Deck 67: High-Risk Pregnancy and Childbirth

Question 1

The neonatal nurse knows the challenges that face newborns when adapting to their new world. What is one of the first interventions performed during the delivery to ensure a safe transition?

A) Suctioning the neonate's airways
B) Testing the neonate's reflexes
C) Facilitating maternal bonding
D) Assessing for congenital defects

Answer 1

Suctioning the neonate's airways

Question 2

The nurse is teaching the new mother what occurs when her baby takes its first breath. Which teaching point is accurate?

A) The breath assists conversion to adult circulation and fills the lungs with fluid.
B) The breath establishes neonatal lung volume and function.
C) The baby's respirations should stabilize immediately at birth.
D) The baby's respiratory rate should be more than 60 breaths per minute after 2 hours.

Answer 2

The breath establishes neonatal lung volume and function.

Question 3

The neonatal nurse knows that the neonate must work to keep warm. What is the most efficient process the neonate uses to maintain its temperature?

A) Using stores of brown fat
B) Producing muscle movement
C) Shivering
D) Taking shallow breaths

Answer 3

Using stores of brown fat

Question 4

The nurse is performing immediate care of the newborn. Which interventions are related to the immediate management goals of the newborn? Select all that apply.

A) Suctioning the baby's nasal passages
B) Placing a cap on the baby's head
C) Assisting the mother to breastfeed
D) Providing a complete body bath and shampoo
E) Placing an identification band on the infant's wrist
F) Reporting Mongolian spots if found on the infant's skin

Question 5

A client has just given birth. After ensuring that the newborn is stable, which intervention should the nurse perform while still in the delivery room to help the client bond with the infant?

A) Attach identification bands to the newborn
B) Have soothing music planning in the recovery room
C) Encourage the mother to hold the infant
D) Allow the mother to breastfeed

Question 6

The nurse is assessing a neonate to obtain an Apgar score. The nurse records the following data: heart rate: 120 bpm, good respiratory effort, neonate crying vigorously, some flexion of extremities, body color: pink, extremities blue. What would be the Apgar score for this neonate?

A) 4
B) 6
C) 8
D) 10

Question 7

Following the 1-minute Apgar score of a neonate, the nurse records the number 5. What is the implied meaning of this number?

A) The newborn is in good condition.
B) The newborn does not need resuscitation.
C) The newborn is in danger of birth-related injury.
D) The newborn needs immediate emergency resuscitation.

Question 8

It is the responsibility of the nurse to initiate some form of identification while the infant is still in the delivery or birth room. Which accurately describes a step in this process?

A) An electronic bracelet may be placed on the infant to create an alarm if the infant is taken off the obstetrical unit.
B) A two-band system with identifying information may be used, with one placed on the mother and the other on the infant.
C) The mother and infant's fingerprints may be taken and placed in the medical record.
D) A chart with all identifying information must be prepared after the newborn leaves the delivery room.

Question 9

The nurse helping to deliver newborns institutes measures to protect the mother and infant as well as the staff from infection or disease. Which accurately describes a form of infection/disease control utilized in the delivery or birthing room?

A) Eye prophylaxis is used for infants born to mothers with diabetes mellitus.
B) Vitamin K is given to prevent bleeding problems.
C) The first vaccination against hepatitis C is given.
D) Universal Precautions are used when handling the baby or caring for the mother.

Question 10

The nurse is facilitating bonding of an infant with the parents. Which is a recommended intervention to assist in this process?

A) Remove the baby from the parents and allow the mother time to recuperate.
B) Place the mother and baby with their bodies in the spoon position.
C) Place the swaddled baby between the mother's breasts.
D) Delay eye prophylaxis until after this critical time period.

Question 11

When assessing the physical condition of a 2-day-old infant, the nurse notices a relatively soft swelling on one side of the skull extending up to the midline. Which condition is associated with this assessment data?

A) Fontanels
B) Caput succedaneum
C) Cephalhematoma
D) Molding

Question 12

The nurse is measuring a newborn after a vaginal delivery. The nurse documents: head circumference: 13.5 in and chest: 11.7 in. What do these numbers mean?

A) The newborn is within the normal parameters for head and body size.
B) The newborn is within the normal parameters for head, but body size is small.
C) The newborn is within the normal parameters for body, but the head size is small.
D) The newborn's head is larger than the body due to molding occurring during delivery.

Question 13

The nurse is caring for a new mother who states she is worried about the soft spots on her newborn's head. What would be the nurse's proper response?

A) "These soft spots are called Mongolian spots caused by birth trauma that will resolve in time.'
B) These soft spots are called molding and are caused by delivering your baby
Vaginally and will resolve with time."
C) "These soft spots are called fontanels and occur so the head can mold to fit through the mother's birth canal. They will close within 3 months."
D) "These soft spots are congenital defects known as fontanels that will require surgery when the infant is a year old."

Question 14

The nurse is examining a newborn male client's genitalia and notes that the opening of the foreskin is so small that it cannot be pulled back at all. What condition would the nurse document on the client record?

A) Prepuce
B) Phimosis
C) Hypospadias
D) Epispadias

Question 15

A 28-year-old client is concerned that her day-old infant has some blood-stained discharge from the vagina. Which should the nurse tell the client is the cause for the discharge?

