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Foundations of Nursing 6th Edition Christensen Kockrow Test Bank

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Foundations of Nursing 6th Edition Christensen Kockrow Test Bank

ISBN-13: 978-0323057325

ISBN-10: 0323057322

 

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Foundations of Nursing 6th Edition Christensen Kockrow Test Bank

ISBN-13: 978-0323057325

ISBN-10: 0323057322

 

 

 

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Free Nursing Test Questions:

 

Christensen: Foundations of Nursing, 6th Edition

 

Chapter 27: Care of the Mother and Newborn

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Twelve hours following the delivery of a baby, the mother is assessed by the nurse. As the nurse palpates the level of the fundus of the uterus, it should be:
a. firm and 2 cm below the umbilicus.
b. firm and at the umbilicus.
c. slightly boggy and 1 cm below the umbilicus.
d. halfway between the umbilicus and the symphysis pubis.

 

ANS:   B

Within 12 hours, the fundus contracts to the level of the umbilicus.

 

DIF:    Cognitive Level: Application             REF:    Page 842         OBJ:    1

TOP:    Postpartum      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The vaginal discharge following delivery is called lochia. It changes color over time and has different names. The initial discharge is charted by the nurse as lochia:
a. serosa.
b. rubra.
c. palatine.
d. alba.

 

ANS:   B

Initially, the drainage is called lochia rubra.

 

DIF:    Cognitive Level: Comprehension      REF:    Page 842         OBJ:    1

TOP:    Lochia             KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse explains that following delivery, the return of the menstrual cycle, which is anovulatory, depends on the return of estrogen to normal levels, which may take from:
a. 3 weeks to 3 months.
b. 4 weeks to 4 months.
c. 6 weeks to 6 months.
d. 8 weeks to 8 months.

 

ANS:   C

The first cycle may be from 6 weeks to 6 months postpartum.

 

DIF:    Cognitive Level: Comprehension      REF:    Page 848, Box 27-6

OBJ:    2                      TOP:    Postpartum     KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The new mother is breastfeeding her baby and asks about the milk from her breasts. The nurse explains that the first secretion produced by the breast is called:
a. prolactin.
b. colostrum.
c. false milk.
d. whey.

 

ANS:   B

The first secretion to be produced by the breast is colostrum.

 

DIF:    Cognitive Level: Application             REF:    Page 844         OBJ:    2

TOP:    Lactation         KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse tells the new mother that the prepregnancy weight is usually achieved without dieting within:
a. 2 to 3 weeks.
b. 4 to 5 weeks.
c. 6 to 8 weeks.
d. 3 months.

 

ANS:   C

The prepregnancy weight is usually achieved within 6 to 8 weeks without dieting.

 

DIF:    Cognitive Level: Application             REF:    Page 851         OBJ:    3

TOP:    Postpartum      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. The postpartum patient complains of discomfort in her breasts. When explaining engorgement to the mother, the nurse states that it:
a. occurs on the first or second postpartum day.
b. is first observed in the axillary region.
c. occurs only in women who are not breastfeeding.
d. occurs near the nipple on the third postpartum day.

 

ANS:   B

Filling of the breast with milk (engorgement) usually begins in the axillary region.

 

DIF:    Cognitive Level: Application             REF:    Page 857         OBJ:    3

TOP:    Engorgement                                      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. When instructing the nursing mother, the nurse explains that engorgement is most likely to occur when the:
a. infant’s mouth surrounds the areola when feeding.
b. breast tissue becomes congested.
c. breast is emptied completely at each feeding.
d. infant’s mouth grasps the nipple firmly.

 

ANS:   B

Engorgement is the result of venous and lymphatic stasis (congestion).

 

DIF:    Cognitive Level: Application             REF:    Page 857         OBJ:    3

TOP:    Engorgement                                      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. When describing colostrum to the new mother, the nurse states that it is:
a. slightly yellow and low in protein.
b. slightly yellow and provides antibodies.
c. creamy and high in fat and protein.
d. colorless and high in fat and carbohydrates.

 

ANS:   B

Colostrum is slightly yellow in color and is rich in antibodies.

 

DIF:    Cognitive Level: Comprehension      REF:    Page 874         OBJ:    3

TOP:    Colostrum       KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. The new mother has decided not to breastfeed the baby. To suppress the milk supply, the nurse recommends that the mother:
a. pump the breasts to remove milk.
b. apply warm, moist compresses.
c. restrict oral fluids.
d. apply a firm bra and ice packs.

 

ANS:   D

If a patient is not breastfeeding, compress the breasts with a firm bra and wrapped ice packs.

 

DIF:    Cognitive Level: Application             REF:    Page 857         OBJ:    3

TOP:    Engorgement                                      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

  1. During the immediate postpartum period, the mother has a temperature of 100.2° F, pulse 52, respirations 18, BP 138/84. What should the nurse do?
a. Report the temperature as abnormal.
b. Continue to monitor every 15 minutes.
c. Report the pulse as abnormal.
d. Report that vital signs are normal.

 

ANS:   D

Vital signs are normal for a new postpartum patient.

 

DIF:    Cognitive Level: Application             REF:    Page 853, Table 27-2

OBJ:    2                      TOP:    Postpartum     KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. When the breastfeeding mother asks about nutritional needs while breastfeeding, the nurse gives her a brochure showing the recommended nutritional requirements during breastfeeding as:
a. an additional 1000 mL of fluids.
b. prenatal vitamins and an additional 300 calories.
c. at least three glasses of milk a day.
d. a well-balanced diet with 500 additional calories.

 

ANS:   D

Dietary choices should include a well-balanced diet with an additional 500 calories.

 

DIF:    Cognitive Level: Application             REF:    Page 851         OBJ:    3

TOP:    Postpartum nutrition                          KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Within the first hour following a vaginal delivery, the nurse assesses the mother and finds the fundus is firm and there is a trickle of bright red blood. The nurse recognizes that:
a. this is a normal occurrence.
b. this is abnormal and should be reported.
c. the perineum needs to be checked frequently.
d. the patient should be restricted to bed rest.

 

ANS:   A

A bright red drainage is normal immediately after delivery.

 

DIF:    Cognitive Level: Application             REF:    Pages 854-855

OBJ:    3                      TOP:    Postpartum     KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse is assessing the fundus of a mother who has just given birth. The proper way to perform this procedure is by using:
a. the side of one hand moving down from the umbilicus.
b. one hand over the lower segment of the uterus.
c. one hand pushing upward from the lower uterus.
d. one hand on the lower uterine segment while the other hand locates the fundus of the uterus.

 

ANS:   D

The proper way to assess the fundus of a mother who has just given birth is by placing one hand on the lower uterine segment while the other hand locates the fundus of the uterus.

 

DIF:    Cognitive Level: Application             REF:    Pages 854-855, Figure 27-1

OBJ:    3                      TOP:    Fundal assessment

KEY:   Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

  1. The new mother is 1 day postpartum and asks about bathing. The nurse provides her with information and recognizes the responsibility to:
a. tell her to take a tub bath to prevent injury.
b. encourage a sponge bath for 3 days.
c. let the patient shower and check on her frequently.
d. suggest she use hot water to get really clean.

 

ANS:   C

The first time the newly delivered woman takes a shower, the nurse should provide for her safety.

 

DIF:    Cognitive Level: Application             REF:    Page 851         OBJ:    3

TOP:    Postpartum bathing                            KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe, Effective Care Environment

 

  1. The postpartum mother tells the nurse she is afraid to have a bowel movement because of her painful episiotomy. What should the nurse do?
a. Offer a suppository or enema.
b. Encourage ambulation.
c. Offer stool softeners as prescribed.
d. Offer pain medication before defecating.

 

ANS:   C

Stool softeners are available to ease the pain of defecation due to hemorrhoids and birth trauma.

 

DIF:    Cognitive Level: Application             REF:    Page 852         OBJ:    3

TOP:    Postpartum elimination                      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. The new mother had spinal anesthesia during a cesarean delivery. She now has a desire to void and can wiggle her toes. If she wants to go to the bathroom, the nurse should:
a. assess her blood pressure.
b. obtain a wheelchair.
c. palpate her bladder.
d. put slippers on her feet.

 

ANS:   D

The nurse should check that the mother is wearing slippers before ambulation following spinal anesthesia to ensure better footing.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 854         OBJ:    3

TOP:    Post–spinal anesthesia                        KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe, Effective Care Environment

 

  1. A mother delivered her baby at midnight and it is now 0900. She wants to sleep and asks the nurse to take care of the baby. The nurse recognizes this is an example of:
a. fatigue from labor.
b. normal “taking in” response.
c. abnormal “taking in” response.
d. risk for altered maternal-infant bonding.

 

ANS:   B

Her primary focus will be on her own needs such as sleep (“taking in” stage).

