MATERNITY & PEDIATRIC NURSING EXAM PRACTICE (2026/2027) | NEWEST
UPDATED EXAM SOLVED
Maternity & Pediatric Nursing Comprehensive Practice Examination | Core Domains: Reproductive
Health & Antepartum Care, Intrapartum & Postpartum Management, Newborn Assessment & Care,
Pediatric Growth & Development, Common Pediatric Illnesses & Disorders, Pediatric Pharmacology &
Medication Safety, Family-Centered Care & Communication, and Health Promotion Across the
Childbearing & Child-Rearing Continuum | Nursing Program Focus | Integrated Specialty Practice
Exam Format
Exam Structure
The Maternity & Pediatric Nursing Practice Exam for the 2026/2027 academic cycle is a 125-question,
multiple-choice question (MCQ) examination.
Introduction
This Maternity & Pediatric Nursing Practice Exam guide for the 2026/2027 cycle provides integrated
preparation for the nursing care of childbearing families and pediatric patients. The content combines
knowledge of maternal-fetal physiology, newborn adaptation, and pediatric health across developmental
stages, emphasizing evidence-based interventions, family dynamics, and safe, age-specific care practices.
Answer Format
All correct answers and nursing interventions must be presented in bold and green, followed by
detailed rationales that apply maternal-fetal and pediatric pathophysiology, integrate developmental
milestones (Erikson, Piaget), justify weight-based medication calculations, prioritize family-centered care,
and incorporate health promotion and risk reduction strategies for both mother and child.
Questions (125 Total)
1. A pregnant client at 32 weeks reports sudden, painless vaginal bleeding. What condition should the
nurse suspect?
A. Placental abruption
B. Placenta previa
C. Ectopic pregnancy
D. Preeclampsia
Rationale: Placenta previa presents with painless, bright red vaginal bleeding in the second or third
trimester due to placental implantation over or near the cervical os. Placental abruption causes painful,
dark red bleeding with uterine tenderness. Vaginal exams are contraindicated until ultrasound confirms
placental location.
2. A newborn’s Apgar score at 1 minute is 8. What does this indicate?
A. Severe distress requiring immediate resuscitation
,B. Good transition with minor adjustments needed
C. Need for NICU admission
D. Normal heart rate but absent reflexes
Rationale: Apgar scores range from 0–10. Scores of 7–10 indicate good condition; 4–6 suggest
moderate difficulty; 0–3 indicate severe distress. An 8 means the infant has strong heart rate,
respiratory effort, muscle tone, reflex irritability, and only mild cyanosis (e.g., acrocyanosis). No
resuscitation is needed beyond routine care.
3. A 4-year-old child weighs 16 kg and is prescribed amoxicillin 40 mg/kg/day divided every 8 hours. The
available suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?
A. 3.2 mL
B. 4.3 mL
C. 5.0 mL
D. 6.4 mL
Rationale: Total daily dose = 40 mg/kg × 16 kg = 640 mg/day. Divided every 8 hours = 3 doses → 640
÷ 3 ≈ 213.3 mg/dose. Concentration = 250 mg/5 mL = 50 mg/mL. Volume = 213.3 ÷ 50 ≈ 4.27 mL →
round to 4.3 mL. Accurate weight-based dosing prevents under/over-treatment.
4. During labor, a client’s fetal heart rate tracing shows late decelerations. What is the nurse’s priority
action?
A. Administer oxygen via nasal cannula
B. Increase IV fluids
C. Reposition the client to left lateral position
D. Prepare for immediate cesarean delivery
Rationale: Late decelerations indicate uteroplacental insufficiency. The first intervention is to improve
perfusion by repositioning the client to left lateral to relieve pressure on the vena cava. Then administer
oxygen, increase IV fluids, and notify the provider. Cesarean delivery is considered if decelerations
persist despite interventions.
5. Which finding in a 2-day-old newborn requires immediate follow-up?
A. Weight loss of 5%
B. Caput succedaneum
C. Jaundice appearing within the first 24 hours
,D. Acrocyanosis
Rationale: Jaundice in the first 24 hours is pathologic and may indicate hemolytic disease (e.g.,
Rh/ABO incompatibility), infection, or metabolic disorder. Physiologic jaundice appears after 24 hours.
Weight loss ≤7% is normal. Caput and acrocyanosis are benign transitional findings.
6. A postpartum client reports feeling sad, tearful, and overwhelmed 4 days after delivery. She is bonding
with her infant but has trouble sleeping. What is the most likely diagnosis?
A. Postpartum psychosis
B. Postpartum blues
C. Postpartum depression
D. Bipolar disorder
Rationale: Postpartum blues affect 50–80% of new mothers, peak at days 3–5, and resolve within 2
weeks. Symptoms include mood swings, crying, fatigue, and anxiety—but the mother remains oriented
and bonded to the infant. Postpartum depression is more severe, persistent (>2 weeks), and impairs
function.
7. According to Erikson, a 2-year-old is in which stage of psychosocial development?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Rationale: Erikson’s stages: Birth–1 year = Trust vs. Mistrust; 1–3 years = Autonomy vs.
Shame/Doubt (toilet training, independence); 3–6 years = Initiative vs. Guilt; 6–12 years = Industry vs.
Inferiority. Supporting autonomy (e.g., allowing choices) fosters healthy development.
8. A pregnant client at 28 weeks has a blood pressure of 142/92 mm Hg and 2+ proteinuria. What
condition is suspected?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Eclampsia
Rationale: Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks with
proteinuria (≥1+ on dipstick or PCR ≥0.3). Eclampsia includes seizures. Immediate monitoring for
HELLP syndrome and fetal well-being is essential.
, 9. When teaching parents about car seat safety for their newborn, the nurse should emphasize:
A. Forward-facing is acceptable after 1 month
B. Rear-facing in the back seat until at least age 2
C. Use of a booster seat immediately
D. Front passenger seat with airbag off
Rationale: AAP recommends infants remain rear-facing in the back seat until at least age 2 or until
they reach the car seat’s height/weight limit. Airbags can cause fatal injury to rear-facing infants in the
front seat. Booster seats are for older children (typically >40 lb).
10. A 6-month-old infant is admitted with bronchiolitis. Which intervention is priority?
A. Administer albuterol nebulizer
B. Suction nares to maintain airway patency
C. Start IV antibiotics
D. Encourage solid foods
Rationale: Infants are obligate nose breathers. Nasal congestion from RSV-induced bronchiolitis
impairs breathing and feeding. Gentle bulb suctioning before feeds and sleep is critical. Albuterol is not
routinely recommended. Antibiotics are ineffective against viruses.
11. A 6-month-old should be able to:
A. Walk with support
B. Roll from back to front
C. Say two-word phrases
D. Use a pincer grasp
Rationale: By 6 months, infants roll front-to-back and back-to-front, sit with support, and babble.
Walking with support occurs at 9–12 months. Two-word phrases emerge at 18–24 months. Pincer grasp
develops around 9 months.
12. A child with croup has a barking cough and stridor. What is the first-line treatment?
A. Antibiotics
B. Nebulized epinephrine and corticosteroids
C. Chest physiotherapy
UPDATED EXAM SOLVED
Maternity & Pediatric Nursing Comprehensive Practice Examination | Core Domains: Reproductive
Health & Antepartum Care, Intrapartum & Postpartum Management, Newborn Assessment & Care,
Pediatric Growth & Development, Common Pediatric Illnesses & Disorders, Pediatric Pharmacology &
Medication Safety, Family-Centered Care & Communication, and Health Promotion Across the
Childbearing & Child-Rearing Continuum | Nursing Program Focus | Integrated Specialty Practice
Exam Format
Exam Structure
The Maternity & Pediatric Nursing Practice Exam for the 2026/2027 academic cycle is a 125-question,
multiple-choice question (MCQ) examination.
Introduction
This Maternity & Pediatric Nursing Practice Exam guide for the 2026/2027 cycle provides integrated
preparation for the nursing care of childbearing families and pediatric patients. The content combines
knowledge of maternal-fetal physiology, newborn adaptation, and pediatric health across developmental
stages, emphasizing evidence-based interventions, family dynamics, and safe, age-specific care practices.
Answer Format
All correct answers and nursing interventions must be presented in bold and green, followed by
detailed rationales that apply maternal-fetal and pediatric pathophysiology, integrate developmental
milestones (Erikson, Piaget), justify weight-based medication calculations, prioritize family-centered care,
and incorporate health promotion and risk reduction strategies for both mother and child.
Questions (125 Total)
1. A pregnant client at 32 weeks reports sudden, painless vaginal bleeding. What condition should the
nurse suspect?
A. Placental abruption
B. Placenta previa
C. Ectopic pregnancy
D. Preeclampsia
Rationale: Placenta previa presents with painless, bright red vaginal bleeding in the second or third
trimester due to placental implantation over or near the cervical os. Placental abruption causes painful,
dark red bleeding with uterine tenderness. Vaginal exams are contraindicated until ultrasound confirms
placental location.
2. A newborn’s Apgar score at 1 minute is 8. What does this indicate?
A. Severe distress requiring immediate resuscitation
,B. Good transition with minor adjustments needed
C. Need for NICU admission
D. Normal heart rate but absent reflexes
Rationale: Apgar scores range from 0–10. Scores of 7–10 indicate good condition; 4–6 suggest
moderate difficulty; 0–3 indicate severe distress. An 8 means the infant has strong heart rate,
respiratory effort, muscle tone, reflex irritability, and only mild cyanosis (e.g., acrocyanosis). No
resuscitation is needed beyond routine care.
