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104 Cards in this Set
- Front
- Back
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A married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. Based on the information given, what family form best describes this family?
a) Married-blended family b) Extended family c) Nuclear family d) Same-sex family |
Married-blended family
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The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family:
a) Rituals and customs b) Values and beliefs c) Boundaries and channels d) Socialization processes |
Values and beliefs
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The nurse's care of a Hispanic family includes teaching about infant care. When developing a plan of care, the nurse bases interventions on the knowledge that in traditional Hispanic families:
a) Breastfeeding is encouraged immediately after birth b) Male infants typically are circumcised c) The maternal grandmother participates in the care of the mother and her infant d) Special herbs mixed in water are used to stimulate the passage of meconium |
The maternal grandmother participates in the care of the mother and her infant
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Which health care service represents the primary level of prevention?
a) Immunizations b) Breast self-examination c) Home care for high risk pregnancies d) Blood pressure screening |
Immunizations
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What is the primary difference between hospital care and home health care?
a) Home care is routinely delivered continuously by professional staff b) Home care is delivered on an intermittent basis by professional staff c) Home care is delivered for emergency conditions d) Home care is not available 24 hours a day |
Home care is delivered on an intermittent basis by professional staff
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To provide competent care to an Asian-American family, the nurse should include the following question during the assessment interview:
a) Do you prefer hot or cold beverages b) Do you want some milk to drink c) Do you want music playing while you are in labor d) Do you have a name selected for the baby |
Do you prefer hot or cold beverages
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The woman's family members are present when the nurse arrives for a postpartum and newborn visit. What should the nurse do?
a) Observe the family member's interactions with the newborn and one another b) Ask the woman to meet with her and the baby alone c) Do a brief assessment on all family members present d) Reschedule the visit for another time so that the mother and infant can be assessed privately |
Observe the family's members' interactions with the newborn and one another
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What is a limitation of a home postpartum visit?
a) The nurse's ability to teach is limited by many distractions b) Identified problems cannot be resolved in the home setting c) Necessary items for infant care are not available d) Home visits to different families may require the nurse to travel a great distance |
Home visits to different families may require the nurse to travel a great distance
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The nurse should be aware that during the childbearing experience, an African-American woman will most likely:
a) Seek prenatal care early in her pregnancy b) Avoid self-treatment of pregnancy-related discomfort c) Request liver in the postpartum period to prevent anemia d) Arrive at the hospital in advanced labor |
Arrive at the hospital in advanced labor
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A health care service representing the tertiary level of prevention includes:
a) Stress management seminars b) Childbirth education classes for single parents c) A breast self-examination (BSE) pamphlet and teaching d) A premenstrual syndrome (PMS) support group |
A PMS support group
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When the services of an interpreter are used, it is important for the nurse to:
a) Use any family member who can interpret b) Use an interpreter who is certified and document the person's name in the nursing notes c) Speak only to the interpreter d) Use an interpreter only in an emergency |
Use an interpreter who is certified and document the person's name in the nursing notes
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A traditional family structure in which male and female partners and their children live as an independent unit is known as a/an:
a) Extended family b) Binuclear family c) Nuclear family d) Blended family |
Nuclear family
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A perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:
a) Uterine atony b) Uterine inversion c) Vaginal hematoma d) Vaginal laceration |
Uterine atony
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A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:
a) Establish venous access b) Perform fundal message c) Prepare the woman for surgical intervention d) Catheterize the bladder |
Perform fundal message
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A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by:
a) Subinvolution of the uterus b) Defective vascularity of the decidua c) Cervical laceration d) Coagulation disorders |
Subinvolution disorders
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Which client is at greatest risk for early postpartum hemorrhage (PPH)?
a) A primiparous woman (G2, P1-0-0-1) being prepared for an emergency cesarean birth for fetal distress b) A woman with severe preeclampsia on magnesium sulfate whose labor is being induced c) A multiparous woman (G3, P2-0-0-2) with an 8 hour labor d) A primigravida in spontaneous labor with preterm twins) |
A woman with severe preeclampsia on mag sulfate whose labor is being induced
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When caring for a postpartum woman experiencing hemorrhagic shock, the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:
a) Absence of cyanosis in the buccal mucosa b) Cool, dry skin c) Diminished restlessness d) Urinary output of at least 30ml/hr |
Urinary output of at least 30ml/hr
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The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy?
