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Maternal and Newborn Nursing focuses on the care of women during pregnancy, childbirth, and the postpartum period, as well as the health and well-being of the newborn. This course covers topics such as prenatal assessment, labor and delivery management, postpartum care, newborn assessment, and identification of at-risk conditions for both mother and child. Students will learn evidence-based practices, family-centered care principles, and the roles of nurses in promoting optimal outcomes for mothers and infants. Emphasis is placed on health education, cultural competence, and collaboration within the multidisciplinary healthcare team.
Recommended Textbook
Foundations of Maternal Newborn and Womens Health Nursing 7th Edition Murray
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812 Verified Questions
812 Flashcards
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Sample Questions
Q1) Expectant parents ask a prenatal nurse educator, "Which setting for childbirth limits the amount of parent-infant interaction?" Which answer should the nurse provide for these parents in order to assist them in choosing an appropriate birth setting?
A)Birth center
B)Home birth
C)Traditional hospital birth
D)Labor, birth, and recovery room
Answer: C
Q2) Which goal is most appropriate for the collaborative problem of wound infection?
A) The patient will not exhibit further signs of infection.
B) Maintain the patient's fluid intake at 1000 mL/8 hour.
C) The patient will have a temperature of 98.6°F within 2 days.
D) Monitor the patient to detect therapeutic response to antibiotic therapy.
Answer: D
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Q1) A Vietnamese patient who speaks little English is admitted to the labor and birth unit in early labor. The nurse plans to use an interpreter during an initial assessment. Which should the nurse plan to implement with regard to using an interpreter? (Select all that apply.)
A) Face the interpreter when speaking.
B) Listen carefully to what the patient says.
C) Speak slowly and smile when appropriate.
D) Plan to use a male interpreter, even if a female interpreter is available.
E) Ask the interpreter to explain exactly what is said as much as possible, instead of paraphrasing.
Answer: B, C, E
Q2) At the present time, which agency governs surrogate parenting?
A) State law
B) Federal law
C) Individual court decision
D) Protective child services
Answer: C
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Sample Questions
Q1) Which statement with regard to reproductive anatomy and physiology is inaccurate?
A) Female patients who are past puberty and sexually active can become pregnant even if they have not had a menstrual cycle.
B) Puberty symptoms are more prominent in males than females.
C) Females enter puberty earlier than their male counterparts.
D) Secondary sexual characteristics develop during puberty.
Answer: B
Q2) A newly pregnant patient asks the nurse, "What is a false pelvis?" Which statement by the nurse will best explain this anatomy to the patient?
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.
Answer: C
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Q1) A couple is undergoing genetic counseling and are very concerned about the possibility of having a child with a birth defect as a result of a strong family history on both sides of the family. Which statement made by the nurse is evidence of therapeutic communication?
A) "It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history."
B) "Given what you have told me, there is little that anyone can do to improve outcomes."
C) "Although you may feel that you have no options, I can't really discuss these matters as only the physician can provide you with information."
D) "Do you have all your forms filled out correctly? This will make the review easier to accomplish. "
Q2) A patient presents with curly hair and blue eyes. These findings are consistent with A) phenotype.
B) genotype.
C) dominant alleles.
D) recessive traits.
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Q1) An expectant mother, diagnosed with oligohydramnios, asks the nurse what this condition means for the baby. Which statement should the nurse provide for the patient?
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.
Q2) 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.
Q3) What 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
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Q1) While providing education to a primiparous patient regarding the normal changes of pregnancy, what is an important information for the nurse to share regarding 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.
Q2) What is the term for the step in maternal role attainment that relates to the woman giving up certain aspects of her previous life?
A) Fantasy
B) Grief work
C) Role playing
D) Looking for a fit
Q3) Which finding is a positive sign of pregnancy?
A) Amenorrhea
B) Breast changes
C) Fetal movement felt by the woman
D) Visualization of fetus by ultrasound
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Sample Questions
Q1) Which laboratory result would be a cause for concern if exhibited by a patient at her first prenatal visit during the second month of her pregnancy?
