Title:** **Maternal-Newborn Nursing
**
Mastery: Intrapartum, Postpartum, and
Newborn Care**
---
### Question 1 of 78
A nurse is assessing a client who is at 38 weeks of gestation and reports a gush of fluid from the vagina.
Which finding indicates rupture of membranes?
A) Nitrazine paper turns yellow
B) Fern-like pattern on a microscope slide
C) Fluid that is dark amber in color
D) Negative pool test result
💫RATIONALE✔️✔️: Amniotic fluid shows ferning (B) on slide and turns nitrazine blue. Dark amber fluid is
meconium-stained.
💫ANSWER✔️✔️: B) Fern-like pattern on a microscope slide
---
### Question 2 of 78
A nurse is caring for a client who is receiving oxytocin (Pitocin) for induction of labor. The nurse notes
contractions every 1.5 minutes lasting 90 seconds and late decelerations. Which action should the nurse
take first?
,A) Decrease the oxytocin infusion rate
B) Position the client on her left side
C) Administer oxygen via face mask
D) Stop the oxytocin infusion
💫RATIONALE✔️✔️: Late decelerations with tachysystole require immediate stopping of oxytocin (D) to
reduce uterine activity and restore placental blood flow.
💫ANSWER✔️✔️: D) Stop the oxytocin infusion
---
### Question 3 of 78
**Select-All-That-Apply (SATA):** A nurse is assessing a newborn who is 5 minutes old. Which findings
should the nurse include in the Apgar score? (Select all that apply.)
A) Heart rate
B) Respiratory effort
C) Muscle tone
D) Reflex irritability
E) Bilirubin level
💫RATIONALE✔️✔️: Apgar includes heart rate (A), respiratory effort (B), muscle tone (C), reflex irritability
(D), and color. Bilirubin (E) is not part of Apgar.
💫ANSWER✔️✔️: A, B, C, D
---
### Question 4 of 78
,A nurse is providing education to a client who is at 10 weeks of gestation about the need for folic acid
supplementation. Which statement by the client indicates understanding?
A) "Folic acid will prevent me from getting anemia during pregnancy."
B) "Folic acid helps reduce the risk of neural tube defects in my baby."
C) "I need folic acid to prevent high blood pressure during labor."
D) "Folic acid will make my baby's bones strong."
💫RATIONALE✔️✔️: Folic acid (400-800 mcg daily) prevents neural tube defects (B) such as spina bifida. It
also helps with RBC production but primary prevention is neural tube closure.
💫ANSWER✔️✔️: B) "Folic acid helps reduce the risk of neural tube defects in my baby."
---
### Question 5 of 78
A nurse is caring for a client who is 6 hours postpartum after a vaginal delivery. The client’s fundus is
firm and at the umbilicus, but she is saturating a perineal pad every 15 minutes with bright red blood.
Which action should the nurse take first?
A) Massage the fundus
B) Assess the perineum for lacerations
C) Administer methylergonovine (Methergine)
D) Notify the healthcare provider
💫RATIONALE✔️✔️: Heavy bright red bleeding with firm fundus suggests lacerations. First assess
perineum (B). Massaging firm fundus is unnecessary.
💫ANSWER✔️✔️: B) Assess the perineum for lacerations
, ---
### Question 6 of 78
A nurse is assessing a newborn who is 2 hours old. The newborn’s respiratory rate is 70 breaths/min
with nasal flaring and grunting. Which action should the nurse take first?
A) Place the newborn on continuous pulse oximetry
B) Notify the healthcare provider
C) Suction the newborn’s mouth and nose
D) Check the newborn’s oxygen saturation
💫RATIONALE✔️✔️: Respiratory distress requires assessment of oxygenation first: place on pulse
oximetry (A) then notify provider. Suctioning if needed later.
💫ANSWER✔️✔️: A) Place the newborn on continuous pulse oximetry
---
### Question 7 of 78
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to a client who is
breastfeeding her newborn. Which statements by the client indicate understanding? (Select all that
apply.)
A) "I will feed my baby every 2 to 3 hours during the day."
B) "My baby should have at least 6 to 8 wet diapers per day by day 4."
C) "I will wash my nipples with antibacterial soap before each feeding."
D) "I can take ibuprofen for after-birth pain while breastfeeding."
E) "If my baby falls asleep after 5 minutes of feeding, that means he is full."
