NR 327 Teaching Prenatal & Newborn Care ISBAR & Ca
Exam (elaborations)
Maternal Exam 2
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Course
NR 327 Teaching Prenatal & Newborn Care ISBAR & Ca
Institution
Chamberlain College Of Nursing
1 . Which woman is most likely to experience strong afterpains?
a. A woman who experienced oligohydramnios
b. A woman who is a gravida 4, para 4-0-0-4
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 pounds, 3 ounces
Ans B . A woman who is a gravida, para 4-0-0-4
...
NR 327 Teaching Prenatal & Newborn Care ISBAR & Ca
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Maternal newborn exam 2
1 . Which woman is most likely to experience strong afterpains?
a. A woman who experienced oligohydramnios
b. A woman who is a gravida 4, para 4-0-0-4
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 pounds, 3 ounces
Ans B . A woman who is a gravida, para 4-0-0-4
2. What are the most common causes for subinvolution of the uterus?
Retained placental fragments and infection
Subinvolution is the failure of the uterus to return to a nonpregnant state. The most common causes of
subinvolution are retained placental fragments and infection. Subinvolution may be caused by an
infection and result in hemorrhage. Multiple gestations may cause uterine atony, resulting in postpartum
hemorrhaging. Uterine tetany and overproduction of oxytocin do not cause subinvolution.
3. A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal, and the
estimated blood loss (EBL) was approximately 1500 mL. When assessing the woman's vital signs, the
nurse would be concerned to see:
a. Temperature 37.9° C, heart rate 120, respirations 20, blood pressure (BP) 90/50.
b. Temperature 37.4° C, heart rate 88, respirations 36, BP 126/68.
c. Temperature 38° C, heart rate 80, respirations 16, BP 110/80.
d. Temperature 36.8° C, heart rate 60, respirations 18, BP 140/90.
Ans A
4, Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during
the puerperium?
a. Varicosities of the legs
b. Carpal tunnel syndrome
c. Periodic numbness and tingling of the fingers
d. Headaches
Ans D
5. Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the
right of the umbilicus?
,a. Notify the physician of an impending hemorrhage.
b. Assess the blood pressure and pulse.
c. Evaluate the lochia.
d. Assist the patient in emptying her bladder.
Ans D
6 . Rho immune globulin will be ordered postpartum if which situation occurs?
a. Mother Rh?2-, baby Rh+
c. Mother Rh+, baby Rh+
b. Mother Rh?2-, baby Rh?2-
d. Mother Rh+, baby Rh?2-
Ans A
Rh?2- mother delivering an Rh+ baby may develop antibodies to fetal cells that entered her bloodstream
when the placenta separated. The Rho immune globulin works to destroy the fetal cells in the maternal
circulation before sensitization occurs. If mother and baby are both Rh+ or Rh?2- the blood types are
alike, so no antibody formation would be anticipated. If the Rh+ blood of the mother comes in contact
with the Rh?2- blood of the infant, no antibodies would develop because the antigens are in the
mother's blood, not the infant's.
7 On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely
saturated a perineal pad within 15 minutes. The nurse's first action is to:
a. Begin an intravenous (IV) infusion of Ringer's lactate solution.
b. Assess the woman's vital signs.
c. Call the woman's primary health care provider.
d. Massage the woman's fundus.
Ans D
The nurse should assess the uterus for atony. Uterine tone must be established to prevent excessive
blood loss. The nurse may begin an IV infusion to restore circulatory volume, but this would not be the
first action. Blood pressure is not a reliable indicator of impending shock from impending hemorrhage;
assessing vital signs should not be the nurse's first action. The physician would be notified after the
nurse completes the assessment of the woman.
, 8. A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is
obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine
"several times" during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70
mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is
positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube
defect (NTD). Which characteristics place the woman in a high risk category?
a. Blood pressure, age, BMI
b. Drug/alcohol use, age, family history
c. Family history, blood pressure, BMI
d. Family history, BMI, drug/alcohol abuse
Ans. D
9. Which assessments are included in the fetal BPP? (Select all that apply.)
Ans: a,b,c,d
a. Fetal movement
b. Fetal tone
c. Fetal heart rate
d. AFI
e. Placental grade
10. Biophysical risks include factors that originate with either the mother or the fetus and affect the
functioning of either one or both. The nurse who provides prenatal care should have an understanding
of these risk factors. Match the specific pregnancy problem with the related risk factor.
a. Polyhydramnios
b. IUGR (maternal cause)
c. Oligohydramnios
d. Chromosomal abnormalities
e. IUGR (fetoplacental cause)
1. Premature rupture of membranes C (oligohydramnios)
2. Advanced maternal age D( chromosomal abnormalities)
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