TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
TEST BANK FOR MATERNAL-CHILD NURSING
5TH EDITION BY MCKINNEY — 2026/2027
Comprehensive Examination — 300 Questions — Aligned with NCLEX-RN Maternal-Newborn &
Pediatric Standards and Evidence-Based Perinatal and Pediatric Practice Guidelines
Section 1: Foundations of Maternal-Child Nursing
Q1: A nurse is caring for a pregnant adolescent who declines a recommended ultrasound due to cultural
beliefs. Which action by the nurse best demonstrates family-centered, culturally competent care?
A. Explain that the ultrasound is medically necessary and proceed with scheduling.
B. Notify the provider and document the patient's refusal without further discussion.
C. Explore the patient's beliefs, provide education in a nonjudgmental manner, and involve a cultural broker if
needed. *[CORRECT]*
D. Reschedule the ultrasound for the postpartum period to respect the patient's wishes.
Correct Answer: C
Rationale: Family-centered, culturally competent care requires the nurse to assess and respect the patient's cultural beliefs while
providing evidence-based information. McKinney emphasizes cultural humility, active listening, and use of cultural brokers or
interpreters to facilitate shared decision-making. Option A disregards patient autonomy, B abandons education, and D
compromises fetal surveillance without exploring alternatives.
Q2: A 17-year-old pregnant patient presents for prenatal care. Under the Mature Minor Doctrine, which
scenario generally allows an adolescent to consent to her own prenatal care without parental notification?
A. The adolescent is emancipated by marriage, military service, or court order. *[CORRECT]*
B. The adolescent is currently living with her parents and attending school.
C. The adolescent is under 16 years of age regardless of maturity.
D. The adolescent's parents have explicitly denied consent for prenatal care.
Correct Answer: A
Rationale: The Mature Minor Doctrine and state-specific minor consent statutes generally allow emancipated minors (married,
in military, or court-emancipated) and certain mature minors to consent to prenatal care without parental involvement.
McKinney emphasizes that nurses must know their state's statutes and institutional policy. Option B describes a non-emancipated
minor; C is incorrect because some states allow minors of any age to consent to prenatal care; D is irrelevant once the minor is
legally authorized to consent.
Q3: A perinatal nurse is implementing evidence-based practice (EBP) on the unit. Which sequence represents
the correct EBP process according to the McKinney framework?
A. Implement intervention, assess outcomes, formulate a question, search literature.
B. Ask a clinical question, acquire the best evidence, appraise the evidence, apply to practice, assess outcomes.
*[CORRECT]*
C. Review institutional policy, apply the policy to all patients, document outcomes.
D. Conduct a randomized controlled trial, publish results, change practice based on publication.
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 1
,TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
Correct Answer: B
Rationale: The McKinney framework follows the five-step EBP process: Ask (PICOT question), Acquire (literature search),
Appraise (critique evidence), Apply (integrate with clinical expertise and patient values), and Assess (evaluate outcomes). Option
A is out of sequence, C reflects policy-driven rather than EBP-driven practice, and D describes primary research generation
rather than EBP integration.
Q4: A nurse obtains informed consent from a Spanish-speaking patient for an emergency cesarean birth using
a translated consent form. The patient signs the form but appears confused. What is the nurse's best action?
A. Proceed with the surgery since the form is signed and witnessed.
B. Verify understanding using a qualified medical interpreter and reinforce teaching before proceeding.
*[CORRECT]*
C. Cancel the surgery until the patient's family can arrive to translate.
D. Notify the provider that informed consent cannot be obtained from this patient.
Correct Answer: B
Rationale: Informed consent requires not only a signature but also comprehension. McKinney stresses the use of qualified
medical interpreters (not family members) and verification of understanding via teach-back. The nurse's role is to witness the
consent and ensure the patient understands; if confusion persists, the provider must be notified to reinforce teaching. Option A
bypasses comprehension, C inappropriately delays emergency care, and D misrepresents the patient's capacity to consent.
