Maternity 3

Placing a newborn infant on a cold scale causes heat loss by which mechanism? Conduction Convection Radiation Evaporation 2. The nurse is assessing a woman on her second postpartum day. Her uterus is contracted, her fundus is palpated midline, 2 cm below the umbilicus, but her bladder is not palpable. The correct conclusion based on these findings is that her: Fundus is decending normal 3. A breastfeeding mother is concerned that her baby is not getting enough to eat. Which of the following is the best explanation to be given to the mother? ? Newborns don't need to eat much ? When the baby falls asleep, he has had enough ? Having at least six wet diapers and several stools in 24 hours is indicative of adequate intake 4. The earliest finding in postpartum hypovolemic shock is usually ? Firm uterus ? Rapid pulse rate ? Pale skin color ? High blood pressure 5. The correct order for the phases of lochia during the post-partum period ? Lochia rubra, lochia alba, lochia serosa ? Lochia alba, lochia rubra. Lochia serosa ? Lochia rubra(Dark Red), lochia serosa(Pinkish brown), lochia alba(Whitish yellow). ? Lochia serosa, lochia rubra, lochia alba 6. A newborn will receive vitamin k ? Intramuscularly in the deltoid ? Subcutaneously in the abdomen ? Intramuscularly in the vastus lateralis ? Intramuscularly in the abdomen 7. The nurse removes the newborn away from the air condition vent to prevent which type of heat loss? 8. The nurse is caring for a woman who is gravida 2, para 1 on her first postpartum day. The assessment reveals temperature 38C (100F) pulse so beats/min, blood pressure 118/80 mm Hg. fundus not contracted at the level of the umbilicus and displaced to right, moderate amount of lochia rubra, and perineum slightly edematous with episiotomy edges well approximated. The first nursing action should be to: ? chart the assessment findings as normal ? assist her to the bathroom to void ? apply an ice pack to her perineum ? notify the nurse-midwife of her temperature 9. The nurse should explain to the woman that breastfeeding shortly after delivery benefits her because it: ? increases the secretion of estrogen ? promotes the contraction of her uterus ? promotes the immediate flow of milk ? increases the secretion of progesterone 10. The three most common causes of early postpartum hemorrhage are ? uterine atony 11. Which breastfeeding position would be the most comfortable for both a patient with an episiotomy and a patient with an abdominal incision? ? Side -lying hold ? Football hold ? Cross -cradle hold ? Cradle hold 12. Which finding in a postpartum woman may indicate complications? ? Negative Homan's sign on the fifth postpartum day ? Mild lochia rubra on the fifth postpartum day ? The temperature of 101 F on the third postpartum day ? Afterpains on the second postpartum day 13. When caring for a newborn infant immediately after birth, the first priority is to? ? establish a clear airway ? obtain the Apgar score ? promote bonding with the mother ? apply warm blankets 14. The first nursing action to prevent heat loss in a newly delivered infant is to 15. During labor and birth, women produce, which natural opiate-like chemicals that increase the pain threshold and help the woman tolerate the pain associated with the labor and birth process ? Analgesics ? Endorphins (Help to relaxe) 16. Hypoglycemia in the newborn may be caused by which of the following? ? Hyperthermia ? Hypothermia ? Early breastfeeding ? Vitamin k injection 17. The return of the uterus to its pre-pregnant state is known as: ? Subinvolution ? Involution (of the uterus.) ? Contractions ? Exfoliation Are NOT return of the uterus to its pre-pregnant state is known as: ? Subinvolution ? Contractions ? Exfoliation Involution 19. The puerperium(postpartum) extends from: ? 6 weeks period from childbirth to the return of the uterus and other organs to a pregnant state ? The onset of labor to discharge from the hospital or birthing center ? delivery of the infant to delivery of the placenta ? expulsion of the placenta to the closure of the cervical os 20. A postpartum patient complains of severe perineal pain. Her uterus is firm, midline, and contracted, and she has mild vaginal bleeding. She states that she feels like she needs to urinate and have a bowel movement but was unable to do either when she went to the bathroom. This assessment data should lead the nurse to suspect that the patient most likely has: 21. On her second postpartum day, a woman complains of cramping abdominal pains. What should the nurse tell her about these pains? If you have been constipated, you may need a laxative These contractions are usually relieved by breastfeeding You are having uterine contractions as a result of oxytocin release that help prevent excessive bleeding These pains are normal and persist for about 6 weeks 22. During the postpartum period, the woman should be instructed to report which of the following danger signs to her health care provider immediately (Homan’s Sign)? Leaking of breast milk between feedings Vaginal discharge persisting over 1 week Tiring more easily than usual Localized pain in the calf or leg 23. The assessment of a newly delivered woman reveals a boggy uterus. The nurse’s first intervention should be to: contact the physician for an order for oxytocin Document findings as normal after delivery catheterize her to empty the bladder express