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144 Cards in this Set
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A client informs the nurse that she intends to bottlefeed her baby. Which of the following actions should the nurse encourage the client to perform?
1. Increase her fluid intake for a few days 2. Massage her breasts every 4 hours 3. Apply heat packs to her axillae 4. Wear a supportive bra 24 hours a day |
4. Wear a supportive bra 24 hours a day
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A bottle feeding mother gave birth 3 days ago. Her breasts are red, firm, and warm. What do you advise?
a. intermittently apply ice packs to her axillae and breasts b. apply lanolin to her breasts and nipples every 3 hours c. express milk from her breasts every 3 hours d. ask the primary doctor for an order for a milk suppressant |
a. Intermittently apply ice packs to her axillae and breasts
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Which of the following statements is true about breastfeeding mothers as compared to bottle feeding mothers?
A. breastfeeding mothers usually involute completely by 3 weeks postpartum B. Breastfeeding mothers have decreased incidence of diabetes mellitis later in life. C. Breastfeeding mothers show higher levels of bone density after menopause D. Breastfeeding mothers are prone to fewer bouts of infection immediately postpartum |
B. Breast feeding mothers have decreased incidence of diabetes mellitis later in life
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Several weeks after giving birth, a breastfeeding woman complains that her first time having sex was very painful. What do you tell her?
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Women who breastfeed often have vaginal dryness. A vaginal lubricant may remedy your discomfort.
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A woman, 24 hours postpartum, is complaining of profuse diaphoresis, She has no other complaints. Which of the following actions by the nurse is appropriate?
1. Take the woman's temperature 2. Advise her to decrease her fluid intake 3. reassure the woman that this is normal 4. inform the doctor |
3. Reassure the woman that this is normal
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The nurse is discussing the importance of doing Kegal exercises during the postpartum period. Which of the following should be included in the teaching plan?
1. repeatedly contract and relax her rectal and thigh muscles 2. practice by stopping the urine flow midstream every time she voids 3. get on her hands and knees whenever performing the exercises |
2. Practice by stopping the urine flow midstream every time she voids as these are the same muscles used to do kegal exercises
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The nurse is evaluating the involution of a woman who is 3 days postpartum. Which finding would she expect:
1. Fundus 1 cm above umbilicus, lochia rosa 2. Fundus 2 cm above the umbilicus, lochia alba 3. Fundus 2 cm below the umbilicus, lochia rubra 4. Fundus 3 cm below the umbilicus, lochia serosa |
4. Fundus 3 cm below the umbilicus, lochia serosa
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The nurse is examining a 2-day postpartum client whose fundus is 2 cm below the umbilicus and whose bright red lochia saturates about 4 inches of a pad in 1 hour. What should the nurse document in the record?
1. Abnormal involution, lochia rubra heavy 2. Abnormal involution, lochia serosa scant 3. Normal involution, lochia rubra moderate 4. Normal involution, lochia serosa heavy |
3. Normal involution, lochia rubra moderate
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A woman is 1 day postpartum. Her lochia is rubra and moderate and her fundus is 2 cm above the umbilicus, boggy, and deviated to the right. What is the first thing you do?
1. notify the doctor 2. massage the fundus 3. escort her to the bathroom 4. check the quantity of the lochia on the peri pad |
2. massage the fundus to firm it up, and then take her to the bathroom afterwords
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Which of the following should be taught to the client who developed hemorrhoids after giving birth; Check all that apply:
1. use a sitz bath daily as a relief measure 2. digitally replace external hemorrhoids into the rectum 3. breastfeed frequently to stimulate oxytocin to reduce the size of the hemorrhoids 4. advise her that the hemorrhoids will increase in size with subsequent pregnancies 5. apply topical anesthetic as a relief measure |
1. use a sitz bath daily as a relief measure
2. digitally replace external hemorrhoids into the rectum 5. apply topical anesthetic as a relief measure |
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A mother is getting ready to be discharged home. She has a 2 year old daughter at home. Which of the following is the most appropriate thing to say to her?
1. "It's always nice when sibling are excited to have the babies go home 2. Your daughter is very advance her her age. She must speak well 3. Your daughter is likely to become very jealous of the new baby 4. Older sister can be very helpful. They love to play mother |
3. Your daughter is likely to become very jealous of the new baby
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Which of the following meals can the Muslim woman eat?
1. ham sandwich 2. bacon and eggs 3. spaghetti with sausage 4. chicken and dumplings |
4. chicken and dumplings since all the others contain pork
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Which of the following is a side effect of Methergine (ergonovine)?
1. headache 2. nausea 3. cramping 4. fatigue |
3. cramping
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Why are obstetric clients most at high risk for cardiovascular compromise during the one hour immediately following a delivery?
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Because of the excess blood volume from pregnancy that is circulating in the woman's periphery.
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A client has been transferred to the PACU from a c-section. The client has spinal anesthesia for the surgery. Which of the following interventions should the nurse perform at this time?
