RNC-MNN Maternal newborn nursing
certification emphasizing postpartum care,
newborn assessment, and family-centered
healthcare practices.
Question 1
A 32-year-old patient at 38 weeks gestation is admitted with a blood pressure of
158/96 mmHg and 2+ proteinuria. She reports a severe headache and epigastric
pain. Which medication should the nurse anticipate administering?
A) Magnesium sulfate
B) Labetalol
C) Nifedipine
D) Hydralazine
Rationale: The patient is exhibiting signs of severe preeclampsia with severe
features (BP ≥160/110, headache, epigastric pain, proteinuria). Labetalol is a first-
line antihypertensive for acute severe hypertension in pregnancy. While
magnesium sulfate is used for seizure prophylaxis, labetalol directly addresses the
elevated blood pressure. Hydralazine is also used but labetalol is preferred due to
its faster onset and fewer side effects.
Question 2
A patient with a history of gestational diabetes is 2 hours postpartum. The nurse
notes that the patient's blood glucose is 45 mg/dL. Which action should the nurse
take first?
A) Administer 50% dextrose IV push
B) Provide a high-carbohydrate snack
C) Recheck the blood glucose in 15 minutes
D) Notify the healthcare provider
Rationale: A blood glucose of 45 mg/dL in a postpartum patient with gestational
diabetes indicates hypoglycemia, which requires immediate correction. The
,priority is to administer 50% dextrose IV push to rapidly raise blood glucose
levels. While oral intake may be appropriate for mild hypoglycemia, IV dextrose is
the safest and fastest route in the acute setting.
Question 3
A patient at 34 weeks gestation with preterm premature rupture of membranes
(PPROM) is receiving antenatal corticosteroids. The nurse understands that the
primary purpose of this therapy is to:
A) Prevent maternal infection
B) Accelerate fetal lung maturity
C) Prolong the pregnancy
D) Reduce the risk of neonatal sepsis
Rationale: Antenatal corticosteroids (betamethasone or dexamethasone) are
administered to accelerate fetal lung maturity and reduce the risk of respiratory
distress syndrome (RDS), intraventricular hemorrhage, and neonatal mortality in
preterm infants. The medication works by stimulating surfactant production in the
fetal lungs.
Question 4
A patient at 41 weeks gestation is undergoing a biophysical profile (BPP). Which
of the following components is included in a standard BPP?
A) Nonstress test, fetal breathing, fetal movement, amniotic fluid volume, and fetal
tone
B) Nonstress test, fetal heart rate, amniotic fluid index, and maternal blood
pressure
C) Fetal breathing, fetal movement, fetal tone, placental grading, and amniotic
fluid volume
D) Nonstress test, fetal breathing, fetal movement, fetal tone, and placental grading
Rationale: A standard biophysical profile (BPP) consists of five components:
nonstress test (NST), fetal breathing movements, fetal gross body movements, fetal
tone (flexion/extension), and amniotic fluid volume. Each component is scored 0
or 2 points, with a maximum score of 10. Placental grading is not part of the BPP.
,Question 5
A patient at 28 weeks gestation with a history of preterm birth is being evaluated
for cervical insufficiency. Which finding on transvaginal ultrasound is most
concerning for preterm birth?
A) Cervical length of 35 mm
B) Cervical length of 20 mm
C) Cervical length of 40 mm
D) Cervical length of 30 mm
Rationale: A cervical length of less than 25 mm on transvaginal ultrasound
between 16 and 24 weeks gestation is associated with an increased risk of preterm
birth. A cervical length of 20 mm is significantly shortened and warrants
consideration of interventions such as cervical cerclage or progesterone therapy.
Question 6
A patient at 32 weeks gestation with placenta previa is admitted with vaginal
bleeding. Which nursing intervention is the priority?
A) Assess fetal heart rate and maternal vital signs
B) Perform a sterile vaginal examination
C) Administer tocolytic therapy
D) Prepare for immediate cesarean delivery
Rationale: The priority in a patient with placenta previa and vaginal bleeding is to
assess fetal well-being and maternal hemodynamic stability. A sterile vaginal
examination is contraindicated in placenta previa due to the risk of provoking
massive hemorrhage. Tocolytics may be considered if the patient is in labor, but
assessment is the first step.
