LVN Maternal & Newborn Nursing 5 — Questions and Answers
Question 1: A client at 28 weeks is admitted with preterm labor. Which medication does the nurse expect to administer to promote fetal lung maturity?
- Indomethacin
- Betamethasone (Correct answer)
- Nifedipine
- Magnesium sulfate
Correct answer: Betamethasone
Betamethasone is a corticosteroid given to mothers before 34 weeks to accelerate fetal lung surfactant production and reduce respiratory distress syndrome.
Question 2: During a routine prenatal visit at 28 weeks, a Rh-negative client with a Rh-positive partner is prescribed Rho(D) immune globulin (RhoGAM). What is the purpose?
- Treat existing maternal Rh antibodies
- Prevent maternal sensitization to Rh-positive fetal blood cells (Correct answer)
- Boost maternal immunity against infections
- Induce labor at term
Correct answer: Prevent maternal sensitization to Rh-positive fetal blood cells
RhoGAM prevents Rh sensitization by destroying any fetal Rh-positive cells before the mother's immune system can produce antibodies.
Question 3: The nurse is performing a newborn assessment and notes the Moro reflex is absent on one side. This finding is most associated with:
- Normal newborn variation
- Brachial plexus injury (Correct answer)
- Hip dysplasia
- Hypothyroidism
Correct answer: Brachial plexus injury
A unilateral absent Moro reflex suggests brachial plexus injury (Erb's palsy), often resulting from shoulder dystocia during delivery.
Question 4: A client with gestational hypertension is being monitored. Which additional finding would upgrade the diagnosis to preeclampsia?
- Blood pressure of 140/90 mmHg on two occasions
- Proteinuria of 300 mg in a 24-hour urine (Correct answer)
- Mild ankle edema
- Heart rate of 92 beats/min
Correct answer: Proteinuria of 300 mg in a 24-hour urine
Preeclampsia is diagnosed when gestational hypertension is accompanied by proteinuria ≥300 mg/24 hours or other end-organ involvement.
Question 5: A nurse assists with the delivery of a newborn with shoulder dystocia. After delivery, which assessment is the priority?
- Blood glucose level
- Brachial plexus function and clavicle integrity (Correct answer)
- Newborn weight
- Skin color assessment
Correct answer: Brachial plexus function and clavicle integrity
Shoulder dystocia can cause brachial plexus injury and clavicle fractures, so assessing arm movement and clavicle palpation is the priority.
Question 6: Which position is contraindicated for a client with a confirmed diagnosis of placenta previa?
- Left lateral recumbent
- Semi-Fowler's
- Digital vaginal examination position (Correct answer)
- Modified Trendelenburg
Correct answer: Digital vaginal examination position
Digital vaginal examinations are absolutely contraindicated in placenta previa because they can cause catastrophic hemorrhage by disturbing the placenta.
Question 7: A new mother asks the nurse how to tell if her breastfed infant is getting enough milk. What is the most reliable indicator?
- The infant sleeps for 4-hour intervals
- The infant produces 6 or more wet diapers and 3–4 stools per day by day 4 (Correct answer)
- The mother feels her breasts soften after each feeding
- The infant nurses for at least 30 minutes per session
Correct answer: The infant produces 6 or more wet diapers and 3–4 stools per day by day 4
Adequate wet diapers (6+) and stool output are objective markers of sufficient breast milk intake and newborn hydration.
LVN Maternal & Newborn Nursing 5
A client at 28 weeks is admitted with preterm labor.
Which medication does the nurse expect to administer to promote fetal lung maturity?