LPN exams maternity and newborn practice questions, set 13
LPN exams · maternity and newborn
LPN exams maternity and newborn practice questionsset 13
You work labor, postpartum, and newborn safety items the way maternity exams write the next action. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five maternity and newborn questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A newborn is 24 hours old, and a healthcare provider is caring for them. Which of the following laboratory findings should the healthcare provider report to the provider?
A. Hgb 20 g/dL
B. Bilirubin 2 mg/dL
C. Platelets 200,000/mm3
D. WBC count 32,000/mm3
Show answer and rationale
Correct answer: D — WBC count 32,000/mm3
The correct answer is D: WBC count 32,000/mm3. A WBC count of 32,000/mm3 is significantly elevated in a newborn and could indicate an infection, which needs immediate attention and intervention. High white blood cell counts in newborns can be concerning as they may suggest an ongoing infection or other underlying issues that require prompt medical evaluation and treatment. Choices A, B, and C are within normal ranges for a newborn and would not typically warrant immediate reporting to the provider. Hgb levels of 20 g/dL (Choice A) are high for newborns, but this is not as concerning as a significantly elevated WBC count. Bilirubin levels of 2 mg/dL (Choice B) are within normal limits for a newborn and do not indicate immediate issues. Platelet count of 200,000/mm3 (Choice C) is also within the normal range for a newborn and would not require immediate reporting.
Question 2
A 40-year-old G2, P1 woman is admitted to the labor and delivery unit with contractions 6 minutes apart. She is 36 weeks pregnant, has a history of placenta previa, and is currently experiencing moderate vaginal bleeding. What should the nurse be prepared to do?
A. Perform a vaginal examination to determine cervical dilation
B. Assist the health care provider to perform artificial rupture of the membranes
C. Initiate external fetal monitoring
D. Encourage patient to ambulate to intensify labor
Show answer and rationale
Correct answer: C — Initiate external fetal monitoring
The correct answer is C: Initiate external fetal monitoring. In this scenario, the patient is at 36 weeks of gestation with a history of placenta previa and moderate vaginal bleeding, indicating a high-risk situation. External fetal monitoring allows for continuous assessment of the fetal heart rate and uterine contractions, which is crucial for identifying signs of fetal distress or complications related to placenta previa. This monitoring can help guide timely interventions and decision-making to ensure the safety of the mother and baby. Performing a vaginal examination (A) may increase the risk of bleeding in cases of placenta previa. Artificial rupture of membranes (B) can also lead to increased bleeding and should be avoided in this situation. Encouraging ambulation (D) is not recommended due to the risk of exacerbating bleeding and potential complications.
Question 3
A pregnant patient at 32 weeks gestation reports persistent nausea and vomiting. What is the nurse's priority action?
A. Instruct the patient to take over-the-counter anti-nausea medication.
B. Monitor the patient's hydration status and assess for signs of dehydration.
C. Encourage the patient to eat large meals more frequently to prevent nausea.
D. Recommend the patient avoid drinking fluids to prevent further vomiting.
Show answer and rationale
Correct answer: B — Monitor the patient's hydration status and assess for signs of dehydration.
The correct answer is B: Monitor the patient's hydration status and assess for signs of dehydration. This is the priority action because nausea and vomiting during pregnancy can lead to dehydration, which can have serious consequences for both the mother and the baby. By monitoring the patient's hydration status and assessing for signs of dehydration, the nurse can ensure early intervention if dehydration occurs.
Incorrect choices:
A: Instruct the patient to take over-the-counter anti-nausea medication - This is not the priority as dehydration needs to be addressed first.
C: Encourage the patient to eat large meals more frequently to prevent nausea - This may exacerbate the nausea and vomiting, leading to further dehydration.
D: Recommend the patient avoid drinking fluids to prevent further vomiting - Dehydration can worsen if the patient avoids fluids.
Question 4
The nurse is assessing a 38-week pregnant woman who is experiencing severe abdominal pain and has not felt her baby move for several hours. What is the most appropriate action for the nurse to take?
A. Encourage the patient to drink water and rest.
B. Notify the healthcare provider immediately.
C. Ask the patient to lie on her left side and monitor fetal movements.
D. Reassure the patient that this is common at the end of pregnancy.
Show answer and rationale
Correct answer: B — Notify the healthcare provider immediately.
The correct answer is B: Notify the healthcare provider immediately. This is the most appropriate action because the pregnant woman is experiencing severe abdominal pain and has not felt her baby move for several hours, which could indicate a potential emergency situation such as placental abruption or fetal distress. Prompt notification of the healthcare provider is crucial for timely evaluation and management to ensure the well-being of both the mother and the baby.
Choice A is incorrect because simply encouraging the patient to drink water and rest may delay necessary medical intervention. Choice C is incorrect as monitoring fetal movements without immediate healthcare provider notification may lead to a critical delay in assessment and treatment. Choice D is incorrect as reassuring the patient without further evaluation could overlook a serious issue.
Question 5
As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer–Betke test is positive. Based on this information, you anticipate that
A. immediate birth is required.
B. the patient should be transferred to the critical care unit for closer observation.
C. RhoGAM should be administered.
D. a tetanus shot should be administered.
Show answer and rationale
Correct answer: A — immediate birth is required.
The correct answer is A: immediate birth is required. The positive Kleihauer–Betke test indicates fetal-maternal hemorrhage, where fetal blood enters the maternal circulation. This can lead to fetal-maternal transfusion, causing fetal anemia. Immediate birth is necessary to assess and manage potential fetal distress, such as anemia and hypoxia, due to the trauma from the MVA.
Choices B, C, and D are incorrect:
B: Transferring to critical care unit is not the immediate priority. The focus should be on addressing the fetal distress.
C: RhoGAM is given to Rh-negative mothers to prevent Rh sensitization, but it is not directly related to the positive Kleihauer–Betke test result.
D: Tetanus shot administration is important for tetanus prevention, but it is not the priority in this case where immediate birth is required due to fetal-maternal hemorrhage.
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Question 6
The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother–infant bonding?
A. The mother is pleased to have the nurse visit her home and baby.
B. The baby's grandmother is present and involved with mother/baby care.
C. The mother focuses the visit on her physical recovery and concerns.
D. The baby's father is on 'paternity leave' and involved with the baby.
Correct answer:
The correct answer is C. The mother focusing the visit on her physical recovery and concerns indicates a possible problem with mother-infant bonding. This is because bonding involves emotional connection and interaction between the mother and the baby, not just physical care. A mother who is solely focused on her physical recovery may not be engaging emotionally with her baby, which can impact bonding.
A: The mother being pleased to have the nurse visit her home and baby is a positive sign of engagement and interest in the baby's well-being.
B: The baby's grandmother being present and involved with mother/baby care is also a positive sign of family support and involvement, which can enhance bonding.
D: The baby's father being on 'paternity leave' and involved with the baby is also a positive sign of parental involvement, which is important for bonding.
What additional assessment is required for the postoperative care of a pregnant woman who undergoes abdominal surgery for appendicitis?
A. Intake and output (I&O) and intravenous (IV) site.
B. Signs and symptoms of infection.
C. Vital signs and incision.
D. Fetal heart rate (FHR) and uterine activity.
Correct answer:
The correct additional assessment for postoperative care of a pregnant woman requiring abdominal surgery for appendicitis is monitoring the fetal heart rate (FHR) and uterine activity. This is crucial due to the presence of the fetus. Continuous fetal and uterine monitoring should be prioritized to ensure the well-being of both the mother and the baby. While assessing I&O levels and the IV site are common postoperative care procedures, they are not specific to the unique needs of a pregnant woman. Evaluating for signs and symptoms of infection is important for any postoperative patient but is not the additional assessment required specifically for a pregnant woman in this scenario. Routine vital signs and incision evaluation are standard components of postoperative care but do not address the specific needs related to the fetus and the uterus in this case.
A labor patient, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse anticipate would be required in the birth room for administration?