 

DIF:    Cognitive Level: Analysis                  REF:    Page 858, Box 27-9

OBJ:    5                      TOP:    “Taking in” response

KEY:   Nursing Process Step: Assessment    MSC:   NCLEX: Psychosocial Integrity

 

  1. The finding the nurse would assess as normal of a 1 day postpartum patient is:
a. pinkish to brown lochia.
b. voiding frequently 50 mL to 75 mL of urine.
c. complaining of “after pains.”
d. fundus 1 cm above the umbilicus.

 

ANS:   C

The normal finding is the common discomfort of after pains. All other options are abnormal.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 861         OBJ:    3

TOP:    Postpartum      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. A new Native-American mother tells the nurse that when she goes home, her mother-in-law will be caring for the baby while she rests. The nurse is concerned, and her response should be to:
a. explain the importance of ambulating to recover.
b. explain the importance of maternal-infant bonding.
c. explore ways to blend this with safe health teaching.
d. encourage this cultural behavior.

 

ANS:   C

Follow principles that facilitate nursing practice within transcultural situations.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 863         OBJ:    13

TOP:    Ethnic considerations                         KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Psychosocial Integrity

 

  1. Before initially feeding an infant, the nurse must assess for the presence of the:
a. Moro reflex.
b. rooting reflex.
c. Babinski reflex.
d. swallow reflex.

 

ANS:   D

The nurse should verify that the infant is able to swallow normally before feeding.

 

DIF:    Cognitive Level: Application             REF:    Page 874         OBJ:    9

TOP:    Postpartum      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Safe, Effective Care Environment

 

  1. Following delivery of the newborn, the nurse ensures the newborn is immediately:
a. weighed.
b. warmed.
c. bathed.
d. inoculated.

 

ANS:   B

Maintenance of body temperature is a primary concern when caring for the newborn.

 

DIF:    Cognitive Level: Application             REF:    Page 867         OBJ:    8

TOP:    Newborn care                                     KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse is performing an Apgar score on a newborn. Cyanosis, which is considered normal, is expected to be found on the:
a. circumoral area.
b. brow.
c. feet.
d. mucous membrane.

 

ANS:   C

The hands and feet may appear slightly blue.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 867         OBJ:    10

TOP:    Newborn assessment                          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse identifies that the newborn is jaundiced within the first 24 hours, with jaundice over bony prominences of the face and the mucous membrane. The nurse recognizes that this is:
a. physiological.
b. normal.
c. abnormal.
d. transitory.

 

ANS:   C

The presence of jaundice during the first 24 hours indicates excessive red blood cell destruction and should be reported.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 867         OBJ:    10

TOP:    Newborn assessment                          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The newborn is covered with a cream cheese–like substance, which protects the infant’s skin from the amniotic fluid. This substance is called:
a. lanugo.
b. meconium.
c. desquamation.
d. vernix caseosa.

 

ANS:   D

At birth, the skin is covered with a yellowish-white cream cheese–like substance called vernix caseosa.

 

DIF:    Cognitive Level: Comprehension      REF:    Page 867         OBJ:    8

TOP:    Newborn assessment                          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse explains that to detect inborn errors of metabolism, state law requires that certain diagnostic tests be performed on the newborn, such as:
a. blood glucose.
b. phenylketonuria (PKU).
c. blood urea nitrogen (BUN).
d. prothrombin time (PT).

 

ANS:   B

State law requires certain diagnostic tests be performed on the newborn, including PKU.

 

DIF:    Cognitive Level: Application             REF:    Pages 872-873

OBJ:    7                      TOP:    Newborn care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. When assessing the newborn, the nurse identifies a finding that suggests a chromosomal disorder, which is:
a. Epstein’s pearls.
b. gynecomastia.
c. Babinski reflex.
d. low-set ears.

 

ANS:   D

Low-set ears may indicate a chromosomal disorder.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 868         OBJ:    10

TOP:    Newborn assessment                          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse explains that vitamin K by injection is given to the newborn at risk for hemorrhage because:
a. most mothers have a vitamin K deficiency that develops during pregnancy.
b. bacteria that synthesize vitamin K are not present in newborns.
c. vitamin K prevents the synthesis of prothrombin.
d. the newborn does not store vitamin K.

 

ANS:   B

Newborns are not able to synthesize vitamin K because bacteria in the intestines are not yet developed.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 873         OBJ:    8

TOP:    Care of newborn                                KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. When discussing care of a circumcised infant after discharge from the hospital, the nurse should tell the mother to:
a. gently remove the yellow exudate from the foreskin.
b. apply sterile petroleum gauze after each diaper change.
c. wipe the circumcision with alcohol each day.
d. apply a plastic-lined diaper to prevent urine from leaking.

