NUR2513 Maternal-Child Nursing Final Exam -
Rasmussen College 2026-2027 - Pre-Licensure Nursing -
65 Items | 2-Hour Comprehensive Study Guide
NCLEX-RN NGN blueprint – 80 % application / 20 % knowledge
Pass target: 56/70 (80 %)
HOW TO USE THIS EXAM
Each vignette is followed by the BEST answer, a concise rationale, and a
“Family-Centered Pearl” you can use in clinical practice. Work through items
sequentially; do not skip rationales.
SECTION 1 Antepartum & Intrapartum Nursing (Items 1-20)
Item 1
A G2P1 client at 32 weeks reports a “frontal headache” that started this morning. BP
142/94 mmHg (repeat), DTR 2+, no pedal edema. Which finding requires immediate
provider notification?
A. 1+ pedal edema at day’s end
B. BP 142/94 mmHg
C. Frontal headache rated 5/10
,D. DTR 2+ bilaterally
Correct: C
Rationale: New-onset headache in preeclamptic range signals cerebral edema →
impending eclampsia.
Pearl: Always ask if headache is “different” or “won’t go away” – a red flag across
pregnancy stages.
Item 2 (NGN Extended Multiple Response)
Client in active labor requests non-pharmacologic pain relief. Which nurse-initiated
actions are appropriate? Select all.
A. Hands-and-knees position
B. Warm blanket on abdomen
C. Patterned breathing
D. Dim lights & quiet voices
E. Ice chips as tolerated
F. Start continuous LR infusion
Correct: A, C, D, E
Rationale: All are evidence-based comfort measures; B is not standard labor relief, F
requires an order/indication.
Pearl: Environment is a drug-free analgesic – dim lighting reduces adrenaline and pain
perception.
,Item 3
You auscultate a fetal heart rate of 180 bpm that has been sustained > 10 min. Maternal
temp 37.9 °C, BP 110/70 mmHg. Priority action?
A. Increase IV fluid rate
B. Apply oxygen 10 L/min via mask
C. Notify provider & obtain maternal temp/antibiotics per protocol
D. Reposition client left-lateral
Correct: C
Rationale: Fetal tachycardia + maternal fever = possible chorioamnionitis → timely
antibiotics improve neonatal outcome.
Pearl: Fetal tachycardia is often the first sign of maternal infection.
Item 4 (Dosage Calc)
Order: Magnesium sulfate 4 g IV loading dose over 30 min. Available: 4 g/100 mL NS.
Pump should be set at ___ mL/hr.
A. 100 mL/hr
B. 200 mL/hr
C. 400 mL/hr
D. 800 mL/hr
Correct: B
, Steps: 100 mL ÷ 0.5 hr = 200 mL/hr.
Pearl: Always use a pump for mag loading; have calcium gluconate on the unit.
Item 5
During transition (second stage) fetal monitor shows early decelerations with each
contraction. Nurse’s conclusion?
A. Normal vagal response to head compression – continue monitoring
B. Maternal hypotension – give ephedrine
C. Placental abruption – call stat section
D. Cord compression – reposition mother
Correct: A
Rationale: Early decels = benign vagal reflex from head compression; symmetrical,
recover by end of contraction.
Pearl: Do NOT treat early decels – document and watch for evolution to late/variable
patterns.
Item 6
You note late decelerations that do not return to baseline by 30 s after contraction ends.
Maternal BP 90/50 mmHg. First action?
A. Increase IV fluids & place left-lateral position
B. Start O2 10 L/min
C. Give terbutaline 0.25 mg SQ
Rasmussen College 2026-2027 - Pre-Licensure Nursing -
65 Items | 2-Hour Comprehensive Study Guide
NCLEX-RN NGN blueprint – 80 % application / 20 % knowledge
Pass target: 56/70 (80 %)
HOW TO USE THIS EXAM
Each vignette is followed by the BEST answer, a concise rationale, and a
“Family-Centered Pearl” you can use in clinical practice. Work through items
sequentially; do not skip rationales.
SECTION 1 Antepartum & Intrapartum Nursing (Items 1-20)
Item 1
A G2P1 client at 32 weeks reports a “frontal headache” that started this morning. BP
142/94 mmHg (repeat), DTR 2+, no pedal edema. Which finding requires immediate
provider notification?
A. 1+ pedal edema at day’s end
B. BP 142/94 mmHg
C. Frontal headache rated 5/10
,D. DTR 2+ bilaterally
Correct: C
Rationale: New-onset headache in preeclamptic range signals cerebral edema →
impending eclampsia.
Pearl: Always ask if headache is “different” or “won’t go away” – a red flag across
pregnancy stages.
Item 2 (NGN Extended Multiple Response)
Client in active labor requests non-pharmacologic pain relief. Which nurse-initiated
actions are appropriate? Select all.
A. Hands-and-knees position
B. Warm blanket on abdomen
C. Patterned breathing
D. Dim lights & quiet voices
E. Ice chips as tolerated
F. Start continuous LR infusion
Correct: A, C, D, E
Rationale: All are evidence-based comfort measures; B is not standard labor relief, F
requires an order/indication.
Pearl: Environment is a drug-free analgesic – dim lighting reduces adrenaline and pain
perception.
,Item 3
You auscultate a fetal heart rate of 180 bpm that has been sustained > 10 min. Maternal
temp 37.9 °C, BP 110/70 mmHg. Priority action?
A. Increase IV fluid rate
B. Apply oxygen 10 L/min via mask
C. Notify provider & obtain maternal temp/antibiotics per protocol
D. Reposition client left-lateral
Correct: C
Rationale: Fetal tachycardia + maternal fever = possible chorioamnionitis → timely
antibiotics improve neonatal outcome.
Pearl: Fetal tachycardia is often the first sign of maternal infection.
Item 4 (Dosage Calc)
Order: Magnesium sulfate 4 g IV loading dose over 30 min. Available: 4 g/100 mL NS.
Pump should be set at ___ mL/hr.
A. 100 mL/hr
B. 200 mL/hr
C. 400 mL/hr
D. 800 mL/hr
Correct: B
, Steps: 100 mL ÷ 0.5 hr = 200 mL/hr.
Pearl: Always use a pump for mag loading; have calcium gluconate on the unit.
Item 5
During transition (second stage) fetal monitor shows early decelerations with each
contraction. Nurse’s conclusion?
A. Normal vagal response to head compression – continue monitoring
B. Maternal hypotension – give ephedrine
C. Placental abruption – call stat section
D. Cord compression – reposition mother
Correct: A
Rationale: Early decels = benign vagal reflex from head compression; symmetrical,
recover by end of contraction.
Pearl: Do NOT treat early decels – document and watch for evolution to late/variable
patterns.
Item 6
You note late decelerations that do not return to baseline by 30 s after contraction ends.
Maternal BP 90/50 mmHg. First action?
A. Increase IV fluids & place left-lateral position
B. Start O2 10 L/min
C. Give terbutaline 0.25 mg SQ
