NUR 2513 Maternal Child Nursing Study Guide 2026 – OB
& Pediatrics Notes, NCLEX Prep, Pregnancy, Labor &
Delivery, Newborn Care, Pediatric Nursing Exam Questions
& Answers
Question 1: A nurse is assessing a pregnant client at 28 weeks gestation. Which finding should
the nurse report to the healthcare provider immediately?
A. Mild ankle edema at the end of the day
B. Blood pressure of 148/96 mm Hg on two readings 4 hours apart
C. Increased vaginal discharge that is clear and odorless
D. Occasional Braxton Hicks contractions
CORRECT ANSWER: B. Blood pressure of 148/96 mm Hg on two readings 4 hours apart
Rationale: A blood pressure reading of 148/96 mm Hg on two separate occasions meets the
diagnostic criteria for gestational hypertension, which requires immediate reporting and
intervention to prevent progression to preeclampsia. Mild edema, physiologic leukorrhea, and
Braxton Hicks contractions are common, benign findings in the third trimester.
Question 2: During a prenatal visit, a client at 12 weeks gestation asks about the purpose of
folic acid supplementation. Which response by the nurse is most accurate?
A. "Folic acid prevents gestational diabetes."
B. "Folic acid reduces the risk of neural tube defects in the developing fetus."
C. "Folic acid helps prevent preterm labor."
D. "Folic acid decreases nausea and vomiting in early pregnancy."
CORRECT ANSWER: B. Folic acid reduces the risk of neural tube defects in the developing
fetus.
Rationale: Folic acid supplementation before conception and during early pregnancy is critical
for proper neural tube closure, significantly reducing the risk of defects such as spina bifida and
anencephaly. It does not prevent gestational diabetes, preterm labor, or nausea.
Question 3: A nurse is teaching a pregnant client about warning signs to report during
pregnancy. Which statement by the client indicates a need for further teaching?
A. "I should call if I have a severe headache that doesn't go away."
B. "I should report any vaginal bleeding, even if it's just spotting."
C. "It's normal to have swelling in my face and hands in the morning."
D. "I need to seek help if I notice decreased fetal movement after 28 weeks."
CORRECT ANSWER: C. It's normal to have swelling in my face and hands in the morning.
Rationale: Sudden or persistent swelling of the face and hands, especially in the morning, is not
normal and may indicate preeclampsia. This requires immediate evaluation. The other
statements reflect accurate understanding of danger signs in pregnancy.
Question 4: A nurse is performing a Leopold maneuver on a client at 36 weeks gestation. The
nurse palpates a firm, round, movable part in the fundal area and a softer, irregular shape in
the suprapubic area. What fetal presentation does this indicate?
A. Breech presentation
B. Transverse lie
C. Cephalic presentation
D. Shoulder presentation
,CORRECT ANSWER: C. Cephalic presentation
Rationale: In Leopold maneuvers, a firm, round, movable part in the fundus is the fetal head,
and a softer, irregular shape in the suprapubic area is the fetal buttocks, indicating a cephalic
(vertex) presentation. Breech presentation would have the buttocks in the fundus and head in
the pelvis.
Question 5: Which assessment finding in a pregnant client at 10 weeks gestation is consistent
with a normal early pregnancy change?
A. Darkening of the areolae
B. Striae gravidarum on the abdomen
C. Linea nigra extending from pubis to umbilicus
D. Chloasma on the face
CORRECT ANSWER: A. Darkening of the areolae
Rationale: Darkening of the areolae is an early pregnancy change due to increased melanocyte-
stimulating hormone and estrogen. Striae gravidarum, linea nigra, and chloasma typically
appear later in pregnancy as the abdomen enlarges and hormone levels peak.
Question 6: A nurse is caring for a client in active labor. The fetal heart rate monitor shows
recurrent late decelerations. What is the nurse's priority action?
A. Administer oxygen via nonrebreather mask at 10 L/min
B. Increase the rate of the intravenous infusion
C. Reposition the client to a lateral position
D. Prepare for immediate cesarean birth
CORRECT ANSWER: C. Reposition the client to a lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority nursing action is
to improve placental perfusion by repositioning the client to a lateral (usually left lateral)
position to relieve pressure on the vena cava. Oxygen and IV fluids are also indicated but
repositioning is the immediate first step.
