Purdue Global Nu143. Maternal Infant Health Unit 10 Final Exam

Question 3

Purdue Global Nu143. Maternal Infant Health Unit 10 Final Exam. A client calls to cancel an appointment for the first prenatal visit after reporting a home pregnancy test is negative. The client reports breast tenderness, frequent urination, fatigue, and amenorrhea. Which reply from the nurse is most appropriate?

• “Did you use a diluted urine specimen for the test?”
• “It sounds like you have a bigger issue other than pregnancy.”
• “Repeat the test after two missed menstrual periods.”
• “Keep the appointment so you can be further assessed.”

Question 4

A pregnant client at 32 weeks’ gestation is at the clinic for a routine appointment. During her visit, she states the baby isn’t moving as much as it had before and her underwear is constantly damp. It is also noted that her fundal height measures at 29 cm. An ultrasound is ordered and she is diagnosed with decreased amniotic fluid, also known as:

• Gestational diabetes
• Preeclampsia
• Hyperemesis gravidarum
• Oligohydramnios

Question 5

The nurse is providing teaching to a pregnant client about warning signs during pregnancy. Which client statement indicates a need for further education?

• Rapid weight gain
• Visual disturbances
• Generalized/facial edema
• Awareness of irregular, painless contractions

Question 6

A nurse is providing teaching to a client at 36 weeks’ gestation who is experiencing dependent edema of the ankles and feet. Which intervention should the nurse recommend to promote venous return?

• Limit your intake of fluid.
• Eliminate all salt from your diet.
• Try to elevate your feet when sitting.
• Wear spandex-like pants when you can.

Question 7

The nurse is teaching a newly pregnant client with a normal BMI of 23. Which statement by the client indicates an understanding of weight gain during this pregnancy?

• “I need to gain 25 to 35 lbs (11 to 16 kg) during this pregnancy.”
• “I need to gain 10 to 15 lbs (4.5 to 6.8 kg) per trimester during this pregnancy.”
• “I need to gain less than 25 lbs (<11 kg) during this pregnancy.”
• “I need to gain 1 lb (0.45 kg) per week throughout this pregnancy.”

Question 8

A pregnant client tells the nurse they have been experiencing a burning pain in the chest that usually occurs after eating and may occur at night. Which action by the nurse is best?

• Auscultate lung sounds for 2 minutes
• Educating the client to eat small meals and stay upright after eating. Purdue Global Nu143. Maternal Infant Health Unit 10 Final Exam
• Inform the client this pain is due to hormonal changes during pregnancy.
• Prepare the client for an electrocardiogram (EKG).

Question 9

A client presents to the health care clinic for their first prenatal checkup. The nurse will ensure the client is getting an adequate amount of which nutrient?

• Vitamin E
• Selenium
• Calcium
• Folic acid

Question 15

The nurse is appraising the medical record of a 28‑week pregnant client who is resting in a darkened room and receiving betamethasone and magnesium sulfate. The nurse recognizes the client is being treated for which condition?

• Gestational hypertension
• Amniotic fluid embolism
• Severe preeclampsia
• Gestational diabetes

Question 16

A client with placenta previa is receiving expectant management and remains clinically stable. As the nurse evaluates whether the client is an appropriate candidate to be discharged home, which client statement would indicate that home management may not be safe or appropriate?

• “My partner and I can still have sex at least once per week.”
• “My parent lives next door and can drive me here if necessary.”
• “I know to call my health care provider right away if I start to bleed again.”
• “I realize the importance of following the discharge instructions for my care.”

Question 20

A nurse reviews the plan of care for a client at 30 weeks’ gestation with polyhydramnios. Which intervention should the nurse implement?

• Blood pressure checks every four hours
• Blood glucose monitoring
• Assess for vaginal bleeding
• Daily weights

Question 21

A nurse reviews the obstetric history of a multiparous client who has had previous cesarean births. Which complication is the nurse most concerned about at delivery?

