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100

A nurse knows she can promote parental-infant bonding by encouraging the parents to complete which of the following during the golden hour?

a. Use a low-pitched voice to speak to the infant
b. Allow the nursing staff to assume the infant care during hospitalization so they may rest
c. Hold and cuddle the infant closely
d. Allow the infant to sleep in the parental bed between the parents

c. Hold and cuddle the infant closely

100

A mother of a preterm baby is performing kangaroo care in the neonatal nursery. Which of the following responses would the nurse evaluate as a positive neonatal outcome?

a. Respiratory rate of 70.
b. Temperature of 97.0°F.
c. Smacking of the lips
d. Flaring of the baby's nares.

c. Smacking of the lips

100

When questioned about bruises, a woman states, "It was an accident. My husband just had a bad day at work. Hes being so gentle now and even brought me flowers. Hes going to get a new job, so it won't happen again." This client is in which phase of the cycle of battering?

A. Phase I: The tension-building phase
B. Phase II: The acute battering incident phase
C. Phase III: The honeymoon phase
D. Phase IV: The resolution and reorganization phase

C. Phase III: The honeymoon phase

100

A pregnant woman at the clinic has just been diagnosed with gestational diabetes. What should the nurse include in her education about possible birthing complications related to her condition?

a. Birth trauma

b. Precipitous labor

c. Respiratory distress

d. Hypoglycemia

e. PPH

a. Birth trauma

c. Respiratory distress

d. Hypoglycemia

Give an example of a birth trauma:

100

In preparing for the actual birth, which fetal presentation would a nurse be least likely to find?

a) Transverse lie

b) Breech

c) Shoulder

d) Oblique lie

c) Shoulder

What are complications of a shoulder presentation?

200

A nurse is providing education to a mom choosing to suppress lactation about ways she can relieve engorgement. Which of the following is the best response by the nurse?

a. “If you were breastfeeding this wouldn’t happen”
b. “Wear a loose bra to relieve the tightness”
c. “Apply cabbage leaves to reduce your milk production”
d. “Avoid your baby because his cries stimulate milk production”

c. “Apply cabbage leaves to reduce your milk production”

200

During an assessment of an infant, you note that when the infant's head is turned to the right side, the leg and arm on the right side will extend, while the leg and arm on the left side will flex. You document this as what type of reflex?

A. Rooting Reflex
B. Sucking Reflex
C. Moro Reflex
D. Tonic Neck Reflex

D. Tonic Neck Reflex

200

Rank the pelvic shapes from most favorable to least favorable for a vaginal delivery

Android

Gynecoid

Anthropoid

Platepelloid 

Gynecoid

Anthropoid

Android

Platypelloid 

200

You are working in a labor and delivery unit as a new graduate nurse. Your patient has lost 2,400 mL of blood following vaginal delivery of a macrosomia newborn. During your second fundal check, the patient begins dispelling clots the size of an egg. Which of the following medications is a first-line defense for PPH? 

a. Oxytocin 

b. Nifedipine 

c. Cytotec

d. Hemabate (carboprost) 

a. Oxytocin 

200

A nurse prepares to administer a Vitamin K injection to a newborn, and the mother asks the nurse why her infant needs the injection. The best response by the nurse would be:

a. Your newborn needs Vitamin K to develop immunity.

b. The Vitamin K will protect your newborn from being jaundiced.

c. Newborns have sterile bowels, and Vitamin K promotes the growth of bacteria in the bowel.

d. Newborns are deficient in Vitamin K, and this injection prevents your newborn from bleeding.

d. Newborns are deficient in Vitamin K, and this injection prevents your newborn from bleeding.

300

A woman in her 3rd trimester advises the nurse that she wishes to breastfeed her baby, "but I don't think my nipples are right." Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time?

A. Advise the client that it is unlikely that she will be able to breastfeed.
B. Refer to the client to a lactation consultant for advice.
C. Call the labor room and notify them that a client with inverted nipples will be admitted.
D. Teach the woman exercises to evert her nipples.

