RNC-MNN Study Questions & Answers. 100% Accurate. Graded A

RNC-MNN Study Questions & Answers. 100% Accurate. Graded A Eve is 2 days postpartum. During palpation, where would you normally expect to find her fundus? a. at the level of the umbilicus b. 2 fingers below umbilicu ...

RNC-MNN Study Questions & Answers. 100% Accurate. Graded A Eve is 2 days postpartum. During palpation, where would you normally expect to find her fundus? a. at the level of the umbilicus b. 2 fingers below umbilicus c. 5 fingers below umbilicus d. non-palpable at this time - ✔✔-b. 2 fingers below umbilicus Keisha delivered her third child about 24 hours ago. She begins to c/o severe uterine cramping while breastfeeding. She is experiencing: a. exfoliation of dead tissue b. involution of uterus c. shedding of the endometrium d. after pains - ✔✔-d. after pains Three days after delivering her child, Gretchen calls the 24 hour hotline. She is crying and states that her breasts suddenly became "bigger" and "really hurt." She is experiencing: a. colostrum production b. a breast tumor c. engorgement d. overproduction of milk - ✔✔-c. engorgement Tiffany delivered via cesarean 2 days ago. She is frustrated by constant perspiration and urination. This is likely the result of: a. changes in urine pH and a possible UTI b. drinking too much fluid in the early postpartum period c. the body's removal of fluids accumulated during pregnancy d. receiving excessive amounts of IV fluids during labor - ✔✔-c. the body's removal of fluids accumulated during pregnancy While assessing Sierra, a 32yo mother of 3, you notice uterine bleeding and find that her uterus is displayed upward and to the right. This is probably cause by: a. retained placental fragments b. rupture of the uterus c. distention of the bladder d. cervical bruising - ✔✔-c. distention of the bladder Olga, a 38yo patient whom you administered the rubella vaccine, states that at her age she plans to get pregnant right away. You tell her she should: a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine b. get pregnant ASAP because of her age c. avoid getting pregnant for at least a year after receiving the MMR vaccine d. abstain from sex for 2 weeks after delivery - ✔✔-a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine Joan is a 17yo and just delivered a healthy baby boy 6 hours ago. She talks on her cell phone whenever you are in the room and refuses to touch or hold her baby, even when he cries. You overhear Joan tell someone that the baby is "ugly like his father." Joan is most likely experiencing: a. exhaustion b. mal-attachment c. normal attachment d. postpartum depression - ✔✔-b. mal-attachment Recommended advice for breastfeeding mothers include: a. avoid the use of a sports bra b. wash the nipples with soap and water after each feeding c. apply a warm compress to ease nipple pain d. "conditioning" the nipples by gently rubbing them with moist tea bags - ✔✔-c. apply a warm compress to ease nipple pain Samantha read in the discharge booklet that postpartum patients are at risk for thrombophlebitis, and she asks you how she can prevent this from happening. You instruct her to: a. remain on strict bedrest b. ambulate frequently c. cross her legs while sitting d. avoid elevating her legs - ✔✔-b. ambulate frequently Suzanne delivered vaginally 8 hours ago. She has uterine cramping and rates her pain a "9" but refuses pain medication. What is your best response regarding her pain? a. tell her she should take the ibuprofen as prescribed by her MD b. encourage her to fight the pain because it will make her stronger c. ask her to use the call button if she changes her mind about taking pain medication d. offer her a non-drug option such as a hot pack or massage - ✔✔-d. offer her a non-drug option such as a hot pack or massage Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She reports she is "bleeding a lot" and her perineal pad, changed 45 minutes ago, is fully saturated. Palpation reveals a boggy uterus. Your first intervention is: a. start IV fluids b. place a catheter c. massage her uterus until firm d. call the MD - ✔✔-c. massage her uterus until firm Mei experienced premature rupture of membranes during her pregnancy and her internal fetal monitors placed during labor. She later delivered by cesarean. 