Maternity Nursing (OB Maternal & Newborn) PROMETRIC 2022 Practice Quiz #1 | 75 Questions

Correct Answer: A. (Endometritis). Endometritis is an infection of the uterine lining and can occur after prolonged rupture of membranes. Symptoms include swelling of the abdomen, abnormal vaginal bleeding or discharge, fever, discomfort with bowel movement, and pain in the lower abdomen or pelvic region.

Correct Answer: B. (The ultrasound identifies blood flow through the umbilical cord). Before amniocentesis, a routine ultrasound is valuable in locating the placenta, locating a pool of amniotic fluid, and showing the physician where to insert the needle. Color Doppler imaging ultrasonography identifies blood flow through the umbilical cord. A routine ultrasound does not accomplish this.

Correct Answer: B. (Protamine sulfate). Protamine sulfate is a heparin antagonist given intravenously to counteract bleeding complications caused by heparin overdose.

Correct Answer: D. (Check the vital signs every 2 to 4 hours). While caring for an infant receiving phototherapy for treatment of jaundice, vital signs are checked every 2 to 4 hours because hyperthermia can occur due to the phototherapy lights.

Correct Answer: D. (Perineum). A bilateral pudendal block is used for vaginal deliveries to relieve pain primarily in the perineum and vagina. Pudendal block anesthesia is adequate for episiotomy and its repair.

Correct Answer: A. “Nausea and vomiting can be decreased if I eat a few crackers before arising” Eating dry crackers before arising can assist in decreasing the common discomfort of nausea and vomiting. Avoiding strong food odors and eating a high-protein snack before bedtime can also help.

Correct Answer: C. Taking hold Beginning after completion of the taking-in phase, the taking-hold phase lasts about 10 days. During this phase, the client is concerned with her need to resume control of all facets of her life in a competent manner. At this time, she is ready to learn self-care and infant care skills.

Correct Answer: A. Activity limited to bed rest Treatment of partial placenta previa includes bed rest, hydration, and careful monitoring of the client’s bleeding.

Correct Answer: C. Breastfeeding the neonate at frequent intervals Prevention of breast engorgement is key. The best technique is to empty the breast regularly while feeding. Engorgement is less likely when the mother and neonate are together, as in single-room maternity care continuous rooming-in, because nursing can be done conveniently to meet the neonate’s and mother’s needs.

Correct Answer: A. Startle reflex The Moro, or startle, reflex occurs when the neonate responds to stimuli by extending the arms, hands open, and then moving the arms in an embracing motion. The Moro reflex, present at birth, disappears at about age 3 months.

Correct Answer: A. Tailor sitting Tailor sitting is an excellent exercise that helps to strengthen the client’s back muscles and also prepares the client for the process of labor. The client should be encouraged to rest periodically during the day and avoid standing or sitting in one position for a long time.

Correct Answer: D. (Apply gentle pressure to the site with a sterile gauze pad). If bleeding occurs after circumcision, the nurse should first apply gentle pressure on the area with sterile gauze. Bleeding is not common but requires attention when it occurs.

Correct Answer: B. (Rigid, board-like abdomen). The most common assessment finding in a client with abruption placenta is a rigid or boardlike abdomen. Pain, usually reported as a sharp stabbing sensation high in the uterine fundus with the initial separation, also is common.

Correct Answer: B. (Notify the physician immediately). The nurse should contact the physician immediately because the client is most likely experiencing hypotonic uterine contractions. These contractions tend to be painful but ineffective. The usual treatment is oxytocin augmentation unless cephalopelvic disproportion exists.

Correct Answer: A. (High-pitched speech with tonal variations). Providing stimulation and speaking to neonates is important. Some authorities believe that speech is the most important type of sensory stimulation for a neonate. Neonates respond best to speech with tonal variations and a high-pitched voice. A neonate can hear all sound louder than about 55 decibels.

