication? IV narcotics administered to the mother during labor
Maternal drug use Hyaline membrane disease Meconium aspiration IV narcotics administered to the mother during labor The nurse should administer naloxone to reverse respiratory depression due to acute narcotic toxicity, which can result from IV narcotics administration during labor. A nurse is discussing epidural anesthesia with a client who is receiving oxytocin for induction of labor. Which of the following statements should the nurse make? "An epidural given too early during labor can cause maternal hypertension." "An epidural given too early during labor will not be effective in active labor." "An epidural given too early can cause fetal depression." "An epidural given too early can prolong labor." An epidural given too early can prolong labor Clients who receive anesthesia before the active phase of labor usually find the progression of their labor to slow. The medication depresses the central nervous system. Therefore, it will take longer for the cervix to dilate and efface. A nurse is caring for a client who is pregnant and reports nausea and vomiting. Which of the following instructions should the nurse provide the client? "You should eat some crackers before rising from bed in the morning." "You should eat foods served at warm temperatures." "You should sip whole milk with breakfast." "You should brush your teeth immediately after meals." You should eat some crackers before rising from bed in the morning Morning sickness is caused by the buildup of human chorionic gonadotropin (hCG) in the mother's system. Dry foods eaten before rising in the morning tend to reduce the risk of nausea in clients who are pregnant. A nurse is caring for a newborn who was born to a client who has a narcotic use disorder. Which of the following nursing actions should the nurse identify as a contraindication for the care of the newborn? Promoting maternal-newborn bonding Tight swaddling of the newborn Small frequent feedings Frequent stimulation Frequent stimulation This newborn needs a quiet, calm environment with minimal stimulation to promote rest and reduce stress. A stimulating environment can trigger irritability and hyperactive behaviors.
"Only you will need to take the metronidazole, but you should not have intercourse until your culture is negative." You and your partner need to take the medication and use a condom during intercourse until cultures are negative Trichomonas vaginalis is the organism that causes the sexually transmitted infection trichomoniasis. Both men and women can be infected with trichomoniasis. Clinical findings include yellowish to greenish, frothy, mucopurulent, copious discharge with an unpleasant odor, as well as itching, burning, or redness of the vulva and vagina. Trichomoniasis can be treated easily with metronidazole. However, for the treatment to work, it is important to make sure both sexual partners receive treatment to prevent reinfection. Instruct the client to use condoms during sexual intercourse while being treated. A nurse is caring for four newborns. Which of the following newborns is at greatest risk for hypoglycemia? A newborn who is large for gestational age A newborn who has an Rh incompatibility A newborn who has pathologic jaundice A newborn who has fetal alcohol syndrome A newborn who is large for gestational age Large for gestational age (LGA) newborns are those newborns whose weight is at or above the 90th percentile. One of the most common etiologies of LGA newborns is a mother who is diabetic. LGA newborns, especially those born to mothers who have diabetes, are at increased risk for hypoglycemia. Other newborns at risk for hypoglycemia are small for gestational age (SGA) newborns (those below the 10th percentile), premature newborns, and newborns who have perinatal hypoxia. A nurse is caring for a client who is 2 hours postpartum. The nurse notes the client's perineal pad has a large amount of lochia rubra with several clots. Which of the following actions should the nurse take first? Check for a full bladder. Massage the fundus. Measure vital signs. Administer carboprost IM. Massage the fundus The primary cause of early postpartum bleeding is uterine atony manifested by a relaxed, boggy uterus. Thus, the greatest risk for the client is hemorrhage. The nurse should massage the client's fundus first. A nurse is caring for a client whose membranes have ruptured and is in active labor. The fetal monitor tracing reveals late decelerations. Which of the following actions should the nurse take first? Turn the client onto her left side. Palpate the client's uterus. Administer oxygen to the client. Increase the client's IV fluids.
