RN Maternal Newborn Online Practice 2023 B

RN Maternal Newborn Online Practice 2023 B Maternal Newborn Practice B Assessment 1. A nurse is teaching a client who has a new prescription for combined oral contraceptives about potential adverse effects of the medication. For which of the following findings should the nurse instruct the client to notify the provider? a. Answer: Shortness of breath b. Why?: Shortness of breath and cheat pain can indicate a pulmonary embolus or myocardial infarction. c. Additional adverse effects to notify the HCP that can indicate potential complications include abdominal pain, sudden or persistent headaches, blurred vision, and severe leg pain. d. Breakthrough bleeding outside of the menstrual period, nausea and vomiting, and breast tenderness is a common adverse effect of combined oral contraceptives. 2. A nurse is caring for a client following an amniocentesis at 18 weeks of gestation. Which of the following findings should the nurse report to the provider as a potential complication? a. Answer: Leakage of fluid from the vagina b. Why?: Could indicate premature leakage of amniotic fluid and should be reported to the HCP c. Decreased fetal movement is a potential complication that should be reported to the HCP d. Upper abdominal discomfort and urinary frequency is not a potential complication associated with an amniocentesis 3. A nurse is calculating a client’s expected date of birth using Nagele’s rule. The client tells the nurse that her last menstrual cycle started on November 27 th . Which of the following dates is the client’s expected date of birth? a. Answer: September 3 rd b. Why?: Subtract 3 months from the first days of the client’s last menstrual cycle and then add 7 days. 4. A nurse is caring for a client who is at 41 weeks of gestation and has a positive contraction stress test. For which of the following diagnostic tests should the nurse prepare the client? a. Answer: Biophysical profile (BPP) b. Why?: BPP is performed to further assess fetal well-being. BPP uses a real time ultrasound to visualize physical and physiological characteristics of the fetus and observe for fetal biophysical responses to stimuli. c. Percutaneous umbilical blood sampling is the most common method used for fetal blood sampling and transfusion. d. Amnioinfusion of normal saline or lactated ringer’s is instilled into the amniotic cavity through a transcervical catheter introduced into the uterus to supplement the amount of amniotic fluid. Reduced the severity of variable decelerations caused by cord compression who clients in labor. e. Chorionic villus sampling (CVS) is the assessment of a portion of the placenta, that is aspirated by a needle inserted into through the abdominal wall or intravaginally through the cervix under ultrasound guidance. Performed during the 1 st trimester. 5. A nurse is teaching a new parent about newborn safety. Which of the following instructions should the nurse include in the teaching? a. Answer: “You can share your room with your baby for the next few weeks.” b. Why?: Allows the parent to be readily available to the newborn and learn the newborn’s cues. Instruct the parent to avoid placing the newborn in their bed as it increases the risk for SIDS c. Place the newborn in a sleep sack or a one-piece sleeper. Covering the newborn with a blanket increases risk for SIDS d. Check the temperature of the newborn’s bath water with their elbow because it is more sensitive to temperature. Hot water heater should be set at or below 49 C (120.2 F) to prevent burns e. Instruct the parents to lay the newborn in a bassinet or crib on their back to sleep because sleeping supine on a firm mattress decreases the risk for SIDS 6. A nurse is caring for a client who is in labor and whose fetus is in the right occiput posterior position. The patient is dilated 8cm and reports back pain. Which of the following actions should the nurse take? a. Answer: Apply sacral counterpressure b. Why?: Assist in relieving back labor pain related to fetal posterior position. c. Perform transcutaneous electrical nerve stimulation (TENS) during the first stage of labor d. Transition a client to pattern-paced breathing during this stage of labor. e. Teach the client about biofeedback during the prenatal period for it to be effective during labor. 7. A nurse is caring for a newborn who is undergoing phototherapy to treat hyperbilirubinemia. Which of the following actions should the nurse take? a. Answer: Cover the newborn’s eyes while under the phototherapy light b. Why?: Prevents damage to the newborn’s retinas and corneas from the phototherapy light c. During phototherapy, keep a diaper or other covering over the newborn’s genitals and buttocks, but remove all other clothing and blankets to expose as much body surface area as possible to the phototherapy light. d. Do not apply any cream or moisture to the newborn’s skin because it can absorb heat and cause burns e. Turn and reposition the newborn every 2 to 3 hours to allow for maximum exposure of body surfaces to the phototherapy light. 8. A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take next? a. Answer: Apply internal upward pressure to the presenting part using two gloved fingers.