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maternity final practice

Total questions: 60

Worksheet time: 30mins

Name
Class
Date
1.

A nurse assesses a newborn and notes acrocyanosis. Which action is most appropriate?

a)

Call the provider immediately

b)

Apply supplemental oxygen

c)

Document as a normal finding

d)

Administer IV fluids

2.

Which of the following respiratory findings in a newborn requires immediate attention?

a)

Irregular breathing with short apnea

b)

Nasal flaring and intercostal retractions

c)

40 breaths per minute

d)

Strong cry during assessment

3.

A newborn's skin is mottled. What should the nurse do first?

a)

Prepare for sepsis protocol

b)

Notify the provider

c)

Warm the infant and reassess

d)

Administer glucose

4.

Which physical assessment finding is considered abnormal in a term newborn?

a)

Caput succedaneum

b)

Peeling of the fingers

c)

Cephalohematoma

d)

Erythema toxicum

5.

A newborn exhibits a high-pitched cry. The nurse should assess for:

a)

Sleep readiness

b)

Colic or pain

c)

Normal hunger

d)

Thermoregulation

6.

Which vital sign is within the normal range for a newborn?

a)

Temperature: 97.1°F

b)

Heart Rate: 180 bpm

c)

Respiratory Rate: 40 breaths/min

d)

Blood Pressure: 100/70 mmHg

7.

A nurse notes a swollen fontanelle that does not pulsate. This may indicate:

a)

Dehydration

b)

Normal closure

c)

Increased intracranial pressure

d)

Fontanelle ossification

8.

Which skin finding is considered abnormal in a newborn?

a)

Vernix caseosa

b)

Milia

c)

Jaundice extending to the legs

d)

Nevus simplex

9.

Which of the following newborn characteristics is a potential sign of Down syndrome?

a)

Lanugo

b)

Extra digit

c)

Incurved fifth finger

d)

Caput succedaneum

10.

Which description best distinguishes cephalohematoma from caput succedaneum?

a)

Cephalohematoma crosses suture lines

b)

Caput succedaneum is firm and doesn't shift

c)

Caput succedaneum crosses suture lines

d)

Cephalohematoma is a soft, fluctuant mass

11.

An umbilical cord stump that is foul-smelling and oozing should be interpreted as:

a)

Normal drying process

b)

Expected inflammation

c)

Possible omphalitis

d)

Umbilical hernia

12.

Low-set ears in a newborn are often associated with:

a)

Respiratory infections

b)

Normal anatomical variation

c)

Genetic syndromes

d)

Feeding difficulties

13.

A nurse assessing a newborn's hips performs Ortolani's maneuver. A 'clunk' is felt. This indicates:

a)

Normal movement

b)

Clubfoot

c)

Developmental dysplasia of the hip (DDH)

d)

Epiphyseal displacement

14.

Which reflex is absent in a newborn with Erb’s palsy?

a)

Rooting

b)

Moro

c)

Sucking

d)

Babinski

15.

A female newborn has slight vaginal bleeding. The appropriate response by the nurse is to:

a)

Administer vitamin K

b)

Document the finding as normal

c)

Notify the provider

d)

Check clotting factors

16.

A finding of a sacral dimple in a newborn should be further evaluated if:

a)

It is shallow and visible

b)

It is located above the gluteal crease

c)

There is a tuft of hair

d)

It closes by 1 month

17.

Which of the following is a normal weight for a term newborn?

a)

2200 grams

b)

2500 grams

c)

4200 grams

d)

4800 grams

18.

An extra digit found on the newborn’s hand should prompt the nurse to:

a)

Call for immediate removal

b)

Explain that it's often benign

c)

Restrict movement of the limb

d)

Apply a splint

19.

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

a)

Grunting, nasal flaring, retractions

b)

Irregular breathing and brief apnea

c)

Respiratory rate of 32/min

d)

Strong, rhythmic cry

20.

When assessing the newborn for normal GI findings, which of the following is expected?

a)

Flat abdomen

b)

Protuberant, soft abdomen

c)

Sunken umbilical area

d)

Palpable liver edge

21.

A parent reports nipple pain during breastfeeding. Which intervention should the nurse prioritize?

a)

Recommend a nipple shield

b)

Assess the infant’s latch and positioning

c)

Instruct the parent to pump exclusively

d)

Suggest reducing feeding frequency

22.

A postpartum patient is concerned about low milk supply. Which nursing response is most appropriate?

a)

Suggest offering formula supplementation

b)

Encourage more frequent breastfeeding or pumping

c)

Recommend stopping breastfeeding overnight

d)

Suggest reducing fluid intake

23.

