NSG 524 -OB Test 3 Questions

NSG 524 -OB Test 3 Questions

NSG 524 -OB Test 3 Questions

1. What does the teaching include for new grandparent?

 

1. She gave us 4 different temperatures, which was would lead you to suspect postpartum infection?

 

1. Immediately after a baby is circumcised what is the nursing priority? Assess the bleeding pg

After a newborn infant undergoes circumcision, which of the following would the nurse include in the post-procedure plan of care?

 

 

The nurse is assessing a newborn’s circumcision 30 minutes after the procedure. The nurse notes excessive bleeding coming from the circumcised area. Which priority intervention should the nurse implement?
a. Apply pressure to the site.
b. Continue to observe for another 30 minutes.
c. Apply the diaper tightly over the circumcised area.
d. Apply petroleum jelly to the site with a small piece of gauze.

ANS:

NSG 524 -OB Test 3 Questions

17) The nurse is caring for a newborn who was recently circumcised. Which nursing intervention is appropriate following the procedure?

1. Keep the infant NPO for 4 hours following the procedure.
2. Observe for urine output.
3. Wrap dry gauze tightly around the penis.
4. Clean with cool water with each diaper change.

 

Explanation: 2. It is important to observe for the first voiding after a circumcision to evaluate for urinary obstruction related to penile injury and/or edema.

 

1. A new mom wants to know how she can tell if breastfeeding is effective?? 6-8 wet diapers a day

A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who:

a. Sleeps for 6 hours at a time between feedings.
b. Has at least one breast milk stool every 24 hours.
c. Gains 1 to 2 ounces per week.
d. Has at least six to eight wet diapers per day.

 

1. A new dad calls the clinic and is worried that his sons hands and feet are still blue after 2 weeks, what do you tell him? You tell him its normal

 

1. The question stated that labs were drawn and all looked good except rubella titer 1:8..what do you anticipate treatment to be?

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8 (EIA 0.8); hematocrit, 30%. How would the nurse best interpret these data?

a.	Rubella vaccine should be given.
b.	A blood transfusion is necessary.
c.	Rh immune globulin is necessary within 72 hours of birth.
d.	A Kleihauer-Betke test should be performed.

 

NSG 524 -OB Test 3 Questions

7. The PP client has a wbc of 20,000 after f days what do you do? Document pg483

If the patients white blood cell (WBC) count is 25,000/mm on her second postpartum day, the nurse should:

a.	Tell the physician immediately.
b.	Have the laboratory draw blood for reanalysis.
c.	Recognize that this is an acceptable range at this point postpartum.
d.	Begin antibiotic therapy immediately.

 

8. A patient has a uterine inversion and the nurse repositions the uterus, what does she do immediately after?

Manual manipulation was used to reposition the uterus of a client who experienced uterine inversion. Which medication would the nurse administer as prescribed after repositioning?

1. a) Magnesium sulfate b) Terbutaline

   c) Low-dose nitroglycerin                               d) Oxytoxic agent

 

9. What is the priority comfort measure for a baby going into drug withdrawal? Swaddle the baby

A plan of care for an infant experiencing symptoms of drug withdrawal should include:

a.	Administering chloral hydrate for sedation.
b.	Feeding every 4 to 6 hours to allow extra rest.
c.	Swaddling the infant snugly and holding the baby tightly.
d.	Playing soft music during feeding.

 

10. Where do you place the newborn whom is suspected of alcohol dependence? Dark corner of nursery

Why would the nurse want to place a newborn with Neonatal Abstinence Syndrome in a quiet area of the nursery with dim lights and no extraneous noises or motion?

NSG 524 -OB Test 3 Questions

11. The newborn delivered in a Cab to a mom who has active herpes lesion?

A mother spontaneously delivers her infant in a taxi cab on the way to the hospital. The emergency room nurse reports that the mother has active herpes (HSVII) lesion on the vulva. What intervention should the nurse implement first when admitting the neonate in the nursery?

