ATI RN
Maternal Newborn Nursing Questions
Question 1 of 5
A newborn is delivered vaginally in the breech presentation. When examining her baby, the mother asks if the baby has been injured during birth because of the large black and blue areas on the buttocks and legs, The nurse should respond that:
Correct Answer: C
Rationale: The correct answer is C) This is a temporary complication that will disappear in about a week. This response is correct because the large black and blue areas on the buttocks and legs of the newborn are likely Mongolian spots, which are benign birthmarks commonly found in dark-skinned babies. These spots are caused by pigmentation and typically fade away on their own within the first few weeks to years of life. Option A is incorrect because simply labeling it as a birthmark without providing further context may lead to confusion for the mother. Option B is incorrect as forceps are not the cause of these marks. Option D is incorrect as it states that Mongolian spots disappear within a year, while in reality, they usually fade away within a few weeks to a few years. In an educational context, it is important for nurses to be knowledgeable about common newborn skin markings to provide accurate information and reassurance to parents. Understanding the normal variations in newborn skin appearance can help alleviate parents' concerns and promote a positive bonding experience between the newborn and parents.
Question 2 of 5
A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Plantar reflex. The plantar reflex is crucial in assessing the neurological integrity of a newborn. When a newborn's birth is prolonged due to wide shoulders, there is a risk of brachial plexus injury, specifically Erb's palsy. This type of injury can affect the nerve supply to the muscles involved in the plantar reflex. Therefore, the nurse needs to closely observe the plantar reflex to detect any abnormalities that may indicate nerve damage from the difficult birth. Option A) Moro reflex is incorrect as it is related to the startle reflex, not specifically affected by shoulder width during birth. Option C) Babinski reflex is related to the upper motor neuron lesion and is not directly impacted by shoulder width during birth. Option D) Stepping reflex is related to motor development and is not typically affected by a difficult birth due to wide shoulders. In an educational context, understanding the significance of the plantar reflex in newborn assessments is crucial for nurses working in maternal newborn care. Recognizing the implications of birth complications, such as shoulder dystocia, on newborn neurological function can help nurses provide timely and appropriate interventions to support optimal outcomes for both the newborn and the mother.
Question 3 of 5
A 2-week-old neonate is admitted to the hospital with a diagnosis of possible sepsis. The neonate weighs 3.2 kg, The health care provider prescribes the following orders for the neonate and signs the order sheet. Which order would the nurse question? Progress Notes: 12/01/22- 10am
Correct Answer: B
Rationale: In this scenario, the nurse would question order B, which is giving ampicillin 200mg/kg IV every 6 hours in D5.45 NSSIV @ 125ml/hr. The correct answer to question this order is due to the fact that the dose of ampicillin prescribed is much higher than the usual recommended dose for neonates, posing a potential risk of toxicity or adverse effects. Neonates have immature renal and hepatic systems, which can impact drug metabolism and excretion. Option A is appropriate as acetaminophen is commonly used for pain relief in neonates at the prescribed dose. Option C allows for breastfeeding, which is crucial for neonatal nutrition and bonding. Option D, drawing blood cultures, is essential in the evaluation of possible sepsis to identify the causative organism. Educationally, this question highlights the importance of accurate medication dosing in neonates, considering their unique physiological characteristics. It also emphasizes the significance of thorough assessment and appropriate interventions in the care of neonates with suspected sepsis. Nurses need to be vigilant in questioning orders that may pose harm to their patients, ensuring safe and effective care delivery.
Question 4 of 5
What should the nurse advise the client regarding Depo-Provera (medroxyprogesterone acetate)?
Correct Answer: B
Rationale: In maternal newborn nursing, it is crucial for nurses to provide accurate information to clients regarding contraception options. The correct answer, B) Refrain from breastfeeding while using Depo-Provera, is important because medroxyprogesterone acetate can pass into breast milk and may potentially affect the infant. By advising the client to refrain from breastfeeding while using this method, the nurse ensures the safety of both the mother and the newborn. Option A) Take the pill at the same time each day is incorrect because Depo-Provera is an injectable contraceptive, not a pill. Option C) Expect to have no periods as long as she takes the medicine is misleading as irregular bleeding is a common side effect of Depo-Provera. Option D) Consider switching to another birth control method in a year or so does not provide accurate information as Depo-Provera is effective for up to three months and can be used long-term if desired. Educationally, understanding the specifics of each contraceptive method, including their administration, side effects, and duration of effectiveness, is vital for nurses to effectively educate clients on making informed decisions about their reproductive health. Providing evidence-based information ensures the safety and well-being of both the client and potential infants.
Question 5 of 5
Which signs/symptoms would the nurse expect to see in a client diagnosed with pubic lice?
Correct Answer: B
Rationale: In a client diagnosed with pubic lice, the nurse would expect to see pruritus (itching) as a prominent sign/symptom. This is because pubic lice infestation commonly leads to intense itching in the affected area due to the inflammatory response caused by the lice's bites and movement. Option A, macular rash on the labia, is incorrect because while pubic lice infestation can cause skin irritation, it typically presents as itching rather than a rash. Option C, hyperthermia, is also incorrect as pubic lice infestation does not cause a rise in body temperature. Option D, foul-smelling discharge, is incorrect as this symptom is not typically associated with pubic lice infestation. Educationally, understanding the signs and symptoms of pubic lice infestation is crucial for nurses working in maternal newborn nursing as they may encounter cases in pregnant women or newborns. Recognizing these symptoms promptly is important for initiating appropriate treatment and preventing further spread of the infestation. Nurses should also educate clients on prevention strategies and proper treatment to manage pubic lice infestations effectively.