Turn the client onto her left side Late decelerations indicate that the client is experiencing uteroplacental insufficiency. The client might be experiencing pressure on the inferior vena cava, which decreases the oxygen to the placenta and thus to the fetus. Turning the client onto her left side will relieve the pressure and facilitate better blood flow to the placenta, thereby increasing the fetal oxygen supply. A nurse is planning care for a client who has a prescription for oxytocin. Which of the following is a contraindication for the use of this medication? Prolonged rupture of membranes at 38 weeks of gestation Intrauterine growth restriction Postterm pregnancy Active genital herpes Active genital herpes The use of oxytocin is contraindicated for clients who have an active genital herpes infection. The newborn can acquire the infection as they pass through the birth canal. Therefore, a cesarean birth is recommended for clients who have an active genital herpes infection. A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following clinical findings should the nurse expect? Extended periods of sleep Poor muscle tone Respiratory rate 50/min Exaggerated reflexes Exaggerated reflexes A newborn who has neonatal abstinence syndrome usually exhibits clinical findings of hyperactivity within the central nervous system (CNS). Exaggerated reflexes are indicative of CNS irritability. A nurse receives report on a client who is in labor and is experiencing contractions 4 minutes apart. Which of the following patterns should the nurse expect on the fetal monitoring tracing? Contractions that last for 60 seconds each with a 4-min rest between contractions Contractions that last for 60 seconds each with a 3-min rest between contractions A contraction that lasts 4 min followed by a period of relaxation Contractions that last 45 seconds each with a 3-min rest between contractions Contractions that last for 60 seconds each with a 3-minute rest between contractions A contraction interval is how often a uterine contraction occurs. The nurse will measure the interval from the beginning of one contraction to the beginning of the next contraction. A contraction lasting 60 seconds with a relaxation period of 3 min is equivalent to contractions every 4 min. A nurse is caring for a client who has clinical manifestations of an ectopic pregnancy. Which of the following findings is a risk factor for an ectopic pregnancy?
Whenever possible, the cesarean birth should be scheduled prior to the onset of labor or rupture of membranes to reduce the risk of neonatal transmission of herpes. A nurse is caring for a client who has a prescription for naloxone. Which of the following is the intended action of the medication in relation to the central nervous system? Accentuate effects of narcotics on the CNS Depress activity of the CNS Block effects of narcotics on the CNS Stimulate activity of the CNS Blocks effects of narcotics on the CNS By blocking the effects of narcotics on the CNS, naloxone prevents CNS and respiratory depression in the newborn following delivery. A nurse in a prenatal clinic is caring for a client who is within the recommended guidelines for weight. The client asks the nurse how much weight is safe for her to gain during her pregnancy. Which of the following responses should the nurse make? "Your provider can discuss an appropriate amount of weight gain with you." "A weight gain of about 14 pounds each trimester is suggested." "If you eat nutritious foods when you feel hungry, the amount of weight gain is insignificant." "A weight gain of about 25 to 35 pounds is good." A weight gain of about 25-35 pounds is good A weight gain of 25 to 35 lb is associated with good fetal outcome. A gain of 4 lb in the first trimester and 12 lb each for the second and third trimester is recommended. A nurse is caring for a client who is in labor and has an epidural for pain relief. Which of the following is a complication from the epidural block? Nausea and vomiting Tachycardia Hypotension Respiratory depression Hypotension Maternal hypotension is an adverse effect of epidural anesthesia. The nurse should administer an IV fluid bolus prior to the placement of epidural anesthesia in order to decrease the likelihood of this complication. A nurse is providing discharge teaching to a client following the removal of a hydatidiform mole. Which of the following statements should the nurse include in the teaching? "Do not become pregnant for at least 1 year." "Seek genetic counseling for yourself and your partner prior to getting pregnant again." "You should have an hCG level drawn in 6 weeks." "Have your blood pressure checked weekly for the next month."
