RN Maternal Newborn Practice 2019

Questions and Answers

What is the priority assessment for a client who is in labor and is to have an amniotomy?

Temperature

What response should the nurse give to a client who reports her menstrual period is 2 weeks late and asks if she is pregnant?

You can miss your period for several other reasons. Describe your typical menstrual cycle.

Using Nagele's rule, what would be the expected date of birth for a client whose last menstrual cycle started on November 27th?

September 3rd

To which area of the abdomen should the nurse apply the ultrasound transducer to assess fetal heart tones for a fetus in left occipital anterior position?

Left lower quadrant Signup and view all the answers

What lab result should the nurse report for a client who is postpartum and has preeclampsia?

Platelets 50,000/mm Signup and view all the answers

What diagnostic test should the nurse prepare for a client at 41 weeks of gestation who has a positive contraction stress test?

Biophysical profile (BPP) Signup and view all the answers

What statement indicates understanding from a client who is Rh negative about Rh0(D) immune globulin?

I will need this medication if I have an amniocentesis Signup and view all the answers

What history finding should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply)

Hypertension Signup and view all the answers

What indication of withdrawal from selective serotonin reuptake inhibitors (SSRI) should the nurse identify in a newborn?

Vomiting Signup and view all the answers

What should the nurse state to a postpartum client about promoting the security of her newborn?

Staff members who take care of your baby will be wearing a photo identification badge. Signup and view all the answers

What information should the nurse include when teaching about levonorgestrel contraception?

You should take the medication within 72 hours following unprotected sexual intercourse. Signup and view all the answers

What action should the nurse take first when caring for a newborn transferred to the nursery with mild respiratory distress?

Verify the newborn's identification. Signup and view all the answers

What action should the nurse take for a client in labor whose fetus is in the right occiput posterior position and reports back pain?

Apply sacral counterpressure. Signup and view all the answers

What statement by a client indicates understanding of terbutaline teaching regarding preterm labor?

I will have blood tests because my potassium might decrease. Signup and view all the answers

If a nurse palpates a uterus to the right above the umbilicus in a client who gave birth vaginally 12 hours ago, what intervention should the nurse perform?

Assist the client to empty her bladder. Signup and view all the answers

What statement indicates a client with gestational type 1 diabetes mellitus understands the management during pregnancy?

I will continue taking my insulin if I experience nausea and vomiting. Signup and view all the answers

What lab result for a 24-hour-old newborn should the nurse report to the provider?

Blood glucose 30 mg/dL Signup and view all the answers

What should the nurse instruct a client with a new prescription for a diaphragm?

You should leave the diaphragm in place for at least 6 hours after intercourse. Signup and view all the answers

What finding in a 4-hour-old newborn should the nurse report to the provider?

Bilirubin 9 mg/dL Signup and view all the answers

What should the nurse include in teaching regarding a 1-hour glucose tolerance test for a client at 24 weeks of gestation?

A blood glucose of 130 to 140 is considered a positive screening result. Signup and view all the answers

What instructions regarding car seat safety should the nurse give to the parents of a newborn?

Place the retainer clip at the level of the newborn's armpits. Signup and view all the answers

What action should the nurse include in the plan of care for a client requesting epidural anesthesia during labor?

Monitor the client's blood pressure every 5 minutes following the first dose of anesthetic solution. Signup and view all the answers

What should the nurse do after noticing an umbilical cord protruding from a patient in labor?

Apply internal upward pressure to the presenting part using two gloved fingers. Signup and view all the answers

What findings in a 28-year-old client require immediate follow-up? (Select all that apply)

Vaginal spotting Signup and view all the answers

Complete the following sentence: The client is experiencing with .

ectopic pregnancy; right lower quadrant abdominal tenderness Signup and view all the answers

Complete the following sentence: Evaluate the client for and .