 

ANS:   B

Wash the penis at diaper change and apply sterile petroleum gauze.

 

DIF:    Cognitive Level: Application             REF:    Page 876         OBJ:    12

TOP:    Circumcision                                      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse is caring for a newborn who has just been circumcised. The nurse alters the care plan to include:
a. administration of a topical anesthetic to the site.
b. application of ice to stop bleeding.
c. retraction of any remaining foreskin.
d. observation for bleeding for the first 12 hours.

 

ANS:   D

If circumcision is performed, the nurse should assess for bleeding the first 12 hours.

 

DIF:    Cognitive Level: Application             REF:    Page 876         OBJ:    12

TOP:    Circumcision                                      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which finding would the nurse suspect as abnormal in the infant during initial assessment?
a. Eyes crossed at times
b. Persistent high-pitched cry
c. Arms and legs flexed
d. Slight bluish tinge of the extremities

 

ANS:   B

A high-pitched cry may indicate neurological problems.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 877         OBJ:    7

TOP:    Newborn assessment                          KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

 

  1. The mother who has been breastfeeding her infant for 5 days asks if the baby’s stools are normal. The nurse describes the normal breastfed stool as:
a. green and loose.
b. dark green and sticky.
c. pale yellow and frequent.
d. bright yellow and pasty.

 

ANS:   C

Breastfed infants tend to pass stools frequently, and they are pale yellow.

 

DIF:    Cognitive Level: Application             REF:    Page 876         OBJ:    8

TOP:    Breastfed stool                                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. The new mother calls the nurse to her room to show how her baby is “jerking around” when she changes his position. The nurse explains that this response is the normal:
a. traction reflex.
b. Babinski reflex.
c. tonic neck reflex.
d. Moro reflex.

 

ANS:   D

The Moro reflex (startle reflex) causes the baby to abduct the extremities and fan the fingers with the thumb and index fingers making a “C” shape followed by flexion and adduction of the extremities.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 870, Table 27-5

OBJ:    9                      TOP:    Reflexes          KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse is giving a bath demonstration for a group of new mothers. An important piece of information she gives this group is to:
a. apply baby powder generously to keep baby dry.
b. cleanse perineum from front to back.
c. use scented soap to make baby smell good.
d. partially submerge head in water when shampooing.

 

ANS:   B

The perineum should be cleansed by wiping from the anterior to the posterior.

 

DIF:    Cognitive Level: Application             REF:    Page 850, Box 27-8

OBJ:    4                      TOP:    Newborn bath

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. After delivery of a 9-pound baby, the nurse assesses a perineal laceration extending through the muscles of the perineum. The nurse records this as a ________-degree laceration.

 

ANS:

second

A second-degree laceration extends through the superficial tissues into the muscles of the perineum.

 

DIF:    Cognitive Level: Analysis                  REF:    Page 844         OBJ:    3

TOP:    Second-degree lacerations                  KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse explains that the Newborn and Mother’s Health Protection Act of 1996 requires that all health program plans allow a postdelivery hospital stay of at least _____ hours.

 

ANS:

48

forty-eight

The Newborn and Mother’s Protection Act of 1996 requires that all health plans include a minimum hospital stay of 48 hours postdelivery.

 

DIF:    Cognitive Level: Comprehension      REF:    Pages 865-866

OBJ:    3                      TOP:    Legislation      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse describes the return of the postpartum patient’s uterus to a pregravid state as ________________.

 

ANS:

involution

Involution is the decrease in size of the uterus to a prepregnant state.

 

DIF:    Cognitive Level: Knowledge             REF:    Page 842         OBJ:    2

TOP:    Involution       KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse explains that vernix caseosa can be left on the newborn for _____ hours.

 

ANS:

48

forty-eight

Vernix caseosa may be left on for 48 hours. Vigorous scrubbing to rid the skin of vernix caseosa can be harmful to the skin of the newborn.

 

DIF:    Cognitive Level: Application             REF:    Page 875         OBJ:    8

TOP:    Vernix caseosa                                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The new mother tells the home health nurse that she is concerned about her 5-day-old infant’s hard, dried umbilical stump. The nurse tells her this desired outcome is called _______________.

 

ANS:

mummification

Drying and hardening of the umbilical stump is called mummification. It is the desired outcome for the umbilical stump.

 

DIF:    Cognitive Level: Application             REF:    Page 875         OBJ:    4

TOP:    Mummification                                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

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