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A series of questions and answers related to maternal and newborn nursing, focusing on key aspects of postpartum care and potential complications. It covers topics such as postpartum hemorrhage, jaundice risk in neonates, preeclampsia management, drug use during breastfeeding, and various newborn assessments and interventions. The material is designed to test and reinforce knowledge of essential nursing practices in maternal and newborn health, providing insights into clinical decision-making and patient care strategies. It addresses critical areas such as recognizing and managing postpartum complications, understanding newborn physiological states, and ensuring safe breastfeeding practices. This resource is valuable for nursing students and professionals seeking to enhance their understanding and skills in maternal and newborn care.
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A postpartum woman complains of excruciating and pressure in the perineal area. She is restless, her pulse is 120, and respirations are 26 per min. Her fundus is firm at the umbilicus with small to moderate rubra lochia. The nurse should suspect - Answer Hematoma
Which neonate is at greatest risk for jaundice? - Answer Late Preterm
Admitted to the postpartum unit, this 20 year old gravida 1, complains of a headache. Her vital signs are: BP 140/88, HR 110, RR 18. She has pitting edema in her legs with a 4+ patellar reflexes and 2 beats of clonus. A dipstick for protein is 3+. These findings indicate a need for - Answer Magnesium sulfate bolus per physician order
Which of the following drugs is used to treat postpartum women that are experiencing heroine withdraw? - Answer Methadone
A high risk factor for chorioamnionitis is - Answer Preterm labor
Metabolic acidemia umbilical blood gases - Answer
The major postpartum maternal risk factor from shoulder dystocia is - Answer hemorrhage
A newborn should be evaluated if a newborn has not voided by - Answer 48 hours
The most common cause of sore nipples in immediate postpartum period is - Answer Improper latch-on and positioning
A vit-K injection is necessary because of which of the following physiological states present in the first few days of life - Answer Absence of normal flora in the gut
Magnesium sulfate is mainly excreted through the - Answer Kidneys
A client is admitted to the clinic and is diagnosed with one tender, red area in one breast that feels small and hard, about the size of a pea just under the skin.
The most likely management for this client is - Response Gentle massage to relieve the lump
Comparison of mature human milk and premature human milk reveals that for an identical volume, mature human milk contains - Response Protein
On physical examination, a nurse notes that there are white patches on the neonates mouth that bleed when an attempt is made to remove them. The nurse should - Answer review maternal hx for vaginal or yeast infection
To prevent a precipitous drop in intra-abdominal pressure, during catheterization of a postpartum patients bladder, what is the maximum amount of urine that should be removed at one time? - Answer 800mL
The impaired ability of the preterm neonate to generate heat, to maintain normal body temperature is most related to - Answer Limited subcutaneous tissue and brown fat stores
A mother is concerned that her newborn does not have tears when crying. The nurse should reassure her that - Answer Emotional tears are not present until approx. 3 months of age
A newborn whose mother was a poorly controlled diabetic during the 3rd trimester is a risk for - Answer polycythemia
The en face position occurs win what phase of initial attachment - Answer acquaintance
A formula-feeding mother asks the nurse whether she can use well water to mix formula. What is the best response? - Answer Needs to be tested to make sure it is safe to use
The nurse would instruct the breastfeeding patient that a tight fitting bra - Answer Can cause duct obstruction leading to mastitis
The parents of a 2-day-old infant ask when their baby's cord will come off. The nurse answers that the average cord separation time is - Answer 10-14 days
On regular rounds, the RN enters a patient room and finds the 33 year old G breastfeeding with good latch crying quietly. The best action for the RN would be to. - Answer Reassure her and ask open ended questions
Fetal heart rate characteristic that is most indicative of the absence of metabolic academia - Answer Presence of moderate variability
When implementing an oxygen saturation monitor on a neonate, the nurse should know that the single most important factor in getting an accurate reading is related to the - Answer Perfusion status of the infant
A 36-hour postpartum insulin-dependent diabetic is diaphoretic, shaky, and has tachycardia. This is consistent with - Answer Hypoglycemia
With the onset of labor, reabsorption of fluid from the alveolar spaces is due to the production of - Answer Catecholamines
The essential principle for resuscitation is that - Answer medications are not a substitute for adequate ventilation
When testing for capillary refill in the newborn, the maximum return if the pink color is how many seconds - Answer 3 seconds
Which neonatal reflex is considered a survival behavior - Answer Sucking
On postpartum day two, a woman who is afebrile has a white blood count of 20,000. This indicates - Answer A normal physiologic response
A woman who is underweight for her height, at a BMI of 18, gains 25 pounds during the course of her pregnancy. This woman is at an increased risk for a neonate with - Answer low birthweight
Congenital Muscular Torticollis - Answer also known as wryneck, condition in which a newborn presents with a shortened and tightened sternocleidomastoid muscle.
