Academic Year 2026–2027 NURS240 Maternal-Newborn Nursing
Updated 2026 | 190+ Questions and Answers | Maternal and Newborn
Nursing Exam Prep, Comprehensive Study Guide, Practice Exam, Test
Bank, Pregnancy Care, Antepartum Nursing, Labor and Delivery,
Postpartum Care, Newborn Assessment, Neonatal Nursing, High-Risk
Obstetrics, NCLEX-Style Review, Detailed Rationales and Complete
Revision Material
Question 1: A 32-year-old primigravida at 38 weeks' gestation is admitted with
preeclampsia with severe features. Her blood pressure is 168/110 mmHg, and she
reports a severe headache and visual disturbances. Which medication is the
priority for the nurse to administer to prevent a seizure?
A. Magnesium sulfate
B. Labetalol
C. Nifedipine
D. Hydralazine
CORRECT ANSWER: A. Magnesium sulfate
Rationale: Magnesium sulfate is the drug of choice for seizure prophylaxis in
preeclampsia with severe features. It acts as a central nervous system depressant to
prevent eclamptic seizures. Labetalol, Nifedipine, and Hydralazine are used for acute
blood pressure reduction, but magnesium is the priority to prevent seizures.
Question 2: The nurse is caring for a patient in active labor who is receiving an
epidural block. Which assessment finding would indicate a complication of this
anesthesia?
A. Maternal blood pressure of 120/78 mmHg
B. Maternal heart rate of 90 beats/min
C. Fetal heart rate of 140 beats/min with moderate variability
D. Maternal respiratory rate of 10 breaths/min and hypotension
CORRECT ANSWER: D. Maternal respiratory rate of 10 breaths/min and
hypotension
Rationale: Epidural blocks can cause sympathetic blockade leading to hypotension
and, if the block ascends too high, can affect the phrenic nerve, causing respiratory
depression. A respiratory rate of 10 breaths/min with hypotension indicates a high block
and requires immediate intervention. The other options represent normal findings.
Question 3: A nurse is assessing a newborn who is 1 hour old. The newborn has a
heart rate of 180 beats/min, a respiratory rate of 80 breaths/min, and is exhibiting
nasal flaring and grunting. Which of the following should the nurse do first?
,A. Place the newborn under a radiant warmer
B. Administer vitamin K
C. Notify the healthcare provider
D. Initiate oxygen saturation monitoring
CORRECT ANSWER: C. Notify the healthcare provider
Rationale: A respiratory rate of 80 breaths/min with nasal flaring and grunting is a sign of
respiratory distress, which can indicate conditions such as transient tachypnea of the
newborn, respiratory distress syndrome, or sepsis. The nurse must notify the healthcare
provider immediately. While monitoring and warming may be necessary, the priority is to
communicate the abnormal findings.
Question 4: During a prenatal visit, a 25-year-old G2P1 patient at 28 weeks'
gestation presents with a negative Coombs' test, a rubella titer of 1:8, and a blood
type of O negative. Which nursing intervention is most important at this time?
A. Administer the first dose of RhoGAM
B. Schedule a glucose tolerance test
C. Administer the rubella vaccine
D. Schedule a biophysical profile
CORRECT ANSWER: A. Administer the first dose of RhoGAM
Rationale: The patient is Rh-negative and requires RhoGAM at 28 weeks of gestation to
prevent the development of antibodies that could harm a subsequent Rh-positive fetus.
Rubella vaccine is contraindicated during pregnancy, and the glucose tolerance test is
scheduled based on risk factors or at 24-28 weeks.
Question 5: A nurse is teaching a postpartum patient about breastfeeding. Which
statement by the mother indicates a correct understanding of the teaching
regarding colostrum?
A. "Colostrum is high in fat and calories."
B. "Colostrum is thick, yellow, and has a low sugar content."
C. "Colostrum is thin, watery, and bluish."
D. "Colostrum is produced about 5 days after birth."
CORRECT ANSWER: B. "Colostrum is thick, yellow, and has a low sugar content."
