Test Bank Foundations Maternal Newborn Womens Health Nursing 6th Edition, Murray
Chapter 01: Maternity and Women’s Health Care Today
1. The nurse is teaching a parenting class to new parents. Which statement should the nurse include in the teaching session about the characteristics of a healthy family?
a. Adults agree on the majority of basic parenting principles.
b. The parents and children have rigid assignments for all the family tasks.
c. Young families assume total responsibility for the parenting tasks, refusing any assistance.
d. The family is overwhelmed by the significant changes that occur as a result of childbirth.
2. Which factor significantly contributed to the shift from home births to hospital births in the early twentieth century?
a. The number of hospital births decreased.
b. Forceps were developed to facilitate difficult births.
c. The importance of early parent-infant contact was identified.
d. Puerperal sepsis was identified as a risk factor in labor and birth.
3. A nurse is teaching a group of nursing students about the history of family-centered maternity care. Which statement should the nurse include in the teaching session?
a. The Sheppard-Towner Act of 1921 promoted family-centered care.
b. Changes in pharmacologic management of labor prompted family-centered care.
c. Demands by physicians for family involvement in childbirth increased the practice of family-centered care.
d. Parental requests that infants be allowed to remain with them rather than in a nursery initiated the practice of family-centered care.
4. Which statement explains why below poverty level African-Americans have the highest infant mortality rate in the United States?
a. Their diets are deficient in protein.
b. Infectious diseases are more prevalent.
c. More African-American infants are born with congenital anomalies.
d. Inadequate prenatal care is associated with low-birth-weight infants.
5. Which situation is most representative of an extended family?
a. It includes adoptive children.
b. It is headed by a single parent.
c. It contains children from previous marriages.
d. It is composed of children, parents, and grandparents living in the same house.
6. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth allows for the least amount of parent-infant interaction?” Which answer should the nurse give to the parents?
a. Birth center
b. Home birth
c. Traditional hospital birth
d. Labor, birth, and recovery room
7. A woman giving birth in the 1960s may have been given a narcotic plus scopolamine for pain control. What is the major problem with this medication regimen?
a. It lacked continuous pain control.
b. It was expensive and available only to women who could afford the medications.
c. The father had to assume the role of decision maker while the mother was on medication.
d. It caused confusion and disorientation so that the mother could not see the infant for several hours postbirth.
8. Which is an advantage to labor, birth, recovery, and postpartum (LDRP) rooms?
a. The family is in a familiar environment.
b. They are less expensive than traditional hospital rooms.
c. The infant is removed to the nursery to allow the mother to rest.
d. The woman’s support system is encouraged to stay until discharge.
9. A single client who has just delivered a baby asks the nurse where she can receive help in getting formula for her baby. Which is the nurse’s best response?
a. Medicaid can help with buying formula.
b. Head Start is a program that helps provide formula.
c. The Women, Infants, and Children (WIC) program can assist you in getting formula.
d. The National Center for Family Planning has a program that helps with obtaining formula.
10. A client at 36 weeks of gestation states, “Why can’t I have an induction now? My sister delivered at 36 weeks and her baby is fine.” Which information about infants born at 34 to 36 weeks should the nurse consider when answering?
a. Birth by induction is low for this gestational age.
b. Infants born at 34 to 36 weeks have mature lungs and do well at birth.
c. The birth of infants between 34 to 36 weeks has declined as more births are going to term or post term.
d. Infants born at 34 to 36 weeks are immature and have more health complications than infants born at term.
Chapter 02: The Nurse’s Role in Maternity and Women’s Health Care
1. Which principle of teaching should the nurse use to ensure learning in a family situation?
a. Motivate the family with praise and positive feedback.
b. Learning is best accomplished with the lecture format.
c. Present complex subject material first while the family is alert and ready to learn.
d. Families should be taught using medical jargon so they will be able to understand the technical language used by physicians.
2. Which nursing intervention is an independent function of the nurse?
a. Administering oral analgesics
b. Requesting diagnostic studies
c. Teaching the client perineal care
d. Providing wound care to a surgical incision
3. Which most therapeutic response to the client’s statement, “I’m afraid to have a cesarean birth” should be made by the nurse?
a. “Everything will be OK.”
b. “Don’t worry about it. It will be over soon.”
c. “What concerns you most about a cesarean birth?”
d. “The physician will be in later and you can talk to him.”
4. Which action should the nurse take to evaluate the client’s learning about performing infant care?
a. Demonstrate infant care procedures.
b. Allow the client to verbalize the procedure.
c. Routinely assess the infant for cleanliness.
d. Observe the client as she performs the procedure.
5. A nurse is reviewing teaching and learning principles. Which situation is most conducive to learning?
a. An auditorium is being used as a classroom for 300 students.
b. A teacher who speaks very little Spanish is teaching a class of Hispanic students.
c. A class is composed of students of various ages and educational backgrounds.
d. An Asian nurse provides nutritional information to a group of pregnant Asian women.
6. Which is the step of the nursing process in which the nurse determines the appropriate interventions for the identified nursing diagnosis?
7. Which goal is most appropriate for the collaborative problem of wound infection?
a. The client will not exhibit further signs of infection.
b. Maintain the client’s fluid intake at 1000 mL/8 hr.
c. The client will have a temperature of 98.6° F within 2 days.
d. Monitor the client to detect therapeutic response to antibiotic therapy.
8. Which nursing intervention is correctly written?
a. Force fluids as necessary.
b. Observe interaction with the infant.
c. Encourage turning, coughing, and deep breathing.
d. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
9. The client makes the statement: “I’m afraid to take the baby home tomorrow.” Which response by the nurse would be the most therapeutic?
a. “You’re afraid to take the baby home?”
b. “Don’t you have a mother who can come and help?”
c. “You should read the literature I gave you before you leave.”
d. “I was scared when I took my first baby home, but everything worked out.”
10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to trauma of tissue, secondary to vaginal birth, as evidenced by client stating pain of 8 on a scale of 10. Which is a correctly stated expected outcome for this problem?
a. Client will state that pain is a 2 on a scale of 10.
b. Client will have a reduction in pain after administration of the prescribed analgesic.
c. Client will state an absence of pain 1 hour after administration of the prescribed analgesic.
d. Client will state that pain is a 2 on a scale of 10, 1 hour after the administration of the prescribed analgesic.
Chapter 03: Ethical, Social, and Legal Issues
l. The nurse is teaching a homeless pregnant teenager about prenatal care. Which should the nurse emphasize in the teaching session?
a. The importance of naming the baby
b. Risk factors associated with pregnancy
c. Information about employment opportunities
d. Eating habits that will provide adequate nutrition
2. The United States ranks 27th in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?
a. Providing more women’s shelters
b. Ensuring early and adequate prenatal care
c. Resolving all language and cultural differences
d. Enrolling pregnant women in the Medicaid program by their eighth month of pregnancy
3. Which statement is true regarding the quality assurance or incident report?
a. Reports are a permanent part of the patient’s chart.
b. The report assures the legal department that there is no problem.
c. The nurse’s notes should contain this statement: “Incident report filed and copy placed in chart.”
d. This report is a form of documentation of an event that may result in legal action.
