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maternity final review

Total questions: 66

Worksheet time: 47mins

Name
Class
Date
1.

Fetal Distress can include WOTF? Select all that apply.

a)

Decreased fetal movement

b)

Changes in fetal heart rate

c)

Meconium in amniotic fluid

d)

Braxton Hick's contractions

2.

WOTF is NOT a treatment for fetal distress?

a)

Adequate oxygen for mother

b)

Tocolysis drugs

c)

Analgesic opioid therapy

d)

Amniocentesis

3.

Lasting about 4-6 hours, this phase of labor is when the cervix is dilated from 1-4 cm, the amniotic membrane may still be in tact, there will possibly be a bloody show. Contraction about every 20 min decreasing to about 5 min. Patient is cooperative, alert, talkative, welcomes diversions. Nursing interventions include preparation for what's to come, establish positive relationship, review breathing and relax techniques. Assess FHR and time contractions.

(a)  

4.

Lasting about 2-6 hours. Cervix dilation is between 4-7cm and the amniotic membrane may rupture. Effacement of cervix occurs. Contractions are about 2-5 min apart, and 40-60 seconds in length. Maternal behaviors include apprehensive, anxious, introverted, less social focused on breathing,starts to sweat, and has facial flushness. May request pain relief, and fears losing control. Nursing interventions: continue maternal/fetal monitoring, help implement strategies from classes, reassure woman, and provide back massage if wanted.

(a)  

5.

lasts about 30 min-2 hours. Cervix dilation is 7 to 10 cm. Cervix is fully effaced. Amniotic mambraes rupture. Contractions are every 2-3 min with duration of 60-90 seconds. Intensity is firm. Mother behavior: irritable, rejects support person, introverted, wants to give up, restless, tremor of legs. Nursing interventions: provide firm coaching of breathing and relaxation. Supports coach. Praise and reassure. Assess and monitor strips of FHR and contractions.

(a)  

6.

1. or expulsion of fetus: (30 min-2hrs). Cervix dilation is 10 cm, contractions are ½ -3 min, with a duration of 60-80 seconds. Intensity is firm. Episiotomy may be performed by HCP. Ends with birth of infant. Mother behavior: bulging perineum, and woman may pass stool. Uncontrollable urge to push. States baby is coming. Exhaustion after each contraction. Nursing interventions: assist woman to assume position that helps her push. Assist with open glottis pushing. Monitor contractions and FHR every 5 min.

(a)  

7.

a temporary increase in FHR over the baseline fetal HR of at least 15 bpm for at least 15 seconds.

(a)  

8.

a periodic decrease in baseline fetal HR; can be early, late, or variable.

(a)  

9.

describes fluctuations, or constant changes in the baseline heart rate; results in a fine sawtooth-shaped tracing on HR monitor.

(a)  

10.

Blood loss greater than 500 ml for a vaginal birth or 1000 ml for a csection, resulting is signs or symptoms of hypovolemia.

(a)  

11.

Occurs when the volume of blood is depleted and cannot fill the circulatory system. Woman can die if blood volume is not corrected.

(a)  

12.

a standardized method of evaluating the newborn’s condition immediately after delivery. HR, respirations, muscle tone, reflexes, and color are evaluated at 1 minutes after birth, and again at 5 minutes after birth.

(a)  

13.

1. WOTF are nonpharmacological ways to treat pain during labor?

a)

Breathing and relaxation techniques

b)

Effleurage

c)

Sacral pressure and thermal stimulation

d)

Methods learned in prenatal classes: lamaze, dick reid, and bradley method.

e)

These are all nonpharmacological ways to treat pain during labor.

14.

WOTF are some pharmacological ways to treat pain during labor? Select all that apply

a)

lamaze method

b)

opioid analgesics

c)

adjunctive drugs

d)

Skin stimulation

15.

Is given by injecting anesthetic drugs so that they bathe the nerves as they emerge from the spinal cord. The spinal cord and nerves are not directly injected. Local anesthesia drugs are usually combine with opioid analgesics, which allows for quicker and longer lasting pain relief with less anesthetic agent and minimal loss of movement.

(a)  

16.

Similar to that of an epidural, the dura is punctured with a thin spinal needle. A few drops of spinal fluid confirm entry into the subarachnoid space. The local anesthetic drug is injected. A much smaller quantity is needed for an this than required for an epidural. Anesthesia occurs quickly and is more profound than epidural blocks. Woman loses all movement and sensations below the block.

(a)  

17.

used to assess the status of the cervix in determining its response to induction. Bishop score above 6, and the presence of increased fetal fibronectin at the cervix determine cervical readiness.

