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WorksheetsNCLEX - LABOR AND DELIVERY Day2 (Part 2)
Total questions: 14
Worksheet time: 14mins
Name
Class
Date
1.
The nurse is caring for a client immediately after a vaginal birth. The nurse notes that the client's uterus is midline and boggy. Which of the following actions should the nurse take first?
a)
Perform uterine fundal massage.
b)
Increase the rate of the oxytocin infusion.
c)
Obtain the client's blood pressure and pulse.
d)
Check for pooled blood under the client's buttocks.
e)
--
2.
A nurse is teaching a postpartum client about cord care for the newborn. Which statement by the client indicates a need for further teaching?
a)
I can expect the cord to turn black in a few days.
b)
I should let the cord fall off by itself, in about 1-2 weeks.
c)
I should use a cotton swab to gently apply alcohol to the cord.
d)
I will fold the diaper below the cord to allow the cord to dry.
e)
--
3.
The nurse is assessing a 72-hour-old, breastfed newborn at term gestation who began receiving phototherapy for hyperbilirubinemia 12 hours ago. Which of the following findings would require immediate follow-up?
a)
Axillary temperature of 99.0 F (37.2 C).
b)
The newborn is wearing only a diaper and eye protection.
c)
Total of 2 black, sticky stools since birth.
d)
Skin on the forehead has a yellowish tint when blanched.
e)
--
4.
The nurse is caring for a full-term newborn who was born 6 hours ago and has asymptomatic hypoglycemia. Which of the following actions would be a priority for the nurse to take?
a)
Administer IV dextrose to the newborn.
b)
Ensure the newborn receives a feeding.
c)
Notify the newborn's health care provider.
d)
Place the newborn under a radiant warmer.
e)
--
5.
The nurse is assessing a newborn 2 hours after a vacuum-assisted vaginal birth. Which of the following findings may indicate a complication associated with vacuum-assisted birth?
a)
Rectus abdominus muscles are separated.
b)
Presence of extra gluteal folds on the left side.
c)
Single testicle noted on palpation of the genitals.
d)
Asymmetric arm movement while testing the Moro reflex.
e)
--
6.
The nurse is assessing a full-term newborn of a mother with poorly controlled diabetes mellitus during pregnancy. Which of the following findings would the nurse most likely expect?
a)
Delayed meconium passage.
b)
Elevated hematocrit level.
c)
Loose stools and sneezing.
d)
Smooth philtrum and thin upper lip.
e)
--
7.
Which of the following actions should the labor and delivery nurse perform when caring for a client who has decided to relinquish her newborn to an adoptive parent? Select all that apply.
a)
Ask the birth mother if she would like to hold the newborn.
b)
Avoid discussing the adoption details until after the birth.
c)
Notify other staff involved in caring for the client of the adoption plan.
d)
Offer the birth mother enough time to say goodbye to the newborn.
e)
Use phrases that illustrate adoption as a decision of love, not abandonment.
8.
A client with poorly controlled diabetes mellitus gives birth to a newborn at term gestation. When caring for the 2-hour-old newborn, which clinical finding requires the nurse to intervene?
a)
Cyanosis of hands and feet.
b)
Heart rate of 165/min while crying.
c)
Jitteriness.
d)
Respirations of 60/min.
e)
--
9.
A client, gravida 4 para 3, at 38 weeks gestation arrives in the emergency department with strong contractions that began 1 hour ago. The client is diaphoretic, grunting, and yelling loudly that she wants an epidural because she feels the need to push. What priority action should the nurse take?
a)
Apply gloves and assess perineal area.
b)
Initiate large-bore IV access.
c)
Notify anesthesia provider of client's request for epidural.
d)
Obtain fetal heart tones via Doppler.
e)
--
10.
The nurse is caring for a newborn 12 hours after an uncomplicated vaginal birth at 39 weeks gestation. Which of the following findings would require follow-up? Select all that apply.
a)
Plantar creases are present over the entire soles of the feet.
b)
Skin on the forehead blanches to a yellowish hue.
c)
Toes fan outward as the sole of the foot is stroked upward.
d)
Umbilical cord has one artery and one vein.
e)
White, pearl-like cysts are present on the gum margins.
11.
The nurse is teaching the mother of a newborn about gastroesophageal reflux. What should the nurse suggest to prevent reflux? Select all that apply.
a)
Engage your baby in active play after feeding.
b)
Feed your baby while in an infant swing or car seat.
c)
Hold your baby upright for 20-30 minutes after feeding.
d)
Offer smaller, more frequent feeds if bottle-feeding.
e)
Pause feedings every couple of ounces and burp your baby.
12.
The nurse is performing an assessment on a 48-hour-old male who was born breech via vaginal birth at 36 weeks gestation. Which assessment finding requires immediate evaluation by the health care provider?
a)
Foreskin adheres to the glans penis.
b)
Scrotum is mildly edematous.
c)
Testes are palpated in the inguinal canal.
d)
Two wet diapers are noted since birth but no meconium.
e)
--
13.
The nurse is caring for a preterm newborn immediately after birth. The newborn is pink and crying vigorously. Which of the following actions should the nurse take? Select all that apply.
a)
Perform diaper changes underneath a radiant warmer.
b)
Use an open bassinet to transport the swaddled newborn.
c)
Encourage skin-to-skin contact between the newborn and parent.
d)
Cover the scale with warmed blankets before weighing the newborn.
e)
Place an identification band on the newborn before wiping off amniotic fluid.
14.
The nurse has attended a staff education program about cold stress in preterm newborns. Which of the following statements by the nurse would require follow-up?
a)
Irritability is a sign of cold stress in preterm newborns.
b)
Cold stress can cause poor feeding and hypoglycemia.
c)
Preterm newborns shiver when experiencing cold stress.
d)
Cold stress can cause the skin to feel cool and appear mottled.
e)
--
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