RN Maternal Newborn Online Practice 2019 A

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Which is the most dangerous effect on the fetus of a patient who smokes cigarettes while pregnant?

  • A. Intrauterine growth restriction
  • B. Genetic changes and anomalies
  • C. Extensive central nervous system damage
  • D. Fetal addiction to the substance inhaled
Correct Answer: A

Rationale: Smoking cigarettes during pregnancy is known to have harmful effects on the fetus, with one of the most serious consequences being intrauterine growth restriction (IUGR). IUGR occurs when the fetus does not grow at a normal rate inside the womb, leading to a lower birth weight. This can have long-term implications on the overall health and development of the baby, including increased risk of various health problems later in life such as respiratory issues, cardiovascular disease, and metabolic disorders. In severe cases, IUGR can even result in stillbirth or neonatal death. Therefore, it is crucial for pregnant individuals to avoid smoking to protect the health and well-being of their unborn child.

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What is the purpose of a Pap smear during preconception screening?

  • A. to check for anemia or other blood disorders
  • B. to evaluate thyroid hormone levels
  • C. to screen for cervical cancer or detect abnormal cervical cells
  • D. to assess cholesterol levels and cardiovascular health
Correct Answer: C

Rationale:

The patient came for an induction and under which circumstances does the nurse remove prostaglandin from the patient's cervix? SATA

  • A. N&V
  • B. Late deceleration
  • C. Contractions every 90 seconds
  • D. Contractions every 5 minutes
Correct Answer: B

Rationale: A. Nausea and vomiting (N&V) are not typically indications for removing prostaglandin from the patient's cervix during induction. These symptoms are common side effects and can be managed without removing the prostaglandin.

A client in labor reports sudden pain and bright red vaginal bleeding. What should the nurse suspect?

  • A. Placenta previa.
  • B. Abruptio placentae.
  • C. Preterm labor.
  • D. Rupture of membranes.
Correct Answer: B

Rationale: Bright red bleeding and sudden pain suggest abruptio placentae, requiring urgent intervention.

A nurse is assessing a newborn who is 48 hours old and has a maternal history of methadone use during pregnancy. Which of the following manifestations should the nurse identify as an indication of neonatal abstinence syndrome?

  • A. Hyporeactivity
  • B. Excessive high-pitched cry
  • C. Acrocyanosis
  • D. Respiratory rate of 50/min
Correct Answer: B

Rationale: Neonatal abstinence syndrome (NAS) occurs in newborns who were exposed to substances, such as methadone, while in the womb. Infants with NAS may exhibit excessive high-pitched crying as one of the manifestations. Other common symptoms of NAS include irritability, tremors, feeding difficulties, sweating, fever, vomiting, diarrhea, and poor weight gain. Therefore, in this case, the excessive high-pitched cry is a manifestation that the nurse should identify as an indication of neonatal abstinence syndrome.

Which assessment finding indicates uterine rupture?

  • A. Ctx abruptly stop during labor
  • B. Fetal tachycardia occurs
  • C. Client becomes dyspneic
  • D. Labor progressing unusually quickly
Correct Answer: A

Rationale: Uterine rupture is a rare but serious obstetric emergency that can occur during labor and delivery. One of the key assessment findings indicating uterine rupture is when contractions (ctx) abruptly stop during labor. This abrupt cessation of contractions can be a sign that the uterine muscle has torn due to excessive pressure or force, leading to a disruption in the normal progress of labor. Other signs and symptoms of uterine rupture may include severe abdominal pain, abnormal fetal heart rate patterns, loss of fetal station, and signs of hypovolemic shock in the mother. Immediate intervention and surgical management are required in cases of uterine rupture to ensure the safety of both the mother and the baby.

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