NCLEX Maternal Newborn

Extract:

Question 1 of 5

The nurse is caring for a child who had a tonsillectomy this morning. The child is observed to be swallowing continuously. What is the most appropriate initial nursing action?

Correct Answer: C

Rationale: Continuous swallowing suggests possible bleeding, a serious post-tonsillectomy complication, requiring immediate notification.

Question 2 of 5

A young woman asks the nurse if oral contraceptives have any side effects. What is the best response for the nurse to make?

A. Nausea, fluid retention, and weight gain.' B. Why do you ask? Look at the benefits.' C. Are you concerned about something?' D. Increased libido, decreased breast size, and diarrhea.'

Correct Answer: A

Rationale: Nausea, fluid retention, and weight gain are common side effects of oral contraceptives, providing accurate information.

Question 3 of 5

A pregnant 16-year-old asks the nurse if she should have an abortion. How should the nurse respond initially?

A. You should ask your parents for advice.' B. Abortion is the deliberate killing of a human being.' C. An abortion would let you finish growing up before you have children.' D. What are your feelings about abortion?'

Correct Answer: D

Rationale: Asking about her feelings promotes a nonjudgmental discussion, respecting her autonomy.

Question 4 of 5

The nurse is caring for a woman who is 30 weeks gestation, has gained 17 pounds during the pregnancy, and has a blood pressure of 110/70. The woman states that she feels warmer than everyone around her. Which interpretation of these findings is most correct?

A. All of these findings are normal. B. Her weight gain is excessive for this point in pregnancy. C. The blood pressure is abnormal. D. She should be evaluated for a serious infection because pregnant women are usually cooler than other people.

Correct Answer: A

Rationale: A 17-pound weight gain at 30 weeks, normal blood pressure, and feeling warm are typical in pregnancy due to increased metabolism.

Question 5 of 5

Which nursing action has the highest priority for a client in the second stage of labor?

A. Help the mother push effectively B. Prepare the mother to breastfeed on the delivery table C. Check the fetal position D. Administer medication for pain

Correct Answer: A

Rationale: Helping the mother push effectively is critical in the second stage to facilitate delivery.

NCLEX Maternal Newborn | Nurselytic

Nurselytic

NCLEX-PN

NCLEX-PN