MCH Adaptive Exam 2024 | MCH Adaptive
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Questions and Correct Answers Rated A+
The nurse has a Rx to obtain a blood sample from a pt to determine
fetal lactate levels. What information should the nurse provide to the pt
before the procedure?
1 "There is an increased risk for after birth hemorrhage."
2 "There may be a need to reconduct the diagnostic test."
3 "There is an increased risk for requiring a cesarean birth."
4 "There will be a small incision on the scalp of the newborn." -
ANSWER-4. "There will be a small incision on the scalp of the
newborn"
While performing a vag exam of the pt in active labor, the nurse notes
deceleration in the FHR during UCs. What should the nurse do in this
situation?
1 Stop applying fundal pressure.
2 Discontinue the oxytocin (Pitocin) drip.
3 Change the maternal position.
4 Document it as a normal finding. -ANSWER-4. Document it as a
normal finding
The nurse is assessing the fetal heart rate (FHR) in a pregnant patient
with diabetes during the first stage of labor. At what time intervals
should the nurse perform FHR tracing?
RATIONALE:
Diabetes is one of the risk factors in preg. If any risk factors are
present, the FHR tracing should be evaluated more frequently (every
15 min) in the 1st stage of labor and every 5 min in the 2nd stage of
labor. FHR should not be evaluated every hour in either low-risk or
high-risk pts. In low-risk pts the FHR tracing should be evaluated for
every 30 min during the 1st stage of labor
After reviewing the umbilical cord acid-base report, the nurse confirms
that the fetus has respiratory acidosis. Which reading is consistent
with the nurse's conclusion?
1 A base deficit value ≥12 mmol/L
2 Blood glucose levels = 120 mg/dL
3 Arterial pH >7.20
4 Partial pressure carbon dioxide >55 mm Hg -ANSWER-4. Partial
pressure carbon dioxide >55 mmHg
RATIONALE:
If Pco2 >55 mmHg (elevated) and base deficit value <12 mmol/L and
pH is <7.2, it indicates resp acidosis. In this case, the partial pressure
carbon dioxide >55 mmHg is indicative of resp acidosis. A pH >7.2
and base deficit value of >/= 12 mmol/L are all considered normal.
Blood glucose level is not a part of this acid-base report.
The nurse is assessing a 3-day-old infant with ecchymosis and finds
that the condition has not yet healed. The nurse informs the primary
,HCP of this finding. Which lab report would the nurse expect the HCP
to order?
1 Platelet count
2 Bilirubin levels
3 Abdominal scan
4 Creatinine levels -ANSWER-1. platelets
RATIONALE:
Ecchymosis is observed in a newborn as a result of injury caused
during delivery. This condition usually heals within 2 days of childbirth.
If the condition persists for more than 2 days, the HCP will order to
test the platelet count to r/o thrombocytopenic purpura.
Thombocytopenic purpura may be the underlying cause for persistent
ecchymosis. Bilirubin levels are usually checked when there is a
discoloration of the skin, but not for ecchymosis. Abdominal scan and
serum creatinine levels are not helpful in determining
thrombocytopenic purpura.
The nurse auscultates a neonate in resting position and hears a
murmur. What further assessments should the nurse make to know if
the infant has any cardiac defects?
1 Measure the circumference of the head
2 Assess movements of the lower extremities
3 Assess blood pressure (BP) in all four extremities
4 Monitor blood pressure (BP) in the upper extremities -ANSWER-3.
Assess BP in all 4 extremities
RATIONALE:
When murmurs are heard, the nurse should check the neonates' BP
from all 4 extremities to r/o congenital heart diseases. Circumference
of the head is measured to detect head-related complications, such as
, microcephaly and hydrocephaly. However, it is unrelated to CHD.
Assessing the body mvts would correlate more with muscular activity
of the neonate but not with cardiac activity.
The nurse evaluates the BP of a neonate and suspects a cardiac
defect. What recordings of the neonate's BP confirm a cardiac defect?
1 The BP in the lower extremities is 60/40 mm Hg and in the upper
extremities is 70/50 mm Hg.
2 The BP in the lower extremities is 50/40 mm Hg and in the upper
extremities is 80/70 mm Hg.
3 The BP in the lower extremities is 70/40 mm Hg and in the upper
extremities is 60/40 mm Hg.
4 The BP in the lower extremities is 80/40 mm Hg and in the upper
extremities is 70/60 mm Hg. -ANSWER-2. The BP in the lower
extremities is 50/40 mmHg and in the upper extremities is 80/70
mmHg
RATIONALE:
Systolic BP should be 60-80 mmHg, and diastolic BP should be 40-50
mmHg. When the recordings are varied by 20 mmHg in both the
extremities, it implies that the neonate has a cardiac defect, such as
coarctation of the aorta. If the BP of the lower extremities is 50/40
mmHg and the upper extremities is 80/70 mmHg, it indicates the
neonate has a cardiac defect, such as coarctation of the aorta. The
same recordings on all the extremities signify that the neonate's heart
functions properly. Variations of 10 mmHg are still considered a
normal finding in a neonate.
On a winter morning the nurse finds the skin color of the newborn
turning blue. The baby also has difficulty breathing. What should be
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