12 hours after delivery, her HR is 104 and her lochia smells foul. You suspect: a. endometriosis b. mastitis c. uterine cancer d. endometritis - ✔✔-d. endometritis You are preparing to discharge Maria after delivering a healthy boy. You believe Maria understands the discharge teaching instructions when she states: a. it is acceptable to have bleeding nipples after breastfeeding for the first few days b. I should not worry if I have a large mass under my breasts c. I will call my nurse-midwife if I saturate a pad in one hour d. suicidal thoughts are okay because the baby blues are normal - ✔✔-c. I will call my nurse-midwife if I saturate a pad in one hour An infant born to a mother who abused drugs during pregnancy exhibited withdrawal signs in the nursery that included fever and poor state control. After stabilization and discharge, the caretaker called to report a return of withdrawal symptoms. This pattern is consistent with maternal abuse of: a. alcohol b. cocaine c. methadone - ✔✔-b. cocaine Leukocytosis that occurs in normal postpartum adaptation can be differentiated from an infectious process by the presence of: a. a 30% increase in WBC count in a 6 hour period b. a concominant increase in the sedimentation rate c. any elevation in temperature - ✔✔-b. a concominant increase in the sedimentation rate Tachypnea, tachycardia, and poor feeding in a 12 hour old neonate, born to a mother with diabetes mellitus, would be more consistent with the onset of: a. congestive heart failure b. hypoglycemia c. respiratory distress syndrome - ✔✔-b. hypoglycemia A postpartum woman has a BP of 150/92 at 6 hours. Later, the BP is 148/90. This finding most likely: a. diminished venous return b. reflects postpartum peak in cardiac output c. requires evaluation for postpartum preeclampsia - ✔✔-c. requires evaluation for postpartum preeclampsia The let down reflex in the breastfeeding woman is responsible for a. movement of the milk from ducts to the nipple b. regulation of milk release to ensure milk is available at any given time c. release of the milk to the alveoli - ✔✔-a. movement of the milk from ducts to the nipple A woman plans not to breastfeed and asks about how to suppress lactation. She should be advised that: a. mechanical suppression occurs with the use of a supportive bra b. medications can be prescribes to stop lactation c. physiologically, lactation will not proceed without breastfeeding and no intervention is needed - ✔✔- a. mechanical suppression occurs with the use of a supportive bra Spinal blockade occurring with epidural anesthesia results in a. hypotension b. tachycardia c. vertigo - ✔✔-a. hypotension Synthesis of vitamin K in the neonate is dependent upon the presence of a. amino acids derived from human or formula proteins b. appropriate bacteria in the GI tract c. passively acquired maternal antibodies - ✔✔-b. appropriate bacteria in the GI tract A woman with a history of breast augmentation asks if she will be able to breastfeed her baby. The factor that will most influence her ability to breastfeed is a. time interval since the surgery b. type of implant c. type of incision - ✔✔-c. type of incision Assessment for the presence of congenital viral infection would be indicated in which of the following: a. 38 weeks, LGA infant with RDS b. late preterm with elevated indirect bilirubin c. term, SGA with widespread petechiae - ✔✔-c. term, SGA with widespread petechiae A woman has been treated with fractionated heparin during pregnancy for thromboembolism. She wants to breastfeed. In the postpartum period, it would be expected that she would a. be changed to a low molecular weight heparin formulation b. be switched to warfarin c. continue with heparin therapy - ✔✔-c. continue with heparin therapy An anatomic breast variation that has been linked with insufficient lactation relates to a. inadequate glandular tissue b. lack of breast tissue elasticity c. shape and size of nipple - ✔✔-a. inadequate glandular tissue A woman is admitted to the postpartum unit following delivery of her infant on the route to the hospital. The RN noted bruises on the woman's back and arms. To assess possible intimate partner violence, the RN should a. directly ask her if anyone has threatened her or physically harmed her b. question her on how she obtained the bruises c. review the patients chart for any indication of domestic violence - ✔✔-b. question her on how she obtained the bruises The use of phototherapy reduces the risk of a. bronze baby syndrome b. exchange transfusion c. skin moles - ✔✔-b. exchange transfusion Uterine prolapse associated with childbirth is due to a. atrophy of the uterine tissue b. bulging of uterine tissue through the cervix c. weakening of the pelvic tissue - ✔✔-c. weakening of the pelvic tissue A new mother