a) Large doses of vitamin C during pregnancy b) Prophylactic antibiotics c) Strict aseptic technique, including handwashing, by all health care personnel d) Limited protein and fat intake |
Strict aseptic technique, including handwashing, by all health care personnel
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One of the first symptoms of puerperal infection to assess for in the postpartum woman is:
a) Fatigue continuing for longer than 1 week b) Pain with voiding c) Profuse vaginal bleeding d) Temperature of 38 degree C (100.4 F) or higher on 2 successive days starting 24 hours after birth |
Temperature of 38 degree C (100.4 F) or higher on 2 successive days starting 24 hours after birth
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The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:
a) Washing the nipples and breasts with mild soap and water once a day b) Using proper breastfeeding techniques c) Wearing a nipple shield for the first few days of breastfeeding d) Wearing a supportive bra 24 hours a day |
Using proper breastfeeding techniques
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Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH). For instance:
a) PPH is easy to recognize early; after all, the woman is bleeding b) Traditionally, it takes more than 1000ml of blood after vaginal birth and 2500ml after cesarean birth to define the condition as PPH c) If anything, nurses and doctors tend to overestimate the amount of blood loss d) Traditionally, PPH has been classified as early or late with respect to birth |
Traditionally, PPH has been classified as early or late with respect to birth
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Lacerations of the cervix, vagina, or perineum are also causes and incidence of obstetric lacerations of the lower genital tract include all except:
a) Operative or precipitate birth b) Adherent retained placenta c) Abnormal presentation of the fetus d) Congenital abnormalities of the maternal soft parts |
Adherent retained placenta
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A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. The nurse should suspect __________ and should confirm the diagnosis by _______________.
a) Disseminated intravascular coagulation (DIC); asking for laboratory tests b) von Willebrand disease (vWD); noting whether bleeding times have been extended c) Thrombophlebitis; using real-time and color Doppler ultrasound d) Thrombocytopenic purpure; drawing blood for laboratory analysis |
Thrombophlebitis; using real-time and color Doppler ultrasound
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It is important for the perinatal nurse to be knowledgeable regaring conditions of abnormal adherence of the placenta. This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta and decidua. Which classification of separation is not recognized as an abnormal adherence pattern?
a) Placenta accreta b) Placenta increta c) Placenta percreta d) Placenta abruptio |
Placenta abruptio
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Medications used to manage postpartum hemorrhage (PPH) include: (choose all that apply)
a) Oxytocin b) Methergine c) Terbutaline d) Hemabate e) Magnesium sulfate |
Oxytocin, Methergine, Hemabate
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_____________ is the most common postpartum infection
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Endometritis
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A woman gave birth vaginally to a 9lb, 12oz girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath tid, and a stool softener. What information is most closely correlated with these orders?
a) The woman is a gravida 2, para 2 b) The woman had a vacuum-assisted birth c) The woman received epidural anesthesia d) The woman has an episiotomy |
The woman has an episiotomy
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The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8; hematocrit, 30%. How would the nurse best interpret these data?
a) Rubella vaccine should be given b) A blood transfusion is necessary c) Rh immune globulin is necessary within 72 hours of birth d) A Kleihauer-Betke test should be performed |
Rubella vaccine should be given
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A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your assessment you notice that both her breasts are swollen, warm, and tender on palpation. The woman should be advised that this condition can best be treated by:
a) Running warm water on her breasts during a shower b) Applying ice to the breasts for comfort c) Expressing small amounts of milk from the breasts to relieve pressure d) Wearing a loose-fitting bra to prevent nipple irritation |
Applying ice to the breasts for comfort
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A primiparous woman is to be discharged from the hospital tomorrow with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged?
