LPN Maternal and Neonatal Nursing

Question 1

A client at 38 weeks gestation reports sudden, painless, bright red vaginal bleeding. The LPN should first:

Accepted Answer

Notify the charge nurse immediately and do NOT perform a vaginal exam

Answer

Perform a vaginal examination to assess cervical dilation

Answer

Apply a pad count and reassess in 30 minutes

Answer

Prepare the client for an amniotomy

Question 2

An Apgar score is assessed at 1 minute and 5 minutes after birth. Which Apgar score at 5 minutes indicates a neonate in good condition?

Accepted Answer

Score of 7–10

Answer

Score of 3

Answer

Score of 5

Answer

Score of 6

Question 3

A postpartum client 6 hours after vaginal delivery has a uterus that is boggy, displaced to the right, and 2 fingerbreadths above the umbilicus. The LPN's first action should be:

Accepted Answer

Have the client void, then reassess fundal height and tone

Answer

Massage the fundus vigorously

Answer

Notify the charge nurse of postpartum hemorrhage

Answer

Apply ice to the abdomen to decrease bleeding

Question 4

The LPN is monitoring a laboring client and notes late decelerations on the fetal monitor. What is the appropriate intervention?

Accepted Answer

Reposition the client to her left side, administer oxygen, and stop Pitocin

Answer

Increase the Pitocin infusion to speed delivery

Answer

Document the findings and continue monitoring

Answer

Perform a vaginal exam to assess progress

Question 5

A breastfeeding client 2 days postpartum reports breast engorgement. The LPN should advise the client to:

Accepted Answer

Feed frequently (every 1–2 hours), apply warm compresses before feeding, and cold packs after

Answer

Stop breastfeeding temporarily and apply ice packs

Answer

Apply cabbage leaves and reduce fluid intake

Answer

Switch to formula feeding to relieve engorgement

Question 6

A newborn's blood glucose is 38 mg/dL at 2 hours of age. The infant is jittery and feeding poorly. The priority intervention is:

Accepted Answer

Administer oral glucose gel per protocol and notify the provider

Answer

Recheck glucose in 4 hours before taking action

Answer

Initiate early oral feeding with breast milk or formula and recheck glucose

Answer

Place the infant under a radiant warmer

Question 7

A client at 36 weeks gestation presents with a blood pressure of 158/104 mmHg, proteinuria (3+ on dipstick), and a severe frontal headache. The LPN should recognize this as:

Accepted Answer

Severe preeclampsia requiring immediate escalation

Answer

Normal blood pressure elevation of late pregnancy

Answer

Gestational hypertension without protein

Answer

Preterm labor symptoms

Question 8

A client receiving magnesium sulfate for preeclampsia has absent deep tendon reflexes (DTRs) and a respiratory rate of 12 breaths/minute. The LPN should immediately:

Accepted Answer

Stop the magnesium infusion and administer calcium gluconate IV

Answer

Increase the magnesium infusion rate to maintain therapeutic levels

Answer

Reposition the client and continue monitoring DTRs every hour

Answer

Document the findings as expected side effects

Question 9

A client 12 hours postpartum is assessed and has a temperature of 38.9°C (102°F). The LPN should first:

Accepted Answer

Notify the charge nurse — a fever this high this early may indicate infection

Answer

Encourage fluid intake to reduce fever caused by dehydration

Answer

Administer the prescribed acetaminophen and document the finding

Answer

Apply ice packs to reduce fever before notifying anyone

Question 10

When performing a newborn assessment, the LPN notes the following: acrocyanosis of hands and feet, heart rate 138 bpm, and respiratory rate 44 breaths/minute. The appropriate action is:

Accepted Answer

Document findings as normal for a newborn

Answer

Initiate resuscitation — these findings indicate cardiorespiratory compromise

Answer

Administer supplemental oxygen for the cyanosis

Answer

Notify the NICU immediately