1. assess the level of the anesthesia 2. encourage the client to urinate in a bedpan 3. provide the client with the diet of her choice 4. check the incision for signs of infection |
1. assess the level of the anesthesia which includes vital signs: this is most pertinent
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Which of the following would the nurse perform during the postpartum assessment on a newly delivered client? CATA
1. palpate the breasts 2. auscultate the carotid 3. check vaginal discharge 4. assess the extremities 5. inspect the perineum |
1. palpate the breasts
3. check vaginal discharge 4. assess the extremities 5. inspect the perineum |
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What is Methylergonovine (Methergine) given for?
What must you check before administering it? |
It is given to help contract the uterus and prevent bleeding.
You must check blood pressure as it can raise it. |
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What do you do if a mother is shaking uncontrollably after giving birth?
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Give her a blanket, this is a normal response.
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What can a hematoma in a neonate cause?
1. Jaundice 2. High H&H 3. Low urine output 4. High urine output |
1. Jaundice, since circulating levels of bilirubin will be higher
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How often are postpartum vitals take?
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Q 15 x 4 then
Q30 x 4 then Q1 x 8 then routine |
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True or False: The nurse knows that a change in vital signs can indicate the presence of a hematoma.
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True: As hypovolemia will cause the blood pressure to drop and the pulse to increase.
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A patient being treated for a deep vein thrombosis who is on anticoagulant therapy should be monitored for:
1. Hematuria, high temperature, epitaxis 2. Low temperature, hematuria, epitaxis 3. Low blood pressure, Hematuria, epitaxis 4. Low blood pressure, high temperature, epitaxis |
3. Low blood pressure, Hematuria, epitaxis: All related to signs and symptoms of bleeding.
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If a patient becomes confused at night, what should you do?
1. Move their bed close to the nurse’s station 2. Turn on the tv and a light 3. Turn off the tv and provide indirect light 4. Call the patient’s family and have them come in |
3. Turn off the tv and provide an indirect source of light
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One hour after giving birth, and the following 24 hours, where should the fundus be located?
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The level of the umbilicus
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Immediately after giving birth, where should the fundus be located?
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Between the symphysis pubis and umbilicus.
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The urine specific gravity of a neonate is 1.002-1.010.
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The specific gravity of a neonate is 1.002-1.010.
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What is the normal specific gravity of a neonate's urine?
a. 1.010-1.020 b. 1.020-1.025 c. 1.002-1.010 d. 1.101-1.201 |
c. 1.002-1.010
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What is the specific gravity of the urine for a neonate?
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1.002-1.010
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The platelet count for a neonate is 150,000-300,000.
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The platelet count for a neonate is 150,000-300,000
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What is the platelet count for a neonate?
a. 150,000-300,000 b. 200,000-500,000 c. 150,000-450,000 d. 450,000-950,000 |
c. 150,000-300,000
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What is a normal neonatal platelet count?
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150,000-300,000
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A normal infant hemoglobin is 17-18.4.
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A normal infant hemoglobin is 17-18.4
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What is a normal infant hemoglobin?
a. 8-10 b. 17.4-18 c. 17-18.4 d. 18-19.4 |
c. 17-18.4
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A normal infant hematocrit is 48-64%.
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A normal Hematocrit is 48-64%
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What is a normal hematocrit?
a. 38-42% b. 42-46% c. 38-46% d. 48-64% |
d. 48-64%
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What is a normal neonatal hematocrit?
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48-64%
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How do anti psychotics work?
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They block the action of dopamine in the brain.
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What is the normal maintenance range of serum lithium ?
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0.6-1.2
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What is the normal range of serum lithium for acute mania?
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1.0-1.5
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When does lochia rubra occur?
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During the first few days after giving birth.
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When does lochia alba occur?
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This starts 10-14 days postpartum and can last up to 6 weeks.
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When does lochia serosa occur?
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This starts 3-4 days after birth.
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Who is Rhogam given to?
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Rh- women within 72 hours of giving birth
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Surfactant production is decreased in infants:
A. Of mothers with hypertension B. Who experienced placental insufficiency while in utero C. Of mothers addicted to heroin D. With hemolytic disorders |
D. With hemolytic disorders
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The role of the liver in successful newborn physiologic transition is to:
A. clean up old blood cells and cellular debris B. Adequately convert glycogen to glucose C. Regulate the neonates total blood volume D. Stimulate RBC production |
B. Adequately convert glycogen to glucose
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Surfactant acts to:
A. enlarge and expand the alveolar tubules B. Increase the surface area within the lungs C. Lower the surface tension in the lungs D. Develop the alveolar-capillary membrane |
C. Lower the surface tension in the lungs
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What is the name given to the small pimple like marks on the newborn's face?
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Milia
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What is erythema toxicum?
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A typical rash that newborns are born with.
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Which finding in a newborn assessment would warrant immediate intervention?
A. Temperature of 97.6 B. Erythema toxicum C. Periauricular papillomas D. Blood glucose of 50 |
A. Temperature of 97.6
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True or False: Newborns usually have 3-4 wet diapers per day during the first 2 weeks of life.