A) Rubella titer, 1:6
B) Platelets, 300,000/mm3
C) White blood cell count, 6000/mm3
D) Hematocrit 38%, hemoglobin 13 g/dL
Q2) Which advice to the patient is one of the most effective methods for preventing venous stasis?
A) Sit with the legs crossed.
B) Rest often with the feet elevated.
C) Sleep with the foot of the bed elevated.
D) Wear elastic stockings in the afternoon.
Q3) Use Nägele's rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.
A) February 19
B) January 19
C) January 21
D) February 7
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Q1) Changes in the diet of the pregnant patient who has phenylketonuria would include
A) adding foods high in vitamin C.
B) eliminating drinks containing aspartame.
C) restricting protein intake to <20 g a day.
D) increasing caloric intake to at least 1800 cal/day.
Q2) The traditional diet of Asian women includes little meat and few dairy products and may be low in calcium and iron. The nurse can assist a patient increase her intake of these foods by which action?
A) Suggest that she eat more tofu, bok choy, and broccoli.
B) Suggest that she eat more hot foods during pregnancy.
C) Emphasize the need for increased milk intake during pregnancy.
D) Tell her husband that she must increase her intake of fruits and vegetables for the baby's sake.
Q3) Which patient would require additional calories and nutrients?
A) A 36-year-old female gravida 2, para 1, in her first trimester of pregnancy
B) An 18-year-old female who delivered a 7-lb baby and is bottle feeding
C) A 23-year-old female who had a cesarean birth and is bottle feeding
D) A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
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Q1) 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
Q2) The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which condition?
A) Hemophilia
B) Sickle cell anemia
C) A neural tube defect
D) Abnormal lecithin-to-sphingomyelin ratio
Q3) Which clinical conditions are associated with increased levels of alpha fetoprotein (AFP)? (Select all that apply.)
A) Down syndrome
B) Molar pregnancy
C) Twin gestation
D) Incorrect gestational age assessment of a normal fetus-estimation is earlier in the pregnancy
E) Threatened abortion
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Q1) Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?
A) Hypoglycemia
B) Hypercalcemia
C) Hypoinsulinemia
D) Hypobilirubinemia
Q2) Anti-infective prophylaxis is indicated for a pregnant patient with a history of mitral valve stenosis related to rheumatic heart disease because the patient is at risk of developing
A) hypertension.
B) postpartum infection.
C) bacterial endocarditis.
D) upper respiratory infections.
Q3) Which data found on a patient's health history would place her at risk for an ectopic pregnancy?
A) Ovarian cyst 2 years ago
B) Recurrent pelvic infections
C) Use of oral contraceptives for 5 years
D) Heavy menstrual flow of 4 days' duration
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Q1) A patient has just acknowledged that she is 20 weeks pregnant and confides to the nurse that she has a daily heroin habit. The nurse discusses treatment options for the patient. Which patient statement requires follow-up?
A) "My plan is to visit the outpatient clinic daily for treatment."
B) "I will see my health care provider at least every 2 weeks."
C) "My baby will not have to go through withdrawal when I take methadone."
D) "With oral methadone, my baby and I are at decreased risk of infection."
Q2) Which congenital defects in a newborn are associated with long-term parenting problems? (Select all that apply.)
A) Polydactyl
B) Cleft lip and palate
C) Ventral septal defect
D) Ambiguous genitalia
Q3) A patient who is older than 35 years may have difficulty achieving pregnancy because
A) prepregnancy medical attention is lacking.
B) personal risk behaviors influence fertility.
C) contraceptives have been used for an extended period of time.
D) the ovaries may be affected by the normal aging process.
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Q1) The nurse who elects to practice in the area of obstetrics often hears discussion regarding the four Ps. What are the four Ps that interact during childbirth? (Select all that apply.)
A) Powers
B) Passage
C) Position
D) Passenger
E) Psyche
Q2) The nurse assesses a laboring patient's contraction pattern and notes the frequency at every 3 to 4 minutes, duration 50 to 60 seconds, and the intensity is moderate by palpation. What is the most accurate documentation for this contraction pattern?