4. The nurse is planning a teaching session for staff on ethical theories. Which situation best reflects the deontologic theory?
a. Approving a physician-assisted suicide
b. Supporting the transplantation of fetal tissue and organs
c. Using experimental medications for the treatment of AIDS
d. Initiating resuscitative measures on a 90-year-old patient with terminal cancer
5. Which step of the nursing process is being used when the nurse decides whether an ethical dilemma exists?
6. The nurse is interviewing a 6-week pregnant client. The client asks the nurse, “Why is elective abortion considered an ethical issue?” Which is the best response that the nurse should make?
a. Abortion requires third-party consent.
b. The U.S. Supreme Court ruled that life begins at conception.
c. Abortion law is unclear about a woman’s constitutional rights.
d. There is a conflict between the rights of the woman and the rights of the fetus.
7. At the present time, surrogate parenting is governed by which of the following?
a. State law
b. Federal law
c. Individual court decision
d. Protective child services
8. Which client will most likely seek prenatal care?
a. Janice, 15 years old, tells her friends, “I don’t believe I am pregnant.”
b. Carol, 28 years old, is in her second pregnancy and abuses drugs and alcohol.
c. Margaret, 20 years old, is in her first pregnancy and has access to a free prenatal clinic.
d. Glenda, 30 years old, is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister.
9. A medical surgical nurse is asked to float to a women’s health unit to care for clients who are scheduled for therapeutic abortions. The nurse refuses to accept this assignment and expresses her personal beliefs as being incongruent with this medical practice. The nursing supervisor states that the unit is short-staffed and that they could really use her expertise because it just involves taking care of clients who have undergone a surgical procedure. In consideration of legal and ethical practices, can the nursing supervisor enforce this assignment?
a. The staff nurse has the responsibility of accepting any assignment that is made while working for a health care unit, so the nursing supervisor is within his or her rights to enforce this assignment.
b. Because the unit is short-staffed, the staff nurse should accept the assignment to provide care by benefit of her or his experience to clients who need care.
c. The staff nurse has expressed a legitimate concern based on his or her feelings; the nursing supervisor does not have the authority to enforce this assignment.
d. The nursing supervisor should emphasize that this assignment requires care of a surgical client for which the staff nurse is adequately trained and should therefore enforce the assignment.
10. With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
a. The nurse did not document fetal heart tones (FHR) during the second stage of labor.
b. The client was only provided ice chips during the labor period, which lasted 8 hours.
c. The nurse allowed the client to use the bathroom rather than a bedpan during the first stage of labor.
d. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the client.
Chapter 04: Reproductive Anatomy and Physiology
1.A postpartum client who had a vaginal birth asks the nurse, “Will my cervix return to its previous shape before I had my baby?” Which is the best response by the nurse?
a. The cervix will now have a slitlike shape.
b. The cervix will be round and smooth after healing occurs.
c. The cervix will remain 50% effaced now that you have had a baby.
d. The cervix will be slightly dilated to 2 cm for about 6 months.
2. The school nurse is conducting health education classes for a group of adolescents. Which statement best describes a secondary sexual characteristic?
a. Maturation of ova
b. Production of sperm
c. Female breast development
d. Secretion of gonadotropin-releasing hormone
3. Which 16-year-old girl may experience secondary amenorrhea?
a. Jackie, 5 ft 2 in, 130 lb
b. Karen, 5 ft 9 in, 150 lb
c. Carol, 5 ft 7 in, 96 lb
d. Linda, 5 ft 4 in, 120 lb
4. Which describes the levator ani?
a. Division of the fallopian tube
b. Collection of three pairs of muscles
c. Imaginary line that divides the true pelvis and false pelvis
d. Basin-shaped structure at the lower end of the spine
5. The nurse is describing the size and shape of the nonpregnant uterus to a client. Which is an accurate description?
a. The nonpregnant uterus is the size and shape of a pear.
b. The nonpregnant uterus is the size and shape of a cantaloupe.
c. The nonpregnant uterus is the size and shape of a grapefruit.
d. The nonpregnant uterus is the size and shape of a large orange.
6. If a woman’s menstrual cycle began on June 2, on which date should ovulation mostly likely have occurred?
a. June 10
b. June 16
c. June 29
d. July 5
7. A client states, “My breasts are so small. I don’t think I will be able to breastfeed.” Which is the nurse’s best response?
a. “It may be difficult but you should try anyway.”
b. “You can always supplement with formula.”
c. “All women have about the same amount of glandular tissue to secrete milk.”
d. “The ability to produce breast milk depends on increased levels of estrogen and progesterone.”
8. The nurse is explaining the function of the male’s cremaster muscle to a group of nursing students. Which statement accurately describes the function of the cremaster muscle?
a. Assists with transporting sperm
b. Aids in temperature control of the testicles
c. Aids in voluntary control of excretion of urine
d. Entraps blood in the penis to produce an erection
9. A newly pregnant client asks the nurse, “What is the false pelvis?” Which is a correct statement that the nurse should give the client?
a. It is the total anterior portion of the pelvis.
b. It is considered to be the lower portion of the pelvis.
c. It provides support for the internal organs and the upper part of the body.
d. It is the narrowest part of the pelvis through which a fetus will pass during birth.
10. Which hormone is responsible for milk production after the birth of the placenta?
Chapter 05: Hereditary and Environmental Influences on Childbearing
1.A clinic nurse is planning a teaching session for childbearing-age female clients. Which should the nurse include in the teaching session with regard to avoiding exposing a fetus to teratogens?
a. Use only category A medications during pregnancy.
b. Immunizations should be updated during the first trimester of pregnancy.
c. Use of saunas and hot tubs during pregnancy should be during the winter months only.
d. Alcoholic beverages can be consumed in the first and third trimesters of pregnancy.
2. The parents of a child with a karyotype of 47,XY, +21 ask the nurse what this means. Which is an accurate response by the nurse?
a. This karyotype is for a normal male.
b. This karyotype is for a normal female.
c. This karyotype is for a male with Down syndrome.
d. This karyotype is for a female with Turner’s syndrome.
3. People who have two copies of the same abnormal autosomal dominant gene will usually be:
a. mildly affected with the disorder.
b. infertile and unable to transmit the gene.
c. carriers of the trait but not affected with the disorder.
d. more severely affected by the disorder than people with one copy of the gene.
