1
Maternal Newborn Practice Assessment A
1. A nurse is teaching a client about Rho(D) immunoglobulin (RhoGAM). Which
of the following statements by the client indicated an understanding of the
teaching?
a. I will receive this medication if my baby is Rh-negative
b. I will receive this medication at time of delivery
c. I will need a second dose of this medication when my baby is 6 weeks
old
d. I will need this medication if I have an amniocentesis- Recommended
because of the potential of fetal RBCs entering the maternal
circulation
2. A nurse is caring for a client who is to receive oxytocin (Pitocin) to augment
her labor. Which of the following contraindicates the initiation of the oxytocin
infusion and requires notification of the provider?
a. Late decelerations- Oxytocin is contraindicated based on late
decelerations noted on fetal assessment findings because they
indicate uteroplacental insufficiency.
b. Baseline variability
c. Cessation of uterine dilation
d. Prolonged active phase of labor
3. A nurse on the newborn unit is planning discharge for four clients. Which of
the following will require care beyond that of a standard follow-up visit with
the provider after delivery?
a. A newborn being sent home after 22 hr after birth- Screening tests
must be repeated if they were performed before he newborn was 24
hr. old.
b. A newborn at 38 weeks of gestational age
c. A newborn who is bottle feeding
d. Twin newborns with Apgar scores of 8 and 9
4. A nurse is assessing a newborn who has a weak cry and is grimacing. The
nurse notes the newborn has a heart rate of 102/min, blueish extremities,
and a flaccid muscle tone. Which of the following reflects the appropriate
APGAR score?
a. 4
b. 5
c. 6
d. 7
5. A nurse is caring for a client who has a history of rheumatic disease, but no
physical symptoms prior to pregnancy. The client begins to experience
dyspnea, orthopnea, and pulmonary edema. Which of the following biological
alterations explains this change?
a. Increased maternal weight
b. Increased blood volume- Increase in blood volume during pregnancy
increase the workload of the heart, which causes the symptoms
c. Change in hematocrit levels
d. Change in heart size
, 2
6. A nurse is providing teaching about nonpharmacological pain management
for a postpartum client who is breastfeed and has engorgement. Which of the
following methods should the nurse recommend?
a. Cold cabbage leaves- Application of this is an effective
nonpharmacological method to relieve pain associated with
engorgement
b. Modified lanolin cream
c. A breast binder
d. Breast shells
7. A nurse is providing discharge teaching to a client who is postpartum about
resuming sexual activity. Which of the following instructions should the nurse
include in the teaching?
a. You should use a water soluble gel for lubrication- This will prevent
discomfort
b. You can resume sexual activity in 10 days
c. Your physical reaction to sexual stimulation ill not be altered
d. You will not ovulate for 3 months after delivery
8. A nurse is admitting a client who is in labor. The client admits to recent
cocaine use. For which of the following complications should the nurse
assess?
a. Abruptio placenta- Cocaines increases the risk for vasoconstriction
and possible abruption placenta
b. Placenta previa
c. Preeclampsia
d. Maternal bradycardia
9. A nurse is providing dietary teaching with a client who has hyperemesis
gravidarum. Which of the following statements by the client indicates an
understanding of the teaching?
a. I should eat to taste instead of trying to balance my meals- Eat to taste
to avoid nausea
b. I will avoid having a snack at bedtime
c. I will have 8 oz of hot tea with each meal
d. I should pair my sweets with a starch instead of eating them alone
10. A nurse is preparing to collect a blood specimen from a newborn via a heel
stick. Which of the following techniques should the nurse use to help
minimize the pain of the procedure for the newborn?
a. Warm the heel prior to the puncture
b. Request a prescription for IM analgesic
c. Use a manual lance blade to pierce the skin
d. Swaddle the newborn after the heel puncture- Effective technique to
diminish the pain experience for the newborn.