Heart rate; Vaginal spotting Signup and view all the answers

Match the following prescriptions to their anticipated status or contraindication:

Transvaginal ultrasound = Anticipated Meperidine IM = Contraindicated Repeat quantitative beta-hCG level = Anticipated Methotrexate IM = Anticipated Blood typing = Anticipated Signup and view all the answers

What actions should the nurse take to prepare a client for surgery? (Select all that apply)

Obtain a CBC Signup and view all the answers

What findings indicate a potential complication following surgery? (Select all that apply)

Blood pressure Signup and view all the answers

What intervention should the nurse plan to implement during the taking-hold phase of postpartum behavioral adjustment?

Demonstrating to the client how to perform a newborn bath. Signup and view all the answers

Which phase of labor is a client likely in if she reports increasing rectal pressure with contractions 2 to 3 minutes apart and cervix dilation of 9 cm?

Transition Signup and view all the answers

What finding indicates that a newborn is experiencing pain following a circumcision?

Chin quivering. Signup and view all the answers

What action should the nurse take first when caring for a client experiencing hypovolemic shock?

Massage the client's fundus. Signup and view all the answers

How many azithromycin tablets should the nurse administer to a client at 16 weeks of gestation with a prescription of 1 g orally available in 250 mg tablets?

4 tablets. Signup and view all the answers

What manifestation of hypoglycemia should the nurse expect in a newborn?

Jitteriness. Signup and view all the answers

Where should the Doppler ultrasound stethoscope be placed to begin assessing fetal heart tones for a patient in the end of her first trimester?

Just above the symphysis pubis. Signup and view all the answers

What finding should the nurse expect when assessing a postpartum client with idiopathic thrombocytopenia purpura (ITP)?

Decreased platelet count. Signup and view all the answers

What instruction should the nurse include when teaching a new parent about newborn safety?

You can share your room with your baby for the next few weeks. Signup and view all the answers

What action should the nurse take for a 22-week gestation client concerned about hyperpigmentation on her forehead?

Explain to the client that this is an expected occurrence. Signup and view all the answers

Identify the sequence the nurse should follow in performing Leopold maneuvers:

Palpate the fundus to identify the fetal part = 1 Determine the location of the fetal back = 2 Palpate for the fetal part presenting at the inlet = 3 Identify the attitude of the head = 4 Signup and view all the answers

What will the nurse explain is the indication for administering betamethasone to a client experiencing preterm labor?

This medication stimulates fetal lung maturity. Signup and view all the answers

What nutrient intake should a nurse advise increasing for a client at 8 weeks of gestation?

Iron. Signup and view all the answers

What manifestation in a 12-hour-old newborn requires nurse intervention?

Substernal chest retractions while sleeping. Signup and view all the answers

What nonpharmacological intervention should the nurse include in the discharge plan for a client who is 3 days postpartum and needs lactation suppression?

Apply cabbage leaves to the breasts. Signup and view all the answers

What action should the nurse include in the plan of care for a client undergoing a nonstress test?

Instruct the client to press the provided button each time fetal movement is detected. Signup and view all the answers

What adverse effect should the nurse instruct a client taking combined oral contraceptives to report?

Shortness of breath. Signup and view all the answers

What findings indicate the need for oxytocin administration postpartum?

Flaccid uterus; Excess vaginal bleeding. Signup and view all the answers

What finding in a client at 30 weeks of gestation should the nurse report to the provider?

Swelling of the face. Signup and view all the answers

What is the first action the nurse should take when a client becomes unresponsive following the delivery of the placenta?

Determine respiratory functions. Signup and view all the answers

What condition indicated the need for fetal assessment using electronic fetal monitoring?

Oligohydramnios. Signup and view all the answers

What instruction should the nurse give to a new mother on using a bulb syringe for suctioning her newborn's secretions?

Stop suctioning when the newborn's cry sounds clear. Signup and view all the answers

Which findings should the nurse report to the provider? (Select all that apply)

Headache Signup and view all the answers

What risks should the nurse assess the client for based on assessment findings? (Select all that apply)

Preeclampsia Signup and view all the answers

Complete the following sentence: Assess the client for and .