• Oligohydramnios
• Placental abruption (abruptio placentae)
• Preeclampsia
• Placenta accreta

Question 22

A nursing instructor identifies which factor in the pregnant client increases the chances of infection when coupled with prolonged labor?

• Multiple births
• Number of previous pregnancies
• Prelabor rupture of membranes
• Lack of prenatal care

Question 23

A pregnant client at 34 weeks’ gestation presents to the obstetric triage unit stating, “I felt a sudden gush of fluid about an hour ago, and it keeps leaking.” The client denies contractions. She states she can feel her baby move, and denies any bleeding. She is very concerned because her baby isn’t due for six more weeks. Which maternal condition is the client most likely experiencing?

• Hyperemesis gravidarum
• Placental abruption
• Prelabor rupture of membranes (PROM)
• Oligohydramnios

Question 24

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data, if noted on the client’s record, would alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy?

• The client is 5 feet, 3 inches tall and weighs 165 pounds.
• The client’s previous deliveries were by cesarean section.
• The client’s last baby weighed 10 pounds at birth.
• The client has a family history of cardiovascular disease.

Question 25

A nursing instructor evaluates students’ understanding of anemia in pregnancy. Which student statement best demonstrates accurate evaluation of the most prevalent type of anemia during pregnancy?

• a) Sickle-cell anemia
• b) Pernicious anemia
• c) Iron-deficiency anemia
• d) Folic acid anemia

Question 26

A nurse is caring for a newborn whose birth parent tested positive for group B streptococcus and did not receive intrapartum treatment. Which finding would most strongly indicate the newborn is developing a complication related to the untreated infection?

• a) blood glucose level: 160 mg/dl (8.88 mmol/l) (normal: 60 to 110 mg/dl; 3.33 to 6.11 mmol/l)
• b) sunken fontanelles
• c) temperature: 102.1°F (38.9°C)
• d) hyperactive Moro reflex

Question 27

The nurse is transcribing messages from the answering service. Which phone message should the nurse return first?

• a) an 18-year-old, 38-week G2P1 client with intermittent cramping; the client’s last blood pressure was 98/50 mm Hg, and proteinuria was 1+
• b) a 25-year-old, 31-week G1P0 client with blood pressure of 100/80 mm Hg and left flank pain; the client’s last blood pressure was 100/77 mm Hg and they had no proteinuria
• c) a 35-year-old, 21-week G3P2 client with blood pressure of 160/110 mm Hg, blurred vision, and whose last blood pressure was 143/99 mm Hg and urine dipstick showed a +2 proteinuria
• d) a 20-year-old, 31-week G1P0 client with malaise and rhinitis; the client’s last blood pressure was 120/70 mm Hg, and they had no proteinuria

Question 28

A client who is 20 weeks pregnant calls the clinic. Which finding would necessitate calling the health care provider to assess the client?

• a) The client vomited
• b) The client has a white vaginal discharge.
• c) The client has pink vaginal discharge and pelvic pressure.
• d) The client has rhinitis and epistaxis.

Question 29

A client at 26 weeks’ gestation is undergoing screening for diabetes with a 1-hour oral glucose challenge test. On the client’s return visit, the nurse anticipates the need to schedule a 3-hour glucose challenge test based on which result of the previous test?

• a) 110 mg/dl
• b) 120 mg/dl
• c) 95 mg/dl
• d) 150 mg/dl

Question 30

After conducting a refresher class on possible congenital infections with a group of perinatal nurses, the nurse recognizes the class was successful when the group identifies which congenital viral infection as the most common?

• a) CMV
• b) HIV
• c) HPV
• d) RSV

Question 31

A pregnant client with known HIV infection presents to the labor and birth unit in active labor. When planning care for this client, which nursing intervention is the highest priority to include?

