100 RNC-NIC Practice Questions with
Answers & Rationales MATERNAL
HISTORY AND LABOR & DELIVERY
ALREADY GRADED A+
1. A 34-week gestation infant is born to a mother with poorly controlled gestational diabetes.
Which complication is the infant at highest risk for?
A. Hyperbilirubinemia
B. Respiratory distress syndrome
C. Hypoglycemia
D. Polycythemia
Answer: C
Rationale: Infants of diabetic mothers (IDMs) are at high risk for hypoglycemia due to fetal
hyperinsulinemia in response to maternal hyperglycemia. After birth, the continued high insulin
levels cause rapid glucose utilization, leading to hypoglycemia. Respiratory distress syndrome
(B) is more common in preterm infants but is not the specific risk associated with maternal
diabetes. Hyperbilirubinemia (A) and polycythemia (D) can occur but are not the primary risk.
2. A mother with preeclampsia delivers a 36-week gestation infant. Which finding would the
nurse expect in this infant?
A. Hyperglycemia
B. Small for gestational age (SGA)
C. Macrosomia
D. Polycythemia
Answer: B
Rationale: Preeclampsia is associated with placental insufficiency, which can lead to intrauterine
1
, growth restriction (IUGR) and infants who are small for gestational age (SGA). Macrosomia (C) is
associated with maternal diabetes. Polycythemia (D) can occur with chronic hypoxia but is not
the primary finding. Hyperglycemia (A) is not typically associated with preeclampsia.
3. A mother received magnesium sulfate for preeclampsia prior to delivery. The nurse should
monitor the neonate for which adverse effect?
A. Hyperthermia
B. Respiratory depression and hypotonia
C. Seizures
D. Hyperglycemia
Answer: B
Rationale: Magnesium sulfate crosses the placenta and can cause neonatal respiratory
depression, hypotonia, and lethargy. The effects are usually transient but require monitoring.
Hyperthermia (A), seizures (C), and hyperglycemia (D) are not expected effects of magnesium
sulfate exposure.
4. A 38-week gestation infant is born to a mother who received opioids during labor. Which
assessment finding would the nurse expect?
A. Hypertonia and jitteriness
B. Respiratory depression and poor feeding
C. Hyperactivity and seizures
D. Hyperthermia and tachycardia
Answer: B
Rationale: Opioids cross the placenta and can cause neonatal respiratory depression, poor
feeding, and sedation. Hypertonia and jitteriness (A) are signs of neonatal abstinence syndrome
(NAS) from chronic opioid exposure, not acute intrapartum administration. Hyperactivity and
seizures (C) are not expected.
5. A mother with chorioamnionitis delivers a preterm infant. Which complication is the infant
at highest risk for?
A. Hypoglycemia
B. Early-onset sepsis
2
, C. Hyperbilirubinemia
D. Necrotizing enterocolitis
Answer: B
Rationale: Chorioamnionitis is a significant risk factor for early-onset sepsis in the neonate due
to ascending infection. The infant should be evaluated for sepsis and started on antibiotics.
Hypoglycemia (A), hyperbilirubinemia (C), and necrotizing enterocolitis (D) are not the primary
risks from chorioamnionitis.
6. A mother with a positive Group B Streptococcus (GBS) screen did not receive intrapartum
antibiotics. The nurse should prioritize which intervention for the newborn?
A. Initiate phototherapy
B. Monitor for signs of sepsis
C. Administer vitamin K
D. Monitor for hypoglycemia
Answer: B
Rationale: GBS is a leading cause of early-onset sepsis in neonates. Without intrapartum
antibiotic prophylaxis, the infant is at increased risk for GBS sepsis and should be closely
monitored for signs of infection (temperature instability, respiratory distress, lethargy, poor
feeding). Phototherapy (A) is for hyperbilirubinemia. Vitamin K (C) is routine for all newborns.