Assess the client's deep tendon reflexes; Assess the client for visual disturbances. Signup and view all the answers

Which actions should the nurse take based on the client's condition?

Urinalysis = Anticipated Monitor intake and output = Anticipated Magnesium sulfate = Anticipated Seizure precautions = Anticipated Labetalol = Contraindicated Draw creatinine and BUN = Anticipated Signup and view all the answers

What actions should the nurse take regarding the client's electronic medical record? (Select all that apply)

Obtain creatinine, platelet, BUN, and liver enzymes Signup and view all the answers

What indicates the newborn is experiencing pain during phototherapy treatment?

Cover the newborn's eyes while under the phototherapy light. Signup and view all the answers

What emotional condition might a client experience based on her statements about her mood swings during pregnancy?

Emotional liability. Signup and view all the answers

What finding should the nurse report as a potential complication following an amniocentesis?

Leakage of fluid from the vagina. Signup and view all the answers

Study Notes

Labor and Delivery

Priority assessment during labor with an amniotomy is the client's temperature to monitor for infection.
For a client with a late menstrual period and anxiety about pregnancy, asking about the typical menstrual cycle helps assess potential causes of the missed period.
Nagele's rule calculates expected date of birth based on the last menstrual period; for a cycle starting November 27th, the expected due date is September 3rd.
Fetal heart tones for a left occipital anterior position are assessed best in the left lower quadrant of the abdomen.
Support for a client at 41 weeks with a positive contraction stress test includes preparing for a biophysical profile (BPP).

Rh Factor and Contradictions

Rh negative clients should be informed that Rh0(D) immune globulin is necessary if undergoing procedures like amniocentesis.
Contraindications for oral contraceptives include conditions like cholecystitis, hypertension, and migraine headaches.

Newborn Assessment and Safety

Signs of withdrawal in newborns from SSRIs include symptoms like vomiting.
Safety measures for newborns include staff wearing photo identification badges.
Teaching about levonorgestrel emergency contraception should stress taking it within 72 hours after unprotected sex.

Postpartum Care

Postpartum clients with uterine displacement (e.g., palpation above umbilicus) require immediate bladder emptying to assess for distention.
AIDS for a postpartum client experiencing hypovolemic shock includes fundus massage after provider notification.
Nursing interventions in the taking-hold phase of postpartum care involve teaching the client about newborn care, such as bathing.

Complications and Monitoring

Lab results indicating potential trouble include low platelet counts in postpartum clients with preeclampsia.
For hypoglycemic newborns, signs such as jitteriness should be monitored closely.
During assessments, indications of issues like elevated blood pressure or visual disturbances should be escalated to providers for further action.

Medications and Therapies

Betamethasone is administered in cases of preterm labor to stimulate fetal lung maturity.
Azithromycin dosage for chlamydia in pregnancy requires knowledge of tablet strength, administering a total of 4 tablets based on a 1 g prescription.

Neonatal Procedures

Newborn care includes actions after circumcision, such as recognizing signs of pain like chin quivering.
Proper use of a bulb syringe for suctioning newborn secretions is crucial to stop when the newborn’s cry is clear.

Nutritional Guidelines

Pregnant clients at 8 weeks should increase daily iron intake for optimal health.
Emotional changes during pregnancy may include emotional liability, indicated by rapid shifts from happiness to tears.

Fetal Monitoring and Testing

Nonstress tests require clients to report fetal movements using an alert button.
Leakage of fluid post-amniocentesis signals a potential complication, necessitating immediate reporting to the provider.

Client Education and Safety Instructions

Car seat safety guidelines specify positioning the retainer clip at the newborn's armpits.
Important discharge instructions for newborns include safe room-sharing practices during the first few weeks.

Emergency Preparedness

Immediate follow-up on findings such as O2 saturation changes, cool skin, or fluctuating blood pressures is critical for preventing complications post-surgery.

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Description

This quiz covers essential concepts and assessments in maternal newborn nursing, focusing on scenarios such as labor and prenatal care. It includes critical topics like amniotomy and early pregnancy signs that nurses must prioritize in their practice.