Maternal And Child Health Nursing NCLEX Quiz 29

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Maternal And Child Health Nursing NCLEX Quiz 29 - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.


Questions and Answers
  • 1. 

    Which of the following conditions will lead to a small-for-gestational-age fetus due to less blood supply to the fetus?

    • A.

      Diabetes in the mother

    • B.

      Maternal cardiac condition

    • C.

      Premature labor

    • D.

      Abruptio placenta

    Correct Answer
    B. Maternal cardiac condition
    Explanation
    In general. when the heart is compromised such as in maternal cardiac condition. the condition can lead to less blood supply to the uterus consequently to the placenta which provides the fetus with the essential nutrients and oxygen. Thus if the blood supply is less. the baby will suffer from chronic hypoxia leading to a small-for-gestational-age condition.

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  • 2. 

    The lower limit of viability for infants in terms of age of gestation is:

    • A.

      21-24 weeks

    • B.

      25-27 weeks

    • C.

      28-30 weeks

    • D.

      38-40 weeks

    Correct Answer
    A. 21-24 weeks
    Explanation
    Viability means the capability of the fetus to live/survive outside of the uterine environment. With the present technological and medical advances. 21 weeks AOG is considered as the minimum fetal age for viability.

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  • 3. 

    A nurse in the labor room is monitoring a client with dysfunctional labor for signs of maternal or fetal compromise. Which of the following assessment findings would alert the nurse to a compromise?

    • A.

      Coordinated uterine contractions

    • B.

      Meconium in the amniotic fluid

    • C.

      Progressive changes in the cervix

    • D.

      Maternal fatigue

    Correct Answer
    B. Meconium in the amniotic fluid
    Explanation
    Signs of maternal or fetal compromise include passage of meconium. decreased movement felt by the mother. nonreassuring fetal heart rate. and fetal metabolic acidosis.Options A and C: Coordinated uterine contractions and progressive changes in the cervix are a reassuring pattern in labor.Option D: Maternal fatigue can occur with prolonged labor. but do not indicate maternal or fetal compromise.

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  • 4. 

    While assessing a G2P2 client who had a normal spontaneous vaginal delivery 30 minutes ago. the nurse notes a large amount of red vaginal bleeding. What would be the initial priority nursing action?

    • A.

      Notify the physician

    • B.

      Encourage to breast-feed soon after birth

    • C.

      Monitor vital signs

    • D.

      Provide fundal massage

    Correct Answer
    D. Provide fundal massage
    Explanation
    Fundal massage also called uterine massage is done to reduce bleeding and cramping of the uterus after childbirth. This would be the priority nursing action since it directly addresses the problem.Options A and C are appropriate nursing actions. but do nothing to stop the immediate bleeding.Option B: Breastfeeding the baby will stimulate the release of oxytocin. which will cause uterine contraction. but it will be slower to do so than the fundal massage.

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  • 5. 

    The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by forceps under epidural anesthesiA. The main rationale for this is:

    • A.

      To allow atraumatic delivery of the baby

    • B.

      To allow a gradual shifting of the blood into the maternal circulation

    • C.

      To make the delivery effort free and the mother does not need to push with contractions

    • D.

      To prevent perineal laceration with the expulsion of the fetal head

    Correct Answer
    C. To make the delivery effort free and the mother does not need to push with contractions
    Explanation
    Forceps delivery under epidural anesthesia will make the delivery process less painful and require less effort to push for the mother. Pushing requires more effort which a compromised heart may not be able to endure.

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  • 6. 

    When giving narcotic analgesics to mother in labor, the special consideration to follow is:

    • A.

      The progress of labor is well established reaching the transitional stage

    • B.

      Uterine contraction is progressing well. and delivery of the baby is imminent

    • C.

      Cervical dilatation has already reached at least 8 cm. and the station is at least (+)2

    • D.

      Uterine contractions are strong and the baby will not be delivered yet within the next 3 hours.

    Correct Answer
    D. Uterine contractions are strong and the baby will not be delivered yet within the next 3 hours.
    Explanation
    Narcotic analgesics must be given when uterine contractions are already well established so that it will not cause stoppage of the contraction thus protracting labor. Also. it should be given when delivery of fetus is imminent or too close because the fetus may suffer respiratory depression as an effect of the drug that can pass through placental barrier.

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  • 7. 

    The cervical dilatation taken at 8:00 AM in a G1P0 patient was 6 centimeters. A repeat I.E. done at 10 A. M. showed that cervical dilation was 7 cm. The correct interpretation of this result is:

    • A.

      Labor is progressing as expected

    • B.

      The latent phase of Stage 1 is prolonged

    • C.

      The active phase of Stage 1 is protracted

    • D.

      The duration of labor is normal

    Correct Answer
    C. The active phase of Stage 1 is protracted
    Explanation
    The active phase of Stage I starts from 4cm cervical dilatation and is expected that the uterus will dilate by 1cm every hour. Since the time elapsed is already 2 hours. the dilatation is expected to be already 8 cm. Hence. the active phase is protracted.

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  • 8. 

    Which of the following techniques during labor and delivery can lead to uterine inversion?

    • A.

      Fundal pressure applied to assist the mother in bearing down during delivery of the fetal head

    • B.

      Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation

    • C.

      Massaging the fundus to encourage the uterus to contract

    • D.

      Applying light traction when delivering the placenta that has already detached from the uterine wall

    Correct Answer
    B. Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation
    Explanation
    When the placenta is still attached to the uterine wall. tugging on the cord while the uterus is relaxed can lead to inversion of the uterus. Light tugging on the cord when placenta has detached is alright in order to help deliver the placenta that is already detached.

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  • 9. 

    The fetal heart rate is checked following rupture of the bag of waters in order to:

    • A.

      Check if the fetus is suffering from head compression

    • B.

      Determine if cord compression followed the rupture

    • C.

      Determine if there is uteroplacental insufficiency

    • D.

      Check if fetal presenting part has adequately descended following the rupture

    Correct Answer
    B. Determine if cord compression followed the rupture
    Explanation
    After the rupture of the bag of waters. the cord may also go with the water because of the pressure of the rupture and flow. If the cord goes out of the cervical opening. before the head is delivered (cephalic presentation). the head can compress on the cord causing fetal distress. Fetal distress can be detected through the fetal heart tone. Thus. it is essential do check the FHB right after rupture of bag to ensure that the cord is not being compressed by the fetal head.

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  • 10. 

    Upon assessment. the nurse got the following findings: 2 perineal pads highly saturated with blood within 2 hours postpartum. PR= 80 bpm. fundus soft and boundaries not well defineD. The appropriate nursing diagnosis is:

    • A.

      Normal blood loss

    • B.

      Blood volume deficiency

    • C.

      Inadequate tissue perfusion related to hemorrhage

    • D.

      Hemorrhage secondary to uterine atony

    Correct Answer
    D. Hemorrhage secondary to uterine atony
    Explanation
    All the signs in the stem of the question are signs of hemorrhage. If the fundus is soft and boundaries not well defined. the cause of the hemorrhage could be uterine atony.

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