Maternal Newborn Nclex Practice Questions

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A nurse is caring for a client who is in active labor with 7 cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client's amniotic membranes are intact. The client suddenly states that she needs to push. Which of the following actions should the nurse

  • A. Assist the client into a comfortable position.
  • B. Observe the perineum for signs of crowning.
  • C. Have the client pant during the next contractions.
  • D. Help the client to the bathroom to void.
Correct Answer: B

Rationale: The sudden urge to push along with the advanced cervical dilation, effacement, and station indicates that the client is likely in the second stage of labor, which is the stage of active pushing. When a woman feels the urge to push, it is essential to assess for the crowning of the fetal head at the perineum as this indicates that the baby is descending and will soon be born. This assessment helps the nurse determine the appropriate actions to take next in assisting the delivery process. Waiting for signs of crowning before guiding the client to push can prevent potential complications related to a rapid birth and help facilitate a more controlled delivery process.

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A nurse is doing genetic counseling with a couple. give to a client undergoing a mastectomy? The mother has Down syndrome and the father

  • A. Tylenol should be avoided after surgery. has no chromosomal abnormalities. What is the
  • B. The affected arm should remain in a sling for chance of their offspring being affected by this 4 weeks. disorder?
  • C. The client should expect the affected arm to be
  • D. 25%
Correct Answer: D

Rationale: When a woman with Down syndrome (trisomy 21) has a child with a man who does not have any chromosomal abnormalities, the chance of their offspring having Down syndrome is 25%. This is because the mother can only pass on one copy of the extra chromosome 21 to her child, resulting in a 50% chance of passing it on. However, since the father does not have an extra chromosome 21 to contribute, the overall chance of the child having Down syndrome is reduced to 25%.

A client at 12 weeks' gestation asks why folic acid is important during pregnancy. What is the nurse's best response?

  • A. It helps prevent gestational diabetes.
  • B. It promotes fetal brain development.
  • C. It reduces the risk of neural tube defects.
  • D. It increases maternal energy levels.
Correct Answer: C

Rationale: Folic acid is essential during early pregnancy to reduce the risk of neural tube defects like spina bifida.

What is the priority nursing action when shoulder dystocia is encountered during delivery?

  • A. Apply fundal pressure
  • B. Call for additional assistance
  • C. Perform the McRoberts maneuver
  • D. Encourage the mother to push harder
Correct Answer: C

Rationale: The McRoberts maneuver widens the pelvic outlet for delivery.

If the physician indicates shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist?

  • A. Assisting the woman into McRoberts maneuver
  • B. Calling a second physician to assist
  • C. Preparing for immediate c/s delivery
  • D. Utilizing fundal pressure to push the fetus out
Correct Answer: A

Rationale: In the scenario of shoulder dystocia during the delivery of a macrosomic fetus, the appropriate action for the nurse to assist would be to help the woman into the McRoberts maneuver. The McRoberts maneuver involves flexing the mother's thighs tightly against her abdomen to flatten the pelvis, allowing for more space to maneuver the baby's shoulder out from behind the pubic bone. This maneuver is often effective at resolving shoulder dystocia without the need for additional interventions such as a cesarean section or fundal pressure. It is a recommended initial step in managing shoulder dystocia and has been shown to be successful in many cases.

Which postpartum client requires further assessment?

  • A. G1P1 with class II heart disease and complains of frequent coughing and has crackles
  • B. G3P2 post c/s client who has active herpes on the labia
  • C. G4P4 who had 4 saturated pads during the last 12 hours
  • D. G2P2 diabetic whose fasting blood sugar is 100
Correct Answer: C

Rationale: The postpartum client who requires further assessment is the G4P4 who had 4 saturated pads during the last 12 hours. This indicates excessive postpartum bleeding, which is abnormal and could potentially be a sign of postpartum hemorrhage. It is crucial to closely monitor and assess the client's vital signs, uterine tone, and overall well-being to prevent any complications related to excessive bleeding. Prompt intervention and medical attention may be necessary to address the postpartum hemorrhage and ensure the client's safety and well-being.

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