NUR 202 Maternal-Newborn Nursing Exam 2 Questions |
100% Correct Answers with Detailed Rationales (2026/2027
Edition)
Fortis Nursing Program Maternal-Newborn Nursing Examination
==============================
SECTION 1: Antepartum Nursing Care
Question 1
A client at 12 weeks gestation asks the nurse why she feels so tired. The nurse should
explain that fatigue during the first trimester is primarily caused by which physiological
change?
A. Increased cardiac output
B. Elevated progesterone levels
C. Decreased blood volume
D. Increased metabolic rate
Correct Answer: B
Rationale: Elevated progesterone levels during the first trimester cause fatigue by acting
as a central nervous system depressant and promoting sleepiness. While increased
metabolic rate and cardiac output occur in pregnancy, progesterone is the primary
cause of first-trimester fatigue. Blood volume actually increases during pregnancy, not
decreases.
,Question 2
A pregnant client at 28 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which dietary instruction should the nurse prioritize when teaching this client?
A. Eliminate all carbohydrates from the diet
B. Consume three large meals daily with no snacks
C. Eat small, frequent meals with complex carbohydrates distributed throughout the day
D. Fast for 12 hours before each prenatal visit
Correct Answer: C
Rationale: The recommended dietary management for GDM includes eating small,
frequent meals with complex carbohydrates distributed throughout the day to maintain
stable blood glucose levels. This approach prevents both hyperglycemia and
hypoglycemia. Eliminating all carbohydrates is unsafe, fasting is contraindicated, and
three large meals can cause glucose spikes.
Question 3
A nurse is caring for a client at 32 weeks gestation with preeclampsia. The client's
blood pressure is 158/96 mmHg, and she reports a severe headache and visual
disturbances. Which nursing intervention is the highest priority?
A. Administer magnesium sulfate as ordered
B. Encourage increased fluid intake
C. Position the client in supine position
D. Administer terbutaline as ordered
Correct Answer: A
Rationale: Magnesium sulfate is the first-line treatment for seizure prophylaxis in severe
preeclampsia. The client's symptoms (severe headache, visual disturbances, elevated
,BP) indicate progression toward eclampsia. Magnesium sulfate prevents seizures by
acting as a central nervous system depressant and vasodilator. Terbutaline is used for
preterm labor, increased fluids are not indicated, and supine positioning worsens blood
pressure.
Question 4
A client at 20 weeks gestation asks the nurse about the purpose of the
alpha-fetoprotein (AFP) screening test. The nurse should explain that this test primarily
screens for which condition?
A. Gestational diabetes
B. Neural tube defects
C. Chromosomal abnormalities
D. Placental abruption
Correct Answer: B
Rationale: Maternal serum alpha-fetoprotein (MSAFP) screening is primarily used to
detect neural tube defects such as spina bifida and anencephaly. Elevated AFP levels
may indicate an open neural tube defect. While low AFP can be associated with
chromosomal abnormalities, the primary purpose is neural tube defect screening. It
does not screen for gestational diabetes or placental abruption.
Question 5
A nurse is assessing a client at 35 weeks gestation who reports sudden onset of
painless vaginal bleeding. The fetal heart rate is 140 bpm and regular. Based on these
findings, the nurse should suspect which complication?
A. Placenta previa
, B. Abruptio placentae
C. Preterm labor
D. Uterine rupture
Correct Answer: A
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
third trimester. The sudden onset of painless bleeding with a normal fetal heart rate is
classic for placenta previa. Abruptio placentae typically presents with painful bleeding
and uterine tenderness. Preterm labor involves contractions, and uterine rupture
presents with severe pain and signs of fetal distress.
Question 6
A client at 24 weeks gestation is Rh-negative and has a negative antibody screen. The
nurse understands that RhoGAM (Rh immune globulin) should be administered at which
time?
A. At 12 weeks gestation and again at 36 weeks
B. At 28 weeks gestation and within 72 hours after delivery if the newborn is Rh-positive
C. Only if the client experiences vaginal bleeding
D. Only after delivery if the newborn is Rh-positive
Correct Answer: B
Rationale: Standard protocol for Rh-negative clients with a negative antibody screen is
to administer RhoGAM at 28 weeks gestation and again within 72 hours after delivery if
the newborn is Rh-positive. The antepartum dose prevents sensitization during
pregnancy, and the postpartum dose prevents sensitization from fetal-maternal
hemorrhage during delivery. Waiting until after delivery or only after bleeding is
insufficient.
