NCC-Maternal Newborn Study 100% Correct A woman with a BMI of 18 gains 25 lbs during her pregnancy. This pregnancy is at increased risk for a. cesarean delivery b. Delivery of low birthweight delivery c. preeclampsia - b. delivery of a low birthweight infant During pregnancy, which of the following cardiovascular parameters increases by 60% a. blood volume b. plasma volume c. red cell mass - b. plasma volume When pregnancy, a woman with epilepsy has a higher risk of seizures a. during labor through 24 hours postpartum b. from 72 hours to 1 week pp c. in the third trimester - a. during labor thru 24 hrs. pp The risk of developing diabetes in women with a history of gestational diabetes is a. increased only if there are also multiple diabetes risk factors b. increased with onset within 10-15 years in about 50% of those women c. the same as women who do not have gest. diabetes - b. increased with onset within 10-15 years in about 50% of those women A woman recieves magnesium sulfate during labor for gestational hypertension. What effect can this have on newborn? a. elevated cortisol levels b.hypoglycemia c.muscle weakness - c. muscle weakness A pregnant woman was diagnosed with varicella-zoster at 32 weeks gestation. She is now in active labor at 40 weeks gestation. The nurse would expect that which of the following would be appropriate in order to ensure the health of the newborn. a. admister zoster immunoglobulin to newborn at delivery b. admister zoster immunoglobulin to patient before delivery c. the mother's antibodies will be protective so no action is needed - c. the mother's antibodies will be protective so no action is needed In order to decrease the risk of fetal death to that of a non-smoker, a woman must quit smoking a. before the pregnancy occurs b. by the end of the first trimester c. by the end of the 2nd trimester - b. by the end of the first trimester
A patient in preterm labor at 30 weeks received indocin, the newborn should be observed for? a. duodenal atresia b. Hirschsprung disease c. necrotizing entercolitis (NEC) - c. necrotizing enercolitis (NEC) What are the characteristics of dizygotic pregnancy? a. 1 placenta and 1 amniotic sac b. 1 placenta and 2 amniotic sacs c. 2 placentas and 2 amniotic sacs - c. 2 placentas and amniotic sacs A woman is diagnosed with oligohydramnios during her pregnancy. the fetus/newborn should be evaluated for a. diabetes insipidus b. klippel-feil syndrome c. polycystic kidney disease - c A fetus at 36 weeks receives a BBP score of 6. the expectated management is a. immediate delivery b. repeat in 24 hrs c. schedule the next test in one week - b In evaluating the patient census for staff assignments, the pp nurse is told that a pateint in the high risk unit may be delivered and transferred to pp after delivery. A L/S ratio was performed with result of 2:0 the nurse would expect the following to occur? a. A PG (phosphatidyglycerol) test needs to be performed b. the lungs are mature, and delivery will occur c. the lungs are still immature, and the L/S will be repeated in 1 week - b Which of the following is a limitation of an alpha-fetaprotein (AFP) test? a. closed neural tube defects are not detected b. it will not detect down syndrome c. its best sensitivity is at 20 weeks - a A postpartum woman's prenatal history shows a quad screen with a maternal serum (MSAFP) lower than normal and higher than HCG and Inhibin A. The nurse can expect the diagnosis of the newborn? a. neural tube defect b. Trisomy 21 c. Underestimated gestational age - b An umbilical gas ( artery) reveals the following ph: 7.27, PC02: 50mm Hg; HC03: 23 meq/Ll base excessl -3.6. this represents a. normal value b. metabolic acidosis
c. respiratory acidosis - a Umbical blood gas values are used to? a. determine etiology of any immediate complication b. direct neonatal resuscitation efforts c. establish the metabolic status of the fetus - c Ultrasound for antepartum testing uses high frequency sound waves to produce an image that varies based on the a. amount of fetus moves b. density of the structure under the transducer c. strength of the reflected energy - b In evaluating a cord blood gas, if the pH is low, what other blood gas parameter is used to determine if the acidosis is respiratory or metabolic? a. PC02 b. HCO3 c. Po2 - a Breech presentation increases risk for a. cord prolapse b. fetal clavicle fracture c. shoulder dystocia - a A newly delivered postpartum patient received received terb and corticosteroids during labor. A potential drug interaction that the pp nurse should watch for in the woman is a. hyperglycemia b. ketoacidosis c. pulmonary edema - a A postpartum patient has a spinal headache. The nurse knows that this can occur as a consequence of epidural due to a. injured nerve pathways b. puncture of the dura c. too rapid adminstration - b Shoulder dystocia places the pp woman at increased risk for a. endometritis b. hemorrhage c. urinary retention - b A newborn is at a higher risk for jaundice when delivered by a. cesarean section b.forceps c. vacuum - c