Rationale: Colostrum is the first milk, produced during the first few days postpartum. It
is thick, yellow, and high in protein, immunoglobulins (especially IgA), and leukocytes,
but low in fat and sugar (lactose). Mature milk is thin, watery, and bluish. It transitions
around day 3-5.
,Question 6: The nurse is monitoring a patient in the first stage of labor. The patient's
cervix is dilated to 6 cm, and the fetal presenting part is at -1 station. The nurse
notes the fetal heart rate has late decelerations. What is the priority nursing
action?
A. Increase the rate of the IV infusion
B. Turn the patient to her left side
C. Prepare for an emergency cesarean section
D. Administer oxygen at 2 L/min via nasal cannula
CORRECT ANSWER: B. Turn the patient to her left side
Rationale: Late decelerations indicate uteroplacental insufficiency. The first priority is to
increase maternal blood flow to the placenta by turning the patient to her left side to
relieve pressure on the vena cava. Other interventions include increasing IV fluids,
administering oxygen, and notifying the provider, but positioning is the immediate
action.
Question 7: A newborn is diagnosed with neonatal abstinence syndrome (NAS).
Which assessment finding would the nurse expect to observe?
A. Lethargy and poor feeding
B. Hypertonicity and a high-pitched cry
C. Hypothermia and bradycardia
D. Constipation and excessive sleeping
CORRECT ANSWER: B. Hypertonicity and a high-picked cry
Rationale: Neonatal abstinence syndrome results from withdrawal from opioids or other
substances. Clinical manifestations include central nervous system irritability, such as
hypertonicity, tremors, a high-pitched cry, and poor feeding. Lethargy, hypothermia, and
constipation are not classic signs of NAS.
Question 8: A nurse is caring for a patient who is 6 hours postpartum. The patient's
fundus is firm at the umbilicus and deviated to the right. The nurse notes a large
amount of lochia rubra. What is the priority action?
A. Massage the fundus firmly
B. Have the patient void
C. Administer oxytocin
D. Assess vital signs
CORRECT ANSWER: B. Have the patient void
Rationale: A fundus that is deviated to the side (usually right) indicates a full bladder
displacing the uterus. The bladder must be emptied to allow the uterus to contract
, effectively and prevent hemorrhage. Massaging a firm fundus is not necessary; the issue
is the displacement.
Question 9: A patient at 32 weeks' gestation is diagnosed with gestational diabetes
mellitus. Which of the following is a potential complication for the newborn?
A. Hyperglycemia
B. Microcephaly
C. Polycythemia
D. Hypocalcemia
CORRECT ANSWER: D. Hypocalcemia
Rationale: Infants of diabetic mothers are at risk for hypocalcemia due to a transient
suppression of parathyroid hormone. While hyperglycemia can occur briefly, the
neonate is more commonly at risk for hypoglycemia. Polycythemia and
hyperbilirubinemia are also risks, but hypocalcemia is a classic complication.
Question 10: The nurse is providing discharge teaching to a new mother on how to
care for her newborn's umbilical cord. Which statement by the mother indicates a
need for further teaching?
A. "I will keep the cord dry and clean."
B. "I will fold the diaper below the cord."
C. "I will clean the base with rubbing alcohol once a day."
D. "I will give the baby a tub bath until the cord falls off."
CORRECT ANSWER: D. "I will give the baby a tub bath until the cord falls off."
Rationale: The newborn should receive sponge baths until the umbilical cord falls off
and the area is healed to keep the cord dry. Submerging the cord in water can increase
the risk of infection. The other statements indicate correct understanding of cord care.
Question 11: A patient at 40 weeks' gestation is being induced with oxytocin. The
nurse notes the patient is having contractions every 1.5 minutes lasting 90
seconds. The fetal heart rate is 150 beats/min with early decelerations. What is the
nurse's priority action?
