LPN exams maternity and newborn practice questions set 18

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The correct answer is B because positioning the pregnant patient in a more upright position can help alleviate the shortness of breath by allowing the diaphragm to move more freely, reducing pressure on the lungs, and improving oxygenation. This action promotes optimal oxygen flow and comfort for the patient. A: Administering oxygen and preparing for delivery may be necessary in some cases but does not address the immediate need to alleviate shortness of breath caused by the supine position. C: Deep breathing exercises may not be effective in relieving shortness of breath caused by the supine position and may even exacerbate the discomfort. D: Instructing the patient to take shallow breaths and avoid exertion does not address the underlying cause of shortness of breath and may not provide adequate relief.

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The correct answer is D: diastasis recti abdominus. This term refers to the separation of the rectus abdominis muscles along the midline of the abdomen. This condition commonly occurs after pregnancy due to the stretching of the abdominal muscles. It is important to differentiate diastasis recti from other conditions such as uterine subinvolution, which is the delayed return of the uterus to its normal size postpartum; umbilical hernia, which is a protrusion of abdominal contents through the umbilical ring; and striae, which are stretch marks caused by rapid stretching of the skin. Diastasis recti is characterized by a visible gap between the muscles, often causing a bulge in the midline of the abdomen. Treatment usually involves specific exercises to strengthen the abdominal muscles and improve the condition.

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Step-by-step rationale: 1. A boggy uterus indicates uterine atony, a common cause of postpartum hemorrhage. 2. A full bladder can prevent the uterus from contracting effectively. 3. Massaging the fundus helps stimulate contractions to prevent further bleeding. 4. Assessing lochia provides information on the amount and type of bleeding. 5. This intervention addresses the underlying issue and promotes uterine contraction, reducing the risk of hemorrhage. Other choices are incorrect: A: Calling for help is not the immediate intervention needed to address the uterine atony and full bladder. B: Starting an IV bolus may be necessary later but is not the priority in this situation. C: Getting the person out of bed is not appropriate when managing postpartum hemorrhage; addressing uterine atony is crucial.

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The correct answer is B: Call the healthcare provider immediately and prepare for further assessment. This is the priority action because sharp abdominal pain and decreased fetal movement at 35 weeks gestation could indicate a serious complication such as placental abruption or fetal distress. Calling the healthcare provider promptly allows for timely intervention and assessment to ensure the safety of both the mother and the baby. Encouraging the patient to drink water and rest (choice A) may not address the underlying issue. Monitoring fetal heart rate and performing a nonstress test (choice C) may be important but not as immediate as contacting the healthcare provider. Asking the patient to lie on her left side and wait for symptoms to resolve (choice D) delays necessary medical evaluation and intervention.

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The correct answer is A: Encourage the patient to drink a sugary beverage and count fetal movements. This action is appropriate as decreased fetal movement can indicate fetal distress, and the sugary beverage can stimulate the baby to move. If the baby responds with increased movements, it indicates a reassuring fetal status. If there is no improvement, further evaluation can be pursued. Incorrect choices: B: Monitoring blood pressure is not the priority in this situation as the main concern is fetal movement. C: Performing a nonstress test is not the first action to take as it requires time and resources, which may delay immediate intervention. D: While eventually contacting the healthcare provider is important, the immediate action should be to assess fetal well-being by encouraging fetal movements.

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The correct answer is B: Hands and knees position. This position helps relieve back pain during labor by promoting optimal fetal positioning, reducing pressure on the back, and allowing gravity to assist in the descent of the baby. It also opens up the pelvic outlet, making it easier for the baby to navigate through the birth canal. Incorrect choices: A: Supine position can worsen back pain as it puts pressure on the lower back and restricts blood flow to the uterus. C: Lithotomy position can exacerbate back pain as it involves lying on the back with legs in stirrups, which can increase pressure on the back. D: Squatting position may not be ideal for relieving back pain in this scenario as it can put additional strain on the back muscles and may not provide optimal support for the laboring individual.

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The correct answer is A: Frequent urination and excessive thirst. In gestational diabetes, the body may not be able to produce enough insulin, leading to high blood sugar levels. The excess sugar in the blood can cause increased thirst and frequent urination as the body tries to eliminate the sugar through urine. This is a key sign that the nurse should monitor for in a pregnant patient at 30 weeks gestation. Nausea and vomiting after meals (B) are more commonly associated with morning sickness in early pregnancy. Increased appetite and weight gain (C) can occur during pregnancy but are not specific signs of gestational diabetes. Fatigue and dizziness during physical activity (D) can be common in pregnancy due to hormonal changes and increased demands on the body but are not specific to gestational diabetes.

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The correct answer is A, a distended bladder. When the fundus is palpated on the right side above the expected level, it indicates that the bladder is full and pushing the uterus upward and to the right. This can interfere with the normal descent of the uterus during involution, leading to the fundus being higher than expected. Choice B, normal involution, is incorrect as it does not explain the fundus being palpated above the expected level. Choice C, lying on her right side too long, is incorrect as body position does not typically result in the fundus being displaced. Choice D, stretched ligaments that are unable to support the uterus, is incorrect as stretched ligaments would not cause the fundus to be palpated above the expected level; rather, it would lead to a lower position of the uterus.

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The correct answer is C: thrush. Thrush is a fungal infection caused by Candida that can be transmitted between the breast-feeding person and the newborn if not treated appropriately. The infection can pass back and forth during breastfeeding. Thrush manifests as white patches on the tongue and inside the mouth of the newborn and as nipple pain and redness in the breast-feeding person. Wound infection (A) typically refers to an infection at the site of a surgical incision and is not transmitted between the breast-feeding person and newborn. Urinary tract infection (B) is a bacterial infection of the urinary tract and is not typically transmitted through breastfeeding. Mastitis (D) is a bacterial infection of the breast tissue and is not directly transferred between the breast-feeding person and the newborn.

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The correct answer is A because administering a bolus of 500 to 1000 mL of D5 normal saline prior to catheter placement helps prevent hypotension, a common side effect of epidural anesthesia. This bolus helps maintain adequate fluid volume, which is crucial for hemodynamic stability during the procedure. Choice B is incorrect because having ephedrine available is not a necessary intervention for preparing a patient for epidural placement. Choice C is incorrect because while monitoring blood pressure is important during epidural administration, it should be done continuously rather than just for the first 15 minutes. Choice D is incorrect because inserting a Foley catheter is not a routine intervention for epidural catheter placement and is not directly related to the procedure's success or safety.