A woman who is 4 hr pp asks the nurse how much weight she might have lost with the deliver. The nurse would know to tell her the average wgt loss at birth is a. 10 lbs b. 12 lbs c. 14 lbs - b When assessing a woman who is 1 day pp, the nurse would expect her fundus to be palpated a. at umbilicus b. 1cm above umbilicus c. 1cm below umbilicus - c Within the first 2 days after birth, progesterone levels fall causing what acid base change? a. Increased PaCO2 b. Decreased PCO2 c. Decreased PaO2 - a Compared to the value seen in the 3rd trimester, the catabolic process of involution causes an increase in which of the following values pp? a.BUN b. creatinine clearance c. proteinuria - a A pp patient on her 2nd day is concerned that she has been urinating large amounts and frequently. Her output is 3000ml, the appropriate response by the nurse a.contact her care provider for an antibiotic order b. explain that this is a normal physilogic response to delivery c. obtain a clean catch urine - b Forceps delivery can result in what complication in the newborn? a.blood clots b.craniosynotosis c.nerve injuries - c To avoid a precipitous drop in intra-abdominal pressure during catheterization of a postpartum patint's bladder, what is the maximum amount of urine that should be removed at one time? a.700 ml b. 800ml c. 900 ml - b A woman is 12 hours pp and has a wbc of 25,000 this indicates a.an expected range b.dehydration and a need to force c.infection and a need for an antibiotic order - a
During pp, the low levels of placental lactogen, estrogen, cortisol, growth hormone, and insulinase result in a.diuresis b.increased angiotensin II c. lower glucose levels - c 2 hours after delivery an examination of the uterine fundus finds it deviated from midline. The nurse should have the woman a. flex her legs and reassess b.further evaluated for infection c. void to empty the bladder - c When assessing a new pp patient, the nurse would expect her blood pressure to be a. consistent w baseline blood pressure during pregnancy b. increased from the work of labor c.lower than normal - a Following delivery, an insulin dependent diabetic will have her insulin dose reduced because. a. her metabolism is in a state of flux immediately pp b. nutritional intake is still low and activity c. the anti-insulin effect ceases after placental separation - c A woman who is 12 hours pp and has a history of asthma, is noted to have uterine atony. the patient's v/s are bp 150/90, pulse 100 and resp 14. her temp is 99.4. the nurse would expect the medication appropriate a. hemabate b. methergine c. oxytocin - c scopalamine is classified as a category 6 drug by the American academy of pediatrics. this means that the drug a. can be used during breastfeeding but watch for signs of poor feeding b. is compatible w breastfeeding c. should not be used while breastfeeding - b A nurse discovers that an order for rh immune globulin (RhoGam) to be given 72 hrs past delivery was missed. It has been 4 days and the pt is to be d/c home. Follwing standard medication error, what is the correct action regarding the administration of the RhoGam at this time? a. a Kleihauer-Betke smear should be obtained before adminstration of Rhogam b. Administer 300 mg of Rhogam c. Adminster 300 mg of Rhogam now and check Kleihauer-Betke at 6 weeks - b A pp woman is given RH immune globin (Rhogam) at two days pp. the nurse would alert the woman to what possible side effects.
a. increased lochia for a few hours following administration b. soreness at the site of injection site c.given at the same time. - b a pp woman has an order for Rh immune globulin and rubella vaccine the nurse knows that the rubella vaccine should be. a. adminstered at the pp office visit b. delayed until 24 hrs after the Rh immune globulin is administered c. given at same time - c The unsensitized Rh-negative mother whose baby is Rh positive should a. have the father's blood type determined b. receive 300 mcg of Rho (D) by 72 hrs of birth c. require no further treatment - b after pains are due to a. hormonal shifts that affect the muscle b. physiologic stress from the birth process c. uterine contractions during involution - c A pp woman who is not breastfeeding states that her mother recommends she bind her breast to prevent painful engorgement. The nurse would advise the patient that binding a. and an order for a diuretic will shorten the engorgement b. and restriction of fluids for 2 days is recommended c.may lead to more leaking - c The American Academy of Pediatrics recommend 400 IU of vitamin D supplement for all infants beginning at what age? a. 2 months b. 4 months c. soon after birth - c. The lactation initiation stage is dependent on a. a cascade of hormonal changes b. early nursing or milk removal c. prolactin - a A new breastfeeding mother wants to begin a reduction diet to lose weight. The min number of kcal a lactating woman should consume per day is a. 1800 b.2000 c.2200 - a While in the hospital the mother of a breastfeeding term newborn is observed to have flat nipples and is having difficulty getting baby to latch on properly. The nurse should recommend