a) The woman is disinterested in learning about infant care b) The woman continues to hold and cuddler her infant after she has fed her c) The woman reads a magazine while her infant sleeps d) The woman changes her infants diaper and then shows the nurse the contents of the diaper |
The woman is disinterested in learning about infant care
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Which finding could prevent early discharge of a newborn who is now 12 hours old?
a) Birth weight of 3000g b) One meconium stool since birth c) Voided, clear, pale urine three times since birth d) Infant breastfed once with some difficulty with latch and sucking and once with some success for about 5 minutes on each breast |
Infant breastfed once with some difficulty with latch and sucking and once with some success for about 5 minutes on each breast
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What is not a postpartum practice for preventing infections?
a) Not letting the mother walk barefoot at the hospital b) Educating the client to wipe from back to front after voiding c) Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay home d) Instructing the mother to change her perineal pad from front to back each time she voids or defecates |
Educating the client to wip from back to front after voiding
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What is not a reliable indicator of impending shock from early hemorrhage?
a) Respirations b) Blood pressure c) Skin condition d) Urinary output |
Blood pressure
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Because a full bladder prevents the uterus from contracting normally, nurses intervent to help the woman empty her bladder spontaneously as soon as possible. If all else fails, the last thing the nurse might try is:
a) Pouring water from a squeeze bottle over the woman's perineum b) Placing oil of peppermint in a bedpan under the woman c) Asking the physician to prescribe analgesics d) Inserting a sterile catheter |
Inserting a sterile catheter
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If a woman is at risk for thrombus and is not ready to ambulate, the nurses might intervene by doing all of these interventions except:
a) Putting her in antiembolic stockings (TED hose) and/or sequential compression device (SCD) boots b) Having her flex, extend, and rotate her feet, ankles and legs c) Having her sit in a chair d) Notifying the physician immediately if a positive Homans' sign occurs |
Having her sit in a chair
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With regard to rubella and Rh issues, nurses should be aware that:
a) Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus b) Woman should be warned that the rubella vaccination is teratogenic and they must avoid pregnancy for at least 1 month after vaccination c) Rh immune globulin is safely administered intravenously because it cannot harm a nursing infant d) Rh immune globulin boosts the immune system and thereby enhances the effectiveness of vaccinations |
Woman should be warned that the rubella vaccination is teratogenic and they must avoid pregnancy for at least 1 month after vaccination
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The ____________________ test is used to detect the amount of fetal blood in the maternal circulation.
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Kleihauer-Betke
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A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this womans fundus?
a) At the level of the umbilicus b) Two centimeters below the umbilicus c) Midway between the umbilicus and the symphysis pubis d) Nonpalpable abdominally |
At the level of the umbilicus
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To provide optimum care for the postpartum woman, the nurse understands that teh most common causes of subinvolution are:
a) Postpartum hemorrhage and infection b) Multiple gestation and postpartum hemorrhage c) Uterine tetany and overproduction of oxytocin d) Retained placental fragments and infection |
Retained placental fragments and infection
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Which woman is most likely to experience strong afterpains?
a) A woman who experienced oligohydramnios b) A woman who is a gravida 4, para 4-0-0-4 c) A woman who is bottle feeding her infant d) A woman whose infant weighed 5lb, 3 oz |
A woman who is a gravida 4, para 4-0-0-4
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A woman who gave birth to a health infant boy 5 days ago. What type of lochia does the nurse expect to find when assessing this woman?
