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Maternal Newborn Nursing Exam 2

Total questions: 115

Worksheet time: 2hrs 35mins

Name
Class
Date
1.

Certain risk factors have been identified as being associated with PPH. The RN should assess at-risk clients more often for PPH. Risk factors for PPH include which of the following ?(SELECT ALL THAT APPLY)

a)

Multiple pregnancies

b)

prolonged labor

c)

macrosomia

d)

microsomia

2.

Identifying the cause of PPH is crucial to its successful treatment. The 4 T's acronym is used to remind nurses of the potential sources to consider. The 4 T's acronym include which of the following (select all that apply)

a)

Tissue

b)

Tone

c)

Thrombin

d)

Tearing

3.

A client just gave birth. The placenta was examined and found to be intact. Fundal massage was completed. Upon reassessment the uterus was found to be boggy. Peripad saturated within 15 min. blood clots noted. what medical prescription does the nurse anticipate as an initial intervention in this situation?

a)

Prepare for blood transfusion/ fluid bolus

b)

prepare for surgical dilation and curettage

c)

initiate intravenous magnesium sulfate

d)

initiate intravenous oxytocin administration

4.

Which of the following is included in the definition of PostPartum Hemorrhage?(select all that apply)

a)

Blood loss greater than 500 mL during a vaginal birth

b)

Blood loss of greater than 1000mL in a c-section

c)

a greater than 5 point decrease in hematocrit from the admision level to postpartum period

d)

a birth that results in the mother requiring a blood transfusion

5.

The nurse is taking care of a 16 yr old client who is G1P0. when reading through prenatal records the nurse notes that the client has been very noncompliant with much of her prenatal care and instructions. The nurse is concerned that the client may be noncompliant with post delivery instructions and be at increased risk of PPH. Th nurse knows that PPH is the result of:

a)

Uterine atony

b)

poor nutrition

c)

anemia during pregnancy

d)

Preterm labor

6.

The nurse is taking care of a postpartum client that has developed areas of brusiing on her arms and legs. She is concerned the client may be developing DIC. She knows that DIC can be triggered by: (SELECT ALL THAT APPLY)

a)

preeclampsia

b)

placental abruption

c)

fetal demise

d)

amniotic fluid embolism

e)

preterm delivery

7.

The nurse is caring for a postpartum clinet who has been experiencing excessive bleeding. The nurse midwife was notified. She came and examined the patient and placed one hand into the vagina and the other over the fundus to compress the uterus together in an attempt to control the bleeding. This technique is called:

a)

Bimanual compression

b)

Massaging the uterus

c)

Balloon tamponade

d)

Uterine stimulation

8.

The nurse is caring for a post partum client that delivered 6 hours ago. she continues to have a large amount of lochia. The nurse knows that early PPH usually occurs within:

a)

12 hours

b)

24 hours

c)

8 hours

d)

36 hours

9.

The nurse is assessing a postpartum client and her assessment findings indicate the client is experiencing PPH. What is the first action that the nurse needs to take?

a)

massage the fundus

b)

take vital signs

c)

call for help

d)

continue to monitor the situation

10.

In the early stage of PPH, vital signs may be within normal limits and tolerated

a)

True

b)

False

11.

The nurse is taking care of a post partum client and determines the uterus is soft and boggy. What action should the nurse take?

a)

Massage the fundus to expel the blood

b)

have the client get up and void

c)

recheck the fundus in 15 min

d)

have the infant breastfeed

12.

The nurse is caring for a postpartum client that has experienced PPH. The nurse is teaching the client about nutrition. She knows that patients that have experienced this should consume a diet to help boost their blood levels therefore she will teach the cient to include which of the following foods in her diet?

a)

Lean meat

b)

Carbs

c)

Vitamin C & D

d)

Unsaturated fats

13.

A nurse is teaching the postpartum client about nutrition. Which of the following will increase tissue healing in the postpartum client who has experienced significant tissue trauma and damage during delivery?

a)

A

b)

D

c)

C

d)

B

14.

The nurse is caring for a postpartum client with uterine atony. She knows that uterine atony can be caused by (select all that apply)

a)

Excessive distention and stretching of the uterine muscles from a large infant

b)

Multiple pregnancies

c)

Polyhydraminos

d)

First time pregnancies

e)

Microcephaly

15.

