RNC-MNN Study Questions/NCC Maternal Newborn Nursing (RNC-MNN) Practice Tests & Test Prep Answered 2022/2023.

RNC-MNN Study Questions/NCC Maternal Newborn Nursing (RNC-MNN) Practice Tests & Test Prep Answered 2022/2023. Eve is 2 days postpartum. During palpation, where would you normally expect to find her fundus? a. at the level of the umbilicus b. 2 fingers below umbilicus c. 5 fingers below umbilicus d. non-palpable at this time b. 2 fingers below umbilicus Keisha delivered her third child about 24 hours ago. She begins to c/o severe uterine cramping while breastfeeding. She is experiencing: a. exfoliation of dead tissue b. involution of uterus c. shedding of the endometrium d. after pains d. after pains Three days after delivering her child, Gretchen calls the 24 hour hotline. She is crying and states that her breasts suddenly became "bigger" and "really hurt." She is experiencing: a. colostrum production b. a breast tumor c. engorgement d. overproduction of milk c. engorgement Tiffany delivered via cesarean 2 days ago. She is frustrated by constant perspiration and urination. This is likely the result of: a. changes in urine pH and a possible UTI b. drinking too much fluid in the early postpartum period c. the body's removal of fluids accumulated during pregnancy d. receiving excessive amounts of IV fluids during labor c. the body's removal of fluids accumulated during pregnancy While assessing Sierra, a 32yo mother of 3, you notice uterine bleeding and find that her uterus is displayed upward and to the right. This is probably cause by: a. retained placental fragments b. rupture of the uterus c. distention of the bladder d. cervical bruising c. distention of the bladder Olga, a 38yo patient whom you administered the rubella vaccine, states that at her age she plans to get pregnant right away. You tell her she should: a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine b. get pregnant ASAP because of her age c. avoid getting pregnant for at least a year after receiving the MMR vaccine d. abstain from sex for 2 weeks after delivery a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine Joan is a 17yo and just delivered a healthy baby boy 6 hours ago. She talks on her cell phone whenever you are in the room and refuses to touch or hold her baby, even when he cries. You overhear Joan tell someone that the baby is "ugly like his father." Joan is most likely experiencing: a. exhaustion b. mal-attachment c. normal attachment d. postpartum depression b. mal-attachment Recommended advice for breastfeeding mothers include: a. avoid the use of a sports bra b. wash the nipples with soap and water after each feeding c. apply a warm compress to ease nipple pain d. "conditioning" the nipples by gently rubbing them with moist tea bags c. apply a warm compress to ease nipple pain Samantha read in the discharge booklet that postpartum patients are at risk for thrombophlebitis, and she asks you how she can prevent this from happening. You instruct her to: a. remain on strict bedrest b. ambulate frequently c. cross her legs while sitting d. avoid elevating her legs b. ambulate frequently Suzanne delivered vaginally 8 hours ago. She has uterine cramping and rates her pain a "9" but refuses pain medication. What is your best response regarding her pain? a. tell her she should take the ibuprofen as prescribed by her MD b. encourage her to fight the pain because it will make her stronger c. ask her to use the call button if she changes her mind about taking pain medication d. offer her a non-drug option such as a hot pack or massage d. offer her a non-drug option such as a hot pack or massage Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She reports she is "bleeding a lot" and her perineal pad, changed 45 minutes ago, is fully saturated. Palpation reveals a boggy uterus. Your first intervention is: a. start IV fluids b. place a catheter c. massage her uterus until firm d. call the MD c. massage her uterus until firm Mei experienced premature rupture of membranes during her pregnancy and her internal fetal monitors placed during labor. She later delivered by cesarean. 12 hours after delivery, her HR is 104 and her lochia smells foul. You suspect: a. endometriosis b. mastitis c. uterine cancer d. endometritis d. endometritis You are preparing to discharge Maria after delivering a healthy boy. You believe Maria understands the discharge teaching instructions when she states: a. it is acceptable to have bleeding nipples after breastfeeding for the first few days b. I should not worry if I have a large mass under my breasts c. I will call my nurse-midwife if I saturate a pad in one hour d. suicidal thoughts are okay because the baby blues are normal c. I will call my nurse-midwife if I saturate a pad in one hour An infant born to a mother who abused drugs during pregnancy exhibited withdrawal signs in the nursery that included fever and poor state control. After stabilization and discharge, the caretaker called to report a return of withdrawal symptoms. This pattern is consistent with maternal abuse of: a. alcohol b. cocaine c. methadone b. cocaine Leukocytosis that occurs in normal postpartum adaptation can be differentiated from an infectious process by the presence of: a. a 30% increase in WBC count in a 6 hour period b. a concominant increase in the sedimentation rate c. any elevation in temperature b. a concominant increase in the sedimentation rate Tachypnea, tachycardia, and poor feeding in a 12 hour old neonate, born to a mother with diabetes mellitus, would be more consistent with the onset of: a. congestive heart failure b. hypoglycemia c. respiratory distress syndrome b. hypoglycemia A postpartum woman has a BP of 150/92 at 6 hours. Later, the BP is 148/90. This