NURS240 MATERNAL-NEWBORN NURSING
2026 STUDY GUIDE | PRACTICE EXAM
QUESTIONS & ANSWERS | MATERNITY &
NEONATAL NURSING TEST BANK
NURS240 MATERNAL-NEWBORN NURSING 2026 STUDY GUIDE
PRACTICE EXAM QUESTIONS & ANSWERS | MATERNITY & NEONATAL NURSING
TEST BANK
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice examination questions
designed to reinforce core concepts in maternal-newborn nursing across
antepartum, intrapartum, postpartum, and neonatal care domains with detailed
EXPERT RATIONALE for every answer.
• Study strategy: Review each question carefully, formulate your answer before
checking the correct response, and use the detailed EXPERT RATIONALE to
strengthen understanding of underlying nursing principles and clinical application.
SECTION 1: ANTEPARTUM NURSING
1. A 28-year-old primigravida at 12 weeks gestation presents for her first
prenatal visit. Which of the following findings would be considered a normal
physiologic change during pregnancy?
A) Decreased plasma volume and increased hematocrit
B) Increased cardiac output and heart rate
C) Decreased glomerular filtration rate
D) Increased blood viscosity
E) Decreased tidal volume
,CORRECT ANSWER: B) Increased cardiac output and heart rate
EXPERT RATIONALE: During pregnancy, cardiac output increases by 30-50% and
heart rate increases by 10-20 bpm as a normal physiologic adaptation to meet
increased oxygen demands of the pregnant woman and developing fetus. Plasma
volume actually increases (not decreases), hematocrit typically decreases due to
hemodilution, glomerular filtration rate increases by 40-50%, blood viscosity
remains unchanged, and tidal volume increases by 30-40%. These adaptations
begin early in pregnancy and are necessary to support the metabolic demands of
pregnancy.
2. A pregnant client asks her nurse about the purpose of the alpha-
fetoprotein (AFP) screening test performed at 15-20 weeks gestation. What is
the primary purpose of this screening?
A) To determine fetal blood type and Rh status
B) To identify pregnancies at risk for chromosomal abnormalities and neural tube
defects
C) To measure placental hormone production
D) To assess fetal renal function
E) To evaluate maternal liver function
CORRECT ANSWER: B) To identify pregnancies at risk for chromosomal
abnormalities and neural tube defects
EXPERT RATIONALE: Maternal serum alpha-fetoprotein (AFP) screening is used as
a marker for Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and
neural tube defects. Elevated AFP levels may indicate neural tube defects or
abdominal wall defects, while low AFP levels combined with other markers may
suggest Down syndrome. Blood type and Rh status are determined through direct
blood testing, placental hormone production is measured through hCG and estriol
levels, renal function cannot be assessed prenatally, and maternal liver function
tests are separate laboratory studies. AFP is a critical component of the triple
screen or quad screen during the second trimester.
,3. A 32-year-old G3P2 at 20 weeks gestation is diagnosed with gestational
diabetes mellitus (GDM). Which maternal complication is this client at
increased risk for developing?
A) Placental abruption and preeclampsia
B) Polyhydramnios and preterm labor
C) Preeclampsia and polyhydramnios
D) Placenta previa and gestational hypertension
E) Hyperemesis gravidarum and cholestasis
CORRECT ANSWER: C) Preeclampsia and polyhydramnios
EXPERT RATIONALE: Women with gestational diabetes mellitus are at significantly
increased risk for developing preeclampsia due to shared pathophysiologic
mechanisms involving endothelial dysfunction and insulin resistance.
Polyhydramnios (excessive amniotic fluid) occurs in 20-25% of GDM pregnancies
due to fetal osmotic diuresis from hyperglycemia. While placental complications
and preterm labor can occur, the most characteristic and common complications
associated with GDM are preeclampsia and polyhydramnios. Strict glycemic control
can reduce these complications and improve maternal-fetal outcomes.