Q5: Which statement best reflects the principle of maternal-fetal conflict resolution in modern perinatal
ethics?
A. The fetus's rights always supersede the mother's rights when viability is possible.
B. The pregnant woman's autonomous decisions regarding her body should be respected unless there is a compelling,
legally defined override. *[CORRECT]*
C. Court-ordered cesareans are routinely performed when fetal distress is documented.
D. Healthcare proxies for the fetus should be appointed at the time of viability.
Correct Answer: B
Rationale: Modern perinatal ethics, as outlined by ACOG and incorporated in McKinney, prioritizes the pregnant woman's
autonomy and bodily integrity. Forced interventions are reserved for rare, legally defined circumstances and are generally
discouraged given the ethical and legal precedent (e.g., In re A.C.). Option A overstates fetal rights, C is incorrect because
court-ordered cesareans are extremely rare and ethically controversial, and D is not standard practice.
Q6: A postpartum nurse suspects that a 4-month-pregnant coworker is diverting fentanyl from the pyxis.
What is the nurse's legal and ethical obligation?
A. Confront the coworker privately and offer to find her a treatment program.
B. Report the suspicion through the facility's established chain of command and document objectively.
*[CORRECT]*
C. Wait until clear evidence of diversion is obtained before reporting.
D. Discuss concerns with other coworkers to confirm suspicions before acting.
Correct Answer: B
Rationale: Nurses have a legal and ethical duty to report suspected impairment or diversion through the facility's established
channels (e.g., supervisor, risk management) to protect patient safety. McKinney emphasizes objective documentation and
following institutional policy and state reporting laws. Option A delays protection of patients, C waits for harm to occur, and D
breaches confidentiality and may be considered defamation.
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 2
,TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
Q7: Which scenario best exemplifies advocacy, a core component of the maternal-child nurse's role?
A. The nurse administers an analgesic exactly as ordered without further assessment.
B. The nurse ensures a non-English-speaking family receives discharge teaching in their preferred language with an
interpreter. *[CORRECT]*
C. The nurse delegates all newborn assessments to the unlicensed assistive personnel.
D. The nurse documents the timing of medication administration at the end of the shift.
Correct Answer: B
Rationale: Advocacy involves actively protecting the patient's rights, ensuring equitable care, and removing barriers to
understanding. Providing a qualified interpreter for discharge teaching ensures informed participation and safe transition home.
McKinney highlights advocacy as essential in family-centered care. Option A is task-focused, C violates scope of practice for
assessment, and D is a documentation shortcut that risks errors.
Q8: A nurse is providing care to a family who practice female genital cutting (FGC) and are expecting a
daughter. What is the most culturally competent, legally appropriate response?
A. Respect the family's cultural tradition and offer to refer them to a provider who performs the procedure.
B. Explain that FGC is illegal in the United States for minors and provide culturally sensitive education about harms
and alternatives. *[CORRECT]*
C. Avoid the topic entirely to maintain a therapeutic nurse-patient relationship.
D. Report the family to child protective services before delivery based on suspicion alone.
Correct Answer: B
Rationale: Federal law in the United States criminalizes FGC on minors. The culturally competent nurse provides respectful,
nonjudgmental education about legal and health consequences while preserving the therapeutic relationship. McKinney
emphasizes cultural humility paired with adherence to law and evidence. Option A would be assisting an illegal act, C is a
missed opportunity for health promotion, and D is premature without evidence of intent or action.
Q9: A registered nurse (RN) is preparing to delegate newborn vital signs to a licensed practical nurse (LPN)
on a postpartum unit. According to the Five Rights of Delegation, which factor is most critical to assess first?
A. The LPN's preference for assignment
B. The patient's clinical condition and stability for the delegated task *[CORRECT]*
C. The cost savings achieved by delegating to a lower-licensed provider
D. The RN's personal workload at the time of delegation
Correct Answer: B
Rationale: The Five Rights of Delegation (right task, right circumstance, right person, right direction, right supervision) require
that the RN first assess the patient's condition to determine appropriateness of delegation. McKinney emphasizes that assessment,
judgment, and evaluation cannot be delegated. Option A is irrelevant to delegation decisions, C is cost rather than safety driven,
and D should not override patient safety considerations.
