ATI RN
Maternal Newborn Nursing Questions
Question 1 of 5
A nurse on the labor and delivery unit is caring for a client who is having a difficult, prolonged labor with severe backache. Which of the following contributing causes should the nurse identify
Correct Answer: D
Rationale: In a labor where the fetal position is persistent occiput posterior, the baby is positioned face up, which can lead to a longer and more difficult labor. In this position, the baby's head is pressing against the mother's spine, causing severe backache for the mother. This malposition can slow down the progress of labor, making it more prolonged and challenging. It can also increase the likelihood of complications such as increased risk of instrumental delivery or cesarean section. Therefore, identifying the fetal position as persistent occiput posterior as a contributing cause to the difficult, prolonged labor with severe backache is crucial for effective management and intervention.
Question 2 of 5
The parents of a male newborn ask the nurse whether they should have their son circumcised. The nurse ‘s most appropriate response would be:
Correct Answer: B
Rationale: The most appropriate response for the nurse in this situation is to encourage open discussion between the parents and the doctor regarding the decision to circumcise their son. This allows the parents to make an informed decision based on their beliefs, values, and medical advice provided by the healthcare provider. It is important for parents to have all the necessary information and support to make the best decision for their child's well-being. The decision to circumcise is a personal one and should be made after careful consideration and consultation with a healthcare professional.
Question 3 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: A
Rationale: The Moro reflex is a normal infantile reflex that is typically present at birth and disappears around 4-6 months of age. This reflex is triggered by a sudden loss of support or a loud noise, causing the infant to throw back the head and extend the arms in a gesture as if trying to grab something. In a situation where the newborn's birth was prolonged due to wide shoulders, there is a higher risk of injury to the brachial plexus (nerves that control arm movement) during delivery. Damage to the brachial plexus can result in weakness or paralysis of the affected arm, and this may impact the Moro reflex as it involves the arms' movement. Therefore, the nurse would be particularly observant for any abnormality or lack of response in the Moro reflex as it may indicate potential nerve injury related to the difficult birth.
Question 4 of 5
What is the first action when a newborn has a heart rate below 100 bpm immediately after birth?
Correct Answer: B
Rationale: In the scenario where a newborn has a heart rate below 100 bpm immediately after birth, the correct first action is to administer oxygen and provide stimulation (Option B). This is based on the principle of supporting the newborn's transition to extrauterine life and addressing potential causes of bradycardia. Administering oxygen helps improve oxygenation, which is crucial for the newborn's vital functions, especially if there is inadequate oxygen supply causing the low heart rate. Providing stimulation, such as rubbing the baby's back or flicking the soles of the feet, can help increase the heart rate through sensory input. The other options are not the first-line interventions in this situation. Providing chest compressions (Option A) is not appropriate as the newborn's heart rate is only slightly below the expected range, and chest compressions are indicated for severe bradycardia or cardiac arrest. Delaying interventions and reassessing in 5 minutes (Option C) could lead to a critical delay in addressing potential issues with oxygenation and perfusion. Starting an IV line for medications (Option D) is not the initial step and should be considered only if other measures fail to improve the newborn's condition. In an educational context, understanding the immediate actions in response to abnormal findings in newborns is crucial for nurses and healthcare providers working in maternal newborn care. This knowledge ensures timely and appropriate interventions to support the newborn's transition and promote positive outcomes in the neonatal period.
Question 5 of 5
What is the nurse's role when preparing a mother for epidural anesthesia?
Correct Answer: C
Rationale: In preparing a mother for epidural anesthesia, the nurse's role includes ensuring the mother is in a supine position (Option C). This position allows for proper placement of the epidural catheter in the lower back, facilitating accurate administration of anesthesia into the epidural space. Option A, monitoring contractions, is not directly related to the preparation for epidural anesthesia. This task typically falls under the domain of assessing labor progress and fetal well-being. Option B, ensuring the mother has an empty bladder, is important for epidural placement but is not solely the nurse's responsibility. It is crucial for the mother's comfort during the procedure and to prevent urinary retention post-anesthesia. Option D, administering a test dose of the epidural medication, is typically the responsibility of the anesthesia provider, not the nurse. This test dose is crucial to assess for any adverse reactions or inadvertent intravascular or intrathecal placement of the catheter. In the context of maternal newborn nursing, understanding the nurse's role in preparing a mother for epidural anesthesia is vital for safe and effective pain management during labor. Nurses play a key role in ensuring proper positioning, advocating for patient comfort and safety, and facilitating communication between the healthcare team and the mother.