(a)  

18.

A firm fundus does not need massaged.

a)

true

b)

false

19.

The purpose of a fundal massage is to prevent excessive postpartum bleeding. Done to mothers who experience both vaginal and c-section birth.

a)

true

b)

false

20.

lack of normal muscle tone in the uterus. The muscle fibers of the uterus are flaccid and do not compress the vessels. Can allow blood vessels at the placental site to bleed freely and usually massively.

(a)  

21.

swelling of the soft tissues of the scalp. It gradually subsides without treatment.

(a)  

22.

subperiosteal swelling containing blood, found on the head of some newborns. The swelling does not cross suture lines and therefore often appears unilateral; usually disappears within a few weeks to 2 months without treatment.

(a)  

23.

Which of the following is evaluated to gather evidence that a newborn is in respiratory distress? Select all that apply.

a)

Rate and character of respirations

b)

Color (cyanosis)

c)

General behavior

d)

Moro reflex

24.

Which of the following are signs and symptoms of respiratory distress in a newborn?

a)

Retractions

b)

Grunting

c)

Irregular pulse

d)

Flaring of nostrils

25.

True or False? The newborn’s pulse is irregular and rapid, and it varies from 110-160 bpm.

a)

true

b)

false

26.

It is normal for the newborn to have higher blood pressure, and the cuff does not affect blood pressure rate.

a)

true

b)

false

27.

True or False? The average blood pressure for a newborn is about 80/46 mm Hg.

a)

true

b)

false

28.

True or False? You should always report pulse rate greater than 160 or less than 30, noisy respirations, and nasal flaring and chest retractions in a newborn.

a)

True

b)

False

29.

The first 3 – 4 days birth the newborn loses approximately __ - __ % of their birth weight.

(a)  

30.

Initial weight loss in a newborn can be a result of WOTF reasons? Select all that apply.

a)

Not consuming enough breast milk or formula

b)

Withdrawal from maternal hormones

c)

Fluid shifts

d)

Loss of feces and urine

31.

Also called icterus neonatorum, is characterized by a yellow tinge of the skin.

(a)  

32.

What is physiological jaundice normally caused by?

a)

Liver disease

b)

Rapid destruction of excess RBC's

c)

Meconium Staining

d)

Low oxygen during birth

33.

Until newborns begin regular feedings, they must use glucose that is stored in their bodies.

a)

true

b)

false

34.

Which of the following are signs and symptoms of hypoglycemia in a newborn? Select all that apply.

a)

Jitteriness

b)

strong cry

c)

poor suck and lethargy

d)

high-pitched cry

e)

seizures

35.

1. Hypothermia can cause (a)   , in which the increased metabolic rate required to generate body heat causes increased respiratory rate and oxygen consumption. If the infant cannot supply the increased demand for oxygen, hypoxia will result.

36.

All the following are nursing interventions to treat cold babies except

a)

Dry the infant.

b)

Place infant in radiant warmer

c)

Place the infant on a cold object.

d)

Wrapping the infant.

e)

Put a hat on infant.

37.

True or False? Preterm birth is responsible for more deaths during the first year of life than any other single factor

a)

true

b)

false

38.

True or False? Post term infants have the highest instance of birth defects.

a)

true

b)

false

39.

A (a)   infant is one that is born before 37 weeks.

40.

A (a)   infant is one that is born beyond 42 weeks.

41.

a condition characterized by an increase of cerebrospinal fluid within the ventricles of the brain, which causes pressure changes in the brain, and a increase in head size.

(a)  

42.

What is the most common cause for hydrocephalus in a newborn?

a)

Passed to infant through genetics

b)

Imbalance between production and absorption of CSF

c)

obstruction from a tumor

d)

birth injury

43.

hydrocephalus is classified as (a)   when it results from obstruction of CSF flow from the ventricles of the brain to the subarachnoid space.

44.

Hydrocephalus is classified as (a)   when it results when CSF is not obstructed in the ventricles but is inadequately reabsorbed in the subarachnoid space.

45.

A mother calls the pediatricians office because her infant is colicky. The helpful measure the nurse would suggest to the parent is:

a)

Sing songs to the infant in a soft voice

b)

Place the infant in a well-lit room

c)

Walk around and massage the infants back

d)

Rock the fussy infant slowly and gently

46.

The nurse is aware that the age at which the posterior fontanelle closes is:


a)

2 to 3 months

b)

3 to 6 months

c)

6 to 9 months

d)

9 to 12 months

47.

The nurse knows that an infants birthweight should be tripled by:

a)

9 months

b)

1 year

c)

18 months

d)

2 years

48.