4. An infant is born with blood type AB. The father is type A and the mother is type B. The father asks why the baby has a blood type different from that of the parents. The nurse’s answer should be based on the knowledge that which is true?
a. Both A and B blood types are dominant.
b. Types A and B are recessive when linked together.
c. The baby has a mutation of the parents’ blood types.
d. Type A is recessive and links more easily with type B.
5. Which statement is true of multifactorial disorders?
a. They may not be evident until later in life.
b. They are usually present and detectable at birth.
c. The disorders are characterized by multiple defects.
d. Secondary defects are rarely associated with them.
6. Which point should the nurse include when telling a couple about the prenatal diagnosis of genetic disorders?
a. The diagnosis may be slow and could be inconclusive.
b. A comprehensive evaluation will result in an accurate diagnosis.
c. Common disorders can be quickly diagnosed through blood tests.
d. Diagnosis can be obtained promptly through most hospital laboratories.
7. A client tells the nurse at a prenatal interview that she has quit smoking, only has a glass of wine with dinner, and has cut down on coffee to four cups a day. Which response by the nurse will be most helpful in promoting a lifestyle change?
a. “Those few things won’t cause any trouble. Good for you.”
b. “You need to do a lot better than that. You are still hurting your baby.”
c. “Here are some pamphlets for you to study. They will help you to find more ways to improve.”
d. “You have made some good progress toward having a healthy baby. Let’s talk about the changes you have made.”
8. A 35-year-old client has an amniocentesis performed to find out whether her baby has a chromosomal defect. Which statement indicates that the client understands her situation?
a. “The doctor will tell me if I should have an abortion when the test results come back.”
b. “When all the lab results come back, my husband and I will make a decision about the pregnancy.”
c. “My mother must not find out about all this testing. If she does, she will think I’m having an abortion.”
d. “I know there are support groups for parents who have a baby with birth defects, but we have plenty of insurance to cover what we need.”
9. Which characteristic is related to Down syndrome?
a. Up-slanting eyes
b. Abnormal genitalia
c. Bleeding tendency
d. Edema of extremities
10. Which question posed by the nurse will most likely promote the sharing of sensitive information during a genetic counseling interview?
a. “What kind of defects or diseases seem to run in the family?”
b. “How many people in your family are mentally retarded or handicapped?”
c. “Did you know that you can always have an abortion if the fetus is abnormal?”
d. “Are there any members of your family who have learning or developmental problems?”
Chapter 06: Conception and Prenatal Development
1.An expectant father asks the nurse, “Which part of the mature sperm contains the male chromosomes?” What is the best response by the nurse?
a. X-bearing sperm
b. The tail of the sperm
c. The head of the sperm
d. The middle portion of the sperm
2. One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. Which finding is considered to be within normal limits?
a. One artery and one vein
b. Two veins and one artery
c. Two arteries and one vein
d. Two arteries and two veins
3. Which is the purpose of the ovum’s zona pellucida?
a. Prevents multiple sperm from fertilizing the ovum
b. Stimulates the ovum to begin mitotic cell division
c. Allows the 46 chromosomes from each gamete to merge
d. Makes a pathway for more than one sperm to reach the ovum
4. The nurse is explaining the process of cell division during the preembryonic period to a group of nursing students. Which describes the morula?
a. Fertilized ovum before mitosis begins
b. Double layer of cells that becomes the placenta
c. Flattened, disk-shaped layer of cells within a fluid-filled sphere
d. Solid ball composed of the first cells formed after fertilization
5. The upper uterus is the best place for the fertilized ovum to implant because the:
a. maternal blood flow is lower.
b. placenta attaches most firmly.
c. uterine endometrium is softer.
d. developing baby is best nourished.
6. Some of the embryo’s intestines remain within the umbilical cord during the embryonic period because the:
a. intestines need this time to grow until week 15.
b. nutrient content of the blood is higher in this location.
c. abdomen is too small to contain all the organs while they are developing.
d. umbilical cord is much larger at this time than it will be at the end of pregnancy.
7. A client who is 16 weeks pregnant with her first baby asks how long it will be before she feels the baby move. Which is the nurse’s best answer?
a. “You should have felt the baby move by now.”
b. “The baby is moving, but you can’t feel it yet.”
c. “Some babies are quiet and you don’t feel them move.”
d. “Within the next month you should start to feel fluttering sensations.”
8. Which best describes what occurs during the fetal period of development?
a. Maturation of organ systems
b. Development of basic organ systems
c. Resistance of organs to damage from external agents
d. Development of placental oxygen–carbon dioxide exchange
9. An expectant parent says to the nurse, “When my sister’s baby was born, it was covered in a cheeselike coating. What is the purpose of this coating?” The correct response by the nurse is to explain that the purpose of vernix caseosa is to:
a. regulate fetal temperature.
b. protect the fetal skin from amniotic fluid.
c. promote normal peripheral nervous system development.
d. allow the transport of oxygen and nutrients across the amnion.
10. An expectant client, diagnosed with oligohydramnios, asks the nurse about what this condition means for the baby. Which statement should the nurse give to the client?
a. Oligohydramnios can cause poor fetal lung development.
b. Oligohydramnios means that the fetus is excreting excessive urine.
c. Oligohydramnios could mean that the fetus has a gastrointestinal blockage.
d. Oligohydramnios is associated with fetal central nervous system abnormalities.
Chapter 07: Physiologic Adaptations to Pregnancy
1.A pregnant client’s mother is worried that her daughter is not “big enough” at 20 weeks of gestation. The nurse palpates and measures the fundal height at 20 cm, which is even with the woman’s umbilicus. Which should the nurse report to the client and her mother?
a. “You’re right. We’ll inform the practitioner immediately.”
b. “Lightening has occurred, so the fundal height is lower than expected.”
c. “The body of the uterus is at the belly button level, just where it should be at this time.”
d. “When you come for next month’s appointment, we’ll check you again to make sure that the baby is growing.”
2. While the vital signs of a pregnant client in her third trimester are being assessed, the client complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?
a. Have the client stand up and retake her blood pressure.
b. Have the client sit down and hold her arm in a dependent position.
c. Have the client turn to her left side and recheck her blood pressure in 5 minutes.
d. Have the client lie supine for 5 minutes and recheck her blood pressure on both arms.
3. A pregnant client has come to the emergency department with complaints of nasal congestion and epistaxis. Which is the correct interpretation of these symptoms by the health care provider?
a. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
b. These conditions are abnormal. Refer the client to an ear, nose, and throat specialist.
c. Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within normal limits.
d. Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.
4. Which suggestion is appropriate for the pregnant client who is experiencing heartburn?
a. Drink plenty of fluids at bedtime.
b. Eat only three meals a day so the stomach is empty between meals.
c. Drink coffee or orange juice immediately on arising in the morning.
d. Use Tums or Alkamints to obtain relief, as directed by the health care provider.