4. A client at 36 weeks gestation reports sudden onset of severe epigastric
pain and shoulder pain. Her blood pressure is 160/110 mmHg. Which
complication should the nurse suspect?
A) Placental abruption
B) Acute cholecystitis
C) HELLP syndrome
D) Preterm labor
E) Urolithiasis
, CORRECT ANSWER: C) HELLP syndrome
EXPERT RATIONALE: HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low
Platelets) is a severe manifestation of preeclampsia characterized by severe
epigastric or right upper quadrant pain, severe hypertension, and systemic
manifestations. The shoulder pain is related to hepatic capsule distension and
referred diaphragmatic irritation. HELLP syndrome occurs in 10-20% of women with
severe preeclampsia and represents a medical emergency requiring immediate
intervention and delivery. While placental abruption can present with severe pain, it
typically presents with vaginal bleeding and abdominal pain rather than epigastric
pain with shoulder involvement. HELLP is a life-threatening condition requiring
maternal and fetal assessment and likely delivery.
5. A 24-year-old primigravida at 8 weeks gestation presents with hyperemesis
gravidarum. Which laboratory finding would be expected in this condition?
A) Hyperkalemia and hypercalcemia
B) Hypokalemia and hypochloremia
C) Hyperchloremia and hypernatremia
D) Hypercalcemia and hyperphosphatemia
E) Hyponatremia and hyperkalemia
CORRECT ANSWER: B) Hypokalemia and hypochloremia
EXPERT RATIONALE: Severe hyperemesis gravidarum results in loss of
hydrochloric acid through repeated vomiting, leading to hypochloremia and
metabolic alkalosis. Fluid losses also result in hypokalemia, which can be life-
threatening and lead to cardiac arrhythmias. Additionally, dehydration may cause
hemoconcentration with elevated hemoglobin and hematocrit. Hyperkalemia does
not occur in hyperemesis; conversely, potassium stores become depleted.
Treatment involves IV fluid and electrolyte replacement, antiemetic medications,
and nutritional support. Vitamin supplementation, particularly thiamine, is crucial
to prevent Wernicke encephalopathy.
2026 STUDY GUIDE | PRACTICE EXAM
QUESTIONS & ANSWERS | MATERNITY &
NEONATAL NURSING TEST BANK
NURS240 MATERNAL-NEWBORN NURSING 2026 STUDY GUIDE
PRACTICE EXAM QUESTIONS & ANSWERS | MATERNITY & NEONATAL NURSING
TEST BANK
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice examination questions
designed to reinforce core concepts in maternal-newborn nursing across
antepartum, intrapartum, postpartum, and neonatal care domains with detailed
EXPERT RATIONALE for every answer.
• Study strategy: Review each question carefully, formulate your answer before
checking the correct response, and use the detailed EXPERT RATIONALE to
strengthen understanding of underlying nursing principles and clinical application.
SECTION 1: ANTEPARTUM NURSING
1. A 28-year-old primigravida at 12 weeks gestation presents for her first
prenatal visit. Which of the following findings would be considered a normal
physiologic change during pregnancy?
A) Decreased plasma volume and increased hematocrit
B) Increased cardiac output and heart rate
C) Decreased glomerular filtration rate
D) Increased blood viscosity
E) Decreased tidal volume
,CORRECT ANSWER: B) Increased cardiac output and heart rate
EXPERT RATIONALE: During pregnancy, cardiac output increases by 30-50% and
heart rate increases by 10-20 bpm as a normal physiologic adaptation to meet
increased oxygen demands of the pregnant woman and developing fetus. Plasma
volume actually increases (not decreases), hematocrit typically decreases due to
hemodilution, glomerular filtration rate increases by 40-50%, blood viscosity
remains unchanged, and tidal volume increases by 30-40%. These adaptations
begin early in pregnancy and are necessary to support the metabolic demands of
pregnancy.
2. A pregnant client asks her nurse about the purpose of the alpha-
fetoprotein (AFP) screening test performed at 15-20 weeks gestation. What is
the primary purpose of this screening?
