**Title:** **Obstetric & Newborn Success: The
Maternal-Newborn Nursing Mastery Exam**
---
### Question 1 of 73
A nurse is caring for a client who is at 38 weeks of gestation and is receiving an oxytocin (Pitocin)
infusion for induction of labor. The nurse notes that the client is having contractions every 1.5 minutes
lasting 90 seconds. The fetal heart rate tracing shows late decelerations. Which of the following actions
should the nurse take first?
A) Decrease the oxytocin infusion rate.
B) Position the client on her left side.
C) Administer oxygen via face mask at 10 L/min.
D) Stop the oxytocin infusion.
💫RATIONALE✔️✔️: Late decelerations indicate uteroplacental insufficiency, often caused by excessive
uterine activity. The first action is to stop the oxytocin infusion (D) to reduce contractions and restore
placental blood flow. After stopping, the nurse should reposition the client, administer oxygen, and
increase IV fluids.
💫ANSWER✔️✔️: D) Stop the oxytocin infusion.
---
### Question 2 of 73
A nurse is assessing a newborn who is 2 hours old. The newborn’s respiratory rate is 68 breaths per
minute with nasal flaring and grunting. Which of the following actions should the nurse take first?
,A) Place the newborn on a cardiorespiratory monitor.
B) Notify the healthcare provider.
C) Suction the newborn’s mouth and nose.
D) Check the newborn’s oxygen saturation.
💫RATIONALE✔️✔️: Tachypnea with grunting and nasal flaring indicates respiratory distress. The first
action is to check oxygen saturation (D) to assess the severity of hypoxemia, then notify the provider.
Suctioning may be needed if secretions are present, but not first.
💫ANSWER✔️✔️: D) Check the newborn’s oxygen saturation.
---
### Question 3 of 73
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to a client who is
breastfeeding her newborn. Which of the following statements by the client indicates understanding?
(Select all that apply.)
A) “I will feed my baby every 2 to 3 hours during the day.”
B) “My baby should have at least 6 to 8 wet diapers per day by day 4.”
C) “I will wash my nipples with antibacterial soap before each feeding.”
D) “I can take ibuprofen for after-birth pain while breastfeeding.”
E) “If my baby falls asleep after 5 minutes of feeding, that means he is full.”
💫RATIONALE✔️✔️: Newborns should feed q2-3h (A). At least 6-8 wet diapers daily by day 4 indicates
adequate hydration (B). Ibuprofen is safe in breastfeeding (D). Soap is drying; plain water is sufficient
(C). Falling asleep early suggests ineffective latch, not fullness (E).
💫ANSWER✔️✔️: A, B, D
---
, ### Question 4 of 73
A nurse is assessing a client who is 6 hours postpartum after a vaginal delivery. The client’s fundus is
firm and at the umbilicus, but she is saturating a perineal pad every 15 minutes with bright red blood.
Which of the following actions should the nurse take first?
A) Massage the fundus.
B) Assess the perineum for lacerations.
C) Administer methylergonovine (Methergine) as prescribed.
D) Notify the healthcare provider.
💫RATIONALE✔️✔️: Heavy bright red bleeding with a firm fundus suggests a vaginal or cervical laceration,
not uterine atony. The nurse should first assess the perineum (B) to identify the source of bleeding.
Massaging a firm fundus is unnecessary.
💫ANSWER✔️✔️: B) Assess the perineum for lacerations.
---
### Question 5 of 73
A nurse is caring for a client who is in active labor. The client’s cervical examination is 7 cm, 90% effaced,
and +1 station. The client suddenly reports severe abdominal pain and the nurse notes a board-like
abdomen and absent fetal heart tones. Which of the following complications should the nurse suspect?
A) Placental abruption
B) Uterine rupture
C) Amniotic fluid embolism
D) Umbilical cord prolapse
Maternal-Newborn Nursing Mastery Exam**
---
### Question 1 of 73
A nurse is caring for a client who is at 38 weeks of gestation and is receiving an oxytocin (Pitocin)
infusion for induction of labor. The nurse notes that the client is having contractions every 1.5 minutes
lasting 90 seconds. The fetal heart rate tracing shows late decelerations. Which of the following actions
should the nurse take first?
A) Decrease the oxytocin infusion rate.
B) Position the client on her left side.
C) Administer oxygen via face mask at 10 L/min.
D) Stop the oxytocin infusion.
💫RATIONALE✔️✔️: Late decelerations indicate uteroplacental insufficiency, often caused by excessive
uterine activity. The first action is to stop the oxytocin infusion (D) to reduce contractions and restore
placental blood flow. After stopping, the nurse should reposition the client, administer oxygen, and
increase IV fluids.
💫ANSWER✔️✔️: D) Stop the oxytocin infusion.
---
### Question 2 of 73
A nurse is assessing a newborn who is 2 hours old. The newborn’s respiratory rate is 68 breaths per
minute with nasal flaring and grunting. Which of the following actions should the nurse take first?
,A) Place the newborn on a cardiorespiratory monitor.
B) Notify the healthcare provider.
C) Suction the newborn’s mouth and nose.
D) Check the newborn’s oxygen saturation.
💫RATIONALE✔️✔️: Tachypnea with grunting and nasal flaring indicates respiratory distress. The first
action is to check oxygen saturation (D) to assess the severity of hypoxemia, then notify the provider.
Suctioning may be needed if secretions are present, but not first.
💫ANSWER✔️✔️: D) Check the newborn’s oxygen saturation.
---
### Question 3 of 73
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to a client who is
breastfeeding her newborn. Which of the following statements by the client indicates understanding?
(Select all that apply.)
A) “I will feed my baby every 2 to 3 hours during the day.”
B) “My baby should have at least 6 to 8 wet diapers per day by day 4.”
C) “I will wash my nipples with antibacterial soap before each feeding.”
D) “I can take ibuprofen for after-birth pain while breastfeeding.”
E) “If my baby falls asleep after 5 minutes of feeding, that means he is full.”
💫RATIONALE✔️✔️: Newborns should feed q2-3h (A). At least 6-8 wet diapers daily by day 4 indicates
adequate hydration (B). Ibuprofen is safe in breastfeeding (D). Soap is drying; plain water is sufficient
(C). Falling asleep early suggests ineffective latch, not fullness (E).
💫ANSWER✔️✔️: A, B, D
---
, ### Question 4 of 73
A nurse is assessing a client who is 6 hours postpartum after a vaginal delivery. The client’s fundus is
firm and at the umbilicus, but she is saturating a perineal pad every 15 minutes with bright red blood.
Which of the following actions should the nurse take first?
A) Massage the fundus.
B) Assess the perineum for lacerations.
C) Administer methylergonovine (Methergine) as prescribed.
D) Notify the healthcare provider.
💫RATIONALE✔️✔️: Heavy bright red bleeding with a firm fundus suggests a vaginal or cervical laceration,
not uterine atony. The nurse should first assess the perineum (B) to identify the source of bleeding.
Massaging a firm fundus is unnecessary.
💫ANSWER✔️✔️: B) Assess the perineum for lacerations.
---
### Question 5 of 73
A nurse is caring for a client who is in active labor. The client’s cervical examination is 7 cm, 90% effaced,
and +1 station. The client suddenly reports severe abdominal pain and the nurse notes a board-like
abdomen and absent fetal heart tones. Which of the following complications should the nurse suspect?
A) Placental abruption
B) Uterine rupture
C) Amniotic fluid embolism
D) Umbilical cord prolapse