It is treated with positioning and exercise
The let-down occurs when there is a release of - Answer Oxytocin from the posterior pituitary
One analgesic that is recommended for women with hypertension and a platelet count of 80,000 is - Answer Acetaminophen
Phototherapy via a fiber optic blanket is ordered for a newborn who is 30 hours old. The mother should be instructed to do which of the following?
a. apply lotion to the skin during tx to prevent drying
b. increase fluids intake to 25% above daily normal
c. no change in care is required - Answer No change in car is required
anxious and tearful at times without reason
The risk for fetal damage as a result of toxoplasmosis infection is more serious if it is acquired during which trimester? - Answer 1st trimester
Toxoplasmosis - Answer a parasite that is most commonly transmitted from pets to humans by contact with contaminated animal feces
On examination of the newborn head, the nurse palpates the margin of parietal and occipital regions along the lambdoidal suture. The area will collapse and recoil under gentle pressure. This finding is indicative of - Answer Craniotabes
To reduce the risk for seizure in the postpartum breastfeeding epileptic woman, the woman should be encouraged to - Answer get a stretch of uninterrupted sleep
The purpose of treatment of gestational diabetes is to reduce the risk of fetal - Answer Macrosomia
A woman on methadone treatment wishes to breastfeed. She should be counseled that - Answer supervised methadone use is considered safe
A newborn may be presumed to be a post mature gestational age if neuromuscular development reflects an advanced stage of - Hip flexion and adduction
Which aromatherapy agent may be used to promote urination for a postprtal woman? Peppermint
Maternal blood volume rises throughout pregnancy, reaching a peak of what percentage above pre-pregnant levels? 50%
A predisposing factor in the development of transient tachypnea of the newborn - cesarean birth
Following delivery, an insulin dependent diabetic will have have her dose of insulin reduced because - Answer The anti-insulin effect stops after placental separation
The usual 5 to 10 percent weight loss that occurs in the term newborn is mainly due to - Answer Fluid shifts
To differentiate swallowed maternal blood from neonatal blood, which of the following test should be obtained - Answer The APT test
which employs alkali denaturation of hemoglobin to determine whether the blood present in a stool or Emesis
Antiretroviral therapy should be recommended to all HIV-infected pregnant women regardless of whether symptomatic to reduce - Answer Rate of perinatal transmission
Of the following, the most common environmental triggers for patent ductus arteriosis is
The current recommended method of umbilical cord care for the prevention of omphalitis - Answer Keeping the cord clean and dry
Immediately after delivery, the fundus is usually located - Answer At the umbilicus or 1- finger breadths below
Breastfeeding in the woman with diabetes is - Answer recommended
Infants from a mother with lupus need to be assessed for - Answer Congenital heart block
to - Answer Gently try pushing hemorrhoid back into rectum
Teaching parents to care for the uncircumcised male includes the need for - Answer Gentle washing of the genital area while bathing
Recommended treatment of the 36 week gestation patient with diagnosed HELLP syndrome is - Answer Prompt Delivery
Can women with an active herpes lesion breastfeed? -Answer Yes, nut they must cover the lesions while breastfeeding
A woman who has just delivered by emergency cesarean for placental abruption begins to develop epistaxis and bleeding from her IV site. This clinical presentation would be suspicious for -Answer DIC
DIC is an abbreviation for Disseminated Intravascular Coagulation. In this condition, clumps of thickened blood (clots) are actually formed inside small blood vessels. These clots consume the blood's clotting factors and can lead to massive bleeding elsewhere in the body.
