2025 maternal–newborn- retake actual exam
100% correct solutions and explanations.
A nurse is developing a plan of care for a client who has preeclampsia and is receiving magnesium sulfate via
a continuous IV infusion. Which of the following interventions should the nurse include in the plan?
Monitor the FHR continuously
A nurse is assessing a client who is at 38 weeks of gestation during a weekly prenatal visit. Which of the
following findings should the nurse report to the provider?
Weight gain of 2.2 kg (4.8 lb)
A nurse is caring for a client who is at 36 weeks of gestation and has a prescription for an amniocentesis. For
which of the following reasons should the nurse prepare the client for an ultrasound?
To locate the pocket of fluid
A nurse is teaching a client who has a new prescription for combined oral contraceptives about potential
adverse effects of the medication. For which of the following findings should the nurse instruct the client to
notify the provider?
A. Shortness of breath
B. Breakthrough bleeding
C. Vomiting
D. Breast tenderness
Answer: Shortness of breath
A. Shortness of breath
,The nurse should instruct the client to notify the provider immediately of any shortness of breath. Shortness
of breath and chest pain can indicate a pulmonary embolus or myocardial infarction. Also, the nurse should
instruct the client to notify the provider of other adverse effects that can indicate potential complications,
including abdominal pain, sudden or persistent headaches, blurred vision, and severe leg pain.
B. Breakthrough bleeding
Breakthrough bleeding outside the menstrual period is a common adverse effect of combined oral
contraceptives.
C. Vomiting
Nausea and vomiting are common adverse effects of combined oral contraceptives.
D. Breast tenderness
Breast tenderness is a common adverse effect of combined oral contraceptives.
.
A nurse is caring for a client following an amniocentesis at 18 weeks of gestation. Which of the following
findings should the nurse report to the provider as a potential complication?
A. Increased fetal movement
B. Leakage of fluid from the vagina
C. Upper abdominal discomfort
D. Urinary frequency
Answer: Leakage of fluid from the vagina
A. Increased fetal movement
Decreased fetal movement is a potential complication that should be reported to the provider.
B. Leakage of fluid from the vagina
,Leakage of fluid from the vagina could indicate premature leakage of amniotic fluid and should be reported
to the provider.
C. Upper abdominal discomfort
Upper abdominal discomfort is not a potential complication associated with an amniocentesis.
D. Urinary frequency
Urinary frequency is not a potential complication associated with an amniocentesis.
A nurse is calculating a client's expected date of birth using Nagele's rule. The client tells the nurse that her
last menstrual cycle started on November 27th. Which of the following dates is the client's expected date of
birth?
Answer: September 3rd
A. September 3rd
When using Nägele's rule to calculate the estimated date of birth for a client, the nurse should subtract 3
months from the first day of the client's last menstrual cycle and then add 7 days. November 27th minus 3
months equals August 27th. August 27th plus 7 days equals September 3rd.
A nurse is providing teaching to a postpartum client who has type 1 diabetes and is breastfeeding her
newborn. Which of the following instructions should the nurse give to the client?
A) Take more insulin with each meal that you did prior to pre pregnancy
B) Maintain scheduled mealtimes for yourself
C) Check your blood glucose levels every 8 hours
D) Limit your carbohydrate intake to 30 grams per day
Maintain scheduled mealtimes for yourself
, A nurse is assessing the reflexes of a term newborn. After placing the newborn in a supine position, which of
the following would the nurse use to elicit the Moro reflex
A) Turn the newborn's head to one side
B) Make a loud noise above the newborn
C) Tap the newborns forehead with a finger
D) Touch the newborns cheek with a finger
Make a loud noise above the newborn
A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the
following actions should the nurse include in the plan?
A) Give the newborn 1 oz of glucose water every 4 hours
B) Apply a thin layer of lotion to the newborns skin every 8 hours
C) Dress the newborn in a thin layer of clothing during the therapy
D) Ensure the newborns eyes are closed beneath the shield
Ensure the newborns eyes are closed beneath the shield
A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following
clients should the nurse asses first?
A) A client who has hyperemesis gravidarum and a sodium level of 110
B) A client who has preeclampsia and a creatine level of 1.1
C) A client who has diabetes mellitus and an HbA1c of 5.8
D) A client who has placenta previa a hematocrit of 36
A client who has hyperemesis gravidarum and a sodium level of 110
100% correct solutions and explanations.