11. A nurse is conducting an initial prenatal visit for a client who is at 6 weeks
gestation. Which of the following laboratory tests should be performed?
a. 24 hour urine for protein
b. Group B streptococcus culture
c. 3-hr glucose tolerance
Maternal Newborn Practice Assessment A
1. A nurse is teaching a client about Rho(D) immunoglobulin (RhoGAM). Which
of the following statements by the client indicated an understanding of the
teaching?
a. I will receive this medication if my baby is Rh-negative
b. I will receive this medication at time of delivery
c. I will need a second dose of this medication when my baby is 6 weeks
old
d. I will need this medication if I have an amniocentesis- Recommended
because of the potential of fetal RBCs entering the maternal
circulation
2. A nurse is caring for a client who is to receive oxytocin (Pitocin) to augment
her labor. Which of the following contraindicates the initiation of the oxytocin
infusion and requires notification of the provider?
a. Late decelerations- Oxytocin is contraindicated based on late
decelerations noted on fetal assessment findings because they
indicate uteroplacental insufficiency.
b. Baseline variability
c. Cessation of uterine dilation
d. Prolonged active phase of labor
3. A nurse on the newborn unit is planning discharge for four clients. Which of
the following will require care beyond that of a standard follow-up visit with
the provider after delivery?
a. A newborn being sent home after 22 hr after birth- Screening tests
must be repeated if they were performed before he newborn was 24
hr. old.
b. A newborn at 38 weeks of gestational age
c. A newborn who is bottle feeding
d. Twin newborns with Apgar scores of 8 and 9
4. A nurse is assessing a newborn who has a weak cry and is grimacing. The
nurse notes the newborn has a heart rate of 102/min, blueish extremities,
and a flaccid muscle tone. Which of the following reflects the appropriate
APGAR score?
a. 4
b. 5
c. 6
d. 7
5. A nurse is caring for a client who has a history of rheumatic disease, but no
physical symptoms prior to pregnancy. The client begins to experience
dyspnea, orthopnea, and pulmonary edema. Which of the following biological
alterations explains this change?
a. Increased maternal weight
b. Increased blood volume- Increase in blood volume during pregnancy
increase the workload of the heart, which causes the symptoms
c. Change in hematocrit levels
d. Change in heart size
, 2
6. A nurse is providing teaching about nonpharmacological pain management
for a postpartum client who is breastfeed and has engorgement. Which of the
following methods should the nurse recommend?
a. Cold cabbage leaves- Application of this is an effective
nonpharmacological method to relieve pain associated with
engorgement
b. Modified lanolin cream
c. A breast binder
d. Breast shells
7. A nurse is providing discharge teaching to a client who is postpartum about
resuming sexual activity. Which of the following instructions should the nurse
include in the teaching?
a. You should use a water soluble gel for lubrication- This will prevent
discomfort
b. You can resume sexual activity in 10 days
c. Your physical reaction to sexual stimulation ill not be altered
d. You will not ovulate for 3 months after delivery
8. A nurse is admitting a client who is in labor. The client admits to recent
cocaine use. For which of the following complications should the nurse
assess?
a. Abruptio placenta- Cocaines increases the risk for vasoconstriction
and possible abruption placenta
b. Placenta previa
c. Preeclampsia
d. Maternal bradycardia
9. A nurse is providing dietary teaching with a client who has hyperemesis
gravidarum. Which of the following statements by the client indicates an
understanding of the teaching?
a. I should eat to taste instead of trying to balance my meals- Eat to taste
to avoid nausea
b. I will avoid having a snack at bedtime
c. I will have 8 oz of hot tea with each meal
d. I should pair my sweets with a starch instead of eating them alone
10. A nurse is preparing to collect a blood specimen from a newborn via a heel
stick. Which of the following techniques should the nurse use to help
minimize the pain of the procedure for the newborn?
a. Warm the heel prior to the puncture
b. Request a prescription for IM analgesic
c. Use a manual lance blade to pierce the skin
d. Swaddle the newborn after the heel puncture- Effective technique to
diminish the pain experience for the newborn.
11. A nurse is conducting an initial prenatal visit for a client who is at 6 weeks
gestation. Which of the following laboratory tests should be performed?
a. 24 hour urine for protein
b. Group B streptococcus culture
c. 3-hr glucose tolerance
