NCLEX-maternity and newborn PREP exam NCLEX-
maternity and newborn PREP exam 2024 with over
150+ questions with verified answers with Rationales
Guaranteed success
Graded A+
A term neonate's mother is O-negative, and cord studies indicate that the neonate is A-positive. Which
of the following would be least likely if the neonate developed hemolytic disease?
Weight loss greater than 10%
RATIONALES: Although weight loss may be greater than 10%, the most important assessments must
include those addressing the problem of a rising bilirubin. Neonates who develop severe jaundice as a
result of Rh and ABO incompatibility will exhibit lethargy or irritability and poor feeding patterns. If
bilirubin levels are high enough to cross the blood brain barrier (usually 20 mg and higher), the
neonate is at serious risk for neurologic impairment due to permanent cell damage (kernicterus
A full-term neonate is diagnosed with hydrocephalus. Nursing assessment is most likely to reveal:
wide or bulging fontanels.
RATIONALES: Hydrocephalus typically causes an enlarged head with wide or bulging fontanels, an
excessive diameter (increased occipitofrontal diameter), a shiny scalp with prominent veins,
separation of the suture lines, and downward-slanting eyes. Other findings in hydrocephalus include
bradycardia, apneic episodes, vomiting, irritability, excessive crying, and reduced alertnes
,A client who used heroin during her pregnancy delivers a neonate. When assessing the neonate, the
nurse expects to find
irritability and poor sucking
RATIONALES: Neonates of heroin-addicted mothers are physically dependent on the drug and
experience withdrawal when the drug is no longer supplied. Signs of heroin withdrawal include
irritability, poor sucking, and restlessness. Lethargy isn't associated with neonatal heroin addiction. A
flattened nose, small eyes, and thin lips are seen in infants with fetal alcohol syndrome. Heroin use
during pregnancy hasn't been linked to specific congenital anomalies.
Accompanied by her husband, a client seeks admission to the labor and delivery area
. She states that she's in labor and says she attended the facility clinic for prenatal care. Which question
should the nurse ask her first?
"What is your expected due date?"
RATIONALES: When obtaining the history of a client who may be in labor, the nurse's highest priority
is to determine her current status, particularly her due date, gravidity, and parity. Gravidity and parity
affect the duration of labor and the potential for labor complications. Later, the nurse should ask
about chronic illnesses, allergies, and support persons.
A primigravid client, age 20, has just completed a difficult, forceps-assisted delivery of twins. Her labor
was unusually long and required oxytocin (Pitocin) augmentation. The nurse who's caring for her should
stay alert for
uterine atony
.RATIONALES: Multiple fetuses, extended labor stimulation with oxytocin, and traumatic delivery
commonly are associated with uterine atony, which may lead to postpartum hemorrhage. Uterine
inversion may precede or follow delivery and commonly results from apparent excessive traction on the
umbilical cord and attempts to deliver the placenta manually. Uterine involution and some uterine
discomfort are normal after delivery.
,The nurse is assessing a client on the 2nd postpartum day. Under normal circumstances, the tone and
location of the client's fundus is:
firm and two fingerbreadths below the umbilicus
RATIONALES: By the 2nd postpartum day, the fundus should be firm and two fingerbreadths below
the umbilicus. The fundus should be at the level of the umbilicus on the day of delivery and falls
below the umbilicus by approximately one fingerbreadth (1 cm) per day, until it has contracted into
the pelvis by the 9th or 10th day. The fundus should be firm, not soft. A soft or boggy fundus indicates
that the uterus isn't contracting properly. The fundus should be palpated in the midline of the
abdomen; if the woman has a full bladder, however, the fundus may be deviated to the right or left.
Which of the following describes a preterm neonate
A neonate born at less than 37 weeks' gestation regardless of weight
RATIONALES: A preterm neonate is a neonate born at less than 37 weeks' gestation regardless of what
the neonate weighs. Neonates weighing less than 2,500 g are described as low-birth-weight neonates.
A neonate who's small for gestational age weighs below the 10th percentile (or two standard
deviations below the mean) as a result of intrauterine growth retardation.
Which of the following is the primary reason for putting breast-feeding neonates to the breast
immediately after delivery?
Breast-feeding neonates immediately after birth establishes a learned response
RATIONALES: Immediately following birth, most neonates are quietly alert and are ready to nurse.