a) Lochia rubra b) Lochia sangra c) Lochia alba d) Lochia serosa |
Lochia serosa
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Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
a) Estrogen b) Progesterone c) Prolactin d) Human placental lactogen |
Prolactin
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Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period is:
a) Elevated temperature caused by postpartum infection b) Increased basal metabolic rate after giving birth c) Loss of increased blood volume associated with pregnancy d) Increased venous pressure in the lower extremities |
Loss of increased blood volume associated with pregnancy
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A nurse caring for a postpartum woman understands that breast engorgement is caused by:
a) Overproduction of colostrum b) Accumulation of milk in the lactiferous ducts and glands c) Hyperplasia of mammary tissue d) Congestion of veins and lymphatics |
Congestion of veins and lymphatics
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A woman gave birth to a 7lb, 6oz infant girl 1 hour age. The birth was vaginal and the estimated blood loss (EBL) was 1500ml. When assessing the woman's vital signs the nurse is concerned to see:
a) Temperature 37.9 C, heart rate 120, respirations 20, blood pressure 90/50 b) Temperature 37.4 C, heart rate 88, respirations 36, blood pressure 126/68 c) Temperature 38 C, heart rate 80, respirations 16, blood pressure 110/80 d) Temperature 36.8 C, heart rate 60, respirations 18, blood pressure 140/90 |
Temperature 37.9 C, heart rate 120, respirations 20, blood pressure 90/50
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The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is called the:
a) Involutionary period because of what happens to the uterus b) Lochia period because of the nature of the vaginal discharge c) Mini-try period because it lasts only 3 to 6 weeks d) Puerperium, or fourth trimester of pregnancy |
Puerperium, or fourth trimester of pregnancy
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The self-destruction of excess hypertrophied tissue in the uterus is called:
a) Autolysis b) Subinvolution c) Afterpain d) Diastasis |
Autolysis
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With regard to the postpartum uterus, nurses should be aware that:
a) At the end of the third stage of labor, it weighs approximately 500g b) After 2 weeks postpartum, it should not be palpable abdominally c) After 2 weeks postpartum, it wighs 100g d) It returns to its original (prepregnancy) size by 6 weeks postpartum |
After 2 weeks postpartum, it should not be palpable abdominally
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With regard to postpartum ovarian function, nurses should be aware that:
a) Almost 75% of women who do not breastfeed resume menstruating within a month after birth b) Ovulation occurs slightly earlier for breastfeeding women c) Because of menstruation/ovulation schedules, contraception considerations can be postponed until after the puerperium d) The first menstrual flow after childbirth usually is heavier than normal |
The first menstrual flow after childbirth usually is heavier than normal
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Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium?
a) Varicosities of the legs b) Carpal tunnel syndrome c) Periodic numbness and tingling of the fingers d) Headaches |
Headaches
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The process in which the uterus returns to a nonpregnant state after birth is known as _______________.
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Involution
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True/False
Changes in the maternal immune system during the postpartum period account for the profuse diaphoresis that new mothers experience. |
False
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True/False
Clotting factors and fibrinogen levels normally are decreased during pregnancy and remain low in the immediate puerperium. This hypercoagulable state increases the risk of thromboembolism, especially after cesarean birth. |
False
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A woman gave birth to a healthy 7lb, 13 oz infant girl. The nurse suggests that the woman place the infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is effective during the first 30 minutes after birth because this is the:
a) Transition period b) first period of reactivity c) Organization stage d) Second period of reactivity |
First period of reactivity
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Part of the health assessment of a newborn is observing the infant's breathing pattern. A full-term newborn's breathing pattern is predominantly:
a) Abdominal with synchronous chest movements b) Chest breathing with nasal flaring c) Diaphragmatic with chest retraction d) Deep with a regular rhythm |
Abdominal with synchronous chest movements
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While assessing a newborn, a nurse should be aware that the average expected apical pulse range of a full-term, quiet, alert newborn is:
a) 80 to 100 beats/min b) 100 to 120 beats/min c) 120 to 160 beats/min d) 150 to 180 beats/min |
120 to 160 beats/min
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A newborn is placed under a radiant heat warmer. The nurse knows that thermoregulation presents a problem for newborns because:
a) Their renal function is not fully developed for newborns because b) Their small body surface area favors more rapid heat loss than does an adult's body surface area c) They have a relatively thin layer of subcutaneous fat that provides poor insulation d) Their normal flexed posture favors heat loss through perspiration |
They have a relatively thin layer of subcutaneous fat that provides poor insulation
