CPNRE Maternal and Newborn Care 4 — Questions and Answers
Question 1: A nurse is caring for a client at 38 weeks gestation who reports sudden, painless, bright red vaginal bleeding. Which condition does this presentation most likely indicate?
- Placental abruption
- Placenta previa (Correct answer)
- Vasa previa
- Bloody show
Correct answer: Placenta previa
Placenta previa typically presents with sudden, painless, bright red vaginal bleeding in the third trimester due to the placenta covering the cervical os.
Question 2: A postpartum client is being discharged after a cesarean birth. Which instruction is most important regarding activity restrictions?
- Avoid climbing stairs for 6 weeks
- Do not lift anything heavier than the newborn for 6 weeks
- Refrain from driving for at least 2 weeks or while taking opioid analgesics (Correct answer)
- Avoid sexual intercourse for 4 weeks
Correct answer: Refrain from driving for at least 2 weeks or while taking opioid analgesics
Driving is contraindicated while taking opioid analgesics and typically for at least 2 weeks post-cesarean due to impaired reaction time and incisional pain.
Question 3: A newborn at 24 hours of life has a bilirubin level of 9 mg/dL. The nurse understands that physiological jaundice in term newborns typically appears:
- Within the first 24 hours of life
- Between 24 and 72 hours of life (Correct answer)
- After 7 days of life
- Only in breastfed infants
Correct answer: Between 24 and 72 hours of life
Physiological jaundice in term newborns typically appears between 24 and 72 hours of life, distinguishing it from pathological jaundice which appears within the first 24 hours.
Question 4: A nurse is monitoring a client in active labour and notes late decelerations on the fetal monitor. What is the priority nursing action?
- Increase the IV oxytocin infusion rate
- Reposition the client to the left lateral position (Correct answer)
- Administer oxygen via face mask at 10 L/min
- Notify the physician and prepare for immediate delivery
Correct answer: Reposition the client to the left lateral position
Repositioning to the left lateral position is the first priority action to relieve aortocaval compression and improve uteroplacental blood flow when late decelerations are noted.
Question 5: Which finding in a 2-day-old newborn should the nurse report to the physician immediately?
- Milia on the nose and cheeks
- Jaundice appearing at 48 hours
- Respiratory rate of 68 breaths per minute (Correct answer)
- Hands and feet that appear bluish (acrocyanosis)
Correct answer: Respiratory rate of 68 breaths per minute
A respiratory rate of 68 breaths per minute exceeds the normal newborn range of 30–60 breaths per minute and requires immediate physician notification.
Question 6: A client at 32 weeks gestation is diagnosed with preeclampsia. Which medication does the nurse anticipate will be ordered to prevent seizures?
- Nifedipine
- Methyldopa
- Magnesium sulfate (Correct answer)
- Hydralazine
Correct answer: Magnesium sulfate
Magnesium sulfate is the drug of choice for seizure prophylaxis and treatment in clients with preeclampsia.
Question 7: A nurse is teaching a new mother about breast engorgement. Which statement by the mother indicates understanding?
- I should stop breastfeeding until the engorgement resolves
- I can apply warm compresses and massage before feeding to help milk flow (Correct answer)
- I should limit feedings to every 4 hours to reduce milk production
- Engorgement means I have too much milk and should pump and discard it
Correct answer: I can apply warm compresses and massage before feeding to help milk flow
Warm compresses and breast massage before feeding promote milk let-down and help relieve engorgement while maintaining breastfeeding.
CPNRE Maternal and Newborn Care 4
A nurse is caring for a client at 38 weeks gestation who reports sudden, painless, bright red vaginal bleeding.
Which condition does this presentation most likely indicate?