Question 7: A newborn is assessed at 1 minute of life using the Apgar score. The infant has a
heart rate of 90 beats/min, slow irregular respirations, some flexion of extremities, grimaces
to stimulation, and a pink body with blue extremities. What is the correct Apgar score?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: B. 5
Rationale: Apgar scoring: Heart rate 90 = 1 point; slow irregular respirations = 1 point; some
flexion = 1 point; grimace = 1 point; acrocyanosis (pink body, blue extremities) = 1 point. Total =
5. Scores 4-6 indicate moderate difficulty and the need for supportive care.
Question 8: A nurse is teaching a new mother about newborn cord care. Which instruction is
most appropriate?
A. "Apply antibiotic ointment to the cord stump twice daily."
B. "Keep the cord stump covered with the diaper to prevent contamination."
,C. "Clean the base of the cord with alcohol or soap and water as directed."
D. "Expect the cord stump to fall off within 24 to 48 hours."
CORRECT ANSWER: C. Clean the base of the cord with alcohol or soap and water as directed.
Rationale: Current evidence supports keeping the cord clean and dry; cleaning with alcohol or
soap and water as per facility policy helps prevent infection. Antibiotic ointment is not routinely
recommended. The diaper should be folded below the cord to promote air drying. The cord
stump typically separates in 7-14 days, not 24-48 hours.
Question 9: A 2-day-old newborn has a total bilirubin level of 14 mg/dL. The newborn is
breastfeeding well, has adequate wet diapers, and is alert. What is the nurse's best action?
A. Prepare for exchange transfusion
B. Initiate phototherapy immediately
C. Encourage frequent breastfeeding and monitor bilirubin trends
D. Supplement with formula to increase caloric intake
CORRECT ANSWER: C. Encourage frequent breastfeeding and monitor bilirubin trends
Rationale: For a healthy, term, breastfeeding newborn at 48 hours with bilirubin of 14 mg/dL
and no risk factors, the preferred management is to support effective breastfeeding (8-12
times/24 hours) to promote bilirubin excretion and monitor levels. Phototherapy thresholds
vary by age in hours and risk factors; 14 mg/dL at 48 hours may be below the treatment
threshold for a low-risk infant.
Question 10: A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone should the infant have achieved?
A. Walking with assistance
B. Pincer grasp
C. Rolling from back to abdomen
D. Saying two meaningful words
CORRECT ANSWER: C. Rolling from back to abdomen
Rationale: By 6 months, most infants can roll from back to abdomen and abdomen to back.
Walking with assistance typically occurs around 9-12 months; pincer grasp develops around 9-
10 months; saying two meaningful words usually occurs around 12 months.
Question 11: A pregnant client with gestational diabetes is being taught about dietary
management. Which statement by the client indicates understanding?
A. "I should avoid all carbohydrates to keep my blood sugar low."
B. "I will eat three large meals and avoid snacks to prevent hyperglycemia."
C. "I need to distribute my carbohydrate intake evenly throughout the day."
D. "I can skip breakfast because my blood sugar is usually lowest in the morning."
CORRECT ANSWER: C. I need to distribute my carbohydrate intake evenly throughout the day.
Rationale: Consistent, balanced carbohydrate intake spread across three meals and 2-4 snacks
helps maintain stable blood glucose levels in gestational diabetes. Eliminating carbohydrates is
unsafe; small, frequent meals are preferred over three large ones; breakfast should not be
skipped due to dawn phenomenon and insulin resistance patterns.
Question 12: A nurse is caring for a postpartum client who had a cesarean birth 24 hours ago.
Which assessment finding requires immediate intervention?
, A. Moderate lochia rubra with small clots
B. Temperature of 100.4°F (38°C)
C. Absent bowel sounds in all quadrants
D. Pain rated 6/10 at the incision site
CORRECT ANSWER: C. Absent bowel sounds in all quadrants
Rationale: Absent bowel sounds 24 hours after cesarean birth may indicate paralytic ileus, a
potential postoperative complication requiring assessment and intervention. Moderate lochia,
low-grade fever within first 24 hours, and expected incisional pain are common findings and do
not require immediate action.
