BSN Maternal-Newborn and Women's Health Nursing 2 — Questions and Answers
Question 1: Which assessment is most important for a nurse to perform before administering RhoGAM (Rh immunoglobulin) to a postpartum patient?
- Confirm the mother is Rh-negative and the newborn is Rh-positive (Correct answer)
- Verify the mother's blood pressure is within normal limits
- Ensure the patient has no known allergy to penicillin
- Confirm the patient delivered more than 72 hours ago
Correct answer: Confirm the mother is Rh-negative and the newborn is Rh-positive
RhoGAM is only indicated when an Rh-negative mother delivers an Rh-positive infant; confirming both blood types is essential before administration.
Question 2: A nurse is assessing a patient for postpartum depression (PPD). Which symptom most distinguishes PPD from normal 'baby blues'?
- Persistent feelings of worthlessness and inability to care for the infant lasting beyond 2 weeks (Correct answer)
- Tearfulness and mood swings on days 3–5 postpartum
- Mild fatigue and anxiety about newborn care
- Temporary difficulty sleeping when the baby sleeps
Correct answer: Persistent feelings of worthlessness and inability to care for the infant lasting beyond 2 weeks
Baby blues resolve within 2 weeks; PPD is characterized by persistent, impairing symptoms including impaired infant bonding and feelings of worthlessness.
Question 3: A patient at 28 weeks' gestation reports decreased fetal movement. The nurse instructs the patient to perform kick counts. Which finding should prompt the patient to contact the provider immediately?
- Fewer than 10 movements in 2 hours (Correct answer)
- Ten movements within the first 45 minutes
- One brief episode of hiccups during counting
- Fetal movement that increases after a snack
Correct answer: Fewer than 10 movements in 2 hours
Fewer than 10 movements in a 2-hour window is the threshold that indicates decreased fetal activity and requires urgent provider evaluation.
Question 4: Which position should the nurse place a laboring patient in to maximize placental perfusion and prevent supine hypotensive syndrome?
- Left lateral (left side-lying) position (Correct answer)
- Supine (flat on back)
- High Fowler's (90-degree sitting)
- Prone (lying on stomach)
Correct answer: Left lateral (left side-lying) position
The left lateral position displaces the uterus off the inferior vena cava, maintaining venous return and preventing supine hypotensive syndrome.
Question 5: A nurse is assessing a 1-day-old newborn and notes jaundice extending to the chest and abdomen. The nurse is aware that jaundice appearing before 24 hours of life is:
- Pathological and requires immediate investigation (Correct answer)
- Physiological and expected at this stage
- A sign of breastfeeding jaundice
- Related to normal meconium passage
Correct answer: Pathological and requires immediate investigation
Jaundice appearing in the first 24 hours of life is always pathological (commonly hemolytic disease) and requires urgent evaluation to prevent kernicterus.
Question 6: A pregnant patient in her first trimester asks about taking over-the-counter medications for a headache. Which medication should the nurse advise the patient to avoid?
- Ibuprofen (Advil) (Correct answer)
- Acetaminophen (Tylenol)
- Plain water and rest
- A cool compress to the forehead
Correct answer: Ibuprofen (Advil)
NSAIDs like ibuprofen are contraindicated in pregnancy, especially the first and third trimesters, because they can affect fetal development and cause premature closure of the ductus arteriosus.
BSN Maternal-Newborn and Women's Health Nursing 2
Which assessment is most important for a nurse to perform before administering RhoGAM (Rh immunoglobulin) to a postpartum patient?