The nurse is taking care of a postpartum client who she suspects subinvolution. The definition of subinvolution is:

a)

A soft, boggy uterus

b)

the inability of the fundus to decrease in size

c)

a firm uterus

d)

excessive bleeding from the uterus

16.

The nurse is caring for a post partum client who is experiencing excessive bleeding. The nurse midwife was notified. The midwife placed a device into the uterus that she inflated with saline to compress the uterus. The name of this procedure is:

a)

Bimanual compression

b)

Balloon tamponade

c)

uterine stimulation

d)

massaging the uterus

17.

The nurse is caring for a postpartum client in which there is a suspicion of retained placental tissue causing PPH. The nurse knows that which of the following actions is requred?

a)

Manual exploration of the uterus and removal of tissue

b)

The application of an automatic suction device to remove tissue

c)

Massaging of the fundus to expell excess blood

d)

IV fluids for hydration and removal of tissue

18.

The nurse is caring for a postpartum client. The midwife is concerned the pt has developed a dangerous complication in which the placenta invades the deeper uterine layers of tissue. The nurse knows the nurse midwife is referring to which of the following conditions?

a)

Placenta accreta

b)

Placenta preveiw

c)

Placenta atrphy

d)

Placenta embedment

19.

The nurse is caring for a postpartum client that recieved oxytocin during labor. Which of the following are considerations for oxytocin?(SELECT ALL THAT APPLY)

a)

Discontinue with signs of water intoxication

b)

Monitor BP during infusion

c)

second line medication for PPH

d)

Used for preeclampsia before delivery of the baby

e)

Given for maternal hypotensino during labor

20.

The nurse is caring for a group of postpartum clients. Which client would be most at risk for a postpartum hemorrhage?

a)

THe client who has a temp of 99F just after delivery

b)

The client who delivered twins by csection

c)

the client who labored for 15 hours

d)

the client who delivered a preterm infant at 34 weeks

21.

When is the APGAR score of the Newborn obtained?

a)

at 1 and 5 minutes

b)

24 hours after delivery

c)

15 and 30 min

d)

1 hour and 12 hours

22.

The nurse has just assessed the APGAR score of a newborn. When would the nurse reassess the infant if the score was 6 or less?

a)

1 minute

b)

5 minutes

c)

10 minutes

d)

30 minutes

23.

A nurse is assessing the APGAR score of an newborn at one min. The score shows that the neonate is blue or pale with flexion of arms and legs; heart rate greater than 100, grimaces with suction, and has a weak cry. What is the APGAR score?

a)

1

b)

2

c)

5

d)

7

24.

An apgar score of 0 to 3 indicates the need for:

a)

full resusitation

b)

some resusitation

c)

routine post delivery care

25.

An apgar score of 4 to 6 indicates the need for:

a)

Full resusitation

b)

some resusitation

c)

routine post delivery care

26.

An apgar score of 7 to 10 indicates the need for:

a)

full resusitation

b)

some resusitation

c)

routine post delivery care

27.

The nurse is assessing reflexes of the newborn. Which reflex is being assessed by stroking the cheek or edge of the newborns mouth resulting in the expected finding of the newborn turning its head toward the side that is touched and starts to suck?

a)

Sucking and Rooting

b)

Palmar Grasp

c)

Plantar Grasp

d)

Moro Reflex

28.

A nurse is caring for a newborn who was born at 38 weeks gestation, weighs 3200g and is in the 60th percentile for weight. Based on the weight and gestational age, the nurse should classify this neonate as which of the following?

a)

Low birth weight

b)

Normal for gestational age

c)

small for gestational age

d)

large for gestational age

29.

A nurse is completing a newborn assessment and observes small pearly white nodules on the roof of the newborns mouth. This finding is a characteristic of which of the following conditions?

a)

Mongolian spots

b)

Milia spots

c)

Erythema toxium

d)

Epstein's pearls

30.

A nurse is assessing the reflexes of a newborn. In checking for the Moro reflex, the nurse should perform which of the following actions?

a)

Hold the newborn vertically under arms and allow one foot to touch the table

b)

Stimulate the pads of the newborns hands with stroking or massage

c)

Stimulate the soles of the newborns feet on the outer lateral surface of each foot

d)

hold the newborn in a semi-sitting postion, then allow the newborns head and trunk to fall backward

31.