Therefore, this is an ideal time to begin breast-feeding. Also, as one of the first postbirth experiences,
the neonate is able to develop a learned response for feeding. The other answers are acceptable, but
they don't consider the importance of developing responses as part of breast-feeding succes
The nurse demonstrates infant bathing to a primiparous client. Which statement by the client indicates
a lack of understanding?
2. "I have all kinds of pretty, scented soaps and lotions to bathe the baby with.
RATIONALES: Scented and medicated soaps and lotions aren't recommended for infants because they
may alter the skin pH, making the skin less able to fight infection. Bathing the infant in a warm room,
, sponge-bathing the infant until the cord area heals, and washing the eyes and face first are
appropriate activities and indicate an understanding of teaching regarding infant bathing
For a client who's fully dilated, which of the following actions would be inappropriate during the second
stage of labor?
Assessing for rupture of membranes
RATIONALES: In most cases, the membranes have ruptured (spontaneously or artificially) by this stage
of labor. Positioning for effective pushing, preparing for delivery, and assessing vital signs every 15
minutes are appropriate actions at this time.
The neonate's respiratory function stabilizes about 24 hours after birth and is maintained by the effects
of biochemical and environmental stimulation. What four physiologic conditions must be present in
order for the neonate's respiratory functioning to proceed?
Functioning respiratory center, patent airway, intact nerves from RATIONALES:
Respiratory functioning requires a patent airway, a functioning respiratory center, intact nerves from
the brain to the chest muscles, and adequate calories to supply energy for the labor of breathing.
With birth comes functional closure of the fetal shunts. However, anatomic closure doesn't occur for
up to 4 weeks. Clinically insignificant functional murmurs or transient cyanosis may result.
Maintaining the neonate's body temperature is essential for successful extrauterine adaptation but
isn't directly responsible for respiratory stabilization. brain to the chest muscles, and adequate
calories .
After completing a second vaginal examination of a client in labor, the nurse-midwife determines that
the fetus is in the right occiput anterior position and at -1 station. Based on these findings, the nurse-
midwife knows that the fetal presenting part is:
. 1 cm above the ischial spines.
RATIONALES: Fetal station — the relationship of the fetal presenting part to the maternal ischial
spines — is described in the number of centimeters above or below the spines. A presenting part
above the ischial spines is designated as -1, -2, or -3. A presenting part below the ischial spines, as +1,
+2, or +3.
maternity and newborn PREP exam 2024 with over
150+ questions with verified answers with Rationales
Guaranteed success
Graded A+
A term neonate's mother is O-negative, and cord studies indicate that the neonate is A-positive. Which
of the following would be least likely if the neonate developed hemolytic disease?
Weight loss greater than 10%
RATIONALES: Although weight loss may be greater than 10%, the most important assessments must
include those addressing the problem of a rising bilirubin. Neonates who develop severe jaundice as a
result of Rh and ABO incompatibility will exhibit lethargy or irritability and poor feeding patterns. If
bilirubin levels are high enough to cross the blood brain barrier (usually 20 mg and higher), the
neonate is at serious risk for neurologic impairment due to permanent cell damage (kernicterus
A full-term neonate is diagnosed with hydrocephalus. Nursing assessment is most likely to reveal:
wide or bulging fontanels.
RATIONALES: Hydrocephalus typically causes an enlarged head with wide or bulging fontanels, an
excessive diameter (increased occipitofrontal diameter), a shiny scalp with prominent veins,
separation of the suture lines, and downward-slanting eyes. Other findings in hydrocephalus include
bradycardia, apneic episodes, vomiting, irritability, excessive crying, and reduced alertnes
,A client who used heroin during her pregnancy delivers a neonate. When assessing the neonate, the
nurse expects to find
irritability and poor sucking
RATIONALES: Neonates of heroin-addicted mothers are physically dependent on the drug and
experience withdrawal when the drug is no longer supplied. Signs of heroin withdrawal include
irritability, poor sucking, and restlessness. Lethargy isn't associated with neonatal heroin addiction. A
flattened nose, small eyes, and thin lips are seen in infants with fetal alcohol syndrome. Heroin use
during pregnancy hasn't been linked to specific congenital anomalies.
Accompanied by her husband, a client seeks admission to the labor and delivery area
. She states that she's in labor and says she attended the facility clinic for prenatal care. Which question
should the nurse ask her first?
"What is your expected due date?"
RATIONALES: When obtaining the history of a client who may be in labor, the nurse's highest priority
is to determine her current status, particularly her due date, gravidity, and parity. Gravidity and parity
affect the duration of labor and the potential for labor complications. Later, the nurse should ask
about chronic illnesses, allergies, and support persons.