A) Stage 1, latent phase
B) Stage 2, latent phase
C) Stage 1, active phase
D) Stage 2, active phase
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Q1) A patient in labor is approaching the transition stage and already has an epidural in place. An additional dose of medication has been prescribed and administered to the patient. Which priority intervention should be performed in order to evaluate the clinical response to treatment?
A) Obtain a pain scale response from the patient based on a 0 to 10 scale.
B) Document maternal blood pressure and fetal heart rates following medication administration and observe for any variations.
C) Document intake and output on the electronic health record (EHR).
D) Increase the flow rate of prescribed parenteral fluid to maintain hydration.
Q2) Which statement is true with regard to the type of pain associated with childbirth experience?
A) Pain is constant throughout the labor experience.
B) Labor pain during childbirth is considered to be an abnormal response.
C) Pain associated with childbirth is self-limiting.
D) Pain associated with childbirth does not allow for adequate preparation.
Q3) The health care provider's prescription reads diphenhydramine (Benadryl), 25 mg IV stat. The medication vial reads diphenhydramine (Benadryl), 50 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Record your answer to one decimal point. _____ mL
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Q1) Which patient is a candidate for internal monitoring with an intrauterine pressure catheter?
A) Obese patient whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds
B) Gravida 1, para 0, whose contractions are 2 to 3 minutes apart, lasting 60 seconds
C) Multigravida whose contractions are 2 minutes apart, lasting 60 to 70 seconds
D) Gravida 2, para 1, in latent phase whose contractions are irregular and mild
Q2) 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) Maternal HIV
Q3) Which clinical finding can be determined only by electronic fetal monitoring?
A) Variability
B) Tachycardia
C) Bradycardia
D) Fetal response to contractions
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Q1) Which aspect of newborn assessment may be limited by the application of a vacuum extractor at birth?
A) Anterior fontanel
B) Coronal suture lines
C) Posterior fontanel
D) Biparietal diameter
Q2) A laboring patient is 10 cm dilated; however, she does not feel the urge to push. The nurse understands that according to laboring down, the advantages of waiting until an urge to push are which of the following? (Select all that apply.)
A) Less maternal fatigue
B) Less birth canal injuries
C) Decreased pushing time
D) Faster descent of the fetus
E) An increase in frequency of contractions
Q3) 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.
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Q1) A pregnant woman develops hypertension. The nurse monitors the patient's blood pressure closely at subsequent visits because the nurse is aware that hypertension is associated with which complication?
A) Abruptio placentae
B) Cardiac abnormalities in the neonate
C) Neonatal jaundice
D) Reduced placental blood flow
Q2) Which pelvic shape is most conducive to vaginal labor and birth?
A) Android
B) Gynecoid
C) Platypelloid
D) Anthropoid
Q3) When reviewing the prenatal record of a patient at 42 weeks' gestation, the nurse recognizes that induction of labor is based upon which indication
A) reduced amniotic fluid volume.
B) cervix 2 cm at last prenatal visit.
C) fundal height measured at the xyphoid process.
D) 1-lb weight gain at each of the last two weekly visits.
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Q1) Which of the following behaviors would be applicable to a nursing diagnosis of Risk for Impaired Parenting?
A) En face behavior is observed between father and infant.
B) Mother relates that she feels exhilarated postbirth.
C) Mother states that she feels excessive fatigue as a result of the childbirth experience.
D) Father displays finger tipping behavior toward infant.
Q2) A postpartum patient calls the clinic and reports to the nurse feelings of fatigue, tearfulness, and anxiety. What is the nurse's most appropriate response at this time?
A) "When did these symptoms begin?"
B) "Sounds like normal postpartum depression."
C) "Are you having trouble getting enough sleep?"
D) "Are you able to get out of bed and provide care for your baby?"
Q3) 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.
