LPN exams maternity and newborn practice questions, set 16
LPN exams · maternity and newborn
LPN exams maternity and newborn practice questionsset 16
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 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I'm bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?
A. Retained placental fragments.
B. Unrepaired vaginal lacerations.
C. Uterine atony.
D. Puerperal infection.
Show answer and rationale
Correct answer: C — Uterine atony.
Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.
Question 2
To determine if the patient is in true labor, the nurse would assess for changes in
A. cervical dilation.
B. amount of bloody show.
C. fetal position and station.
D. pattern of uterine contractions.
Show answer and rationale
Correct answer: D — pattern of uterine contractions.
The correct answer is D: pattern of uterine contractions. This is because the pattern of contractions is a key indicator of true labor. True labor contractions are regular, increasing in frequency, duration, and intensity. Assessing the pattern helps differentiate true labor from false labor.
A: Cervical dilation is important but may not necessarily indicate true labor as it can occur in false labor as well.
B: The amount of bloody show is a sign of cervical changes, but it alone does not confirm true labor.
C: Fetal position and station are important for labor progress but do not definitively confirm true labor.
In summary, assessing the pattern of uterine contractions is crucial in determining true labor as it provides direct insight into the progression and intensity of contractions, distinguishing it from false labor.
Question 3
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.†Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
A. Separation from the baby’s father
B. Personal history of bipolar disorder
C. Prolonged labor resulting in cesarean
D. Loss of first child from a heart defect
Show answer and rationale
Correct answer: B — Personal history of bipolar disorder
The correct answer is B, personal history of bipolar disorder. Postpartum psychosis is a severe mental health condition that can occur in women with a history of bipolar disorder. Bipolar disorder is a major risk factor for developing postpartum psychosis due to the hormonal changes and stress of childbirth. The extreme agitation, depressed mood, and delusional thoughts exhibited by the patient in the scenario are indicative of postpartum psychosis.
Choice A, separation from the baby’s father, is not a strong risk factor for postpartum psychosis. Choice C, prolonged labor resulting in cesarean, is associated with physical complications but not necessarily with postpartum psychosis. Choice D, loss of the first child from a heart defect, is a traumatic event but is not directly linked to the development of postpartum psychosis.
Question 4
A client with diabetes mellitus is at 37 weeks gestation. She has had weekly NSTs for the last 3 weeks, and the results have been reactive. This week, the NST was nonreactive after 40 minutes. The nurse anticipates which of the following will be performed for the client based on these results?
A. Scheduled for an immediate ultrasound
B. Scheduled for a biophysical profile
C. Admitted to the hospital for induction of labor
D. Scheduled for a follow-up appointment for NST in 2 days
Show answer and rationale
Correct answer: B — Scheduled for a biophysical profile
The correct answer is B: Scheduled for a biophysical profile. At 37 weeks gestation, a nonreactive NST after 40 minutes indicates a need for further evaluation with a biophysical profile to assess fetal well-being comprehensively. This test includes NST along with ultrasound evaluation of amniotic fluid volume, fetal tone, fetal breathing movements, and gross body movements. Biophysical profile provides a more detailed assessment of fetal status compared to NST alone.
Choice A is incorrect because an immediate ultrasound is not the next step after a nonreactive NST. Choice C is incorrect because hospital admission for labor induction is premature based on one nonreactive NST result. Choice D is incorrect because waiting for 2 days for a follow-up NST is not recommended due to the urgency of assessing fetal well-being promptly.
Question 5
What nursing diagnosis would be appropriate for the person with a coagulation disorder?
A. risk for bleeding
B. risk for fluid overload
C. risk for breast-feeding failure
D. risk for hypertension
Show answer and rationale
Correct answer: B — risk for fluid overload
The correct answer is B: risk for fluid overload. A person with a coagulation disorder is at risk for excessive bleeding, which may lead to fluid overload due to blood loss and subsequent fluid replacement. This nursing diagnosis addresses the potential complications related to fluid imbalance in this population.
Incorrect choices:
A: risk for bleeding - While bleeding is a concern for someone with a coagulation disorder, this choice does not address the potential fluid overload that may result from excessive bleeding.
C: risk for breast-feeding failure - This choice is not relevant to the immediate health concerns of a person with a coagulation disorder.
D: risk for hypertension - Hypertension is not directly related to a coagulation disorder, therefore this choice is not appropriate as a nursing diagnosis in this context.
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Question 6
A patient who is 8 cm dilated develops circumoral numbness and dizziness. What is the nurse’s priority intervention?