A) To determine fetal blood type and Rh status
B) To identify pregnancies at risk for chromosomal abnormalities and neural tube
defects
C) To measure placental hormone production
D) To assess fetal renal function
E) To evaluate maternal liver function
CORRECT ANSWER: B) To identify pregnancies at risk for chromosomal
abnormalities and neural tube defects
EXPERT RATIONALE: Maternal serum alpha-fetoprotein (AFP) screening is used as
a marker for Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and
neural tube defects. Elevated AFP levels may indicate neural tube defects or
abdominal wall defects, while low AFP levels combined with other markers may
suggest Down syndrome. Blood type and Rh status are determined through direct
blood testing, placental hormone production is measured through hCG and estriol
levels, renal function cannot be assessed prenatally, and maternal liver function
tests are separate laboratory studies. AFP is a critical component of the triple
screen or quad screen during the second trimester.
,3. A 32-year-old G3P2 at 20 weeks gestation is diagnosed with gestational
diabetes mellitus (GDM). Which maternal complication is this client at
increased risk for developing?
A) Placental abruption and preeclampsia
B) Polyhydramnios and preterm labor
C) Preeclampsia and polyhydramnios
D) Placenta previa and gestational hypertension
E) Hyperemesis gravidarum and cholestasis
CORRECT ANSWER: C) Preeclampsia and polyhydramnios
EXPERT RATIONALE: Women with gestational diabetes mellitus are at significantly
increased risk for developing preeclampsia due to shared pathophysiologic
mechanisms involving endothelial dysfunction and insulin resistance.
Polyhydramnios (excessive amniotic fluid) occurs in 20-25% of GDM pregnancies
due to fetal osmotic diuresis from hyperglycemia. While placental complications
and preterm labor can occur, the most characteristic and common complications
associated with GDM are preeclampsia and polyhydramnios. Strict glycemic control
can reduce these complications and improve maternal-fetal outcomes.
4. A client at 36 weeks gestation reports sudden onset of severe epigastric
pain and shoulder pain. Her blood pressure is 160/110 mmHg. Which
complication should the nurse suspect?
A) Placental abruption
B) Acute cholecystitis
C) HELLP syndrome
D) Preterm labor
E) Urolithiasis
, CORRECT ANSWER: C) HELLP syndrome
EXPERT RATIONALE: HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low
Platelets) is a severe manifestation of preeclampsia characterized by severe
epigastric or right upper quadrant pain, severe hypertension, and systemic
manifestations. The shoulder pain is related to hepatic capsule distension and
referred diaphragmatic irritation. HELLP syndrome occurs in 10-20% of women with
severe preeclampsia and represents a medical emergency requiring immediate
intervention and delivery. While placental abruption can present with severe pain, it
typically presents with vaginal bleeding and abdominal pain rather than epigastric
pain with shoulder involvement. HELLP is a life-threatening condition requiring
maternal and fetal assessment and likely delivery.
5. A 24-year-old primigravida at 8 weeks gestation presents with hyperemesis
gravidarum. Which laboratory finding would be expected in this condition?
A) Hyperkalemia and hypercalcemia
B) Hypokalemia and hypochloremia
C) Hyperchloremia and hypernatremia
D) Hypercalcemia and hyperphosphatemia
E) Hyponatremia and hyperkalemia
CORRECT ANSWER: B) Hypokalemia and hypochloremia
EXPERT RATIONALE: Severe hyperemesis gravidarum results in loss of
hydrochloric acid through repeated vomiting, leading to hypochloremia and
metabolic alkalosis. Fluid losses also result in hypokalemia, which can be life-
threatening and lead to cardiac arrhythmias. Additionally, dehydration may cause
hemoconcentration with elevated hemoglobin and hematocrit. Hyperkalemia does
not occur in hyperemesis; conversely, potassium stores become depleted.
Treatment involves IV fluid and electrolyte replacement, antiemetic medications,
and nutritional support. Vitamin supplementation, particularly thiamine, is crucial
to prevent Wernicke encephalopathy.