A. Stop the oxytocin infusion
B. Turn the patient to her right side
C. Continue to monitor as this is a normal finding
D. Administer a bolus of IV fluids
CORRECT ANSWER: A. Stop the oxytocin infusion
Updated 2026 | 190+ Questions and Answers | Maternal and Newborn
Nursing Exam Prep, Comprehensive Study Guide, Practice Exam, Test
Bank, Pregnancy Care, Antepartum Nursing, Labor and Delivery,
Postpartum Care, Newborn Assessment, Neonatal Nursing, High-Risk
Obstetrics, NCLEX-Style Review, Detailed Rationales and Complete
Revision Material
Question 1: A 32-year-old primigravida at 38 weeks' gestation is admitted with
preeclampsia with severe features. Her blood pressure is 168/110 mmHg, and she
reports a severe headache and visual disturbances. Which medication is the
priority for the nurse to administer to prevent a seizure?
A. Magnesium sulfate
B. Labetalol
C. Nifedipine
D. Hydralazine
CORRECT ANSWER: A. Magnesium sulfate
Rationale: Magnesium sulfate is the drug of choice for seizure prophylaxis in
preeclampsia with severe features. It acts as a central nervous system depressant to
prevent eclamptic seizures. Labetalol, Nifedipine, and Hydralazine are used for acute
blood pressure reduction, but magnesium is the priority to prevent seizures.
Question 2: The nurse is caring for a patient in active labor who is receiving an
epidural block. Which assessment finding would indicate a complication of this
anesthesia?
A. Maternal blood pressure of 120/78 mmHg
B. Maternal heart rate of 90 beats/min
C. Fetal heart rate of 140 beats/min with moderate variability
D. Maternal respiratory rate of 10 breaths/min and hypotension
CORRECT ANSWER: D. Maternal respiratory rate of 10 breaths/min and
hypotension
Rationale: Epidural blocks can cause sympathetic blockade leading to hypotension
and, if the block ascends too high, can affect the phrenic nerve, causing respiratory
depression. A respiratory rate of 10 breaths/min with hypotension indicates a high block
and requires immediate intervention. The other options represent normal findings.
Question 3: A nurse is assessing a newborn who is 1 hour old. The newborn has a
heart rate of 180 beats/min, a respiratory rate of 80 breaths/min, and is exhibiting
nasal flaring and grunting. Which of the following should the nurse do first?
,A. Place the newborn under a radiant warmer
B. Administer vitamin K
C. Notify the healthcare provider
D. Initiate oxygen saturation monitoring
CORRECT ANSWER: C. Notify the healthcare provider
Rationale: A respiratory rate of 80 breaths/min with nasal flaring and grunting is a sign of
respiratory distress, which can indicate conditions such as transient tachypnea of the
newborn, respiratory distress syndrome, or sepsis. The nurse must notify the healthcare
provider immediately. While monitoring and warming may be necessary, the priority is to
communicate the abnormal findings.
Question 4: During a prenatal visit, a 25-year-old G2P1 patient at 28 weeks'
gestation presents with a negative Coombs' test, a rubella titer of 1:8, and a blood
type of O negative. Which nursing intervention is most important at this time?
A. Administer the first dose of RhoGAM
B. Schedule a glucose tolerance test
C. Administer the rubella vaccine
D. Schedule a biophysical profile
CORRECT ANSWER: A. Administer the first dose of RhoGAM
Rationale: The patient is Rh-negative and requires RhoGAM at 28 weeks of gestation to
prevent the development of antibodies that could harm a subsequent Rh-positive fetus.
Rubella vaccine is contraindicated during pregnancy, and the glucose tolerance test is
scheduled based on risk factors or at 24-28 weeks.
Question 5: A nurse is teaching a postpartum patient about breastfeeding. Which
statement by the mother indicates a correct understanding of the teaching
regarding colostrum?
A. "Colostrum is high in fat and calories."
B. "Colostrum is thick, yellow, and has a low sugar content."
C. "Colostrum is thin, watery, and bluish."
D. "Colostrum is produced about 5 days after birth."
CORRECT ANSWER: B. "Colostrum is thick, yellow, and has a low sugar content."