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An African-American woman noticed some bruises on her newborn girl's buttocks. She asks the nurse who spanked her daughter. The nurse explains that these marks are called:
a) Lanugo b) Vascular nevi c) Nevus flammeus d) Mongolian spots |
Mongolian spots
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While examining a newborn, the nurse notes uneven skin folds on the buttocks and a clunk when performing the Ortolani maneuver. The nurse recognizes these findings as a sign that the newborn probably has:
a) Polydactyly b) Clubfoot c) Hip dysplasia d) Webbing |
Hip dysplasia
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A new mother states that her infant must be cold because teh baby's hands and feet are blue. The nurse explains that this is a common and temporary condition called:
a) Acrocyanosis b) Erythema neonatorum c) Harlequin color d) Vernix caseosa |
Acrocyanosis
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The nurse assessing a newborn knows that the most critical physiologic change required of the newborn is:
a) Closure of fetal shunts in the circulatory system b) Full function of the immune defense system at birth c) Maintenance of a stable temperature d) Initiation and maintenance of respirations |
Initiation and maintenance of respirations
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A primiparous woman is watching her newborn sleep. She wants him to wake up and respond to her. The mother asks the nurse how much he will sleep every day. The nurses best response to her is:
a) He will only wake up to be fed, and you should not bother him between feedings b) The newborn sleeps about 17 hours a day, with periods of wakefulness gradually increasing c) He will probably follow your same sleep and wake patterns, and you can expect him to be awake soon d) He is being stubborn by not waking up when you want him to. You should try to keep him awake during the daytime so that he will sleep through the night |
The newborn sleeps about 17 hours a day, with periods of wakefulness gradually increasing
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The parents of a newborn ask the nurse how much the newborn can see. The parents specifically want to know what type of visual stimuli they should provide for their newborn. The nurse responds to the parents by telling them:
a) Infants can see very little until about 3 months of age b) Infants can track their parents eyes and can distinguish patterns; they prefer complex patterns c) The infants eyes must be protected. Infants enjoy looking at brightly colored stripes d) Its important to shield the newborn's eyes. Overhead lights help them see better |
Infants can track their parents eyes and can distinguish patterns; they prefer complex patterns
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While assessing the integument of a 24 hour old newborn, the nurse notes a pink papular rash with vesicles superimposed on the thorax, back, and abdomen. The nurse should:
a) Notify the physician immediately b) Move the newborn to an isolation nursery c) Document the finding as erythema toxicum d) Take the newborn's temperature and obtain a culture of one of the vesicles |
Document the finding as erythema toxicum
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A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket. The mother asks why. The nurses best response is:
a) Your baby may lose heat by convection, which means that he will lost heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him b) Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air form blowing on him c) Your baby may lose hear by evaporation, which menas that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him d) Your baby will get cold stressed easily and needs to be bundled up at all times |
Your baby may lose heat by convection, which means that he will lost heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him
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The transition period between intrauterine and extrauterine existence for the newborn:
a) Consists of four phases, two reactive and two of decreased responses b) Lasts from birth to 28 days of life c) Applies to full-term births only d) Varies by socioeconomic status and the mother's age |
Lasts from birth to 28 days of life
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All of these statements describe the first stage of the transition period except:
a) It lasts no longer than 30 minutes b) It is marked by spontaneous tremors, crying, and head movements c) It includes the passage of meconium d) It may involve the infant suddenly sleeping briefly |
It may involve the infant suddenly sleeping briefly
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With regard to the newborn's developing and cardiovascular system, nurses should be aware that:
a) The heart rate of a crying infant may rise to 120 beats/min b) Heart murmurs heard after the first few hours are cause for concern c) The point of maximal impulse often is visible on the chest wall d) Persistent bradycardia may indicate respiratory distress syndrome |
The point of maximal impulse often is visible on the chest wall
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By knowing about variations in infants' blood counts, nurses can explain to their clients that:
a) A somewhat lower than expected red blood cell count could be the result of delay in clamping the umbilical cord b) The early high white blood cell cound is normal at birth and should decrease rapidly c) Platelet counts are higher than in adults for a few months d) Even a modest vitamin K deficiency means a problem with the blood's ability to clot properly |
The early high white blood cell count (WBC) is normal at birth and should decrease rapidly
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What infant response to cool environmental conditions is either not effective or not available to them?
a) Constriction of peripheral blood vessels b) Metabolism of brown fat c) Increased respiratory rates d) Unflexing from the normal position |
Unflexing from the normal position
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With regard to the functioning of the renal system in newborns, nurses should be aware that:
a) The pediatrician should be notified if the newborn has not voided in 24 hours b) Breastfed infants likely will void more often during the first few days after birth c) "Brick dust" or blood on a diaper is always cause to notify the physician d) Weight loss from fluid loss and other normal factors should be made up in 4 to 7 daus |
The pediatrician should be notified if the newborn has not voided in 24 hours
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All of these statements about physiologic jaundice are true except:
a) Neonatal jaundice is common, but kernicterus is rare b) The appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process c) Because jaundice may not appear before discharge, parents need instruction on how to assess it and when to call for medical help d) Breastfed babies have a lower incidence of jaundice |
Breastfed babies have a lower incidence of jaundice
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The cheeselike whitish substance that fuses with the epidermis and serves as a protective coating is called _________________.
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Vernix caseosa
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What marks on a baby's skin may indicate an underlying problem that requires notification of a physician?
a) Mongolian spots on the back b) Telangiectatic nevi on the nose or nape of the neck c) Petechiae scattered over the infant's body d) Erythema toxicum anywhere on the body |
Petechiae scattered over the infants body
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During life in utero, oxygenation of the fetus occurs through transplacental gas exhange. When birth occurs, four factors combine to stimulate the respiratory center in the medulla. The initiation of respiration then follows. Which is not one of these essential factors?
a) Chemical b) Mechanical c) Thermal d) Psychologic |
Psychologic
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A collection of blood between the skull bone and its periosteum is known as a cephalhematoma. In order to reassure the new parents whose infant develops such a soft bulge, it is important that the nurse is aware that this condition:
a) May occur with spontaneous vaginal birth b) Only happens as the result of a forceps or vacuum-assisted delivery c) Is present immediately after birth d) Will gradually absorb over the first few months of life |
May occur with spontaneous vaginal birth
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The shivering mechanism of heat production is rarely functioning in the newborn. Nonshivering _____________________ is accomplished primarily by metabolism of brown fat, which is unique to the newborn, and by increased metabolic activity in the brain, heart, and liver.
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Thermogenesis
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An infant boy was born a few minutes ago. The nurse is conducting the intial assessment. Part of the assessment includes the Apgar scores. The Apgar assessment is performed:
a) Only if the newborn is in obvious distress b) Once by the obstetrician, just after the birth c) At least twice, 1 minute and 5 minutes after birth d) Every 15 minutes during the newborn's first hour after birth |
At least twice, 1 minute and 5 minutes after birth
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A new father wants to know what the medication was put into his infant's eyes and why it is needed. The nurse explains to the father that the purpose of the erythromycin ophthalmic oitment is to:
a) Destroy an infectious exudate caused by Staphylococcus that could make the infant blind b) Prevent gonorrheal and chlamydial infection of the infant's eyes potentially acquired from the birth canal c) Prevent potentially harmful exudate from invading the tear ducts of the infant's eyes, leading to dry eyes d) Prevent the infant's eyelids from sticking together and help the infant see |
Prevent gonorrheal and chlamydial infection of the infants eyes potentially acquired from the birth canal
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The nurse administers vitamin K to the newborn for what reason?
a) Most mothers have a diet deficient in vitamin K, which results in the infant being deficient b) Vitamin K prevents the synthesis of prothrombin in the liver and must be given by injection c) Bacteria that synthesize vitamin K are not present in the newborns intestinal tract d) The supply of vitamin K is inadequate for at least 3 to 4 months, and the newborn must be supplemented |
Bacteria that synthesize vitamin K are not present in the newborns intestinal tract
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The nurse is using the New Ballard Scale to determine the gestational age of a newborn. Which assessment finding is consistent with a gestational age of 40 weeks?
a) Flexed posture b) Abundant lanugo c) Smooth, pink skin with visible veins d) Faint red marks on the soles of the feet |
Flexed posture
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A newborn is jaundiced and is receiving phototherapy via ultraviolet lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method is to:
a) Apply an oil-based lotion to the newborn's skin to prevent drying and cracking b) Limit the newborn's intake of milk to prevent nausea, vomiting and diarrhea c) Place eye shields over the newborns closed eyes d) Change the newborns position every 4 hours |
Place eye shields over the newborns closed eyes
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Early this morning an infant boy was circumcised using the PlastiBell method. The nurse tells the mother that she and the infant can be discharged after:
a) The bleeding stops completely b) Yellow exudate forms over the glans c) The PlastiBell rim falls off d) The infant voids |
The infant voids
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A mother is changing the diaper of the newborn son. She notices that his scrotum appears large and swollen. She asks the nurse, "What is that?" The best response from the nurse is:
a) This is a hydrocele, which is a common findings in newborn males. The swelling usually decreases without intervention b) I dont know, but I'm sure its is nothing c) Your baby might have testicular cancer d) Your baby's urine is backing up into his scrotum |
This is a hydrocele, which is a common finding in newborn males. The swelling usually decreases without intervention
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As part of standard precautions, nurses wear gloves when handing the newborn. The chief reason is:
a) To protect the baby from infection b) It is part of the Apgar score c) To protect the nurse from contamination by the newborn d) Because the nurse has primary for the baby during the first 2 hours |
To protect the nurse from contamination by the newborn
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At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats/min, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. The nurse calculates an Apgar score of:
a) 4 b) 5 c) 6 d) 7 |
5
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In the classification of newborns by gestational age and birth weight, the appropriate-for-gestational age (AGA) weight:
a) Falls between the 25th and 75th percentiles for the infant's age b) Depends on the infant's length and the size of the head c) Falls between the 10th and 90th percentiles for the infants age d) Is modified to consider intrauterine growth restriction (IUGR) |
Falls between the 10th and 90th percentiles for the infants age
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During the complete physical examination 24 hours after birth:
a) The parents are excused to reduce their normal anxiety b) The nurse can gauge the neonates maturity level by assessing his or her general appearance c) Once often neglected, blood pressure is not routinely checked d) When the nurse listens to the heart, the S1 and S2 sounds can be heard; the first sound is somewhat higher in pitch and sharper than the second |
The nurse can gauge the neonates maturity level by assessing his or her general appearance
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Nurses can help parents deal with the issue and fact of circumcision if they explain:
a) The pros and cons of the procedure during the prenatal period b) That the american academy of pediatrics recommends that all newborn males be routinely circumcised c) That circumcision is rarely painful and that any discomforts can be managed without medication d) That the infant will likely be alert and hungry shortly after the procedure |
The pros and cons of the procedure during the prenatal period
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An assessment tool for pain in newborns uses the acronym CRIES to identify behavioral indicators of pain. In the acronym:
a) R stands for requiring more medication b) I stands for increased vital signs c) E stands for elimination d) S stands for sleepiness |
I stands for increased vital signs
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Although most blood specimens are drawn by laboratory technicians, nurses may be required to perform heelsticks to obtain blood for glucose monitoring or newborn screening. The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. To prevent this problem the stick should be made:
a) At the outer aspect of the heel b) On the walking surface of the heel c) In the ball of the foot d) In the area just below the fifth tow |
At the outer aspect of the heel
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The normal term infant has little difficulty clearing its airway after birth. Most secretions are brought up to the oropharynx by the cough reflex. However, if the infant has excess secretions, the mouth and nasal passages can easily be cleared with a bulb syringe. When instructing parents on the correct use of this piece of equipment, it is important that the nurse teach them to:
a) Avoid suctioning the nares b) Insert the compressed bulb into the center of the mouth c) Suction the mouth first d) Remove the bulb syringe from the crib when finished |
Suction the mouth first
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As part of the infant discarge teaching, the nurse is reviewing the use of the infant car safety seat. The nurse is teaching that:
a) Infant carriers are fine until an infant car safety seat can be purchased b) For traveling on airplanes, buses, and trains, infant carriers are satisfactory c) Infant car safety seats are used for infants only from birth to 15 pounds d) Infant car seats should be rear facing and placed in the back seat of the car |
Infant car seats should be rear facing and placed in the back seat of the car
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Parents lost their first child to sudden infant death syndrome (SIDS). Therefore, you are teaching then infant CPR. You know they are knowledgeable when they demonstrate infant CPR compressions of ______ per minute.
a) 50 b) 75 c) 100 d) 125 |
100
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A woman has chosen the calendar method of conception control. During the assessment process, it is most important that the nurse:
a) Obtain a history of menstrual cycle lengths for the past 6 to 12 months b) Determine the client'w weight gain and loss pattern for the previous year c) Examine skin pigmentation and hair texture for hormonal changes d) Explore the client's previous experiences with conception control |
Obtain a history of menstrual cycle lengths for the past 6 to 12 months
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A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). The nurse's most appropriate reply is:
a) They're not very effective, and its very likely you'll get pregnant b) They can be effective for many couples, but they require motivation c) These methods have a few advantages and several health risks d) You would be much safer going on the pill and not having to worry |
They can be effective for many couples, but they require motivation
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A woman who has just undergone a first-trimester abortion will be using oral contraceptives. To protect against pregnancy, she should be advised to:
a) Avoid sexual contact for at least 10 days after starting the pill b) Use condoms and foam for the first few weeks as backup c) Use another method of contraception for 1 week after starting the pill d) Begin sexual relations once vaginal bleeding has ended |
Use another method of contraception for 1 week after starting the pill
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A woman currently uses a diaphragm and spermicide for contraception. She asks the nurse what the major differences are between the cervical cap and diaphragm. The nurse's most appropriate response is:
a) No spermicide is used with the cervical cap, so its less messy b) The diaphragm can be left in place longer after intercouse c) Repeated intercourse with the diaphragm is more convenient d) The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later |
The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide
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An unmarried young woman describes her sex life as "active" and involving "many" partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). The nurse's most appropriate response is:
a) The IUD does not interfere with sex b) The risk of pelvic inflammatory disease will be higher for you c) The IUD will protect you from sexuall transmitted infections d) Pregnancy rates are high with the IUDs |
The risk of pelvic inflammatory disease will be higher for you
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A woman will be taking oral contraceptives using a 28 day pack. The nurse should advise this woman to protect against pregnancy by:
a) Limiting sexual contact for one cycle after starting the pill b) Using condoms and foam instead of the pill for as long as she takes an antibiotic c) Taking one pill at the same time every day d) Thworing away the pack and using a backup method if she misses two pills during week 1 of her cycle |
Taking one pill at the same time every day
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12. Although reported in small numbers, toxic shock syndrome can occur with the use of a diaphragm. If a client is interested in this form of conception control, the nurse should teach the woman how to reduce her risk of TSS. The nurse might say:
a. “You should always remove your diaphragm 6 to 8 hours after intercourse. Don’t use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4º C, hypotension, and a rash.” b. “You should remove your diaphragm right after intercourse to prevent TSS.” c. “It’s okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly first to prevent TSS.” d. “Make sure you don’t leave your diaphragm in for longer than 24 hours, or you may get TSS.” |
You should always remove your diaphragm 6 to 8 hours after intercourse. Don't use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash
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Which contraceptive method best protects against sexually transmitted infections and HIV?
a) Periodic abstinence b) Barrier methods c) Hormonal methods d) They all offer about the same protection |
Barrier methods
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With regard to the use of intrauterine devices (IUDs), nurses should be aware that:
a) Return to fertility can take several weeks after the device is removed b) IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse c) IUDs offer the same protection against sexually transmitted infections as the diaphragm d) Consent forms are not needed for IUD insertion |
IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse
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Which statement is the most complete and accurate description of medical abortions?
a) They are performed only for maternal health b) They can be achieved through surgical procedures or with drugs c) They are mostly performed in the second trimester d) They can be either elective or therapeutic |
They can be either elective or therapeutic
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