verbalizes her concern about the presence of stork bites nevus on her infant's eyelid. The RN's response will be based on the knowledge that a. further growth and facial involvement is likely overtime b. the location of the birth mark carries a risk of eye involvement c. this type of vascular lesions tend to disappear by the age of one - ✔✔-c. this type of vascular lesions tend to disappear by the age of one The recommended antibiotic treatment for postpartum endometritis is a. a broad spectrum antibiotic b. based on endometrial culture c. selected based on provider's preference - ✔✔-a. a broad spectrum antibiotic It is difficult to determine the extent of blood loss with a vaginal hematoma because a. blood is retained in the tissue b. blood loss is mistaken as part of the normal postpartum course c. symptoms don't correlate to the amount of blood loss - ✔✔-a. blood is retained in the tissue A newborn is noted at birth to be hypotonic with characteristics that include small ears, flat appearance to the face, slanted palpebral tissues, and simian creases on both palms. Based on the findings, the RN can expect a work up that includes a. blood work sent for TORCH titers b. genetic consult from chromosome studies c. review of the prenatal history of maternal alcohol use - ✔✔-b. genetic consult from chromosome studies Milk transfer, a key physiologic principle in lactation, is most efficient with a. adequate prolactin levels b. good lactation c. strong negative pressure action by the baby - ✔✔-b. good lactation More than 2/3 of sentinel events reported to the Joint Commission were caused by a. communication failure among healthcare team members b. fatigue and shift work related problems c. inadequate staffing - ✔✔-a. communication failure among healthcare team members During the recovery period following a rapid delivery, a woman had an elevated BP, epigastric pain, and severe headache. IV mag sulfate was started at 2 gm/hr. 2 hours later, the woman is lethargic with worsening visual disturbances and has now lapsed into a comatose state. She should be evaluated for a. cerebral hemorrhage b. HELLP syndrome c. mag toxicity - ✔✔-c. mag toxicity A central venous hematocrit would be chosen over a heel stick sample to confirm diagnosis of a. hyperbilirubenemia b. polycythemia c. vitamin K deficiency - ✔✔-b. polycythemia Polycythemia occurs more frequently in the IUGR neonate due to a. decreased erythropoietin activity b. immaturity of the hematologic system c. physiologic response to hypoxia - ✔✔-c. physiologic response to hypoxia Which of the following would be suggestive of a hydrocele? a. a bluish-red colored swelling of the scrotum b. irreducible swelling of the scrotum that transilluminates c. presence of scrotal mass which does not transilluminate - ✔✔-b. irreducible swelling of the scrotum that transilluminates A breastfeeding woman developed endomyometriosis 3 days after her cesarean. She was treated with IV antibiotics and discharged home on oral antibiotics. On her 6th postpartum day, she returns to the hospital with fever, shaking chills, tachycardia, and flank pain. She has urinary frequency and urgency. The patient should be further assessed for a. cystitis b. pyelonephritis c. wound infection - ✔✔-b. pyelonephritis Assessment of which of the following neonatal reflexes would be most important in evaluation for brachial plexus nerve damage? a. moro b. rooting c. stepping - ✔✔-a. moro A woman with preeclampsia is at greater risk for an eclamptic seizure if she has a. developing epigastric abdominal pain b. elevated BP despite being treated with mag sulfate c. poor urinary output - ✔✔-c. poor urinary output The greatest morbidity from placental abruption occurs in women who a. develop malnutrition b. develop preeclampsia with a preterm gestation c. have a history of preeclampsia with previous pregnancy - ✔✔-b. develop preeclampsia with a preterm gestation The breastfeeding woman with a yeast infection on the breast, typically presents with a. breast pain while breastfeeding b. development of generalized rash of the breast c. low grade fever that doesn't respond to antipyretics - ✔✔-a. breast pain while breastfeeding Release of hepatic glucose is a response that occur in term neonates a. at times of decreased glucagon secretion b. following initial attempt of breastfeeding c. with declining glucose levels following birth - ✔✔-c. with declining glucose levels following birth The newborn experiencing a delay in clearing fetal lung fluid after birth is at increased risk for a. aspiration pneumonitis b. RDS c. transient tachypnea of the newborn - ✔✔-c. transient tachypnea of the newborn A method to differentiate between jitteriness and potential seizure activity is to a. passively flex the extremities to determine if tremors cease b. make a loud noise to see if tremors are elicited c. note the length of time that tremor activity continues - ✔✔-a. passively flex the extremities to determine if tremors cease A 4 hour old newborn that has been swaddled and sleeping soundly for about 2 hours is noted to have a HR of 170/min. An appropriate initial intervention would be to a. contact the PCP immediately b. obtain an axillary temperature c. prepare for a sepsis workup - ✔✔-b. obtain an axillary temperature A mother asks how her newborn's vision can be evaluated in the nursery. The RN responds by a. demonstrating that the baby can fix on and follow a bright object b. explaining that the vision cannot be assessed because of eye prophylaxis c. holding the baby upright to show that the baby's eyes open - ✔✔-a. demonstrating that the baby can fix on and follow a bright object Hypercoagulability in pregnancy places the postpartum woman at an increased risk for a. DVT b. greater blood loss at delivery c. polycythemia - ✔✔-a. DVT Maternal mag sulfate administration during labor places the neonate at increased risk for a. cardiac dysrhythmias b. decreased suck reflex c. GI reflux - ✔✔-b. decreased suck reflex A normal finding on inspection of the perineum following suturing of a laceration 24 hours postpartum is a. presence of ecchymoses b. skin edges that are not fully approximated c. some edema or tenderness - ✔✔-c. some edema or tenderness Postpartum psychosis is a variant of a. bipolar disorder b. an anxiety disorder c. PTSD - ✔✔-a. bipolar disorder A priority of care to administering methergine postpartum is to check a. blood pressure b. history of asthma c. urinary output - ✔✔-a. blood pressure Vaginal examination is initiated for a woman who reports increasing episiotomy pain to detect a. hematoma b. retained placental fragments c. undetected laceration - ✔✔-a. hematoma An otherwise stable 12 hour old term neonate is noted to have multiple white topped papules on reddened macular bases on the face and trunk. Based on these findings, the RN would recognize the need to a. document as a benign finding b. institute airborne isolation ASAP c. obtain a surface culture - ✔✔-a. document as a benign finding A parameter used in Ballard score for determination of gestational age is a. babinski reflexes b. hair texture c. heel to ear maneuver - ✔✔-c. heel to ear maneuver The primary function of the ductus arteriosis in the normal fetus is to a. ensure circulation to the liver b. provide a route for blood to bypass the lungs c. shunt blood to the right side of the heart - ✔✔-b. provide a route for blood to bypass the lungs Insulin requirements decrease in the immediate postpartum period, in a diabetic woman, because a. anti-insulin placental hormones decrease b. exogenous insulin production increases c. moderate ketonuria develops - ✔✔-a. anti-insulin placental hormones decrease The major challenge of the adolescent mother transitioning to the role of motherhood is a. egocentricity b. lack of life experience c. physiologic immaturity - ✔✔-a. egocentricity Increased stroke volume during the postpartum period is responsible for what normal physiologic postpartum change? a. increased cardiac output b. increased heart rate c. reduced vascular resistance - ✔✔-a. increased cardiac output Attention to the neonate's age in hours is essential when a. determining the timing of metabolic screening b. interpreting total serum bilirubin levels c. scheduling a circumcision - ✔✔-b. interpreting total serum bilirubin levels Three hours following a prolonged labor that resulted in a cesarean, a postpartum woman shows little interest in her infant and is reluctant to breastfeed. The reason for this behavior is most likely related to a. possible attachment disorder b. extreme fatigue c. postpartum depression - ✔✔-b. extreme fatigue Once breastfeeding is well established, milk production is sustained by a. adequate maternal calorie and fluid intake b. consistent milk removal by breastfeeding or pumping c. increasing prolactin production - ✔✔-b. consistent milk removal by breastfeeding or pumping At a postpartum home visit, a woman who had a cesarean 2 weeks ago reports tenderness, edema, and skin discoloration. She is afebrile and now has drainage. It is important to recognize that a. fever must be