When a newborn takes its first breath, what physical changes occur in the heart to increase oxygenation of the body?

The ductus arteriosus expands to allow more blood to enter the lungs

The foramen ovale closes, preventing blood exchange from right to left in the heart

The umbilical vein that carried oxygenated blood in utero becomes the ascending aorta entering the right atrium

The ductus venosus shunts oxygenated aortic blood to the lungs.

Answer and Explanation

The Correct Answer is B

The foramen ovale closes, preventing blood exchange from right to left in the heart. This is because the foramen ovale is a fetal shunt that allows blood to bypass the lungs and flow from the right atrium to the left atrium. After birth, when the baby starts to breathe air, the lungs expand and the pulmonary resistance decreases. This causes an increase in blood flow and pressure in the left atrium, which pushes the foramen ovale closed. This prevents blood from mixing between the right and left sides of the heart and allows oxygenated blood to circulate to the body¹².

Choice A is not correct because the ductus arteriosus does not expand to allow more blood to enter the lungs. The ductus arteriosus is another fetal shunt that

connects the pulmonary artery to the aorta. It allows blood to bypass the lungs and flow from the right ventricle to the aorta. After birth, when the baby starts to breathe air, the oxygen concentration in the blood increases and causes the ductus arteriosus to constrict and close. This increases blood flow to the lungs and decreases blood flow to the aorta.

Choice C is not correct because the umbilical vein that carried oxygenated blood in utero does not become the ascending aorta entering the right atrium. The umbilical vein is a fetal vessel that carries oxygenated blood from the placenta to the fetus. It connects to either the portal vein or the ductus venosus, which then drains into the inferior vena cava. After birth, when the umbilical cord is clamped and cut, the umbilical vein collapses and becomes a fibrous cord called ligamentum teres hepatis.

Choice D is not correct because the ductus venosus does not shunt oxygenated aortic blood to the lungs. The ductus venosus is another fetal vessel that connects the umbilical vein to the inferior vena cava. It allows some of the oxygenated blood from the placenta to bypass the liver and enter directly into the systemic circulation. After birth, when the umbilical cord is clamped and cut, the ductus venosus closes and becomes a fibrous cord called ligamentum venosum.

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Correct Answer is A

Explanation

To check for postpartum hemorrhage.

This is because postpartum hemorrhage is a serious and potentially life-threatening complication that can occur within 24 hours of birth or later. It is defined as a blood loss of more than 500 mL in a vaginal delivery or more than 1000 mL in a cesarean delivery. The most common cause of postpartum hemorrhage is uterine atony, which is the failure of the uterus to contract after delivery. Other causes include lacerations, retained placental fragments, coagulation disorders, and uterine rupture. Monitoring the vital signs, especially blood pressure, and pulse, can help detect signs of hypovolemia due to blood loss. Other signs include pale skin, cold and clammy extremities, delayed capillary refill, decreased urine output, and altered mental status.

Choice B is not correct because determining if the mother's milk is coming in is not the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery. Milk production usually begins around 48 to 72 hours after delivery and is influenced by hormonal changes, breastfeeding frequency, and maternal health. Although breastfeeding support is important for postpartum care, it is not a priority over checking for postpartum hemorrhage.

Choice C is not correct because monitoring the mother's blood pressure to note any elevations is not the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery. Elevated blood pressure can indicate gestational hypertension or preeclampsia, which are serious conditions that can affect postpartum women. However, these conditions are more likely to cause symptoms such as headache, blurred vision, epigastric pain, and proteinuria⁴.

Moreover, blood pressure may not be a sensitive indicator of blood loss and may remain normal until a significant amount of blood is lost¹.

Choice D is not correct because answering questions the new parents may have is not the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery. Although providing education and support to the new parents is an essential part of postpartum care, it is not a priority over checking for postpartum hemorrhage. The new parents may have questions about infant care, feeding, contraception, recovery, and other topics that can be addressed during the postpartum period.

A. Blood pressure B. Amount of lochia C. Fulness of the bladder D. Level of pain

Correct Answer is C

Explanation

Fullness of the bladder. A boggy uterus with the fundus above the umbilicus and deviated to the side indicates that the uterus is not contracting properly and may be displaced by a full bladder. A full bladder can interfere with uterine involution and increase the risk of postpartum hemorrhage. The nurse should assess the bladder and assist the patient to empty it if needed.

Choice A. Blood pressure is not the next assessment because it is not related to the position and tone of the uterus. Blood pressure may be affected by blood loss, but it is not a priority in this situation.

Choice B. Amount of lochia is not the next assessment because it is not related to the position and tone of the uterus. Lochia may be increased or decreased depending on the uterine contraction, but it is not a priority in this situation.

Choice D. Level of pain is not the next assessment because it is not related to the position and tone of the uterus. Pain may be present due to uterine cramping or other factors, but it is not a priority in this situation.

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When a newborn takes its first breath, what physical changes occur in the heart to increase oxygenation of the body?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery?

Correct Answer is A

Explanation

The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side. The nurse should next assess:

Correct Answer is C

Explanation

A nurse is caring for a newborn shortly after birth and places the newborn under a radiant warmer. Which of the following potential complications does this action help to prevent?

The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

A woman had a vaginal delivery two days ago and is preparing for discharge. To help prevent postpartum complications, the nurse plans to teach the woman to report any:

A nurse is collecting data from a postpartum client and finds a large amount of lochia rubra with several clots on the client's perineal pad. Which of the following actions should the nurse take first?

Parents express concern about the milia on the face and nose of their baby. The nurse's most helpful response would be to instruct the parents to:

A nurse is collecting data from a client who delivered 2 hours ago. The client has moderate lochia rubra, temperature within normal limits, breasts soft, fundus firm, slightly deviated to the right, pulse rate 88/min, respiratory rate 18/min. Which of the following actions should the nurse perform?

The nurse is caring for a new mother and newborn in a rooming-in unit and watches the mother put the infant in the bed, lying on her side, propped up with a pillow. The nurse should point out that this position can increase the risk of which situation?

When the newborn's crib was moved suddenly, the nurse noticed that his legs flexed and the arms fanned out, and then both came back toward the midline. The nurse would interpret this behavior as: