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
Which will the nurse teach the patient about the benefits of combining relaxation with walking, slow dancing, or rocking?
- A. This method may help increase abdominal pressure.
- B. This method may help manage stress throughout life.
- C. This method may help the baby rotate through the pelvis.
- D. This method may help distract and divert from pain.
Explanation
Combining relaxation with gentle movements such as walking, slow dancing, or rocking encourages optimal fetal positioning and helps the baby rotate through the pelvis during labor. These rhythmic motions promote pelvic mobility and alignment, allowing gravity to assist in fetal descent. Relaxation prevents muscle tension that can hinder labor progress, while movement facilitates uterine contractions and improves maternal comfort, supporting a smoother, more efficient labor process.
A pregnant patient is receiving tocolytic therapy with magnesium sulfate. Under which patient circumstance would the nurse suggest discontinuing the therapy?
- A. Urine output is 40 mL/hr.
- B. Respiratory rate is 10 breaths/min.
- C. Blood pressure is 120/80 mm Hg.
- D. 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.
The nurse instructs the pregnant patient to exercise her lower limbs frequently. Which clinical condition is the nurse trying to prevent?
- A. Endometritis
- B. Dyspareunia
- C. Thromboembolism
- D. Hemorrhoids
Explanation
During pregnancy, increased estrogen and progesterone levels, along with venous stasis from uterine pressure and hypercoagulability, predispose women to thromboembolism (blood clots, particularly deep vein thrombosis—DVT). Regular lower limb exercises, such as ankle rotations and leg stretches, improve circulation and venous return, reducing the risk of clot formation. This is especially important during long periods of sitting or bed rest, such as during late pregnancy or postpartum recovery.
Which of the following are one of the 5 Ps of labor? Select all that apply.
- A. Position
- B. Psychological response
- C. Powers
- D. Passenger
- E. Passageway
- F. Placenta
Explanation
A. Position
Position refers to the posture and movements of the laboring mother. The woman’s position affects the mechanics of labor by influencing pelvic dimensions, fetal alignment, and uterine efficiency. Positions such as squatting, side-lying, or hands-and-knees can facilitate descent and rotation of the fetus. Frequent position changes also promote comfort and enhance circulation to both the mother and fetus.
B. Psychological response
Psychological response refers to the emotional and mental state of the mother during labor. Anxiety, fear, and tension can release catecholamines that reduce uterine contractility and blood flow to the uterus, slowing labor. A calm, supported, and confident mother typically experiences more effective contractions and smoother labor progression.
C. Powers
Powers represent the forces that expel the fetus. These include the primary powers (involuntary uterine contractions) and secondary powers (voluntary maternal pushing efforts). Effective contractions lead to cervical dilation, effacement, and fetal descent. Coordination between contractions and pushing ensures safe and efficient delivery.
D. Passenger
Passenger refers to the fetus and its relationship to the maternal pelvis. Key aspects include fetal size, presentation, lie, attitude, and position. For example, a cephalic presentation and proper fetal alignment usually lead to an easier labor, while abnormal presentations like breech can complicate delivery.
E. Passageway
Passageway encompasses the mother’s bony pelvis and soft tissues through which the baby passes. The size, shape, and flexibility of the pelvis, along with the condition of the cervix, vagina, and perineum, affect how smoothly the baby descends. Adequate pelvic dimensions and tissue elasticity are crucial for safe delivery.
The nurse instructs a pregnant patient to breathe through the mouth and keep it open while pushing during labor. Which is the rationale for this nursing intervention?
- A. To decrease the efforts required for pushing
- B. To avoid nasal congestion in the patient
- C. To facilitate increased oxygen to the fetus
- D. To avoid deceleration in the fetal heart rate
Explanation
During labor, open-mouth breathing ensures a steady flow of oxygen to both the mother and the fetus. Controlled breathing helps the woman avoid prolonged breath-holding (Valsalva maneuver), which can reduce venous return and cardiac output, thereby decreasing uteroplacental blood flow and leading to fetal hypoxia. By keeping the mouth open and breathing rhythmically, the patient maintains better oxygenation, which supports effective contractions and reduces stress on the fetus.
Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet?
- A. Iron and folate
- B. Calcium and zinc
- C. Vitamins C and B6
- D. Vitamins A and D
Explanation
Iron and folate (folic acid) are the most commonly recommended supplements during pregnancy. Folate is crucial in the first trimester to prevent neural tube defects such as spina bifida, while iron supports the increased production of maternal red blood cells and prevents iron-deficiency anemia. Both nutrients are vital for fetal growth, placental development, and adequate oxygen delivery to the fetus.
A woman is experiencing back labor and reports having intense pain in her lower back. The nurse instructs the support person to use which nonpharmacologic technique?
- A. Effleurage
- B. Conscious relaxation or guided imagery
- C. Counterpressure against the sacrum
- D. Slow-paced breathing techniques
Explanation
Counterpressure against the sacrum is an effective nonpharmacologic technique for relieving back labor pain, which often occurs when the fetus is in the occiput posterior position. Steady pressure applied to the lower back or sacrum helps relieve discomfort caused by fetal head pressure on the maternal spine. The technique provides immediate pain relief and can be used in combination with other comfort measures during labor.
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?
- A. Apply local heat or ice
- B. Perform Kegel exercises
- C. Eat dry carbohydrates
- D. 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.
How does a cesarean delivery affect the transition of fetal respiration?
- A. The cesarean delivery increases the fetal oxygen (Po2) pressure.
- B. There is an increase in the bicarbonate level.
- C. Fetal lung fluid may not be effectively cleared from the lung passages.
- D. 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.
Which is the most likely complication associated with a patient that has multifetal gestation?
- A. Postpartum hemorrhage
- B. Von Willebrand disease (vWD)
- C. Vaginal hematomas
- D. Abnormal development of limbs
Explanation
Postpartum hemorrhage is the most likely complication associated with multifetal gestation. The uterus becomes overstretched due to carrying multiple fetuses, increasing the risk of uterine atony after delivery. When the uterus fails to contract effectively, it leads to excessive bleeding. The enlarged placental area and prolonged labor in multifetal pregnancies further heighten the risk of postpartum hemorrhage, making vigilant monitoring and uterotonic support essential.
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