• a) Helping the client choose a newborn feeding method
• b) Educating the client about family planning
• c) Maintaining standard precautions
• d) Preparing the client for cesarean birth

Question 32

Human papillomavirus (HPV) can cause condylomata acuminata, which may appear in clusters on the vulva, within the vagina, on the cervix, or around the anus. What potential risks are associated with these lesions?

• a) Block a vaginal birth
• b) neonatal auricular papillomas
• c) heavy bleeding during vaginal birth
• d) neonatal hemorrhage

Question 33

A 28-year-old Hispanic patient is pregnant with her second baby at 25 weeks gestation. She has a BMI of 27 and weighs 180 pounds. She complains of constantly needing to use the bathroom and always feeling hungry. Her history indicates she delivered her first baby at 27 weeks, and the baby weighed 10 pounds at birth. Which condition is the client most likely experiencing?

• a) Urinary tract infection
• b) Polycystic kidney disease
• c) Gestational diabetes
• d) Cystocele

Question 34

When teaching a class for pregnant clients about the effects of substance use during pregnancy, the nurse will include which effect?

• a) low-birth-weight infants
• b) excessive weight gain
• c) higher pain tolerance
• d) longer gestational periods

Question 35

A nurse at a local community clinic is developing a program to address the prevention of sexually transmitted infections (STIs) and proper condom use. What should the nurse include in the program?

• a) “Condoms are not effective at preventing STIs.”
• b) “Condoms can be reused as long as it is with the same set of partners.”
• c) “Use the condoms during the entire extent of sexual genital contact.”
• d) “Store the condoms in your car where you may access them in a pinch.”

Question 36

Of the following, identify the priority nursing assessment for a client during the fourth stage of labor.

• a) The client’s psyche
• b) Blood pressure
• c) Hemorrhage
• d) Heart rate

Question 37

A pregnant client at a prenatal clinic appears uncomfortable. The nurse observes strong contractions occurring at 12:05 p.m., 12:10 p.m., 12:15 p.m., and 12:20 p.m. What conclusion should the nurse make?

• a) The client is in transition.
• b) The duration of the contractions is every 5 minutes.
• c) The frequency of the contractions is every 5 minutes.
• d) The client can be sent home.

Question 38

Upon examination, the nurse determines the fetus is at +3 station. How should the nurse interpret this finding regarding the fetal position?

• a) 3 cm above the pubic bone.
• b) 3 cm below the ischial spines.
• c) 3 cm below the pubic bone.
• d) 3 cm above the ischial spines.

Question 39

A nurse is caring for a client in labor when the client’s membranes rupture. The nurse assesses the fluid’s characteristics. Which finding would the nurse identify as normal? Purdue Global Nu143. Maternal Infant Health Unit 10 Final Exam

• a) clear
• b) cloudy
• c) green
• d) Malodorous

Question 40

A nurse is monitoring the fetal heart rate (FHR) of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention will the nurse implement?

• a) Encourage the Valsalva maneuver.
• b) Change the client’s position to a side-lying position.
• c) Administer exogenous oxytocin.
• d) Place the client in the lithotomy position.

Question 41

The nurse is monitoring a client who has given birth and is now bonding with their infant. Which finding should the nurse prioritize and report immediately for intervention?

• a) The postpartum client is unable to void after 4 hours.
• b) Tachycardia and falling blood pressure in the postpartum client
• c) Placental separation 15 minutes after birth
• d) Dark red lochia

Question 42

A nurse is caring for a client in labor who received fentanyl for pain relief 20 minutes ago. The client’s most recent assessment shows: pulse 62 beats per minute, temperature 100°F (37.8°C), respirations 9 breaths per minute, and pain rating 2/10. Which agent does the nurse expect will be administered?

• a) Butorphanol
• b) Naloxone
• c) Flumazenil
• d) Acetaminophen

Question 43

As a client enters the second stage of labor and their membranes spontaneously rupture, what should the nurse’s priority assessment be?