A. Oxytocin (Pitocin)
B. Naloxone (Narcan)
C. Bromocriptine (Parlodel)
D. Oxygen
Correct answer:
The correct answer is B: Naloxone (Narcan). Meperidine is an opioid analgesic that can cross the placenta and potentially cause respiratory depression in the newborn if given close to delivery. Naloxone is a specific opioid antagonist that can reverse the effects of opioids like meperidine quickly and effectively. Administering naloxone in this scenario can help prevent or reverse neonatal respiratory depression.
Choice A: Oxytocin (Pitocin) is not required in this scenario as it is used to induce or augment labor, not to counter the effects of meperidine.
Choice C: Bromocriptine (Parlodel) is a medication used to suppress lactation and is not indicated in this situation.
Choice D: Oxygen may be needed during delivery for maternal or fetal distress, but it is not the specific medication needed to counter the effects of meperidine in the newborn.
A nurse is assessing a pregnant patient who is at 38 weeks gestation and reports a sudden decrease in fetal movement. What is the nurse's priority action?
A. Encourage the patient to drink a cold beverage and lie down to stimulate fetal movement.
B. Ask the patient to monitor fetal movements for 24 hours and report any changes.
C. Perform a nonstress test and assess fetal heart rate.
D. Wait until the next prenatal appointment to check for fetal movement.
Correct answer:
The correct answer is C, performing a nonstress test and assessing fetal heart rate. This is the priority action because a sudden decrease in fetal movement at 38 weeks gestation could indicate fetal distress or potential complications. A nonstress test helps evaluate fetal well-being by monitoring the fetal heart rate in response to fetal movement. This test provides immediate information about the baby's condition and any need for further intervention. Encouraging the patient to drink a cold beverage and lie down may not be effective in this situation, as it does not address the underlying cause of decreased fetal movement. Asking the patient to monitor fetal movements for 24 hours could delay necessary intervention, and waiting until the next prenatal appointment could lead to missed opportunities for timely assessment and management of fetal distress.
The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning?
A. The couple observes other individuals who are mothers and fathers.
B. The couple attends hospital classes addressing newborn and infant care.
C. The couple discusses with each other how they were parented.
D. The couple watches media containing parenting roles.
Correct answer:
The correct answer is B: The couple attends hospital classes addressing newborn and infant care. This is associated with intentional learning as it involves actively seeking out structured education on parenting skills. Attending classes allows the couple to acquire knowledge and skills related to newborn and infant care in a deliberate and purposeful manner.
Incorrect choices:
A: Observing other individuals who are mothers and fathers may provide some insights, but it is more passive and may not involve structured learning.
C: Discussing how they were parented is reflective but may not necessarily involve acquiring new parenting skills through intentional learning.
D: Watching media containing parenting roles is passive and may not provide the same level of structured education as attending classes specifically addressing newborn and infant care.
Arrange the seven cardinal movements of labor, in order.
A. Descent
B. Expulsion
C. Extension
D. External rotation
Correct answer:
The correct order of cardinal movements of labor is:
1. Engagement
2. Descent
3. Flexion
4. Internal rotation
5. Extension
6. Restitution
7. External rotation
Engagement occurs first as the fetal presenting part enters the maternal pelvis. Descent is the second cardinal movement, where the fetus moves down the birth canal. Flexion follows, allowing the smallest diameter of the fetal head to present. Internal rotation positions the fetus for delivery. Extension occurs next, facilitating the passage of the head through the birth canal. Restitution aligns the fetal head with the shoulders. External rotation allows the shoulders to rotate for delivery. Therefore, Descent is the correct first cardinal movement in the sequence. Other choices like Expulsion, Extension, and External rotation occur later in the process and are not in the correct order.
A patient at 36 weeks gestation is undergoing a nonstress (NST) test. The nurse observes the fetal heart rate baseline at 135 beats per minute (bpm) and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for periods of 20 to 25 seconds each. How will the nurse record these findings?
A. NST positive, nonreassuring
B. NST negative, reassuring
C. NST reactive, reassuring
D. NST nonreactive, nonreassuring
Correct answer:
Step 1: The baseline fetal heart rate is 135 bpm, which is within the normal range of 110-160 bpm.