The nurse is completing an assessment on a newborn. Which of the following data indicate the newborn is adapting to extrauterine life? (SELECT ALL THAT APPLY)

a)

expiratory grunting

b)

inspiratory nasal flaring

c)

Apnea for 10 second periods

d)

Crackles and wheezing

e)

obligatory nose breathing

32.

A nurse is teaching a newly licensed nurse how to bathe a newborn and observes a bluish brown marking across the newborn's lower back. The nurse should include which of the following information in the teaching about mongolian spots?

a)

This is more commonly seen in newborns who have dark skin

b)

This is a finding indicating hyperbilirubinemia

c)

this is a forceps mark from an operative delivery

d)

this is related to prolonged birth or trauma during delivery

33.

A nurse is preparing to administer prophylactic eye ointment to a newborn to prevent opthalmia neonatorum. Which of the following medications should the nurse anticipate administering?

a)

Ofloxacin

b)

Nystatin

c)

Erythromycin

d)

Ceftriaxone

34.

A newborn was not dried completely after birth. This places the infant at risk for which of the following types of heat loss?

a)

Conduction

b)

Convection

c)

Evaporation

d)

Radiation

35.

A nurse is caring for a newborn immediately following birth. Which of the following nursing interventions is the highest priority?

a)

Initiating breastfeeding

b)

performing the intitial bath

c)

Giving vitamin K injection

d)

Covering the newborns head with a cap

36.

A nurse is preparing to administer a vitamin K (phytonadione) injectino to a newborn. Which of the following responses should the nurse make when the parent asks why this medication is being given?

a)

It assists with blood clotting

b)

It is a preventative vaccine

c)

it provides immunity

d)

It promotes maturation of the bowel

37.

A nurse is taking a newborn to a parent following a circumcision. which of the following actions should the nurse take for security purposes?

a)

ask the parent to state their full name

b)

look at the name on the newborns bassinet

c)

match the parent's ID band with the newborns ID band

d)

Compare the name on the bassinet and the room number

38.

The postpartum nurse is providing instructions to the mother of a newborn with hyperbilirubinemia who is being breastfed. The nurse should provide which instruction to the mother?

a)

feed the newborn less frequently

b)

continue to breastfeed every 2-4 hours

c)

switch to bottle feeding the infant for the next 2 weeks

d)

stop breastfeeding and switch to bottle feeding permanently

39.

Rooting Reflex

a)

Newborns close their hands tightly when their palms are touched

b)

Newborns extend their toes when the soles of their feet are touched

c)

When newborns are touched on one of their cheeks, they turn their heads in that direction and open their mouths

d)

When babies lie on their backs, they turn their heads to one side. If they turn to the right, their right hands go out, and their left arms go up.

e)

When newborns are startled by a sudden movement, they spread their arms and legs apart and then bring them together again.

40.
Put the baby on its __________ to sleep
a)
tummy
b)
side
c)
back
d)
any way they prefer
41.

Palmer Grasp Reflex

a)

Newborns close their hands tightly when their palms are touched

b)

Newborns extend their toes when the soles of their feet are touched

c)

When newborns are touched on one of their cheeks, they turn their heads in that direction and open their mouths

d)

When babies lie on their backs, they turn their heads to one side. If they turn to the right, their right hands go out, and their left arms go up.

e)

When newborns are startled by a sudden movement, they spread their arms and legs apart and then bring them together again.

42.

Newborns generally feed about every _________________ hours.

a)

4 - 5 hours

b)

2 - 3 hours

c)

3 - 5 hours

d)

6 - 8 hours

43.

Colostrum _______?

a)

is produced by hormones

b)

is early breastmilk

c)

helps fight infections

d)

all of the above

44.
An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect?
a)
Weight gain
b)
Bradycardia
c)
Poor skin turgor
d)
Brisk capillary refill
45.

Jaundice is caused by:

a)

A lack of vitamin K

b)

Urinary Retention

c)

Increased levels of unconjugated bilirubin

d)

Shock in the newborn after birth

46.