7. A 32-week gestation infant is born to a mother who received antenatal corticosteroids
(betamethasone) 48 hours prior to delivery. The nurse understands that this medication was
given to:
A. Prevent neonatal hypoglycemia
B. Accelerate fetal lung maturity and reduce RDS
C. Prevent intraventricular hemorrhage
D. Reduce the risk of hyperbilirubinemia
Answer: B
Rationale: Antenatal corticosteroids (betamethasone or dexamethasone) are given to
accelerate fetal lung maturity and reduce the incidence and severity of respiratory distress
syndrome (RDS) in preterm infants. They also reduce the risk of intraventricular hemorrhage
(IVH) and necrotizing enterocolitis (NEC), but the primary purpose is lung maturation.
Hypoglycemia (A) and hyperbilirubinemia (D) are not affected.
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, 8. A mother with prolonged rupture of membranes (PROM) for 18 hours delivers a term
infant. Which complication should the nurse monitor for?
A. Hypoglycemia
B. Sepsis
C. Polycythemia
D. Meconium aspiration
Answer: B
Rationale: Prolonged rupture of membranes (>18 hours) increases the risk of chorioamnionitis
and neonatal sepsis. The infant should be monitored for signs of infection. Hypoglycemia (A),
polycythemia (C), and meconium aspiration (D) are not directly related to PROM.
9. A mother with a history of herpes simplex virus (HSV) infection has active genital lesions at
the time of delivery. The nurse should anticipate which intervention for the newborn?
A. Initiation of acyclovir therapy
B. Isolation in a positive-pressure room
C. Administration of immunoglobulin
D. Monitoring for hyperbilirubinemia
Answer: A
Rationale: Infants born to mothers with active genital HSV lesions are at high risk for neonatal
HSV infection, which can be devastating. The infant should be started on acyclovir therapy
empirically. Isolation (B) is not specifically indicated for HSV. Immunoglobulin (C) is not the
primary treatment.
10. A 35-week gestation infant is born to a mother with thyroid disease. Which complication
should the nurse monitor for?
A. Hyperbilirubinemia
B. Thyroid dysfunction
C. Hypoglycemia
D. Polycythemia
Answer: B
Rationale: Maternal thyroid disease can affect fetal thyroid function. The infant should be
monitored for thyroid dysfunction, including both hypothyroidism and hyperthyroidism.
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Answers & Rationales MATERNAL
HISTORY AND LABOR & DELIVERY
ALREADY GRADED A+
1. A 34-week gestation infant is born to a mother with poorly controlled gestational diabetes.
Which complication is the infant at highest risk for?
A. Hyperbilirubinemia
B. Respiratory distress syndrome
C. Hypoglycemia
D. Polycythemia
Answer: C
Rationale: Infants of diabetic mothers (IDMs) are at high risk for hypoglycemia due to fetal
hyperinsulinemia in response to maternal hyperglycemia. After birth, the continued high insulin
levels cause rapid glucose utilization, leading to hypoglycemia. Respiratory distress syndrome
(B) is more common in preterm infants but is not the specific risk associated with maternal
diabetes. Hyperbilirubinemia (A) and polycythemia (D) can occur but are not the primary risk.
2. A mother with preeclampsia delivers a 36-week gestation infant. Which finding would the
nurse expect in this infant?
A. Hyperglycemia
B. Small for gestational age (SGA)
C. Macrosomia
D. Polycythemia
Answer: B
Rationale: Preeclampsia is associated with placental insufficiency, which can lead to intrauterine
1
, growth restriction (IUGR) and infants who are small for gestational age (SGA). Macrosomia (C) is
associated with maternal diabetes. Polycythemia (D) can occur with chronic hypoxia but is not
the primary finding. Hyperglycemia (A) is not typically associated with preeclampsia.
3. A mother received magnesium sulfate for preeclampsia prior to delivery. The nurse should
monitor the neonate for which adverse effect?
A. Hyperthermia
B. Respiratory depression and hypotonia
C. Seizures
D. Hyperglycemia
Answer: B
Rationale: Magnesium sulfate crosses the placenta and can cause neonatal respiratory
depression, hypotonia, and lethargy. The effects are usually transient but require monitoring.
Hyperthermia (A), seizures (C), and hyperglycemia (D) are not expected effects of magnesium
sulfate exposure.
4. A 38-week gestation infant is born to a mother who received opioids during labor. Which
assessment finding would the nurse expect?
