NARM Clinical Knowledge and Skills 5

Question 1

Which finding during a newborn's initial assessment is a normal variant that requires no intervention?

Accepted Answer

Epstein's pearls on the hard palate

Answer

Unilateral absent red reflex

Answer

Respiratory rate of 68 breaths per minute at 2 hours of life

Answer

Absent femoral pulses bilaterally

Question 2

A client at 38 weeks develops a temperature of 38.5°C (101.3°F) in active labor with rupture of membranes for 18 hours. The most likely diagnosis is:

Accepted Answer

Intra-amniotic infection (chorioamnionitis)

Answer

Normal physiological response to labor

Answer

Epidural-related fever

Answer

Urinary tract infection

Question 3

Which station indicates that the leading bony part of the presenting part is at the level of the ischial spines?

Accepted Answer

0 station

Answer

+1 station

Answer

-1 station

Answer

+2 station

Question 4

A client experiencing postpartum hemorrhage has a firmly contracted uterus and ongoing vaginal bleeding. The most likely source of bleeding is:

Accepted Answer

Genital tract laceration

Answer

Uterine atony

Answer

Retained placental fragments

Answer

Uterine inversion

Question 5

When counseling a client about Group B Streptococcus (GBS) prophylaxis, which scenario requires intrapartum antibiotic administration?

Accepted Answer

GBS-positive vaginal/rectal culture at 36 weeks with planned vaginal delivery

Answer

GBS-unknown status with elective cesarean at 39 weeks with intact membranes

Answer

GBS-positive status with prior cesarean delivery at 40 weeks

Answer

GBS-negative culture at 35 weeks with rupture of membranes at 38 weeks

Question 6

During a water birth, which of the following is most important to ensure newborn safety at the moment of birth?

Accepted Answer

The newborn's face should be brought to the surface of water promptly after complete emergence of the body

Answer

The water temperature should be below 36°C to prevent hyperthermia

Answer

Pitocin should be withheld until the newborn is fully submerged for cord clamping

Answer

The placenta must be delivered underwater to prevent cord traction

Question 7

A client at 37 weeks with gestational diabetes controlled by diet reports decreased fetal movement. Her fasting glucose this morning was 115 mg/dL. The priority action is:

Accepted Answer

Perform a non-stress test and assess amniotic fluid index

Answer

Initiate insulin therapy and recheck movement tomorrow

Answer

Schedule a routine biophysical profile for next week

Answer

Reassure the client that decreased movement is common near term