LPN exams maternity and newborn practice questions, set 8
LPN exams · maternity and newborn
LPN exams maternity and newborn practice questionsset 8
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 pregnant patient at 34 weeks gestation reports sudden swelling of the hands, feet, and face. What is the nurse's priority action?
A. Monitor the patient's blood pressure and check for signs of preeclampsia.
B. Encourage the patient to elevate the legs to reduce swelling.
C. Administer diuretics as prescribed to reduce fluid retention.
D. Instruct the patient to drink more water and reduce sodium intake.
Show answer and rationale
Correct answer: A — Monitor the patient's blood pressure and check for signs of preeclampsia.
The correct answer is A: Monitor the patient's blood pressure and check for signs of preeclampsia.
Rationale:
1. Sudden swelling of the hands, feet, and face in a pregnant patient at 34 weeks gestation can be a sign of preeclampsia.
2. Preeclampsia is a serious condition characterized by high blood pressure and protein in the urine, which can lead to complications for both the mother and the baby.
3. Monitoring the patient's blood pressure and checking for signs of preeclampsia is crucial for early detection and management of the condition.
4. Prompt intervention is necessary to prevent potential severe outcomes such as seizures, stroke, or organ damage.
Summary of Incorrect Choices:
B: Elevating the legs may provide temporary relief but does not address the underlying cause of the sudden swelling, which could be preeclampsia.
C: Administering diuretics without assessing the patient's blood pressure and ruling out
Question 2
Which physiologic effect may occur in the presence of increased maternal pain perception during labor?
A. Increase in uterine contractions in response to catecholamine secretion
B. Decrease in blood pressure in response to alpha receptors
C. Decreased perfusion to the placenta in response to catecholamine secretion
D. Increased uterine blood flow, causing increase in maternal blood pressure
Show answer and rationale
Correct answer: C — Decreased perfusion to the placenta in response to catecholamine secretion
The correct answer is C. Increased maternal pain perception during labor can lead to decreased perfusion to the placenta due to catecholamine secretion. When a mother experiences pain, stress hormones like catecholamines are released, causing vasoconstriction of blood vessels, including those supplying the placenta. This vasoconstriction reduces blood flow to the placenta, potentially compromising fetal oxygenation and nutrient delivery.
Choice A is incorrect because increased catecholamine secretion would not directly cause an increase in uterine contractions. Choice B is incorrect because alpha receptors are not typically involved in decreasing blood pressure in response to pain perception. Choice D is incorrect because increased uterine blood flow would not cause an increase in maternal blood pressure; in fact, it would likely have the opposite effect as increased blood flow typically leads to decreased blood pressure.
Question 3
A nurse is providing preoperative teaching for a woman who is undergoing a total mastectomy. Which will this teaching include? Select all that apply.
A. Explain that she will have an IV, a drain, and a dressing in place on awakening. Tell her about expectations she may have regarding physical appearance, pain management, equipment that will be used (IVs, drains, etc.).
B. Explain that she will be provided pain management as needed; monitor and review the pain scale to be used to identify level of intensity.
C. Have her elevate the affected arm with pillows.
D. Turn the woman every 4 hours, alternating between the unaffected side and affected side. To prevent pneumonia and complications, have her cough and take deep breaths every 2 hours, while nurse applies support to the chest.
Show answer and rationale
Correct answer: C — Have her elevate the affected arm with pillows.
Rationale for Answer C (Correct Answer):
1. Elevating the affected arm with pillows post-mastectomy helps reduce swelling and promote lymphatic drainage, aiding in preventing lymphedema.
2. By elevating the arm, it reduces strain on the surgical site and surrounding tissues, promoting comfort and aiding in the healing process.
3. This positioning also helps in preventing postoperative complications such as shoulder stiffness and contractures.
Summary of Why Other Choices are Incorrect:
- Choice A: While important aspects of preoperative teaching, it does not specifically address the need to elevate the affected arm post-mastectomy.
- Choice B: Pain management is crucial, but it does not directly relate to the need for arm elevation post-mastectomy.
- Choice D: Turning every 4 hours and coughing exercises are important for preventing complications but do not address the specific need for arm elevation post-mastectomy.
Question 4
A patient who smokes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition?
A. Congenital anomalies
B. Death before or after birth
C. Neonatal hypoglycemia
D. Neonatal withdrawal syndrome
Show answer and rationale
Correct answer: B — Death before or after birth
The correct answer is B: Death before or after birth. Smoking during pregnancy increases the risk of fetal death, both before and after birth, due to the harmful effects of nicotine and other toxins on the developing fetus. Smoking can lead to complications such as placental abruption, preterm birth, low birth weight, and stillbirth.
