Spring Semester 2026 NURS240 Maternal-Newborn Nursing |
Comprehensive Study Guide, Practice Exam Questions and Answers,
Exam Prep Test Bank, Prenatal and Antenatal Care, Fetal Development
and Pregnancy Adaptations, Labor and Delivery Nursing Management,
Postpartum Assessment and Recovery, Newborn and Neonatal Nursing
Care, High-Risk Obstetric Conditions, Maternal Pharmacology,
Breastfeeding Support, Family-Centered Care, Clinical Judgment and
NCLEX-Style Questions, Updated 2026
Question 1: A primigravida at 38 weeks gestation is admitted with a diagnosis of
preeclampsia with severe features. Which assessment finding indicates the need
for immediate administration of intravenous magnesium sulfate?
A. Blood pressure of 156/94 mmHg
B. Deep tendon reflexes of 3+
C. Urine output of 20 mL/hr
D. A headache that is unrelieved by acetaminophen
CORRECT ANSWER: C. Urine output of 20 mL/hr
Rationale: Oliguria (<30 mL/hr) in a patient with severe preeclampsia indicates renal
impairment and is a sign of worsening disease. Magnesium sulfate is administered to
prevent seizures, but it is also a tocolytic and central nervous system depressant. The
presence of oliguria is a key criterion for initiating magnesium sulfate therapy as part of
the management plan.
Question 2: A postpartum patient with a history of deep vein thrombosis is
receiving enoxaparin. The nurse should monitor for which adverse effect?
A. Bradycardia
B. Thrombocytopenia
C. Hypertension
D. Hyperkalemia
CORRECT ANSWER: B. Thrombocytopenia
Rationale: Enoxaparin, a low-molecular-weight heparin, can cause immune-mediated
thrombocytopenia (HIT), though less frequently than unfractionated heparin. The nurse
must monitor platelet counts periodically. Bradycardia, hypertension, and hyperkalemia
are not primary adverse effects of this medication.
Question 3: During a routine prenatal visit, a nurse palpates the fetal presentation
as cephalic. Which fetal part is the nurse most likely identifying in the maternal
fundus?
A. Head
B. Buttocks
C. Back
D. Feet
,CORRECT ANSWER: B. Buttocks
Rationale: In a cephalic presentation, the fetal head is engaged in the maternal pelvis.
The buttocks and lower extremities are therefore situated in the fundal region of the
uterus. Palpating the buttocks in the fundus is a key finding that supports a cephalic
presentation.
Question 4: A client at 32 weeks gestation is diagnosed with gestational diabetes.
The nurse is educating the client on the importance of fetal movement counting.
What should the nurse instruct the client to report immediately?
A. Feeling fewer than 10 movements in 2 hours
B. Feeling movements only after eating
C. Feeling more than 20 movements in 1 hour
D. Feeling movements that are rhythmic and repetitive
CORRECT ANSWER: A. Feeling fewer than 10 movements in 2 hours
Rationale: A decrease in fetal movement, specifically fewer than 10 movements in 2
hours, is a warning sign of potential fetal compromise and requires immediate
reporting. Rhythmic movements are often fetal hiccups and are normal. Increased
movements are generally not concerning.
Question 5: A nurse is assisting with a non-stress test (NST) for a patient at 36
weeks gestation. The fetal heart rate shows two accelerations of 15 beats per
minute lasting 15 seconds in a 20-minute period. How should the nurse interpret
this finding?
A. Reactive NST, indicating fetal well-being
B. Non-reactive NST, requiring further testing
C. Reactive NST, indicating maternal stress
D. Non-reactive NST, indicating fetal acidosis
CORRECT ANSWER: A. Reactive NST, indicating fetal well-being
Rationale: A reactive NST is defined as the presence of at least two accelerations of the
fetal heart rate (≥15 bpm above baseline, lasting ≥15 seconds) within a 20-minute
window. This is a reassuring sign of adequate fetal oxygenation and an intact autonomic
nervous system.
Question 6: The nurse is providing discharge teaching to a postpartum client who
had a cesarean section. Which statement by the client indicates a correct
understanding of incisional care?
