PN Maternal Newborn Nursing Edition 13.0

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Sample questions from PN Maternal Newborn Nursing Edition 13.0

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

1. 1.In the postpartum unit, a 24-year-old client is 2 hours after a vaginal birth. The client reports feeling faint, and the PN notes a saturated perineal pad in 15 minutes and a boggy fundus. Which action should the PN take first?

   • A.Document the amount of lochia and reassess in 30 minutes.
   • B.Notify the RN immediately and remain with the client.
   • C.Offer oral fluids and assist the client to the bathroom.
   • D.Reinforce teaching about expected postpartum bleeding.

   Rationale: A boggy fundus, rapidly saturated pad, and dizziness suggest postpartum hemorrhage and require immediate reporting to the RN. Reassessment in 30 minutes could delay treatment, and ambulation could increase the risk of injury. Teaching and fluids do not address the urgent change in condition. The PN should promptly report concerning findings and remain available to monitor the client.

2. 2.At change of shift on a postpartum unit, a 29-year-old client is stable after an uncomplicated birth, a 31-year-old client is requesting routine assistance with breastfeeding, a 26-year-old client has new shortness of breath, and a 34-year-old client asks when discharge teaching will begin. Which client should the PN report to the RN first?

   • A.The client asking about discharge teaching
   • B.The client requesting assistance with breastfeeding
   • C.The stable client after an uncomplicated birth
   • D.The client with new shortness of breath

   Rationale: New shortness of breath may indicate a serious cardiopulmonary complication and requires immediate RN assessment. Breastfeeding assistance and discharge questions are important but can wait until the urgent concern is addressed. The stable client has no reported change requiring priority follow-up. The PN prioritizes reporting acute changes rather than delaying them for routine care.

3. 3.Refer to the client's chart. Which findings should the PN report to the RN immediately? Select all that apply.

   • A.The client rates perineal soreness as 3 out of 10 at 1015.
   • B.The pad is saturated in 20 minutes at 1015.
   • C.The temperature is 37.2 C at 1000.
   • D.The fundus remains boggy after the client voids at 1015.
   • E.The client reports feeling dizzy when sitting up at 1015.

   Rationale: A pad saturated in 20 minutes, a persistently boggy fundus, and dizziness are concerning for ongoing postpartum blood loss and should be reported promptly. The temperature of 37.2 C is not a fever, and mild perineal soreness is an expected finding when no other concerning cue is present. The chart shows a rising heart rate and falling blood pressure alongside increased bleeding, which strengthens the need for immediate escalation. The PN reports changes and continues monitoring rather than independently managing a possible hemorrhage.

4. 4.A provider prescribes oral iron for a 32-year-old client at a prenatal clinic. The client says, 'I take my iron with milk because it is easier on my stomach.' Which response is appropriate for the PN?

   • A.Reinforce taking iron with a source of vitamin C and separating it from milk when possible.
   • B.Tell the client to stop taking iron until the next prenatal appointment.
   • C.Explain that milk improves iron absorption and the current routine should continue.
   • D.Advise taking the iron with an antacid to prevent constipation.

   Answer and rationale are in the full material.

5. 5.During a home visit, a 41-year-old client who is 5 days postpartum says the newborn has been difficult to wake for feeds. The client reports that the newborn has had one wet diaper in the past 24 hours. Which action should the PN take?

   • A.Schedule a routine follow-up visit for the following week.
   • B.Tell the client this pattern is expected during the first week.
   • C.Report the concern to the RN promptly and continue collecting feeding and output information.
   • D.Recommend giving the newborn water between feedings.

   Answer and rationale are in the full material.