PN Maternal Newborn 2020 with NGN
Total Questions : 57
Showing 25 questions, Sign in for moreA nurse is reinforcing teaching with a client who has a pre-pregnancy BMI of 21. How much weight should the nurse recommend the client gain during the course of the pregnancy?
Explanation
16.4 to 20.5 kg (36 to 45 lb): This range of weight gain is higher than the recommended amount for a client with a pre-pregnancy BMI of 21. It is more appropriate for individuals with a lower BMI.
5 to 7.7 kg (11 to 17 lb): This range of weight gain is lower than the recommended amount for a client with a pre-pregnancy BMI of 21. It is more appropriate for individuals with a higher BMI.
11.4 to 15.9 kg (25 to 35 lb): This range of weight gain is higher than the recommended amount for a client with a pre-pregnancy BMI of 21. It is more appropriate for individuals with a lower BMI.
8.2 to 10.9 kg (18 to 24 lb): This range of weight gain falls within the recommended guidelines for a client with a pre-pregnancy BMI of 21. It is the most appropriate choice for this specific client.
A nurse is collecting data from a client who has just had a positive pregnancy test. The first day of her last menstrual period was February 16. Using Naegele's rule, what should the nurse tell the client the estimated date of birth is? (Use the MMDD format.)
Explanation
- To use Naegele's rule, add 7 days to the first day of the last menstrual period and subtract 3 months.
- In this case, adding 7 days to February 16 gives February 23, and subtracting 3 months gives November 23.
- Therefore, the estimated date of birth is 1123.
A nurse is reinforcing teaching with a client who is postpartum and receiving warfarin for deep- vein thrombosis. Which of the following instructions should the nurse include?
Explanation
A. Incorrect. While using a disposable razor is a precaution for individuals taking anticoagulants to reduce the risk of bleeding, it is not specific to warfarin.
B. Correct. Taking oral contraceptives along with warfarin can increase the risk of bleeding.
Therefore, the client should be advised not to take oral contraceptives while on warfarin.
C. Incorrect. Aspirin is not typically recommended for pain relief in individuals taking warfarin due to the increased risk of bleeding.
D. Incorrect. The duration of warfarin therapy is individualized based on the specific condition being treated. It is not a fixed 2-week period.
A nurse is collecting data from a client who is at 35 weeks of gestation. The nurse should identify that which of the following findings indicates abruptio placentae?
Explanation
A. Incorrect. Uterine atony is a condition characterized by poor uterine muscle tone and is not specifically indicative of abruptio placentae.
B. Incorrect. Polyhydramnios is an excessive accumulation of amniotic fluid and is not a specific sign of abruptio placentae.
C. Correct. Painless vaginal bleeding is a classic sign of abruptio placentae. It occurs when the placenta partially or completely detaches from the uterine wall.
D. Incorrect. A board-like abdomen is a sign of peritonitis or a surgical abdomen and is not specific to abruptio placentae.
A nurse is reinforcing teaching with a newly licensed nurse concerning a client on a postpartum unit following a cesarean birth. Which of the following measures should the nurse include in the instructions to prevent thrombophlebitis?
Explanation
A. Correct. Applying elastic stockings (compression stockings) helps promote venous return and prevent stasis of blood, which can contribute to thrombophlebitis.
B. Incorrect. Applying warm, moist packs can provide comfort but does not specifically prevent thrombophlebitis.
C. Incorrect. Ambulation is important for preventing thrombophlebitis as it encourages blood flow, but it should be combined with other measures like wearing elastic stockings.
D. Incorrect. While NSAIDs can be used for pain relief, they do not directly prevent
thrombophlebitis. Other measures like compression stockings are more specific for prevention.
A nurse is planning care for a newborn who is large for gestational age. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)
Explanation
A. Correct. Large for gestational age (LGA. infants may have a higher risk of birth injuries, including ecchymosis (bruising) due to their size.
B. Correct. Encouraging breastfeeding is important for all newborns, including those who are large for gestational age.
C. This action is not specifically related to caring for a newborn who is large for gestational age. Meconium may be collected for other reasons, but it is not a priority in this situation.
D. Correct. LGA infants are at increased risk for hypoglycemia due to maternal gestational diabetes. Monitoring blood glucose levels is important.
E. This action is not typically indicated for newborns who are large for gestational age. It is important to focus on monitoring and providing supportive care unless there arespecific medical indications for a blood transfusion.
A nurse is reinforcing teaching with a client about obtaining a clean catch urine specimen. Identify the sequence of steps the nurse should instruct the client to follow. (Move the steps by placing them in the order of performance. Use all the steps.)
No explanation
A nurse is assisting in the care of a client who is experiencing an unruptured ectopic pregnancy that is at 8 weeks of gestation. Which of the following medications should the nurse expect the provider to prescribe?
Explanation
A. Terbutaline is a medication used to relax the uterine muscles and is not indicated for the treatment of ectopic pregnancy.
B. Magnesium sulfate is typically used for conditions like preeclampsia and eclampsia, not for treating ectopic pregnancy.