present for a diagnosis of infection b. these are early signs of infection and should be evaluated c. the presents the normal healing process - ✔✔-b. these are early signs of infection and should be evaluated The mother of a 2 day old infant, recently discharged, calls the nursery in a panic because the diaper has a streak of rust colored staining. The RN's response to this mother will be based on the knowledge that this finding is a. a normal reaction between urine and urates b. an early sign of renal failure c. possible hematuria and suggests a bleeding disorder - ✔✔-a. a normal reaction between urine and urates The fetus of a diabetic mother has a lecithin/sphingomyelin (L/S) ratio of 2:1. It should be understood that a. the fetus will need surfactant b. there is a high rate of false positive findings in this population c. this is a definitive finding of lung maturity in any fetus - ✔✔-b. there is a high rate of false positive findings in this population For the late preterm neonate being bottle fed, a supportive feeding intervention is to a. enlarge the nipple hole for better milk flow and less fatigue b. insert the nipple and use a push-pull motion to stimulate suck c. use a low flow nipple and finish the feeding by gavage if needed - ✔✔-b. insert the nipple and use a push-pull motion to stimulate suck A neonate has experienced multiple heel sticks to follow bilirubin levels. The RN notes during morning lab stick that the infant has a fixed gaze and no response to the heel stick. This observation is indicative of a. a mature neonatal behavior state b. decreased responsiveness to a repeated stimulus c. the onset of acute bilirubin encephalopathy - ✔✔-b. decreased responsiveness to a repeated stimulus A rational for measuring head circumference at birth is that it serves as a reflection of a. birth trauma experienced b. brain growth during gestation c. intrauterine positioning effects - ✔✔-b. brain growth during gestation The newborn's ability to concentrate urine is reflected in results of a a. 24 hour urine output total b. serum potassium level c. urine specific gravity reading - ✔✔-c. urine specific gravity reading The most common complication of mastitis is a. cessation of breastfeeding b. development of breast abscess c. systemic infection - ✔✔-b. development of breast abscess A postpartum effect of oxytocin administration during labor is a. hypertension b. hypocalcemia c. increased lochia flow - ✔✔-a. hypertension The RN would suspect the presence of a patent urachus in the newborn who has a. large edematous umbilical cord that remains moist b. staining of the cord with meconium flecks around the base c. visible loops of bowel within the Wharton's jelly - ✔✔-a. large edematous umbilical cord that remains moist Leakage of spinal fluid at the puncture site during administration of spinal anesthesia can lead to a. headache b. meningeal inflammation c. transient motor dysfunction - ✔✔-a. headache A term neonate is born with gasping respirations and HR of 50/min following an uncomplicated birth. By 30 seconds of age, initial steps of resuscitation are ongoing use bag/mask ventilation. However, the neonate remains apneic with a HR of 65/min. The most appropriate intervention at this point is a. administer epinephrine b. continue positive pressure ventilation c. initiate cardiac compression - ✔✔-c. initiate cardiac compression A redistribution of cardiac output to the heart and brain occurs during a. periods of aerobic metabolism b. prolonged metabolic alkalosis c. the onset of asphyxiation - ✔✔-c. the onset of asphyxiation A neonate is born at 36 weeks following a placental abruption. At 2 hours of age, the infant has a BP of 88/57. These findings are most consistent with a. alcohol b. cocaine c. methadone - ✔✔-b. cocaine Butarphanol (Stadol) should not be given to a drug dependent woman because of the risk of a. profound respiratory depression b. seizures c. withdrawal symptoms - ✔✔-c. withdrawal symptoms Which of the following descriptions best characterizes a term neonate who experienced IUGR? a. birth weight of 2489g with the facial appearance of an old man b. head circumference of 32.5cm, with reduced lanugo over the body c. length of 49cm with vernix present only on major body creases - ✔✔-a. birth weight of 2489g with the facial appearance of an old man As the transition of colostrum to mature milk occurs, there is a decrease in a. fat content and calories per mL of milk b. immunoglobulin concentration c. water content - ✔✔-b. immunoglobulin concentration At birth, a