Treatment for Hyperbilirubinemia includes:

a)

Flurotherapy- use of fluorescent light , provide additional fluids to prevent dehydration, monitor serum bilirubin.

b)

Phototherapy- use of fluorescent light , provide no additional fluids to prevent dehydration, monitor serum bilirubin.

c)

Phototherapy- use of fluorescent light , provide additional fluids to prevent dehydration, monitor serum bilirubin.

d)

Psychotherapy- use of fluorescent light , provide additional fluids to prevent dehydration, monitor serum bilirubin.

47.
A nurse assessing a newborn finds an apical heart rate of 130/min. Which of the following is the appropriate nursing action?
a)
Ask another nurse to verify the heart rate.
b)
Document this as an expected finding.
c)
Call the neonatologist to assess the newborn.
d)
Prepare the newborn for transport to the NICU
48.

All of these are safe sleep practices EXCEPT

a)

Lying baby down on their back

b)

Keeping the room temperature at 60 degrees or below

c)

No soft objects in with baby that can impede breathing

d)

Dressing baby in a sleeper that will keep them warm enough without a blanket

e)

Putting baby down on a firm surface

49.

when baby needs phototherapy for jaundice, (check all that apply)

a)

make sure eyes are covered

b)

mother should continue to breastfeed as often as possible

c)

make sure you cover baby with warm blanket

d)

change diaper every hour

e)

place baby on it's abdomen

50.

best treatment for diaper rash

a)

keep baby's skin clean and dry as possible

b)

clean with rubbing alcohol and air dry

c)

apply baking soda and vinegar

d)

clean with scented baby wipes

51.

Cord care

a)

leave open to air

b)

clean with rubbing alcohol

c)

cover it with the diaper

d)

put vaseline around the site

52.

how do you know baby has had enough to drink (check all that apply)

a)

baby removes themself from the breast

b)

baby seems satisfied

c)

5-6 diapers per day (after 5 days)

d)

baby cries often

e)

skin is dry

53.

Which is a normal newborn's vital sign

a)

R-40/min,P-150/min, BP-60/50, T- 36.6

b)

R-20/min, P-160/min, BP-100/60, T-36.8

c)

R-45/min, P-150/min, BP-70/40, T-35.2

d)

R-50/min, P-90/min, BP-70/40, T-38.0

54.

A nurse should recognize which of the following as a manifestation of sepsis in the neonate? (Select all that apply)

a)

lethargy

b)

tachypnea

c)

hypothermia

d)

sunken fontanel

e)

low serum glucose

55.

While assessing a 29 y/o G2 P2 who had a normal Spontaneous vaginal delivery 30 minutes ago, the nurse notes a large amount of red vaginal bleeding. What would be the first priority nursing action.

a)

check V/S

b)

notify the HCP

c)

firmly massage the uterine fundus

d)

put the baby to breast

56.

A 26 y/o G1 P1 who underwent a Cesarean 24 hours ago tells the nurse she is having trouble breast feeding. Which tasks can be appropriately delegated to the Unlicensed assistive personnel. Select all that apply.

a)

providing the mother with an ordered abdominal binder

b)

taking the mother's vital signs

c)

checking the amount of lochia present

d)

assisting the mother with ambulation

e)

assisting the mother with breastfeeding

57.

A full term newborn is in the clinic with his parents. he is 4 days old. His birth weight was 7lbs (3.2kg). Which assessment made by the nurse is the Most significant?

a)

today's weight is 6 # 9 oz (3Kg)

b)

the infants skin is peeling

c)

the infants breast tissue is swollen

d)

there is a yellow discharge from the infants right eye.

58.

Methylergonovine is prescribed for a patient with postpartum hemorrhage. Before administering the medication, the nurse should contact the HCP if which condition is documented in the patients medical history?

a)

hypotension

b)

hypothyroidism

c)

diabetes mellitus

d)

peripheral vascular disease

59.

The nurse is preparing to administer exogenous surfactant to a premature infant who has respiratory distress syndrome. The nurse prepares to administer the medication by which route?

a)

Intradermal

b)

Intratracheal

c)

Subcutaneous

d)

Intramuscular

60.

A client in preterm labor (31) weeks who is dilated to 4 cms has been started on Magnesium Sulfate and the contractions have stopped. If the clients labor can be stopped for the next 48 hours, which medication can the nurse anticipate a prescription for?

a)

Nulbuphine

b)

Betamethasone

c)

RH Immune globulin

d)

Dinoprostone vaginal insert

61.