Question 7
A patient at 20 weeks gestation is diagnosed with gestational diabetes after a 1-
hour glucose challenge test of 155 mg/dL. Which test should be performed next?
A) Hemoglobin A1c
B) 3-hour oral glucose tolerance test
C) Fasting blood glucose
D) Random blood glucose
, Rationale: A 1-hour glucose challenge test (GCT) result ≥140 mg/dL (or ≥130
mg/dL in some guidelines) indicates the need for a 3-hour oral glucose tolerance
test (OGTT) to confirm the diagnosis of gestational diabetes. The OGTT involves
fasting, then measuring blood glucose at 1, 2, and 3 hours after a 100-g glucose
load.
Question 8
A patient with a history of deep vein thrombosis is at 12 weeks gestation and is
started on prophylactic anticoagulation. Which medication is most commonly used
during pregnancy?
A) Low-molecular-weight heparin
B) Warfarin
C) Aspirin
D) Rivaroxaban
Rationale: Low-molecular-weight heparin (LMWH) is the anticoagulant of choice
during pregnancy because it does not cross the placenta and is not associated with
fetal teratogenicity. Warfarin is contraindicated due to its teratogenic effects.
Aspirin may be used for preeclampsia prevention but is not sufficient for DVT
prophylaxis in high-risk patients.
Question 9
A patient at 39 weeks gestation is diagnosed with chorioamnionitis. Which clinical
finding is most consistent with this diagnosis?
A) Maternal fever ≥100.4°F (38°C) with uterine tenderness
B) Maternal hypotension
C) Fetal heart rate decelerations only
D) Maternal hypertension
Rationale: Chorioamnionitis (intra-amniotic infection) is characterized by
maternal fever ≥100.4°F (38°C) plus at least two of the following: maternal
tachycardia, fetal tachycardia, uterine tenderness, purulent amniotic fluid, or
maternal leukocytosis. Fever is the hallmark finding.
certification emphasizing postpartum care,
newborn assessment, and family-centered
healthcare practices.
Question 1
A 32-year-old patient at 38 weeks gestation is admitted with a blood pressure of
158/96 mmHg and 2+ proteinuria. She reports a severe headache and epigastric
pain. Which medication should the nurse anticipate administering?
A) Magnesium sulfate
B) Labetalol
C) Nifedipine
D) Hydralazine
Rationale: The patient is exhibiting signs of severe preeclampsia with severe
features (BP ≥160/110, headache, epigastric pain, proteinuria). Labetalol is a first-
line antihypertensive for acute severe hypertension in pregnancy. While
magnesium sulfate is used for seizure prophylaxis, labetalol directly addresses the
elevated blood pressure. Hydralazine is also used but labetalol is preferred due to
its faster onset and fewer side effects.
Question 2
A patient with a history of gestational diabetes is 2 hours postpartum. The nurse
notes that the patient's blood glucose is 45 mg/dL. Which action should the nurse
take first?
A) Administer 50% dextrose IV push
B) Provide a high-carbohydrate snack
C) Recheck the blood glucose in 15 minutes
D) Notify the healthcare provider
Rationale: A blood glucose of 45 mg/dL in a postpartum patient with gestational
diabetes indicates hypoglycemia, which requires immediate correction. The
,priority is to administer 50% dextrose IV push to rapidly raise blood glucose
levels. While oral intake may be appropriate for mild hypoglycemia, IV dextrose is
the safest and fastest route in the acute setting.
Question 3
A patient at 34 weeks gestation with preterm premature rupture of membranes
(PPROM) is receiving antenatal corticosteroids. The nurse understands that the
primary purpose of this therapy is to:
A) Prevent maternal infection
B) Accelerate fetal lung maturity
C) Prolong the pregnancy
D) Reduce the risk of neonatal sepsis
Rationale: Antenatal corticosteroids (betamethasone or dexamethasone) are
administered to accelerate fetal lung maturity and reduce the risk of respiratory
distress syndrome (RDS), intraventricular hemorrhage, and neonatal mortality in
preterm infants. The medication works by stimulating surfactant production in the
fetal lungs.