physiologic change that occurs in the neonate once respirations are initiated is a. decreasing pulmonary vascular resistance b. falling alveolar PO2 levels c. increasing alveolar surface tension - ✔✔-a. decreasing pulmonary vascular resistance A primary reason for using erythromycin or a tetracycline eye ointment instead of silver nitrate for newborns is a. silver nitrate is not effective against chlamydia b. there is a shortage of the silver nitrate c. use of silver nitrate masks the signs of conjunctivitis - ✔✔-a. silver nitrate is not effective against chlamydia A soft swelling confined to the parietal area of the skill is observed in an 18 hour old neonate born vaginally following prolonged labor. This presentation is consistent with the presence of a. caput succedaneum b. cephalahematoma c. subgaleal hemorrhage - ✔✔-a. caput succedaneum When caring for parents who have suffered a perinatal loss, it is important to remember that the grief response a. is abnormal if emotions are not immediately expressed b. is individual to each parent c. follows the order of the 5 stages of grief - ✔✔-b. is individual to each parent A breastfeeding woman reports pain during breastfeeding because the baby is chewing on her nipple. This represents a problem related to a. breast anatomy b. insufficient milk supply c. latch - ✔✔-c. latch Craniotabes can be best described as a. an elongated head with flattened temporoparietal regions b. premature fusions of one or more sutures c. softened skull bones that indent and pop back into place - ✔✔-c. softened skull bones that indent and pop back into place An RN realizes that during the previous day's shift, a call to the attending physician to report a critical lab value was not charted. Since hospital policy was followed in making the call and appropriate follow up was done, at this point the RN should a. avoid any additional documentation b. complete an occurrence report for submission to risk management c. enter the info as late entry with current date and time indicated - ✔✔-c. enter the info as late entry with current date and time indicated The most common cause of fever during the early postpartum period is a. breast engorgement b. endometriosis c. UTI - ✔✔-b. endometriosis A mother contacts the nursery because her 1 week old term infant "has started to turn yellow." The RN should recognize that the onset of jaundice in this infant is most likely a result of a. antibody-induced hemolysis b. maternal hormones in the breast milk c. physiologic hepatic function - ✔✔-b. maternal hormones in the breast milk Low levels of estrogen in the postpartum period have what effect? a. decrease in ovarian function b. diaphoresis c. transient urinary incontinence - ✔✔-a. decrease in ovarian function Based on patterns of fetal and neonatal glucose metabolism, the nurse would monitor the glucose status of an infant born to a mother with DM because of the anticipated impact of a. decreased hepatic glycogen stores b. increased insulin responses c. sudden onset of glycogenesis - ✔✔-a. decreased hepatic glycogen stores A test performed to detect classic developmental dislocation of the hip is a. barlow b. ortolani c. pavlik - ✔✔-b. ortolani A predisposing factor of retained placental fragments is a. manual removal of the placenta b. multiple gestation c. placenta accreta - ✔✔-c. placenta accreta Placement of an orogastric tube during initial stabilization of a neonate with suspected duodenal atresia is done primarily to a. decompress the stomach b. remove excess fluid c. prevent GI reflux - ✔✔-a. decompress the stomach A breastfeeding woman at 2 weeks postpartum is pumping her breasts to increase her milk supply. She should be advised that the factor that will most stimulate milk production when pumping is a. duration of each pumping session b. frequency of pumping sessions c. use of an electric pump - ✔✔-b. frequency of pumping sessions A postpartum woman with preeclampsia remains on magnesium after delivery. It is important for the RN to monitor urine output because magnesium can cause a. decreased creatinine clearance b. oliguria c. osmotic diuresis - ✔✔-c. osmotic diuresis What is means to be a father for most men is a. affected by how he was fathered b. determined by financial readiness to assume the role c. determined by how well he prepared for the role during pregnancy - ✔✔-c. determined by how well he prepared for the role during pregnancy In the absence of vascular disease, the pathological manifestation of DM in pregnancy is usually the result of a. hyperglycemia