C. Methotrexate is the preferred medication for treating unruptured ectopic pregnancies, especially when they are in early stages (before rupture occurs).
D. Calcium gluconate is used to treat calcium deficiencies and is not indicated for ectopic pregnancy.
A nurse is assisting with a prenatal class discussion about newborn safety. Which of the following statements by a participant indicates an understanding of the teaching?
Explanation
A. Elevating a baby's head on a cushion during sleep is not recommended, as it may increase the risk of Sudden Infant Death Syndrome (SIDS).
B. Using baby powder with each diaper change is not recommended, as it can be harmful if inhaled by the baby.
C. Setting the hot water heater to 130 degrees Fahrenheit is too hot and can scald a baby. The recommended temperature is around 120 degrees Fahrenheit.
D. This statement indicates an understanding of the importance of regularly changing smoke detector batteries, which is a critical aspect of newborn safety.
A nurse is collecting data from a client who is receiving epidural anesthesia. Which of the following findings indicates an adverse effect of this method of pain management?
Explanation
A. Tachypnea (rapid breathing) is not typically an adverse effect of epidural anesthesia.
B. Hypertension (high blood pressure) is not typically an adverse effect of epidural anesthesia.
C. Tachycardia (rapid heart rate) can be an adverse effect of epidural anesthesia, potentially due to a decrease in blood pressure leading to a compensatory increase in heart rate.
D. Fever is not a common adverse effect of epidural anesthesia.
A nurse is receiving change-of-shift report for four newborns. Which of the following newborns should the nurse attend to first?
Explanation
A. This newborn has cyanosis (blue hands and feet) along with a low axillary temperature, indicating potential circulation and temperature regulation issues. This requires immediate attention.
B. While weight loss in a newborn is a concern, it's not as urgent as a potential circulation issue.
C. Yellow exudate 24 hours post-circumcision is likely normal, as it may be indicative of healing.
D. A blood glucose level of 63 mg/dL is within the normal range for a newborn.
A nurse is caring for a client who inquires about available methods of contraception. Which of the following actions should the nurse take?
Explanation
A. The nurse's role is to provide education and information about available methods of contraception without imposing personal beliefs or preferences.
B. It is not the nurse's role to select the method of contraception for the client. The decision should be made by the client based on their individual preferences and health considerations.
C. While assessing the client's socioeconomic status may be relevant for some aspects of care, it is not directly related to providing information about contraception.
D. Collecting a dietary history is not relevant to a client's inquiry about contraception.
A nurse in a prenatal clinic is reinforcing teaching with a client about expected physiological changes during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
A: A dark line in the middle of the abdomen (linea nigra. is a normal pigment change during pregnancy and is not indicative of an infection.
B: Hormonal changes during pregnancy can lead to increased pigmentation, often called "mask of pregnancy" or chloasma. This can cause discoloration on the cheeks.
C: Swelling of fingers and face (edema. can occur during pregnancy due to fluid retention, but it is not universal for all pregnant individuals.
D: Burning during urination is more indicative of a urinary tract infection and should be reported to a healthcare provider.
A nurse is reinforcing teaching about breastfeeding with a client who is postpartum. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
A: The baby should take in both the areola and nipple for effective breastfeeding, not just the nipple.
B: This position helps ensure that the baby's mouth is at the same level as the breast, which promotes proper latch and feeding.
C: The duration of breastfeeding can vary, and it's often recommended to nurse until the baby is satisfied rather than setting a specific time limit.
D: Applying vitamin E oil after each feeding is not a standard practice and is not necessary for successful breastfeeding.
A nurse is collecting data from a client who is receiving terbutaline to treat preterm labor. Which of the following findings should the nurse report to the provider?
Explanation
A. Nausea is a common side effect of terbutaline, but it is not typically a cause for concern. It may be managed with measures like taking the medication with food.
B. Tremors are a known side effect of terbutaline. While they may be uncomfortable for the client, they are an expected side effect and not necessarily indicative of a problem requiring immediate intervention.
C. Dizziness can occur as a side effect of terbutaline. It is important to monitor the client for this, but it is not typically a severe side effect that requires immediate reporting to the provider.
D. Crackles (also known as rales) in the lungs suggest the possibility of fluid accumulation, which could be a sign of pulmonary edema. This is a serious concern and should be reported to the provider promptly, as it may require a change in treatment or further evaluation.
A nurse is caring for a newborn who requires a blood glucose test. Which of the following actions should the nurse take?
Explanation
A. Applying a warm pack prior to the procedure may increase blood flow, potentially leading to inaccurate results in a blood glucose test.
B. Using a mummy restraint is not a recommended practice. There are less restrictive and more patient-friendly methods to hold a newborn during a procedure.
C. Applying antiseptic solution after the procedure is important to prevent infection at the puncture site.
D. Elevating the extremity prior to the procedure is not necessary for a blood glucose test.
A nurse is caring for a client who reports discomfort due to afterpains following breastfeeding. Which of the following actions should the nurse take?
Explanation
A. Placing the client in a side-lying position may be a comfort measure, but it may not address the afterpains directly.
B. Applying a cool compress may provide some relief, but it may not be as effective as administering medication for pain relief.