A) Injury during delivery procedure
B) Lack of vitamin K in the newborn baby
C) Medication used by the nursing mother
D) Sudden absence of the mother's hormones

Question 16

A nurse cleansing a newborn in the delivery room notices small purple dots on the face of the newborn. How should the nurse record this finding?

A) Mongolian spots
B) Petechiae
C) Erythema toxicum
D) Port-wine stain

Question 17

A nurse caring for a 2-day-old infant assesses the infant's movement and activity. Which finding should the nurse report as abnormal?

A) Sleeping for approximately 17 hours a day
B) Moving the limbs asymmetrically
C) Keeping the extremities in a flexed position
D) Being unable to support the weight of the head

Question 18

During assessment of the reflexes in the newborn, the nurse notices that the newborn baby turns her head in the direction of the touch when the cheek is stroked. What is this reflex called?

A) Babinski reflex
B) Moro reflex
C) Stepping reflex
D) Rooting reflex

Question 19

The nurse who assisted in the delivery of a newborn is giving a report to the nurse receiving the newborn in the labor-delivery-recovery room (LDR). What information must the nurse report to the healthcare personnel who take responsibility for the care of this infant? Select all that apply.

A) Length of the first and second stages of labor
B) Whether vitamin K was given
C) Whether immunizations were given
D) Condition of the placenta
E) Whether the baby passed the meconium plug
F) Newborn's vital signs

Question 20

A nurse is assessing a newborn baby boy. Which finding indicates a strong possibility of congenital defects in the newborn?

A) Presence of cyanotic discoloration of the newborn's arms and legs
B) Absence of indentation over the xiphoid process during breathing
C) Presence of two blood vessels on the umbilical cord
D) Enlargement and darker pigmentation of the scrotum

Question 21

The nurse is observing a newborn for respiratory status. Which sign confirms that the respiratory status is normal?

A) Movement of diaphragm and abdominal muscles should be synchronized.
B) The chest should expand from side to side on inhalation.
C) The muscles of the chest wall should show considerable effort with breathing.
D) The baby should flare nostrils and make grunting noises when breathing.

Question 22

A nurse attending the delivery of a newborn assesses and records the vital signs of the newborn. Which finding is a cause for concern?

A) Pulse rate is 90 beats per minute
B) Axillary temperature is 98.2°F
C) Blood pressure is 60/40 mm Hg
D) Respiratory rate is 55 breaths per minute

Question 23

The nurse is teaching a new mother how to handle and dress her newborn. Which statement from the mother indicates that teaching was effective?

A) "When I pick up my baby I should turn him over on his stomach first."
B) "I should hold my baby close to my body like I'm holding a football."
C) "I should fold the diaper above the cord stump."
D) "I should not wrap the baby in a blanket to avoid overheating."

Question 24

The nurse is teaching a class of new mothers how to provide care for their babies' cord and genitals. Which guideline is recommended for this care?

A) Do not use alcohol to swab the stump during diaper change.
B) When bathing the infant, submerge the cord and clean with soap and water.
C) For a female baby, clean folds of the labia wiping from back to front.
D) For a male baby, stretch the foreskin over the glans penis for cleaning once a day.

Question 25

The nurse is bringing a newborn to her mother to breastfeed for the first time. Which intervention would be appropriate to facilitate the process?

A) Set a schedule; do not allow the newborn to breastfeed as often as the mother wishes.
B) Allow the baby to feed on one breast for 20 minutes before offering the other breast.
C) If engorgement occurs, teach the mother to apply cold compresses.
D) When finished nursing, teach the mother to place the baby on his or her back.

Question 26

The nurse is using the LATCH Breastfeeding Charting System to evaluate the effectiveness of a newborn's breastfeeding experience. The nurse documents the following on the chart: L = repeated attempts; A = a few audible swallows with stimulation, T = everted nipple; C = engorged nipples; H = holding without assist from staff. What number would the nurse document using these data?

A) 4
B) 6
C) 8
D) 10

Question 27

A new mother who is breastfeeding reports sore and cracked nipples. What would be the best nursing interventions to help alleviate this problem?

A) Reposition the infant.
B) Shorten the feeding period.
C) Swab the nipple with alcohol.
D) Apply cold compresses to the nipple.

Question 28

The nurse is aware that a well-nourished mother ensures an adequate and nutritious milk supply for her newborn and protects her own health. Which guideline is accurate for the nutritional needs of nursing mothers?

A) The nursing mother needs 1,000 extra calories per day.
B) Fluid intake should be limited to prevent engorgement.
C) Moderate alcohol can be used to relax the mother and stimulate the let-down reflex.
D) Strongly flavored foods should be avoided because they can cause colic in newborns.

Question 29

The mother of a 2-month-old infant reports to the nurse that the infant has been crying continuously all evening. On examination the nurse understands that the newborn is colicky. Which is the most common reason for the onset of colic in an infant?

A) Consumption of caffeine by the nursing mother
B) Consumption of cow's milk by the nursing mother
C) Consumption of alcohol by the nursing mother
D) Frequent breastfeeding by the newborn

Question 30

A 25-year-old client who has given birth is apprehensive about the use of certain drugs when breastfeeding. Which drug should the nurse ask the client to avoid during breastfeeding?

A) Acetaminophen
B) Amphetamines
C) Codeine
D) Pseudoephedrine