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True!
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What type of infant is described by the following:
exhibits thick vernix covering the body, smooth soles without creases, and lanugo covering the entire body. |
A preterm infant
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What type of neonate has dry peeling skin?
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A postterm infant.
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A nurse is assessing a 3 day old preterm neonate with a diagnosis of RDS. Which assessment finding indicates that the neonate's respiratory status is improving?
A Edema of the hands and feed B. Presence of a systolic murmur C. Urine output of 1 to 3 mL/kg/hour D. respiratory rate between 60-70 per minute |
C. Urine output of 1-3 mL/kg/hour: Increased urination is an early sign that the neonate's respiratory condition is improving. Lung fluid moves from the lungs into the bloodstream as the condition improves and the alveoli open. This extra fluid circulates to the kidneys, which results in increased voiding.
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A nurse in the delivery room assists with the delivery of a newborn infant. Following delivery, the nurse prevents heat loss in the newborn infant resulting from conduction by:
A. Wrapping the newborn in a blanket B. Closing the doors to the delivery room C. Drying the newborn with a warm blanket D. Placing a warm pad on the crib before placing the newborn in the crib |
D. Placing a warm pad on the crib before placing the newborn in the crib
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A nurse determines that a client understands the purpose of a vitamin K injection for her newborn if the client states that vitamin K is administered because newborns:
A. lack vitamins B. Have low blood levels C. Lack intestinal bacteria D. Cannot produce vitamin K in the liver |
C. Lack intestinal bacteria
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How does colostrum help prevent jaundice?
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It is a natural laxative and helps promote the passage of meconium.
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Where should the fundus be located right after giving birth?
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Half way between the umbilicus and symphasis pubis.
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Where should the fundus be located 6-12 hours after birth?
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The umbilicus.
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The fundus drops about __ cm per day below the umbilicus.
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1 cm per day
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A breastfeeding mother has engorged breasts. What should the nures advise her to do?
A. Avoid the use of a bra during engorgement B. Apply cool packs to both breasts 20 minutes before feeding C. Gently massage the breast from outer to inner during feeding D. Feed the infant less frequently |
C. Gently massage the breast from outer to inner during feeding as this will help the milk come out
-A supportive bra should always be warn -Warm packs are used before breastfeedings -The infant should be fed more frequently if needed |
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A nurse is caring for a term infant who is 24 hours old who had a confirmed episode of hypoglycemia when 1 hour old. Which observation by the nurse would indicate the need for further evaluation?
A. weight loss of 4 ounces and dry, peeling skin B. blood glucose of 40 before the last feeding C. breast feeding for 20 minutes or more, with strong sucking D. high pitched cry, drinking 10-15 mL of formula per feeding |
D. high pitched cry, drinking 10-15 mL of formula per feeding
-At 24 hours old, a term infant should be able to consume at least 1 ounce of formula per feeding. A high-pitched cry is indicative of neurological involvement. Blood glucose levels are acceptable at 40 mg/dL during the first few days of life. Weight loss over the first few days of life and dry, peeling skin are normal findings for term infants. Breast-feeding for 20 minutes with a strong suck is an excellent finding. Hypoglycemia causes central nervous system symptoms (high-pitched cry), and it is also exhibited by a lack of strength for eating enough for growth. |
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A mother just delivered a healthy infant. When palpating the fundus, the nurse notes that it is located 5 cm above the umbilicus. What does this indicated, and what should you do?
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This may indicate that there are blood clots pushing the uterus upward. You can expel the blood clots by massaging the uterus.
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A woman is in the postpartum unit 1 hour after the vaginal delivery. She received epidural anesthesia for the delivery. Which of the following would be the best indicator that she has a vaginal hematoma?
A. changes in vital signs B. signs of vaginal bruising C. client complains of a tearing sensation D. client complains of intense vaginal pressure |
A. changes in vital signs:
Changes in vital signs indicate hypovolemia in the anesthetized postpartum woman with a vaginal hematoma. Because the client received anesthesia, she would not feel pain or pressure. Vaginal bruising may be present, but this may be a result of the delivery process and additionally is not the best indicator of the presence of a hematoma. |
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A nurse is preparing to administer medication to a newborn infant with RDS. The nurse monitors the infant closely, knowing that drug toxicity is more likely to occur in an infant because:
A. The infant's lungs are immature B. The infant's kidneys are smaller C. Cerebral function is not fully developed in an infant D. The liver is not fully developed in an infant |
D. The liver is not fully developed in an infant
The liver is not fully developed in the newborn infant and the infant cannot detoxify many medications. Options 1, 2, and 3 are not associated with detoxifying medications. |
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A newborn infant of a mother with diabetes mellitis displays irregular respiration, grunting, substernal retraction, and lethargy. The nurse anticipated the respiratory distress noted in the newborn infant based on assessment of which test results performed in the week prior to delivery?