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Q1) A postpartum patient has developed deep vein thrombosis (DVT) and treatment with warfarin (Coumadin) has been initiated. Which dietary selection should be modified in view of this treatment regimen?
A) Fresh fruits
B) Milk
C) Lentils
D) Soda
Q2) Early postpartum hemorrhage is defined as a blood loss greater than
A) 500 mL within 24 hours after a vaginal birth.
B) 750 mL within 24 hours after a vaginal birth.
C) 1000 mL within 48 hours after a cesarean birth.
D) 1500 mL within 48 hours after a cesarean birth.
Q3) Nursing measures that help prevent postpartum urinary tract infection include
A) forcing fluids to at least 3000 mL/day.
B) promoting bed rest for 12 hours after birth.
C) encouraging the intake of grapefruit juice and carbonated beverages.
D) discouraging voiding until the sensation of a full bladder is present.
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Q1) A newborn is admitted to the special care nursery with hypothermia. Which complication should the nurse monitor for closely?
A) Hyperglycemia
B) Metabolic acidosis
C) Respiratory acidosis
D) Vasodilation of peripheral blood vessels
Q2) An infant at 39 weeks' gestation was just delivered; included in the protocol for a term infant is an initial blood glucose assessment. The nurse obtains the blood sample and the reading is 58 mg/dL. What is the priority nursing action based upon this reading?
A) Document the finding in the newborn's chart.
B) Double-wrap the newborn under a warming unit.
C) Feed the newborn a 10% dextrose solution.
D) Notify the neonatal intensive care unit (NICU) of the pending admission.
Q3) Which action by the nurse can result in hyperthermia in the newborn?
A) Placing a cap on the newborn
B) Wrapping the newborn in a warm blanket
C) Placing the newborn in a skin to skin position with the mother
D) Placing the newborn in the radiant warmer without attaching the skin probe
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Q1) Inspection of a newborn's head following birth reveals a hard ridged area and significant molding. The anterior and posterior fontanels show no sign of depression. Delivery history indicates that the mother was pushing for over 3 hours and had epidural anesthesia. A vacuum extraction was necessary. Based on this information the nurse would
A) continue to monitor newborn and anticipate that molding will subside.
B) inspect and document location of fontanels to complete the head assessment.
C) contact the pediatric provider.
D) note findings as being within normal limits as a result of the strenuous birth process.
Q2) The nurse is performing the initial assessment of a newborn and notes retractions, nasal flaring, and tachypnea. The nurse will continue to perform a focused assessment on which system?
A) Respiratory
B) Cardiovascular
C) Gastrointestinal
D) Musculoskeletal
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Q1) The nurse is evaluating a newborn's circumcision 30 minutes after the procedure. The nurse notes excessive bleeding coming from the circumcised area. Which priority intervention should the nurse implement at this time?
A) Apply pressure to the site.
B) Continue to observe for another 30 minutes.
C) Apply the diaper tightly over the circumcised area.
D) Apply petroleum jelly to the site with a small piece of gauze.
Q2) A nursing student has been caring for a patient and newborn all morning. After taking the newborn to the nursery for hearing screening, the student is returning the infant to his mother. Which procedure is correct for identifying the newborn?
A) Ask the mother to state her name and the name of her infant.
B) Call out the mother's full name before leaving the infant with her.
C) Have the mother read her printed band number and verify that it matches the infant's number.
D) Return the infant with no special procedure because the student knows the mother and infant.
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Q1) Which hormone is essential for milk production?
A) Estrogen
B) Prolactin
C) Progesterone
D) Lactogen
Q2) Which type of formula should not be diluted before being administered to an infant?
A) Powdered
B) Concentrated
C) Ready to use
D) Modified cow's milk
Q3) Which is an important consideration regarding the storage of breast milk?
A) Can be thawed and refrozen
B) Can be frozen for up to 6 months
C) Should be stored only in glass bottles
D) Can be kept refrigerated for 72 hours
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Q1) A preterm infant is on a ventilator, with intravenous lines and other medical equipment. When the parents come to visit for the first time, what is the most important action by the nurse?