5. While providing education to a primiparous client regarding the normal changes of pregnancy, what is important for the nurse to explain about Braxton Hicks contractions?
a. These contractions may indicate preterm labor.
b. These are contractions that never cause any discomfort.
c. Braxton Hicks contractions only start during the third trimester.
d. These occur throughout pregnancy, but you may not feel them until the third trimester.
6. What is the reason for vascular volume increasing by 40% to 60% during pregnancy?
a. Prevents maternal and fetal dehydration
b. Eliminates metabolic wastes of the mother
c. Provides adequate perfusion of the placenta
d. Compensates for decreased renal plasma flow
7. Physiologic anemia often occurs during pregnancy because of:
a. inadequate intake of iron.
b. the fetus establishing iron stores.
c. dilution of hemoglobin concentration.
d. decreased production of erythrocytes.
8. Which is a positive sign of pregnancy?
b. Breast changes
c. Fetal movement felt by the woman
d. Visualization of fetus by ultrasound
9. A client is currently pregnant; she has a 5-year-old son and a 3-year-old daughter. She had one other pregnancy that terminated at 8 weeks. Which are her gravida and para?
a. 3, 2
b. 4, 3
c. 4, 2
d. 3, 3
10. A client’s last menstrual period was June 10. What is her estimated date of birth (EDD)?
a. April 7
b. March 17
c. March 27
d. April 17
Chapter 08: Psychosocial Adaptations to Pregnancy
1.Which comment made by a client in her first trimester indicates ambivalent feelings?
a. “My body is changing so quickly.”
b. “I haven’t felt well since this pregnancy began.”
c. “I’m concerned about the amount of weight I’ve gained.”
d. “I wanted to become pregnant, but I’m scared about being a mother.”
2. A client who is 7 months pregnant states, “I’m worried that something will happen to my baby.” Which is the nurse’s best response?
a. “Your baby is doing fine.”
b. “Tell me about your concerns.”
c. “There is nothing to worry about.”
d. “The doctor is taking good care of you and your baby.”
3. An expectant client asks the nurse about the behavior of “mimicry.” Which is an example of mimicry that the nurse should relate to the client?
a. Daydreaming about the newborn
b. Imagining oneself as a good mother
c. Babysitting for a neighbor’s children
d. Wearing maternity clothes before they are needed
4. What is the term for the step in maternal role attainment that relates to the woman giving up certain aspects of her previous life?
b. Grief work
d. Looking for a fit
5. An expectant client in her third trimester reports that she developed a strong tie to her baby from the beginning and now is really in tune to her baby’s temperament. The nurse interprets this as the development of which maternal task of pregnancy?
a. Learning to give of herself
b. Developing attachment with the baby
c. Securing acceptance of the baby by others
d. Seeking safe passage for herself and her baby
6. Which situation best describes a man trying on fathering behaviors?
a. Reading books on newborn care
b. Spending more time with his siblings
c. Coaching a little league baseball team
d. Exhibiting physical symptoms related to pregnancy
7. Margaret, a 36-year-old divorcee with a successful modeling career, finds out that her 18-year-old married daughter is expecting her first child. Which is a major factor in determining how Margaret will respond to becoming a grandmother?
a. Her age
b. Her career
c. Being divorced
d. Age of the daughter
8. Which comment made by a new mother to her own mother is most likely to encourage the grandmother’s participation in the infant’s care?
a. “Could you help me with the housework today?”
b. “The baby is spitting up a lot. What should I do?”
c. “I know you are busy, so I’ll get John’s mother to help me.”
d. “The baby has a stomachache. I’ll call the nurse to find out what to do.”
9. Which is a major concern among members of lower socioeconomic groups?
a. Practicing preventive health care
b. Meeting health needs as they occur
c. Maintaining an optimistic view of life
d. Maintaining group health insurance for their families
10. Which comment made by a new mother exhibits understanding of her toddler’s response to a new sibling?
a. “I can’t believe he is sucking his thumb again.”
b. “He is being difficult and I don’t have time to deal with him.”
c. “When we brought the baby home, we made Michael stop sleeping in the crib.”
d. “My husband is going to stay with the baby so I can take Michael to the park tomorrow.”
Chapter 09: Nutrition for Childbearing
1.When planning a diet with a pregnant client, what should the nurse’s first action be?
a. Teach the client about MyPlate.
b. Review the client’s current dietary intake.
c. Instruct the client to limit the intake of fatty foods.
d. Caution the client to avoid large doses of vitamins, especially those that are fat-soluble.
2. A nurse is teaching a nutrition class to a group of pregnant clients. The nurse should include that the major source of nutrients in the diet of a pregnant woman should be composed of which?
c. Simple sugars
d. Complex carbohydrates
3. To increase the absorption of iron in a pregnant client, with what should an iron preparation be given?
d. Orange juice
4. When should iron supplementation during a normal pregnancy begin?
a. Before pregnancy
b. In the first trimester
c. In the third trimester
d. In the second trimester
5. What is the recommended weight gain during pregnancy for a client who begins pregnancy at a normal weight?
a. 10 to 15 lb
b. 15 to 20 lb
c. 20 to 25 lb
d. 25 to 35 lb
6. A client in her fifth month of pregnancy asks the nurse, “How many more calories should I be eating daily?” What should the nurse’s response be?
a. 180 more calories a day
b. 340 more calories a day
c. 452 more calories a day
d. 500 more calories a day
7. A pregnant client’s diet may not meet her need for folate. What is a good source of this nutrient?
d. Green leafy vegetables
8. A pregnant client asks the nurse if she can double her prenatal vitamin dose because she doesn’t like to eat vegetables. What is the nurse’s response about the danger of taking excessive vitamins?
a. Increases caloric intake
b. Has toxic effects on the fetus
c. Increases absorption of all vitamins
d. Promotes development of pregnancy-induced hypertension (PIH)
9. A nurse is conducting a prenatal nutritional education class for a group of nursing students. Which should the nurse include as the definition of pica?
a. Iron deficiency anemia
b. Intolerance to milk products
c. Ingestion of nonfood substances
d. Episodes of anorexia and vomiting
10. Which is the common effect of both smoking and cocaine use on the pregnant client?
b. Increased appetite
c. Increased metabolism
d. Changes in insulin metabolism
Chapter 10: Antepartum Fetal Assessment
1.A pregnant client’s biophysical profile score is 8. She asks the nurse to explain the results. What is the nurse’s best response?
a. “The test results are within normal limits.”
b. “Immediate birth by cesarean birth is being considered.”
c. “Further testing will be performed to determine the meaning of this score.”
d. “An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.”
2. Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?
a. Biophysical profile
b. Multiple-marker screening
c. Lecithin-to-sphingomyelin ratio
d. Blood type and crossmatch of maternal and fetal serum
3. The clinic nurse is obtaining a health history on a newly pregnant client. Which is an indication for fetal diagnostic procedures if present in the health history?
a. Maternal diabetes
b. Weight gain of 25 lb
c. Maternal age older than 30
d. Previous infant weighing more than 3000 g at birth
4. When is the most accurate time to determine gestational age through ultrasound?
a. First trimester
b. Second trimester
c. Third trimester
d. No difference in accuracy among the trimesters
5. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which?
b. Sickle cell anemia
c. A neural tube defect
d. A normal lecithin-to-sphingomyelin ratio
6. When is the earliest that chorionic villus sampling can be performed during pregnancy?
a. 4 weeks
b. 8 weeks
c. 10 weeks
d. 12 weeks
7. On which aspect of fetal diagnostic testing do parents usually place the most importance?
a. Safety of the fetus
b. Duration of the test
c. Cost of the procedure
d. Physical discomfort caused by the procedure
8. The nurse’s role in diagnostic testing is to provide which of the following?
a. Advice to the couple
b. Information about the tests
c. Reassurance about fetal safety
d. Assistance with decision making
9. Which should be considered a contraindication for transcervical chorionic villus sampling?
a. Rh-negative mother
b. Gestation less than 15 weeks
c. Maternal age younger than 35 years
d. Positive for group B Streptococcus
10. Which nursing intervention is necessary prior to a second-trimester transabdominal ultrasound?
a. Perform an abdominal prep.
b. Administer a soap suds enema.
c. Ensure the client is NPO for 12 hours.
d. Instruct the client to drink 1 to 2 quarts of water.
Chapter 11: Perinatal Education
1.The birth educator is discussing the advantages and disadvantages of birthing options. Which disadvantage is common with epidural anesthesia?
a. Effective pushing is optimized.
b. The risk of catheterization is decreased.
c. The length of labor and birth may be decreased.
d. The use of forceps and oxytocin administration is increased.
2. What is covered by early pregnancy classes offered in the first and second trimesters?
a. Methods of pain relief
b. The phases and stages of labor
c. Coping with common discomforts of pregnancy
d. Prebirth and postbirth care of a client having a cesarean birth
3. Which client is most likely to experience pain during labor?
a. Gravida 1 whose fetus is in a breech presentation
b. Gravida 3 who is using Lamaze breathing techniques
c. Gravida 2 who is anxious because her last labor was difficult
d. Gravida 2 who has not attended childbirth preparation classes
4. When reading a new client’s birth plan, the nurse notices that the client will be bringing a doula to the hospital during labor. What does the nurse think that this means?
a. The client will have her grandmother as a support person.
b. The client will bring a paid, trained labor support person with her during labor.
c. The client will have a special video she will play during labor to assist with relaxation.
d. The client will have a bag that contains all the approved equipment that may help with the labor process.
5. Which is the method of childbirth that helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor?
6. Which type of cutaneous stimulation involves massage of the abdomen?
c. Mental stimulation
d. Thermal stimulation
7. What does a birth plan help the parents accomplish?
a. Avoidance of an episiotomy
b. Determining the outcome of the birth
c. Assuming complete control of the situation
d. Taking an active part in planning the birth experience
8. Which client could safely be cared for by a certified nurse-midwife?
a. Gravida 3, para 2, with no complications
b. Gravida 1, para 0, with mild hypertension
c. Gravida 2, para 1, with insulin-dependent diabetes
d. Gravida 1, para 0, with borderline pelvic measurements
9. Martha is a gravida 3, para 2, whose last child was born 5 years ago. She attended childbirth preparation classes with her first pregnancy. Which class would be most appropriate for her?
a. Refresher course
b. Infant care classes
c. Postpartum classes
d. Early pregnancy classes
10. A client asks, “What can I do to help decrease the amount of pain with labor?” What should be the nurse’s best response?
a. “Nothing. That is the way God intended it to be.”
b. “We can give you medications to help with the pain.”
c. “You should not worry about the pain; leave that concern up to the staff.”
d. “By trying to relax, the contractions will be more efficient and the pain may be less.”
Chapter 12: Processes of Birth
1.The husband of a laboring woman asks the nurse how he can help his wife throughout the first stage of labor. The nurse informs him that in addition to all that he’s doing now, he could tell her when the contractions are:
a. 2 minutes apart.
b. at their acme.
c. at their increment.
d. at their decrement.
2. The nurse is explaining to a group of nursing students what occurs during active labor as the uterus contracts. Which statement explains the maternal-fetal exchange of oxygen and waste products during a contraction?
a. Is not significantly affected
b. Increases as blood pressure decreases
c. Diminishes as the spiral arteries are compressed
d. Continues except when placental functions are reduced
3. The nurse is directing an unlicensed assistive personnel (UAP) to take maternal vital signs between contractions. Which statement is the best rationale for assessing maternal vital signs between contractions?
a. Vital signs taken during contractions are not accurate.
b. During a contraction, assessing fetal heart rate is the priority.
c. Maternal blood flow to the heart is reduced during contractions.
d. Maternal circulating blood volume increases temporarily during contractions.
4. Uncontrolled maternal hyperventilation during labor results in:
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory acidosis.
d. respiratory alkalosis.
5. Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
c. Internal rotation
d. External rotation
6. The laboring client asks the nurse how the labor contractions work to dilate the cervix. The best response by the nurse is that labor contractions facilitate cervical dilation by:
a. promoting blood flow to the cervix.
b. contracting the lower uterine segment.
c. enlarging the internal size of the uterus.
d. pulling the cervix over the fetus and amniotic sac.
7. Pregnant clients can usually tolerate the normal blood loss associated with childbirth because they have:
a. a higher hematocrit.
b. increased leukocytes.
c. increased blood volume.
d. a lower fibrinogen level.
8. The nurse is assessing the duration of a client’s labor contractions. Which action does the nurse implement to assess the duration of labor contractions?
a. Assess the strongest intensity of each contraction.
b. Assess uterine relaxation between two contractions.
c. Assess from the beginning to the end of each contraction.
d. Assess from the beginning of one contraction to the beginning of the next.
9. Which event is the best indicator of true labor?
a. Bloody show
b. Cervical dilation and effacement
c. Fetal descent into the pelvic inlet
d. Uterine contractions every 7 minutes
10. Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis?
Chapter 13: Nursing Care During Labor and Birth
1.The nurse is preparing to perform Leopold’s maneuvers. Why are Leopold’s maneuvers used by practitioners?
a. To determine the status of the membranes
b. To determine cervical dilation and effacement
c. To determine the best location to assess the fetal heart rate
d. To determine whether the fetus is in the posterior position
2. Which comfort measure should a nurse use to assist a laboring woman to relax?
a. Recommend frequent position changes.
b. Palpate her filling bladder every 15 minutes.
c. Offer warm wet cloths to use on the client’s face and neck.
d. Keep the room lights lit so the client and her coach can see everything.