Question 13: A nurse is preparing to administer vitamin K to a newborn. The parent asks why
this injection is necessary. Which response is most accurate?
A. "Vitamin K prevents bleeding disorders because newborns have low levels at birth."
B. "Vitamin K helps the baby's liver mature faster."
C. "Vitamin K reduces the risk of jaundice in the first week of life."
D. "Vitamin K boosts the newborn's immune system."
CORRECT ANSWER: A. Vitamin K prevents bleeding disorders because newborns have low
levels at birth.
Rationale: Newborns are born with physiologically low vitamin K stores, which is essential for
synthesis of clotting factors II, VII, IX, and X. Prophylactic vitamin K administration prevents
vitamin K deficiency bleeding (VKDB), a potentially life-threatening condition. It does not
accelerate liver maturation, prevent jaundice, or enhance immunity.
Question 14: A 4-year-old child is admitted with suspected epiglottitis. Which action should
the nurse avoid?
A. Keeping the child in a sitting position
B. Providing humidified oxygen
C. Attempting to visualize the throat with a tongue depressor
D. Preparing for possible intubation
CORRECT ANSWER: C. Attempting to visualize the throat with a tongue depressor
Rationale: Manipulation of the airway (e.g., using a tongue depressor) in a child with suspected
epiglottitis can trigger laryngospasm and complete airway obstruction. The child should be kept
calm, in a position of comfort (often sitting upright), with humidified oxygen, and the team
should prepare for advanced airway management in a controlled setting.
Question 15: A nurse is teaching a pregnant client about the signs of preterm labor. Which
symptom should the client be instructed to report immediately?
A. Mild lower backache that resolves with rest
B. Regular uterine contractions every 10 minutes for one hour
C. Increased fetal movement after a meal
D. Mild pelvic pressure that occurs with walking
CORRECT ANSWER: B. Regular uterine contractions every 10 minutes for one hour
Rationale: Regular uterine contractions (e.g., every 10 minutes or more frequently) lasting for
an hour or more, especially before 37 weeks, are a key sign of preterm labor and require
immediate evaluation. Mild backache, pelvic pressure, or increased fetal movement are
& Pediatrics Notes, NCLEX Prep, Pregnancy, Labor &
Delivery, Newborn Care, Pediatric Nursing Exam Questions
& Answers
Question 1: A nurse is assessing a pregnant client at 28 weeks gestation. Which finding should
the nurse report to the healthcare provider immediately?
A. Mild ankle edema at the end of the day
B. Blood pressure of 148/96 mm Hg on two readings 4 hours apart
C. Increased vaginal discharge that is clear and odorless
D. Occasional Braxton Hicks contractions
CORRECT ANSWER: B. Blood pressure of 148/96 mm Hg on two readings 4 hours apart
Rationale: A blood pressure reading of 148/96 mm Hg on two separate occasions meets the
diagnostic criteria for gestational hypertension, which requires immediate reporting and
intervention to prevent progression to preeclampsia. Mild edema, physiologic leukorrhea, and
Braxton Hicks contractions are common, benign findings in the third trimester.
Question 2: During a prenatal visit, a client at 12 weeks gestation asks about the purpose of
folic acid supplementation. Which response by the nurse is most accurate?
A. "Folic acid prevents gestational diabetes."
B. "Folic acid reduces the risk of neural tube defects in the developing fetus."
C. "Folic acid helps prevent preterm labor."
D. "Folic acid decreases nausea and vomiting in early pregnancy."
CORRECT ANSWER: B. Folic acid reduces the risk of neural tube defects in the developing
fetus.
Rationale: Folic acid supplementation before conception and during early pregnancy is critical
for proper neural tube closure, significantly reducing the risk of defects such as spina bifida and
anencephaly. It does not prevent gestational diabetes, preterm labor, or nausea.
Question 3: A nurse is teaching a pregnant client about warning signs to report during
pregnancy. Which statement by the client indicates a need for further teaching?
A. "I should call if I have a severe headache that doesn't go away."
B. "I should report any vaginal bleeding, even if it's just spotting."
C. "It's normal to have swelling in my face and hands in the morning."
D. "I need to seek help if I notice decreased fetal movement after 28 weeks."
CORRECT ANSWER: C. It's normal to have swelling in my face and hands in the morning.
