Question

Newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority?

Answer 1

Correct Answers:

Beginning resuscitative measures

Rationale :

💎 A newborn with an Apgar score of 6 indicates moderate distress, requiring immediate support to improve oxygenation and ventilation.

💎 Resuscitative measures (such as suctioning, oxygen administration, and stimulation) help establish adequate respirations and prevent hypoxia.

💎 The Apgar score evaluates heart rate, respiratory effort, muscle tone, reflex irritability, and color; a score below 7 warrants intervention.

💎 Initiating IV fluids is not the first priority unless there is hypovolemia; the primary concern is ensuring effective breathing and oxygen exchange.

💎 Prompt action helps prevent complications such as respiratory failure, acidosis, or brain injury due to oxygen deprivation.

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Answer 2

Correct Answers:

Possible experience of fluctuations in sexual interest
Use of a water-based lubricant to ease vaginal discomfort
Possibility of increased breast sensitivity during sexual activity

Rationale :

💎 Fluctuations in sexual interest are common postpartum due to hormonal changes, fatigue, and body image adjustments.

💎 Water-based lubricants reduce discomfort during intercourse, especially since breastfeeding lowers estrogen levels, causing vaginal dryness.

💎 Breast sensitivity increases due to hormonal shifts and milk let-down reflex, making nipple stimulation more pronounced during intimacy.

💎 Early resumption of intercourse (before 4–6 weeks) increases infection risk; it should only occur once lochia has ceased and healing is complete.

💎 Combined hormonal contraceptives are avoided during early breastfeeding because estrogen suppresses milk production; progestin-only methods are preferred.

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Answer 3

Correct Answers:

Nasal flaring

Rationale :

💎 Nasal flaring is an early sign of respiratory distress indicating the newborn is struggling to obtain enough oxygen.

💎 It occurs as the baby tries to reduce airway resistance by widening the nostrils during inhalation.

💎 Other signs may follow, such as grunting, retractions, and cyanosis, if oxygenation continues to decrease.

💎 The normal respiratory rate of a newborn (30–60 breaths/min) and mild abdominal breathing are expected findings.

💎 Early identification and intervention prevent progression to respiratory failure or hypoxemia.

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Answer 4

Correct Answers:

Aspirate the oral and nasal pharynx with a bulb syringe.

Rationale :

💎 A bluish (cyanotic) newborn gagging indicates airway obstruction from mucus or fluid.

💎 Using a bulb syringe clears the airway, allowing effective ventilation.

💎 Suctioning should be done gently—mouth first, then nose—to avoid aspiration.

💎 Immediate airway clearance restores oxygenation and prevents hypoxia-related complications.

💎 Oxygen or provider notification follows only if the newborn fails to respond to airway clearance.

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Answer 5

Correct Answers:

Offering round-the-clock nursery care for all infants

Rationale :

💎 Constant nursery care limits parent-infant contact, reducing opportunities for bonding and attachment.

💎 Bonding is enhanced by skin-to-skin contact and rooming-in, allowing the parents to learn their baby’s cues.

💎 Family-centered care promotes confidence and emotional connection between the newborn and caregivers.

💎 Encouraging early and frequent interaction aids breastfeeding success and attachment development.

💎 The facility policy should promote parental presence and not routine separation unless medically indicated.

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Answer 6

Correct Answers:

Rewarm the newborn gradually.

Rationale :

💎 A temperature of 94°F (34.4°C) indicates cold stress or hypothermia, which can lead to hypoglycemia and respiratory distress.

💎 Gradual rewarming prevents sudden vasodilation and hypotension, maintaining perfusion to vital organs.

💎 Methods include skin-to-skin (kangaroo) care, radiant warmer use, or warm blankets.

💎 Continuous temperature monitoring ensures stability and avoids hyperthermia.

💎 Immediate provider notification is required if rewarming fails or distress develops.

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Answer 7

Correct Answers:

Taking the prescribed antibiotic until it is finished
Washing hands before and after perineal care
Handling perineal pads by the edges

Rationale :

💎 Complete antibiotic course ensures eradication of the infection and prevents resistance or recurrence.

💎 Hand hygiene before and after perineal care reduces contamination and cross-infection.

💎 Handling perineal pads by edges maintains cleanliness, minimizing bacterial exposure to healing tissues.

💎 Frequent temperature checks (daily) are necessary until infection resolves; once a week is insufficient.

💎 Perineal cleaning should flow front to back to prevent introducing fecal bacteria to the perineum.