A: Congenital anomalies - While smoking during pregnancy can increase the risk of certain birth defects, the primary concern related to smoking is not congenital anomalies.
C: Neonatal hypoglycemia - Smoking during pregnancy is not directly linked to neonatal hypoglycemia, which is usually related to maternal diabetes or other factors.
D: Neonatal withdrawal syndrome - Although smoking during pregnancy can lead to nicotine exposure in the fetus, resulting in withdrawal symptoms after birth, the immediate risk of death is a more critical concern associated with smoking during pregnancy.
Question 5
The labor nurse is developing a plan of care for a patient admitted in active labor with
A. On admission, vital signs were as follows: maternal heart rate (HR) 92 bpm; fetal rate (FHR) baseline, 150 to 160 bpm; blood pressure, 124/76 mm Hg; temperature 37.2° C (99° F). What is the priority nursing action for this patient?
B. Fetal acoustic stimulation
C. Assess temperature everyN 2 hRourIs G
D. Change absorption pads under her hips every 2 hours
Show answer and rationale
Correct answer: A — On admission, vital signs were as follows: maternal heart rate (HR) 92 bpm; fetal rate (FHR) baseline, 150 to 160 bpm; blood pressure, 124/76 mm Hg; temperature 37.2° C (99° F). What is the priority nursing action for this patient?
The correct answer is A: On admission, vital signs were as follows: maternal heart rate (HR) 92 bpm; fetal rate (FHR) baseline, 150 to 160 bpm; blood pressure, 124/76 mm Hg; temperature 37.2° C (99° F). The priority nursing action for this patient is to assess the vital signs. The maternal heart rate, fetal heart rate, blood pressure, and temperature are crucial indicators of the patient's and the fetus's well-being during labor. Monitoring these vital signs helps the nurse detect any abnormalities or signs of distress promptly, allowing for timely intervention.
Choice B, fetal acoustic stimulation, is not the priority at this stage as there are no indications in the question stem that suggest the need for this intervention. Choice C, assessing temperature every 2 hours, is not the priority as the patient's temperature is within normal range on admission. Choice D, changing absorption pads under her hips every 2 hours,
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Question 6
A nurse is caring for a client who is G1P0 and 36 weeks gestation who has been diagnosed with severe pre-eclampsia. Her blood pressure is 165/110. The physician has ordered hydralazine. The nurse knows she should do which of the following when administering this medication?
A. Position the client supine with the head of the bed elevated 30 degrees.
B. Get baseline blood pressure and pulse and monitor frequently during administration.
C. Administer medication every 5 minutes until blood pressure is stabilized.
D. Inform the client that this may cause a positive direct Coombs test result.
Correct answer:
The correct answer is B. Getting baseline blood pressure and pulse and monitoring frequently during administration is crucial because hydralazine is a potent antihypertensive medication that can cause significant drops in blood pressure. Monitoring allows for early detection of hypotension or adverse reactions.
A is incorrect because positioning the client supine with the head of the bed elevated 30 degrees is not specific to the administration of hydralazine for pre-eclampsia.
C is incorrect because administering medication every 5 minutes until blood pressure is stabilized is not a standard protocol for hydralazine administration; it should be given as per physician's orders with appropriate monitoring.
D is incorrect because informing the client about a positive direct Coombs test result is not relevant to the administration of hydralazine; this is more pertinent to medications that can cause hemolytic anemia.
A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?
A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
B. von Willebrand disease (vWD); noting whether bleeding times have been extended
C. Thrombophlebitis; using real-time and color Doppler ultrasound
D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct answer:
Pain and tenderness in the extremities, which show warmth, redness, and hardness, is likely thrombophlebitis. A Doppler ultrasound examination is a common noninvasive way to confirm the diagnosis. A diagnosis of DIC is made according to clinical findings and laboratory markers. With DIC, a physical examination will reveal symptoms that may include unusual bleeding, petechiae around a blood pressure cuff on the woman’s arm, and/or excessive bleeding from the site of a slight trauma such as a venipuncture site. Symptoms of vWD, a type of hemophilia, include recurrent bleeding episodes, prolonged bleeding time, and factor VIII deficiency. A risk for PPH exists with vWD but does not exhibit a warm or reddened area in an extremity. ITP is an autoimmune disorder in which the life span of antiplatelet antibodies is decreased. Increased bleeding time is a diagnostic finding, and the risk of postpartum uterine bleeding is increase
A nurse is caring for a pregnant patient at 34 weeks gestation who has been diagnosed with gestational hypertension. What is the nurse's priority intervention?
