Maternal and Newborn Nursing

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A nurse is assessing a client who is at 27 weeks of gestation and has preeclampsia. Which of the following findings should the nurse report to the provider?

  • A. Urine protein concentration 200 mg/ 24 hr.
  • B. Creatinine 0.8 mg/ Dl
  • C. Hemoglobin 14.8 g/ dL
  • D. Platelet Count 60.000/ mm3
Correct Answer: D

Rationale: A platelet count of 60,000/mm3 is significantly low and can be indicative of thrombocytopenia, a potential complication of preeclampsia known as HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelet count). Thrombocytopenia increases the risk of bleeding complications during pregnancy and delivery, requiring prompt evaluation and management by the healthcare provider. The nurse should report this finding immediately to prevent any adverse outcomes for the client and baby.

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Which of the following is an example of healthy grieving?

  • A. The mother exhibits an absence of crying or expression of feelings.
  • B. The parents do not mention the baby in conversation with family members.
  • C. The mother asks that the baby be taken away from the delivery area quickly.
  • D. While holding the baby, the mother says to her husband, "He has your eyes and nose."
Correct Answer: D

Rationale: Option D, while holding the baby, the mother saying to her husband, "He has your eyes and nose," is an example of healthy grieving. In this scenario, the mother is acknowledging the baby, expressing emotions, and involving her partner in the process. Verbalizing thoughts and emotions, as well as creating meaningful connections with relevant support persons, are important aspects of healthy grieving. Sharing memories and recognizing the physical similarities between the baby and family members can be therapeutic in the grieving process.

The nurse is performing Leopold's maneuvers. What is the primary goal?

  • A. Determine fetal well-being.
  • B. Assess fetal position and presentation.
  • C. Measure amniotic fluid volume.
  • D. Evaluate uterine contractions.
Correct Answer: B

Rationale: Leopold's maneuvers are used to assess fetal position, presentation, and engagement.

What physical findings would the nurse expect in a bulimic client?

  • A. Mastoiditis.
  • B. Hirsutism.
  • C. Gynecomastia.
  • D. Esophagitis.
Correct Answer: D

Rationale: Repeated vomiting damages the esophagus.

During the assessment of a newborn, it is most important for the nurse to report a:

  • A. Temperature of 97.7 degrees Fahrenheit
  • B. Pale pink, rust-colored stain in the diaper
  • C. Heart rate that drops to 120 beats/min
  • D. Breathing pattern that is diaphragmatic with sternal retractions
Correct Answer: D

Rationale: Sternal retractions indicate respiratory difficulty.

A patient's newborn is neurologically impaired. The most important nursing action should be:

  • A. Assist the patient and her family with the grieving process.
  • B. Perform neurological assessments of the newborn every four hours.
  • C. Arrange for social services to discuss possible placement of the newborn
  • D. Obtain an order for an antidepressant to help the patient cope with the depressing news.
Correct Answer: A

Rationale: Supporting the family through grief is crucial.

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