At 48 hours of age, a 39 week gestation male has failed to pass meconium - Answer Hirschsprung disease
hereditary defect causing absence of enteric nervous system
Compared to unfractionated heparin, low molecular-weight heparin half-life is - Answer longer
Prenatal nuchal translucency is a screening test for - Answer Aneuploidy-
Abnormal number of chromosomes
A normal blood finding in the term neonate on day one of life is - Answer a hemoglobin level of 18 g/dL
A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic fluid was scored as normal. The expected management is - Answer repeat the test in 24 hours
Balloon catheters (Bakari balloon) are used to manage postpartum hemorrhage by - Answer Providing uterine tamponade
The greatest risk for maternal transmission of HIV is - Answer Intrapartum
The best treatment for breast engorgement is Answer breastfeeding the infant frequently
Elemental formulas are indicated for infants with Answer with malabsorption
Proteins against viral or bacterial infection of the intestinal tract in the breastfeeding infant is due to the presence of large amounts of which immunoglobulin in the breastmilk? Answer IgA
IgA Answer
A woman is 12 hours postpartum after a 36 hour labor. She has little interest in her newborn. The nurse should - Answer Preform a psychological assessment after a nap
Most safety initiatives are successful when the safety goals are based on - Answer A change in the culture of the institution
Both small for gestational age and post-term neonates are at increased risk for - Answer congenital anomalies
A woman with a history of having delivered an infant with anencephaly should be
A giant nevus is the most concerning of the genital pigmented nevi because it - Answer is a risk of malignant transformation
After a massive hemorrhage of 2000cc blood loss, a woman presents to the clinic on day 5 postpartum verbalizing her milk has not come in - Answer Sheehan's syndrome
Sheehan's syndrome - Answer Hypopituitarism caused by uterine hemorrhage during child birth. Blood loss prevents the pituitary gland from functioning.
Sx: amenorrhea, fatigue, unable to breast-feed baby, anxiety, decreased BP, Hair loss
Tx: Hormone therapy
Tests: CT scan of pituitary gland, check pituitary hormone levels
A 36 hours old breastfeeding infant has nursed 8 times in the last 24 hours on one breast each feeding. The infant demonstrated rhythmic sucking with audible swallowing during feedings. The infant has had 2 wet diapers and 2 moderate-sized free bowel movements. This assessment that the infant is - Answer Feeding well and as expected for this age
In evaluation of developmental dysplasia of the hips - Answer The Ortolani maneuvers determine if the femoral head is dislocated laterally
A GBS positive mother received two doses of antibiotics during labor. Four hours after delivery, the newborn is cyanotic with fluctuating temperatures and labored respirations. Blood cultures are drawn and sent to the lab. The nurse knows that blood cultures. - Answer May show false negative results due to the mother receiving antibiotics
Common manifestations of neonates who were exposed to barbiturates in utero include
A hispanic woman just delivered her newborn. She states she is going to breastfeed nut is asking the nurse for formula. The nurse needs to realize that in some cultures - Answer Colostrum is considered "bad"
After delivery, a newborn exhibits limp left lower arm and hand. The birth was complicated by shoulder dystocia. The expected diagnosis is - Answer Brachial plexus injury
The standard of care is established by what a _________________ reasonable and prudent nurse would have done
A postpartum woman who tells the nurse she was diagnosed with gestational diabetes during her pregnancy asks the nurse what type of plan she will need to follow now. The nurse knows that _________________ Serum glucose will be monitored at the 6 weeks postpartum visit
Compared to a midline episiotomy, blood loss for a mediolateral episiotomy is - Answer Greater
A term, Large for gestational age newborn had an initial breastfeeding at 30 minutes after birth. The initial glucose scream 30 minutes after feeding was 28. The newborn was asymptotic. The American Academy of pediatrics recommendation for this newborn is - Answer feed and check glucose in 1 hour
Ilotycin ointment is administered to the newborn after delivery to prevent infection from
The ethical-legal principle that serves as the basis for the necessity of informed consent procedure is - Answer Autonomy
Regarding circumcision, parents of a male are instructed that a yellowish film that develops on the circumcised area is - Answer normal granulation tissue
cosmetic effect of this skin disorder. The nurse should advise that - Answer Involution will occur around 1 year of age
Which of the following women have the highest risk of hematoma? -Answer G1 with forceps delivery
A Rh negative mother will be given an injection of Rhogam prior to discharge from postpartum if - Answer The indirect Coombs test of mother is negative, and the direct Coombs test of the infant is negative
The appropriate teaching regarding breast engorgement for non-breastfeeding mother is to - Answer Wear 24 hour support bra for comfort
The cranial sutures in the neonate are normally - Answer mobile
The correct position for cardiac compressions during neonatal resuscitation - Answer Find the right position for chest compressions by drawing an imaginary line between the nipples to find the middle of the breastbone. Place 2 fingers just below that line on the breastbone and push down hard on the breastbone 1½ inches toward the backbone.