A. Encourage the patient to rest and increase fluid intake.
B. Monitor the patient's blood pressure regularly and assess for signs of preeclampsia.
C. Administer antihypertensive medications as prescribed.
D. Instruct the patient to lie on her back to relieve pressure on the uterus.
Correct answer:
The correct answer is B: Monitor the patient's blood pressure regularly and assess for signs of preeclampsia. At 34 weeks gestation with gestational hypertension, monitoring blood pressure and assessing for signs of preeclampsia are crucial to detect any worsening condition. Preeclampsia is a serious complication of gestational hypertension that can lead to adverse outcomes for both the mother and fetus. Regular monitoring allows for timely intervention if necessary.
Choice A is incorrect because simply encouraging rest and increased fluid intake may not address the potential severity of gestational hypertension and preeclampsia.
Choice C is incorrect because administering antihypertensive medications without proper monitoring and assessment can be harmful to the patient and fetus.
Choice D is incorrect because lying on her back can actually worsen the patient's condition by decreasing blood flow to the uterus.
What anticipatory guidance should the nurse provide for new parents regarding sociologic changes?
A. Explain that roles will not change at home
B. Explain that stresses will be over now that the newborn is born.
C. Tell the parents not to stress over household changes.
D. Prepare them for possible strains on relationships.
Correct answer:
The correct answer is D: Prepare them for possible strains on relationships. This guidance is important as the arrival of a newborn can bring significant changes to the dynamics of a relationship. By preparing new parents for possible strains on relationships, the nurse can help them navigate challenges together.
A: Incorrect. Roles are likely to change at home with the addition of a newborn, so it is important to address this rather than dismissing it.
B: Incorrect. Stressors may actually increase with the arrival of a newborn, so it is not accurate to say stresses will be over.
C: Incorrect. Ignoring household changes can lead to added stress, so it is not advisable to tell parents not to stress over them.
In summary, option D is correct as it addresses the potential strains on relationships that new parents may face, while the other options do not acknowledge the reality of sociologic changes that can occur.
A pregnant patient at 36 weeks gestation reports sudden swelling of the face and hands. What is the nurse's priority action?
A. Monitor the patient's blood pressure and check for signs of preeclampsia.
B. Instruct the patient to rest and elevate her feet.
C. Recommend the patient drink more water to reduce swelling.
D. Administer diuretics as prescribed to manage fluid retention.
Correct answer:
The correct answer is A: Monitor the patient's blood pressure and check for signs of preeclampsia. At 36 weeks gestation, sudden swelling of the face and hands can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. Monitoring blood pressure and assessing for other signs of preeclampsia, such as headache or vision changes, is crucial for timely diagnosis and intervention to prevent complications for both the mother and baby.
Summary:
B: Instructing the patient to rest and elevate her feet may provide some relief for swelling but does not address the underlying potential issue of preeclampsia.
C: Recommending increased water intake may not be appropriate if the swelling is due to preeclampsia and can worsen the condition.
D: Administering diuretics without proper assessment and diagnosis of preeclampsia can be harmful and is not the initial priority action.
A nurse is taking care of a G2P2 woman with a third-degree perineal tear during the fourth stage of labor. The nurse should include which intervention in the plan of care during her 12-hour shift?
A. Assess vital signs every 4 hours.
B. Keep patient NPO for first 12 hours.
C. Catheterize patient prior to first ambulation.
D. Prepare ice pack for application to perineal area.
Correct answer:
The correct answer is D: Prepare ice pack for application to perineal area. This intervention is crucial for managing pain and reducing swelling in the perineal area post third-degree tear. Ice packs help vasoconstriction, decreasing blood flow and minimizing inflammation. It also provides comfort to the patient.
A: Assess vital signs every 4 hours - This is important but not the priority in this situation. Monitoring vital signs is essential, but immediate comfort measures should be prioritized for the patient with a perineal tear.
B: Keep patient NPO for first 12 hours - There is no indication to keep the patient NPO for 12 hours. Adequate hydration and nutrition are important for postpartum recovery.
C: Catheterize patient prior to first ambulation - Catheterization may not be necessary unless there are specific indications. It is not a routine intervention for a perineal tear during the fourth stage of labor.
The nurse is educating a pregnant patient about the importance of prenatal vitamins. Which statement by the patient indicates effective teaching?