Rationale: Sudden or persistent swelling of the face and hands, especially in the morning, is not
normal and may indicate preeclampsia. This requires immediate evaluation. The other
statements reflect accurate understanding of danger signs in pregnancy.
Question 4: A nurse is performing a Leopold maneuver on a client at 36 weeks gestation. The
nurse palpates a firm, round, movable part in the fundal area and a softer, irregular shape in
the suprapubic area. What fetal presentation does this indicate?
A. Breech presentation
B. Transverse lie
C. Cephalic presentation
D. Shoulder presentation
,CORRECT ANSWER: C. Cephalic presentation
Rationale: In Leopold maneuvers, a firm, round, movable part in the fundus is the fetal head,
and a softer, irregular shape in the suprapubic area is the fetal buttocks, indicating a cephalic
(vertex) presentation. Breech presentation would have the buttocks in the fundus and head in
the pelvis.
Question 5: Which assessment finding in a pregnant client at 10 weeks gestation is consistent
with a normal early pregnancy change?
A. Darkening of the areolae
B. Striae gravidarum on the abdomen
C. Linea nigra extending from pubis to umbilicus
D. Chloasma on the face
CORRECT ANSWER: A. Darkening of the areolae
Rationale: Darkening of the areolae is an early pregnancy change due to increased melanocyte-
stimulating hormone and estrogen. Striae gravidarum, linea nigra, and chloasma typically
appear later in pregnancy as the abdomen enlarges and hormone levels peak.
Question 6: A nurse is caring for a client in active labor. The fetal heart rate monitor shows
recurrent late decelerations. What is the nurse's priority action?
A. Administer oxygen via nonrebreather mask at 10 L/min
B. Increase the rate of the intravenous infusion
C. Reposition the client to a lateral position
D. Prepare for immediate cesarean birth
CORRECT ANSWER: C. Reposition the client to a lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority nursing action is
to improve placental perfusion by repositioning the client to a lateral (usually left lateral)
position to relieve pressure on the vena cava. Oxygen and IV fluids are also indicated but
repositioning is the immediate first step.
Question 7: A newborn is assessed at 1 minute of life using the Apgar score. The infant has a
heart rate of 90 beats/min, slow irregular respirations, some flexion of extremities, grimaces
to stimulation, and a pink body with blue extremities. What is the correct Apgar score?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: B. 5
Rationale: Apgar scoring: Heart rate 90 = 1 point; slow irregular respirations = 1 point; some
flexion = 1 point; grimace = 1 point; acrocyanosis (pink body, blue extremities) = 1 point. Total =
5. Scores 4-6 indicate moderate difficulty and the need for supportive care.
Question 8: A nurse is teaching a new mother about newborn cord care. Which instruction is
most appropriate?
A. "Apply antibiotic ointment to the cord stump twice daily."
B. "Keep the cord stump covered with the diaper to prevent contamination."
,C. "Clean the base of the cord with alcohol or soap and water as directed."
D. "Expect the cord stump to fall off within 24 to 48 hours."
CORRECT ANSWER: C. Clean the base of the cord with alcohol or soap and water as directed.
Rationale: Current evidence supports keeping the cord clean and dry; cleaning with alcohol or
soap and water as per facility policy helps prevent infection. Antibiotic ointment is not routinely
recommended. The diaper should be folded below the cord to promote air drying. The cord
stump typically separates in 7-14 days, not 24-48 hours.
Question 9: A 2-day-old newborn has a total bilirubin level of 14 mg/dL. The newborn is
breastfeeding well, has adequate wet diapers, and is alert. What is the nurse's best action?
A. Prepare for exchange transfusion
B. Initiate phototherapy immediately
C. Encourage frequent breastfeeding and monitor bilirubin trends
D. Supplement with formula to increase caloric intake
CORRECT ANSWER: C. Encourage frequent breastfeeding and monitor bilirubin trends
Rationale: For a healthy, term, breastfeeding newborn at 48 hours with bilirubin of 14 mg/dL
and no risk factors, the preferred management is to support effective breastfeeding (8-12
times/24 hours) to promote bilirubin excretion and monitor levels. Phototherapy thresholds
vary by age in hours and risk factors; 14 mg/dL at 48 hours may be below the treatment
threshold for a low-risk infant.