A. A reassuring nonstress test B. Biophysical profile C. Ultrasound series D. L/S ratio |
D. L/S ratio
-The newborn infant is having respiratory distress. Hyperglycemia during pregnancy delays fetal lung maturity. An L/S ratio is needed to predict sufficient surfactant to prevent respiratory distress syndrome (RDS). The ultrasound would not indicate RDS but would reflect the size of the infant and other anatomical findings. Both the reassuring nonstress test and the biophysical profile indicate well-being of the fetus and would not be a predictor of RDS |
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A nurse is reviewing the record of a newborn infant in the nursery and notes that the physician has documented the presence of a suture split greater than 1 cm. On the basis of this documentation, the nurse would monitor for which of the following?
A. Swelling of the soft tissues of the head and scalp B. Edema resulting from bleeding below the periosteum of the cranium C. Increased intracranial pressure D. Craniosynostosis |
C. Increased intracranial pressure
-Normal suture lines may be approximated or overriding. They are also mobile. Overriding suture lines are most often caused by the birthing process and resolve spontaneously. A split in the sutures of as much as 1 cm is considered normal. A suture split of greater than 1 cm may indicate increased intracranial pressure. Option 1 describes a caput succedaneum. Option 2 describes a cephalhematoma. A hard, rigid, immobile suture line can be associated with premature closure or craniosynostosis and should be investigated further. |
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A nurse is assessing a postterm infant born after the 42nd week of gestation. the significant information related to the infant's birth status is obtained when the nurse:
A. Determines the maternal blood type B. Observes infant behaviors C. Obtains the infant's footprints for future reference D. Carefully estimates the true gestational age by recording the infant's weight, length, and head circumference on growth charts |
D. Carefully estimates the true gestational age by recording the infant's weight, length, and head circumference on growth charts
-The medical management of a postterm infant is very different than that of a preterm or term infant. Estimating the true gestational age is an important factor in determining management of the infant. Although options 1, 2, and 3 identify data that would be obtained, option 4 specifically identifies information necessary for the care of the postterm infant. |
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An infant born past 42 weeks gestation is considered postmature and has little subcutaneous fat. The nurse writing a care plan for the infant will include that the infant should:
A Have supplemental calories added to the breast milk or formula B. Be provided with a neutral thermal environment C. Be offered feedings every 4-6 hours D. Remain in the hospital for an extended period of time |
B. Be provided with a neutral thermal environment
-Temperature regulation may be poor in the postmature infant because fat stores have been used for nourishment in utero. The infant may need to remain in a radiant warmer or incubator until thermoregulation is stable. Options 1, 3, and 4 are unassociated with temperature regulation and the postmature infant. |
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A nurse assigned to care for a lactating postpartum client plans to instruct the client to:
A. Resume the prepregnancy diet B. Increase caloric intake by 500 calories a day C. Continue folate and iron supplements at the same level as during the pregnancy |
B. Increase caloric intake by 500 calories a day
-Lactating women will require at least 500 additional calories above that consumed during pregnancy to ensure an adequate milk supply. Women are encouraged to increase their normal fluid intake (6 to 8 eight-ounce glasses per day). Folate and iron requirements are lower than during pregnancy. |
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A nurse determines that a breast-feeding client is at risk of developing mastitis if the nurse observes the mother:
A. Placing her finger in the infant's mouth to break suction on her nipple B. Offering one breast per feeding C. Manually expressing the remainder of breast milk after each feeding D. Gently pressing breast tissue away from the infant's nose while nursing |
B. Offering one breast per feeding
-Offering only one breast per feeding causes milk stasis, which is a risk factor for mastitis. The mother is encouraged to allow the infant to empty one breast completely, then continue feeding the infant on the opposite breast. Newborns frequently become fatigued and do not completely empty the second breast. The mother is instructed to express remaining milk manually and to offer the second breast first at the next feeding. A safety pin attached to the brassiere cup will allow the mother to remember which breast should be offered first each feeding. Breaking the infant's suction before removing the infant from the breast will reduce nipple trauma (another risk factor for mastitis). Gentle pressure placed on the tissue will not influence the development of mastitis. It is recommended to allow the infant to breathe through the nose unobstructed while nursing. |
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A pregnant woman with type I diabetes asks the nurse what effect this condition will have on her baby. What do you tell her?
A. It will have no effect on the baby B. The baby will be born with type I diabetes C. The baby will be bigger than usual D. The baby will be smaller than usual |
C. The baby will be bigger than usual
-Typically, infants of diabetic mothers are large for gestational age. Maternal glucose crosses the placenta to the fetus. The fetus is able to produce its own insulin; therefore, excessive body growth (macrosomia) results from high maternal glucose. |
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A nurse is changing the diaper of a 1-day old term female newborn and notes that the genitalia are red and swollen and that a thick white mucoid vaginal discharge is present. Based on these findings, the nurse determines that the best action would be to:
A. Obtain a specimen of the discharge for culture B. Document the findings C. Notify the physician D. Review the mother's record to determine a history of gonorrhea |
B. Document the findings:
-The genitalia of a newborn female are frequently red and swollen. This edema disappears in a few days. A vaginal discharge of thick white mucus is seen in the first week of life. The mucus is occasionally blood tinged by about the third or fourth day, and stains the diaper. The cause of the pseudomenstruation, like that of breast engorgement, is the withdrawal of maternal hormones. |
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A nurse is preparing a postpartum client who had a cesarean delivery for discharge to home. Which statement by the client indicates a need for additional discharge preparation?
