NCLEX-RN
RN NCLEX Maternal Neonatal Nursing Questions
Extract:
Question 1 of 5
A multigravid laboring client has an extensive documented history of drug addiction. Her last reported usage was 5 hours ago. She is 2 cm dilated with contractions every 3 minutes of moderate intensity. The physician orders nalbuphine (Nubain) 15 mg slow I.V. push for pain relief followed by an epidural when the client is 4 cm dilated. Within 10 minutes of receiving the nalbuphine, the client states she thinks she is going to have her baby now. Of the following drugs available at the time of the delivery, which should the nurse avoid using with this client in this situation?
Correct Answer: B
Rationale: In a client with recent opioid use, naloxone (Narcan) could precipitate withdrawal symptoms, which is risky during delivery. Lidocaine, local anesthetics, or pudendal blocks are safe for perineal anesthesia and do not interact with the client's history.
Question 2 of 5
The charge nurse is preparing for the day shift on the Labor and Delivery unit. Which of the following would be included in the responsibilities for this position? Select all that apply.
Correct Answer: A,D,E
Rationale: Charge nurse responsibilities include reviewing client status, following up post-delivery, and handing off to the next charge nurse to ensure unit oversight. Admitting clients and completing another nurse's work are typically primary nurse duties.
Question 3 of 5
A client is considering the contraceptive injection. Which of the following side effects should the nurse discuss?
Correct Answer: B,D
Rationale: The contraceptive injection can cause irregular menstrual bleeding and decreased bone density with long-term use, which are important side effects to discuss. It does not cause permanent weight loss or guarantee regular periods.
Question 4 of 5
A post-term neonate diagnosed with persistent pulmonary hypertension is prescribed intravenous tolazoline (Priscoline). While administering this drug, the nurse should monitor the neonate for?
Correct Answer: D
Rationale:
Tolazoline is a vasodilator, and monitoring blood pressure is critical due to the risk of hypotension.
Question 5 of 5
Assessment of a 15-year-old primigravid client at term in active labor reveals cervical dilation at 7 cm with complete effacement. The nurse should assess the client for which of the following first?
Correct Answer: B
Rationale: At 7 cm dilation in active labor, assessing for cephalopelvic disproportion is critical, as it can impede labor progression and may require intervention. Uterine inversion and rapid third stage occur post-delivery, and decreased pushing ability is relevant only in the second stage.