Delights Test Banks 1
"High-Yield NCLEX Test Bank: Newborn Complications
(Maternal Nursing) | 250+ NGN Questions & Detailed
Rationales"
Master NCLEX-RN Newborn Complications with NGN-Style Questions and Clinical
Scenarios
, Delights Test Banks 2
Question 1 (TTN – MCQ)
Scenario: A term newborn delivered via elective C-section develops tachypnea
(68 breaths/min) and intermittent grunting at 1 hour of life. Oxygen saturation
is 92% on room air. The chest X-ray shows "wet lungs" with fluid in the
fissures. What is the most likely diagnosis?
Options:
A. Respiratory distress syndrome (RDS)
B. Transient tachypnea of the newborn (TTN)
C. Pneumonia
D. Congenital diaphragmatic hernia
Correct Answer: B (TTN)
Rationale:
• TTN is caused by delayed clearance of fetal lung fluid, common in C-
section babies (no "thoracic squeeze" during vaginal delivery) (Ricci p.
645).
• Key Clues:
o Mild hypoxia (SaO₂ >90%) vs. RDS (SaO₂ often <85%).
o "Wet lung" on X-ray (diffuse infiltrates, fluid in fissures).
• Why Not Others?:
o A (RDS): Preterm infants + "ground glass" X-ray.
o C (Pneumonia): Requires maternal fever/chorioamnionitis.
o D (CDH): Scaphoid abdomen + bowel in chest on X-ray.
, Delights Test Banks 3
Question 2 (RDS – SATA)
Scenario: A 30-week preterm newborn has worsening retractions, expiratory
grunting, and oxygen saturation of 80% on 40% FiO₂. Which interventions does
the nurse anticipate?
Options:
A. Administer exogenous surfactant.
B. Initiate CPAP.
C. Intubate for mechanical ventilation.
D. Obtain a blood culture.
E. Give prophylactic ampicillin.
Correct Answers: A, B, C
Rationale:
• RDS is caused by surfactant deficiency (Ricci p. 648).
o A: Surfactant replacement is first-line for preterm infants.
o B: CPAP prevents alveolar collapse.
o C: Intubation if FiO₂ >40% fails.
• Why Not D/E?:
o D/E: Sepsis workup is not urgent unless maternal risk factors
exist.
, Delights Test Banks 4
Question 3 (Meconium Aspiration – NGN Bowtie)
Scenario: A newborn delivered through thick meconium-stained fluid has
labored breathing and cyanosis.
Priority Actions Rationale
1. Intubate & suction Removes meconium from trachea (Ricci p. 650).
2. Start antibiotics High risk for secondary pneumonia.
3. Monitor for PPHN Meconium can cause pulmonary hypertension.
Incorrect Actions:
• Give albuterol (no role in MAS).
• Delay suctioning until HR stabilizes (airway takes priority).
Transient Tachypnea of the Newborn (TTN) – Questions 4-15
Question 4
Scenario: A term newborn born via cesarean section at 38 weeks has
respiratory rate of 70 breaths/min, mild retractions, and oxygen saturation of
93% on room air. The nurse suspects TTN. Which finding on the chest X-
ray would confirm this diagnosis?
"High-Yield NCLEX Test Bank: Newborn Complications
(Maternal Nursing) | 250+ NGN Questions & Detailed
Rationales"
Master NCLEX-RN Newborn Complications with NGN-Style Questions and Clinical
Scenarios
, Delights Test Banks 2
Question 1 (TTN – MCQ)
Scenario: A term newborn delivered via elective C-section develops tachypnea
(68 breaths/min) and intermittent grunting at 1 hour of life. Oxygen saturation
is 92% on room air. The chest X-ray shows "wet lungs" with fluid in the
fissures. What is the most likely diagnosis?
Options:
A. Respiratory distress syndrome (RDS)
B. Transient tachypnea of the newborn (TTN)
C. Pneumonia
D. Congenital diaphragmatic hernia
Correct Answer: B (TTN)
Rationale:
• TTN is caused by delayed clearance of fetal lung fluid, common in C-
section babies (no "thoracic squeeze" during vaginal delivery) (Ricci p.
645).
• Key Clues:
o Mild hypoxia (SaO₂ >90%) vs. RDS (SaO₂ often <85%).
o "Wet lung" on X-ray (diffuse infiltrates, fluid in fissures).
• Why Not Others?:
o A (RDS): Preterm infants + "ground glass" X-ray.
o C (Pneumonia): Requires maternal fever/chorioamnionitis.
o D (CDH): Scaphoid abdomen + bowel in chest on X-ray.
, Delights Test Banks 3
Question 2 (RDS – SATA)
Scenario: A 30-week preterm newborn has worsening retractions, expiratory
grunting, and oxygen saturation of 80% on 40% FiO₂. Which interventions does
the nurse anticipate?
Options:
A. Administer exogenous surfactant.
B. Initiate CPAP.
C. Intubate for mechanical ventilation.
D. Obtain a blood culture.
E. Give prophylactic ampicillin.
Correct Answers: A, B, C
Rationale:
• RDS is caused by surfactant deficiency (Ricci p. 648).
o A: Surfactant replacement is first-line for preterm infants.
o B: CPAP prevents alveolar collapse.
o C: Intubation if FiO₂ >40% fails.
• Why Not D/E?:
o D/E: Sepsis workup is not urgent unless maternal risk factors
exist.
, Delights Test Banks 4
Question 3 (Meconium Aspiration – NGN Bowtie)
Scenario: A newborn delivered through thick meconium-stained fluid has
labored breathing and cyanosis.
Priority Actions Rationale
1. Intubate & suction Removes meconium from trachea (Ricci p. 650).
2. Start antibiotics High risk for secondary pneumonia.
3. Monitor for PPHN Meconium can cause pulmonary hypertension.
Incorrect Actions:
• Give albuterol (no role in MAS).
• Delay suctioning until HR stabilizes (airway takes priority).
Transient Tachypnea of the Newborn (TTN) – Questions 4-15
Question 4
Scenario: A term newborn born via cesarean section at 38 weeks has
respiratory rate of 70 breaths/min, mild retractions, and oxygen saturation of
93% on room air. The nurse suspects TTN. Which finding on the chest X-
ray would confirm this diagnosis?
