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NCLEX PN· Maternal-Newborn · NCLEX Practice Questions Maternal Newborn

Full Question & Rationale Repository

Showing all 5 practice questions with expert explanatory rationales.

Question 1 of 5

The mother of a term newborn born two hours ago asks the nurse why the baby's hands and feet are blue. What information should the nurse include when responding?

A. Blue hands and feet can indicate possible heart defects.

B. This is normal in newborns for the first 24 hours.

C. This pattern of coloration is more common in infants who will eventually have darker skin color.

D. Once the baby's temperature is stabilized, the hands and feet will warm up and be less blue.

Expert Explanatory Rationale

Correct Answer: This is normal in newborns for the first 24 hours.

Question 2 of 5

A 6-year-old with tetralogy of Fallot has open heart surgery. The septal defect was closed, and the pulmonic valve was replaced. When the child returns to the unit, he has oxygen, IVs, and closed chest drainage. How should the nurse position the chest drainage system?

A. Above the level of the bed

B. At the level of the heart

C. Below the level of the bed

D. Alternating above and below the bed every two hours

Expert Explanatory Rationale

Correct Answer: Below the level of the bed

Question 3 of 5

A 2-year-old child has just been diagnosed with a Wilms' tumor. Surgery is recommended. The parents tell the nurse that they feel they are being pushed into surgery and wonder if they should wait and get more opinions. What information is essential for the nurse to include when responding to the parents?

A. Surgery is one of several options for treating a Wilms' tumor.

B. Surgery is an essential part of the treatment for Wilms' tumor and must be done immediately.

C. Surgery can be safely delayed for up to a year after diagnosis.

D. Wilms' tumor has been successfully treated by chemotherapy and radiation therapy.

Expert Explanatory Rationale

Correct Answer: Surgery is an essential part of the treatment for Wilms' tumor and must be done immediately.

Question 4 of 5

What should the nurse do to assess for a positive sign of pregnancy?

A. Perform a pregnancy test on the woman's urine.

B. Auscultate for fetal heart sounds.

C. Ask the woman when she had her last menstrual period.

D. Ask the woman if her breasts are tender.

Expert Explanatory Rationale

Correct Answer: Auscultate for fetal heart sounds.

Question 5 of 5

Ten days after cardiac surgery, an 18-month-old child is recovering well. The child is alert and fairly active and is playing well with the parents. The nurse notes that the parents are still very reluctant to allow the child to do anything without help. What is the best initial action for the nurse to take?

A. Reemphasize the need for autonomy in toddlers

B. Provide opportunities for autonomy when the parents are not present

C. Reassess the parent's needs and concerns

D. Discuss the success of the surgery and how well the child is doing

Expert Explanatory Rationale

Correct Answer: Reassess the parent's needs and concerns

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