Q10: A pregnant patient at 32 weeks gestation informs the nurse she uses marijuana daily for nausea. What is
the nurse's best initial response?
A. Inform the patient that marijuana is safe in pregnancy because it is a natural substance.
B. Counsel the patient about potential fetal risks, screen for substance use, and offer referrals for cessation support.
*[CORRECT]*
C. Refuse further prenatal care until the patient demonstrates abstinence.
D. Recommend switching to synthetic cannabinoids to avoid impurities.
Correct Answer: B
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 3
, TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
Rationale: Marijuana use in pregnancy is associated with potential risks including low birth weight and neurodevelopmental
concerns. McKinney stresses a nonjudgmental, screening-based approach with brief intervention and referral (SBIRT) and
patient education. Option A is false, C is unethical patient abandonment, and D is medically dangerous as synthetic
cannabinoids carry greater risk.
Q11: Which scenario most clearly constitutes a mandatory report of suspected child abuse for a
maternal-child nurse?
A. A 2-year-old presents with a single bruise on the shin from a documented fall.
B. A 6-month-old infant has patterned bruising on the buttocks, conflicting parental explanations, and a delay in
seeking care for a femur fracture. *[CORRECT]*
C. A 4-year-old is brought in for a routine well-child visit and reports being spanked once for misbehavior.
D. A toddler has a fever and the parents report reluctance to vaccinate.
Correct Answer: B
Rationale: Patterned bruising (e.g., loop or hand marks), injuries inconsistent with the history, conflicting explanations, delayed
care, and femur fractures in non-ambulatory infants are sentinel injuries that warrant mandatory reporting. McKinney
emphasizes the nurse's legal duty to report suspected abuse; the threshold is reasonable suspicion, not certainty. Option A is
consistent with a typical injury, C describes acceptable discipline in many jurisdictions, and D is unrelated to abuse.
Q12: A labor and delivery nurse is caring for a Jehovah's Witness patient who refuses a potentially life-saving
blood transfusion. The patient is alert and oriented. What is the most appropriate nursing action?
A. Administer the transfusion because the fetus's right to life supersedes the mother's refusal.
B. Respect the patient's refusal, document the discussion, ensure informed refusal, and implement bloodless
management protocols. *[CORRECT]*
C. Obtain an emergency court order to transfuse the patient.
D. Persuade the patient by exaggerating the risk of death without transfusion.
Correct Answer: B
Rationale: A competent adult has the right to refuse treatment, including life-saving transfusions. The nurse must ensure
informed refusal, document the discussion, and implement alternatives such as erythropoietin, cell salvage, and minimize blood
loss. McKinney emphasizes cultural and religious respect. Option A violates autonomy, C is rarely appropriate for a competent
adult, and D constitutes coercion.
Q13: Which outcome best reflects the integration of QSEN competencies (Quality and Safety Education for
Nurses) into maternal-child nursing practice?
A. The nurse completes all tasks within shift hours without regard to patient preferences.
B. The nurse uses standardized handoff communication (e.g., SBAR) during shift report and encourages patients to
ask questions about their care. *[CORRECT]*
C. The nurse relies solely on memory for medication administration.
D. The nurse performs independent quality improvement research as a primary role.
Correct Answer: B
Rationale: QSEN competencies (Patient-Centered Care, Teamwork & Collaboration, Evidence-Based Practice, Quality
Improvement, Safety, Informatics) are demonstrated by structured communication tools like SBAR and active patient
engagement. McKinney integrates QSEN throughout maternal-child nursing. Option A is task-focused rather than
patient-centered, C violates safety principles of medication verification, and D exceeds the staff nurse's typical role.