Which of the following is a common reason for early cessation of breastfeeding in the U.S.?

a)

Inadequate healthcare access

b)

Return to work without lactation support

c)

Lack of interest in infant bonding

d)

High cost of breastfeeding supplies

24.

A parent asks about using a breast pump. When should pumping typically begin if breastfeeding is going well?

a)

Within 24 hours after birth

b)

One month before returning to work

c)

After 6 months of breastfeeding

d)

Immediately after each feeding

25.

What is the nurse’s priority when assisting with breastfeeding in the first 24 hours?

a)

Schedule feedings every 4 hours

b)

Encourage skin-to-skin and early initiation

c)

Provide pacifiers to soothe the infant

d)

Limit feedings to 5 minutes per side

26.

What is the maximum amount of time freshly expressed breast milk can be stored at room temperature (77°F/25°C)?

a)

2 hours

b)

4 hours

c)

6 hours

d)

8 hours

27.

Which container is preferred for storing human milk?

a)

Any plastic bag

b)

Disposable water bottles

c)

Bags specifically designed for breast milk

d)

Reused formula containers

28.

What is the correct method to thaw frozen breast milk?

a)

Microwave the milk for 30 seconds

b)

Leave it on the counter overnight

c)

Warm it under running warm water or in the refrigerator

d)

Shake the milk vigorously to mix it

29.

Which hand hygiene practice is essential before expressing or pumping milk?

a)

Using alcohol gel

b)

Washing with warm water only

c)

Rinsing hands for 10 seconds

d)

Washing hands with soap and water

30.

How long can human milk be safely stored in a standard freezer?

a)

2 weeks

b)

3 months

c)

6–12 months

d)

Indefinitely

31.

Which formula preparation mistake places an infant at highest risk for hyponatremia?

a)

Adding cereal to the formula

b)

Mixing too much water with powder

c)

Using warm water

d)

Not burping the baby after feeding

32.

Which of the following is a safe practice when warming formula?

a)

Use the microwave

b)

Boil the bottle directly

c)

Test temperature on inner wrist after warming in warm water

d)

Mix formula with hot tap water

33.

A parent plans to feed their infant formula using the powder form. What should the nurse emphasize?

a)

Scoop size does not matter

b)

Always mix one scoop with 3 oz of water

c)

Follow manufacturer's instructions for water-to-powder ratio

d)

Store prepared formula at room temperature overnight

34.

Which bottle-feeding technique best supports an infant’s self-regulation and digestion?

a)

Propping the bottle during feeds

b)

Feeding in a reclined position

c)

Paced bottle-feeding with upright infant positioning

d)

Feeding while the infant is sleeping

35.

What should the nurse teach parents about feeding frequency during the first weeks of life?

a)

Feed every 6 hours

b)

Only feed when the baby cries

c)

Feed on demand every 2–3 hours

d)

Schedule feeds strictly to promote routine

36.

A newborn is jittery, has a weak cry, and is difficult to arouse. What is the priority nursing intervention?

a)

Perform a blood glucose test

b)

Swaddle the newborn tightly

c)

Offer pacifier for comfort

d)

Encourage skin-to-skin contact

37.

A premature newborn at 30 weeks gestation is experiencing nasal flaring, retractions, and grunting. What intervention is expected?

a)

Administer surfactant via endotracheal tube

b)

Place the infant on continuous IV fluids

c)

Encourage oral feedings

d)

Delay oxygen therapy to avoid dependency

38.

A nurse is caring for a 2-day-old newborn receiving phototherapy for jaundice. Which statement by the parents indicates a need for further teaching?

a)

I should keep my baby’s eyes covered with eye shields.

b)

I should increase my baby’s feeding frequency.

c)

I should apply lotion to prevent my baby’s skin from drying out.

d)

I should check my baby’s temperature often.

39.

A newborn exposed to opioids in utero is experiencing tremors, excessive crying, and poor feeding. Which intervention is most appropriate?

a)

Offer a pacifier and swaddle tightly

b)

Encourage frequent handling by family

c)

Delay feedings to avoid overstimulation

d)

Place the newborn under bright lights

40.

A newborn is hypothermic and has a blood glucose of 30 mg/dL. What intervention should the nurse perform first?

a)

Administer oral glucose

b)

Place the newborn under a radiant warmer

c)

Wrap the newborn in multiple blankets

d)

Offer formula feeding

41.

A newborn is noted to be jittery, lethargic, and has poor feeding. Blood glucose is 32 mg/dL. What is the nurse's priority action?

a)

Administer phototherapy

b)

Initiate IV antibiotics

c)

Feed the infant or administer dextrose per protocol

d)

Apply a radiant warmer

42.