b. hyperinsulinemia c. insulin resistance - ✔✔-c. insulin resistance Oligohydramnios associated with PROM in preterm pregnancies at less than 24 weeks may cause a. bronchopulmonary dysplasia b. pulmonary hypoplasia c. surfactant inactivation - ✔✔-b. pulmonary hypoplasia A woman with type II diabetes is breastfeeding. She is on insulin therapy. To minimize hypoglycemic episodes, she should be advised to a. discuss using oral agents while breastfeeding with her MD b. make sure she has a snack with each breastfeeding session c. use a split dose insulin regimen - ✔✔-b. make sure she has a snack with each breastfeeding session A woman is recovering from the birth of her child which was complicated by placental abruption and postpartum hemorrhage. She is pale, clammy, hypotensive, and tachycardic. These findings are consistent with a. DIC b. hereditary thrombophilia c. Sheehan's syndrome - ✔✔-a. DIC The hypoestrogenic state in the postpartum period is responsible for a. a delay in the perineal healing b. development of cervical edema c. dyspareunia - ✔✔-c. dyspareunia A finding noted during an initial newborn physical exam that warrants further follow up would be the presence of a. small area of midline swelling in the back b. diastasis rectus of the abdominal musculature c. small white inclusion cysts along the gum line - ✔✔-a. small area of midline swelling in the back The RN would anticipate that a term newborn with a CV condition marked by right to left shunting through the foramen ovale would appear a. cyanotic b. pink c. very pale - ✔✔-a. cyanotic The dilation of the ureters and renal pelvis that occurs during pregnancy reverts at what time? a. between 2-8 weeks postpartum b. does not occur until after uterine involution c. never completely reverses but is nearly normal by 6 months postpartum - ✔✔-c. never completely reverses but is nearly normal by 6 months postpartum Vitamin K preparation for neonatal prophylaxis should be a. given with 4 hours b. diluted prior to subQ administration c. stored away from light - ✔✔-c. stored away from light A newborn is ready for discharge following a course of phototherapy for ABO incompatibility. Based on the history, the RN will convey the important of keeping the infant's scheduled follow up appointment because of the increased risk of a. dehydration b. late onset hearing loss c. rebound bilirubin levels - ✔✔-c. rebound bilirubin levels A woman with unilateral mastitis can be advised that she can continue to breastfeed a. if there is no abscess present b. with the use of nipple shields on the affected breast c. without restrictions - ✔✔-a. if there is no abscess present A 2 hour old newborn appears generally pale with a dusky appearance to the nail beds and a grayish appearance to the mucous membranes inside the mouth. The finding most indicative of oxygen desaturation is the presence of a. dusky nail beds b. grayish mucous membranes c. overall pale - ✔✔-b. grayish mucous membranes The uterus of a postpartum woman is boggy and midline. Initial management should include a. fundal massage b. having her void c. vaginal exam - ✔✔-a. fundal massage On uterine assessment, the RN notices that the uterus is boggy and difficult to differentiate. While she massages it with one hand, she places one hand just above the symphysis pubis in order to a. assess the bladder distention b. minimize lochia flow c. provide stability to the uterus - ✔✔-c. provide stability to the uterus A 2 day old neonate born at 36 weeks develops jaundice and is breastfeeding poorly. In addition to a moderate evaluation in the total serum bilirubin, lab results indicate O Rh positive blood type with a maternal blood type A Rh positive. The RN would recognize that a major contributor to the rising bilirubin level is most likely a. increased enterohepatic shunting b. ongoing hemolysis c. presence of maternal hormones in the breast milk - ✔✔-b. ongoing hemolysis An RN would provide pre-discharge education regarding the need to assess a neonate for jaundice if the mom received drug therapy within a few weeks of birth using medications classified as a. anticoagulation b. antihistamines c. sulfonamides - ✔✔-c. sulfonamides A predisposing factor to amniotic fluid embolism is a. adolescent pregnancy b. distocia c. induction of labor - ✔✔-b. distocia The newborn with documented polycythemia should be further assessed for jaundice based on a. a genetic enzyme deficiency b. an increased production of bilirubin c. the presence of a systemic infection - ✔✔-b. an increased production of