Correct Answer: D. (Transitional phase). The transitional phase of labor extends from 8 to 10 cm; it is the shortest but most difficult and intense for the patient.

Correct Answer: B. (“No, it can initiate premature uterine contractions.”) Castor oil can initiate premature uterine contractions in pregnant women. It also can produce other adverse effects, but it does not promote sodium retention.

Correct Answer: B. (Fluid volume deficit). If bleeding and clots are excessive, this patient may become hypovolemic. Pad count should be instituted. Blood volume expands during pregnancy, and a considerable portion of the weight of a pregnant woman is retained water.

Correct Answer: A. (Fetal body flexion or extension). Fetal attitude—the overall degree of body flexion or extension—determines the type of molding in the head of a neonate.

Correct Answer: A. (The membranes must rupture). Internal fetal heart rate monitoring uses an electronic transducer connected directly to the fetal skin. A wire electrode is attached to the fetal scalp or other body parts through the cervical opening and is connected to the monitor. Internal EFM can be applied only after the patient’s membranes have ruptured when the fetus is at least at the -1 station, and when the cervix is dilated at least 2 cm.

Correct Answer: A. (Around the pelvic girdle) During most of the first stage of labor, pain centers around the pelvic girdle. During the late part of this stage and the early part of the second stage, pain spreads to the upper legs and perineum. The pain of early labor is referred to T10-T12 dermatomes such that the pain is felt in the lower abdomen, sacrum, and back. This pain is dull in character and is not always sensitive to opioid drugs.

Correct Answer: D. (Tubal or ectopic pregnancy) Women taking the mini pill have a higher incidence of tubal and ectopic pregnancies, possibly because progestin slows ovum transport through the fallopian tubes.

Correct Answer: C. (Proteinuria, headaches, double vision) A patient with pregnancy-induced hypertension complains of a headache, double vision, and sudden weight gain. A urine specimen reveals proteinuria.

Correct Answer: A. (Oxytocin causes water intoxication) The nurse should monitor fluid intake and output because prolonged oxytocin infusion may cause severe water intoxication, leading to seizures, coma, and death. In addition, oxytocin may cause water intoxication via an antidiuretic hormone-like activity when administered in excessive doses with electrolyte-free solution.

Correct Answer: C. (Cools incubator walls) A common source of radiant heat loss includes cool incubator walls and windows. Radiant heat loss constitutes the transfer of heat from an infant’s warm skin, via infrared electromagnetic waves, to the cooler surrounding walls that absorb heat.

Correct Answer: D. (Nausea and Vomiting) Bethanechol will increase GI motility, which may cause nausea, belching, vomiting, intestinal cramps, and diarrhea. Bethanechol directly stimulates cholinergic receptors in the parasympathetic nervous system while stimulating the ganglia to a lesser extent.

Correct Answer: D. (Transitional phase) The transitional phase, which lasts 1 to 3 hours, is the shortest but most difficult part of the first stage of labor. This phase is characterized by intense uterine contractions that occur every 1 ½ to 2 minutes and last 45 to 90 seconds.

Correct Answer: B. (Lubricate her nipples with expressed milk before feeding) Measures that help relieve nipple soreness in a breastfeeding patient include lubricating the nipples with a few drops of expressed milk before feedings, applying ice compresses just before feeding, letting the nipples air dry after feedings, and avoiding the use of soap on the nipples.

Correct Answer: B. (Between 16 and 20 weeks’ gestation) A pregnant woman usually can detect fetal movement (quickening) between 16 and 20 weeks’ gestation.

Correct Answer: A. (Bright red blood) Lochia should never contain large clots, tissue fragments, or membranes. A foul odor may signal infection, as may absence of lochia.

Correct Answer: C. (“What is your expected due date?”) When obtaining the history of a patient who may be in labor, the nurse’s highest priority is to determine her current status, particularly her due date, gravidity, and parity. Gravidity and parity affect the duration of labor and the potential for labor complications. Later, the nurse should ask about chronic illness, allergies, and support persons.

