Maternal Newborn NCLEX RN Practice Questions
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Question 1 of 5.
Extract:The nurse in the emergency department is caring for a 37-year-old female client. • History and Physical 0830: A 37-year-old nulliparous woman at 36 weeks gestation presents to the emergency department with complaints of severe headache, blurred vision, and upper abdominal pain. She reports feeling generally unwell and fatigued for the past 24 hours. Her pregnancy has been uncomplicated until now, with consistent prenatal care. On arrival, her vital signs are: blood pressure 160/100 mmHg, heart rate 88 bpm, respiratory rate 20 breaths per minute, temperature 98.6°F (37°C), and oxygen saturation 98% on room air. Physical exam reveals mild lower extremity edema and no signs of trauma. Fetal monitoring shows a baseline heart rate of 150 bpm with moderate variability, no accelerations, and no decelerations. The client has no uterine contractions. • Nurses' Notes 0900: Client evaluated following complaints of severe headache, blurred vision, and upper abdominal discomfort. BP remains elevated compared to baseline. Physical exam reveals mild lower extremity edema. Laboratory results reviewed and show elevated liver enzymes, decreased platelet count, and positive proteinuria. Fetal monitoring remains reassuring at this time. Based on clinical presentation and lab findings, the client is diagnosed with preeclampsia.Orders 0830 • Complete Blood Count (CBC) • Comprehensive Metabolic Panel (CMP) • Urinalysis (UA) • Continuous Fetal Monitoring
The nurse is considering the risks associated with the client's condition.Complete the sentence below from the lists of options. The nurse recognizes that if the client develops seizures, they have progressed to------------------which introduces the risk of-----------------
- A. HELLP syndrome
- B. Eclampsia
- C. Maternal and fetal mortality.
- D. chronic neurological impairment.
- E. Idiopathic hypertension
- B. Eclampsia
- C. Maternal and fetal mortality.
Correct arrangement
Explanation: When a pregnant client with elevated blood pressure and symptoms such as headache, visual disturbances, and epigastric pain develops seizures, this indicates progression to eclampsia. Eclampsia is defined by the occurrence of new-onset seizures in a client with preeclampsia and requires immediate intervention to prevent serious complications for both the client and fetus. The presence of seizures reflects central nervous system involvement and significantly increases the risk for maternal and fetal morbidity or mortality due to possible complications such as hypoxia, trauma, or placental disruption. HELLP syndrome involves hemolysis, elevated liver enzymes, and low platelet count but does not include seizures as a defining feature. Idiopathic hypertension refers to chronic high blood pressure without a known cause and is not associated with seizure onset in the absence of other neurologic signs. Epilepsy is a chronic seizure disorder unrelated to hypertensive complications in pregnancy. Similarly, chronic neurological impairment, elevated insulin requirements, and uterine rupture are not immediate or direct consequences of seizure activity in this clinical scenario.
Question 2 of 5.
The nurse is caring for a 30-year-old client who has developed iron-deficiency anemia during pregnancy. Which complication would this client be at an increased risk for due to iron deficiency anemia? Select all that apply.
A. Low birth weight
B. Preterm delivery
C. Gestational diabetes
D. Perinatal mortality
E. Placenta previa
Explanation: Iron-deficiency anemia reduces oxygen-carrying capacity, increasing risks for low birth weight, preterm delivery, and perinatal mortality due to compromised fetal oxygenation. Gestational diabetes and placenta previa are unrelated to iron deficiency.
Question 3 of 5.
At the initial prenatal visit, and often the subsequent visits, the health care provider will obtain a urine specimen to look for all of the following, except:
A. Ketones
B. Sexually transmitted infections
C. Glucose
D. Testosterone levels
Explanation: Urine tests during prenatal visits screen for ketones, glucose, and infections, but testosterone levels are not relevant to pregnancy monitoring.
Question 4 of 5.
The nurse is teaching parents about antepartum testing. Which statements should the nurse include? Select all that apply.
A. Oral glucose tolerance testing will measure fetal activity at certain intervals.
B. A nonstress test may be used to measure fetal heart rate.
C. Amniocentesis may be used to assess if you have preeclampsia.
D. Chorionic villus sampling may be done to assess for neural tube defects.
E. You may need to fill up your bladder prior to an ultrasound.
Explanation: Nonstress tests monitor fetal heart rate, and a full bladder may be needed for ultrasound visualization. The other statements are incorrect.
Question 5 of 5.
A nurse at an obstetric clinic has conducted a teaching class on sexuality during pregnancy. Which of the following comments from a participant would indicate that the teaching has been effective?
A. At around the time I would normally have my period, I should abstain from intercourse.
B. I should no longer have sex during the last trimester of pregnancy.
C. My sexual desire will remain the same for the entire pregnancy.
D. The best time to enjoy sex is in the second trimester.
Explanation: The second trimester is often the most comfortable for sexual activity due to reduced nausea and fatigue.
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