NCLEX-PN
Maternal NCLEX Questions Questions
Extract:
Question 1 of 5
The laboring client just had a convulsion after being given regional anesthesia. Which interventions should the nurse implement? Select all that apply.
Correct Answer: A,C,D,E
Rationale: The client experiencing a convulsion related to anesthesia should first have an airway established. The client experiencing a convulsion related to anesthesia should receive 100% oxygen so that the mother and fetus remain oxygenated. Small doses of diazepam or thiopental can be administered to stop the convulsions. The anesthesiologist should be STAT paged to provide assistance; the convulsion was initiated by the regional anesthetic. The client’s head should be turned to the side if vomiting occurs, but the client typically remains in a left lateral tilt position so an airway can be maintained. Positioning on the right side can cause aortocaval compression.
Question 2 of 5
The nurse advises a client with a history of miscarriage to monitor which symptom?
Correct Answer: B
Rationale: Vaginal spotting may indicate a threatened miscarriage, requiring close monitoring and medical evaluation.
Question 3 of 5
The nurse is caring for the postpartum primiparous client who is 13 hours post—vaginal delivery. The nurse observes that the client is passive and hesitant about making decisions about her own and her newborn’s care. In response to this observation, which interventions should be implemented by the nurse? Select all that apply.
Correct Answer: A,B,C
Rationale: Many women hesitate to ask for medication, as they believe their pain is expected. Thus, the nurse should ask the client about pain and assure her that there are methods to decrease her pain. During the initial postpartum “taking-in” phase, the client may have a great need to talk about her birthing experience and to ask questions for clarification as necessary. By encouraging this verbalization, the nurse helps the client to accept the experience and enables her to move to the next maternal phase. Physical discomfort can be intense initially postpartum and can interfere with rest. Sleep is a major need and should be encouraged. Anxiety and preoccupation with her new role often narrow the client’s perceptions, and information is not as easily assimilated at this time.
Therefore, attending education sessions should be delayed if possible until the mother has completed this “taking in” phase. The client needs to suspend her involvement in everyday responsibilities during the “taking—in” phase, so writing birth announcements should be delayed until the mother has completed this phase.
Question 4 of 5
The nurse recognizes which symptom as a warning sign of preterm labor?
Correct Answer: B
Rationale: Regular contractions before 37 weeks are a key sign of preterm labor, requiring immediate medical attention.
Question 5 of 5
Which client statement indicates a need for immediate intervention?
Correct Answer: C
Rationale: A lack of fetal movement may indicate fetal distress, requiring immediate assessment and intervention.