Do not become pregnant for at least 1 year Hydatidiform moles are uncontrolled growths in the uterus arising from placental or fetal tissue in early pregnancy. There is an increased incidence of choriocarcinoma associated with molar pregnancies. Pregnancy must be avoided for 1 year so the client can be closely monitored for manifestations of this condition. A nurse is planning care for a client who is at 35 weeks of gestation. Which of the following laboratory tests should the nurse obtain? Rubella titer Blood type Group B streptococcus ß-hemolytic 1-hour glucose tolerance test Group B streptococcus B-hemolytic The nurse should obtain a vaginal/anal group B streptococcus ß-hemolytic (GBS) culture at 35 to 37 weeks of gestation to screen for infection. Prophylactic antibiotics should be given during labor to the client who is positive for GBS. A nurse is caring for a client who is at 34 weeks of gestation and has a prescription for terbutaline for preterm labor. Which of the following statements by the client is the priority? "My ankles are swollen at the end of the day." "I can feel the baby kicking my ribs, and it is very uncomfortable." "I'm growing more and more worried every day." "My heart feels as if it is racing." My heart feels as if it is racing The primary action of terbutaline is to cause bronchodilation and relax smooth muscles. However, an adverse effect is tachycardia. If the pulse is greater than 130/min, the terbutaline needs to be held until the provider is notified. A nurse is planning care for a newborn who requires phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan of care? Swaddle the newborn in a receiving blanket during the treatment. Maintain NPO status until the newborn's bilirubin is within the expected reference range. Ensure the newborn's eyes are closed before applying the eye shield. Apply lotion to the newborn's skin twice per day. Ensure the newborns eyes are closed before applying the eye shield Overexposure to the lights during treatment can cause damage to the newborn's corneas. Therefore, the nurse should gently close the newborn's eyes prior to applying the eye shield. A nurse administers betamethasone to a client who is at 33 weeks gestation to stimulate fetal lung maturity. Which planning care for the newborn, which of the following conditions should the nurse
I should press the button on the handheld marker when my baby moves The purpose of the test is to assess fetal well-being. The client should press the button on the handheld marker when she feels fetal movement. A nurse is caring for a client who is at 36 weeks of gestation and has preeclampsia. Which of the following findings should the nurse identify as the priority? 1+ proteinuria Blood pressure 140/98 mm Hg Nonreactive nonstress test Fundal height 33 cm Nonreactive nonstress test In a nonreactive nonstress test, there are no accelerations. Absence of FHR accelerations suggests that the fetus might be going into distress. A nurse is caring for a client who is in labor. The client questions the application of an internal fetal scalp monitor. Which of the following responses should the nurse make? "Don't worry. Your baby is fine." "You will need to ask your provider." "Your provider feels it would be best." "We need to observe your baby more closely." We need to observe your baby more closely The client has asked an information-seeking question. This therapeutic response provides information to the client in an honest, nonthreatening manner. The use of an internal fetal scalp monitor, or an internal spiral electrode, provides a more accurate assessment of fetal well-being during labor. A nurse is assessing a client who is receiving magnesium sulfate as treatment for preeclampsia. Which of the following clinical findings is the nurse's priority? Respirations 16/min Urinary output 40 mL in 2 hr Reflexes + Fetal heart rate 158/min Urinary output 40ml in 2 hours Urinary output is critical to the excretion of magnesium from the body. The nurse should discontinue the magnesium sulfate if the hourly output is less than 30 mL/hr A nurse is speaking with an expectant father who says that he feels resentful of the added attention others are giving to his wife since the pregnancy was announced several weeks ago. Which of the following responses should the nurse make? "Has your wife sensed your anger toward her and the baby?" "These feelings are common to expectant fathers in early pregnancy."
"I'm sure that it's really hard to accept this when it's your baby, too." "It would be wise for you to speak to a therapist about these feelings." These feelings are common to expectant fathers in early pregnancy A nurse is caring for a client who is receiving oxytocin for induction of labor. Which of the following actions should the nurse take? Perform continuous fetal heart rate monitoring. Measure maternal temperature every hour. Evaluate maternal contraction pattern every hour. Check blood pressure every 5 min. Perform continuous fetal heart rate monitoring When oxytocin is administered to an antepartum client, the fetal monitor must be used to continuously monitor the fetal heart rate and maternal contractions. A nurse is discussing diaphragm use with a client. Which of the following statements by the client indicates an understanding of the teaching? "I should clean my diaphragm with alcohol each time I use it." "I should leave the diaphragm in place 4 hours after intercourse." "I should replace my diaphragm every 2 years." "I should use a vaginal lubricant to insert my diaphragm." I should replace my diaphragm every 2 years The diaphragm is a flexible rubber cup that is filled with spermicide and is inserted over the cervix prior to intercourse. The diaphragm is a prescribed device fitted by the provider. It should be replaced every 2 years. A nurse is caring for a newborn who has irregular respirations of 52/minute with several periods of apnea lasting approximately 5 seconds. The newborn is pink with acrocyanosis. Which of the following actions should the nurse take? Administer oxygen. Place the newborn in an isolette. Continue to routinely monitor the newborn. Assess the newborn's blood glucose. Continue to routinely monitor the newborn A nurse is caring for a preterm newborn who is receiving oxygen therapy. Which of the following findings should the nurse identify as a potential complication from the oxygen therapy? Atelectasis Retinopathy Interstitial emphysema Necrotizing enterocolitis