A. "I will lift nothing heavier than the baby for 2 weeks" B. "I can start doing abdominal exercises as soon as I get home." C. "If a fever develops, I will call my doctor" D. "When getting out of bed, I will turn on my side and push up with my arms." |
B. "I can start doing abdominal exercises as soon as I get home."-Abdominal exercises should not be started after abdominal surgery until 3 to 4 postoperative weeks to allow healing of the incision.
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A postpartum nurse obtains the vital signs on a mother who delivered a healthy newborn infant 2 hours ago. The mother's temperature is 100 degree F. The initial nursing action would be to:
A. Document the finding B. Notify the physician C. Administer Tylenol D. Encourage oral fluid intake |
D. Encourage oral fluid intake: During the first 24 hours after delivery, the mother's temperature may increase to 100° F (38° C) as a result of the dehydrating effects of labor. Therefore the initial nursing action is to encourage fluid intake. The nurse would document the temperature, but this is not the initial action
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A client has just experienced a precipitate delivery. The nurse notes that the mother is lying quietly in bed and is avoiding physical contact with the newborn infant. The nurse takes which appropriate action?
A. Requests a psychiatric consult B. Contacts the physician C. Encourages the mother to breast-feed the infant D. Provides support to the mother |
D. Provides support to the mother: After a precipitate delivery, the mother may need help to process what has happened and time to assimilate it all. The mother may be exhausted, in pain, stunned by the rapid nature of the delivery, or simply following cultural norms. Providing support to the mother is the most appropriate and therapeutic action by the nurse. Options 1 and 2 are comparable or alike and do not enhance the therapeutic relationship. Option 3 is an appropriate nursing intervention, but the question does not indicate whether the mother is going to be breast-feeding.
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Which of the following would you choose/do when administering vitamin K to an infant?
A. Use a 1 inch needle at a 90 degree angle B. Use a 3/4 inch needle at a 45 degree angle C. Use a 5/8 inch needle at a 90 degree angle D. Use a 1/2 inch needle at a 90 degree angle |
C. Use a 5/8 inch needle at a 90 degree angle: Vitamin K is given in the middle third of the vastus lateralis muscle using a 25-gauge, 5/8-inch needle. It is injected into skin that has been cleansed with alcohol and allowed to dry for 1 minute. It is administered at a 90-degree angle. The site is massaged after removing needle to increase absorption of the medication.
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A client with a known history of panic disorder comes to the emergency department and states to the nurse, "Please help me, I think I'm having a heart attack." What is the priority nursing action?
A. Check the client's vital signs B. Encourage the client to use relaxation techniques C. Identify the manifestations related to the panic disorder D. Determine what the client's activity involved when the pain started |
A. Check the client's vital signs: Clients with panic disorders can experience acute physical symptoms, such as chest pain and palpitations. The priority is to assess the client's physical condition to rule out a physiological disorder. Although options 2, 3, and 4 may be appropriate at some point in the care of the client, they are not the priority.
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A nurse is caring for a client who is receiving ECT for a major depressive disorder. Which assessment finding would the nurse identify as an unexpected side effect of ECT that requires notifying the physician?
A. Confusion B. Memory loss C. Hypertension D. Disorientation |
C. Hypertension:The major side effects of ECT are confusion, disorientation, and memory loss. A change in blood pressure would not be an anticipated side effect, and it would be a cause for concern. If hypertension occurred after ECT, the physician should be notified.
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A nurse is caring for a client who has bipolar disorder and is in a manic state. The nurse determines that which menu choice would be best for this client?
A. Beef stew, fruit salad, tea B. Cheeseburger, banana, milk C. Macaroni and cheese, apple, milk D. Scrambled eggs, orange juice, coffee with cream and sugar |
B. Cheeseburger, banana, milk: The client in a manic state often has inadequate food and fluid intake as a result of physical agitation. Foods that the client can eat "on the run" are best, because the client is too active to sit at meals and use utensils. Additionally, clients in a manic state should not have any products that contain caffeine.
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Immediately after birth, what is the first nursing intervention for the newborn?
A. Dry and place in a warm environment B. Cut the umbilical cord and attach a clamp C. Administer oxygen until the cyanosis resolves D. Perform an abbreviated systematic physical assessment |
A. Dry and place in a warm environment: Warming the infant will reduce cyanosis if no respiratory obstruction is present
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What reflex is absent when paresis is present or in neonates born vaginally in the breech presentation?
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The stepping reflex.
