Question 16
RN Maternal Newborn 2023. A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client with which of the following vaccines? (Select all that apply.)
- Inactivated influenza
- Human papillomavirus
- Measles, mumps, and rubella
- Varicella
- Diphtheria-acellular pertussis
Question 18
A nurse is providing teaching about expected body changes during pregnancy for a primigravida client who is at 10 weeks of gestation. Which of the following statements indicates that the client understands the teaching?
- “During my pregnancy, I will notice darkening of the areola.”
- “During my pregnancy, I should lose weight during the third trimester.”
- “In another two weeks, I will see stretch marks on my belly.”
- “In another two weeks, I will notice my feet getting puffy.”
Question 19
A nurse in an obstetrician’s office receives a phone call from a client who is at 30 weeks of gestation and reports a blood pressure of 160/98 mm Hg. Which of the following questions should the nurse ask?
- “Have you noticed any changes in your vision?”
- “Have you been urinating more often than usual?”
- “Have you been having pain in your lower abdomen?”
- “Have you lost any weight over the last few days?”
Question 20
A nurse is reviewing the history of a client who is pregnant. Which of the following clinical data indicates the client is at risk for preterm delivery?
- Previous delivery at 37 weeks gestation
- Previous reactive non-stress test
- Previous delivery of a newborn weighing 2.5 kg (5.5 lb)
- Previous cervical cerclage RN Maternal Newborn 2023
Question 21
A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?
- “The car seat should be positioned in the car at a 45-degree angle.”
- “I can use a sleep sack to keep my baby warm in the car seat.”
- “My baby will need a car seat challenge test before discharge.”
- “When my baby is 1 year old, I can turn their car seat facing forward.”
Question 22
A nurse is caring for a client who is at 37 weeks of gestation immediately following an eclamptic seizure. Which of the following actions should the nurse take?
- Prepare the client for cerclage placement.
- Insert a nasogastric tube.
- Insert an intrauterine pressure catheter.
- Prepare to administer magnesium sulfate IV.
Question 23
A nurse is preparing to perform a heel stick on a newborn who has a prescription for a total serum bilirubin. Which of the following actions should the nurse take?
- Puncture the lateral side of the heel for the procedure.
- Select a 21-gauge needle to perform the procedure.
- Apply an alcohol pad to the site after the procedure.
- Place a cool cloth at the site for 15 min before the procedure.
Question 24
A nurse is caring for a newborn immediately following birth who is grunting and retracting, and has nasal flaring, a respiratory rate of 72/min, and a heart rate of 174/min. Which of the following actions should the nurse take?
- Place the newborn in a prone position.
- Give the newborn epinephrine.
- Administer oxygen therapy.
- Initiate chest compressions.
Question 25
A nurse is reviewing the medical record of a client who is pregnant. Which of the following information should the nurse identify as a risk factor for preeclampsia?
- The client is gravida 2 para 1.
- The client is 25 years old.
- The client has type 1 diabetes mellitus.
- The client is pregnant with one child.
Question 26
A nurse is caring for a client who is 1 hr postpartum and has uterine atony. The client is exhibiting a large amount of vaginal bleeding. Which of the following actions should the nurse take?
- Obtain a specimen for a Kleihauer-Betke test.
- Assess for abdominal tenderness.
- Avoid performing sterile vaginal examinations.
- Perform a fundal massage.
Question 27
A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect? (Select all that apply.)
- Tachypnea
- Hypotonia
- Shrill pitched cry
- Exaggerated Moro reflex
- Acrocyanosis
Question 28
A nurse is caring for a newborn 4 hr after their birth. Which of the following findings should the nurse report to the provider?
- Soft grunting noises with respiration
- Blood-tinged discharge from the vagina
- Pale blue hands and feet
- Positive Babinski reflex
Question 29 & 30
A nurse in a provider’s office is caring for a client who is at 30 weeks of gestation. (Exhibits: Vital signs 110/60, HR 89; SVE 2cm/80%/-1; Contractions every 2-3 min; WBC 20,000).
Which findings require follow-up? (Select 3):
- Low back pain
- Uterine contractions
- Abdominal cramping
Identify if findings are consistent with Placenta Previa, Preterm Labor, or Abruptio Placenta:
- Cervical dilation: Preterm Labor
- Vaginal bleeding: Placenta Previa, Preterm Labor, Abruptio Placenta
- Abdominal tenderness: Abruptio Placenta
- Uterine contractions: Preterm Labor, Abruptio Placenta RN Maternal Newborn 2023
- Client report of low back pain: Preterm Labor
Question 31
Identify the planned action for the following conditions:
- Administer nifedipine: Preterm Labor
- Perform a nonstress test: Both
- Administer betamethasone: Preterm Labor
- Obtain a 24-hr urine collection: Pre-eclampsia
- Monitor intake and output: Both
Question 32
A nurse is caring for a client who is at 30 weeks of gestation and has a prescription for magnesium sulfate IV to treat pre-eclampsia. Which of the following actions should the nurse take?
- Administer magnesium sulfate.
Question 35
A nurse is assessing a client who is at 37 weeks of gestation. Which of the following statements by the client requires immediate intervention by the nurse?