A. "I will apply antibiotic cream to the incision daily."
B. "I will keep the incision dry and covered with a sterile dressing."
C. "I can take a bath in the tub to clean the incision."
D. "I will remove the steri-strips if they become itchy."
,CORRECT ANSWER: B. "I will keep the incision dry and covered with a sterile
dressing."
Rationale: Keeping the incision dry and covered helps prevent infection. Clients should
avoid tub baths until cleared by their provider and should not apply ointments or
remove steri-strips prematurely without a provider's order.
Question 7: A patient in active labor requests an epidural for pain relief. The nurse
should first assess which of the following?
A. The patient's complete blood count
B. The patient's temperature
C. The patient's blood pressure
D. The patient's cervical dilation
CORRECT ANSWER: C. The patient's blood pressure
Rationale: The primary side effect of an epidural is maternal hypotension due to
sympathetic blockade. Prior to administration, the nurse must assess baseline blood
pressure and ensure appropriate intravenous hydration. The other options are relevant
but not the immediate priority.
Question 8: The nurse is performing Leopold's maneuvers on a client at 39 weeks.
The first maneuver identifies a firm, round mass in the fundus. What is this finding?
A. The fetal head
B. The fetal buttocks
C. The fetal back
D. The fetal extremities
CORRECT ANSWER: A. The fetal head
Rationale: The first Leopold maneuver determines the fetal part in the fundus. A firm,
round, and hard mass is characteristic of the fetal head (cephalic presentation). A soft,
irregular mass indicates the buttocks (breech presentation).
Question 9: A newborn has Apgar scores of 7 at 1 minute and 9 at 5 minutes. What
is the correct interpretation of these scores?
A. The newborn is in severe distress and requires resuscitation.
B. The newborn responded well to initial interventions.
C. The newborn has a congenital anomaly.
D. The newborn's condition is deteriorating.
CORRECT ANSWER: B. The newborn responded well to initial interventions.
Rationale: An Apgar score of 7 at 1 minute indicates the newborn needed some
resuscitative measures. An improvement to a score of 9 at 5 minutes indicates the
newborn is responding positively to those interventions and transitioning well to
extrauterine life.
, Question 10: A client in her third trimester complains of severe back pain. The
nurse should suspect which of the following as the most likely cause?
A. Round ligament pain
B. Pelvic pressure from the fetal head
C. Relaxation of pelvic joints and change in center of gravity
D. Placental abruption
CORRECT ANSWER: C. Relaxation of pelvic joints and change in center of gravity
Rationale: During pregnancy, hormonal changes cause relaxation of the sacroiliac
joints and ligaments. As the uterus enlarges, the client's center of gravity shifts forward,
placing increased strain on the lower back muscles, leading to back pain. Placental
abruption presents with a different symptom profile (e.g., vaginal bleeding, uterine
tenderness).
Question 11: The nurse is caring for a newborn with jaundice who is undergoing
phototherapy. Which intervention is essential to include in the plan of care?
A. Keep the newborn's eyes covered at all times.
B. Encourage oral intake of glucose water.
C. Discontinue breastfeeding until jaundice resolves.
D. Keep the newborn fully clothed to prevent hypothermia.
CORRECT ANSWER: A. Keep the newborn's eyes covered at all times.
Rationale: The bright lights used in phototherapy can damage the newborn's retinas.
Therefore, the infant's eyes must be covered with protective patches at all times during
the therapy. Breastfeeding should continue, and clothing should be minimal to
maximize skin exposure.
Question 12: A client at 41 weeks gestation is scheduled for a biophysical profile
(BPP). The nurse explains that the test evaluates the fetus in which of the following
ways?
A. Fetal heart rate only
B. Fetal lung maturity
C. Amniotic fluid volume and fetal well-being
D. Fetal position and station
CORRECT ANSWER: C. Amniotic fluid volume and fetal well-being
Rationale: A BPP combines a non-stress test with ultrasound to evaluate five
components: fetal breathing movements, fetal movement, fetal tone, amniotic fluid
volume, and fetal heart rate reactivity. It is used to assess fetal well-being, particularly in
post-term pregnancies.
Question 13: A postpartum patient is Rh-negative and has just given birth to an Rh-
positive infant. Which medication should the nurse anticipate administering to the
patient?