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Answer 8

Correct Answers:

Feeding intolerance

Rationale :

💎 Feeding intolerance—vomiting, gastric residuals, or abdominal distension—is an early sign of necrotizing enterocolitis (NEC).

💎 NEC involves inflammation and necrosis of the intestinal wall, often triggered by bacterial overgrowth or ischemia.

💎 Early recognition allows prompt discontinuation of feedings to prevent bowel perforation.

💎 Other late signs include bloody stools and lethargy, indicating advanced disease.

💎 Monitoring abdominal girth and gastric aspirates helps detect NEC progression.

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Answer 9

Correct Answers:

Inspecting the placenta after delivery for intactness

Rationale :

💎 Retained placental fragments are a major cause of late postpartum hemorrhage (PPH).

💎 Careful inspection ensures all lobes and membranes are present, confirming complete separation.

💎 Retained tissue prevents uterine contraction, causing delayed bleeding days or weeks postpartum.

💎 Immediate recognition allows timely intervention, such as uterine exploration or medications.

💎 Educating staff on placental examination reduces PPH-related morbidity.

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Answer 10

Correct Answers:

Mother's birth canal

Rationale :

💎 Group B Streptococcus (GBS) is transmitted from the maternal genital tract during vaginal delivery.

💎 Colonized mothers may asymptomatically carry GBS in the vagina or rectum.

💎 The infection can cause sepsis, pneumonia, or meningitis in newborns.

💎 Preventive management includes maternal GBS screening at 35–37 weeks and intrapartum antibiotic prophylaxis.

💎 Proper hand hygiene and sterile technique help prevent additional nosocomial spread after birth.

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Examplify_ Fall 2025 OB Exam III (1)

No.

1 :
Newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority?

2 :
A nurse is developing a teaching plan about sexuality and contraception for a postpartum woman who is breastfeeding. Which information would the nurse most likely include? Select all that apply.

3 :
The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?

4 :
While making rounds in the nursery, the nurse sees a 6-hour-old baby girl gagging and turning bluish. What would the nurse do first?

5 :
A nurse is reviewing the policies of a facility related to bonding and attachment with newborns. Which practice would the nurse identify as needing to be changed?

6 :
**Just after birth, a newborn's axillary temperature is 94 deg * F (34.4 deg * C) What action would be most appropriate?**

7 :
The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which measures would the nurse most likely include in this teaching plan? Select all that apply.

8 :
A preterm newborn is receiving enteral feedings. Which finding would alert the nurse to suspect that the newborn is developing NEC?

9 :
A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program?

10 :
A newborn has been diagnosed with a group B streptococcal infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause?

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Examplify_ Fall 2025 OB Exam III (1)

No.

1 : Newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority?

2 : A nurse is developing a teaching plan about sexuality and contraception for a postpartum woman who is breastfeeding. Which information would the nurse most likely include? Select all that apply.

3 : The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?

4 : While making rounds in the nursery, the nurse sees a 6-hour-old baby girl gagging and turning bluish. What would the nurse do first?

5 : A nurse is reviewing the policies of a facility related to bonding and attachment with newborns. Which practice would the nurse identify as needing to be changed?

6 : Just after birth, a newborn's axillary temperature is 94 deg * F (34.4 deg * C) What action would be most appropriate?

7 : The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which measures would the nurse most likely include in this teaching plan? Select all that apply.

8 : A preterm newborn is receiving enteral feedings. Which finding would alert the nurse to suspect that the newborn is developing NEC?

9 : A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program?

10 : A newborn has been diagnosed with a group B streptococcal infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause?

1 :
Newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority?

2 :
A nurse is developing a teaching plan about sexuality and contraception for a postpartum woman who is breastfeeding. Which information would the nurse most likely include? Select all that apply.

3 :
The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?

4 :
While making rounds in the nursery, the nurse sees a 6-hour-old baby girl gagging and turning bluish. What would the nurse do first?

5 :
A nurse is reviewing the policies of a facility related to bonding and attachment with newborns. Which practice would the nurse identify as needing to be changed?

6 :
**Just after birth, a newborn's axillary temperature is 94 deg * F (34.4 deg * C) What action would be most appropriate?**

7 :
The nurse is developing a discharge teaching plan for a postpartum woman who has developed a postpartum infection. Which measures would the nurse most likely include in this teaching plan? Select all that apply.

8 :
A preterm newborn is receiving enteral feedings. Which finding would alert the nurse to suspect that the newborn is developing NEC?

9 :
A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program?

10 :
A newborn has been diagnosed with a group B streptococcal infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause?