Practice a- Maternal Newborn

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Sample questions from Practice a- Maternal Newborn

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 26-year-old client at 39 weeks' gestation is in the labor unit with contractions every 3 minutes. The fetal heart rate baseline is 140/min with moderate variability and recurrent late decelerations. Maternal blood pressure is 118/72 mm Hg. Which action should the nurse take first?

   • A.Reposition the client to a lateral position
   • B.Increase the oxytocin infusion
   • C.Prepare the client to push
   • D.Obtain a fetal scalp blood sample

   Rationale: Repositioning laterally can improve uteroplacental perfusion and is an immediate response to recurrent late decelerations. Increasing oxytocin may worsen uterine activity and fetal oxygenation. Pushing is inappropriate before complete dilation and may add fetal stress. Fetal scalp blood sampling is not the first intervention for this pattern.

2. 2.A 30-year-old client at 40 weeks' gestation is receiving oxytocin in the labor unit. Contractions occur every 1 minute and last 100 seconds; the fetal heart rate is 170/min with minimal variability. Maternal blood pressure is 124/76 mm Hg. What should the nurse do first?

   • A.Stop the oxytocin infusion
   • B.Increase the oxytocin to improve labor progress
   • C.Encourage the client to bear down
   • D.Document the pattern and reassess in 30 minutes

   Rationale: The contraction pattern indicates uterine tachysystole with concerning fetal findings, so stopping oxytocin is the priority. Increasing the infusion would intensify the problem. Bearing down is not appropriate unless the client is fully dilated and can worsen fetal stress. Waiting 30 minutes delays correction of a potentially reversible cause.

3. 3.A 24-year-old client at 38 weeks' gestation arrives at the birth unit reporting a sudden gush of clear fluid. The fetal heart rate is 145/min, and the client is afebrile with a blood pressure of 116/70 mm Hg. Which assessment is the priority?

   • A.Assess the fetal heart rate
   • B.Perform a digital cervical examination
   • C.Obtain a urine specimen
   • D.Encourage ambulation to promote labor

   Rationale: Fetal heart rate assessment is the priority after rupture of membranes because umbilical cord prolapse can cause sudden fetal compromise. A digital examination can increase infection risk and should be avoided unless indicated. Urine testing does not address the immediate risk. Ambulation should wait until fetal status and cord-prolapse risk are assessed.

4. 4.A 22-year-old client at 36 weeks' gestation is admitted to the labor unit with painless bright-red vaginal bleeding. The fetal heart rate is 150/min, and blood pressure is 112/68 mm Hg. Which action should the nurse avoid?

   • A.Performing a digital vaginal examination
   • B.Establishing a large-bore IV access
   • C.Monitoring fetal heart rate continuously
   • D.Quantifying the visible blood loss

   Answer and rationale are in the full material.

5. 5.A 29-year-old client at 35 weeks' gestation reports constant abdominal pain and dark vaginal bleeding. The uterus is firm and tender; blood pressure is 98/60 mm Hg, pulse is 116/min, and the fetal heart rate is 170/min. What is the nurse's priority action?

   • A.Establish large-bore IV access and notify the obstetric team
   • B.Perform a digital cervical examination
   • C.Apply fundal pressure to reduce bleeding
   • D.Offer oral fluids and reassess in 1 hour

   Answer and rationale are in the full material.