MCKINNEY EVOLVE RESOURCES FOR
MATERNAL CHILD NURSING 5 2026 MATERNAL
NEWBORN ASSESSMENT TEST PAPER
QUESTIONS SOLUTIONS GRADED A+
◉ A student nurse is trying to assess vital signs on a laboring
woman. Which statement by the
registered nurse is the best rationale for assessing maternal vital
signs between contractions?
A. During a contraction, assessing fetal heart rates is the priority.
B. Maternal circulating blood volume increases temporarily during
contractions.
C. Maternal blood flow to the heart is reduced during contractions.
D. Vital signs taken during contractions are not accurate.
Answer: ANS: B
During uterine contractions, blood flow to the placenta temporarily
stops, causing a relative
increase in the mother's blood volume, which in turn temporarily
increases blood pressure and
slows pulse. It is important to monitor fetal response to
contractions, but the question is
concerned with the maternal vital signs so assessing the fetal heart
rate is not the priority. Vital
,signs are altered by contractions but are considered accurate for
that period of time. However,
they do not reflect the woman's baseline.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 289 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance
◉ Which mechanism of labor occurs when the largest diameter of
the fetal presenting part
passes the pelvic inlet?
a. Engagement
b. Extension
c. Internal rotation
d. External rotation
Answer: ANS. A
Engagement occurs when the presenting part fully enters the pelvic
inlet. Extension occurs
when the fetal head meets resistance from the tissues of the pelvic
floor and the fetal neck
stops under the symphysis. This causes the fetal head to extend.
Internal rotation occurs when
the fetus enters the pelvic inlet. The rotation allows the longest fetal
head diameter to
,conform to the longest diameter of the maternal pelvis. External
rotation occurs after the birth
of the head. The head then turns to the side so the shoulders can
internally rotate and are
positioned with their transverse diameter in the anteroposterior
diameter of the pelvic outlet.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 299 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Main
◉ To adequately care for patients, the nurse understands that labor
contractions facilitate
cervical dilation by
a. contracting the lower uterine segment.
b. enlarging the internal size of the uterus.
c. promoting blood flow to the cervix.
d. pulling the cervix over the fetus and amniotic sac.
Answer: ANS: D
Effective uterine contractions pull the cervix upward at the same
time that the fetus and
amniotic sac are pushed downward. The contractions are stronger at
the fundus. The internal
size becomes smaller with the contractions; this helps to push the
fetus down. Blood flow
, decreases to the uterus during a contraction.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 290 OBJ: Nursing Process: Asse
◉ A student asks how pregnant women can usually tolerate the
normal blood loss associated
with childbirth. Which response by the nurse is best? "It is because
they have
a. a higher hematocrit."
b. increased blood volume."
c. a lower fibrinogen level."
d. increased leukocytes."
Answer: ANS: B
Women have a significant increase in blood volume during
pregnancy, which allows them to
tolerate the normal blood loss seen in delivery. The hematocrit
decreases with pregnancy due
to the high fluid volume. Fibrinogen levels increase with pregnancy.
Leukocyte levels
increase during labor, but that is not the reason for the toleration of
blood loss.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 290 OBJ: Integrated Process: Teaching-Learning
MATERNAL CHILD NURSING 5 2026 MATERNAL
NEWBORN ASSESSMENT TEST PAPER
QUESTIONS SOLUTIONS GRADED A+
◉ A student nurse is trying to assess vital signs on a laboring
woman. Which statement by the
registered nurse is the best rationale for assessing maternal vital
signs between contractions?
A. During a contraction, assessing fetal heart rates is the priority.
B. Maternal circulating blood volume increases temporarily during
contractions.
C. Maternal blood flow to the heart is reduced during contractions.
D. Vital signs taken during contractions are not accurate.
Answer: ANS: B
During uterine contractions, blood flow to the placenta temporarily
stops, causing a relative
increase in the mother's blood volume, which in turn temporarily
increases blood pressure and
slows pulse. It is important to monitor fetal response to
contractions, but the question is
concerned with the maternal vital signs so assessing the fetal heart
rate is not the priority. Vital
,signs are altered by contractions but are considered accurate for
that period of time. However,
they do not reflect the woman's baseline.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 289 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance
◉ Which mechanism of labor occurs when the largest diameter of
the fetal presenting part
passes the pelvic inlet?
a. Engagement
b. Extension
c. Internal rotation
d. External rotation
Answer: ANS. A
Engagement occurs when the presenting part fully enters the pelvic
inlet. Extension occurs
when the fetal head meets resistance from the tissues of the pelvic
floor and the fetal neck
stops under the symphysis. This causes the fetal head to extend.
Internal rotation occurs when
the fetus enters the pelvic inlet. The rotation allows the longest fetal
head diameter to
,conform to the longest diameter of the maternal pelvis. External
rotation occurs after the birth
of the head. The head then turns to the side so the shoulders can
internally rotate and are
positioned with their transverse diameter in the anteroposterior
diameter of the pelvic outlet.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 299 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Main
◉ To adequately care for patients, the nurse understands that labor
contractions facilitate
cervical dilation by
a. contracting the lower uterine segment.
b. enlarging the internal size of the uterus.
c. promoting blood flow to the cervix.
d. pulling the cervix over the fetus and amniotic sac.
Answer: ANS: D
Effective uterine contractions pull the cervix upward at the same
time that the fetus and
amniotic sac are pushed downward. The contractions are stronger at
the fundus. The internal
size becomes smaller with the contractions; this helps to push the
fetus down. Blood flow
, decreases to the uterus during a contraction.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 290 OBJ: Nursing Process: Asse
◉ A student asks how pregnant women can usually tolerate the
normal blood loss associated
with childbirth. Which response by the nurse is best? "It is because
they have
a. a higher hematocrit."
b. increased blood volume."
c. a lower fibrinogen level."
d. increased leukocytes."
Answer: ANS: B
Women have a significant increase in blood volume during
pregnancy, which allows them to
tolerate the normal blood loss seen in delivery. The hematocrit
decreases with pregnancy due
to the high fluid volume. Fibrinogen levels increase with pregnancy.
Leukocyte levels
increase during labor, but that is not the reason for the toleration of
blood loss.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 290 OBJ: Integrated Process: Teaching-Learning