Rationale: Colostrum is the first milk, produced during the first few days postpartum. It
is thick, yellow, and high in protein, immunoglobulins (especially IgA), and leukocytes,
but low in fat and sugar (lactose). Mature milk is thin, watery, and bluish. It transitions
around day 3-5.
,Question 6: The nurse is monitoring a patient in the first stage of labor. The patient's
cervix is dilated to 6 cm, and the fetal presenting part is at -1 station. The nurse
notes the fetal heart rate has late decelerations. What is the priority nursing
action?
A. Increase the rate of the IV infusion
B. Turn the patient to her left side
C. Prepare for an emergency cesarean section
D. Administer oxygen at 2 L/min via nasal cannula
CORRECT ANSWER: B. Turn the patient to her left side
Rationale: Late decelerations indicate uteroplacental insufficiency. The first priority is to
increase maternal blood flow to the placenta by turning the patient to her left side to
relieve pressure on the vena cava. Other interventions include increasing IV fluids,
administering oxygen, and notifying the provider, but positioning is the immediate
action.
Question 7: A newborn is diagnosed with neonatal abstinence syndrome (NAS).
Which assessment finding would the nurse expect to observe?
A. Lethargy and poor feeding
B. Hypertonicity and a high-pitched cry
C. Hypothermia and bradycardia
D. Constipation and excessive sleeping
CORRECT ANSWER: B. Hypertonicity and a high-picked cry
Rationale: Neonatal abstinence syndrome results from withdrawal from opioids or other
substances. Clinical manifestations include central nervous system irritability, such as
hypertonicity, tremors, a high-pitched cry, and poor feeding. Lethargy, hypothermia, and
constipation are not classic signs of NAS.
Question 8: A nurse is caring for a patient who is 6 hours postpartum. The patient's
fundus is firm at the umbilicus and deviated to the right. The nurse notes a large
amount of lochia rubra. What is the priority action?
A. Massage the fundus firmly
B. Have the patient void
C. Administer oxytocin
D. Assess vital signs
CORRECT ANSWER: B. Have the patient void
Rationale: A fundus that is deviated to the side (usually right) indicates a full bladder
displacing the uterus. The bladder must be emptied to allow the uterus to contract
, effectively and prevent hemorrhage. Massaging a firm fundus is not necessary; the issue
is the displacement.
Question 9: A patient at 32 weeks' gestation is diagnosed with gestational diabetes
mellitus. Which of the following is a potential complication for the newborn?
A. Hyperglycemia
B. Microcephaly
C. Polycythemia
D. Hypocalcemia
CORRECT ANSWER: D. Hypocalcemia
Rationale: Infants of diabetic mothers are at risk for hypocalcemia due to a transient
suppression of parathyroid hormone. While hyperglycemia can occur briefly, the
neonate is more commonly at risk for hypoglycemia. Polycythemia and
hyperbilirubinemia are also risks, but hypocalcemia is a classic complication.
Question 10: The nurse is providing discharge teaching to a new mother on how to
care for her newborn's umbilical cord. Which statement by the mother indicates a
need for further teaching?
A. "I will keep the cord dry and clean."
B. "I will fold the diaper below the cord."
C. "I will clean the base with rubbing alcohol once a day."
D. "I will give the baby a tub bath until the cord falls off."
CORRECT ANSWER: D. "I will give the baby a tub bath until the cord falls off."
Rationale: The newborn should receive sponge baths until the umbilical cord falls off
and the area is healed to keep the cord dry. Submerging the cord in water can increase
the risk of infection. The other statements indicate correct understanding of cord care.
Question 11: A patient at 40 weeks' gestation is being induced with oxytocin. The
nurse notes the patient is having contractions every 1.5 minutes lasting 90
seconds. The fetal heart rate is 150 beats/min with early decelerations. What is the
nurse's priority action?
A. Stop the oxytocin infusion
B. Turn the patient to her right side
C. Continue to monitor as this is a normal finding
D. Administer a bolus of IV fluids
CORRECT ANSWER: A. Stop the oxytocin infusion