B. Refer to the client to a lactation consultant for advice.

300

A nurse in the newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs if noted in the newborn infant would alert the nurse to the possibility of this syndrome?

a. Hypotension and Bradycardia
b. Tachypnea and retractions
c. Acrocyanosis and grunting
d. The presence of a barrel chest with grunting

b. Tachypnea and retractions

300

Name a few things that can be tested with a heel stick:

Newborn screening (PKU, hypothyroidism, cystic fibrosis, other rare genetic conditions) glucose

300

Which of the following are indicators of true labor?

a. Bloody show 

b. Contractions slowing down with movement 

c. Feeling contractions in the back 

d. Progressive cervical changes

e. Fetal heart rate accelerations 

f. Membrane rupture 

c. Feeling contractions in the back 

d. Progressive cervical changes

300

List Leopold’s maneuvers in order

1. What is the presenting part?

2. On which maternal side is the fetal back located? 

3. What fetal part is located in the fundus?

4. Is the fetal head flexed and engaged in the pelvis?

Maneuver 1: What fetal part (head or buttocks) is located in the fundus (top of the uterus)?

Maneuver 2: On which maternal side is the fetal back located? (Fetal heart tones are best auscultated through the back of the fetus.)

Maneuver 3: What is the presenting part? (Bottom of uterus)

Maneuver 4: Is the fetal head flexed and engaged in the pelvis? (sides of belly)

400

The nurse has just administered ibuprofen (Motrin) to a child with a temperature of 38.8° C (102° F). The nurse should also take which action?

a. Withhold oral fluids for 8 hours.
b. Sponge the child with cold water.
c. Plan to administer salicylate in 4 hours.
d. Remove excess clothing and blankets from the child.

d. Remove excess clothing and blankets from the child.

400

A nurse is working in a community health clinic, screening new mothers for postpartum depression. Which of the following statements best aligns with postpartum psychosis?

A. “This morning I found a strange man holding my baby, I called the police and they told me he was my husband. I didn’t recognize him”
B. “I have been crying every day for three months and I should be ecstatic. I wanted to get pregnant for years”
C. “I have felt like I can’t do anything right. I go from happy to crying frequently”
D. “I have not been able to sleep, I am too worried about SIDS” 

A. “This morning I found a strange man holding my baby, I called the police and they told me he was my husband. I didn’t recognize him”

400

A nurse is preparing to perform a fundal assessment on a postpartum client. The initial nursing action in performing this assessment is which of the following?

A) Ask the client to turn on her side

B) Ask the client to lie flat on her back with the knees and legs flat and straight

C) Ask the mother to urinate and empty her bladder

D) Massage the fundus gently before determining the level of the fundus.

C) Ask the mother to urinate and empty her bladder

Bonus: describe how to perform a fundal assessment, and what the uterus should feel like.

400

With regard to systemic analgesics administered during labor, nurses should be aware that:

A) systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier.

B) effects on the fetus and newborn can include decreased alertness and delayed sucking.

C) IM administration is preferred over IV administration.

D) IV patient-controlled analgesia (PCA) results in increased use of an analgesic.

B) effects on the fetus and newborn can include decreased alertness and delayed sucking.

400

A new mother who is breast feeding her infant ask the nurse. "What kind of stools will my baby have, and how many will there be during the next month?" What is the nurses best response?

A) one or two well formed yellow orange stools per day

B) as many as 6-10 small, loose, yellow stools per day

C) A well formed brown stool at least every other day

D) frequent loose, green stools

B) as many as 6-10 small, loose, yellow stools per day

500

Fetal bradycardia is most common during:

A. Intraamniotic infection
B. Fetal anemia
C. Prolonged umbilical cord compression
D. Tocolytic treatment using ritodrine

C. Prolonged umbilical cord compression

500

On assessment of a client who is 30 minutes into the fourth stage of labor, the nurse finds the client's perineal pad saturated with blood and blood soaked into the bed linen under the client's buttocks. The nurse's initial action is which of the following.

A. Call the physician
B. Assess the client's vital signs
C. Gently massage the uterine fundus
D. Administer a 300ml bolus of a 20 units/L Oxytocin(Pitocin) solution

C. Gently massage the uterine fundus

500

Upon assessment of a woman in labor, the nurse saying the baby is breech, refers to the fetal:

a. Lie

b. Attitude

c. Position

d. Presentation

d. Presentation 

Bonus: give an example of fetal lie, attitude, and position.

500

Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased?

a) Semirecumbent

b) Sitting

c) Squatting

d) Side-lying

c) Squatting

500

The nurse assisted with the delivery of a newborn. Which nursing action is most effective in preventing heat loss by evaporation?

a. Warming the crib pad

b. Closing the doors to the room

c. Drying the infant with a warm blanket

d. Turning on the overhead radiant warmer

c. Drying the infant with a warm blanket

What are the other examples of?

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