Question 4
A patient at 41 weeks gestation is undergoing a biophysical profile (BPP). Which
of the following components is included in a standard BPP?
A) Nonstress test, fetal breathing, fetal movement, amniotic fluid volume, and fetal
tone
B) Nonstress test, fetal heart rate, amniotic fluid index, and maternal blood
pressure
C) Fetal breathing, fetal movement, fetal tone, placental grading, and amniotic
fluid volume
D) Nonstress test, fetal breathing, fetal movement, fetal tone, and placental grading
Rationale: A standard biophysical profile (BPP) consists of five components:
nonstress test (NST), fetal breathing movements, fetal gross body movements, fetal
tone (flexion/extension), and amniotic fluid volume. Each component is scored 0
or 2 points, with a maximum score of 10. Placental grading is not part of the BPP.
,Question 5
A patient at 28 weeks gestation with a history of preterm birth is being evaluated
for cervical insufficiency. Which finding on transvaginal ultrasound is most
concerning for preterm birth?
A) Cervical length of 35 mm
B) Cervical length of 20 mm
C) Cervical length of 40 mm
D) Cervical length of 30 mm
Rationale: A cervical length of less than 25 mm on transvaginal ultrasound
between 16 and 24 weeks gestation is associated with an increased risk of preterm
birth. A cervical length of 20 mm is significantly shortened and warrants
consideration of interventions such as cervical cerclage or progesterone therapy.
Question 6
A patient at 32 weeks gestation with placenta previa is admitted with vaginal
bleeding. Which nursing intervention is the priority?
A) Assess fetal heart rate and maternal vital signs
B) Perform a sterile vaginal examination
C) Administer tocolytic therapy
D) Prepare for immediate cesarean delivery
Rationale: The priority in a patient with placenta previa and vaginal bleeding is to
assess fetal well-being and maternal hemodynamic stability. A sterile vaginal
examination is contraindicated in placenta previa due to the risk of provoking
massive hemorrhage. Tocolytics may be considered if the patient is in labor, but
assessment is the first step.
Question 7
A patient at 20 weeks gestation is diagnosed with gestational diabetes after a 1-
hour glucose challenge test of 155 mg/dL. Which test should be performed next?
A) Hemoglobin A1c
B) 3-hour oral glucose tolerance test
C) Fasting blood glucose
D) Random blood glucose
, Rationale: A 1-hour glucose challenge test (GCT) result ≥140 mg/dL (or ≥130
mg/dL in some guidelines) indicates the need for a 3-hour oral glucose tolerance
test (OGTT) to confirm the diagnosis of gestational diabetes. The OGTT involves
fasting, then measuring blood glucose at 1, 2, and 3 hours after a 100-g glucose
load.
Question 8
A patient with a history of deep vein thrombosis is at 12 weeks gestation and is
started on prophylactic anticoagulation. Which medication is most commonly used
during pregnancy?
A) Low-molecular-weight heparin
B) Warfarin
C) Aspirin
D) Rivaroxaban
Rationale: Low-molecular-weight heparin (LMWH) is the anticoagulant of choice
during pregnancy because it does not cross the placenta and is not associated with
fetal teratogenicity. Warfarin is contraindicated due to its teratogenic effects.
Aspirin may be used for preeclampsia prevention but is not sufficient for DVT
prophylaxis in high-risk patients.
Question 9
A patient at 39 weeks gestation is diagnosed with chorioamnionitis. Which clinical
finding is most consistent with this diagnosis?
A) Maternal fever ≥100.4°F (38°C) with uterine tenderness
B) Maternal hypotension
C) Fetal heart rate decelerations only
D) Maternal hypertension
Rationale: Chorioamnionitis (intra-amniotic infection) is characterized by
maternal fever ≥100.4°F (38°C) plus at least two of the following: maternal
tachycardia, fetal tachycardia, uterine tenderness, purulent amniotic fluid, or
maternal leukocytosis. Fever is the hallmark finding.
