Management of normal newborn, management of normal puerperium
What is the highest priority nursing action for a normal newborn immediately after birth?
[a] Administering the Vitamin K injection.
[b] Obtaining the infant's weight and length.
[c] Ensuring a patent airway and providing warmth.
[d] Applying the identification bands.
A nurse assesses the uterine fundus of a postpartum patient 12 hours after delivery. Where should the nurse expect to palpate the fundus?
[a] 2 cm below the umbilicus.
[b] Approximately at the level of the umbilicus.
[c] Midway between the symphysis pubis and the umbilicus.
[d] In the pelvic cavity, non-palpable abdominally.
The Apgar score is assessed at 1 and 5 minutes after birth. It includes heart rate, respiratory effort, muscle tone, reflex irritability, and:
[a] Temperature.
[b] Blood pressure.
[c] Color.
[d] Birth weight.
A postpartum woman is in her second day after delivery. The nurse expects her lochia to be:
[a] Lochia rubra (bright red).
[b] Lochia serosa (pinkish-brown).
[c] Lochia alba (yellowish-white).
[d] Absent.
The prophylactic administration of Vitamin K to a newborn is to prevent:
[a] Neonatal sepsis.
[b] Jaundice.
[c] Hypoglycemia.
[d] Hemorrhagic disease of the newborn.
Which finding is a potential danger sign during the puerperium that requires immediate notification of the provider?
[a] Afterpains while breastfeeding.
[b] A temperature of 37.5°C (99.5°F).
[c] Soaking a perineal pad in one hour or less.
[d] The presence of lochia serosa on day 5 postpartum.
A nurse is teaching a new mother about umbilical cord care. The most important instruction is to:
[a] Apply an antibiotic ointment to the cord stump daily.
[b] Cover the cord stump with the diaper to keep it warm.
[c] Keep the cord stump clean and dry, exposed to air.
[d] Clean the cord stump with hydrogen peroxide at each diaper change.
To prevent heat loss by evaporation immediately after birth, the nurse should:
[a] Place the infant under a radiant warmer.
[b] Wrap the infant in warm blankets.
[c] Place a cap on the infant's head.
[d] Thoroughly dry the infant.
A postpartum mother who is not breastfeeding complains of breast engorgement. The nurse should recommend:
[a] Applying warm compresses to her breasts.
[b] Pumping her breasts to relieve the pressure.
[c] Wearing a supportive bra and applying ice packs.
[d] Massaging her breasts frequently to express milk.
The first stool passed by a newborn, which is greenish-black and tarry, is called:
[a] Transitional stool.
[b] Meconium.
[c] Milk stool.
[d] Seedy stool.
Which statement best describes "postpartum blues" or "baby blues"?
[a] It is a severe form of depression requiring immediate psychiatric intervention.
[b] It is a transient period of weepiness and mood swings that usually resolves within two weeks.
[c] It only affects women who have had a traumatic delivery.
[d] It is a rare complication of childbirth.
The normal range for a newborn's respiratory rate is:
[a] 12-20 breaths per minute.
[b] 20-30 breaths per minute.
[c] 30-60 breaths per minute.
[d] 60-80 breaths per minute.
A nurse assesses swelling on a newborn's scalp that crosses the suture lines. This finding is characteristic of:
[a] Caput succedaneum.
[b] Cephalohematoma.
[c] Molding.
[d] Subgaleal hemorrhage.
The primary purpose of applying erythromycin ophthalmic ointment to a newborn's eyes is to:
[a] Prevent blocked tear ducts.
[b] Prevent ophthalmia neonatorum caused by gonorrhea or chlamydia.
[c] Treat congenital cataracts.
[d] Reduce eye irritation from the birthing process.
The BUBBLE-HE acronym is a tool for postpartum assessment. The "E" stands for:
[a] Engagement.
[b] Edema.
[c] Episiotomy/Laceration and Emotional status.
[d] Elimination.
Physiological jaundice in a full-term newborn typically appears:
[a] Within the first 24 hours of life.
[b] After the first 24 hours of life.
[c] After the first week of life.
[d] Only in premature infants.
A multiparous woman who is breastfeeding is more likely to experience strong "afterpains" because:
[a] Her uterus is more relaxed than a primipara's.
[b] Breastfeeding releases oxytocin, which causes uterine contractions.
[c] She is more sensitive to pain after multiple births.
[d] The placenta was larger with this pregnancy.
Which reflex is elicited when an infant's cheek is stroked, causing the infant to turn their head toward that side and open their mouth?
[a] Moro reflex.
[b] Sucking reflex.
[c] Rooting reflex.
[d] Babinski reflex.
A nurse is teaching a new mother about signs of effective breastfeeding. Which sign indicates the infant is getting enough milk?
[a] The infant feeds for 5 minutes on each breast every 4 hours.
[b] The mother's breasts feel soft before feedings.
[c] The infant has at least 6-8 wet diapers per day after day 4.
[d] The infant consistently has small, hard, dark stools.
Rho(D) immune globulin (RhoGAM) is administered during the postpartum period to:
[a] An Rh-positive mother who gave birth to an Rh-negative baby.
[b] Any mother who had a caesarean section.
[c] An Rh-negative mother who gave birth to an Rh-positive baby.
[d] A mother who is planning to breastfeed.
The term for the return of the uterus to its non-pregnant state is:
[a] Lochia.
[b] Puerperium.
[c] Involution.
[d] Diastasis.
The normal puerperium period is defined as the:
[a] First 24 hours after delivery.
[b] First week after delivery.
[c] First 6 weeks after delivery.
[d] First 3 months after delivery.
A key component of discharge teaching for parents of a new baby is car seat safety, which includes instructing them to:
[a] Place the car seat in the front passenger seat.
[b] Use a forward-facing car seat for all newborns.
[c] Use a rear-facing car seat in the back seat.
[d] Hold the infant in their arms for short trips.
The most appropriate initial intervention for a postpartum woman with a fourth-degree perineal laceration is to:
[a] Encourage early ambulation.
[b] Apply ice packs to the perineum for the first 24 hours.
[c] Administer a cleansing enema.
[d] Encourage the use of a warm sitz bath.
A new mother should be taught to call her healthcare provider if she experiences which of the following?
[a] Passing lochia serosa on the fifth postpartum day.
[b] Feeling tired and overwhelmed.
[c] Experiencing afterpains while nursing.
[d] A fever of 38°C (100.4°F) or higher, foul-smelling lochia, or severe uterine tenderness.
Legislation in nursing, profession and related organisations.
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