3. Which assessment finding could indicate hemorrhage in the postpartum patient?
a. Elevated pulse rate
b. Elevated blood pressure
c. Firm fundus at the midline
d. Saturation of two perineal pads in 4 hours
4. Which is an essential part of nursing care for a laboring client?
a. Helping the woman manage the pain
b. Eliminating the pain associated with labor
c. Feeling comfortable with the predictable nature of intrapartal care
d. Sharing personal experiences regarding labor and birth to decrease her anxiety
5. A client at 40 weeks’ gestation should be instructed to go to a hospital or birth center for evaluation when she experiences:
a. fetal movement.
b. irregular contractions for 1 hour.
c. a trickle of fluid from the vagina.
d. thick pink or dark red vaginal mucus.
6. Which client at term should go to the hospital or birth center the soonest after labor begins?
a. Gravida 2, para 1, who lives 10 minutes away
b. Gravida 1, para 0, who lives 40 minutes away
c. Gravida 2, para 1, whose first labor lasted 16 hours
d. Gravida 3, para 2, whose longest previous labor was 4 hours
7. A woman who is gravida 3, para 2, enters the intrapartum unit. The most important nursing assessments are:
a. contraction pattern, amount of discomfort, and pregnancy history.
b. fetal heart rate, maternal vital signs, and the woman’s nearness to birth.
c. last food intake, when labor began, and cultural practices the couple desires.
d. identification of ruptured membranes, the woman’s gravida and para, and her support person.
8. A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the client to be:
a. discharged home with a sedative.
b. admitted for extended observation.
c. admitted and prepared for a cesarean birth.
d. discharged home to await the onset of true labor.
9. The nurse auscultates the fetal heart rate and determines a rate of 152 bpm. Which nursing intervention is appropriate?
a. Inform the mother that the rate is normal.
b. Reassess the fetal heart rate in 5 minutes because the rate is too high.
c. Report the fetal heart rate to the physician or nurse-midwife immediately.
d. Tell the mother that she is going to have a boy because the heart rate is fast.
10. Which should the nurse recognize as being associated with fetal compromise?
a. Active fetal movements
b. Fetal heart rate in the 140s
c. Contractions lasting 90 seconds
d. Meconium-stained amniotic fluid
Chapter 14: Intrapartum Fetal Surveillance
1.The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?
a. This pattern reflects variable decelerations. No interventions are necessary at this time.
b. Document this reassuring fetal heart rate pattern but decrease the rate of the intravenous (IV) fluid.
c. Continue to monitor these early decelerations, which occur as the fetal head is compressed during a contraction.
d. This deceleration pattern is associated with uteroplacental insufficiency, so the nurse acts quickly to improve placental blood flow and fetal oxygen supply.
2. Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
a. Unruptured membranes
b. Cervix dilated to 4 cm
c. Fetus has known heart defect
d. External monitors currently being used
3. The nurse is instructing a nursing student on the application of fetal monitoring devices. Which method of assessing the fetal heart rate requires the use of a gel?
c. Scalp electrode
4. A client is receiving oxytocin (Pitocin) to induce labor. The uterine contractions have become persistently hypertonic and the infusion is stopped. The health care provider has prescribed a tocolytic to stop contractions. Which medication should the nurse be prepared to administer?
a. Naloxone (Narcan)
b. Terbutaline (Brethine)
d. Diphenhydramine (Benadryl)
5. Proper placement of the tocotransducer for electronic fetal monitoring is:
a. inside the uterus.
b. on the fetal scalp.
c. over the uterine fundus.
d. over the mother’s lower abdomen.
6. Which can be determined only by electronic fetal monitoring?
d. Fetal response to contractions
7. Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy?
a. Continuous auscultation with a fetoscope
b. Continuous electronic fetal monitoring
c. Intermittent assessment with a Doppler transducer
d. Intermittent electronic fetal monitoring for 15 minutes each hour
8. Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
a. Fetal chemoreceptors are stimulated.
b. The mother may become hypotensive.
c. Maternal fluid volume deficit may occur.
d. Uteroplacental exchange may be compromised.
9. The nurse is concerned that a client’s uterine activity is too intense and that her obesity is preventing accurate assessment of the actual intrauterine pressure. Based on this information, which action should the nurse take?
a. Reposition the tocotransducer.
b. Reposition the Doppler transducer.
c. Obtain an order from the health care provider for a spiral electrode.
d. Obtain an order from the health care provider for an intrauterine pressure catheter.
10. If the position of a fetus in a cephalic presentation is right occiput anterior, the nurse should assess the fetal heart rate in which quadrant of the maternal abdomen?
a. Right upper
b. Left upper
c. Right lower
d. Left lower
Chapter 15: Pain Management During Childbirth
1.Childbirth preparation can be considered successful if the outcome is described as which of the following?
a. Labor was pain-free.
b. The birth experiences of friends and families were ignored.
c. Only nonpharmacologic methods for pain control were used.
d. The client rehearsed labor and practiced skills to master pain.
2. A woman with a known heroin habit is admitted in early labor. Which drug is contraindicated with opiate-dependent patients?
a. Nalbuphine (Nubain)
b. Hydroxyzine (Vistaril)
c. Promethazine (Phenergan)
d. Diphenhydramine (Benadryl)
3. A client is admitted to the labor and birth room in active labor; contractions are 4 to 5 minutes apart and last for 30 seconds. The nurse needs to perform a detailed assessment. When is the best time to ask questions or do procedures?
a. After the contraction is over
b. When it is all right with the coach
c. During increment of next contraction
d. After administration of analgesic-anesthetic
4. Childbirth pain is different from other types of pain in that it is:
a. less intense.
b. associated with a physiologic process.
c. more responsive to pharmacologic management.
d. designed to make one withdraw from the stimulus.
5. Excessive anxiety during labor heightens the client’s sensitivity to pain by increasing:
a. muscle tension.
b. the pain threshold.
c. blood flow to the uterus.
d. rest time between contractions.
6. Which fetal position may cause the laboring client more back discomfort?
a. Left occiput anterior
b. Left occiput posterior
c. Right occiput anterior
d. Right occiput transverse
7. A major advantage of nonpharmacologic pain management is that:
a. a more rapid labor is likely.
b. more complete pain relief is possible.
c. the woman remains fully alert at all times.
d. there are no side effects or risks to the fetus.
8. The best time to teach nonpharmacologic pain control methods to an unprepared laboring client is during which stage?
a. Latent phase
b. Active phase
c. Second stage
d. Transition phase
9. The primary side effect of maternal narcotic analgesia in the newborn is:
d. respiratory depression.