Correct Answer: B. (Every 15 minutes) During the second stage of labor, the nurse should assess the strength, frequency, and duration of contraction every 15 minutes. If maternal or fetal problems are detected, more frequent monitoring is necessary.

Correct Answer: A. (Blurred vision). Blurred vision or other visual disturbance, excessive weight gain, edema, and increased blood pressure may signal severe preeclampsia. This condition may lead to eclampsia, which has potentially serious consequences for both the patient and fetus.

Correct Answer: B. (The patient has a child with cystic fibrosis). Cystic fibrosis is a recessive trait; each offspring has a one in four chance of having the trait or the disorder.

Correct Answer: C. 3 (Full days of elevated basal body temperature and clear, thin cervical mucus). Ovulation (the period when pregnancy can occur) is accompanied by a basal body temperature increase of 0.7 degrees F to 0.8 degrees F and clear, thin cervical mucus.

Correct Answer: A. (At the beginning of each fetal movement). An NST assesses the FHR during fetal movement. In a healthy fetus, the FHR accelerates with each movement. By pushing the control button when a fetal movement starts, the client marks the strip to allow easy correlation of fetal movement with the FHR.

Correct Answer: B. (“If I have blurred or double vision, I should call the clinic immediately.”) Blurred or double vision may indicate hypertension or preeclampsia and should be reported immediately. It can affect the visual pathways, from the anterior segment to the visual cortex.

Correct Answer: B. (“I support your commitment; however, you may have to supplement each feeding with formula.”) Recent breast reduction surgeries are done in a way to protect the milk sacs and ducts, so breastfeeding after surgery is possible. Still, it’s good to check with the surgeon to determine what breast reduction procedure was done. There is the possibility that reduction surgery may have decreased the mother’s ability to meet all of her baby’s nutritional needs, and some supplemental feeding may be required. Preparing the mother for this possibility is extremely important because the client’s psychological adaptation to mothering may be dependent on how successfully she breast-feeds.

Correct Answer: B. (Instructing the client to use two or more peri pads to cushion the area). Using two or more peripads would do little to reduce the pain or promote perineal healing. A fourth-degree perineal laceration is the injury to the perineum involving the anal sphincter complex and anorectal mucosa.

Correct Answer: B. (Grapelike clusters). In a client with gestational trophoblastic disease, an ultrasound performed after the 3rd month shows grapelike clusters of transparent vesicles rather than a fetus. The vesicles contain a clear fluid and may involve all or part of the decidual lining of the uterus. Usually, no embryo (and therefore no fetus) is present because it has been absorbed.

Correct Answer: C. (1 cm above the ischial spines). Fetal station — the relationship of the fetal presenting part to the maternal ischial spines — is described in the number of centimeters above or below the spines. A presenting part above the ischial spines is designated as –1, –2, or –3.

Correct Answer: D. (The baby’s lips smacking). Assessing the attachment process for breast-feeding should include all of the answers except the smacking of lips. A baby who’s smacking his lips isn’t well attached and can injure the mother’s nipples.

Correct Answer: D. (Ultrasound). Ultrasound is used between 18 and 40 weeks’ gestation to identify normal fetal growth and detect fetal anomalies and other problems.

Correct Answer: C. (The fetus isn’t in distress at this time). The BPP evaluates fetal health by assessing five variables: fetal breathing movements, gross body movements, fetal tone, reactive fetal heart rate, and qualitative amniotic fluid volume. A normal response for each variable receives 2 points; an abnormal response receives 0 points. A score between 8 and 10 is considered normal, indicating that the fetus has a low risk of oxygen deprivation and isn’t in distress. A fetus with a score of 6 or lower is at risk for asphyxia and premature birth; this score warrants detailed investigation. The BPP may or may not be repeated if the score isn’t within normal limits.