clots that have accumulated in the uterus 24. Signs and symptoms of puerperal infection to assess for in the postpartum woman are: F atigue and bradycardia. uterine tenderness and enlargement within the first 24 hours after delivery temperature 38 ? C (100.4 F) or higher on two successive days after the first 24 hours after delivery. profuse vaginal bleeding 25. The parents of a preterm infant are visiting their baby in the high-risk nursery for the first time. It would be important for the nurse to explain that: parental contact is not needed by the baby at this stage. parents are encouraged to touch, hold, and feed their baby C.the baby D. it is too fragile to be touched is best to let the nurses feed the baby at this time. 26. During assessment of a woman in the immediate postpartum period, which finding would ALERT the nurse to uterine atony? Boggy uterine fundus Severe abdominal pain Absence of lochia Fundus below the umbilicus 27. Nonpharmacologic methods can be used to calm and provide pain relief to newborn. Examples include all of the following except: Kangaroo care Aromatherapy Swaddling I V sedation 28. What should the nurse tell the postpartum patient who does NOT wish to breastfeed about breast engorgement? Swelling, redness and tenderness is normal Breast engorgement is caused by the excessive expression of Milk A supportive bra, ice packs, and mild analgesics relieve discomfort , Cabbage leaves Pump the breasts ten times daily to reduce pain 29. . What should the nurse tell the postpartum patient who said YES wish to breastfeed about breast engorgement? Swelling, redness and tenderness is normal Breast engorgement is caused by the excessive expression of Milk Pump the breasts ten times daily to reduce pain and warm compress Cold compress, Cabbage leaves, Ice pack 30. The nurse is assisting a postpartum woman with perineal care for the first time. She would need to correct her technique if she observed her doing which of the following? Applying topical medication after cleansing Washing her hands before cleansing her perineum Wiping her perineum from back to front Changing peripads several times a day 31. The effect of standards of care on nursing is to: A. encourage lawsuits by presenting unrealistic expectations of nurses B. specify what action a nurse with a master’s degree would take in a given situation establish minimum criteria for competent nursing care allow other professions to determine what constitutes nursing care 32. Which statement best explains why newborns who are delivered by cesarean birth are at greater risk for respiratory complications than newborns delivered vaginally? Without going through the normal birth process, the newborn delivered by cesarean does not produce surfactant In most cases, newborns delivered by cesarean are already in Fetal distress before birth. A newborn delivered by cesarean does not have the compressions of the birth canal on the chest, which force fluid from the lungs Newborns delivered by cesarean do not develop the temporary hypoxia that normally stimulates respirations 33. Moving the newborn away from cold walls and windows after birth helps prevent heat loss by which mechanism? Radiation Evaporation Convection Conduction 34. The nurse assessing a newborn recognizes that the most critical physiologic change required of the newborn is full function of the immune system at birth I nitiation and maintenance of respiration maintenance of a stable temperature closure of fetal shunts in the circulatory system 35. Which HORMONE stimulates milk production after birth? A. Prolactin B. Progesterone C. Relaxin D. Estrogen 36. Which of the following physiologic mechanisms does the newborn use to maintain body temperature? Metabolism of brown fat Warm blankets Production of newborn fatty acids Shivering 38. A new mother tells the nurse that her baby must be cold because his hands and feet are blue. The nurse explains that this is a common and temporary condition known as: harlequin sign erythema toxicum cutis marmorata acrocyanosis 39. During a postpartum assessment, the nurse detects a positive Homans’ sign. A positive Homans’ sign is elicited when: the woman stands and feels pain in her foot he knee is held flat, the foot rotated, and pain is felt in her calf the knee is slightly flexed, the foot plantarflexed, and pain is felt in her calf the knee is slightly flexed, the foot is dorsiflexed, and pain is felt in her calf 40. The nurse is helping a new mother who is learning to breastfeed her newborn. The nurse shows her how to hold the infant and touch the corner of the infant’s mouth, which causes the infant to turn toward the stimulated side. The nurse tells the mother that this response is called: sucking r ooting moro tonic neck 41. The nurse accidentally bumped the newborn’s bassinet. The infant responded by extending and abducting the extremities, and the fingers fanned to form a C. The infant then flexed both arms in an embracing motion. This is an example of which newborn reflex? rooting moro Babinski tonic neck 42. What is called to check Stroke the side of the baby foot and the baby’s toes open up and big toe dorsiflexi on? Babinski 43. What is called baby grasp onto things on their palms and plantar grasp is when their toe curl up? Palmar Grasp (Nervous system or Neurological) 44. A newborn has minimal response to stimulation, a heart rate of 110 beats/min, respiration of 20 breaths/min, good strong cry, is limp, and has a pink color except for bluish hands and feet. You should assign this newborn an Apgar score of 5 6 7 8 45.You are the NURSE taking care of a newborn. During what phase of newborn care will the Apgar score initially be performed on this newborn? ? Phase 2 ? Stage 2 ? Phase 3 47. What changes about their new born circulatory system use? The baby shunts close and now the blood has to go to the organs that it was originally by passing in utero. 