A postpartum patient is concerned about loosing her "baby fat." She is breastfeeding and knows that increased calories are important but thinks the recommended 2500 to 2700 is too much for her. The nurse should explain that too few calories can lead to - Answer decreased milk production
Common manifestations of neonates who were exposed to barbiturates in utero include
A newborn is noted on initial assessment to have bounding in peripheral pulses. this indicates - Answer Patent ductus arteriosus
Maintenance of milk supply is controlled by adequate secretion of - Answer Prolactin
Early diagnosis of HELLP Syndrome includes identification of - Answer Burr cells
Q A primipara who is 3 hours postpartum has trickling of bright red blood from her vagina. Her fundus is firm and 2 fingers below the umbilicus. She denies discomfort. this is indicative of - Answer genital tract lacerations
At 48 hours postpartum. A cesarean section for failure to progress has a temperature of 100.8 and 101 on two occasions 6 hours apart. This is indicative of - Answer Infection
Diffuse borders, blanch with pressure and become pinker with crying. A flat pink lesion on the nose of a neonate. The nurse should suspect - Answer Nevvus simplex
What describes the normal newborn's urinary function after birth? - Answer The neonate is able to dilute but has limited ability to concentrate urine
Characteristic 2 year old sibling responses to the new baby include - Response Regress feeding
The most common indication for the use of magnesium sulfate in preeclampsia is - Response Seizure prophylaxis
The term newborn following vacuum extraction is at risk for hypovolemic shock due to - Response Subgaleal hematoma
A newborn has meconium stained fluid at birth. Newborn has good respiratory effort, good tone, and heart rate is 102 bpm. The best course of action to institute would be - Answer Clear mouth and nose of secretions
Late fetal heart rate decelerations - Answer placental insufficiency
A term, healthy infant who has been breastfeeding well develops jaundice on day 5 of life. The bilirubin peaks on day 14. This type of jaundice is called - Answer Breast milk jaundice
A newborn was delivered to a mother who developed varicella 4 days before delivery. The newborn should - Answer Receive varicella zoster immune globulin
The suggestion for freezing breast milk is to freeze it if it will not be used by - Answer 2 days
The ductus arteriosclerosis constricts due to increased - Answer Blood p
At what rate per minute should chest compressions be done during newborn resuscitation? - Answer 90
A primary difference between the nutrient composition of human milk and formula is the
After birth, an increase in left arterial pressure over right atrial pressure encourages the closure of the - Answer Foremen ovale
Fetal tachycardia should make the nurse suspect - Answer Infection
After delivery cardiac output declines by 30%in the first - Answer 2 weeks
A neonate is born to a mother with active syphillis. The infant screening tigers are lower that those of the mother, and the infant has no symptomatology. The next course of action would be to - Answer No evaluation and no treatment
Stages of development - Answer Conception
Pre-Embryo
Embryo: Day 15-end of 8th week
Fetus: 8th week to birth
Neonate: birth to 28 days
Infant: 28 days to 1 year
Estrogen - Answer -Uterine and breast development
-increased vascularization and hyperplasia of genitals
-softens connective tissue
-alters nutrient metabolism
Progesterone - Answer -development of deciduous
-reduce uterine excitability
-Alters, nutrient, metabolism
-decreased, smooth, muscle tone
-increased basal body temperature
HCG - Answer Human chorionic gonadotropin, maintains the corpus luteum,
Diagnosis of pregnancy, and may surprise immune response
When a neonate has persistent tachycardia, an echocardiogram is done to - Answer Identify any abnormal, cardiac structure
Which of the following maternal conditions would place a term newborn at risk for hyperbilirubinemia? - Answer Diabetes
A one day, old neonate demonstrates temperature instability, lethargy and poor muscle tone sepsis is suspected. The nurse can anticipate that prophylactic antibiotics will be prescribed, including - Answer Gentamicin