finding most likely: a. diminished venous return b. reflects postpartum peak in cardiac output c. requires evaluation for postpartum preeclampsia c. requires evaluation for postpartum preeclampsia The let down reflex in the breastfeeding woman is responsible for a. movement of the milk from ducts to the nipple b. regulation of milk release to ensure milk is available at any given time c. release of the milk to the alveoli a. movement of the milk from ducts to the nipple A woman plans not to breastfeed and asks about how to suppress lactation. She should be advised that: a. mechanical suppression occurs with the use of a supportive bra b. medications can be prescribes to stop lactation c. physiologically, lactation will not proceed without breastfeeding and no intervention is needed a. mechanical suppression occurs with the use of a supportive bra Spinal blockade occurring with epidural anesthesia results in a. hypotension b. tachycardia c. vertigo a. hypotension Synthesis of vitamin K in the neonate is dependent upon the presence of a. amino acids derived from human or formula proteins b. appropriate bacteria in the GI tract c. passively acquired maternal antibodies b. appropriate bacteria in the GI tract A woman with a history of breast augmentation asks if she will be able to breastfeed her baby. The factor that will most influence her ability to breastfeed is a. time interval since the surgery b. type of implant c. type of incision c. type of incision Assessment for the presence of congenital viral infection would be indicated in which of the following: a. 38 weeks, LGA infant with RDS b. late preterm with elevated indirect bilirubin c. term, SGA with widespread petechiae c. term, SGA with widespread petechiae A woman has been treated with fractionated heparin during pregnancy for thromboembolism. She wants to breastfeed. In the postpartum period, it would be expected that she would a. be changed to a low molecular weight heparin formulation b. be switched to warfarin c. continue with heparin therapy c. continue with heparin therapy An anatomic breast variation that has been linked with insufficient lactation relates to a. inadequate glandular tissue b. lack of breast tissue elasticity c. shape and size of nipple a. inadequate glandular tissue A woman is admitted to the postpartum unit following delivery of her infant on the route to the hospital. The RN noted bruises on the woman's back and arms. To assess possible intimate partner violence, the RN should a. directly ask her if anyone has threatened her or physically harmed her b. question her on how she obtained the bruises c. review the patients chart for any indication of domestic violence b. question her on how she obtained the bruises The use of phototherapy reduces the risk of a. bronze baby syndrome b. exchange transfusion c. skin moles b. exchange transfusion Uterine prolapse associated with childbirth is due to a. atrophy of the uterine tissue b. bulging of uterine tissue through the cervix c. weakening of the pelvic tissue c. weakening of the pelvic tissue A new mother verbalizes her concern about the presence of stork bites nevus on her infant's eyelid. The RN's response will be based on the knowledge that a. further growth and facial involvement is likely overtime b. the location of the birth mark carries a risk of eye involvement c. this type of vascular lesions tend to disappear by the age of one c. this type of vascular lesions tend to disappear by the age of one The recommended antibiotic treatment for postpartum endometritis is a. a broad spectrum antibiotic b. based on endometrial culture c. selected based on provider's preference a. a broad spectrum antibiotic It is difficult to determine the extent of blood loss with a vaginal hematoma because a. blood is retained in the tissue b. blood loss is mistaken as part of the normal postpartum course c. symptoms don't correlate to the amount of blood loss a. blood is retained in the tissue A newborn is noted at birth to be hypotonic with characteristics that include small ears, flat appearance to the face, slanted palpebral tissues, and simian creases on both palms. Based on the findings, the RN can expect a work up that includes a. blood work sent for TORCH titers b. genetic consult from chromosome studies c. review of the prenatal history of maternal alcohol use b. genetic consult from chromosome studies Milk transfer, a key physiologic principle in lactation, is most efficient with a. adequate prolactin levels b. good lactation c. strong negative pressure action by the baby b. good lactation More than 2/3 of sentinel events reported to the Joint Commission were caused by a. communication failure among healthcare team members b. fatigue and shift work related problems c. inadequate staffing a. communication failure among healthcare team members During the recovery period following a rapid delivery, a woman had an elevated BP, epigastric pain, and severe headache. IV mag sulfate was started at 2 gm/hr. 2 hours later, the woman is lethargic with worsening visual disturbances and has now lapsed into a comatose state. She should be evaluated for a. cerebral hemorrhage b. HELLP syndrome c. mag toxicity c. mag toxicity A central venous hematocrit would be chosen over a heel stick sample to confirm diagnosis of a. hyperbilirubenemia b. polycythemia c. vitamin K deficiency b. polycythemia Polycythemia occurs more frequently in the IUGR neonate due to a. decreased erythropoietin activity b. immaturity of the hematologic system c. physiologic response to hypoxia c. physiologic response to hypoxia Which of the following would be suggestive of a hydrocele? a. a bluish-red colored swelling of the scrotum b. irreducible swelling of the scrotum that transilluminates