48. Dry the new born is called: Evaporation 49. When evaluating a fetus in utero, a documentation of flexed is noted. This described the? Atituted 50. which of the following would be abnormal finding in a new born infant? 2 veins and one artery in the umbilical cord 51. In what order should a newborn be suctioned using a bulb syringe? Mouth first then nose 52. On the second postpartum day, a new mother questions whether colostrum provides adequate nutrition for her newborn because “it doesn’t look like milk.” The nurse should tell her that colostrum: is mostly sugar, so it will protect the infant from hypoglycemia, which is common in the first few days of life It is like ‘liquid gold’ and rich in nutrients and provides antibodies to protect the infant from infection. does not meet the infant’s needs but will soon be replaced by mature milk. I s high in fat, which will help the baby regain the weight lost during the first few days of life. 53. which Chemical help to contraction it called? Pitocin 54. After watching the nurse place ointment in his baby’s eyes, a new father asks what the medication is and why it is needed. The nurse explains that the purpose of the erythromycin ophthalmic ointment is to: - prevent potentially harmful exudate from invading the tear ducts, leading to dry eyes. - prevent the baby’s eyelids from sticking together and to help the baby see - determine eye color - prevent infection of the baby’s eyes with gonorrhea and chlamydia potentially acquired from the birth canal. 55. what rate the fundus decent? 1 cm per day, the land mark using umbilicus 56. how many days I should not be palpate ? 10 days 57. if the mother have medication antyschycotic medication breast feeding? Teach mother pump and dump 58. A nurse reinforcing teaching newly mother about recommendation breast feeding newborn which following statement indicating understanding of teaching? 20 min each side so the baby can get hind milk. 59. a nurse caring client 2 hour1st following spontaneous respond vaginal delivery note saturanial 2 pad in 30 minutes period, which of the following action should nurse do? A. Notify the physician B. administer Pitocin C. increase the rate IV fluid D. Check the client fundus consistency 60. During which stage of labor do we have a new born? Stage 2 61. What system or how to asses nervous system would you suspect inmature premature newborn if theyre not breathing? Nervous system (Brain) or Neurological System 62. Squezing throwing the birth canal or happen when the umbilical cord is cut? Chemical stimulation 63. If the baby taking Formula feed what colors the stools? Dark tarry stools 64. What colors mood disorder for postpartum mother? Blue, continue to monitor 65. What is called inflammation or infection of the breast? Mastitis During the immediate postpartum period, the body regulates its fluid volume through which of the following compensatory mechanisms? (select all that apply) - Increased body temperature - Diarrhea - Decreased pulse rate - Diuresis - Diaphoresis After a vaginal delivery, the woman without any complications may stay in the hospital for how long? - 48 hours - 12 hours - 1 hour - 96 hours Increased vascularity during pregnancy can put the postpartum woman at risk for which potential complication? -Urinary retention -Decreased oxygenation. -Constipation -Thromboembolism A baby was born 2 hours ago at 37 weeks’ gestation weighing 4139 g (9 lb, 2 oz). The newborn appears chubby with a flushed complexion and is very shaky. The tremors are most likely the result of: -hypoglycemia -seizures -heat loss -birth injury 1. You are assessing the one-minute APGAR score for a newborn. She is flexed, pink all over, and has a pulse of 120. As you dry her off she begins to cry vigorously and kick her legs. Her APGAR score is Heart rate Respiratory Effort Muscle Tone Reflex Irritability Color 2. A newborn has a strong cry and is actively moving his blue extremities when stimulated. Vital signs are P88, R42. What is his APGAR score Heart rate Respiratory Effort Muscle Tone Reflex Irritability Color 3. A newly delivered infant is pink all over, pulse rate of 160, and minimally responds to your attempts to stimulate her. She also appears to be limp and taking slow, gasping breaths. What is her APGAR score Heart rate Respiratory Effort Muscle Tone Reflex Irritability Color 4. One minute after birth, your newborn patient is minimally crying in response to your bulb syringe. His body is pink, and he is actively moving his blue extremities. His heart rate is 90. What is the newborns APGAR score Heart rate Respiratory Effort Muscle Tone Reflex Irritability Color 5. A newly delivered infant is acrocyanotic, has a pulse rate of 130, and does not respond to your attempts to stimulate her. She also appears to be sluggish with a slow cry. What is her APGAR score Heart rate Respiratory Effort Muscle Tone Reflex Irritability Color