a. nipple rolling b. nursing w a nipple shield c. wearing breast shells btw feedings - c. a pt reports painful nipples. the nurse knows that a. a lack of nipple preparation can result in pain b. nursing too long can cause pain c. specific areas of pain can have a specific cause - c a pp mother who would like to breastfeed her baby is diagnosed w hepatitis A virus before delivery. what is the recommendation regarding breastfeeding for this patient? a. Administer immunoglobin and hepatitis antivirus vaccine to the newborn and allow nursing b. do not nurse due to the risk of horizontal transmission from the mother c. pump and discard milk for 1 week following vaccine administration to the newborn - a A pp mother diagnosed with cytomegalovirus (CMV) during 3rd trimester delivers a baby at 40 weeks. what is the recommendation regarding breastfeeding? a. breastfeed after deilivery b. breastfeed after two or more weeks of treatment of the mother c. restrict breastfeeding until treatment is completed - a When deciding on a mechanical breast pump, which of the following features is the most important? a. cycle pressure sustained for 2 seconds or a rate of 30 pumps per min b. manually controlled pressure c. negative pressure of >250mm/hg to initiate milk flow - a The cause of sudden late onset of pp hemorrhage secondary to retained placental fragments is due to a. increased uterine contraction activity b.nectrotic tissue separation from the uterus b. weakness in the uterine musculature - ab Clinical signs of hemorrhage such as b/p 90/70 pule 118, tachypnea can be seen when the blood loss reaches a. 900 b. 1200 c. 1800 - b THe most common pp infection is a. endometritis b. mastitis c.UTI - a
A pp patient had documented prenatal exposure to parovovirus. a serologic test shows preexisting IgG antibodies the patient is concerned about the infection. Her hx indicates that which of the following recommendations would be appropriate? a. breastfeeding may expose the newborn b. recurrence is unlikely c. she should have the test repeated in 3 weeks - b A woman 4 hours pp reports sudden, excrutiating vulvar pain and severe rectal pressure. the patient is likely exhibiting symptoms of a. Bartholin gland cyst b. vulvar edema c. vulvar hematoma - c Following a cesarean birth, the insulin infusion of a diabetic woman should be a. decreased by 50% until eating is resumed b. maintained at her pre-delivery level the first 24 hours c. stopped and sq insulin restarted - a A pt is admitted to pp unit w a hx of pre-eclampsia during labor. what percent of eclampsia cases will occur during the pp period. a. 10% b. 20% c. 30% - c A pt has a 2 hr glucose tolerance (GTT)result of 140. the nurse would expect which of the following recommendations for the pt to obtain the best assessment of her current risk of diabetes? a. annual fasting blood sugars b. two hr GTT at 6 wks and every 3 yrs if normal c. two hr GTT at 6 weeks and then annually if normal - b on pp day 2 , a woman exhibits signs of sleep disturbances, irritabiltiy, agitation, and confusion.. the nurse would suspect a. pp psychosis b. ptsd c. sepsis - a The process that triggers the metabolism of brown fat in the neonate occurs for what purpose? a. nutritional supplement b. o2 stimulation when levels fall below 90 c. thermoregulation - c At birth the most potent stimulus for constriction of the ductus arteriosis is an increase in a. Co2 b. Pao2
c. PC02 - b A normal breathing pattern for a two hr old neonate may include a. brief periods of apnea b. seesaw breathing c. tachypnea - a At what rate per minute should chest compressions be done a. 80 b. 90 c. 100 - b What size endotracheal tube should be available to resuscitate a 36 wk 2500 gm newborn a. 2.5mm b.3.0 mm c. 3.5mm - c The use of heat shield will prevent what type of heat loss a. conduction b. convection c. radiation - c When considering thermoregulation in the nbn, the loss of heat to moving air at the skin surface is called a. conduction b. convection c. radiation - b A nbn with hypothermia should be observed for a. dehydration b. metabolic acidosis c. tachypnea - b A critical finding of hyperthermia is a.hypoglycemia b. shivering c. tachycardia - c Which of the following temp of a term newborn is considered normal a. 36. C b. 37 C c. 38 C - b. Gavage feedings are frequently needed to meet the nutritional needs of preterm infants bc a. lactose enzyme activity is not adequate b. suck, swallow, and breathing reflexes are uncoordinated