- “I have been seeing spots this morning.” RN Maternal Newborn 2023
Question 36
A nurse manager is revising a maternal unit policy to ensure proper identification of newborns. Which of the following should the nurse include in the policy?
- Obtain an imprint of the infant’s feet prior to taking him to the nursery.
Question 37
A nurse is preparing to perform a gestational age assessment for a newborn who is 36 hr old. Which of the following assessment tools should the nurse use?
- New Ballard score
Question 38
A nurse is caring for a client who is on IV magnesium sulfate 12 hours postpartum. The client had a vaginal birth following induction of labor at 35 weeks due to preeclampsia. Which of the following should the nurse recognize as an adverse effect of this treatment?
- Uterine atony with fundal massage
Question 39
A nurse is educating a pregnant client about health risks during pregnancy after performing an initial assessment. Which of the following information should the nurse include in the teaching?
- The risk of miscarriage is greater in pregnant clients whose partner is exposed to mutagenic agents.
Question 41
A nurse is caring for a client who is in labor and has spontaneous rupture of membranes. The nurse notes that the umbilical cord is protruding from the client’s vagina. After calling for help, which of the following actions should the nurse take first?
- Use fingers to exert upward pressure on the presenting part.
Question 42
A nurse in a clinic is reviewing newborn hygiene with a group of clients. Which of the following instructions should the nurse include in the teaching?
- “Start by washing your newborn’s face and then the rest of their body.”
Question 43
A nurse is providing discharge teaching to a client who is 3 days postpartum and is breastfeeding. Which of the following instructions should the nurse include in the teaching?
- “You should consume an additional 500 calories per day.” RN Maternal Newborn 2023
Question 43
- A client who had a previous stillbirth
- ✅ A client who has a previous classical incision
- A client who had a nonreactive nonstress test
- A client who has gestational diabetes mellitus
Question 44
- Position the client in a modified left-lateral position.
- Ensure the client’s bladder is full.
- ✅ Place a wedge under the client’s left hip.
- Initiate an oxytocin infusion.
Question 45
- Assist the client with a warm sitz bath twice daily.
- ✅ Monitor for manifestations of infection.
- Perform a vaginal assessment every 8 hr.
- ✅ Initiate a 7 day course of ampicillin.
- ✅ Assess fetal heart tones.
Question 46
- ✅ Temperature instability
- Abdominal distention
- Acrocyanosis
- ✅ Hypotonia
- ✅ Jitteriness
Question 47
- ✅ Dizziness
- Urinary frequency
- ✅ Pruritus
- ✅ Prolonged labor
- Hypertension
Question48
- ✅ History of uterine atony
- ✅ Vacuum-assisted delivery
- ✅ Labor induction with oxytocin
- Newborn weight 2.948 kg (6 lb 8 oz)
- History of human papillomavirus RN Maternal Newborn 2023
Question 49
- Monitor for clonus.
- Assess blood pressure twice daily.
- Administer magnesium sulfate.
- ✅ Assess for edema.
Question 50
- “I’m sure the baby’s grandparents will feel differently.”
- “You will feel ready once the baby is born.”
- “Why do you feel that you’re not ready to be a parent?”
- ✅ “It’s common to feel some ambivalence throughout your pregnancy.”
Question 51
- “Use 2 teaspoons of baby oil to lubricate the diaphragm before insertion.”
- “Insert the diaphragm up to 12 hours before intercourse.”
- “Remove the diaphragm 2 hours after intercourse.”
- ✅ “Replace the diaphragm every 2 years.”
Question 52
- ✅ “Keep bath water temperature between 100 and 104 degrees Fahrenheit.”
- “Wash your baby’s face with warm water and mild soap.”
- “You should have your baby sleep in your bed during the first few weeks at home.”
- “Cover your baby with a light blanket for nighttime sleeping.”
Question53
- “I will wash the diaper area with antibacterial soap during each diaper change.”
- “I will clean the diaper area with a scented baby wipe.”
- “I will apply a thin layer of talc to the diaper area twice a day.”
- ✅ “I will allow the diaper area to dry before applying a clean diaper.”
Question 54
- “You will need to have your hemoglobin monitored after you receive the medication.”
- ✅ “This medication will increase your baby’s lung development.”
- “You will take the medication by mouth twice daily for 2 days.”
- “This medication will be given to induce your labor.”
Question55
- Overriding cranial bones
- Shallow respirations at a rate of 56/min
- Bluish discoloration of the palms of the hands
- ✅ Head circumference of 28 cm (11 in)
Question 56
- “I will remove the crust with each diaper change.”
- “I will secure the diaper tightly with each diaper change.”
- ✅ “I will apply petroleum jelly to the area with each diaper change.”
- “I will wash the penis with soap and water daily.”
Question 57
- ✅ Administer magnesium sulfate.
- Obtain a prescription for misoprostol.
- Obtain a prescription for betamethasone.
- Administer an IV bolus of lactated Ringer’s.
Question58
- Administer naloxone to the client.
- Prepare the client for an amnioinfusion.
- ✅ Position the client in a lateral position.
- Place the client in knee-chest position.
