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 is the factor that enables the baby to initiate respiration immediately postpartum?
- Arterial carbon dioxide pressure is decreased.
- Fetal respiratory movements increase during labor.
- Fetal lung fluid is cleared from the air passage.
- 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 is the most likely reason for preeclampsia in a pregnant patient during the second trimester of her pregnancy?
- Body mass index (BMI) of 34.2 kg/m²
- Severe hypotension
- Hypervitaminosis
- Lower extremity edema
Explanation
A BMI of 34.2 kg/m² indicates obesity, which is a major risk factor for preeclampsia. Obesity contributes to endothelial dysfunction, insulin resistance, and chronic inflammation, all of which impair placental perfusion and increase blood pressure. Preeclampsia typically develops after 20 weeks of gestation and is characterized by hypertension and proteinuria due to abnormal placental vascular development. Obese women are at higher risk for complications such as gestational hypertension, preeclampsia, and eclampsia.
How does a cesarean delivery affect the transition of fetal respiration?
- The cesarean delivery increases the fetal oxygen (Po2) pressure.
- There is an increase in the bicarbonate level.
- Fetal lung fluid may not be effectively cleared from the lung passages.
- 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.
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?
- Pyrosis and peptic ulcers
- Nausea and vomiting
- Black or dark green stools
- 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 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?
- Excessive uterine bleeding
- Urinary tract infection
- Bladder wall atony
- 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 minerals and vitamins usually are recommended to supplement a pregnant woman's diet?
- Iron and folate
- Calcium and zinc
- Vitamins C and B6
- 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.
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?
- Take the supplement at bedtime
- Take the supplement between meals
- Take a double dose of iron if a dose is missed
- 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 will the nurse teach the patient about the benefits of combining relaxation with walking, slow dancing, or rocking?
- This method may help increase abdominal pressure.
- This method may help manage stress throughout life.
- This method may help the baby rotate through the pelvis.
- 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 postpartum patient has urinary incontinence. Which is the best nursing intervention to help this patient?
- Have the patient practice better personal hygiene.
- Provide an epidural block.
- Encourage the patient to intake more fluids.
- Tell the patient to perform more Kegel exercises.
Explanation
Kegel exercises are the most effective nursing intervention for managing postpartum urinary incontinence. They strengthen the pelvic floor muscles that support the bladder, uterus, and rectum—muscles often weakened during pregnancy and vaginal delivery. Performing these exercises regularly improves bladder control, prevents urinary leakage, and promotes faster recovery of pelvic muscle tone. Nurses should teach the patient to contract and hold the pelvic muscles for 10 seconds, followed by relaxation, repeating several times daily.
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?
- Postpartum hemorrhage
- Infection
- High oxytocin levels
- 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.
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