• a) Test a sample of amniotic fluid for protein.
• b) Ask them to bear down with the next contraction.
• c) Elevate their hips to prevent cord prolapse.
• d) Assess fetal heart rate.

Question 44

The nurse is assessing a new client in early labor. The nurse determines that the fetus has a normal heart rate if the heart rate falls within which range?

• a) 90 to 140 bpm
• b) 100 to 150 bpm
• c) 110 to 160 bpm
• d) 120 to 170 bpm

Question 45

The client presents to labor and delivery triage at 37 weeks’ gestation reporting anxiety related to intermittent abdominal contractions that began approximately 4 hours ago. The client states the contractions occurred in clusters, with two contractions within 5 minutes followed by a 10-minute period without contractions. The client reports concern that labor was beginning and rushed to pack belongings. Upon sitting in the car, the contractions stopped, and the client has not experienced any contractions since arrival to triage. What condition is the client most likely experiencing?

• a) True labor
• b) Placental abruption
• c) Gas cramps
• d) Braxton Hicks Contractions

Question 46

A 21-year-old is at her annual appointment and tells her doctor how she hasn’t had a period for 2 months and has been really tired, but she is also training for a marathon. The doctor orders a pregnancy test, and it is positive. When asked when her last period was, she said around July 4. Based on that information, when is her estimated due date?

• a) October 11
• b) April 11
• c) October 4
• d) September 30

Question 47

A nurse is admitting a newborn who weighs 4,200 grams. When planning care for this infant, which term should the nurse use to document the finding?

• a) Hydrocephalus
• b) Macrosomia
• c) Meconium
• d) Microsomia

Question 48

A nursing student correctly identifies the problem of fetal buttocks instead of the head presenting first as which type of presentation?

• a) Breech presentation
• b) Face and brow presentation
• c) Persistent occiput posterior
• d) Normal presentation

Question 49

A nurse is admitting a client who expresses a desire for a Vaginal Birth After Cesarean (VBAC). Which piece of information from the client’s surgical history is a contraindication to this plan?

• a) The interval between pregnancies is 24 months
• b) A previous low-transverse incision
• c) A previous classic uterine incision
• d) The previous cesarean was performed related to fetal distress.

Question 50

A 25-year-old client presents to the maternity unit on February 2. The client reports an estimated date of delivery (EDD) of March 22. For the past several days, the client has experienced dull lower back pain, a sensation of pelvic pressure, and episodes of diarrhea. On admission for observation, vital signs are as follows: blood pressure 128/80 mm Hg, pulse 100 beats/minute, respirations 16 breaths/minute, and temperature 37.2°C (99°F). The nurse plans care based on which interpretation?

• a) The client is suffering from an intestinal bacterial infection and needs IV antibiotics.
• b) The client requires further evaluation for preterm labor.
• c) The client is exhibiting signs and symptoms of gestational hypertension.
• d) The client needs instruction on pelvic tilts to decrease lower back pain.

Question 51

A G3P2 client at 39 weeks’ gestation is highly agitated and reports that something “came out” when their water broke. The nurse notes that the umbilical cord is hanging out of the vagina. Which action should the nurse prioritize?

• a) With the client in lithotomy position, hold their legs and sharply flex them toward their shoulders.
• b) Put the client in bed immediately, call for help, and lift the presenting part of the fetus off the cord.
• c) Place the client in Trendelenburg position and gently attempt to reinsert the cord.
• d) Contact the health care provider and prepare the client for an emergent vaginal birth.

Question 52

A client’s membranes rupture. The nurse observes the fetal heart rate drop from 156 to 100. The nurse inspects the client’s perineum and sees a loop of umbilical cord. What is the nurse’s priority concern in this situation?