100% Correct Answers with Detailed Rationales (2026/2027
Edition)
Fortis Nursing Program Maternal-Newborn Nursing Examination
==============================
SECTION 1: Antepartum Nursing Care
Question 1
A client at 12 weeks gestation asks the nurse why she feels so tired. The nurse should
explain that fatigue during the first trimester is primarily caused by which physiological
change?
A. Increased cardiac output
B. Elevated progesterone levels
C. Decreased blood volume
D. Increased metabolic rate
Correct Answer: B
Rationale: Elevated progesterone levels during the first trimester cause fatigue by acting
as a central nervous system depressant and promoting sleepiness. While increased
metabolic rate and cardiac output occur in pregnancy, progesterone is the primary
cause of first-trimester fatigue. Blood volume actually increases during pregnancy, not
decreases.
,Question 2
A pregnant client at 28 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which dietary instruction should the nurse prioritize when teaching this client?
A. Eliminate all carbohydrates from the diet
B. Consume three large meals daily with no snacks
C. Eat small, frequent meals with complex carbohydrates distributed throughout the day
D. Fast for 12 hours before each prenatal visit
Correct Answer: C
Rationale: The recommended dietary management for GDM includes eating small,
frequent meals with complex carbohydrates distributed throughout the day to maintain
stable blood glucose levels. This approach prevents both hyperglycemia and
hypoglycemia. Eliminating all carbohydrates is unsafe, fasting is contraindicated, and
three large meals can cause glucose spikes.
Question 3
A nurse is caring for a client at 32 weeks gestation with preeclampsia. The client's
blood pressure is 158/96 mmHg, and she reports a severe headache and visual
disturbances. Which nursing intervention is the highest priority?
A. Administer magnesium sulfate as ordered
B. Encourage increased fluid intake
C. Position the client in supine position
D. Administer terbutaline as ordered
Correct Answer: A
Rationale: Magnesium sulfate is the first-line treatment for seizure prophylaxis in severe
preeclampsia. The client's symptoms (severe headache, visual disturbances, elevated
,BP) indicate progression toward eclampsia. Magnesium sulfate prevents seizures by
acting as a central nervous system depressant and vasodilator. Terbutaline is used for
preterm labor, increased fluids are not indicated, and supine positioning worsens blood
pressure.
Question 4
A client at 20 weeks gestation asks the nurse about the purpose of the
alpha-fetoprotein (AFP) screening test. The nurse should explain that this test primarily
screens for which condition?
A. Gestational diabetes
B. Neural tube defects
C. Chromosomal abnormalities
D. Placental abruption
Correct Answer: B
Rationale: Maternal serum alpha-fetoprotein (MSAFP) screening is primarily used to
detect neural tube defects such as spina bifida and anencephaly. Elevated AFP levels
may indicate an open neural tube defect. While low AFP can be associated with
chromosomal abnormalities, the primary purpose is neural tube defect screening. It
does not screen for gestational diabetes or placental abruption.
Question 5
A nurse is assessing a client at 35 weeks gestation who reports sudden onset of
painless vaginal bleeding. The fetal heart rate is 140 bpm and regular. Based on these
findings, the nurse should suspect which complication?
A. Placenta previa
, B. Abruptio placentae
C. Preterm labor
D. Uterine rupture
Correct Answer: A
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
third trimester. The sudden onset of painless bleeding with a normal fetal heart rate is
classic for placenta previa. Abruptio placentae typically presents with painful bleeding
and uterine tenderness. Preterm labor involves contractions, and uterine rupture
presents with severe pain and signs of fetal distress.
Question 6
A client at 24 weeks gestation is Rh-negative and has a negative antibody screen. The
nurse understands that RhoGAM (Rh immune globulin) should be administered at which
time?
A. At 12 weeks gestation and again at 36 weeks
B. At 28 weeks gestation and within 72 hours after delivery if the newborn is Rh-positive
C. Only if the client experiences vaginal bleeding
D. Only after delivery if the newborn is Rh-positive
Correct Answer: B
Rationale: Standard protocol for Rh-negative clients with a negative antibody screen is
to administer RhoGAM at 28 weeks gestation and again within 72 hours after delivery if
the newborn is Rh-positive. The antepartum dose prevents sensitization during
pregnancy, and the postpartum dose prevents sensitization from fetal-maternal
hemorrhage during delivery. Waiting until after delivery or only after bleeding is
insufficient.