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 4
TEST BANK FOR MATERNAL-CHILD NURSING
5TH EDITION BY MCKINNEY — 2026/2027
Comprehensive Examination — 300 Questions — Aligned with NCLEX-RN Maternal-Newborn &
Pediatric Standards and Evidence-Based Perinatal and Pediatric Practice Guidelines
Section 1: Foundations of Maternal-Child Nursing
Q1: A nurse is caring for a pregnant adolescent who declines a recommended ultrasound due to cultural
beliefs. Which action by the nurse best demonstrates family-centered, culturally competent care?
A. Explain that the ultrasound is medically necessary and proceed with scheduling.
B. Notify the provider and document the patient's refusal without further discussion.
C. Explore the patient's beliefs, provide education in a nonjudgmental manner, and involve a cultural broker if
needed. *[CORRECT]*
D. Reschedule the ultrasound for the postpartum period to respect the patient's wishes.
Correct Answer: C
Rationale: Family-centered, culturally competent care requires the nurse to assess and respect the patient's cultural beliefs while
providing evidence-based information. McKinney emphasizes cultural humility, active listening, and use of cultural brokers or
interpreters to facilitate shared decision-making. Option A disregards patient autonomy, B abandons education, and D
compromises fetal surveillance without exploring alternatives.
Q2: A 17-year-old pregnant patient presents for prenatal care. Under the Mature Minor Doctrine, which
scenario generally allows an adolescent to consent to her own prenatal care without parental notification?
A. The adolescent is emancipated by marriage, military service, or court order. *[CORRECT]*
B. The adolescent is currently living with her parents and attending school.
C. The adolescent is under 16 years of age regardless of maturity.
D. The adolescent's parents have explicitly denied consent for prenatal care.
Correct Answer: A
Rationale: The Mature Minor Doctrine and state-specific minor consent statutes generally allow emancipated minors (married,
in military, or court-emancipated) and certain mature minors to consent to prenatal care without parental involvement.
McKinney emphasizes that nurses must know their state's statutes and institutional policy. Option B describes a non-emancipated
minor; C is incorrect because some states allow minors of any age to consent to prenatal care; D is irrelevant once the minor is
legally authorized to consent.
Q3: A perinatal nurse is implementing evidence-based practice (EBP) on the unit. Which sequence represents
the correct EBP process according to the McKinney framework?
A. Implement intervention, assess outcomes, formulate a question, search literature.
B. Ask a clinical question, acquire the best evidence, appraise the evidence, apply to practice, assess outcomes.
*[CORRECT]*
C. Review institutional policy, apply the policy to all patients, document outcomes.
D. Conduct a randomized controlled trial, publish results, change practice based on publication.
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 1
,TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
Correct Answer: B
Rationale: The McKinney framework follows the five-step EBP process: Ask (PICOT question), Acquire (literature search),
Appraise (critique evidence), Apply (integrate with clinical expertise and patient values), and Assess (evaluate outcomes). Option
A is out of sequence, C reflects policy-driven rather than EBP-driven practice, and D describes primary research generation
rather than EBP integration.
Q4: A nurse obtains informed consent from a Spanish-speaking patient for an emergency cesarean birth using
a translated consent form. The patient signs the form but appears confused. What is the nurse's best action?
A. Proceed with the surgery since the form is signed and witnessed.
B. Verify understanding using a qualified medical interpreter and reinforce teaching before proceeding.
*[CORRECT]*
C. Cancel the surgery until the patient's family can arrive to translate.
D. Notify the provider that informed consent cannot be obtained from this patient.
Correct Answer: B
Rationale: Informed consent requires not only a signature but also comprehension. McKinney stresses the use of qualified
medical interpreters (not family members) and verification of understanding via teach-back. The nurse's role is to witness the
consent and ensure the patient understands; if confusion persists, the provider must be notified to reinforce teaching. Option A
bypasses comprehension, C inappropriately delays emergency care, and D misrepresents the patient's capacity to consent.
Q5: Which statement best reflects the principle of maternal-fetal conflict resolution in modern perinatal
ethics?