A nurse is developing a plan of care for a client who has preeclampsia and is receiving magnesium sulfate via
a continuous IV infusion. Which of the following interventions should the nurse include in the plan?
Monitor the FHR continuously
A nurse is assessing a client who is at 38 weeks of gestation during a weekly prenatal visit. Which of the
following findings should the nurse report to the provider?
Weight gain of 2.2 kg (4.8 lb)
A nurse is caring for a client who is at 36 weeks of gestation and has a prescription for an amniocentesis. For
which of the following reasons should the nurse prepare the client for an ultrasound?
To locate the pocket of fluid
A nurse is teaching a client who has a new prescription for combined oral contraceptives about potential
adverse effects of the medication. For which of the following findings should the nurse instruct the client to
notify the provider?
A. Shortness of breath
B. Breakthrough bleeding
C. Vomiting
D. Breast tenderness
Answer: Shortness of breath
A. Shortness of breath
,The nurse should instruct the client to notify the provider immediately of any shortness of breath. Shortness
of breath and chest pain can indicate a pulmonary embolus or myocardial infarction. Also, the nurse should
instruct the client to notify the provider of other adverse effects that can indicate potential complications,
including abdominal pain, sudden or persistent headaches, blurred vision, and severe leg pain.
B. Breakthrough bleeding
Breakthrough bleeding outside the menstrual period is a common adverse effect of combined oral
contraceptives.
C. Vomiting
Nausea and vomiting are common adverse effects of combined oral contraceptives.
D. Breast tenderness
Breast tenderness is a common adverse effect of combined oral contraceptives.
.
A nurse is caring for a client following an amniocentesis at 18 weeks of gestation. Which of the following
findings should the nurse report to the provider as a potential complication?
A. Increased fetal movement
B. Leakage of fluid from the vagina
C. Upper abdominal discomfort
D. Urinary frequency
Answer: Leakage of fluid from the vagina
A. Increased fetal movement
Decreased fetal movement is a potential complication that should be reported to the provider.
B. Leakage of fluid from the vagina
,Leakage of fluid from the vagina could indicate premature leakage of amniotic fluid and should be reported
to the provider.
C. Upper abdominal discomfort
Upper abdominal discomfort is not a potential complication associated with an amniocentesis.
D. Urinary frequency
Urinary frequency is not a potential complication associated with an amniocentesis.
A nurse is calculating a client's expected date of birth using Nagele's rule. The client tells the nurse that her
last menstrual cycle started on November 27th. Which of the following dates is the client's expected date of
birth?
Answer: September 3rd
A. September 3rd
When using Nägele's rule to calculate the estimated date of birth for a client, the nurse should subtract 3
months from the first day of the client's last menstrual cycle and then add 7 days. November 27th minus 3
months equals August 27th. August 27th plus 7 days equals September 3rd.
A nurse is providing teaching to a postpartum client who has type 1 diabetes and is breastfeeding her
newborn. Which of the following instructions should the nurse give to the client?
A) Take more insulin with each meal that you did prior to pre pregnancy
B) Maintain scheduled mealtimes for yourself
C) Check your blood glucose levels every 8 hours
D) Limit your carbohydrate intake to 30 grams per day
Maintain scheduled mealtimes for yourself
, A nurse is assessing the reflexes of a term newborn. After placing the newborn in a supine position, which of
the following would the nurse use to elicit the Moro reflex
A) Turn the newborn's head to one side
B) Make a loud noise above the newborn
C) Tap the newborns forehead with a finger
D) Touch the newborns cheek with a finger
Make a loud noise above the newborn
A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the
following actions should the nurse include in the plan?
A) Give the newborn 1 oz of glucose water every 4 hours
B) Apply a thin layer of lotion to the newborns skin every 8 hours
C) Dress the newborn in a thin layer of clothing during the therapy
D) Ensure the newborns eyes are closed beneath the shield
Ensure the newborns eyes are closed beneath the shield
A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following
clients should the nurse asses first?
A) A client who has hyperemesis gravidarum and a sodium level of 110
B) A client who has preeclampsia and a creatine level of 1.1
C) A client who has diabetes mellitus and an HbA1c of 5.8
D) A client who has placenta previa a hematocrit of 36
A client who has hyperemesis gravidarum and a sodium level of 110