Comprehensive Study Guide, Practice Exam Questions and Answers,
Exam Prep Test Bank, Prenatal and Antenatal Care, Fetal Development
and Pregnancy Adaptations, Labor and Delivery Nursing Management,
Postpartum Assessment and Recovery, Newborn and Neonatal Nursing
Care, High-Risk Obstetric Conditions, Maternal Pharmacology,
Breastfeeding Support, Family-Centered Care, Clinical Judgment and
NCLEX-Style Questions, Updated 2026
Question 1: A primigravida at 38 weeks gestation is admitted with a diagnosis of
preeclampsia with severe features. Which assessment finding indicates the need
for immediate administration of intravenous magnesium sulfate?
A. Blood pressure of 156/94 mmHg
B. Deep tendon reflexes of 3+
C. Urine output of 20 mL/hr
D. A headache that is unrelieved by acetaminophen
CORRECT ANSWER: C. Urine output of 20 mL/hr
Rationale: Oliguria (<30 mL/hr) in a patient with severe preeclampsia indicates renal
impairment and is a sign of worsening disease. Magnesium sulfate is administered to
prevent seizures, but it is also a tocolytic and central nervous system depressant. The
presence of oliguria is a key criterion for initiating magnesium sulfate therapy as part of
the management plan.
Question 2: A postpartum patient with a history of deep vein thrombosis is
receiving enoxaparin. The nurse should monitor for which adverse effect?
A. Bradycardia
B. Thrombocytopenia
C. Hypertension
D. Hyperkalemia
CORRECT ANSWER: B. Thrombocytopenia
Rationale: Enoxaparin, a low-molecular-weight heparin, can cause immune-mediated
thrombocytopenia (HIT), though less frequently than unfractionated heparin. The nurse
must monitor platelet counts periodically. Bradycardia, hypertension, and hyperkalemia
are not primary adverse effects of this medication.
Question 3: During a routine prenatal visit, a nurse palpates the fetal presentation
as cephalic. Which fetal part is the nurse most likely identifying in the maternal
fundus?
A. Head
B. Buttocks
C. Back
D. Feet
,CORRECT ANSWER: B. Buttocks
Rationale: In a cephalic presentation, the fetal head is engaged in the maternal pelvis.
The buttocks and lower extremities are therefore situated in the fundal region of the
uterus. Palpating the buttocks in the fundus is a key finding that supports a cephalic
presentation.
Question 4: A client at 32 weeks gestation is diagnosed with gestational diabetes.
The nurse is educating the client on the importance of fetal movement counting.
What should the nurse instruct the client to report immediately?
A. Feeling fewer than 10 movements in 2 hours
B. Feeling movements only after eating
C. Feeling more than 20 movements in 1 hour
D. Feeling movements that are rhythmic and repetitive
CORRECT ANSWER: A. Feeling fewer than 10 movements in 2 hours
Rationale: A decrease in fetal movement, specifically fewer than 10 movements in 2
hours, is a warning sign of potential fetal compromise and requires immediate
reporting. Rhythmic movements are often fetal hiccups and are normal. Increased
movements are generally not concerning.
Question 5: A nurse is assisting with a non-stress test (NST) for a patient at 36
weeks gestation. The fetal heart rate shows two accelerations of 15 beats per
minute lasting 15 seconds in a 20-minute period. How should the nurse interpret
this finding?
A. Reactive NST, indicating fetal well-being
B. Non-reactive NST, requiring further testing
C. Reactive NST, indicating maternal stress
D. Non-reactive NST, indicating fetal acidosis
CORRECT ANSWER: A. Reactive NST, indicating fetal well-being
Rationale: A reactive NST is defined as the presence of at least two accelerations of the
fetal heart rate (≥15 bpm above baseline, lasting ≥15 seconds) within a 20-minute
window. This is a reassuring sign of adequate fetal oxygenation and an intact autonomic
nervous system.
Question 6: The nurse is providing discharge teaching to a postpartum client who
had a cesarean section. Which statement by the client indicates a correct
understanding of incisional care?