A. Obtain blood specimen for serum glucose level
B. Document the temperature on the flow sheet
C. Place newborn in the isolation area of the nursery
D. Administer Vitamin K injection

 

 

12. Baby comes out of birth canal and his left arm has little or no flexion and crepitus over the shoulder?

While completing a newborn assessment, the nurse should be aware that the most common birth injury is:

a.	To the soft tissues.
b.	Caused by forceps gripping the head on delivery.
c.	Fracture of the humerus and femur.
d.	Fracture of the clavicle.

 

13. An infant born after 43 weeks gestation and weighing over 9lbs delivered vaginally, what does the nurse check for? Erbs palsy, Bells palsy, tachycardia, pg843

The client vaginally delivers an infant that weighs 4750 g. Moderate shoulder dystocia occurred during the birth. During the initial assessment of this infant, what should the nurse look for?
1. Bell’s palsy                                2. Bradycardia
3. Erb palsy                                   4. Petechiae

 

 

14. A preterm baby, with a high pitch cry and jitters, what is your priority assessment?

An infant was born 2 hours ago at 37 weeks of gestation and weighing 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of:

a.	Birth injury.	c.	Hypoglycemia.
b.	Hypocalcemia.	d.	Seizures.

 

The nurse is caring for an newborn who is 18 inches long, weighs 4 lbs, 14 oz has a head circumference of 13 inches and chest circumference is of 10 inches. Based on these physical findings , assessment for which condition has the highest priority?

A. Hyperthermia
B. Hyperbillirubinemia
C. Polycythemia
D. Hypoglycemia

15. What medicine will a baby with patent ductus arteriosis receive?

A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication?

A) Alprostadil                                            B) Heparin

C) Indomethacin                                       D) Spironolactone

 

16. What is a contraindication for a baby who is about to go on ECMO? Intracerebral hemorrhage

What is considered the most concerning complication of ECMO in the newborn?

 

17. What is the biggest reward for the new dad? The baby’s smile

Early development of involved father role

1. Expectations and intentions: desire for emotional involvement and deep connection
   2. Confronting reality: Dealing with unrealistic expectations, frustrations, helplessness, etc
   3. Creating the role of involved father: altering expectations, new priorities, learning care, increasing interaction
   4. Reaping rewards: infant smile, sense of meaning, completeness

 

18. Mom is walking to bathroom for the 1^st time after delivery and you notice some trickling what do you do? I said its normal and got it right on her test but on the HESI it was not and that’s because on the hesi it says continuous red blood trickling

The nurse is assisting a multiparous woman to the bathroom for the first time since her delivery 3 hours ago. When the client stands up, blood runs down her legs and pools on the floor. The client turns pale and feels weak. What would be the first action of the nurse?
1. Assist the client to empty her bladder
2. Help the client back to bed to check the fundus
3. Assess her blood pressure and pulse
4. Begin an IV of lactated Ringer’s solution

 

19. A new mom is about to be transported to Post partum unit, what would stop the nurse from taking her?

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20. What do you do to prevent hematoma ?

Approximately 8 hours ago, a woman gave birth after 2.5 hours of pushing. She required an episiotomy and an assisted birth (forceps). The perinatal nurse assesses a slight bulge in the perineum and the presence of ecchymosis to the right of the episiotomy. The area feels full and is approximately 4 cm in diameter. The patient describes this area as tender. What intervention does the nurse anticipate for this situation?
A. Application of ice                           B. Exploratory surgery
C. Incision and drainage                    D. Sitz bath every 12 hours

 

21. What is Vitamin K used for? Bacteria or baby doesn’t have enough Vitamin K?

In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is:

a.	Important in the production of red blood cells.
b.	Necessary in the production of platelets.
c.	Not initially synthesized because of a sterile bowel at birth.
d.	Responsible for the breakdown of bilirubin and prevention of jaundice.