• a) Decreased strength of uterine contractions
• b) Decreased fetal oxygenation
• c) Increased risk for infection
• d) Increased risk for placental abruption

Question 53

A young client is experiencing contractions at 33 weeks’ gestation. The nurse applies external monitors and notes a regular contraction pattern. What treatment can the nurse expect the client to be prescribed?

• a) Muscle relaxants
• b) Tocolytic therapy
• c) Labetalol
• d) Uterine stimulants

Question 54

The LPN has reported that uterine massage is ineffective on a client. The nurse anticipates the health care provider will prescribe which medication to address this issue?

• a) Digoxin
• b) Ibuprofen
• c) Penicillin
• d) Oxytocin

Question 55

Which instruction should the nurse include in the discharge teaching for a postpartum client with a previous thromboembolic event to help prevent another one?

• a) Refrain from performing leg exercises.
• b) Wear support hose or antiembolic stockings.
• c) Flex the muscles at the groin.
• d) Avoid pressure on the thigh muscles. Purdue Global Nu143. Maternal Infant Health Unit 10 Final Exam

Question 56

A client who had a vaginal birth 12 hours ago now has a temperature of 100°F (37.8°C). What is the most appropriate nursing action?

• a) Continue to monitor the client’s temperature every 4 hours; this finding is normal.
• b) Notify the health care provider about this elevation; this finding reflects infection.
• c) Obtain a urine culture; the client most likely has a urinary tract infection.
• d) Initiate a broad-spectrum antibiotic.

Question 57

A nurse is conducting a home visit for a postpartum client. What discovery would prompt the nurse to suspect that a woman might be experiencing postpartum psychosis?

• a) hallucinations
• b) feelings of guilt
• c) sadness
• d) insomnia

Question 58

A primiparous client delivered a healthy newborn girl through vaginal birth 12 hours ago. During an assessment, the nurse palpates the client’s fundus and notes the expected assessment finding:

• a) two fingerbreadths above the umbilicus
• b) at the level of the umbilicus
• c) two fingerbreadths below the umbilicus
• d) four fingerbreadths below the umbilicus

Question 59

Which assessment finding on the third postpartum day would indicate a client is experiencing uterine subinvolution?

• a) Their uterus is 2 cm above the symphysis pubis.
• b) Their uterus is three finger widths under the umbilicus.
• c) Their uterus is at the level of the umbilicus.
• d) They experience “pulling” pain while breastfeeding.

Question 60

A nursing instructor is discussing conditions associated with postpartum hemorrhage. The instructor determines that the discussion was effective when students correctly identify the most common cause of postpartum hemorrhage.

• a) Hematoma
• b) Perineal lacerations
• c) Uterine atony
• d) Disseminated intravascular coagulation

Question 65

While assessing a 2-day-old newborn, the nurse observes yellow discoloration of the skin and sclera. Based on this finding, the nurse identifies the newborn as most likely exhibiting which condition?

• a) Cyanosis
• b) Harlequin sign
• c) Jaundice
• d) Pallor

Question 66

On examination, the hands and feet of a 12-hour-old infant are cyanotic without other signs of distress. The nurse should document this as:

• a) Acrocyanosis
• b) Cold stress
• c) Poor oxygenation
• d) Risk for respiratory distress

Question 107

A nurse is caring for a pregnant client diagnosed with gestational diabetes. Which meal option would be most appropriate for the nurse to recommend?

• a) baked chicken, green beans, and chocolate cake
• b) baked turkey, brown rice, and strawberries
• c) pizza, corn, and orange slices
• d) steak, baked potato with butter, and ice cream

Question 108

A pregnant client diagnosed with iron-deficiency anemia is instructed to begin taking an iron supplement. As the nurse evaluates strategies to maximize the effectiveness of the treatment, which substance should be recommended to enhance the absorption of the supplemental iron?

• a) Liver
• b) Milk
• c) Orange juice
• d) Spinach salad

Question 109

A nurse needs to obtain the fetal heart rate (FHR) for a pregnant client. If the fetus is in a cephalic presentation, which area of the client’s abdomen should the nurse place the monitor to hear the FHR clearly?

