(NGN) ATI RN MATERNAL NEWBORN PROCTORED EXAM TESTBANKACTUAL QUESTIONS WITH VERIFIED SOLUTIONS/A+ GRADE ASSURED 1.Question 1 1 point(s ) At what stage of labor and delivery does a primigravida differ mainly from a multigravida? o A. Stage 1 o B. Stage 2 o C. Stage 3 o D. Stage 4 Answer Correct Answer: A. Stage 1 In stage 1 during normal vaginal delivery of a vertex presentation, the multigravida may have about 8 hours of labor while the primigravida may have up to 12 hours labor. • Option B: The second stage of labor commences with complete cervical dilation to 10 centimeters and ends with the delivery of the neonate. In women who have delivered vaginally previously, whose bodies have acclimated to delivering a fetus, the second stage may only require a brief trial, whereas a longer duration may be required for a nulliparous female. • Option C: The third stage of labor commences when the fetus is delivered and concludes with the delivery of the placenta. Separation of the placenta from the uterine interface is hallmarked by three cardinal signs including a gush of blood at the vagina, lengthening of the umbilical cord, and a globular shaped uterine fundus on palpation. • Option D: During the fourth stage of labor, the baby is born, the placenta has delivered, and the woman and her partner will probably feel joy, relief, and fatigue. Most babies are ready to nurse within a short period after birth. Others wait a little longer. If the woman is planning to breastfeed, it is strongly encouraged to try to nurse as soon as possible after the baby is born. Nursing right after birth will help the uterus to contract and will decrease the amount of bleeding. 2. 2. Question 1 point(s ) The first thing that a nurse must ensure when the baby’s head comes out is o A. The cord is intac t o B. No part of the cord is encircling the baby’s nec k o C. The cord is still attached to the placent a o D. The cord is still pulsatin g Answer Correct Answer: B. No part of the cord is encircling the baby’s neck The nurse should check right away for possible cord coil around the neck because if it is present, the baby can be strangled by it and the fetal head will have difficulty being delivered. • Option A: In a newborn who was born a few hours ago, the cord may look plump and pale yellow. One of the umbilical arteries may be visible and protruding from the cut edge. A normal cord has two arteries and one vein. • Option C: The cord is expelled from the mother within a half -
hour after birth. It is still attached to the placenta, which is commonly called “the afterbirth.” With its function completed, it is no longer needed and so is discarded by the mother’s body. • Option D: Some cords may pulsate (the pulsation assists the transfer of your baby’s blood back into their body) for as long as 30 minutes or more, where others may stop pulsating at 5 minutes or less after the baby is born. 3. 3. Question 1 point(s ) To ensure that the baby will breathe as soon as the head is delivered, the nurse’s priority action is to o A. Slap the baby’s buttocks to make the baby cry . o B. Suction the nose and mouth to remove mucous secretions . o C. Clamp the cord about 6 inches from the base . o D. Check the baby’s color to make sure it is not cyanotic . Answer Correct Answer: B. Suction the nose and mouth to remove mucous secretions. Suctioning the nose and mouth of the fetus as soon as the head is delivered will remove any obstruction that may be present allowing for better breathing. Also, if mucus is in the nose and mouth, aspiration of the mucus is possible which can lead to aspiration pneumonia. (Remember that only the baby’s head has come out as given in the situation.) • Option A: Earlier, many doctors would hold the baby upside down firmly around his legs and then slap the butt gently. This not only causes slight pain to the child, but the motion also helps loosen any residues that might be obstructing the airways. Constantly doing so can irritate the child enough to begin crying. • Option C: Late cord clamping (performed approximately 1 –3 min after birth) is recommended for all births while initiating simultaneous essential neonatal care. Early umbilical cord clamping (less than 1 min after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation. • Option D: When a baby is first born, the skin is a dark red to purple color. As the baby starts to breathe air, the color changes to red. This redness normally starts to fade on the first day. A baby’s hands and feet may stay bluish in color for several days. This is a normal response to a baby’s underdeveloped blood circulation. But blue coloring of other parts of the body isn’t normal. 4. 4. Question 1 point(s ) When doing perineal care in preparation for delivery, the nurse should observe the following, except ? o A. Use up -down technique with one stroke . o B. Clean from the mons veneris to the anus . o C. Use mild soap and warm water . o D. Paint the inner thighs going towards the perineal area . Answer Correct Answer: D. Paint the inner thighs going towards the perineal area Painting of the perineal area in preparation for delivery of the baby must always be done but the stroke should be from the perineum going outwards to the thighs. The perineal area is the one being prepared for the delivery and must be kept clean • Option A: Wipe the perineum in one stroke to prevent the transfer of infectious microorganisms from the anal area to the perineum. • Option B: Always wash from front to back to prevent spreading fecal matter from the anal area to the vagina or urethra. • Option C: Use mild soap and warm water. Mild soap would avoid killing the normal flora that lives in and around the perineum. 5. 5. Question 1 point(s ) What are the important considerations that the nurse must remember after the placenta is delivered? Select all that apply. o A. Check if the placenta is complete including the membrane s o B. Check if the cord is long enough for the bab y o C. Check if the umbilical cord has 3 blood vessel s o D. Check if the cord has a meaty portion and a shiny portio n Answer Correct Answer: A & C The nurse after delivering the placenta must ensure that all the cotyledons and the membranes of the placenta are complete. Also, the nurse must
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