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An assessment of a newborn includes the differentiation between cephalhematoma and caput succedaneum. When making this assessment, the nurse identifies that the newborn with caput succedaneum has scalp edema that:
A. Becomes ecchymotic B. Crosses the suture line C. Increases within 24 hours D. Is tender in the surrounding area |
B. Crosses the suture line: This is a sign that differentiates between these two conditions: caput succedaneum the swelling crosses the suture line and it does not with cephalhematoma
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On the second day of life, minutes after drinking 2 1/2 ounces of formula, a newborn regurgitates about half an ounce. The mother states, "My baby spits up after every feeding." The nurse should:
A. Reassure the mother that many babies spit up some milk at first B. Suggest that she hold her baby upright for 30 minutes after feeding C. Feed another 1/2 ounce of fresh formula when the baby returns to the nursery D. Teach her how to prop the baby in an infant seat at a 20-degree angle for an hour after feeding |
B. Suggest that she hold her baby upright for 30 minutes after feeding to enable gravity to pull the feeding through the pyloric sphincter; and minimize regurgitation.
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A newborn male is being discharged 4 hours after having a circumcision. The nurse should teach the mother to:
A. Apply the diaper loosely for 2-3 days B. Check for bleeding every 2 hours during the first day home C. Call the doctor is there is whitish exudate around the glans D. Call the doctor if a portion of the dried up cord is found in the baby's diaper |
A. Apply the diaper loosely for 2-3 days to avoid pressure on the circumcised area because the glans remain tender for 2-3 days. Also you should check for bleeding every hour for the first 12 hours following circumcision; and whitish exudate around the glans is expected.
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The best indication that correct attachment to the breast has occurred is when the:
A. Baby's tongue is securely on top of the nipple B. Baby's mouth covers most of the areolar surface C. Baby makes loud sucking sounds while nursing at each breast D. Baby sucks each breast vigorously for 5 minutes before falling asleep |
B. Baby's mouth covers most of the areolar surface: This is the proper attachment and helps compress the milk glands
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The mother who is formula feeding her 1 month old infant asks the nurse whether any vitamin or mineral supplements are required. The nurse bases the reply on the knowledge that infants who are fed with ready to use formula require:
A. Iron B. Fluoride C. Vitamin K D. Vitamin B12 |
B. Fluoride: Unless fluoridated water is used by the manufacturer, fluoride supplementation of 0.25 mg daily is required.
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On admission to the nursery a newborn is observed to be experiencing cold stress. The basis for the nursing intervention at this time is to minimize:
A. Shivering B. Hyperglycemia C. Oxygen consumption D. Metabolism of brown fat stores |
D. Metabolism of brown fat stores: Increased brown fat metabolism elevates fatty acids in the blood predisposing them to acidosis.
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What is the poop like for a breast feeding baby? How about a bottle feeding baby?
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Breastfeeding- seedy yellow
Bottlefeeding- pasty yellow |
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A jaundiced baby is put under bili lights. How will you know if the bilirubin is decreasing in the blood?
A. Their poops will be brown/green B. They will be more alert C. They skin will have transitioned to a light brown D. Their urine will become lighter in color |
A. Their poop will be a brown/green color
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Erica is planning on getting pregnant, when should she plan to start taking folic acid supplements?
A. Before pregnancy B. As soon as pregnancy is confirmed C. 1 week into pregnancy D. At the start of her last trimester |
A. Before pregnancy: The best way to ensure availability of the nutrient to the fetus is to consume it before and during pregnancy.
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A woman in labor suddenly complains of tingling fingers. What does this indicate?
A. A drop in her blood pressure B. She is hyperventilating C. Her epidural needs to be turned down D. She getting ready to faint |
B. She is hyperventilating: This results in respiratory alkalosis which causes tingling of the fingers and dizziness.
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A client at 18 weeks of gestation presents to the prenatal clinic for a routine check up. When reviewing the results from a maternal serum alpha-fetoprotein test, the nurse notes a lower than expected value for gestational age. The nurse should recognize that the fetus is at risk for which of the following?
A. Ompghalocele B. Anencephaly C. Spina bifida D. Down syndrome |
D. Down syndrome: Low maternal serum alpha-protein levels indicate a risk for Down syndrome.
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A nurse is caring for a client who presents to the emergency department in a active labor. She has a history of precipitate labor. Which of the following interventions should the nurse take first?
A. Perform a vaginal exam B. Monitor fetal heart rate C. Prepare for emergency delivery D. Notify the primary care provider |
A. Perform a vaginal exam
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What is terbutaline given for?
A. To initiate labor B. To increase the strength of uterine contractions C. To stop labor D. To facilitate Vitamin K productions |
C. To stop labor: It can be give if a person's L/S ratio is too low, and labor needs to be held off.
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A nurse assesses a term newborn delivered less than 1 hour ago. The nurse suspects a problem based on which of the following findings?
