Maternal And Child Health Nursing NCLEX Practice Questions

1. As soon as the placenta is delivered. the nurse must do which of the following actions?

Inspect the placenta for completeness including the membranes

Place the placenta in a receptacle for disposal

Label the placenta properly

Leave the placenta in the kidney basin for the nursing aide to dispose properly

The placenta must be inspected for completeness to include the membranes because an incomplete placenta could mean that there is retention of placental fragments which can lead to uterine atony. If the uterus does not contract adequately. hemorrhage can occur.

Explanation

The placenta must be inspected for completeness to include the membranes because an incomplete placenta could mean that there is retention of placental fragments which can lead to uterine atony. If the uterus does not contract adequately. hemorrhage can occur.

2. This drug is usually given parentally to enhance uterine contraction:

Terbutaline

Pitocin

Magnesium sulfate

Lidocaine

The common oxytocin given to enhance uterine contraction is Pitocin. This is also the drug given to induce labor.

Explanation

The common oxytocin given to enhance uterine contraction is Pitocin. This is also the drug given to induce labor.

3. The partograph is a tool used to monitor labor. The maternal parameters measured/monitored are the following EXCEPT:

Vital signs

Fluid intake and output

Uterine contraction

Cervical dilatation

Partograph is a monitoring tool designed by the World Health Organization for use by health workers when attending to mothers in labor. especially the high risk ones. For maternal parameters all of the above is placed in the partograph except the fluid intake since this is placed in a separate monitoring sheet.

Explanation

Partograph is a monitoring tool designed by the World Health Organization for use by health workers when attending to mothers in labor. especially the high risk ones. For maternal parameters all of the above is placed in the partograph except the fluid intake since this is placed in a separate monitoring sheet.

4. The basic delivery set for normal vaginal delivery includes the following instruments/articles EXCEPT:

2 clamps

Pair of scissors

Kidney Basin

Retractor

For normal vaginal delivery. the nurse needs only the instruments for cutting the umbilical cord such as 2 clamps (straight or curve) and a pair of scissors as well as the kidney basin to receive the placenta. The retractor is not part of the basic set. In the hospital setting. needle holder and tissue forceps are added especially if the woman delivering the baby is a primigravida wherein episiotomy is generally done.

Explanation

For normal vaginal delivery. the nurse needs only the instruments for cutting the umbilical cord such as 2 clamps (straight or curve) and a pair of scissors as well as the kidney basin to receive the placenta. The retractor is not part of the basic set. In the hospital setting. needle holder and tissue forceps are added especially if the woman delivering the baby is a primigravida wherein episiotomy is generally done.

5. In a gravido-cardiac mother. the first 2 hours postpartum (4th stage of labor and delivery) particularly in a cesarean section is a critical period because at this stage

There is a fluid shift from the placental circulation to the maternal circulation which can overload the compromised heart.

The maternal heart is already weak and the mother can die

The delivery process is strenuous to the mother

The mother is tired and weak which can distress the heart

During the pregnancy. there is an increase in maternal blood volume to accommodate the need of the fetus. When the baby and placenta have been delivered. there is a fluid shift back to the maternal circulation as part of physiologic adaptation during the postpartum period. In a cesarean section. the fluid shift occurs faster because the placenta is taken out right after the baby is delivered giving it less time for the fluid shift to gradually occur.

Explanation

During the pregnancy. there is an increase in maternal blood volume to accommodate the need of the fetus. When the baby and placenta have been delivered. there is a fluid shift back to the maternal circulation as part of physiologic adaptation during the postpartum period. In a cesarean section. the fluid shift occurs faster because the placenta is taken out right after the baby is delivered giving it less time for the fluid shift to gradually occur.

6. When the shiny portion of the placenta comes out first. this is called the ___ mechanism.

Schultze

Ritgens

Duncan

Marmets

There are 2 mechanisms possible during the delivery of the placenta. If the shiny portion comes out first. it is called the Schultze mechanism

Explanation

There are 2 mechanisms possible during the delivery of the placenta. If the shiny portion comes out first. it is called the Schultze mechanism

7. When the baby's head is out. the immediate action of the nurse is

Cut the umbilical cord

Wipe the baby’s face and suction mouth first

Check if there is cord coiled around the neck

Deliver the anterior shoulder

The nurse should check if there is a cord coil because the baby will not be delivered safely if the cord is coiled around its neck. Wiping off the face should be done seconds after you have ensured that there is no cord coil but suctioning of the nose should be done after the mouth because the baby is a “nasal obligate” breather. If the nose is suctioned first before the mouth. the mucus plugging the mouth can be aspirated by the baby.

Explanation

The nurse should check if there is a cord coil because the baby will not be delivered safely if the cord is coiled around its neck. Wiping off the face should be done seconds after you have ensured that there is no cord coil but suctioning of the nose should be done after the mouth because the baby is a “nasal obligate” breather. If the nose is suctioned first before the mouth. the mucus plugging the mouth can be aspirated by the baby.

8. The following are signs that the placenta has detached EXCEPT:

Lengthening of the cord

Uterus becomes more globular

Sudden gush of blood

Mother feels like bearing down

Placental detachment does not require the mother to bear down. A normal placenta will detach by itself without any effort from the mother.

Explanation

Placental detachment does not require the mother to bear down. A normal placenta will detach by itself without any effort from the mother.

9. When delivering the baby's head the nurse supports the mother's perineum to prevent a tear. This technique is called

Marmet’s technique

Ritgen’s technique

Duncan maneuver

Schultze maneuver

Ritgen’s technique is done to prevent the perineal tear. This is done by the nurse by support the perineum with a sterile towel and pushing the perineum downward with one hand while the other hand is supporting the baby’s head as it goes out of the vaginal opening.

Explanation

Ritgen’s technique is done to prevent the perineal tear. This is done by the nurse by support the perineum with a sterile towel and pushing the perineum downward with one hand while the other hand is supporting the baby’s head as it goes out of the vaginal opening.

10. In vaginal delivery done in the hospital setting. the doctor routinely orders an oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because:

Oxytocin will prevent bleeding

Oxytocin can make the cervix close and thus trap the placenta inside

Oxytocin will facilitate placental delivery

Giving oxytocin will ensure complete delivery of the placenta

The action of oxytocin is to make the uterus contract as well make the cervix close. If it is given prior to placental delivery. the placenta will be trapped inside because the action of the drug is almost immediate if given parentally.

Explanation

The action of oxytocin is to make the uterus contract as well make the cervix close. If it is given prior to placental delivery. the placenta will be trapped inside because the action of the drug is almost immediate if given parentally.