LVN Maternal & Newborn Nursing 4 — Questions and Answers
Question 1: A G1P0 client is in the second stage of labor for 2.5 hours. The nurse notes variable decelerations and the provider orders an amnioinfusion. What is the purpose of this intervention?
- Stimulate uterine contractions
- Relieve cord compression by instilling fluid into the uterus (Correct answer)
- Treat fetal infection
- Dilate the cervix more rapidly
Correct answer: Relieve cord compression by instilling fluid into the uterus
Amnioinfusion instills saline into the uterine cavity to cushion the umbilical cord and relieve variable decelerations caused by cord compression.
Question 2: A postpartum client reports excessive lochia and saturates a pad in 15 minutes. Fundal massage yields large clots. What medication should the nurse anticipate administering?
- Magnesium sulfate
- Terbutaline
- Oxytocin (Pitocin) (Correct answer)
- Betamethasone
Correct answer: Oxytocin (Pitocin)
Oxytocin promotes uterine contraction and is the first-line uterotonic agent for postpartum hemorrhage due to uterine atony.
Question 3: Which assessment finding in a newborn requires immediate reporting to the provider?
- Respiratory rate of 44 breaths/min
- Acrocyanosis of the hands and feet at 2 hours of age
- Grunting with each exhalation (Correct answer)
- Anterior fontanelle that is soft and flat
Correct answer: Grunting with each exhalation
Expiratory grunting is a sign of respiratory distress as the newborn attempts to maintain residual lung volume, requiring immediate evaluation.
Question 4: The nurse is caring for a client with a diagnosis of hyperemesis gravidarum. Which intervention takes priority?
- Encourage three large meals per day
- Administer IV fluid and electrolyte replacement (Correct answer)
- Restrict all fluid intake to prevent vomiting
- Provide a high-fat, high-protein diet
Correct answer: Administer IV fluid and electrolyte replacement
IV rehydration and electrolyte correction are the priority interventions for hyperemesis gravidarum to prevent dehydration and metabolic imbalances.
Question 5: A client is receiving oxytocin for labor induction. The nurse notes contractions every 90 seconds lasting 75 seconds. What is the correct action?
- Continue the infusion and document the findings
- Increase the oxytocin rate to accelerate delivery
- Discontinue or reduce the oxytocin infusion (Correct answer)
- Administer terbutaline to enhance contractions
Correct answer: Discontinue or reduce the oxytocin infusion
Tachysystole (>5 contractions in 10 minutes or contractions lasting >90 seconds) requires stopping or reducing oxytocin to prevent fetal hypoxia.
Question 6: A nurse is teaching a client about signs of postpartum depression (PPD). Which symptom most distinguishes PPD from baby blues?
- Tearfulness in the first 3 days after delivery
- Mood swings lasting 2–3 days
- Persistent feelings of worthlessness and inability to care for the infant lasting >2 weeks (Correct answer)
- Mild anxiety about newborn care
Correct answer: Persistent feelings of worthlessness and inability to care for the infant lasting >2 weeks
PPD is distinguished from baby blues by symptoms lasting more than 2 weeks and significantly impairing the mother's functioning.
Question 7: A newborn is placed under phototherapy for hyperbilirubinemia. Which nursing action is essential during treatment?
- Keep the infant bundled to maintain warmth under the lights
- Cover the infant's eyes with shields and ensure adequate hydration (Correct answer)
- Limit feedings to reduce bilirubin load
- Discontinue phototherapy once bilirubin begins to fall slightly
Correct answer: Cover the infant's eyes with shields and ensure adequate hydration
Eye shields protect the newborn's retinas from phototherapy light damage, and increased fluid intake promotes bilirubin excretion.
LVN Maternal & Newborn Nursing 4
A G1P0 client is in the second stage of labor for 2.5 hours.
The nurse notes variable decelerations and the provider orders an amnioinfusion.
What is the purpose of this intervention?