RPN Maternal and Newborn Care 2 — Questions and Answers
Question 1: A nurse is caring for a client at 38 weeks gestation who reports decreased fetal movement. Which action should the nurse take first?
- Perform a biophysical profile
- Instruct the client to perform a kick count
- Apply external fetal monitor (Correct answer)
- Notify the physician immediately
Correct answer: Apply external fetal monitor
Applying an external fetal monitor provides immediate assessment of fetal heart rate and activity patterns.
Question 2: Which finding during a postpartum assessment at 12 hours after delivery indicates a normal finding?
- Uterine fundus at the umbilicus, firm (Correct answer)
- Lochia rubra with large clots
- Temperature of 38.5°C (101.3°F)
- Urine output of 150 mL over 8 hours
Correct answer: Uterine fundus at the umbilicus, firm
A firm fundus at the umbilical level is expected within the first 12 hours after delivery.
Question 3: A newborn is assessed at 1 minute after birth and receives an Apgar score of 6. Which intervention is priority?
- Initiate chest compressions
- Stimulate and provide supplemental oxygen (Correct answer)
- Intubate the newborn immediately
- Transfer to the NICU without delay
Correct answer: Stimulate and provide supplemental oxygen
An Apgar score of 4–6 indicates moderate depression and requires stimulation and supplemental oxygen.
Question 4: A breastfeeding mother reports sore, cracked nipples on day 3 postpartum. What is the most appropriate nursing intervention?
- Recommend switching to formula feeding temporarily
- Evaluate the infant's latch and positioning (Correct answer)
- Apply antibiotic ointment to the nipples
- Advise pumping exclusively until healed
Correct answer: Evaluate the infant's latch and positioning
Sore, cracked nipples are most often caused by improper latch, so assessing and correcting positioning is the priority intervention.
Question 5: Which maternal vital sign change during active labor is most concerning and requires immediate intervention?
- Heart rate of 90 bpm
- Blood pressure of 160/110 mmHg (Correct answer)
- Temperature of 37.6°C (99.7°F)
- Respiratory rate of 20 breaths/min
Correct answer: Blood pressure of 160/110 mmHg
A blood pressure of 160/110 mmHg meets the criteria for severe-range hypertension and indicates risk for eclampsia.
Question 6: A nurse is teaching a new mother about newborn jaundice. Which statement by the mother indicates understanding?
- 'I should stop breastfeeding until the jaundice resolves.'
- 'I will feed my baby frequently to help clear the bilirubin.' (Correct answer)
- 'My baby only needs sunlight exposure to treat the jaundice.'
- 'Jaundice appearing on day 1 is normal and expected.'
Correct answer: 'I will feed my baby frequently to help clear the bilirubin.'
Frequent feedings promote stooling, which eliminates bilirubin and helps reduce physiologic jaundice.
Question 7: A client is receiving oxytocin (Pitocin) augmentation. The nurse notes uterine contractions every 2 minutes lasting 95 seconds. What is the priority action?
- Increase the oxytocin infusion rate
- Document the finding and continue monitoring
- Discontinue the oxytocin infusion (Correct answer)
- Reposition the client to the left lateral position
Correct answer: Discontinue the oxytocin infusion
Contractions lasting more than 90 seconds (tachysystole) can compromise fetal oxygenation, so the oxytocin must be discontinued.
RPN Maternal and Newborn Care 2
A nurse is caring for a client at 38 weeks gestation who reports decreased fetal movement.
Which action should the nurse take first?