10. A client received 25 mg of meperidine (Demerol) intravenously 1 hour before birth. Which drug should the nurse have readily available?
a. Naloxone (Narcan)
b. Butorphanol (Stadol)
c. Nalbuphine (Nubain)
d. Promethazine (Phenergan)
Chapter 16: Nursing Care During Obstetric Procedures
1.The nurse knows that a urinary catheter is added to the instrument table if a forceps-assisted birth is anticipated. The correct rationale for this intervention is that:
a. a sterile urine specimen is needed preoperatively.
b. an empty bladder provides more room in the pelvis.
c. spontaneous release of urine might contaminate the sterile field.
d. a Foley catheter prevents the membranes from spontaneously rupturing.
2. After a forceps-assisted birth, the client is observed to have continuous bright red lochia but a firm fundus. Which other data would indicate the presence of a potential vaginal wall hematoma?
a. Lack of an episiotomy
b. Mild, intermittent perineal pain
c. Lack of pain in the perineal area
d. Edema and discoloration of the labia and perineum
3. The nurse is positioning the Foley catheter prior to a cesarean birth. Which position should the nurse use to place the catheter drainage tubing and catheter bag?
a. Place near the head of the table.
b. Position on top of the patient’s leg.
c. Place at the foot and clamp during the cesarean section.
d. Position at the foot of the surgeon under the sterile drapes.
4. Which condition is a contraindication for an amniotomy?
a. –2 station
b. Breech presentation
c. Dilation less than 3 cm
d. Right occiput posterior position
5. Which client status is an acceptable indication for serial oxytocin induction of labor?
a. Multiple fetuses
c. History of long labors
d. Past 42 weeks of gestation
6. The nurse is explaining the technique of internal version to a group of nursing students. Which describes the technique of internal version?
a. Manipulation of the fetus from a breech to a cephalic presentation before labor begins
b. Manipulation of the fetus from a transverse lie to a longitudinal lie before cesarean birth
c. Manipulation of the second twin from an oblique lie to a transverse lie before labor begins
d. Manipulation of the second twin from a transverse lie to a breech presentation during vaginal birth
7. The greatest risk to the newborn after an elective cesarean birth is:
a. tachypnea because of maternal anesthesia.
b. tachycardia because of maternal narcotics.
c. trauma because of manipulation during birth.
d. prematurity because of miscalculation of gestation.
8. Which client is most at risk for a uterine rupture?
a. A gravida 4 who had a classic cesarean incision
b. A gravida 5 who had two vaginal births and one cesarean birth
c. A gravida 3 who has had two low-segment transverse cesarean births
d. A gravida 2 who had a low-segment vertical incision for birth of a 10-lb infant
9. Before the health care provider performs an external version, the nurse should expect an order for a:
a. Foley catheter.
b. tocolytic drug.
c. local anesthetic.
d. contraction stress test (CST).
10. A maternal indication for the use of vacuum extraction is:
a. a wide pelvic outlet.
b. maternal exhaustion.
c. a history of rapid deliveries.
d. failure to progress past 0 station.
Chapter 17: Postpartum Physiologic Adaptations
1.A postpartum client overhears the nurse tell the health care provider that she has a positive Homans sign and asks what it means. Which is the nurse’s best response?
a. “You have pitting edema in your ankles.”
b. “You have deep tendon reflexes rated 2+.”
c. “You have calf pain when the nurse flexes your foot.”
d. “You have a ’fleshy’ odor to your vaginal drainage.”
2. Which client would be most likely to have severe afterbirth pains and request a narcotic analgesic?
a. Gravida 5, para 5
b. Primipara who delivered a 7-lb boy
c. Client who is bottle feeding her first child
d. Client who wishes to breastfeed as soon as her baby is out of the neonatal intensive care unit
3. Which maternal event is abnormal in the early postpartal period?
a. Diuresis and diaphoresis
b. Flatulence and constipation
c. Extreme hunger and thirst
d. Lochial color changes from rubra to alba
4. Which fundal assessment finding at 12 hours after birth requires further assessment?
a. The fundus is palpable at the level of the umbilicus.
b. The fundus is palpable two fingerbreadths above the umbilicus.
c. The fundus is palpable one fingerbreadth below the umbilicus.
d. The fundus is palpable two fingerbreadths below the umbilicus.
5. If the client’s white blood cell (WBC) count is 25,000/mm3 on her second postpartum day, which action should the nurse take?
a. Document the finding.
b. Tell the health care provider.
c. Begin antibiotic therapy immediately.
d. Have the laboratory draw blood for reanalysis.
6. Postpartal overdistention of the bladder and urinary retention can lead to which complication?
a. Fever and increased blood pressure
b. Postpartum hemorrhage and eclampsia
c. Urinary tract infection and uterine rupture
d. Postpartum hemorrhage and urinary tract infection
7. A postpartum client asks, “Will these stretch marks go away?” Which is the nurse’s best response?
a. “No, never.”
b. “Yes, eventually.”
c. “They will fade to silvery lines but won’t disappear completely.”
d. “They will continue to fade and should be gone by your 6-week checkup.”
8. A pregnant client asks when the dark line on her abdomen (linea nigra) will go away. The nurse knows the pigmentation will decrease after birth because of:
a. increased estrogen.
b. increased progesterone.
c. decreased human placental lactogen.
d. decreased melanocyte-stimulating hormone.
9. If the fundus is palpated on the right side of the abdomen above the expected level, the nurse should suspect that the client has which?
a. Distended bladder
b. Normal involution
c. Been lying on her right side too long
d. Stretched ligaments that are unable to support the uterus
10. The Centers for Disease Control and Prevention (CDC) recommends the use of which personal protective equipment with which the nurse is likely to come into contact?
a. Any body fluids
b. Any client at any time
c. Blood and blood products
d. Any client suspected of being HIV-positive
Chapter 18: Postpartum Psychosocial Adaptations
1.The term reciprocal attachment behavior refers to which of the following?
a. Behavior during the sensitive period when the infant is in the quiet alert stage
b. Positive feedback an infant exhibits toward parents during the attachment process
c. Unidirectional behavior exhibited by the infant, initiated and enhanced by eye contact
d. Behavior by the infant during the sensitive period to elicit feelings of “falling in love” from the parents
2. The postpartum client who continually repeats the story of her labor, birth, and recovery experiences is doing which?
a. Making the birth experience “real”
b. Accepting her response to labor and birth
c. Providing others with her knowledge of events
d. Taking hold of the events leading to her labor and birth
3. During which stage of role attainment do the parents become acquainted with their baby and combine parenting activities with cues from the infant?