Correct Answer: C. (“What changes have you made at home to get ready for the baby?”) During the third trimester, the pregnant client typically perceives the fetus as a separate being. To verify that this has occurred, the nurse should ask whether she has made appropriate changes at home such as obtaining infant supplies and equipment.

Correct Answer: B. (Preparing for immediate delivery). This question requires an understanding of station as part of the intrapartum assessment process. Based on the client’s assessment findings, this client is ready for delivery, which is the nurse’s top priority.

Correct Answer: A. (Change the client’s position). Variable decelerations in fetal heart rate are an ominous sign, indicating compression of the umbilical cord. Changing the client’s position from supine to side-lying may immediately correct the problem.

Correct Answer: A. (Risk for deficient fluid volume related to hemorrhage). Hemorrhage jeopardizes the client’s oxygen supply — the first priority among human physiological needs. Therefore, the nursing diagnosis of Risk for deficient fluid volume related to hemorrhage takes priority over-diagnoses of Risk for Infection, Pain, and Urinary retention.

Correct Answer: A. (Lactation). Lactation is an example of a progressive physiological change that occurs during the postpartum period. Lactation is the process of milk production.

Correct Answer: B. (Abruptio placentae). The major maternal adverse reactions from cocaine use in pregnancy include spontaneous abortion first, not third, trimester abortion and abruptio placentae. The hypertension and increased levels of catecholamines caused by cocaine abuse are thought to be responsible for a vasospasm in the uterine blood vessels that causes placental separation and abruption.

Correct Answer: D. (Nonstress testing is performed weekly until 32 weeks’ gestation). For most clients with type 1 diabetes mellitus, non-stress testing is done weekly until 32 weeks’ gestation and twice a week to assess fetal well-being.

Correct Answer: A. (Prevent seizures). The chemical makeup of magnesium is similar to that of calcium and, therefore, magnesium will act like calcium in the body. As a result, magnesium will block seizure activity in a hyper-stimulated neurologic system by interfering with signal transmission at the neuromuscular junction.

Correct Answer: B. (7 days). The blastocyst takes approximately 1 week to travel to the uterus for implantation. Implantation is a process in which a developing embryo, moving as a blastocyst through a uterus, makes contact with the uterine wall and remains attached to it until birth.

Correct Answer: A. (Shortens the second stage of labor). An episiotomy serves several purposes. It shortens the second stage of labor, substitutes a clean surgical incision for a tear, and decreases undue stretching of perineal muscles. An episiotomy helps prevent tearing of the rectum but it does not necessarily relieve pressure on the rectum. Tearing may still occur.

Correct Answer: D. (Physician who will attend the delivery of the infant). The fetus of a cocaine-addicted mother is at risk for hypoxia, meconium aspiration, and intrauterine growth retardation (IUGR). Therefore, the nurse must notify the physician of the client’s cocaine use because this knowledge will influence the care of the client and neonate. The information is used only in relation to the client’s care.

Correct Answer: B. (Pregnancy should be avoided for 3 months after the immunization). After administration of rubella vaccine, the client should be instructed to avoid pregnancy for at least 3 months to prevent the possibility of the vaccine’s toxic effects to the fetus.

Correct Answer: D. (Maintain a patent airway). The priority for the pregnant client having a seizure is to maintain a patent airway to ensure adequate oxygenation to the mother and the fetus. Additionally, oxygen may be administered by face mask to prevent fetal hypoxia.

Correct Answer: A. (Yogurt). In some birth settings, intravenous therapy is not used with low-risk clients. Thus, clients in early labor are encouraged to eat healthy snacks and drink fluid to avoid dehydration. Yogurt, which is an excellent source of calcium and riboflavin, is soft and easily digested. During pregnancy, gastric emptying time is delayed. In most hospital settings, clients are allowed only ice chips or clear liquids.

Correct Answer: A. (Inspect the perineum). When the client says the baby is coming, the nurse should first inspect the perineum and observe for crowning to validate the client’s statement. If the client is not delivering precipitously, the nurse can calm her and use appropriate breathing techniques.