A. Hypertonia and jitteriness
B. Respiratory depression and poor feeding
C. Hyperactivity and seizures
D. Hyperthermia and tachycardia
Answer: B
Rationale: Opioids cross the placenta and can cause neonatal respiratory depression, poor
feeding, and sedation. Hypertonia and jitteriness (A) are signs of neonatal abstinence syndrome
(NAS) from chronic opioid exposure, not acute intrapartum administration. Hyperactivity and
seizures (C) are not expected.
5. A mother with chorioamnionitis delivers a preterm infant. Which complication is the infant
at highest risk for?
A. Hypoglycemia
B. Early-onset sepsis
2
, C. Hyperbilirubinemia
D. Necrotizing enterocolitis
Answer: B
Rationale: Chorioamnionitis is a significant risk factor for early-onset sepsis in the neonate due
to ascending infection. The infant should be evaluated for sepsis and started on antibiotics.
Hypoglycemia (A), hyperbilirubinemia (C), and necrotizing enterocolitis (D) are not the primary
risks from chorioamnionitis.
6. A mother with a positive Group B Streptococcus (GBS) screen did not receive intrapartum
antibiotics. The nurse should prioritize which intervention for the newborn?
A. Initiate phototherapy
B. Monitor for signs of sepsis
C. Administer vitamin K
D. Monitor for hypoglycemia
Answer: B
Rationale: GBS is a leading cause of early-onset sepsis in neonates. Without intrapartum
antibiotic prophylaxis, the infant is at increased risk for GBS sepsis and should be closely
monitored for signs of infection (temperature instability, respiratory distress, lethargy, poor
feeding). Phototherapy (A) is for hyperbilirubinemia. Vitamin K (C) is routine for all newborns.
7. A 32-week gestation infant is born to a mother who received antenatal corticosteroids
(betamethasone) 48 hours prior to delivery. The nurse understands that this medication was
given to:
A. Prevent neonatal hypoglycemia
B. Accelerate fetal lung maturity and reduce RDS
C. Prevent intraventricular hemorrhage
D. Reduce the risk of hyperbilirubinemia
Answer: B
Rationale: Antenatal corticosteroids (betamethasone or dexamethasone) are given to
accelerate fetal lung maturity and reduce the incidence and severity of respiratory distress
syndrome (RDS) in preterm infants. They also reduce the risk of intraventricular hemorrhage
(IVH) and necrotizing enterocolitis (NEC), but the primary purpose is lung maturation.
Hypoglycemia (A) and hyperbilirubinemia (D) are not affected.
3
, 8. A mother with prolonged rupture of membranes (PROM) for 18 hours delivers a term
infant. Which complication should the nurse monitor for?
A. Hypoglycemia
B. Sepsis
C. Polycythemia
D. Meconium aspiration
Answer: B
Rationale: Prolonged rupture of membranes (>18 hours) increases the risk of chorioamnionitis
and neonatal sepsis. The infant should be monitored for signs of infection. Hypoglycemia (A),
polycythemia (C), and meconium aspiration (D) are not directly related to PROM.
9. A mother with a history of herpes simplex virus (HSV) infection has active genital lesions at
the time of delivery. The nurse should anticipate which intervention for the newborn?
A. Initiation of acyclovir therapy
B. Isolation in a positive-pressure room
C. Administration of immunoglobulin
D. Monitoring for hyperbilirubinemia
Answer: A
Rationale: Infants born to mothers with active genital HSV lesions are at high risk for neonatal
HSV infection, which can be devastating. The infant should be started on acyclovir therapy
empirically. Isolation (B) is not specifically indicated for HSV. Immunoglobulin (C) is not the
primary treatment.
10. A 35-week gestation infant is born to a mother with thyroid disease. Which complication
should the nurse monitor for?
A. Hyperbilirubinemia
B. Thyroid dysfunction
C. Hypoglycemia
D. Polycythemia
Answer: B
Rationale: Maternal thyroid disease can affect fetal thyroid function. The infant should be
monitored for thyroid dysfunction, including both hypothyroidism and hyperthyroidism.
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