Maternal And Child Health Nursing NCLEX Quiz 16

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  • 1/10 Questions

    During the first 4 hours after a male circumcision, assessing for which of the following is the priority?

    • Infection
    • Hemorrhage
    • Discomfort
    • Dehydration
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About This Quiz

Do you understand maternal and child health nursing well? This maternal and child health quiz will test your understanding and knowledge of child care. While taking this quiz, you will also learn how to respond to new mothers with concerns about their newborns. You must be able to satisfy them with a valid answer to normalize their anxiety. Start the quiz and see how much you know. All the best! You can also share the quiz with others preparing for nursing.

Maternal And Child Health Nursing NCLEX Quiz 16 - Quiz

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  • 2. 

    The post-term neonate with meconium-stained amniotic fluid needs care designed to especially monitor for which of the following?

    • Respiratory problems

    • Gastrointestinal problems

    • Integumentary problems

    • Elimination problems

    Correct Answer
    A. Respiratory problems
    Explanation
    Intrauterine anoxia may cause relaxation of the anal sphincter and empty of meconium into the amniotic fluid. At birth, some of the meconium fluid may be aspirated, causing mechanical obstruction or chemical pneumonitis. Option B: The infant is not at increased risk for gastrointestinal problems. Option C: Even though the skin is stained with meconium, it is noninfectious (sterile) and nonirritating. Option D: The post-term meconium-stained infant is not at additional risk for bowel or urinary problems.

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  • 3. 

    A client with severe preeclampsia is admitted with BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client’s plan of care?

    • Daily weights

    • Seizure precautions

    • Right lateral positioning

    • Stress reduction

    Correct Answer
    A. Seizure precautions
    Explanation
    Women hospitalized with severe preeclampsia need to be decreased CNS stimulation to prevent a seizure. Seizure precautions provide environmental safety should a seizure occur. Option A: Because of edema, daily weight is important but not the priority. Option C: Preeclampsia causes vasospasm and, therefore, can reduce uteroplacental perfusion. The client should be placed on her left side to maximize blood flow, and reduce blood pressure. and promote diuresis. Option D: Interventions to reduce stress and anxiety are very important to facilitate coping and a sense of control, but seizure precautions are the priority.

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  • 4. 

    A newborn who has an asymmetrical Moro reflex response should be further assessed for which of the following?

    • Talipes equinovarus

    • Fractured clavicle

    • Congenital hypothyroidism

    • Increased intracranial pressure

    Correct Answer
    A. Fractured clavicle
    Explanation
    A fractured clavicle would prevent the normal Moro response of symmetrical sequential extension and abduction of the arms, followed by flexion and adduction. Option A: In talipes equinovarus (clubfoot), the foot is turned medially and in plantar flexion, with the heel elevated. The feet are not involved with the Moro reflex. Option C: Hypothyroidism does not affect primitive reflexes. Option D: The absence of the Moro reflex is the most significant single indicator of central nervous system status, but it is not a sign of increased intracranial pressure.

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  • 5. 

    The mother asks the nurse, “What’s wrong with my son’s breasts? Why are they so enlarged?” Which of the following would be the best response by the nurse?

    • “The breast tissue is inflamed from the trauma experienced with birth.”

    • “A decrease in material hormones present before birth causes enlargement.”

    • “You should discuss this with your doctor. It could be a malignancy.”

    • “The tissue has hypertrophied while the baby was in the uterus.”

    Correct Answer
    A. “The breast tissue is inflamed from the trauma experienced with birth.”
    Explanation
    The presence of excessive estrogen and progesterone in the maternal-fetal blood, followed by prompt withdrawal at birth, precipitates breast engorgement, which will spontaneously resolve in 4 to 5 days after birth. Option A: The trauma of the birth process does not cause inflammation of the newborn’s breast tissue. Option C: Newborns do not have breast malignancy. This reply by the nurse would cause the mother to have undue anxiety. Option D: Breast tissue does not hypertrophy in the fetus or newborns.

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  • 6. 

    The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following statements by the mother indicates effective teaching?