A. I will take prenatal vitamins only during the first trimester.
B. I will take prenatal vitamins throughout the pregnancy to support my baby's growth.
C. Prenatal vitamins are only necessary if I have a history of birth defects in my family.
D. I should stop taking prenatal vitamins after the baby is born.
Correct answer:
The correct answer is B: "I will take prenatal vitamins throughout the pregnancy to support my baby's growth." This statement indicates effective teaching because prenatal vitamins are essential for the entire duration of pregnancy to support the developing baby's growth and development. Prenatal vitamins contain key nutrients like folic acid, iron, and calcium that are crucial for the health of both the mother and the baby throughout the pregnancy. Taking prenatal vitamins only during the first trimester (option A) may not provide adequate support for the baby's growth during the entire pregnancy. Option C is incorrect because prenatal vitamins are recommended for all pregnant women, regardless of their family history of birth defects. Option D is incorrect because stopping prenatal vitamins after the baby is born does not align with the need to support the mother's postpartum health and potential breastfeeding needs.
A pregnant patient at 30 weeks gestation is complaining of severe heartburn. What should the nurse recommend?
A. Lie down after meals to improve digestion.
B. Drink a large amount of water after eating.
C. Eat smaller meals more frequently and avoid lying down after meals.
D. Take antacids regularly to relieve heartburn.
Correct answer:
The correct answer is C: Eat smaller meals more frequently and avoid lying down after meals. This is the best recommendation for the pregnant patient experiencing severe heartburn at 30 weeks gestation. Eating smaller meals more frequently can help reduce the amount of stomach acid produced, thus decreasing the likelihood of heartburn. Avoiding lying down after meals can prevent stomach acid from flowing back into the esophagus, further reducing heartburn symptoms.
Rationale for why other choices are incorrect:
A: Lying down after meals can worsen heartburn by allowing stomach acid to flow back into the esophagus.
B: Drinking a large amount of water after eating may worsen heartburn by increasing stomach pressure and pushing stomach acid back up.
D: Taking antacids regularly may provide temporary relief but is not addressing the root cause of the heartburn and may not be safe for long-term use during pregnancy.
A nursing student is asked to set goals that will decrease the fetal death outcomes during delivery. What guidelines will the nursing student use to assist in setting her goals?
A. WHO Maternal care guidelines
B. Healthy People 2020
C. AWHONN white papers
D. State Practice Act
Correct answer:
The correct answer is B: Healthy People 2020. This is because Healthy People 2020 provides specific objectives related to maternal and child health, including reducing fetal death outcomes during delivery. The goals and targets outlined in Healthy People 2020 are evidence-based and nationally recognized, making it a reliable guide for setting healthcare goals.
A: WHO Maternal care guidelines focus more broadly on global maternal health issues and may not provide specific goals related to reducing fetal death outcomes during delivery.
C: AWHONN white papers may offer valuable insights and recommendations, but they are not as comprehensive or widely recognized as the goals outlined in Healthy People 2020.
D: State Practice Acts govern the scope of practice for healthcare providers in a specific state, but they do not typically include specific goals related to reducing fetal death outcomes during delivery.
A patient who has been on prolonged bedrest for bleeding associated with placenta previa was taken to the operating room for an emergency cesarean delivery. Sixteen hours postoperatively, the patient complains that her left leg is hurting. The nurse finds that the entire left leg is swollen and has pitting edema, while the right leg appears to be normal. Which order does the nurse anticipate when paging the health care provider to the room?
A. White blood cell count (WBC)
B. Ultrasound of the leg
C. X-ray of the leg
D. Serum creatinine
Correct answer:
The correct answer is B: Ultrasound of the leg. In this scenario, the patient is at risk for deep vein thrombosis (DVT) due to prolonged bedrest and recent surgery. The symptoms of leg pain, swelling, and pitting edema raise suspicion for DVT. An ultrasound of the leg is the most appropriate diagnostic test to confirm the presence of a blood clot. This test is non-invasive, highly sensitive, and specific for detecting DVT. It allows for prompt diagnosis and initiation of appropriate treatment such as anticoagulation therapy to prevent potential complications like pulmonary embolism.
Summary:
- A: White blood cell count (WBC) is not indicated for evaluating leg pain and swelling in this context.
- C: X-ray of the leg is not useful for diagnosing DVT, as it primarily shows bones and is not sensitive for detecting blood clots.
- D: Serum creatinine is a test for kidney function and is not relevant for assessing
About these LPN exams maternity and newborn questions
LPN exams maternity and newborn practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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