A. Relaxed posture while awake B. Apical pulse of 145-150 C. Resp rate of 50-60 D. Transient tremors in the lower extremities when crying |
A. Relaxed posture while awake, or hypotonia, may indicate hypoxia in utero, which requires further assessment.
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A nurse is providing nutrition counseling to a client who is at 12 weeks of gestation. Which of the following statements indicates to the nurse that the client needs further instruction?
A. I will add 300 calories per day to my diet B. A bedtime snack of milk and graham crackers will help me maintain good nutrition C. I should gain about 2 lbs per week for the rest of my pregnancy D. It is important for me to drink about 2 liters of fluid a day |
C. I should gain about 2 lbs each week for the rest of my pregnancy: During the 2nd and 3rd trimesters a pregnant woman should only gain about .88 lb per week.
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A nurse is providing discharge teaching to the parents of a 3 day old newborn with hyperbilirubinemia who has been prescribed home phototherapy with a biliblanket. Which of the following statements by the newborn's parents indicates a need for further teaching?
A. I can feed my baby while he is on the biliblanket B. I will call my doctor if my baby doesn't have six to eight wet diapers per day C. I will keep the eye patches on while my baby is in the biliblanket D. I can reposition my baby frequently to ex pose more skin surfaces to the light |
C. I will keep the eye patches on while my baby is in the biliblanket: Eye patches are not necessary when the newborn is being treated with a biliblanket.
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A nurse is providing education about car seat safety to the parents of a newborn. Which of the following should the nurse include in the teaching?
A. Secure the car seat harness at the newborn's waist B. Position the newborn in the car seat at a 45 degree angle C. Obtain approval from hospital staff before purchasing the car seat |
B. Position the newborn in the car seat at a 45 degree angle.
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A woman has blood clots that need to be expelled. Why must the uterus be firmly contracted prior to expressing the blood clots?
A. Bleeding will occur B. Pain will occur C. The uterus will invert D. The uterus will become more boggy |
C. The uterus will invert and result in extensive hemorrhage
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What are the risk factors for postpartum thromboembolic disease?
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Maternal age over 30, obesity, multiparity, smoking, diabetes mellitus(among the other typical risk factors).
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Which of the following client's is at most risk for a postpartum infection?
A. A client who experienced a precipitate labor less than 3 hours in duration B. A client with premature rupture of membranes and prolonged labor C. A client who delivered a large for gestational age infant D. A client with a boggy uterus that is not well-contracted |
B. A client with premature rupture of membranes and prolonged labor.
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True or false: A woman is advised to void prior to breastfeeding.
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True
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The nurse knows that the umbilical cord has ____vein(s) and ____arterie(s).
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1 vein and 2 arteries
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Which fontanel is the smaller one?
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The posterior fontanel.
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Mom has green eyes and Dad has brown eyes. Mom bets dad $50 that the baby will have green eyes; all money to be paid of course the day the baby is born. Who will win the bet that day?
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Nobody! The eyes of a newborn are blue or gray at birth; permanent eye color is established within 3-12 months.
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Upon examination of the newborn's head, the nurse notices the ears are low set. What can this indicate?
A. a renal disorder B. a cardiac disorder C. an endocrine disorder D. a respiratory disorder |
A. a renal disorder
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When selecting the proper size blood pressure cuff for the newborn, what size cuff should the nurse choose?
A. 10 cm cuff B. 5 cm cuff C. 2.5 cm cuff D. none of the above |
C. 2.5cm
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Heat loss from a cooler solid surface that is close to, but not in direct contact, such as a window is termed:
A. Conduction B. Convection C. Evaporation D. Radiation |
D. Radiation
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A baby's bassinet is in direct line with a fan. Heat is lost through:
A. Conduction B. Convection C. Evaporation D. Radiation |
B. Convection- think convection oven with an air current
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A nurse touches her cold stethoscope to the newborn's chest. Heat is lost via:
A. Conduction B. Convection C. Evaporation D. Radiation |
A. Conduction
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By keeping the nursery temperature warm and wrapping the newborn in warm blankets, the nurse is preventing which of the following types of heat loss?
A. Conduction B. Convection C. Evaporation D. Radiation |
B. Convection
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A nurse is taking a newborn to her mother for her first breastfeeding. The mother tells the nurse that her breasts are small and she is concerned she will not be able to breastfeed. Which of the following statements by the nurse is most appropriate?
A. The size of your breasts does not affect your ability to breastfeed B. Your baby will probably have to be supplemented with formula C. It would be best to bottle feed so your baby receives adequate calories D. Drink lots of fluids so you can increase your milk production |
A. The size of your breasts does not affect your ability to breastfeed.
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How much weight is normal for a newborn to lose during the first 24 hours?
A. None B. 5-10% C. 10-20% D. 15-20% |
B. 5-10%
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With hypospadias and epispadias, which involves the urethra opening to the under side of the penis, and which involves it opening to the top side of the penis.
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Hypospadias: Opening on the undersurface,
Epispadias: Opening on the outer surface |
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Which of the following measures is implemented in planning a circumcision?