A. The fetus's rights always supersede the mother's rights when viability is possible.
B. The pregnant woman's autonomous decisions regarding her body should be respected unless there is a compelling,
legally defined override. *[CORRECT]*
C. Court-ordered cesareans are routinely performed when fetal distress is documented.
D. Healthcare proxies for the fetus should be appointed at the time of viability.
Correct Answer: B
Rationale: Modern perinatal ethics, as outlined by ACOG and incorporated in McKinney, prioritizes the pregnant woman's
autonomy and bodily integrity. Forced interventions are reserved for rare, legally defined circumstances and are generally
discouraged given the ethical and legal precedent (e.g., In re A.C.). Option A overstates fetal rights, C is incorrect because
court-ordered cesareans are extremely rare and ethically controversial, and D is not standard practice.
Q6: A postpartum nurse suspects that a 4-month-pregnant coworker is diverting fentanyl from the pyxis.
What is the nurse's legal and ethical obligation?
A. Confront the coworker privately and offer to find her a treatment program.
B. Report the suspicion through the facility's established chain of command and document objectively.
*[CORRECT]*
C. Wait until clear evidence of diversion is obtained before reporting.
D. Discuss concerns with other coworkers to confirm suspicions before acting.
Correct Answer: B
Rationale: Nurses have a legal and ethical duty to report suspected impairment or diversion through the facility's established
channels (e.g., supervisor, risk management) to protect patient safety. McKinney emphasizes objective documentation and
following institutional policy and state reporting laws. Option A delays protection of patients, C waits for harm to occur, and D
breaches confidentiality and may be considered defamation.
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 2
,TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
Q7: Which scenario best exemplifies advocacy, a core component of the maternal-child nurse's role?
A. The nurse administers an analgesic exactly as ordered without further assessment.
B. The nurse ensures a non-English-speaking family receives discharge teaching in their preferred language with an
interpreter. *[CORRECT]*
C. The nurse delegates all newborn assessments to the unlicensed assistive personnel.
D. The nurse documents the timing of medication administration at the end of the shift.
Correct Answer: B
Rationale: Advocacy involves actively protecting the patient's rights, ensuring equitable care, and removing barriers to
understanding. Providing a qualified interpreter for discharge teaching ensures informed participation and safe transition home.
McKinney highlights advocacy as essential in family-centered care. Option A is task-focused, C violates scope of practice for
assessment, and D is a documentation shortcut that risks errors.
Q8: A nurse is providing care to a family who practice female genital cutting (FGC) and are expecting a
daughter. What is the most culturally competent, legally appropriate response?
A. Respect the family's cultural tradition and offer to refer them to a provider who performs the procedure.
B. Explain that FGC is illegal in the United States for minors and provide culturally sensitive education about harms
and alternatives. *[CORRECT]*
C. Avoid the topic entirely to maintain a therapeutic nurse-patient relationship.
D. Report the family to child protective services before delivery based on suspicion alone.
Correct Answer: B
Rationale: Federal law in the United States criminalizes FGC on minors. The culturally competent nurse provides respectful,
nonjudgmental education about legal and health consequences while preserving the therapeutic relationship. McKinney
emphasizes cultural humility paired with adherence to law and evidence. Option A would be assisting an illegal act, C is a
missed opportunity for health promotion, and D is premature without evidence of intent or action.
Q9: A registered nurse (RN) is preparing to delegate newborn vital signs to a licensed practical nurse (LPN)
on a postpartum unit. According to the Five Rights of Delegation, which factor is most critical to assess first?
A. The LPN's preference for assignment
B. The patient's clinical condition and stability for the delegated task *[CORRECT]*
C. The cost savings achieved by delegating to a lower-licensed provider
D. The RN's personal workload at the time of delegation
Correct Answer: B
Rationale: The Five Rights of Delegation (right task, right circumstance, right person, right direction, right supervision) require
that the RN first assess the patient's condition to determine appropriateness of delegation. McKinney emphasizes that assessment,
judgment, and evaluation cannot be delegated. Option A is irrelevant to delegation decisions, C is cost rather than safety driven,
and D should not override patient safety considerations.