 

22. The erythromycin is used to treat what sort of infection?

 

23. The mom is streptococcus positive and has chills and fever, what med do you anticipate being given and what other kind of care?

 

24. The baby under phototherapy what does the care include?

A 48-hour-old infant who is being breast-fed is diagnosed with physiological jaundice and is prescribed phototherapy treatment. Which measure taken by the nurse would enhance bilirubin excretion?

A. keeping the infant snugly wrapped
B. placing the infant in a quite, darkened area
C. providing the infant with additional oral fluids every 3 hours
D. encouraging the mother to temporarily suspend breast-feeding her infant

NSG 524 -OB Test 3 Questions

25. There was a question about hip displacement in the baby, im not sure what it said exactly

A nurse assesses a newborn with asymmetric gluteal and thigh skinfolds, a left leg shorter than the right, and a clicking sound of the right hip. What condition does this information indicate that the newborn most likely has?

A. fractured pelvis                                     B. fractured right leg
C. congenital hip dysplasia                       D. underdeveloped femur

 

26. What were the criteria for early discharge?

1. term infant with weight appropriate for gestation
   2. normal physical assessment
   3. Temp, RR, HR within normal limits for 12 hours preceding discharge
   4. @ least 2 successful feedings
   5. urinated/pooped once
   6. no excessive bleeding at circumcision site for at least 2 hours
   7. initial hep B vaccine given or at first follow up visit

 

27. The infant is suspected of having NEC, what signs and symptoms do you see?

 

28. The surfactant question again! This one was worded like you tell the parents that the baby’s lungs could collapse with every breath

 

29. There was a question about pain in the lower leg, redness, swelling and hard mass (poss DVT) what was the nursing priority?

 

30. Immediately after birth the fundus is 2cm below the umbilicus and firm, what is the next nursing action?

 

31. The contraceptive that you would discourage with a breast feeding mom is?

 

32. How do you prevent mastitis? Proper feeding technique ?

The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:

a.	Washing the nipples and breasts with mild soap and water once a day.
b.	Using proper breastfeeding techniques.
c.	Wearing a nipple shield for the first few days of breastfeeding.
d.	Wearing a supportive bra 24 hours a day.

 

33. Why does the NICU nurse encourage baby to do non nutriative sucking during gavage feeding?

A preterm infant is being fed by gavage. What is an important consideration for this infant?

a. Warm the feeding to body temperature before feeding.
b. Feed the infant in an isolette to minimize handling.
c. Provide a pacifier for nonnutritive sucking during bolus feeding.
d. Do not allow the infant to have increased stress by becoming hungry.

A preterm infant is being gavage fed in the NICU. What do you teach the parents about stimulating the infant?

1. Ways to stimulate include using a black and white mobile, STROKING gently, talking to the infant, rocking or providing ROM activity or Kangaroo care.
   c. A pacifier may be used. Stimulation during feeding should be at a minimal. Stimulation and interaction with pt should be provided between feedings
   gavage feeding to provide nonnutritive sucking

 

34. Your initial assessment of the baby after birth??

 

STUFF RELATED TO WHAT SHE SAID WORD FOR WORD

The breastfeeding mother should be taught a safe method to remove the breast from the babys mouth. Which suggestion by the nurse is most appropriate?

a.	Slowly remove the breast from the babys mouth when the infant has fallen asleep and the jaws are relaxed.
b.	Break the suction by inserting your finger into the corner of the infants mouth.
c.	A popping sound occurs when the breast is correctly removed from the infants mouth.
d.	Elicit the Moro reflex to wake the baby and remove the breast when the baby cries.

 

A woman delivered a 9-lb, 10-oz baby 1 hour ago. When you arrive to perform her 15-minute assessment, she tells you that she feels all wet underneath. You discover that both pads are completely saturated and that she is lying in a 6-inch-diameter puddle of blood. What is your first action?

a.	Call for help.	c.	Take her blood pressure.
b.	Assess the fundus for firmness.	d.	Check the perineum for lacerations.