Step 2: The four nonepisodic patterns of fetal heart rate reaching 160 bpm for 20-25 seconds each indicate accelerations, a positive sign.
Step 3: A reactive NST requires at least two accelerations of the fetal heart rate within a 20-minute window, which this scenario meets.
Step 4: Therefore, the nurse will record these findings as NST reactive, reassuring because the fetal heart rate responded appropriately to stimuli.
Summary of Other Choices:
A: NST positive, nonreassuring - Inaccurate, as the findings indicate a reassuring response.
B: NST negative, reassuring - Incorrect, as the test results are actually reactive, not negative.
D: NST nonreactive, nonreassuring - Wrong, as the test is reactive and reassuring, not nonreactive and nonreassuring.
An infant was born 1 minute ago and the Apgar score is being assigned. The infant has blue extremities, minimal flexion, a weak cry, a heart rate of 110 beats per minute, and coughs and pulls away when suctioned. How many points should be assigned? Record your answer using a whole number:
A. 3
B. 2
C. 1
D. 0
Correct answer:
The correct answer is A: 3 points. Apgar scoring assesses the newborn's overall condition at 1 and 5 minutes after birth. In this case, the infant's Apgar score should be 3 because the baby displays signs of mild distress with blue extremities, weak cry, and minimal flexion. The heart rate of 110 BPM and response to suctioning indicate some normal function. Each category (color, heart rate, reflex irritability, muscle tone, and respiratory effort) can score up to 2 points, totaling 10 points. Blue extremities and weak cry correspond to 1 point each, while minimal flexion corresponds to 0 points. The heart rate (110 BPM) and response to suctioning indicate 2 points each, totaling 3 points. Therefore, the correct score is 3 points. Choices B, C, and D are incorrect as they do not accurately reflect the severity of the infant's condition based on the Apgar
Which patient would require additional calories and nutrients?
A. A 36-year-old female gravida 2, para 1, in her first trimester of pregnancy
B. An 18-year-old female who delivered a 7-lb baby and is bottle feeding
C. A 23-year-old female who had a cesarean birth and is bottle feeding
D. A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
Correct answer:
The correct answer is D because breastfeeding requires additional calories and nutrients to support the mother's milk production and maintain her own health. Breastfeeding burns extra calories, so the mother needs to consume more to meet her body's needs. Additionally, breastfeeding mothers need to ensure they are getting enough nutrients like calcium, iron, and protein to support their own health and the production of nutritious breast milk for their baby.
Choice A is incorrect because the patient is in her first trimester of pregnancy, not breastfeeding. Choice B is incorrect because bottle feeding does not require as many additional calories and nutrients as breastfeeding. Choice C is incorrect because although the patient had a cesarean birth, the method of feeding (bottle feeding) does not require as much additional nutrition as breastfeeding.
A new mother expresses frustration about how to know what her baby wants. The mother states, 'I don't know what I expect, but then, the baby doesn't know either.' Which situation does the nurse use as an example of neonate communication?
A. The baby is content to lie still on the mother's abdomen.
B. The baby is easily awakened if irritated by loud noises.
C. The baby resists eye contact if bored or disinterested.
D. The baby roots for the breast when the cheek is stroked.
Correct answer:
The correct answer is D because rooting reflex is a clear example of neonate communication. When the baby's cheek is stroked, the baby turns its head in the direction of the touch, indicating a desire for feeding. This reflexive behavior demonstrates the baby's ability to communicate its needs for nourishment.
A: The baby being content to lie still on the mother's abdomen does not directly relate to communication.
B: Being easily awakened by loud noises is a sensory response but not specifically a form of communication.
C: Resisting eye contact if bored or disinterested involves more complex social cues and is not typically seen in neonatal communication.
In summary, choice D is correct as it directly involves a neonatal communication reflex, while the other choices do not demonstrate clear communication cues in the context of a newborn baby.
About these LPN exams maternity and newborn questions
LPN exams maternity and newborn practice questions, set 13 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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