    • “Daily soap and water cleansing are best.”

    • ‘Alcohol helps it dry and kills germs.”

    • “An antibiotic ointment applied daily prevents infection.”

    • “He can have a tub bath each day.”

    Correct Answer
    A. ‘Alcohol helps it dry and kills germs.”
    Explanation
    The application of 70% isopropyl alcohol to the cord minimizes microorganisms (germicidal) and promotes drying. The cord should be kept dry until it falls off and the stump has healed. Option C: Antibiotic ointment should only be used to treat an infection, not as a prophylaxis. Option D: Infants should not be submerged in a tub of water until the cord falls off and the stump has completely healed.

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  • 7. 

    When measuring a client’s fundal height, which of the following techniques denotes the correct method of measurement used by the nurse?

    • From the xiphoid process to the umbilicus

    • From the symphysis pubis to the xiphoid process

    • From the symphysis pubis to the fundus

    • From the fundus to the umbilicus

    Correct Answer
    A. From the symphysis pubis to the fundus
    Explanation
    The nurse should use a nonelastic, flexible paper measuring tap, placing the zero point on the superior border of the symphysis pubis and stretching the tape across the abdomen at the midline to the top of the fundus. Options A. B. and D: The xiphoid and umbilicus are not appropriate landmarks to use when measuring the height of the fundus (McDonald’s measurement).

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  • 8. 

    A postpartum primipara asks the nurse. “When can we have sexual intercourse again?” Which of the following would be the nurse’s best response?

    • “Anytime you both want to.”

    • “As soon as you choose a contraceptive method.”

    • “When the discharge has stopped, and the incision is healed.”

    • “After your 6 weeks examination.”

    Correct Answer
    A. “When the discharge has stopped, and the incision is healed.”
    Explanation
    Cessation of the lochial discharge signifies healing of the endometrium. Risk of hemorrhage and infection is minimal 3 weeks after a normal vaginal delivery. Option A: Telling the client anytime is inappropriate because this response does not provide the client with the specific information she is requesting. Option B: The choice of a contraceptive method is important, but not the specific criteria for the safe resumption of sexual activity. Option D: Culturally, the 6-week examination has been used as the time frame for resuming sexual activity, but it may be resumed earlier.

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  • 9. 

    A newborn weighing 3000 grams and feeding every 4 hours needs 120 calories/kg of body weight every 24 hours for proper growth and development. How many ounces of 20 cals/oz formula should this newborn receive at each feeding to meet nutritional needs?

    • 2 ounces

    • 3 ounces

    • 4 ounces

    • 6 ounces

    Correct Answer
    A. 3 ounces
    Explanation
    To determine the amount of formula needed, do the following mathematical calculation. 3 kg x 120 cal/kg per day = 360 calories/day feeding q 4 hours = 6 feedings per day = 60 calories per feeding: 60 calories per feeding; 60 calories per feeding with formula 20 cal/oz = 3 ounces per feeding. Based on the calculation. 2. 4 or 6 ounces are incorrect.

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  • 10. 

     Immediately after birth, the nurse notes the following on a male newborn: respirations 78; apical heart rate 160 BPM, nostril-flaring; mild intercostal retractions, and grunting at the end of expiration. Which of the following should the nurse do?

    • Call the assessment data to the physician’s attention

    • Start oxygen per nasal cannula at 2 L/min.

    • Suction the infant’s mouth and nares

    • Recognize this as the normal first period of reactivity

    Correct Answer
    A. Recognize this as the normal first period of reactivity
    Explanation
    The first 15 minutes to 1 hour after birth is the first period of reactivity involving respiratory and circulatory adaptation to extrauterine life. The data given reflect the normal changes during this time period. Options A and B: The infant’s assessment data reflect normal adaptation. Thus, the physician does not need to be notified, and oxygen is not needed. Option C: The data do not indicate the presence of choking, gagging, or coughing, which are signs of excessive secretions. Suctioning is not necessary.

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  • Current Version
  • Mar 15, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 04, 2017
    Quiz Created by
    Santepro
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