A mother is Rh-negative, and her fetus is Rh-positive. She delivered her first Rh-positive baby without receiving Rho(D) immune globulin. Which complication may occur in a future pregnancy if sensitization has occurred?

Neonatal hypoglycemia

Miscarriage

Fetal macrosomia

Placenta previa

Answer and Explanation

The Correct Answer is B

A. Hypoglycemia in newborns is generally caused by maternal diabetes, preterm birth, intrauterine growth restriction, or perinatal stress. It occurs because the newborn produces excess insulin or has limited glycogen stores. Rh sensitization does not affect glucose metabolism, so neonatal hypoglycemia is unrelated to maternal Rh status.

B. If an Rh-negative mother becomes sensitized after delivering an Rh-positive infant without receiving Rho(D) immune globulin, she can form anti-Rh antibodies. In a future pregnancy with an Rh-positive fetus, these antibodies can cross the placenta and destroy fetal red blood cells, causing hemolytic disease of the newborn (HDN). Severe HDN may lead to fetal anemia, hydrops fetalis, or miscarriage/stillbirth if left untreated.

C. Macrosomia, defined as birth weight >4,000–4,500 g, is typically associated with maternal diabetes, maternal obesity, or genetic predisposition. Rh incompatibility does not influence fetal growth or increase the risk of macrosomia, so it is not a concern in sensitized mothers.

D. Placenta previa occurs when the placenta partially or completely covers the cervical os, which can cause bleeding during pregnancy. Its risk factors include previous cesarean delivery, uterine surgery, multiple gestations, or advanced maternal age, but Rh sensitization has no effect on placental location, so it is unrelated.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Tonsils are part of the lymphatic system, which is most active in early childhood to help the body respond to infections and build immunity. It is common for tonsils to appear large in healthy children between ages 3 and 6. This is a normal physiological finding and usually does not indicate illness unless accompanied by symptoms such as fever, difficulty breathing, or recurrent infections.

B. While significantly enlarged tonsils causing airway obstruction, sleep apnea, or recurrent infections may require evaluation, tonsillar enlargement alone in an otherwise healthy child is typically normal and does not require urgent referral.

C. Enlarged tonsils in this age group indicate a normally active immune system, not underdevelopment. They help the body recognize and respond to antigens, supporting healthy immune function.

D. Chronic or acute infections may cause tonsillar enlargement, but in the absence of symptoms such as fever, redness, or exudate, there is no evidence of infection, and antibiotics are not indicated.

A. Numeric Rating Scale (0-10) B. FLACC scale C. Visual Analog Scale D. Oucher Pain Scale

Correct Answer is D

Explanation

A. This scale requires the child to understand numbers and quantify pain. A 5-year-old who has difficulty with numbers cannot reliably use this scale, making it inappropriate.

B. While FLACC is excellent for observational assessment of nonverbal or pre-verbal children, it does not allow the child to self-report pain. Since the nurse wants the child to self-report, this is not the best choice.

C. This scale requires the child to mark a point on a line representing their pain intensity. It also requires abstract thinking and fine motor skills, which may be challenging for a 5-year-old, especially if they can’t reliably understand numbers or gradients.

D. The Oucher scale uses pictures of faces showing increasing pain intensity along with a numeric scale. For children who understand pictures but struggle with numbers, this scale allows them to self-report pain by pointing to the face that matches their discomfort. It is validated for children aged 3–12 years, making it the most appropriate choice for a 5-year-old who can use pictorial cues.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A mother is Rh-negative, and her fetus is Rh-positive. She delivered her first Rh-positive baby without receiving Rho(D) immune globulin. Which complication may occur in a future pregnancy if sensitization has occurred?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a routine checkup, a nurse observes that a 4-year-old child has noticeably enlarged tonsils but is otherwise healthy with no signs of infection. The child's parents express concern. Which statement BEST explains this finding?

Correct Answer is A

Explanation

A 5-year-old child is scheduled for a vaccination. The nurse wants the child to self-report pain. The child can understand pictures but has difficulty with numbers. Which pain assessment tool is MOST appropriate?

Correct Answer is D

Explanation

A woman who is 32 weeks pregnant presents to the clinic. The nurse suspects preeclampsia. Which of the following findings support this diagnosis? (Select All that Apply.)

A nurse in the emergency department is assessing a 4-month-old infant who has suspected pertussis. Which of the following findings should the nurse identify as consistent with this diagnosis? (Select all that apply.)

A nurse is caring for a toddler who is hospitalized with respiratory syncytial virus (RSV). Which of the following nursing interventions is the priority?

A mother is Rh-negative, and her fetus is Rh-positive. She delivered her first Rh-positive baby without receiving Rho(D) immune globulin. Which complication may occur in a future pregnancy if sensitization has occurred?

A pregnant client completes the 1-hour glucose tolerance test (GTT) at 26 weeks' gestation. The nurse explains that if the blood glucose result is above ____ to ____mg/dL. It is considered a positive screening and the client will need a 3-hour oral glucose tolerance test.