c. presence of scrotal mass which does not transilluminate b. irreducible swelling of the scrotum that transilluminates A breastfeeding woman developed endomyometriosis 3 days after her cesarean. She was treated with IV antibiotics and discharged home on oral antibiotics. On her 6th postpartum day, she returns to the hospital with fever, shaking chills, tachycardia, and flank pain. She has urinary frequency and urgency. The patient should be further assessed for a. cystitis b. pyelonephritis c. wound infection b. pyelonephritis Assessment of which of the following neonatal reflexes would be most important in evaluation for brachial plexus nerve damage? a. moro b. rooting c. stepping a. moro A woman with preeclampsia is at greater risk for an eclamptic seizure if she has a. developing epigastric abdominal pain b. elevated BP despite being treated with mag sulfate c. poor urinary output c. poor urinary output The greatest morbidity from placental abruption occurs in women who a. develop malnutrition b. develop preeclampsia with a preterm gestation c. have a history of preeclampsia with previous pregnancy b. develop preeclampsia with a preterm gestation The breastfeeding woman with a yeast infection on the breast, typically presents with a. breast pain while breastfeeding b. development of generalized rash of the breast c. low grade fever that doesn't respond to antipyretics a. breast pain while breastfeeding Release of hepatic glucose is a response that occur in term neonates a. at times of decreased glucagon secretion b. following initial attempt of breastfeeding c. with declining glucose levels following birth c. with declining glucose levels following birth The newborn experiencing a delay in clearing fetal lung fluid after birth is at increased risk for a. aspiration pneumonitis b. RDS c. transient tachypnea of the newborn c. transient tachypnea of the newborn A method to differentiate between jitteriness and potential seizure activity is to a. passively flex the extremities to determine if tremors cease b. make a loud noise to see if tremors are elicited c. note the length of time that tremor activity continues a. passively flex the extremities to determine if tremors cease A 4 hour old newborn that has been swaddled and sleeping soundly for about 2 hours is noted to have a HR of 170/min. An appropriate initial intervention would be to a. contact the PCP immediately b. obtain an axillary temperature c. prepare for a sepsis workup b. obtain an axillary temperature A mother asks how her newborn's vision can be evaluated in the nursery. The RN responds by a. demonstrating that the baby can fix on and follow a bright object b. explaining that the vision cannot be assessed because of eye prophylaxis c. holding the baby upright to show that the baby's eyes open a. demonstrating that the baby can fix on and follow a bright object Hypercoagulability in pregnancy places the postpartum woman at an increased risk for a. DVT b. greater blood loss at delivery c. polycythemia a. DVT Maternal mag sulfate administration during labor places the neonate at increased risk for a. cardiac dysrhythmias b. decreased suck reflex c. GI reflux b. decreased suck reflex A normal finding on inspection of the perineum following suturing of a laceration 24 hours postpartum is a. presence of ecchymoses b. skin edges that are not fully approximated c. some edema or tenderness c. some edema or tenderness Postpartum psychosis is a variant of a. bipolar disorder b. an anxiety disorder c. PTSD a. bipolar disorder A priority of care to administering methergine postpartum is to check a. blood pressure b. history of asthma c. urinary output a. blood pressure Vaginal examination is initiated for a woman who reports increasing episiotomy pain to detect a. hematoma b. retained placental fragments c. undetected laceration a. hematoma An otherwise stable 12 hour old term neonate is noted to have multiple white topped papules on reddened macular bases on the face and trunk. Based on these findings, the RN would recognize the need to a. document as a benign finding b. institute airborne isolation ASAP c. obtain a surface culture a. document as a benign finding A parameter used in Ballard score for determination of gestational age is a. babinski reflexes b. hair texture c. heel to ear maneuver c. heel to ear maneuver The primary function of the ductus arteriosis in the normal fetus is to a. ensure circulation to the liver b. provide a route for blood to bypass the lungs c. shunt blood to the right side of the heart b. provide a route for blood to bypass the lungs Insulin requirements decrease in the immediate postpartum period, in a diabetic woman, because a. anti-insulin placental hormones decrease b. exogenous insulin production increases c. moderate ketonuria develops a. anti-insulin placental hormones decrease The major challenge of the adolescent mother transitioning to the role of motherhood is a. egocentricity b. lack of life experience c. physiologic immaturity a. egocentricity Increased stroke volume during the postpartum period is responsible for what normal physiologic postpartum change? a. increased cardiac output b. increased heart rate c. reduced vascular resistance a. increased cardiac output Attention to the neonate's age in hours is essential when a. determining the timing of metabolic screening b. interpreting total serum bilirubin levels c. scheduling a circumcision b. interpreting total serum bilirubin levels Three hours following a prolonged labor that resulted in a cesarean, a postpartum woman shows little interest in her infant and is reluctant to breastfeed. The reason for this behavior is most likely related to a. possible attachment disorder b. extreme fatigue c. postpartum depression