**
Mastery: Intrapartum, Postpartum, and
Newborn Care**
---
### Question 1 of 78
A nurse is assessing a client who is at 38 weeks of gestation and reports a gush of fluid from the vagina.
Which finding indicates rupture of membranes?
A) Nitrazine paper turns yellow
B) Fern-like pattern on a microscope slide
C) Fluid that is dark amber in color
D) Negative pool test result
💫RATIONALE✔️✔️: Amniotic fluid shows ferning (B) on slide and turns nitrazine blue. Dark amber fluid is
meconium-stained.
💫ANSWER✔️✔️: B) Fern-like pattern on a microscope slide
---
### Question 2 of 78
A nurse is caring for a client who is receiving oxytocin (Pitocin) for induction of labor. The nurse notes
contractions every 1.5 minutes lasting 90 seconds and late decelerations. Which action should the nurse
take first?
,A) Decrease the oxytocin infusion rate
B) Position the client on her left side
C) Administer oxygen via face mask
D) Stop the oxytocin infusion
💫RATIONALE✔️✔️: Late decelerations with tachysystole require immediate stopping of oxytocin (D) to
reduce uterine activity and restore placental blood flow.
💫ANSWER✔️✔️: D) Stop the oxytocin infusion
---
### Question 3 of 78
**Select-All-That-Apply (SATA):** A nurse is assessing a newborn who is 5 minutes old. Which findings
should the nurse include in the Apgar score? (Select all that apply.)
A) Heart rate
B) Respiratory effort
C) Muscle tone
D) Reflex irritability
E) Bilirubin level
💫RATIONALE✔️✔️: Apgar includes heart rate (A), respiratory effort (B), muscle tone (C), reflex irritability
(D), and color. Bilirubin (E) is not part of Apgar.
💫ANSWER✔️✔️: A, B, C, D
---
### Question 4 of 78
,A nurse is providing education to a client who is at 10 weeks of gestation about the need for folic acid
supplementation. Which statement by the client indicates understanding?
A) "Folic acid will prevent me from getting anemia during pregnancy."
B) "Folic acid helps reduce the risk of neural tube defects in my baby."
C) "I need folic acid to prevent high blood pressure during labor."
D) "Folic acid will make my baby's bones strong."
💫RATIONALE✔️✔️: Folic acid (400-800 mcg daily) prevents neural tube defects (B) such as spina bifida. It
also helps with RBC production but primary prevention is neural tube closure.
💫ANSWER✔️✔️: B) "Folic acid helps reduce the risk of neural tube defects in my baby."
---
### Question 5 of 78
A nurse is caring for a client who is 6 hours postpartum after a vaginal delivery. The client’s fundus is
firm and at the umbilicus, but she is saturating a perineal pad every 15 minutes with bright red blood.
Which action should the nurse take first?
A) Massage the fundus
B) Assess the perineum for lacerations
C) Administer methylergonovine (Methergine)
D) Notify the healthcare provider
💫RATIONALE✔️✔️: Heavy bright red bleeding with firm fundus suggests lacerations. First assess
perineum (B). Massaging firm fundus is unnecessary.
💫ANSWER✔️✔️: B) Assess the perineum for lacerations
, ---
### Question 6 of 78
A nurse is assessing a newborn who is 2 hours old. The newborn’s respiratory rate is 70 breaths/min
with nasal flaring and grunting. Which action should the nurse take first?
A) Place the newborn on continuous pulse oximetry
B) Notify the healthcare provider
C) Suction the newborn’s mouth and nose
D) Check the newborn’s oxygen saturation
💫RATIONALE✔️✔️: Respiratory distress requires assessment of oxygenation first: place on pulse
oximetry (A) then notify provider. Suctioning if needed later.
💫ANSWER✔️✔️: A) Place the newborn on continuous pulse oximetry
---
### Question 7 of 78
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to a client who is
breastfeeding her newborn. Which statements by the client indicate understanding? (Select all that
apply.)
A) "I will feed my baby every 2 to 3 hours during the day."
B) "My baby should have at least 6 to 8 wet diapers per day by day 4."
C) "I will wash my nipples with antibacterial soap before each feeding."
D) "I can take ibuprofen for after-birth pain while breastfeeding."
E) "If my baby falls asleep after 5 minutes of feeding, that means he is full."
