PN 136-01 Maternal Health Nursing Exam at Nightingale College
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Free PN 136-01 Maternal Health Nursing Exam at Nightingale College Questions
The nurse advises a pregnant patient to take an iron supplement as well as incorporate whole grains, bran, vegetables, and nuts in the diet, while also drinking adequate amounts of fluids. The most likely rationale is that iron supplements can cause which complication?
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Pyrosis and peptic ulcers
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Nausea and vomiting
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Black or dark green stools
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Severe constipation
Explanation
Iron supplements commonly cause gastrointestinal side effects, the most significant being constipation. Iron slows intestinal motility by binding with digestive enzymes, which reduces peristalsis. Pregnant women are especially prone to constipation due to progesterone-induced smooth muscle relaxation. Therefore, the nurse recommends high-fiber foods (whole grains, bran, vegetables, and nuts) and adequate fluid intake to promote bowel regularity and minimize discomfort.
A patient in the first trimester of pregnancy tells the nurse, "I urinate frequently and am not able to hold urine even for a short time." Which strategy would the nurse suggest to ease the patient's discomfort?
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Apply local heat or ice
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Perform Kegel exercises
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Eat dry carbohydrates
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Get back rubs regularly
Explanation
Kegel exercises help strengthen the pelvic floor muscles, which support the bladder and urethra. During early pregnancy, hormonal changes and uterine growth increase pressure on the bladder, causing urinary frequency or slight leakage. Regularly performing Kegel exercises improves bladder control, reduces incontinence, and enhances pelvic muscle tone. This practice also prepares the pelvic muscles for childbirth and promotes faster postpartum recovery of bladder function.
Which actions does the nurse take to provide improved and efficient care to a patient? Select all that apply.
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Uses advanced technology
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Uses the internet and social media
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Suggests expensive treatments
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Involves the patient in decision-making
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Implements traditional nursing practices
Explanation
A. Uses advanced technology:
Integrating modern medical technologies—such as electronic health records, telehealth, and monitoring devices—enhances accuracy, efficiency, and safety in nursing care. Technology allows for faster communication, real-time assessment, and evidence-based interventions.
D. Involves the patient in decision-making:
Engaging the patient in shared decision-making promotes patient-centered care, improves satisfaction, and enhances adherence to the care plan. Collaboration fosters trust and empowers patients to take an active role in their health outcomes.
A pregnant patient is receiving tocolytic therapy with magnesium sulfate. Under which patient circumstance would the nurse suggest discontinuing the therapy?
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Urine output is 40 mL/hr.
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Respiratory rate is 10 breaths/min.
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Blood pressure is 120/80 mm Hg.
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Serum magnesium level is 5 mEq/L.
Explanation
Magnesium sulfate can cause respiratory depression when serum magnesium levels become toxic. A respiratory rate below 12 breaths per minute indicates potential magnesium toxicity and requires immediate discontinuation of the drug. The nurse should notify the provider, stop the infusion, and administer calcium gluconate as the antidote if ordered. Continuous monitoring of reflexes, respiratory rate, and urine output is critical during magnesium sulfate therapy to ensure maternal safety.
A patient gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the patient's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, what is the most serious consequence likely to occur from bladder distention?
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Excessive uterine bleeding
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Urinary tract infection
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Bladder wall atony
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Ruptured bladder
Explanation
Bladder distention displaces the uterus upward and to the side, preventing effective uterine contraction. A relaxed (boggy) uterus cannot compress blood vessels at the placental site, leading to excessive postpartum bleeding or hemorrhage. Prompt bladder emptying—either through spontaneous voiding or catheterization—restores uterine tone and position, reducing the risk of hemorrhage and promoting normal postpartum recovery.
Which guidance will the nurse provide to a pregnant patient with iron-deficiency anemia who was recently started on iron supplementation, when the patient reports nausea?
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Take the supplement at bedtime
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Take the supplement between meals
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Take a double dose of iron if a dose is missed
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Take the supplement with a glass of whole milk
Explanation
Iron supplements often cause gastrointestinal discomfort, including nausea, constipation, and stomach upset. Taking the supplement at bedtime may help reduce nausea because the patient is lying down and less likely to feel the side effects. This adjustment improves adherence while still allowing for adequate absorption. The nurse should also encourage taking iron with vitamin C (e.g., orange juice) to enhance absorption and avoid taking it with dairy, tea, or coffee.
Which is the factor that enables the baby to initiate respiration immediately postpartum?
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Arterial carbon dioxide pressure is decreased.
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Fetal respiratory movements increase during labor.
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Fetal lung fluid is cleared from the air passage.
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Arterial pH and bicarbonate levels are increased.
Explanation
At birth, clearing of fetal lung fluid from the airways is essential for the newborn to initiate effective respiration. During labor and delivery, thoracic compression and hormonal changes help expel lung fluid, allowing the alveoli to fill with air upon the first breath. This clearance decreases pulmonary vascular resistance, increases oxygen exchange, and establishes functional residual capacity—key steps in the newborn’s adaptation to extrauterine life.
Which will the nurse mention to the patient about the effect of secondary powers during labor?
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Contractions are expulsive in nature
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Contractions begin at pacemaker points
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Contractions move downward in waves
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The intraabdominal pressure is decreased
Explanation
Secondary powers refer to the voluntary bearing-down efforts made by the mother during the second stage of labor, which aid in expelling the fetus. These powers work in conjunction with uterine contractions (primary powers) and are expulsive in nature, generated by increased intra-abdominal pressure from the diaphragm and abdominal muscles. The effectiveness of secondary powers largely determines the progress of fetal descent and delivery.
A patient who gave birth 4 days ago reports that her vaginal discharge has an offensive odor. Which patient clinical condition does the nurse infer from this?
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Postpartum hemorrhage
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Infection
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High oxytocin levels
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Normal lochia discharge
Explanation
A foul or offensive odor from vaginal discharge (lochia) after childbirth is an abnormal finding and typically indicates a uterine or vaginal infection, such as endometritis. Normally, lochia has a fleshy or musty odor, but never a strong or foul smell. Infection may also be accompanied by fever, uterine tenderness, and increased lochia volume. The nurse should notify the healthcare provider immediately for evaluation and treatment with antibiotics to prevent complications like sepsis.
How does a cesarean delivery affect the transition of fetal respiration?
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The cesarean delivery increases the fetal oxygen (Po2) pressure.
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There is an increase in the bicarbonate level.
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Fetal lung fluid may not be effectively cleared from the lung passages.
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Fetal respiratory movements increase during birth.
Explanation
During a cesarean delivery, the fetus does not experience the mechanical compression of the thorax that occurs in a vaginal birth. This compression normally helps expel fluid from the lungs. As a result, infants delivered by cesarean section may retain more lung fluid, leading to transient tachypnea of the newborn (TTN). This can temporarily impair effective gas exchange and delay normal respiratory adaptation after birth.
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