A. Call the health care provider immediately.
B. Increase intravenous fluid, as these are signs of hypovolemia.
C. Have the patient slow down her breathing.
D. Have her start pushing, as these are signs of the beginning of the second stage.
Correct answer:
The correct answer is C: Have the patient slow down her breathing. When a patient is 8 cm dilated and experiences circumoral numbness and dizziness, these are signs of hyperventilation caused by rapid breathing. Hyperventilation can lead to respiratory alkalosis, which can have serious implications for both the mother and baby. By having the patient slow down her breathing, it can help restore the balance of oxygen and carbon dioxide levels in the blood, reducing the risk of complications. Calling the healthcare provider immediately (choice A) may cause delay in addressing the immediate issue. Increasing intravenous fluid (choice B) is not indicated as the symptoms are not suggestive of hypovolemia. Having her start pushing (choice D) is not advisable as she is not fully dilated, and pushing prematurely can lead to complications.
The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all that apply.)
A. Progesterone levels become higher than estrogen levels.
B. Natural oxytocin in conjunction with other substances plays a role
C. Stretching, pressure, and irritation of the uterus and cervix increase
D. The secretion of prostaglandins from the fetal membranes decreases.
Correct answer:
Step 1: Natural oxytocin is a hormone that plays a crucial role in initiating labor by stimulating uterine contractions.
Step 2: Other substances like prostaglandins also contribute to the initiation of labor by promoting cervical ripening and uterine contractions.
Step 3: Therefore, the correct answer is B as it accurately reflects the role of natural oxytocin and other substances in the initiation of labor.
Summary:
A: Progesterone levels becoming higher than estrogen levels is not directly related to the initiation of labor.
C: While stretching, pressure, and irritation of the uterus and cervix can contribute to labor, they are not the primary factors in labor initiation.
D: The secretion of prostaglandins from the fetal membranes actually increases during labor to facilitate the process, so this statement is incorrect.
Five minutes after delivery of the infant, the umbilical cord is protruding more from the woman's vaginal introitus and there is a sudden gush of blood with a contracted uterus. What does this signal to the nurse?
A. Laceration of the genital tract
B. The second stage of labor
C. Separation of the placenta
D. Postpartum hemorrhage
Correct answer:
The sudden gush of blood and the contracted uterus indicate a separation of the placenta, which is a serious complication called placental abruption. This condition can lead to significant bleeding and jeopardize the health of both the mother and the baby. It is essential for the nurse to recognize this situation promptly and take immediate action to manage the hemorrhage and stabilize the patient.
Explanation for incorrect choices:
A: Laceration of the genital tract would not typically cause a sudden gush of blood and a contracted uterus.
B: The second stage of labor is characterized by the delivery of the baby, not by a sudden gush of blood and a contracted uterus.
D: Postpartum hemorrhage could be a consequence of placental separation, but it is not the primary issue indicated by the symptoms described in the scenario.
A nurse is assessing a pregnant patient at 28 weeks gestation who reports occasional dizziness and fainting. What should the nurse assess first?
A. The patient's blood pressure and hydration status
B. The fetal heart rate and activity levels
C. The patient's hemoglobin and hematocrit levels
D. The patient's weight gain and diet history
Correct answer:
The correct answer is A: The patient's blood pressure and hydration status. This is the priority because dizziness and fainting can be signs of hypotension or dehydration, which can be dangerous during pregnancy. Checking blood pressure and hydration status will help determine if these symptoms are related to these issues.
B: Assessing fetal heart rate and activity levels is important but not the priority in this scenario as the patient's symptoms are more likely related to her own health rather than the fetus.
C: Checking hemoglobin and hematocrit levels is important for assessing anemia but is not the immediate concern in a patient experiencing dizziness and fainting.
D: Weight gain and diet history are important aspects of prenatal care but are not the priority when dealing with symptoms of dizziness and fainting.
A nurse is providing postpartum care to a G4P4 woman who gave birth vaginally 48 hours ago to a 9 pound 10 ounce boy with only a pudendal block for anesthesia. The physician has written orders for the woman to have a sitz bath three times a day. Which information is most closely correlated with the order?
A. The woman is multiparous.
B. The woman has an episiotomy.
C. The woman had a vaginal birth.
D. The woman received a pudendal block for anesthesia.
Correct answer:
The correct answer is B: The woman has an episiotomy. A sitz bath is often recommended postpartum for women who have had an episiotomy to promote healing and relieve discomfort. An episiotomy is a surgical incision made in the perineum during childbirth to facilitate delivery and prevent tearing. The warm water in a sitz bath helps to reduce swelling, promote circulation, and clean the area.
Incorrect choices:
A: The woman is multiparous - Multiparity does not directly correlate with the need for a sitz bath postpartum.
C: The woman had a vaginal birth - While this is true, it does not specifically address the need for a sitz bath.
D: The woman received a pudendal block for anesthesia - Although this information may be relevant to the birth experience, it does not directly relate to the need for a sitz bath postpartum.
How should the nurse respect the rapid psychologic changes occurring in the fourth stage of labor?