Correct Answer: A. (Prevent uterine inversion). Using both hands to assess the fundus is useful for preventing uterine inversion. The recent uterine inversion with placenta already separated from it may often be replaced by manually pushing up on the fundus with the palm and fingers in the direction of the long axis of the vagina.

Correct Answer: (Answer: A, C, & D). The emergence of family unit, sexual intimacy relationship continuing and defining one’s individual roles represent interdependent behaviors associated with the letting-go phase. During the letting go phase, the woman finally accepts her new role and gives up her old roles like being a childless woman or just a mother of one child.

Correct Answer: C. (Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn). One week after birth the woman should exhibit behaviors characteristic of the dependent-independent or taking-hold stage. She still has needs for nurturing and acceptance by others.

Correct Answer: A. (Accreta). Placenta accreta is the most common kind of placental adherence seen in pregnant women and is characterized by slight penetration of myometrium.

Correct Answer: D. (Transvaginal ultrasound). An ultrasound is the method of biophysical assessment of the infant that is performed at this gestational age. Transvaginal ultrasound is especially useful for obese women, whose thick abdominal layers cannot be penetrated adequately with the abdominal approach.

Correct Answer: C. (Is considered to have a negative result if no late decelerations are observed with the contractions). No late decelerations indicate a positive CST result.

Correct Answer: C. (Geographic). The fourth category is correctly referred to as the sociodemographic risk category. Several risk factors for high-risk pregnancy were present before pregnancy, including multiple pregnancies, maternal age under 16 or over 35 years, and interval between pregnancies less than one year.

Correct Answer: D. (“This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”) The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements.

Correct Answer: B. (Maternal diabetes mellitus and postmaturity). The contraction stress test helps predict how the baby will do during labor. The test triggers contractions and registers how the baby’s heart reacts. A normal heartbeat is a good sign that the baby will be healthy during labor.

Correct Answer: A. (Doppler blood flow analysis). Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of high-risk pregnancy due to intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labor.

Correct Answer: (B, C, & D). The fetal alarm signal is reached when no fetal movements are noted for a period of 12 hours. Fetal movement is one show of a baby’s health in the womb. Each woman should learn the normal pattern and number of movements for her own baby. A change in the normal pattern or number of fetal movements may mean the baby is under stress. And it’s not normal for a baby to stop moving with the start of labor.

Correct Answer: (B & C). Ultrasound is used prior to the procedure as a visualization aid to assist with insertion of the transabdominal needle. RhoGAM is a prescription medicine that is used to prevent Rh immunization, a condition in which an individual with Rh-negative blood develops antibodies after exposure to Rh-positive blood. RhoGAM is administered by intramuscular (IM) injection. RhoGAM is purified from human plasma containing anti-Rh (anti-D).

Correct Answer: B. (Infants with asymmetric IUGR have the potential for normal growth and development). The infant with asymmetric IUGR has the potential for normal growth and development. SGA infants have reduced brain capacity. The asymmetric form occurs in the later stages of pregnancy.

Correct Answer: C. (Impaired bowel motility related to pain medication and immobility). Impaired bowel motility caused by surgical anesthesia, pain medication, and immobility is the priority nursing diagnosis and addresses the potential problem of a paralytic ileus.

Correct Answer: C. (Gonorrhea). Erythromycin ointment is instilled into the lower conjunctiva of each eye within 2 hours after birth to prevent ophthalmia neonatorum, an infection caused by gonorrhea (C), and inclusion conjunctivitis, an infection caused by Chlamydia. The infant may be exposed to these bacteria when passing through the birth canal.

Correct Answer: C. (Encourage the mother to stop feeding for a few minutes and comfort the infant). The infant is becoming frustrated and so is the mother; both need a time out. The mother should be encouraged to comfort the infant and to relax herself. After such a time out, breastfeeding is often more successful.