The nurse is aware that the age at which an infant is able to sit steadily alone is:

a)

4 months

b)

5 months

c)

8 months

d)

15 months

49.

The infant should be able to walk independently by the age of:


a)

8-10 months

b)

12-15 months

c)

15-18 months

d)

18-21

50.

The parent of a 3-month-old infant asks the nurse, At what age do infants usually begin drinking from a cup? The nurse would reply

a)

5 months

b)

9 months

c)

1 year

d)

2 years

51.

The nurse would expect a 4-month-old to be able to:


a)

Hold a cup

b)

stand with assistance

c)

lift head and shoulders

d)

sit with back straight

52.

The abnormal finding in an evaluation of growth and development for a 6-month-old infant would be:

a)

weight gain of 4-7 ounces per week

b)

length increase of 1 inch in 2 months

c)

Head lag present

d)

can sit alone for a few seconds

53.

A parent brings a 6-month-old infant to the pediatric clinic for her well-child examination. Her birthweight was 8 pounds, 2 ounces. The nurse weighing the infant today would expect her weight to be at least:

a)

12 lbs

b)

16 lbs

c)

20 lbs

d)

24 lbs

54.

The nurse would advise a parent when introducing solid foods to:


a)

Begin with one tablespoon of the food.

b)

Mix foods together

c)

Eliminate a refused food from the diet

d)

Introduce each new food 4 to 7 days apart

55.

When talking with a parent about tooth eruption, the nurse explains that the first deciduous teeth to erupt are the:

a)

lower central incisors

b)

upper central incisors

c)

lower lateral incisors

d)

upper lateral incisors

56.

When assessing development in a 9-month-old infant, the nurse would expect to observe the infant:

a)

sitting if supported

b)

grasping objects with the palm

c)

imitating sounds such as dada

d)

beginning to use a spoon rather sloppily

57.

The statement made by a parent that indicates correct understanding of infant feeding is:

a)

I've been mixing rice cereal and formula in the baby's bottle.

b)

I switched the baby to low-fat milk at 9 months.

c)

The baby really likes little pieces of chocolate.

d)

I give the baby any new foods before he takes his bottle.

58.

The nurse would advise a mother who is concerned because her 10-month-old is lethargic, to:

a)

Keep the baby's room well-lit.

b)

Rub the baby's soles vigorously.

c)

Offer the baby a pacifier.

d)

Handle the infant slowly and gently.

59.

The nurse discusses safety-proofing the home with the mother of a 9-month-old. The statement made by the mother that indicates an unsafe behavior is:

a)

I put covers on all of the electrical outlets.

b)

In the car, she rides in a front-facing car seat.

c)

There are locks on all of the cabinets in the house.

d)

I have a gate at the top and bottom of the stairs.

60.

The nurse observes a 10-month-old infant using her index finger and thumb to pick up Cheerios. This behavior is evidence that the infant has developed the:

a)

Pincer grasp

b)

Grasp reflex

c)

Prehension ability

d)

Parachute reflex

61.

A parent is concerned because her infant has a diaper rash. The nurse would advise the parent to:

a)

Use commercial diaper wipes to clean the area.

b)

Apply a protective ointment on the area.

c)

Change the baby's diaper less frequently.

d)

Keep the diaper area covered all of the time.

62.

The mother of an infant born prematurely tells the nurse, The baby is irritable. He cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe him? The most appropriate recommendation to help this parent would be:

a)

Plat the radio or TV while you feed the baby.

b)

Put the baby in a room with sunlight.

c)

Cover the baby snugly when you hold him.

d)

Change the baby's position quickly.

63.

The most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old would be:

a)

Ride a tricycle

b)

Spend time in an infant swing.

c)

Play with push-pull toys.

d)

Read large picture books.

64.

The statement that indicates the mother of an 8-month-old understands infant sleep patterns is:

a)

I put the baby in my bed until she falls asleep, then I put her in her crib.

b)

I let the baby skip an afternoon nap so she will fall asleep earlier.

c)

I put the pacifier in the crib so she can find it when she wakes up.

d)

I rock the baby back to sleep if she wakes up at night.

65.

The nurse is aware that the 7-month-old can signal feeding readiness by: Select all that apply.

a)

Pulling spoon toward mouth

b)

Biting at spoon with upper and lower incisors

c)

Pointing to food bowl

d)

Bouncing up and down with excitement at sight of food.

e)

Manipulating finger foods

66.

The nurse reminds the parents that the first DPT, oral polio, and flu immunizations should be given when the child is (a)   months old.