Maternal And Child Health Nursing NCLEX Quiz 6

1. When administering magnesium sulfate to a client with preeclampsia. the nurse understands that this drug is given to:

Prevent seizures

Reduce blood pressure

Slow the process of labor

Increase dieresis

The chemical makeup of magnesium is similar to that of calcium and. therefore. magnesium will act like calcium in the body. As a result. magnesium will block seizure activity in a hyper-stimulated neurologic system by interfering with signal transmission at the neuromuscular junction.

Explanation

The chemical makeup of magnesium is similar to that of calcium and. therefore. magnesium will act like calcium in the body. As a result. magnesium will block seizure activity in a hyper-stimulated neurologic system by interfering with signal transmission at the neuromuscular junction.

2. A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first?

Pad the side rails

Place a pillow under the left buttock

Insert a padded tongue blade into the mouth

Maintain a patent airway

The priority for the pregnant client having a seizure is to maintain a patent airway to ensure adequate oxygenation to the mother and the fetus. Additionally. oxygen may be administered by face mask to prevent fetal hypoxia.

Explanation

The priority for the pregnant client having a seizure is to maintain a patent airway to ensure adequate oxygenation to the mother and the fetus. Additionally. oxygen may be administered by face mask to prevent fetal hypoxia.

3. The multigravida mother with a history of rapid labor who us in active labor calls out to the nurse. "The baby is coming!" which of the following would be the nurse's first action?

Inspect the perineum

Time the contractions

Auscultate the fetal heart rate

Contact the birth attendant

When the client says the baby is coming. the nurse should first inspect the perineum and observe for crowning to validate the client’s statement. If the client is not delivering precipitously. the nurse can calm her and use appropriate breathing techniques.

Explanation

When the client says the baby is coming. the nurse should first inspect the perineum and observe for crowning to validate the client’s statement. If the client is not delivering precipitously. the nurse can calm her and use appropriate breathing techniques.

4. A primigravida client at about 35 weeks gestation in active labor has had no prenatal care and admitted to cocaine use during the pregnancy. Which of the following persons must the nurse notify?

Nursing unit manager so appropriate agencies can be notified

Head of the hospital’s security department

Chaplain in case the fetus dies in utero

Physician who will attend the delivery of the infant

The fetus of a cocaine-addicted mother is at risk for hypoxia. meconium aspiration. and intrauterine growth retardation (IUGR). Therefore. the nurse must notify the physician of the client’s cocaine use because this knowledge will influence the care of the client and neonate. The information is used only in relation to the client’s care.

Explanation

The fetus of a cocaine-addicted mother is at risk for hypoxia. meconium aspiration. and intrauterine growth retardation (IUGR). Therefore. the nurse must notify the physician of the client’s cocaine use because this knowledge will influence the care of the client and neonate. The information is used only in relation to the client’s care.

5. When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum period. the nurse in charge should include which of the following?

The vaccine prevents a future fetus from developing congenital anomalies

Pregnancy should be avoided for 3 months after the immunization

The client should avoid contact with children diagnosed with rubella

The injection will provide immunity against the 7-day measles.

After administration of rubella vaccine. the client should be instructed to avoid pregnancy for at least 3 months to prevent the possibility of the vaccines toxic effects to the fetus.

Explanation

After administration of rubella vaccine. the client should be instructed to avoid pregnancy for at least 3 months to prevent the possibility of the vaccines toxic effects to the fetus.

6. What is the approximate time that the blastocyst spends traveling to the uterus for implantation?

2 days

7 days

10 days

14 weeks

The blastocyst takes approximately 1 week to travel to the uterus for implantation.

Explanation

The blastocyst takes approximately 1 week to travel to the uterus for implantation.

7. A client with type 1 diabetes mellitus who is a multigravida visits the clinic at 27 weeks gestation. The nurse should instruct the client that for most pregnant women with type 1 diabetes mellitus:

Weekly fetal movement counts are made by the mother.

Contraction stress testing is performed weekly.

Induction of labor is begun at 34 weeks’ gestation.

Nonstress testing is performed weekly until 32 weeks’ gestation

For most clients with type 1 diabetes mellitus. non-stress testing is done weekly until 32 weeks’ gestation and twice a week to assess fetal well-being.

Explanation

For most clients with type 1 diabetes mellitus. non-stress testing is done weekly until 32 weeks’ gestation and twice a week to assess fetal well-being.

8. After teaching a pregnant woman who is in labor about the purpose of the episiotomy. which of the following purposes stated by the client would indicate to the nurse that the teaching was effective?

Shortens the second stage of labor

Enlarges the pelvic inlet

Prevents perineal edema

Ensures quick placenta delivery

An episiotomy serves several purposes. It shortens the second stage of labor. substitutes a clean surgical incision for a tear. and decreases undue stretching of perineal muscles. An episiotomy helps prevent tearing of the rectum but it does not necessarily relieves pressure on the rectum. Tearing may still occur.

Explanation

An episiotomy serves several purposes. It shortens the second stage of labor. substitutes a clean surgical incision for a tear. and decreases undue stretching of perineal muscles. An episiotomy helps prevent tearing of the rectum but it does not necessarily relieves pressure on the rectum. Tearing may still occur.

9. While caring for a multigravida client in early labor in a birthing center. which of the following foods would be best if the client requests a snack?

Yogurt

Cereal with milk

Vegetable soup

Peanut butter cookies

In some birth settings. intravenous therapy is not used with low-risk clients. Thus. clients in early labor are encouraged to eat healthy snacks and drink fluid to avoid dehydration. Yogurt. which is an excellent source of calcium and riboflavin. is soft and easily digested. During pregnancy. gastric emptying time is delayed. In most hospital settings. clients are allowed only ice chips or clear liquids.

Explanation

In some birth settings. intravenous therapy is not used with low-risk clients. Thus. clients in early labor are encouraged to eat healthy snacks and drink fluid to avoid dehydration. Yogurt. which is an excellent source of calcium and riboflavin. is soft and easily digested. During pregnancy. gastric emptying time is delayed. In most hospital settings. clients are allowed only ice chips or clear liquids.

10. While assessing a primipara during the immediate postpartum period. the nurse in charge plans to use both hands to assess the client's fundus to:

Prevent uterine inversion

Promote uterine involution

Hasten the puerperium period

Determine the size of the fundus

Using both hands to assess the fundus is useful for preventing uterine inversion.

Explanation

Using both hands to assess the fundus is useful for preventing uterine inversion.