A. Invite the family to come in and see the newborn.
B. Take the lead from the parents regarding interruption of the bonding.
C. Ask multiple questions about taking pictures of the newborn.
D. Take the newborn to the nursery to encourage the parents to rest.
Correct answer:
The correct answer is B because in the fourth stage of labor, immediate postpartum bonding between parents and newborn is crucial. The nurse should respect the rapid psychologic changes by taking cues from the parents on how they want this bonding experience to unfold. This approach ensures that the parents are supported in establishing a strong emotional bond with their newborn, promoting a positive postpartum experience.
Choice A is incorrect because inviting the family in may not align with the parents' wishes for privacy during this intimate moment. Choice C is incorrect as asking multiple questions about taking pictures may be intrusive and disrupt the bonding process. Choice D is incorrect as separating the newborn from the parents can hinder bonding and may not align with current best practices in postpartum care.
An absence of what may facilitate the occurrence of bacterial vaginosis?
A. Antibodies
B. Lactobacillus acidophilus
C. Gardnerella vaginalis
D. Vaginal mucosa
Correct answer:
Correct Answer: B - Lactobacillus acidophilus
Rationale: Lactobacillus acidophilus is a beneficial bacteria that helps maintain the acidic pH of the vagina, inhibiting the growth of harmful bacteria like Gardnerella vaginalis. An absence of Lactobacillus acidophilus can disrupt the vaginal microbiota balance, allowing for the overgrowth of harmful bacteria and leading to bacterial vaginosis.
Summary of Incorrect Choices:
A: Antibodies - Antibodies play a role in the immune response but are not directly related to the occurrence of bacterial vaginosis.
C: Gardnerella vaginalis - Gardnerella vaginalis is a bacteria associated with bacterial vaginosis, not its absence.
D: Vaginal mucosa - The integrity of the vaginal mucosa is important for protection, but its absence would not directly facilitate bacterial vaginosis.
Which of the following is the most appropriate nursing action for a patient who has been administered an epidural block and is now experiencing hypotension?
A. Administer a bolus of IV fluids
B. Place the patient in a Trendelenburg position
C. Administer oxygen via mask
D. Raise the head of the bed slightly
Correct answer:
The correct answer is A: Administer a bolus of IV fluids. Hypotension after an epidural block is often due to vasodilation caused by the block. Administering IV fluids can help increase blood volume and improve blood pressure. This action is crucial in maintaining perfusion to vital organs.
Choice B: Placing the patient in a Trendelenburg position can potentially worsen hypotension by increasing venous return to the heart, leading to further vasodilation and reduced blood pressure.
Choice C: Administering oxygen via mask may be important in some situations but is not the primary intervention for hypotension caused by epidural block.
Choice D: Raising the head of the bed slightly is not the best option for treating hypotension as it does not address the underlying cause of vasodilation and decreased blood pressure.
A nurse is caring for a pregnant patient who is 30 weeks gestation and is diagnosed with mild preeclampsia. Which of the following should be included in the plan of care?
A. Administer magnesium sulfate to prevent seizures.
B. Monitor blood pressure and assess for protein in the urine.
C. Encourage rest and restricted activity to lower blood pressure.
D. Perform daily blood glucose monitoring for gestational diabetes.
Correct answer:
The correct answer is B: Monitor blood pressure and assess for protein in the urine. This is crucial in the care of a pregnant patient with mild preeclampsia at 30 weeks gestation. Monitoring blood pressure helps in assessing the severity of the condition and guiding treatment. Assessing for protein in the urine confirms the diagnosis and helps in monitoring kidney function and overall disease progression.
Explanation of why the other choices are incorrect:
A: Administering magnesium sulfate is typically indicated for severe preeclampsia to prevent seizures, not mild preeclampsia.
C: Encouraging rest and restricted activity can help manage symptoms but is not a primary intervention for mild preeclampsia.
D: Daily blood glucose monitoring is important for gestational diabetes, not specifically for mild preeclampsia.
What is the priority intervention for a laboring person with a suspected uterine rupture?
A. prepare for an emergency cesarean section
B. perform uterine massage
C. apply pressure to the abdomen
D. monitor the fetal heart rate continuously
Correct answer:
The correct answer is B: perform uterine massage. This intervention aims to prevent excessive bleeding and stabilize the uterus. Uterine massage helps to maintain uterine tone, which is crucial in managing uterine rupture. This intervention can help reduce the risk of maternal hemorrhage and improve fetal oxygenation.
Incorrect choices:
A: Emergency cesarean section may be necessary but is not the priority as immediate measures to control bleeding and maintain uterine tone are crucial.
C: Applying pressure to the abdomen is not recommended as it can further exacerbate uterine rupture and increase the risk of complications.
D: Continuous monitoring of the fetal heart rate is important but not the priority in managing uterine rupture, which requires immediate intervention to prevent maternal and fetal complications.
About these LPN exams maternity and newborn questions
LPN exams maternity and newborn practice questions, set 16 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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