A primigravid client, age 20, has just completed a difficult, forceps-assisted delivery of twins. Her labor
was unusually long and required oxytocin (Pitocin) augmentation. The nurse who's caring for her should
stay alert for
uterine atony
.RATIONALES: Multiple fetuses, extended labor stimulation with oxytocin, and traumatic delivery
commonly are associated with uterine atony, which may lead to postpartum hemorrhage. Uterine
inversion may precede or follow delivery and commonly results from apparent excessive traction on the
umbilical cord and attempts to deliver the placenta manually. Uterine involution and some uterine
discomfort are normal after delivery.
,The nurse is assessing a client on the 2nd postpartum day. Under normal circumstances, the tone and
location of the client's fundus is:
firm and two fingerbreadths below the umbilicus
RATIONALES: By the 2nd postpartum day, the fundus should be firm and two fingerbreadths below
the umbilicus. The fundus should be at the level of the umbilicus on the day of delivery and falls
below the umbilicus by approximately one fingerbreadth (1 cm) per day, until it has contracted into
the pelvis by the 9th or 10th day. The fundus should be firm, not soft. A soft or boggy fundus indicates
that the uterus isn't contracting properly. The fundus should be palpated in the midline of the
abdomen; if the woman has a full bladder, however, the fundus may be deviated to the right or left.
Which of the following describes a preterm neonate
A neonate born at less than 37 weeks' gestation regardless of weight
RATIONALES: A preterm neonate is a neonate born at less than 37 weeks' gestation regardless of what
the neonate weighs. Neonates weighing less than 2,500 g are described as low-birth-weight neonates.
A neonate who's small for gestational age weighs below the 10th percentile (or two standard
deviations below the mean) as a result of intrauterine growth retardation.
Which of the following is the primary reason for putting breast-feeding neonates to the breast
immediately after delivery?
Breast-feeding neonates immediately after birth establishes a learned response
RATIONALES: Immediately following birth, most neonates are quietly alert and are ready to nurse.
Therefore, this is an ideal time to begin breast-feeding. Also, as one of the first postbirth experiences,
the neonate is able to develop a learned response for feeding. The other answers are acceptable, but
they don't consider the importance of developing responses as part of breast-feeding succes
The nurse demonstrates infant bathing to a primiparous client. Which statement by the client indicates
a lack of understanding?
2. "I have all kinds of pretty, scented soaps and lotions to bathe the baby with.
RATIONALES: Scented and medicated soaps and lotions aren't recommended for infants because they
may alter the skin pH, making the skin less able to fight infection. Bathing the infant in a warm room,
, sponge-bathing the infant until the cord area heals, and washing the eyes and face first are
appropriate activities and indicate an understanding of teaching regarding infant bathing
For a client who's fully dilated, which of the following actions would be inappropriate during the second
stage of labor?
Assessing for rupture of membranes
RATIONALES: In most cases, the membranes have ruptured (spontaneously or artificially) by this stage
of labor. Positioning for effective pushing, preparing for delivery, and assessing vital signs every 15
minutes are appropriate actions at this time.
The neonate's respiratory function stabilizes about 24 hours after birth and is maintained by the effects
of biochemical and environmental stimulation. What four physiologic conditions must be present in
order for the neonate's respiratory functioning to proceed?
Functioning respiratory center, patent airway, intact nerves from RATIONALES:
Respiratory functioning requires a patent airway, a functioning respiratory center, intact nerves from
the brain to the chest muscles, and adequate calories to supply energy for the labor of breathing.
With birth comes functional closure of the fetal shunts. However, anatomic closure doesn't occur for
up to 4 weeks. Clinically insignificant functional murmurs or transient cyanosis may result.
Maintaining the neonate's body temperature is essential for successful extrauterine adaptation but
isn't directly responsible for respiratory stabilization. brain to the chest muscles, and adequate
calories .
After completing a second vaginal examination of a client in labor, the nurse-midwife determines that
the fetus is in the right occiput anterior position and at -1 station. Based on these findings, the nurse-
midwife knows that the fetal presenting part is:
. 1 cm above the ischial spines.
RATIONALES: Fetal station — the relationship of the fetal presenting part to the maternal ischial
spines — is described in the number of centimeters above or below the spines. A presenting part
above the ischial spines is designated as -1, -2, or -3. A presenting part below the ischial spines, as +1,
+2, or +3.