Q10: A pregnant patient at 32 weeks gestation informs the nurse she uses marijuana daily for nausea. What is
the nurse's best initial response?
A. Inform the patient that marijuana is safe in pregnancy because it is a natural substance.
B. Counsel the patient about potential fetal risks, screen for substance use, and offer referrals for cessation support.
*[CORRECT]*
C. Refuse further prenatal care until the patient demonstrates abstinence.
D. Recommend switching to synthetic cannabinoids to avoid impurities.
Correct Answer: B
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 3
, TEST BANK — MATERNAL-CHILD NURSING 5TH EDITION (MCKINNEY) | 2026/2027
Rationale: Marijuana use in pregnancy is associated with potential risks including low birth weight and neurodevelopmental
concerns. McKinney stresses a nonjudgmental, screening-based approach with brief intervention and referral (SBIRT) and
patient education. Option A is false, C is unethical patient abandonment, and D is medically dangerous as synthetic
cannabinoids carry greater risk.
Q11: Which scenario most clearly constitutes a mandatory report of suspected child abuse for a
maternal-child nurse?
A. A 2-year-old presents with a single bruise on the shin from a documented fall.
B. A 6-month-old infant has patterned bruising on the buttocks, conflicting parental explanations, and a delay in
seeking care for a femur fracture. *[CORRECT]*
C. A 4-year-old is brought in for a routine well-child visit and reports being spanked once for misbehavior.
D. A toddler has a fever and the parents report reluctance to vaccinate.
Correct Answer: B
Rationale: Patterned bruising (e.g., loop or hand marks), injuries inconsistent with the history, conflicting explanations, delayed
care, and femur fractures in non-ambulatory infants are sentinel injuries that warrant mandatory reporting. McKinney
emphasizes the nurse's legal duty to report suspected abuse; the threshold is reasonable suspicion, not certainty. Option A is
consistent with a typical injury, C describes acceptable discipline in many jurisdictions, and D is unrelated to abuse.
Q12: A labor and delivery nurse is caring for a Jehovah's Witness patient who refuses a potentially life-saving
blood transfusion. The patient is alert and oriented. What is the most appropriate nursing action?
A. Administer the transfusion because the fetus's right to life supersedes the mother's refusal.
B. Respect the patient's refusal, document the discussion, ensure informed refusal, and implement bloodless
management protocols. *[CORRECT]*
C. Obtain an emergency court order to transfuse the patient.
D. Persuade the patient by exaggerating the risk of death without transfusion.
Correct Answer: B
Rationale: A competent adult has the right to refuse treatment, including life-saving transfusions. The nurse must ensure
informed refusal, document the discussion, and implement alternatives such as erythropoietin, cell salvage, and minimize blood
loss. McKinney emphasizes cultural and religious respect. Option A violates autonomy, C is rarely appropriate for a competent
adult, and D constitutes coercion.
Q13: Which outcome best reflects the integration of QSEN competencies (Quality and Safety Education for
Nurses) into maternal-child nursing practice?
A. The nurse completes all tasks within shift hours without regard to patient preferences.
B. The nurse uses standardized handoff communication (e.g., SBAR) during shift report and encourages patients to
ask questions about their care. *[CORRECT]*
C. The nurse relies solely on memory for medication administration.
D. The nurse performs independent quality improvement research as a primary role.
Correct Answer: B
Rationale: QSEN competencies (Patient-Centered Care, Teamwork & Collaboration, Evidence-Based Practice, Quality
Improvement, Safety, Informatics) are demonstrated by structured communication tools like SBAR and active patient
engagement. McKinney integrates QSEN throughout maternal-child nursing. Option A is task-focused rather than
patient-centered, C violates safety principles of medication verification, and D exceeds the staff nurse's typical role.
McKinney Maternal-Child Nursing 5th Ed. — Test Bank 2026/2027 | Page 4