C. Administering ibuprofen or other appropriate pain medication can help relieve afterpains, which are caused by uterine contractions after childbirth.
D. Encouraging Kegel exercises is not relevant to relieving afterpains. Kegel exercises are beneficial for pelvic floor muscle strength but do not directly address afterpains.
A nurse is reinforcing teaching with a client who is at 12 weeks of gestation and is scheduled for placement of a cervical cerclage. Which of the following statements by the client indicates understanding of the teaching?
Explanation
A. Resuming an exercise program within 24 hours after a cervical cerclage placement is not recommended, as it can put unnecessary strain on the cervix.
B. The cerclage is typically removed closer to the end of pregnancy, around 36-38 weeks, not at 10 weeks.
C. While urinary frequency can be a concern during pregnancy, it is not directly related to cervical cerclage placement.
D. Avoiding sexual activity is important after a cervical cerclage placement to reduce the risk of complications and to support the integrity of the cervix.
A nurse is caring for a full-term newborn who is 1 day old. Which of the following laboratory findings should the nurse report to the provider?
Explanation
A. Hemoglobin (Hgb. level of 9.5 g/dL is within the normal range for a newborn.
B. Platelets of 225,000/mm is within the normal range for a newborn.
C. A glucose level of 60 mg/dL in a newborn is considered low and should be reported to the provider for further evaluation.
D. White blood cell (WBC. count of 10,000/mm is within the normal range for a newborn.
A nurse is reinforcing teaching about safety precautions to take when driving a car with a client who is in the first trimester of pregnancy. Which of the following instructions should the nurse include in the teaching?
Explanation
A. The shoulder harness should be placed between the breasts and to the side of the gravid uterus to avoid direct pressure on the abdomen.
B. Moving the seat too far from the steering wheel may make it difficult for the pregnant client to reach the pedals comfortably.
C. Wearing the lap belt high across the abdomen helps to protect both the mother and the fetus in case of a sudden stop or accident.
D. Disabling the vehicle's driver-side airbags is not recommended. Airbags are designed to protect passengers, including pregnant women, in the event of a collision.
A nurse is collecting data from a client who is 20 hr postpartum following a vaginal delivery. Which of the following findings should the nurse expect?
Explanation
A. Homans' sign is a test for deep vein thrombosis and is not a normal postpartum finding.
B. Full, firm breasts typically occur a few days after delivery when milk production begins, not at 20 hours postpartum.
C. A firm fundus at the midline is an expected finding in the immediate postpartum period, indicating that the uterus is contracting and involuting properly.
D. Lochia serosa (pinkish-brown discharge) is a normal finding around 3 to 10 days postpartum, but it is not typically present at 20 hours postpartum.
A nurse in a provider's office is collecting data from a client who is requesting a prescription for a transdermal contraceptive patch. The nurse should recognize that which of the following client findings is a contraindication for this method of contraception?
Explanation
A. A history of spontaneous abortion is not a contraindication for using a transdermal contraceptive patch.
B. Peptic ulcer disease is not a contraindication for using a transdermal contraceptive patch.
C. Blood pressure of 120/70 mm Hg is within the normal range and is not a contraindication for using a transdermal contraceptive patch.
D. The transdermal contraceptive patch may be less effective for individuals with a weight of 90 kg (198 lB. or more. Therefore, it is contraindicated for clients who weigh 98 kg (216 lb). These clients may need to consider alternative contraceptive methods.
A nurse is discussing a client's maternal serum alpha-fetoprotein screening results with a newly licensed nurse. Which of the following conditions is associated with low levels?
Explanation
A. Multiple gestation is associated with elevated levels of alpha-fetoprotein, not low levels.
B. Down syndrome is associated with low levels of alpha-fetoprotein.
C. Intrauterine growth restriction is not directly associated with maternal serum alpha-fetoprotein levels.
D. High levels of maternal serum alpha fetoprotein indicate a neurl tube defect such as spina bifida
A nurse is auscultating fetal heart tones with a Doppler device for a client who is at 12 weeks of gestation. Where should the nurse expect to auscultate the fetal heart tones?
Explanation
A. The suprapubic area is typically where the uterus can be palpated, but it's not the location for auscultating fetal heart tones at 12 weeks of gestation.
B. The umbilical area is not typically where fetal heart tones are auscultated at 12 weeks of gestation.
C. At 12 weeks of gestation, the fetal heart tones are typically auscultated above the left iliac crest.
D. Auscultating below the liver border on the right abdomen is not the correct location for fetal heart tones at 12 weeks of gestation.
A nurse is collecting data from a client who is 2 days postoperative following a cesarean birth. Which of the following findings should the nurse report to the provider?
Explanation
A. Left calf tenderness can be a sign of deep vein thrombosis (DVT), which is a serious postoperative complication and should be reported to the provider.
B. Moderate lochia rubra is an expected finding after a cesarean birth.
C. A urine output of 3,000 mL is within normal range and does not warrant immediate reporting to the provider.
D. Breast engorgement is an expected finding in the postpartum period, especially if the client is not breastfeeding. It does not require immediate reporting.
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