• a) lower quadrant of the client’s abdomen
• b) at the level of the client’s umbilicus
• c) left upper quadrant
• d) just above the client’s umbilicus

Question 110

A 37-year-old primigravida client at 40 weeks’ gestation arrives for a scheduled prenatal visit. Which client-reported symptom would lead the nurse to anticipate that labor is approaching?

• a) nesting
• b) fatigue
• c) dyspnea
• d) polyuria

Question 112

A pregnant client in preterm labor is receiving magnesium sulfate. Which assessment finding requires the nurse’s immediate intervention?

• a) respiratory rate of 16 breaths per minute
• b) diminished deep tendon reflexes
• c) urine output of 45 mL/hour
• d) Alert and oriented

Question 113

Following the spontaneous rupture of membranes, the nurse observes a prolapsed cord. Recognizing this as an emergency, the nurse promptly knows to position the woman in which specific position.

• a) Reverse trendelenberg
• b) Side lying
• c) Supine
• d) Semifowlers

Question 114

A nurse is performing a newborn assessment on a 1-hour-old female infant. The infant was born at 39 weeks gestation in a frank breech position. It’s noted the infant has unequal gluteal folds. There is a slight resistance when attempting to abduct the hips, and a “clunk” is felt. 29. Choose manifestations associated with the condition. Which condition is this baby experiencing?

• a) Broken femoral head
• b) Congenital hip dysplasia
• c) Talipes equinovarus
• d) Tibial torsion

Question 115

A 28-year-old G3P3 has just delivered a 9 lb, 4 oz (4.2 kg) infant after a prolonged second stage of labor. The patient had her labor augmented with Pitocin and has gestational diabetes. The nurse is performing a postpartum fundal check 15 minutes after the delivery of the placenta. Your assessment reveals the uterus 2 cm above the umbilicus and undefined uterine outline with dark red blood with large clots. Which condition is your client most likely experiencing? Purdue Global Nu143. Maternal Infant Health Unit 10 Final Exam

• a) Retained placental parts
• b) Vaginal laceration
• c) Uterine Inversion
• d) Uterine atony

Question 116

A nurse is providing teaching to a newly pregnant client with a history of mitral valve replacement. Which client statement indicates an understanding of how this preexisting condition may affect the pregnancy?

• a) “I don’t have to worry about this because I had the problem fixed before I became pregnant.”
• b) “I know I will be fine, but I worry about the fetus.”
• c) “I understand that my baby and I both are at risk for complications.”
• d) “I know my fetus will be fine, but I am worried about having a personal complication.”

Question 117

A nurse is reviewing the fetal heart rate (FHR) pattern and observes abrupt decreases in FHR below baseline, appearing as a U-shaped pattern. The nurse interprets these changes as reflecting which type of deceleration?

• a) Early deceleration
• b) Late deceleration
• c) Prolonged deceleration
• d) Variable deceleration

Question 118

The nurse determines that the fetal heart rate averages approximately 140 beats per minute over a 10-minute period. The nurse identifies this as:

• a) Fetal bradycardia
• b) Fetal baseline
• c) Short term variability
• d) Baseline variability

Question 119

Of the following, identify the priority nursing assessment for a client during the fourth stage of labor.

• a) The client’s psyche
• b) Blood pressure
• c) Hemorrhage
• d) Heart rate

Question 120

The nurse recognizes the patient is in which stage of labor when the placenta delivers.

• a) First stage
• b) Second stage
• c) Third stage
• d) Fourth stage

Question 121

A pregnant client who is undergoing labor induction is receiving an oxytocin infusion. What assessment discovery would demand immediate intervention by the nurse?

• a) Fetal heart rate with a baseline of 155
• b) Positive fetal movement
• c) Contractions 45 seconds apart
• d) Urine output 60 mL/hour