LVN Maternal & Newborn Nursing 3 — Questions and Answers
Question 1: A nurse is monitoring a client in active labor on continuous electronic fetal monitoring. Late decelerations are noted with every contraction. What is the priority intervention?
- Increase IV fluid rate and reposition the client (Correct answer)
- Prepare for immediate cesarean delivery
- Administer oxygen at 2 L/min via nasal cannula
- Document and continue to monitor
Correct answer: Increase IV fluid rate and reposition the client
Late decelerations indicate uteroplacental insufficiency; repositioning and IV fluid bolus are first-line interventions to improve placental perfusion.
Question 2: A nurse assesses a newborn and notes a soft, fluctuant swelling that crosses the suture lines on the scalp. This finding is most consistent with:
- Cephalohematoma
- Caput succedaneum (Correct answer)
- Subgaleal hemorrhage
- Craniosynostosis
Correct answer: Caput succedaneum
Caput succedaneum is edema of the scalp soft tissue that crosses suture lines and resolves within a few days.
Question 3: Which laboratory value indicates HELLP syndrome in a pregnant client with hypertension?
- Platelet count of 180,000/mm³
- Hemoglobin of 12 g/dL
- AST of 80 units/L (Correct answer)
- Serum creatinine of 0.8 mg/dL
Correct answer: AST of 80 units/L
Elevated liver enzymes (AST/ALT) are part of the HELLP syndrome triad: Hemolysis, Elevated Liver enzymes, Low Platelets.
Question 4: A postpartum nurse notes a client has a temperature of 38.4°C on day 2 after a vaginal delivery. What is the most likely cause?
- Normal postpartum fever
- Breast engorgement
- Endometritis (Correct answer)
- Urinary tract infection
Correct answer: Endometritis
Fever after 24 hours postpartum is most commonly caused by endometritis, especially after vaginal delivery with prolonged labor or rupture of membranes.
Question 5: A nurse is teaching a new mother about newborn jaundice. Which statement indicates correct understanding?
- Jaundice appearing in the first 24 hours is normal and expected
- Phototherapy converts bilirubin into a water-soluble form for excretion (Correct answer)
- Formula supplementation is always needed to treat jaundice
- Jaundice only occurs in breastfed infants
Correct answer: Phototherapy converts bilirubin into a water-soluble form for excretion
Phototherapy converts unconjugated bilirubin into lumirubin, a water-soluble isomer that can be excreted without liver conjugation.
Question 6: A client at 36 weeks gestation is diagnosed with gestational diabetes mellitus (GDM). Which teaching point is most important?
- GDM resolves immediately after delivery with no further monitoring needed
- Insulin is always required to manage GDM
- Blood glucose monitoring and dietary management are the first-line interventions (Correct answer)
- GDM does not affect the fetus
Correct answer: Blood glucose monitoring and dietary management are the first-line interventions
Medical nutrition therapy and blood glucose self-monitoring are the foundations of GDM management; insulin is added only if glycemic targets are not met.
Question 7: When administering erythromycin ophthalmic ointment to a newborn, which is the correct technique?
- Apply from the outer canthus to the inner canthus of each eye
- Apply to the inner lower conjunctival sac from inner to outer canthus (Correct answer)
- Place drops directly on the cornea
- Administer only if the mother has active gonorrhea
Correct answer: Apply to the inner lower conjunctival sac from inner to outer canthus
Erythromycin is applied to the lower conjunctival sac from the inner to outer canthus to prevent ophthalmia neonatorum.
LVN Maternal & Newborn Nursing 3
A nurse is monitoring a client in active labor on continuous electronic fetal monitoring.
Late decelerations are noted with every contraction.
What is the priority intervention?