Maternal & Newborn
NCLEX® practice.

Free practice set · 2 questions

2 more free maternal & newborn NCLEX-RN® practice questions

Real questions from the same bank the app serves. Pick an answer in your head, then open the rationale to see why the correct option holds and why each other option falls short. No account needed for these.

1. Question 1 of 2 · Newborn & Early Infancy Care

   A 78-year-old man presents to the emergency department after falling twice this month. His wife reports 3 days of fluctuating confusion and 6% unintentional weight loss in 6 months. He is independent with bathing, dressing, eating, toileting, transfers, and continence, but needs help cooking, finances, transportation, and organizing medications. His Mini-Cog is 2/5, GDS is negative, MNA indicates risk, and he fears falling. Medications include diphenhydramine nightly, oxybutynin, lisinopril, ibuprofen, and newly prescribed trimethoprim-sulfamethoxazole; eGFR is 42 mL/min/1.73 m². Which plan should the nurse implement?

   1. AProceed with the antibiotic plan and ask the family to manage medications without first reviewing the complete medication list or fall risk.
   2. BComplete a medication reconciliation with Beers screening, assess reversible causes of delirium, and initiate fall, nutrition, and medication-support interventions.
   3. CReassure him that confusion, falls, and weight loss commonly occur with advanced age, then continue the planned discharge teaching.
   4. DTell his wife that he cannot make health decisions, use a slower childlike speaking style, and recommend the usual adult antibiotic dose.
   Show the answer and rationale

   Correct answer: B. Complete a medication reconciliation with Beers screening, assess reversible causes of delirium, and initiate fall, nutrition, and medication-support interventions.

   Complete the medication and geriatric assessment before discharge because this client has acute fluctuating confusion, recurrent falls, substantial weight loss, impaired screening results, and medication risks that are not explained by normal aging. The Beers Criteria support reviewing diphenhydramine and oxybutynin for anticholinergic harm, while renal function requires the health care provider or pharmacist to evaluate dosing of renally cleared drugs. AGS fall-prevention guidance supports a multifactorial fall assessment and tailored prevention, including exercise and environmental changes. Address nutrition, sleep, cognition, medication support, caregiver capacity, social isolation, and advance-care planning rather than postponing them.

   A. Proceed with the antibiotic plan and ask the family to manage medications without first reviewing the complete medication list or fall risk.

   Starting or continuing treatment without a complete reconciliation misses potentially inappropriate medications and interactions. Diphenhydramine and oxybutynin can worsen anticholinergic effects, cognition, and falls, and renal function may require dosing evaluation. The nurse should review the list and communicate concerns before discharge rather than treating polypharmacy as a secondary issue.

   B. Complete a medication reconciliation with Beers screening, assess reversible causes of delirium, and initiate fall, nutrition, and medication-support interventions.

   This action integrates the acute change with the medication list and geriatric screening results. Fluctuating confusion suggests delirium requiring assessment for infection, adverse drug effects, or other illness; it should not be labeled normal aging. Beers screening, fall prevention, nutrition support, and medication assistance address modifiable risks while preserving the client's independence and capacity until assessed.

   C. Reassure him that confusion, falls, and weight loss commonly occur with advanced age, then continue the planned discharge teaching.

   New fluctuating confusion, repeated falls, and rapid weight loss are pathologic warning signs, not expected aging changes. This response delays assessment for delirium, infection, medication adverse effects, and systemic disease. It also fails to address a reported fall risk and nutritional decline, violating the need for prompt, individualized geriatric intervention.

   D. Tell his wife that he cannot make health decisions, use a slower childlike speaking style, and recommend the usual adult antibiotic dose.

   An intact older adult is addressed directly and presumed capable until capacity is assessed; elderspeak and automatic transfer of decisions to family are ageist. Standard middle-adult dosing is unsafe when renal clearance is reduced, so dosing must be evaluated using renal function. This option also omits the needed fall assessment and intervention.

2. Question 2 of 2 · Antepartum, Intrapartum & Postpartum Care

   A client at 39 weeks of gestation is in active labor with an oxytocin infusion running. The fetal monitor shows a baseline heart rate of 145 beats/min with minimal variability and late decelerations occurring after 60% of contractions over the past 20 minutes. The nurse recognizes this tracing as which of the following?

   1. AA Category III pattern requiring immediate intervention
   2. BAn expected finding from normal contraction frequency during active labor
   3. CA sign of maternal infection requiring a temperature check before any other action
   4. DA reassuring Category I pattern showing the fetus is tolerating labor well
   Show the answer and rationale

   Correct answer: A. A Category III pattern requiring immediate intervention

   Recognizing the category of a fetal heart rate tracing is the first step before deciding how to intervene. A baseline of 145 with minimal variability and recurrent late decelerations after more than half of contractions meets the criteria for a Category III tracing, which signals fetal hypoxia and impaired placental perfusion and is treated as an obstetric emergency. Minimal variability plus recurrent late decelerations is never reassuring, no matter how the contractions are progressing. Option D mislabels this pattern as Category I, missing the red flag entirely. Option B confuses uterine activity with fetal status; contraction frequency does not determine FHR category and cannot make an abnormal tracing "expected." Option C shifts focus to a maternal temperature check, which addresses a different concern (infection) and is irrelevant to classifying the fetal heart rate pattern itself; this delays recognition of the true emergency. Correctly identifying the tracing as Category III is the essential recognition step that must occur before any action such as repositioning or adjusting the oxytocin can be selected.

   A. A Category III pattern requiring immediate intervention

   Minimal variability combined with late decelerations after most contractions meets Category III criteria, the classification denoting probable fetal acid-base abnormality and requiring urgent recognition before any intervention is chosen.

   B. An expected finding from normal contraction frequency during active labor

   This option wrongly equates strong labor progress with fetal well-being; contraction pattern alone does not classify FHR status, and calling the tracing expected ignores the abnormal deceleration pattern.

   C. A sign of maternal infection requiring a temperature check before any other action

   This choice substitutes an unrelated maternal infection concern for fetal heart rate classification, which is irrelevant to recognizing the emergency pattern currently present on the monitor.

   D. A reassuring Category I pattern showing the fetus is tolerating labor well

   This choice mistakes an ominous pattern for reassuring, missing the defining red flag of minimal variability with recurrent late decelerations that rules out a Category I label.