c. hyperbilirubinemia is likely - b Surfactant production for an infant with RDS is inhibited b/c of a. prematurity b. infection c. hypoglycemia - a Which statement is not true about RDS a. It is characterized by atelectasis b. it may be induced by hypothermia in a preterm infant c. with adequate supportive care, it is self-resolving in approx 72 hrs. - c The best indicator an infants need for oxygen is a. resp rate b. skin color c. arterial Pa02 - c What problem may the LGA infant experience a. PDA b. facial nerve damage c. poor suck swallow, breathing coordination - b Why is hyperbilirubinemia of special concern in preterm infants. a. immature liver function b. poor vascular system c. immature endocrine function - a To assess the fontanelles, the newborn should be in what position a. lying flat on its back b. sitting position c. turned to one side - b The nurse notes hair on the ears of a newborn. she knows that this is seen in babies born to mothers who are a. diabetic b. drug addicted c. post dates - a When providing cord care to a newborn, which of the following should be used. a. alcohol b. betadine c. sterile water - a A neonate born to a mother whose HBsAg status is unknown should have a. hepatitis B vaccine and HBIG adminstered only after the mother b. the first dose of hep B within the first 12 hrs after birth
c. the same schedule as a neonate born to HBsAG neg mother - b The pp discharge instructions given to an HBsAg mother whose newborn received Hepatitis B vaccine at birth should include the follow up vaccines to be administered to the newborn at what ages? a. 1 month and 5 mos b. 2 mos and 4 mos c. 3 mos and 6 mos - b When the nurse examines the umbilical cord of a newborn, she notes an umbilical cord hernia, This is more commonly seen in which ethnic population a. African American b. Caucasian c. Latino - a. On the day of birth, a vitamin K injection is necessary bc of which of the following physiological states present in the first few days of life a. absence of normal flora in the gut for synthesis of vit K b. coagulation factors are unstable c.the newborn liver does not have complete physiological function - a What class of antibiotic can interfere with the binding of bilirubin to protein in the first month? a. Aminoglycosides b. penicillins c. sulfas - c A newborn observed to have hepatomegaly, cardiac gallop, tachypnea, tachycardia, cyanosis, diaphoresis, and feeding problems most likely has a. CHF b.tetralogy of fallot c. ventricular septal defect - b A few hours after administering the eye prophylaxis to the newborn, the nurse notes edema and a greenish yellow discharge. This is most likely a reaction to a. erythromycin b silver nitrate c. tetracycline - b A newborn is noted to have cyanosis when quiet but is pink when crying. this is most likely due to a. choanal atresia b. pneumothorax c. tetrology of fallot - a
Which of the following newborn diagnoses is a result of delayed re-absorption of fetal lung fluid production. a. pneumothorax b. respiratory distress syndrome c. transient tachypnea of the newborn - b Newborns delivered by what method are more likely to develop ttn of the newborn a. c/s b. induction c. vacuum - a a newborn is delivered w meconium staining who is responsive should be managed how a. always suction a the perineum b. no suction if baby is active and does not require resuscitation c. suction only after the airway has been inspected - b at birth the newborn is noted to have absent breath sounds on the left with heart sounds shifted to the right. the abd is noted to be scaphoid and ventilation is difficult. the most likely diagnosis is a. congential pneumothorax b. diaphragmatic hernia c. transposition of the great vessels - b Which of the following is chacteristic of jitterness and not of seizures? a. eye deviations b. motion can elicit c.tachycardia - b Phototherapy via a fiber optic blanket is ordered for a newborn who is 30 hours old. The mother should be instructed to do which of the following? a. apply lotion to the skin during tx to prevent drying b. increase fluids intake to 25% above daily normal c. no change in care is required - c In a 12 hour newborn, the nurse notes a tremor in which the amplitude and rate of the alternating mvmt is equal. this is characteristic of a. cold stess b jitteriness c. seizure - c A woman delivers a newborn with spina bifida. She questions what her chances is that another baby would have a similar problem. The nurse knows that the risk of another pregnancy with a neural tube defect is a. a random event b. ten times more likely the next pregnancy c. the same as the first - b
A neonate has scrotal swelling which is soft, non-tender and transilluminates there are no palpable masses. the most likely diagnosis is a. cyrptorchidism b. hydrocele c. hypospadias - b Group B streptococcus (GBS) and what other organism are currently the most common pathogens seen with neonatal sepsis? a. chlamydia b. E. coli c. Klebsiella - b Born to a mother of HIV, which of the following tests would be appropriate for the nb. a. ELISA testing at birth w cord blood b. DNA and polymerase chain reaction (PCR) test before 48 hours of age c. western blot test at birth and repeat at discharge - b. The specific tests that are mandated in newborn screening for inborn errors of metabolism are determined by a. hospital policy b. individual state law c. the CDC - b A newborn whose mother was a poorly controlled diabetic during the third trimester is at risk for a. hypercalcemia b. magnesium deficiency c. polycythemia - c