4. The nurse observes a client on her first postpartum day sitting in bed while her newborn lies awake in the bassinet. Which appropriate action should the nurse take?
a. Hand the baby to the woman.
b. Explain “taking-in” to the woman.
c. Offer to hand the baby to the woman.
d. No action, because this situation is perfectly acceptable.
5. A postpartum nurse is observing a client holding the baby she delivered less than 24 hours ago. Her husband is watching his wife and asking questions about newborn care. The 4-year-old big brother is punching his mother on the back. Which action should the nurse should take?
a. Report the incident to the social services department.
b. Advise the parents that the older son needs to be reprimanded.
c. No action; this is a normal family adjusting to family change.
d. Report to oncoming staff that the mother is probably not a good disciplinarian.
6. During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby?
7. A 25-year-old gravida 1, para 1, who had an emergency cesarean birth 3 days ago is scheduled for discharge. As you prepare her for discharge, she begins to cry. Which should be your initial action?
a. Assess her for pain.
b. Allow her time to express her feelings.
c. Point out how lucky she is to have a healthy baby.
d. Explain that she is experiencing postpartum blues.
8. A husband calls the nurse’s station stating that his wife, who delivered last week, is happy one minute and crying the next. He says, “She was never like this before the baby was born.” Which should be the nurse’s initial response?
a. Reassure him that this behavior is normal.
b. Advise him to get immediate psychological help for her.
c. Tell him to ignore the mood swings because they will go away.
d. Instruct him in the signs, symptoms, and duration of postpartum blues.
9. To promote bonding and attachment immediately after birth, which action should the nurse take?
a. Assist the mother in feeding her baby.
b. Allow the mother quiet time with her infant.
c. Teach the mother about the concepts of bonding and attachment.
d. Assist the mother in assuming an en face position with her newborn.
10. While the nurse is demonstrating a baby bath, the client states, “The other nurse told me to do it a different way.” Which response should the nurse make?
a. Tell her to do the procedure whichever way works best for her.
b. Confront the other nurse about her knowledge of the procedure.
c. Reassure her that procedures are based on standard principles and may vary.
d. Tell her that the other nurse does not have much experience in caring for newborns.
Chapter 19: Normal Newborn: Processes of Adaptation
1.A nursing student is helping the nursery nurse with morning vital signs. A baby born 10 hours ago via cesarean section is found to have moist lung sounds. Which is the best interpretation of this information?
a. This is an emergency situation.
b. The neonate must have aspirated surfactant.
c. If this baby was born vaginally, it could indicate a pneumothorax.
d. The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.
2. Which organs are nonfunctional during fetal life?
a. Eyes and ears
b. Lungs and liver
c. Kidneys and adrenals
d. Gastrointestinal system
3. Which method of heat loss may occur if a newborn is placed on a cold scale or touched with cold hands?
4. How can nurses prevent evaporative heat loss in the newborn?
a. Placing the baby away from the outside wall and the windows
b. Keeping the baby out of drafts and away from air conditioners
c. Drying the baby after birth and wrapping the baby in a dry blanket
d. Warming the stethoscope and nurse’s hands before touching the baby
5. The nurse is explaining how a newly delivered baby initiates respirations. Which statement explains this process?
a. Drying off the infant
b. Chemical, thermal, and mechanical factors
c. An increase in the PO2 and a decrease in the PCO2
d. The continued functioning of the foramen ovale
6. During fetal circulation the pressure is greatest in the:
a. left atrium.
b. right atrium.
c. hepatic system.
d. pulmonary veins.
7. Parents ask the nurse, “What makes the opening between the baby’s atriums close at birth?” The nurse’s response is that cardiovascular changes that cause the foramen ovale to close at birth are a direct result of:
a. changes in the hepatic blood flow.
b. increased pressure in the left atrium.
c. increased pressure in the right atrium.
d. decreased blood flow to the left ventricle.
8. The infant’s heat loss immediately at birth is predominantly from:
9. The nurse is explaining the risk of hypothermia in the newborn to a group of nursing students. Which should the nurse include as an explanation of hypothermia in the newborn?
a. Newborns shiver to generate heat.
b. Newborns have decreased oxygen demands.
c. Newborns have increased glucose demands.
d. Newborns have a decreased metabolic rate.
10. Which infant has the lowest risk of developing high levels of bilirubin?
a. The infant who developed a cephalohematoma
b. The infant who was bruised during a difficult birth
c. The infant who uses brown fat to maintain temperature
d. The infant who is breastfed during the first hour of life
Chapter 20: Assessment of the Normal Newborn
1. The hips of a newborn are examined for developmental dysplasia. Which sign indicates an incomplete development of the acetabulum?
a. Negative Barlow test
b. Equal knee heights
c. Negative Ortolani sign
d. Thigh and gluteal creases are asymmetric
2. Which newborn reflex is elicited by stroking the lateral sole of the infant’s foot from the heel to the ball of the foot?
c. Tonic neck
d. Plantar grasp
3. Infants who develop cephalohematoma are at increased risk for:
c. caput succedaneum.
d. erythema toxicum.
4. Which action should the nurse take if a discrepancy is found between the measurements of a newborn and the normative criteria?
a. Remeasure the infant.
b. Consider this a normal deviation.
c. Perform an expanded assessment.
d. Inform the parents so that they can follow the infant’s growth.
5. Which explains why a newborn with a congenital defect of the penis should not be circumcised?
a. There is increased risk of infection.
b. The foreskin might be needed for future repairs.
c. A circumcision will make the defect more visible.
d. There is no medical rationale for a circumcision.
6. A maculopapular rash with a red base and a small white papule in the center is:
b. Mongolian spots.
c. erythema toxicum.
d. café-au-lait spots.
7. A newborn who is a large-for-gestational-age (LGA) infant is in which percentile(s) for weight?
a. Below the 90th
b. Less than the 10th
c. Greater than the 90th
d. Between the 10th and 90th
8. A new client asks, “Why are you doing a gestational age assessment on my baby?” The nurse’s best response is:
a. “It was ordered by your physician.”
b. “This must be done to meet insurance requirements.”
c. “It helps us identify infants who are at risk for any problems.”
d. “The gestational age determines how long the infant will be hospitalized.”
9. Which nursing action is designed to avoid unnecessary heat loss in the newborn?
a. Maintain room temperature at 70° F.
b. Place a blanket over the scale before weighing the infant.
c. Take the rectal temperature every hour to detect early changes.
d. Undress the infant completely for assessments so that they can be finished quickly.
10. The nurse is performing a gestational age assessment on a newborn. Which characteristic shows the greatest gestational maturity?
a. The infant’s arms and legs are extended.
b. There is some peeling and cracking of the skin.
c. There are few rugae on the scrotum and the testes are high in the scrotum.
d. The arm can be positioned with the elbow beyond the midline of the chest.
AND MUCH MORE