Question 10: A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone should the infant have achieved?
A. Walking with assistance
B. Pincer grasp
C. Rolling from back to abdomen
D. Saying two meaningful words
CORRECT ANSWER: C. Rolling from back to abdomen
Rationale: By 6 months, most infants can roll from back to abdomen and abdomen to back.
Walking with assistance typically occurs around 9-12 months; pincer grasp develops around 9-
10 months; saying two meaningful words usually occurs around 12 months.
Question 11: A pregnant client with gestational diabetes is being taught about dietary
management. Which statement by the client indicates understanding?
A. "I should avoid all carbohydrates to keep my blood sugar low."
B. "I will eat three large meals and avoid snacks to prevent hyperglycemia."
C. "I need to distribute my carbohydrate intake evenly throughout the day."
D. "I can skip breakfast because my blood sugar is usually lowest in the morning."
CORRECT ANSWER: C. I need to distribute my carbohydrate intake evenly throughout the day.
Rationale: Consistent, balanced carbohydrate intake spread across three meals and 2-4 snacks
helps maintain stable blood glucose levels in gestational diabetes. Eliminating carbohydrates is
unsafe; small, frequent meals are preferred over three large ones; breakfast should not be
skipped due to dawn phenomenon and insulin resistance patterns.
Question 12: A nurse is caring for a postpartum client who had a cesarean birth 24 hours ago.
Which assessment finding requires immediate intervention?
, A. Moderate lochia rubra with small clots
B. Temperature of 100.4°F (38°C)
C. Absent bowel sounds in all quadrants
D. Pain rated 6/10 at the incision site
CORRECT ANSWER: C. Absent bowel sounds in all quadrants
Rationale: Absent bowel sounds 24 hours after cesarean birth may indicate paralytic ileus, a
potential postoperative complication requiring assessment and intervention. Moderate lochia,
low-grade fever within first 24 hours, and expected incisional pain are common findings and do
not require immediate action.
Question 13: A nurse is preparing to administer vitamin K to a newborn. The parent asks why
this injection is necessary. Which response is most accurate?
A. "Vitamin K prevents bleeding disorders because newborns have low levels at birth."
B. "Vitamin K helps the baby's liver mature faster."
C. "Vitamin K reduces the risk of jaundice in the first week of life."
D. "Vitamin K boosts the newborn's immune system."
CORRECT ANSWER: A. Vitamin K prevents bleeding disorders because newborns have low
levels at birth.
Rationale: Newborns are born with physiologically low vitamin K stores, which is essential for
synthesis of clotting factors II, VII, IX, and X. Prophylactic vitamin K administration prevents
vitamin K deficiency bleeding (VKDB), a potentially life-threatening condition. It does not
accelerate liver maturation, prevent jaundice, or enhance immunity.
Question 14: A 4-year-old child is admitted with suspected epiglottitis. Which action should
the nurse avoid?
A. Keeping the child in a sitting position
B. Providing humidified oxygen
C. Attempting to visualize the throat with a tongue depressor
D. Preparing for possible intubation
CORRECT ANSWER: C. Attempting to visualize the throat with a tongue depressor
Rationale: Manipulation of the airway (e.g., using a tongue depressor) in a child with suspected
epiglottitis can trigger laryngospasm and complete airway obstruction. The child should be kept
calm, in a position of comfort (often sitting upright), with humidified oxygen, and the team
should prepare for advanced airway management in a controlled setting.
Question 15: A nurse is teaching a pregnant client about the signs of preterm labor. Which
symptom should the client be instructed to report immediately?
A. Mild lower backache that resolves with rest
B. Regular uterine contractions every 10 minutes for one hour
C. Increased fetal movement after a meal
D. Mild pelvic pressure that occurs with walking
CORRECT ANSWER: B. Regular uterine contractions every 10 minutes for one hour
Rationale: Regular uterine contractions (e.g., every 10 minutes or more frequently) lasting for
an hour or more, especially before 37 weeks, are a key sign of preterm labor and require
immediate evaluation. Mild backache, pelvic pressure, or increased fetal movement are