The nurse in a newborn nursery is monitoring a preterm infant for respiratory distress syndrome. Which assessment findings should alert the nurse to the possibility of this syndrome. Select all that apply.

a)

Cyanosis

b)

Tachypnea

c)

Hypotension

d)

Retractions

e)

Audible grunts

62.

The nurse assisted with the birth of a newborn. which nursing action is the most effective in preventing heat loss by evaporation?

a)

warming the crib pad

b)

closing the doors to the room

c)

drying the infant with a warm blanket

d)

turning on the overhead radiant warmer

63.

The nurse is assessing a newborn after circumcision and notes the circumcised area is red with a small amount of bloody drainage. Which nursing action is the most appropriate?

a)

apply gently pressure

b)

reinforce the dressing

c)

document the findings

d)

contact the HCP

64.

The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign is noted, would be an early sign of excessive blood loss?

a)

a temperature of 100.4 (38 c)

b)

an increase in pulse rate from 88 to 102 bpm

c)

a blood pressure change from 130/88 to 124/80 mmHG

d)

an increase in the respiratory rate from 18 to 22 breaths/min

65.

The nurse is assessing the client in the fourth stage of labor and notes the fundus is firm, but that bleeding is excessive. Which should be the initial action?

a)

document the findings

b)

massage the fundus

c)

notify the HCP

d)

place the client in Trendelenburg

66.

On assessment of a postpartum client, the nurse notes that the uterus feels soft and boggy. The nurse should take which initial action?

a)

document the findings

b)

elevate the clients legs

c)

massage the fundus until its firm

d)

push on the uterus to assist in expressing clots

67.

A postpartum client is diagnosed with cystitis. The nurse should plan for which priority action in the care of the client?

a)

providing sitz baths

b)

encouraging fluid intake

c)

placing ice on the perineum

d)

motioning H&H levels

68.

The nurse is planning care for a postpartum client who had a vaginal delivery 2 hours ago. the client required an episiotomy and has several hemorrhoids. What is the priority nursing consideration for this client?

a)

client pain level

b)

inadequate urinary output

c)

client perception of body changes

d)

potential for imbalanced body fluid volume

69.

Tonic Neck Reflex

a)

Newborns close their hands tightly when their palms are touched

b)

Newborns extend their toes when the soles of their feet are touched

c)

When newborns are touched on one of their cheeks, they turn their heads in that direction and open their mouths

d)

When babies lie on their backs, they turn their heads to one side. If they turn to the right, their right hands go out, and their left arms go up.

e)

When newborns are startled by a sudden movement, they spread their arms and legs apart and then bring them together again.

70.

Feeding a baby when they are hungry, as opposed to every 2 hours is called....

a)

none of the above

b)

schedule

c)

on demand

d)

timing

71.

Until your baby's umbilical falls off you should do what?

a)

Only give sponge baths

b)

Bathe the baby in 2 inches of water

c)

Bathe the baby in a baby bath seat

d)

Do not give the baby any form of a bath

72.

Reflexes are controlled by what body system?

a)

digestive

b)

circulatory

c)

nervous

d)

cardiovascular

73.

What is the normal period needed for a human baby to develop?

a)

37 weeks

b)

40 weeks

c)

45 weeks

d)

17 weeks

74.

The soft spot on a baby's head is called ______

a)

milia

b)

fontanel

75.

Which type of lochia should the nurse expect to find in a client 2 days PP?

a)

Lochia delta

b)

Lochia serosa

c)

Lochia alba

d)

Lochia rubra

76.

A post-partum nurse is providing instructions to a woman after delivery of a healthy newborn infant. The nurse instructs the mother that she should expect normal bowel elimination to return:

a)

On the day of the delivery

b)

3 days PP

c)

7 days PP

d)

within 2 weeks PP

77.

A new mother is breastfeeding her 2-day-old infant and tells the home health nurse that she can not believe her newborn wants to breastfeed again, since she just fed him 2 ½ hours ago. The nurse should plan to teach the client that a newborn usually should be nursed:

a)

Hourly

b)

On Demand

c)

Every 4 hours

d)

At 5-hour intervals

78.
A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000-gram infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the woman void and massages her fundus, but her fundus remains difficult to find and the rubra lochia remains heavy. The nurse should
a)
Continue to massage the fundus
b)
 Insert a Foley catheter
c)
Recheck vital signs
d)
Notify the physician
79.
The nurse is aware that because of excess blood loss during delivery, the woman is at risk for hypovolemic shock. What is one of the earliest signs that shock is occurring?
a)
 Increase in respirations
b)
 Tachycardia
c)
Decrease in urinary output
d)
Woman is anxious and confused
80.
The nurse knows that late postpartum hemorrhage can be prevented by
a)
 Administering broad-spectrum antibiotics
b)
Manually removing the placenta
c)
Inspecting the placenta after delivery
d)
 Pulling on the umbilical cord to hasten the delivery of the placenta
81.
The nurse is assessing a woman that delivered 1 hour ago. She noted the uterus is boggy. What should the first interventions be for this woman?
a)
Notify the nurse-midwife.
b)
Massage the uterus until firm. 
c)
Administer Pitocin.
d)
Have the woman void.
82.
One hour after a woman gives birth vaginally, the nurse notes that her fundus is firm, 2 fingerbreadths above the umbilicus, and deviated to the right. Lochia rubra is moderate. Her perineum is slightly edematous, with not bruising; an ice pack is in place. The priority nursing action is to:
a)
chart the expected assessments.
b)
have the woman empty her bladder in the bathroom.
c)
change the perineal ice pack to a warm pack.
d)
increase the rate of the oxytocin infusion.
83.
The nurse's initial response to a suspected pulmonary embolism should be to: 
a)
start a second intravenous line of hypotonic solution
b)
raise the head of the bed and administer oxygen.
c)
insert a catheter to monitor urine output.
d)
lower the head of the bed and elevate the legs.
84.
A breastfeeding woman develops mastitis. She tells the nurse that she will just feed her baby formula instead of breastfeeding. The best nursing response is that: 
a)
emptying the breast is important to prevent an abscess.
b)
a tight breast binder or bra will help reduce engorgement. 
c)
she should continue to drink extra fluids while weaning.
d)
breastfeeding can continue when her temperature is normal. 
85.
A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests
a)
 Uterine atony
b)
 Lacerations of the genital tract
c)
Perineal hematoma
d)
 Infection of the uterus
86.
Which of the following explains why breastfed babies have fewer infections and hospitalizations than formula-fed infants
a)
They bond with their mother more
b)
Antibodies pass from mother to baby and strengthen the immune system
c)
The time mothers must commit to breastfeeding reduces the time babies are exposed to outside people and places
d)
Breast milk is not man made, and there for is not at risk of contamination such as that made in factories
87.

Needed to control the babies temperature

a)

thermoregurigitation

b)

positive feedback

c)

warming

d)

Thermoregulation

88.
Which of the  physical problems may affect preterm babies?
a)
weak suck reflex
b)
lack body fat for warmth
c)
immature lungs
d)
all of these
89.

Milk thawed in the refridgerator can be stored for _____

a)

6 hours

b)

24 hours

c)

2 days

d)

One week

90.

Weight is the most important the most important determinant of the percent of total body fluid loss in infants and younger children?

a)

True

b)

False

91.

Secondary predictors of dehydration include all EXCEPT:

a)

changing LOC

b)

decreased skin elasticity and turgor

c)

prolonged cap refill >2sec

d)

absent crying

e)

sunken eyes and fontanelles

92.

Circumcision has been linked to which health benefits (select all that apply):

a)

Prevention of UTI's in male infants younger than 1 year

b)

Decreased risk of STI's (particularly HIV) in heterosexual intercourse

c)

Increased hygiene

d)

Reduced risk for penile cancer

e)

Reduced risk for prostate cancer

93.

Signs of hypoglycemia include: (Select all the apply)

a)

Tremors

b)

Hunger

c)

Weak cry

d)

Lethargy

e)

Jaundice

94.

Infants most at risk for cold stress are:

a)

Large for gestational age

b)

Premature

c)

Macrosomic

d)

Born in a hospital

95.

The nurse checks the blood sugar of a 2-hour-old newborn and the glucometer reading is 32 mg/dL. The nurse should:

a)

Recognize that this is a normal reading and document it.

b)

Initiate breastfeeding.

c)

Call the laboratory for a STAT blood glucose level.

d)

Transfer the newborn to the NICU.

96.

Respiratory Distress Syndrome (RDS) is caused by:

a)

Lack of surfactant and immaturity of the lungs

b)

Excessive surfactant and post-term delivery

c)

Immaturity of the lungs due to use of insulin in diabetes

d)

Excessive red blood cells due to chronic fetal hypoxia

97.

A diabetic patient delivers her baby at 36 weeks gestation. The infant is jittery and lethargic. Which is the priority nursing action for this infant?

a)

Applying oxygen

b)

Obtaining a heel stick blood glucose

c)

After drying, wrapping the infant in warm blankets

d)

Putting the baby to the breast

98.

Which intervention should the nurse include in the plan of care for a jaundiced newborn who is to receive phototherapy?

a)

Keeping the baby fully clothed to avoid burns

b)

Encouraging breastfeeding four to six

times per day

c)

Placing eye protection on the baby during therapy

d)

Reporting fewer than two stools per day to the provider

99.

Which of the physical signs could indicate a risk for hyperbilirubinemia?

a)

Acrocyanosis

b)

Cephalohematoma

c)

Newborn rash

d)

Tremors

100.
Which of the following is appropriate for an infant's crib, in order to help reduce the risk of SIDS? 
a)
A crib bumper
b)
A blanket to keep the baby warm
c)
A firm mattress
d)
A stuffed animal to help comfort the baby
101.
Shaken Baby Syndrome can result in all of the following EXCEPT what?
a)
Death
b)
Blindness
c)
Asthma
d)
Paralysis
102.
How should a baby sleep?
a)
In the bed with their parents
b)
On their side in a crib
c)
On their back in a crib
d)
On their stomach in a craddle
103.
A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse recognizes the adverse effect of this contraction pattern is:
a)
prolonged labor
b)
reduced fetal oxygen supply
c)
delayed cervical dilation
d)
increased maternal stress
104.
What kind of fetal anomalies are most often associated with oligohydramnios?
a)
cardiac
b)
gastrointestinal
c)
renal
d)
neurologic
105.

On days 9 of postpartum, the color of lochia is usually

a)

dark red

b)

yellowish

c)

clear and watery

d)

pinkish brown

106.

Following the birth, the fundus

a)

decreases about 1 cm/day for the first 9–10 days

b)

decreases about 2 cm/day for the first 9–10 days

c)

decreases about 3 cm/day for the first 9–10 days

d)

increases the first two days and then decreases

107.

Assessment of breastfeeding includes observing

a)

attachment and effectiveness of suckling

b)

effectiveness of suckling

c)

position, attachment, and effectiveness of suckling

d)

whether the mother has a sufficient supply of breast milk

108.

The first step in the management of atonic uterus is

a)

bimanual compression of the uterus

b)

manual removal of the placenta

c)

massage of uterus through the abdominal wall

d)

compression of the abdominal aorta

109.

What type of milk is present in the breasts 1-3 days PP?

a)

mature milk

b)

colostrum

c)

transitional milk

d)

pure milk

110.

Which of the following complications is most likely responsible for a delayed postpartum hemorrhage?

a)

Cervical laceration

b)

Perineal laceration

c)

Clotting deficiency

d)

Uterine subinvolution

111.

Which of the following physiological responses is considered normal in the early postpartum period?

a)

Urinary urgency and dysuria

b)

Decrease in blood pressure

c)

Increase motility of the GI system

d)

Rapid diuresis

112.

Causative agent can cause mastitis are

a)

Candida albican

b)

Staphylococcus aureus

c)

E.coli

d)

Bacteria vaginalis

113.

Which of the following amounts of blood loss following birth marks the criterion for describing postpartum hemorrhage?

a)

More than 200 ml

b)

More than 300 ml

c)

More than 400 ml

d)

More than 500 ml

114.

Which of the following are not the symptoms of postpartum blues?

a)

hallucination

b)

insomnia

c)

loneliness

d)

anxiety

115.

4 T are causes of postpartum hemorrhage EXCEPT

a)

tissue

b)

tone

c)

thrombin

d)

target