A. The infant is tied to the restraint board 30 minutes prior to the procedure to allow it to become accustomed to it B. The infant is put under general anesthesia C. The bottlefed infant is kept NPO for 4 hours prior D. The breastfed infant is kept NPO for 4 hours prior |
C. The bottlefed infant is kept NPO for 4 hours prior: To prevent vomiting and aspiration; The breastfed infant may feed up until the procedure.
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A nurse is assessing an infant immediately following circumcision and notes that the circumcised area is red with a small amount of bloody drainage. Which of the following is the most appropriate nursing action?
A. Document the findings B. Contact the primary care provider C. Reassess in 4 hrs D. Reinforce the dressing |
A. Document the findings; these are normal and expected findings. No further action is needed.
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What affect can valium have on the fetus, when given to the laboring mother?
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It can cause jaundice.
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Nubaine is contraindicated if the mother:
a) is a drug user b) is HIV positive c) has aides d) smokes |
a) is a drug user
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Which of the following forms of anesthesia would cause partial loss of sensation?
a) spinal b) general c) epidural |
c) epidural
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Which of the following forms of anesthesia would cause complete loss of sensation?
a) spinal b) epidural c) local d) topical |
a) spinal
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A doctor is inserting an epidural and fluid begins dripping out. What happened?
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He pushed the needle in too far and entered the spinal cord. He needs to retract the needle.
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Are you able to feel pressure with an epidural?
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Yes
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Are you able to feel pressure with a spinal?
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No
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A patient is having a c-section and has a spinal. She suddenly complains of difficulty in breathing. What is the first thing you do?
a) apply oxygen via nasal cannula b) apply oxygen via face mask c) prepare for intubation d) raise the HOB |
d) raise the HOB so that the anesthesia stays lower in the spinal cord
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How long do spinals last for?
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1-2 hours
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Which of the following best describes a spinal?
a) a small catheter attached to a pump in which you press the button for medication b) a small catheter attached to a pump which the nurse regulates c) a shot given into the spinal cord d) a topical lidocaine cream applied to the perineum |
c) a shot given into the spinal cord
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Who are spinals indicated for?
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People undergoing a c-section who need 1-2 hours of anesthesia.
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How long do you have to revive a crashing baby with life threatening heart rate and/or respiratory problems?
a) 1 minute b) 2 minutes c) 6 minutes d) 10 minutes |
d) 10 minutes
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What would be an appropriate needle gauge for insertion on a labor patient?
a) 18 b) 22 c) 24 d) 26 |
a) 18: A large bore needle is needed in case IV fluids need to be administered quickly or blood needs to be given.
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Which of the following patients would need extra monitoring when their pitocin rate is increased? A patient with:
a) asthma b) CHF c) diabetes d) an endocrine disorder |
a) asthma
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A medication that causes uterine contraction would also cause ____ contraction.
a) sphincter b) bronchiole c) cardiac d) GI |
b) bronchiole: Smooth muscle contraction!
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What is a good variability in the fetal heart rate?
a) 0-5 b) 5-25 c) 30-40 d) 40-50 |
b) 5-25 is appropriate
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For 15 minutes, the mother feels no movement, and the baby's fetal heart rate shows no variability, with a HR of 140. What can this mean?
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The fetus is sleeping, resting, or medication has crossed the placenta.
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Can loss of variability ever be ok?
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Yes, if the fetus is sleeping or resting which typically occurs for 10-15 minutes.
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What is early deceleration usually related to?
a) head compression b) cord compression c) uteroplacental insufficiency d) over medication |
a) head compression
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With early deceleration, the fetal heart rate:
a) remains low after the contraction b) remains high after the contraction c) returns to normal after the contraction d) all of the above |
c) returns to normal after the contraction as the placenta is filled with blood again
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With late decelerations, what is the cause?
a) head compression b) umbilical cord compression c) uteroplacental insufficiency d) fetal distress |
c) uteroplacental insufficiency
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What does cocaine use cause?
a) head compression b) umbilical cord compression c) uteroplacental insufficiency d) fetal distress |
c) uteroplacental insufficiency
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What's the first thing you do when late decelerations are detected?
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Apply oxygen via face mask.
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What's the first thing you do when variable decelerations are detected?
a) stop the pitocin b) increase IV fluid rate c) apply oxygen via face mask d) turn her on the left side |
d) Turn her on her left side
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With variable decelerations, how do you position the patient?
a) on her left side b) on her right side c) standing d) it varies |
d) it varies, depending on the location of the umbilical cord depression; They will move them to several different positions to find the one that prefuses the cord the best.
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What PROCEDURE can help to relieve pressure on the umbilical cord?
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amnioinfusion
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Looking at the fetal monitor, you see accelerations. What does this indicate?
a) the baby is moving b) the baby is in distress c) the mother is moving d) the mother is bearing down |
a) the baby is moving
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What does the presence of meconium indicate?
a) fetal distress b) a LGA c) a SGA d) an AGA |
a) fetal distress
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