Which newborn is at highest risk for developing hypoglycemia?

a)

A term infant born via vaginal delivery

b)

A post-term infant without complications

c)

A large-for-gestational-age (LGA) infant of a diabetic parent

d)

A baby born via emergency cesarean after labor

43.

A nurse is caring for a preterm newborn experiencing nasal flaring, grunting, and central cyanosis. What is the priority intervention?

a)

Administer a feeding

b)

Suction the airway and provide oxygen

c)

Begin phototherapy

d)

Encourage skin-to-skin contact

44.

Which assessment finding suggests neonatal sepsis?

a)

Warm, flushed skin and increased tone

b)

Hypoglycemia, temperature instability, and poor tone

c)

Strong feeding reflex

d)

Jitteriness and irritability only

45.

A newborn has yellowing of the skin starting at the face and moving downward. What action is most appropriate?

a)

Begin IV antibiotics

b)

Apply nasal cannula oxygen

c)

Assess serum bilirubin levels

d)

Feed the newborn glucose water

46.

Which finding is most concerning in a newborn with respiratory distress syndrome (RDS)?

a)

Respiratory rate of 65

b)

Grunting with central cyanosis

c)

Use of brown fat stores

d)

Mild nasal flaring

47.

Which nursing action best prevents hypothermia in a newborn?

a)

Delay first feeding

b)

Delay skin-to-skin contact

c)

Place the baby in a thermoneutral environment

d)

Bathe the baby immediately after birth

48.

A nurse is educating a parent of a newborn receiving phototherapy. Which statement indicates a need for further teaching?

a)

I should protect my baby’s eyes during treatment.

b)

I will increase feedings to help clear bilirubin.

c)

I can turn off the phototherapy lights for 6 hours at night.

d)

I will change my baby’s diaper frequently to monitor output.

49.

A nurse suspects hypothermia in a newborn. Which finding supports this?

a)

Axillary temp of 37.5°C

b)

Warm, pink extremities

c)

Pale, cool skin with poor tone

d)

Jitteriness and increased feeding

50.

A preterm newborn is receiving care in the NICU. Which intervention best supports thermoregulation?

a)

Delay feeding for 24 hours

b)

Maintain a radiant warmer and limit heat loss

c)

Encourage frequent bathing

d)

Swaddle loosely in cool blankets

51.

A newborn is pale, has bradycardia, poor feeding, and temperature instability. The nurse suspects sepsis. What is the priority nursing action?

a)

Administer phototherapy

b)

Notify the provider and obtain cultures

c)

Give oral glucose

d)

Place baby under a warmer

52.

What is the goal blood glucose level in a newborn to prevent complications?

a)

≥ 20 mg/dL

b)

≥ 30 mg/dL

c)

≥ 40 mg/dL

d)

≥ 50 mg/dL

53.

Which of the following is a preventive strategy for hyperbilirubinemia?

a)

Early and frequent feedings

b)

Skin-to-skin contact only at night

c)

Avoiding phototherapy until symptoms are severe

d)

Administering dextrose before breastfeeding

54.

What is a distinguishing sign of neonatal jaundice that helps in early detection?

a)

Jaundice that begins in the toes and moves up

b)

Yellowing of the sclera and face

c)

Dark green stool

d)

Hyperactive reflexes

55.

Which infant should the nurse monitor most closely for respiratory distress syndrome (RDS)?

a)

A term baby born via vaginal delivery

b)

A late-preterm baby born via elective C-section

c)

A post-term infant with meconium-stained fluid

d)

A baby with a birthweight of 3.5 kg and Apgar of 9

56.

A nurse is teaching a client about oral contraceptive pills. Which statement by the client indicates the need for further teaching?

a)

I will take the pill at the same time every day.

b)

If I miss one pill, I will take two pills the next day.

c)

This method protects me from getting pregnant.

d)

I will still need to use condoms to protect against STIs.

57.

A 35-year-old client who smokes asks about starting oral contraceptives. What is the best response by the nurse?

a)

You can take the pill as long as you reduce your smoking.

b)

You should avoid combined oral contraceptives due to clotting risk.

c)

The pill is safe as long as you have no history of hypertension.

d)

You should try a barrier method instead.

58.

A client using a diaphragm for contraception should be instructed to:

a)

Insert it immediately before intercourse

b)

Remove it immediately after intercourse

c)

Use it with spermicidal gel

d)

Replace it every 2 years

59.

Emergency contraception is most effective when taken within how many hours of unprotected sex?

a)

12 hours

b)

24 hours

c)

72 hours

d)

120 hours

60.

Which contraceptive method provides protection against STIs?

a)

Oral contraceptives

b)

IUD

c)

Male condom

d)

Contraceptive implant