NCLEX-PN
Maternal Newborn NCLEX Practice Questions Questions
Extract:
Question 1 of 5
Six hours after delivery, the nurse notes that a woman's fundus is two finger breadths above the umbilicus and deviated to the right of the midline. What is the most likely cause of this finding?
Correct Answer: B
Rationale: A fundus deviated to the right and above the umbilicus is typically caused by bladder distention.
Question 2 of 5
A woman comes to the doctor's office for her routine checkup. She is 34 weeks gestation. The nurse notes all of the following. Which would be of greatest concern to the nurse?
Correct Answer: D
Rationale: A blood pressure of 150/94 suggests pregnancy-induced hypertension, requiring immediate evaluation.
Question 3 of 5
The nurse is caring for a woman the day after the insertion of radium rods for treatment of cancer of the cervix. The woman calls the nurse and says, 'There is something between my legs. It fell out of me.' What is the most appropriate initial action for the nurse to take?
Correct Answer: C
Rationale: Using long forceps to place the rod in a lead-lined container ensures safe handling of radioactive material, protecting the nurse and client.
Question 4 of 5
A 3-month-old infant is admitted to the pediatric unit with a diagnosis of Hirschsprung's disease. What is most important when monitoring the infant's status?
Correct Answer: C
Rationale: Measuring abdominal girth monitors for distension, a key concern in Hirschsprung's disease due to bowel obstruction.
Question 5 of 5
A 21-year-old married woman thinks she may be pregnant. She goes to her physician and tells the nurse that the drugstore test was positive for pregnancy. She asks the nurse if the test is reliable. What is the best response for the nurse to make?
Correct Answer: A
Rationale: Home pregnancy tests are reliable but require confirmation with clinical assessment, prompting further information collection.