CPNRE - Canadian Practical Nurse Registration Examination Maternal and Newborn Care Questions and Answers

Question 1

A practical nurse is assessing a newborn who is 12 hours old. Which of the following findings requires immediate intervention?

Accepted Answer

Nasal flaring and sternal retractions

Answer

Nasal flaring and sternal retractions are signs of respiratory distress in a newborn and require immediate notification of the registered nurse or primary care provider. Acrocyanosis is common in the first 24-48 hours. A respiratory rate of 30-60 breaths per minute is normal. Passing meconium is an expected finding.

Question 2

A new mother who is 2 days postpartum tells the practical nurse she is concerned because her breasts have become hard, warm, and tender. Which of the following is the most appropriate response by the nurse?

Accepted Answer

"This is likely breast engorgement, which is common. Applying cold packs after feeding can help."

Answer

The symptoms described are characteristic of primary breast engorgement, which occurs as the milk comes in around day 2-5 postpartum. Management includes frequent breastfeeding, ensuring proper latch, applying cold compresses between feedings to reduce swelling, and warm compresses before feeding to facilitate milk flow. Stopping breastfeeding or limiting feedings would worsen the condition. Engorgement indicates a robust milk supply, not a low one.

Question 3

The practical nurse is reinforcing teaching with a new mother about umbilical cord care. Which statement by the mother indicates a need for further education?

Accepted Answer

"I should cover the cord with the diaper to keep it protected."

Answer

To promote drying and prevent infection, the diaper should be folded down, below the umbilical cord stump, to keep it exposed to air and free from urine contamination. Cleaning with water if soiled, expecting it to fall off in 1-2 weeks, and monitoring for signs of infection are all correct practices.

Question 4

A practical nurse is performing a postpartum assessment on a client who delivered vaginally 8 hours ago. The fundus is firm, located 2 cm above the umbilicus, and deviated to the right. What is the priority nursing action?

Accepted Answer

Assist the client to empty her bladder.

Answer

A fundus that is deviated to the side (usually the right) and positioned above the umbilicus is most often indicative of a full bladder. A full bladder can impede uterine contraction and increase the risk of postpartum hemorrhage. The priority action is to assist the client to void. The fundus is already firm, so vigorous massage is not the priority. While the finding needs documentation, it requires an intervention first.

Question 5

Which of the following is a key component of family-centred maternity care in Canada?

Accepted Answer

Involving the family in decision-making and respecting their choices.

Answer

Family-centred care, a guiding principle in Canada, emphasizes a collaborative approach where the woman and her family are integral to the decision-making process. It respects their values and choices and encourages participation in care. Restricting visitors or making decisions for the family contradicts this philosophy.

CPNRE - Canadian Practical Nurse Registration Examination Practice Test

CPNRE - Canadian Practical Nurse Registration Examination Practice Test

CPNRE - Canadian Practical Nurse Registration Examination Maternal and Newborn Care Questions and Answers