Maternal Newborn Nursing Test Maternity Nursing (OB Maternal & Newborn) 3 — Questions and Answers
Question 1: A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which condition does the nurse suspect first?
- Abruptio placentae
- Placenta previa (Correct answer)
- Bloody show of labor onset
- Ruptured uterus
Correct answer: Placenta previa
Painless bright red vaginal bleeding in the third trimester is the hallmark presentation of placenta previa due to abnormal placental implantation.
Question 2: The nurse is teaching a client about the Leopold maneuvers. Which maneuver determines fetal lie and what part of the fetus is in the uterine fundus?
- First maneuver (Correct answer)
- Second maneuver
- Third maneuver
- Fourth maneuver
Correct answer: First maneuver
The first Leopold maneuver is performed by palpating the fundus to identify which fetal part (head or buttocks) occupies the upper uterus.
Question 3: A newborn at 36 hours of life has a total serum bilirubin of 14 mg/dL and is receiving phototherapy. Which nursing action is most important during phototherapy?
- Keep the infant dressed in a full sleeper to prevent heat loss
- Cover the infant's eyes with phototherapy shields at all times (Correct answer)
- Decrease oral feedings to reduce intestinal motility
- Position the infant prone only to maximize skin exposure
Correct answer: Cover the infant's eyes with phototherapy shields at all times
Eye shields must be applied during phototherapy to protect the retina from damage caused by the high-intensity light.
Question 4: A client in active labor has an external fetal monitor showing late decelerations with each contraction. The nurse's priority action is to:
- Increase IV oxytocin rate to shorten labor
- Reposition the client to the left lateral position and apply oxygen (Correct answer)
- Prepare for immediate cesarean delivery without further assessment
- Document the finding and continue to monitor
Correct answer: Reposition the client to the left lateral position and apply oxygen
Late decelerations indicate uteroplacental insufficiency; repositioning to the left lateral position and applying oxygen are the initial nursing interventions to improve placental perfusion.
Question 5: Which maternal lab value is most concerning in a client with HELLP syndrome?
- Platelet count of 80,000/mm³ (Correct answer)
- Hemoglobin of 11.2 g/dL
- Serum creatinine of 0.9 mg/dL
- ALT of 25 IU/L
Correct answer: Platelet count of 80,000/mm³
HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelets; a platelet count of 80,000/mm³ is critically low and indicates severe disease with bleeding risk.
Question 6: A nurse is performing a gestational age assessment using the Ballard score on a newborn. Which physical finding suggests a gestational age of approximately 40 weeks?
- Abundant lanugo covering the entire body
- Ear cartilage that is soft with slow recoil
- Plantar creases covering the entire sole (Correct answer)
- Transparent, gelatinous skin with visible veins
Correct answer: Plantar creases covering the entire sole
Full-term newborns (40 weeks) have plantar creases extending across the entire sole of the foot, reflecting mature skin development.
Question 7: A postpartum client is diagnosed with deep vein thrombosis (DVT) of the left leg. Which nursing action is contraindicated?
- Applying warm moist heat to the affected leg
- Administering anticoagulant therapy as ordered
- Massaging the affected calf to relieve discomfort (Correct answer)
- Elevating the affected extremity
Correct answer: Massaging the affected calf to relieve discomfort
Massaging a leg with suspected or confirmed DVT is contraindicated because it can dislodge the thrombus and cause a pulmonary embolism.