3. A 4-year-old child weighs 16 kg and is prescribed amoxicillin 40 mg/kg/day divided every 8 hours. The
available suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?
A. 3.2 mL
B. 4.3 mL
C. 5.0 mL
D. 6.4 mL
Rationale: Total daily dose = 40 mg/kg × 16 kg = 640 mg/day. Divided every 8 hours = 3 doses → 640
÷ 3 ≈ 213.3 mg/dose. Concentration = 250 mg/5 mL = 50 mg/mL. Volume = 213.3 ÷ 50 ≈ 4.27 mL →
round to 4.3 mL. Accurate weight-based dosing prevents under/over-treatment.
4. During labor, a client’s fetal heart rate tracing shows late decelerations. What is the nurse’s priority
action?
A. Administer oxygen via nasal cannula
B. Increase IV fluids
C. Reposition the client to left lateral position
D. Prepare for immediate cesarean delivery
Rationale: Late decelerations indicate uteroplacental insufficiency. The first intervention is to improve
perfusion by repositioning the client to left lateral to relieve pressure on the vena cava. Then administer
oxygen, increase IV fluids, and notify the provider. Cesarean delivery is considered if decelerations
persist despite interventions.
5. Which finding in a 2-day-old newborn requires immediate follow-up?
A. Weight loss of 5%
B. Caput succedaneum
C. Jaundice appearing within the first 24 hours
,D. Acrocyanosis
Rationale: Jaundice in the first 24 hours is pathologic and may indicate hemolytic disease (e.g.,
Rh/ABO incompatibility), infection, or metabolic disorder. Physiologic jaundice appears after 24 hours.
Weight loss ≤7% is normal. Caput and acrocyanosis are benign transitional findings.
6. A postpartum client reports feeling sad, tearful, and overwhelmed 4 days after delivery. She is bonding
with her infant but has trouble sleeping. What is the most likely diagnosis?
A. Postpartum psychosis
B. Postpartum blues
C. Postpartum depression
D. Bipolar disorder
Rationale: Postpartum blues affect 50–80% of new mothers, peak at days 3–5, and resolve within 2
weeks. Symptoms include mood swings, crying, fatigue, and anxiety—but the mother remains oriented
and bonded to the infant. Postpartum depression is more severe, persistent (>2 weeks), and impairs
function.
7. According to Erikson, a 2-year-old is in which stage of psychosocial development?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Rationale: Erikson’s stages: Birth–1 year = Trust vs. Mistrust; 1–3 years = Autonomy vs.
Shame/Doubt (toilet training, independence); 3–6 years = Initiative vs. Guilt; 6–12 years = Industry vs.
Inferiority. Supporting autonomy (e.g., allowing choices) fosters healthy development.
8. A pregnant client at 28 weeks has a blood pressure of 142/92 mm Hg and 2+ proteinuria. What
condition is suspected?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Eclampsia
Rationale: Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks with
proteinuria (≥1+ on dipstick or PCR ≥0.3). Eclampsia includes seizures. Immediate monitoring for
HELLP syndrome and fetal well-being is essential.
, 9. When teaching parents about car seat safety for their newborn, the nurse should emphasize:
A. Forward-facing is acceptable after 1 month
B. Rear-facing in the back seat until at least age 2
C. Use of a booster seat immediately
D. Front passenger seat with airbag off
Rationale: AAP recommends infants remain rear-facing in the back seat until at least age 2 or until
they reach the car seat’s height/weight limit. Airbags can cause fatal injury to rear-facing infants in the
front seat. Booster seats are for older children (typically >40 lb).
10. A 6-month-old infant is admitted with bronchiolitis. Which intervention is priority?
A. Administer albuterol nebulizer
B. Suction nares to maintain airway patency
C. Start IV antibiotics
D. Encourage solid foods
Rationale: Infants are obligate nose breathers. Nasal congestion from RSV-induced bronchiolitis
impairs breathing and feeding. Gentle bulb suctioning before feeds and sleep is critical. Albuterol is not
routinely recommended. Antibiotics are ineffective against viruses.
11. A 6-month-old should be able to:
A. Walk with support
B. Roll from back to front
C. Say two-word phrases
D. Use a pincer grasp
Rationale: By 6 months, infants roll front-to-back and back-to-front, sit with support, and babble.
Walking with support occurs at 9–12 months. Two-word phrases emerge at 18–24 months. Pincer grasp
develops around 9 months.
12. A child with croup has a barking cough and stridor. What is the first-line treatment?
A. Antibiotics
B. Nebulized epinephrine and corticosteroids
C. Chest physiotherapy