A. "I will apply antibiotic cream to the incision daily."
B. "I will keep the incision dry and covered with a sterile dressing."
C. "I can take a bath in the tub to clean the incision."
D. "I will remove the steri-strips if they become itchy."
,CORRECT ANSWER: B. "I will keep the incision dry and covered with a sterile
dressing."
Rationale: Keeping the incision dry and covered helps prevent infection. Clients should
avoid tub baths until cleared by their provider and should not apply ointments or
remove steri-strips prematurely without a provider's order.
Question 7: A patient in active labor requests an epidural for pain relief. The nurse
should first assess which of the following?
A. The patient's complete blood count
B. The patient's temperature
C. The patient's blood pressure
D. The patient's cervical dilation
CORRECT ANSWER: C. The patient's blood pressure
Rationale: The primary side effect of an epidural is maternal hypotension due to
sympathetic blockade. Prior to administration, the nurse must assess baseline blood
pressure and ensure appropriate intravenous hydration. The other options are relevant
but not the immediate priority.
Question 8: The nurse is performing Leopold's maneuvers on a client at 39 weeks.
The first maneuver identifies a firm, round mass in the fundus. What is this finding?
A. The fetal head
B. The fetal buttocks
C. The fetal back
D. The fetal extremities
CORRECT ANSWER: A. The fetal head
Rationale: The first Leopold maneuver determines the fetal part in the fundus. A firm,
round, and hard mass is characteristic of the fetal head (cephalic presentation). A soft,
irregular mass indicates the buttocks (breech presentation).
Question 9: A newborn has Apgar scores of 7 at 1 minute and 9 at 5 minutes. What
is the correct interpretation of these scores?
A. The newborn is in severe distress and requires resuscitation.
B. The newborn responded well to initial interventions.
C. The newborn has a congenital anomaly.
D. The newborn's condition is deteriorating.
CORRECT ANSWER: B. The newborn responded well to initial interventions.
Rationale: An Apgar score of 7 at 1 minute indicates the newborn needed some
resuscitative measures. An improvement to a score of 9 at 5 minutes indicates the
newborn is responding positively to those interventions and transitioning well to
extrauterine life.
, Question 10: A client in her third trimester complains of severe back pain. The
nurse should suspect which of the following as the most likely cause?
A. Round ligament pain
B. Pelvic pressure from the fetal head
C. Relaxation of pelvic joints and change in center of gravity
D. Placental abruption
CORRECT ANSWER: C. Relaxation of pelvic joints and change in center of gravity
Rationale: During pregnancy, hormonal changes cause relaxation of the sacroiliac
joints and ligaments. As the uterus enlarges, the client's center of gravity shifts forward,
placing increased strain on the lower back muscles, leading to back pain. Placental
abruption presents with a different symptom profile (e.g., vaginal bleeding, uterine
tenderness).
Question 11: The nurse is caring for a newborn with jaundice who is undergoing
phototherapy. Which intervention is essential to include in the plan of care?
A. Keep the newborn's eyes covered at all times.
B. Encourage oral intake of glucose water.
C. Discontinue breastfeeding until jaundice resolves.
D. Keep the newborn fully clothed to prevent hypothermia.
CORRECT ANSWER: A. Keep the newborn's eyes covered at all times.
Rationale: The bright lights used in phototherapy can damage the newborn's retinas.
Therefore, the infant's eyes must be covered with protective patches at all times during
the therapy. Breastfeeding should continue, and clothing should be minimal to
maximize skin exposure.
Question 12: A client at 41 weeks gestation is scheduled for a biophysical profile
(BPP). The nurse explains that the test evaluates the fetus in which of the following
ways?
A. Fetal heart rate only
B. Fetal lung maturity
C. Amniotic fluid volume and fetal well-being
D. Fetal position and station
CORRECT ANSWER: C. Amniotic fluid volume and fetal well-being
Rationale: A BPP combines a non-stress test with ultrasound to evaluate five
components: fetal breathing movements, fetal movement, fetal tone, amniotic fluid
volume, and fetal heart rate reactivity. It is used to assess fetal well-being, particularly in
post-term pregnancies.
Question 13: A postpartum patient is Rh-negative and has just given birth to an Rh-
positive infant. Which medication should the nurse anticipate administering to the
patient?