A) Encourage the parents to touch their infant.
B) Reassure the parents that the infant is progressing well.
C) Discuss the care they will give their infant when the infant goes home.
D) Suggest that the parents visit for only a short time to reduce their anxiety.
Q2) Which statement regarding newborns classified as small for gestational age (SGA) is accurate?
A) They weigh less than 2500 G
B) They are born before 38 weeks of gestation.
C) They are below the tenth percentile on gestational growth charts.
D) Placental malfunction is the only recognized cause of this condition.
Q3) Which nursing diagnosis would be considered a priority for a newborn infant who is receiving phototherapy in an isolette?
A) Hypothermia because of phototherapy treatment
B) Impaired skin integrity related to diarrhea as a result of phototherapy
C) Fluid volume deficit related to phototherapy treatment
D) Knowledge deficit (parents) related to initiation of medical therapy
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Q1) The difference between nonphysiologic jaundice (pathologic jaundice) and physiologic jaundice is that nonphysiologic jaundice
A) may result in kernicterus.
B) appears during the first 24 hours of life.
C) begins on the head and progresses down the body.
D) results from the breakdown of excessive erythrocytes not needed after birth.
Q2) The drug-exposed infant often presents with irritability, frantic crying, and is difficult to console. Which nursing measures can be used to prevent this behavior in this high-risk infant? (Select all that apply.)
A) Keep the room well lit.
B) Swaddle the infant.
C) Rock slowly and gently.
D) Coo softly and gently.
E) Avoid pacifier use.
Q3) Transitory tachypnea of the newborn (TTN) is thought to occur as a result of A) a lack of surfactant.
B) hypoinflation of the lungs.
C) inadequate absorption of fetal lung fluid.
D) a delayed vaginal birth associated with meconium-stained fluid.
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Q1) A nurse is leading a discussion regarding options for birth control. Which of the following methods is considered the most reliable?
A) Coitus interruptus
B) Breastfeeding
C) Natural family planning
D) Intrauterine device
Q2) A male patient asks, "Why do I have to use another contraceptive? I had a vasectomy last week." The best response is
A) "A vasectomy is only 80% effective."
B) "A vasectomy is not effective in all men."
C) "Semen may contain sperm for 6 months following a vasectomy."
D) "Complete sterilization doesn't occur until all sperm have left the system."
Q3) The method of contraception that is considered the safest for women is a(n)
A) IUD.
B) diaphragm.
C) male condom.
D) oral contraceptive.
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Q1) The procedure in which ova are removed by laparoscopy, mixed with sperm, and the embryo(s) returned to the woman's uterus is
A) in vitro fertilization (IVF).
B) tubal embryo transfer (TET).
C) therapeutic insemination (IUI).
D) gamete intrafallopian transfer (GIFT).
Q2) A woman who is undergoing infertility testing states, "My husband won't discuss this with me. I don't think he cares about or wants a baby." The nurse's ideal response is
A) "You should confront him about this."
B) "He probably doesn't understand your concern."
C) "Men are sometimes less eager to have children."
D) "It may be harder for him to express his feelings."
Q3) A couple who has not achieved a successful pregnancy is scheduled to meet with a fertility specialist. Which simple evaluation is usually the first test to be performed?
A) Semen analysis
B) Testicular biopsy
C) Endometrial biopsy
D) Hysterosalpingography
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Q1) Which are the most common sites of breast cancer metastasis?
A) Kidneys
B) Bones and liver
C) Heart and blood vessels
D) Skin
Q2) A 45-year-old patient asks how often she should have a mammogram. The most appropriate answer is
A) whenever she feels a lump.
B) every year beginning at age 40.
C) they are unnecessary until age 50.
D) every year if you have risk factors.
Q3) Which treatment option minimizes the development of lymphedema in the surgical management of a patient with breast cancer?
A) Radical mastectomy procedure
B) Radiation therapy
C) Sentinel lymph node mapping
D) Ultrasound
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