MATERNAL CHILD NURSING
(PERRY’S CH28 4TH EDITION)
QUESTIONS AND THEIR REVIEWED
ANSWERS
A pregnant woman at 37 weeks of gestation has had
ruptured membranes for 26 hours. A cesarean section
is performed for failure to progress. The fetal heart
rate (FHR) before birth is 180 beats/min with limited
variability. At birth the newborn has Apgar scores of 6
and 7 at 1 and 5 minutes and is noted to be pale and
tachypneic. On the basis of the maternal history, the
cause of this newborn's distress is most likely to be:
a. Hypoglycemia. c. Respiratory distress syndrome.
b. Phrenic nerve injury. d. Sepsis.
ANS: D
The prolonged rupture of membranes and the tachypnea
(before and after birth) both suggest sepsis. An FHR of
180 beats/min is also indicative. This infant is at high risk
for sepsis.
The most important nursing action in preventing
neonatal infection is:
a. Good handwashing. c. Separate gown technique.
b. Isolation of infected infants. d. Standard
Precautions.
ANS: A
Virtually all controlled clinical trials have demonstrated that
,effective handwashing is responsible for the prevention of
nosocomial infection in nursery units. Measures to be
taken include Standard Precautions, careful and thorough
cleaning, frequent replacement of used equipment, and
disposal of excrement and linens in an appropriate
manner. Overcrowding must be avoided in nurseries.
However, the most important nursing action for preventing
neonatal infection is effective handwashing.
A pregnant woman presents in labor at term, having
had no prenatal care. After birth her infant is noted to
be small for gestational age with small eyes and a thin
upper lip. The infant also is microcephalic. On the
basis of her infant's physical findings, this woman
should be questioned about her use of which
substance during pregnancy?
a. Alcohol c. Heroin
b. Cocaine d. Marijuana
ANS: A
The description of the infant suggests fetal alcohol
syndrome, which is consistent with maternal alcohol
consumption during pregnancy. Fetal brain, kidney, and
urogenital system malformations have been associated
with maternal cocaine ingestions. Heroin use in pregnancy
frequently results in intrauterine growth restriction. The
infant may have a shrill cry and sleep cycle disturbances
and present with poor feeding, tachypnea, vomiting,
diarrhea, hypothermia or hyperthermia, and sweating.
Studies have found a higher incidence of meconium
staining in infants born of mothers who used marijuana
during pregnancy.
, A plan of care for an infant experiencing symptoms of
drug withdrawal should include:
a. Administering chloral hydrate for sedation.
b. Feeding every 4 to 6 hours to allow extra rest.
c. Swaddling the infant snugly and holding the baby
tightly.
d. Playing soft music during feeding.
ANS: C
The infant should be wrapped snugly to reduce self-
stimulation behaviors and protect the skin from abrasions.
Phenobarbital or diazepam may be administered to
decrease central nervous system (CNS) irritability. The
infant should be fed in small, frequent amounts and
burped well to diminish aspiration and maintain hydration.
The infant should not be stimulated (such as with music)
because this will increase activity and potentially increase
CNS irritability.
Human immunodeficiency virus (HIV) may be
perinatally transmitted:
a. Only in the third trimester from the maternal
circulation.
b. By a needlestick injury at birth from unsterile
instruments.
c. Only through the ingestion of amniotic fluid.
d. Through the ingestion of breast milk from an
infected mother.
ANS: D
Postnatal transmission of HIV through breastfeeding may
occur. Transmission of HIV from the mother to the infant
may occur transplacentally at various gestational ages.
(PERRY’S CH28 4TH EDITION)
QUESTIONS AND THEIR REVIEWED
ANSWERS
A pregnant woman at 37 weeks of gestation has had
ruptured membranes for 26 hours. A cesarean section
is performed for failure to progress. The fetal heart
rate (FHR) before birth is 180 beats/min with limited
variability. At birth the newborn has Apgar scores of 6
and 7 at 1 and 5 minutes and is noted to be pale and
tachypneic. On the basis of the maternal history, the
cause of this newborn's distress is most likely to be:
a. Hypoglycemia. c. Respiratory distress syndrome.
b. Phrenic nerve injury. d. Sepsis.
ANS: D
The prolonged rupture of membranes and the tachypnea
(before and after birth) both suggest sepsis. An FHR of
180 beats/min is also indicative. This infant is at high risk
for sepsis.
The most important nursing action in preventing
neonatal infection is:
a. Good handwashing. c. Separate gown technique.
b. Isolation of infected infants. d. Standard
Precautions.
ANS: A
Virtually all controlled clinical trials have demonstrated that
,effective handwashing is responsible for the prevention of
nosocomial infection in nursery units. Measures to be
taken include Standard Precautions, careful and thorough
cleaning, frequent replacement of used equipment, and
disposal of excrement and linens in an appropriate
manner. Overcrowding must be avoided in nurseries.
However, the most important nursing action for preventing
neonatal infection is effective handwashing.
A pregnant woman presents in labor at term, having
had no prenatal care. After birth her infant is noted to
be small for gestational age with small eyes and a thin
upper lip. The infant also is microcephalic. On the
basis of her infant's physical findings, this woman
should be questioned about her use of which
substance during pregnancy?
a. Alcohol c. Heroin
b. Cocaine d. Marijuana
ANS: A
The description of the infant suggests fetal alcohol
syndrome, which is consistent with maternal alcohol
consumption during pregnancy. Fetal brain, kidney, and
urogenital system malformations have been associated
with maternal cocaine ingestions. Heroin use in pregnancy
frequently results in intrauterine growth restriction. The
infant may have a shrill cry and sleep cycle disturbances
and present with poor feeding, tachypnea, vomiting,
diarrhea, hypothermia or hyperthermia, and sweating.
Studies have found a higher incidence of meconium
staining in infants born of mothers who used marijuana
during pregnancy.
, A plan of care for an infant experiencing symptoms of
drug withdrawal should include:
a. Administering chloral hydrate for sedation.
b. Feeding every 4 to 6 hours to allow extra rest.
c. Swaddling the infant snugly and holding the baby
tightly.
d. Playing soft music during feeding.
ANS: C
The infant should be wrapped snugly to reduce self-
stimulation behaviors and protect the skin from abrasions.
Phenobarbital or diazepam may be administered to
decrease central nervous system (CNS) irritability. The
infant should be fed in small, frequent amounts and
burped well to diminish aspiration and maintain hydration.
The infant should not be stimulated (such as with music)
because this will increase activity and potentially increase
CNS irritability.
Human immunodeficiency virus (HIV) may be
perinatally transmitted:
a. Only in the third trimester from the maternal
circulation.
b. By a needlestick injury at birth from unsterile
instruments.
c. Only through the ingestion of amniotic fluid.
d. Through the ingestion of breast milk from an
infected mother.
ANS: D
Postnatal transmission of HIV through breastfeeding may
occur. Transmission of HIV from the mother to the infant
may occur transplacentally at various gestational ages.
