DRILL EXAM MATERNITY AND PEDIATRIC NURSING (2026/2027) | NEWEST UPDATED
EXAM SOLVED
Maternity & Pediatric Nursing Intensive Drill Examination | Core Domains: Antepartum, Intrapartum
& Postpartum Complications, High-Risk Newborn Care, Pediatric Emergency & Critical Conditions,
Pediatric Infectious Diseases & Immunizations, Pediatric Chronic Illness Management, Maternal &
Pediatric Pharmacology, and Family Crisis & Bereavement Support | Nursing Program Focus |
High-Acuity & Complication-Focused Drill Exam Format
Exam Structure
The Maternity & Pediatric Nursing Drill Exam for the 2026/2027 academic cycle is an 80-question,
multiple-choice question (MCQ) examination.
Introduction
This Maternity & Pediatric Nursing Drill Exam for the 2026/2027 cycle provides intensive,
scenario-based practice focusing on complications, emergencies, and high-acuity situations in
maternal-child health. The content emphasizes rapid assessment, critical decision-making, and
evidence-based interventions for life-threatening maternal, neonatal and pediatric conditions, preparing
nurses for high-stakes clinical situations.
Answer Format
All correct answers and priority interventions must be presented in bold and green, followed by
detailed rationales that apply emergency protocols (e.g., neonatal resuscitation, eclampsia management),
explain pathophysiological crises, justify time-sensitive pharmacologic interventions, and prioritize
actions based on maternal-fetal or pediatric clinical stability.
Questions (80 Total)
1. A pregnant client at 36 weeks suddenly develops seizures. What is the nurse’s priority action?
A. Administer oral antihypertensives
B. Maintain airway and administer magnesium sulfate IV
C. Prepare for immediate vaginal delivery
D. Place in Trendelenburg position
Rationale: This is eclampsia—a medical emergency. Priority is maternal airway protection and
seizure control. Magnesium sulfate is the first-line anticonvulsant. Do not restrain or place anything in
the mouth. After stabilization, delivery is definitive treatment, but airway and seizure control come first
per ACOG guidelines.
2. A newborn is not breathing at birth. After initial steps (warm, dry, stimulate), there is no respiratory
effort. What is the next action?
A. Administer epinephrine
,B. Begin positive-pressure ventilation (PPV) with a bag-mask device
C. Perform chest compressions
D. Delay intervention for 1 more minute
Rationale: Per Neonatal Resuscitation Program (NRP) 2025 guidelines, if a newborn remains apneic
after initial steps, PPV is initiated immediately. Heart rate determines next steps: if HR <60 after 30 sec
of effective PPV, start compressions. Epinephrine is given only if HR remains <60 after PPV and
compressions.
3. A 2-year-old presents with stridor, drooling, and sitting upright leaning forward. What condition is
suspected?
A. Croup
B. Epiglottitis
C. Asthma
D. Foreign body aspiration
Rationale: Epiglottitis is a life-threatening bacterial infection (often H. influenzae type B, though rare
post-vaccine) causing supraglottic swelling. Classic triad: drooling, dysphagia, and distress in tripod
position. Do NOT examine the throat—this can trigger complete airway obstruction. Prepare for
possible intubation or tracheostomy in controlled setting.
4. A postpartum client 24 hours after delivery has a boggy uterus and heavy lochia. What is the priority
intervention?
A. Administer oxytocin IV
B. Massage the fundus until firm
C. Increase oral fluids
D. Apply ice pack to perineum
Rationale: Uterine atony is the leading cause of postpartum hemorrhage. Fundal massage stimulates
contraction and is the immediate bedside action. Oxytocin is also given, but massage is first. Assess
bladder distension—full bladder displaces uterus and prevents contraction.
5. A 6-month-old with bronchiolitis has a respiratory rate of 70/min, nasal flaring, and grunting. What is
the priority concern?
A. Dehydration
B. Impending respiratory failure
C. Fever
, D. Ear infection
Rationale: Tachypnea >60, nasal flaring, and grunting are signs of respiratory distress. Grunting is a
compensatory mechanism to maintain FRC. These indicate progression toward respiratory failure.
Monitor oxygen saturation closely; prepare for possible CPAP or intubation. Hydration is important but
secondary to airway.
6. A child with type 1 diabetes has blood glucose of 52 mg/dL and is lethargic but responsive. What should
the nurse administer?
A. Glucagon IM
B. Oral glucose gel or juice
C. IV dextrose 50%
D. Subcutaneous insulin
Rationale: For a conscious, responsive child with hypoglycemia, fast-acting carbohydrate (e.g., 15 g
glucose gel, juice) is first-line. Glucagon or IV dextrose is reserved for unconscious/unresponsive
patients. Insulin would worsen hypoglycemia. Recheck glucose in 15 minutes (Rule of 15).
7. A pregnant client with preeclampsia has a platelet count of 80,000/mm³, elevated LFTs, and RUQ
pain. What complication is developing?
A. Gestational diabetes
B. HELLP syndrome
C. Placenta previa
D. Ectopic pregnancy
Rationale: HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of
preeclampsia. RUQ or epigastric pain suggests hepatic capsular distension. It is a medical emergency
requiring delivery and supportive care. Platelets <100,000, AST/ALT >70, and LDH elevation confirm
diagnosis.
8. A newborn delivered at 28 weeks gestation is cyanotic with weak respiratory effort. What is the first
intervention?
A. Administer vitamin K
B. Initiate positive-pressure ventilation with 21–30% oxygen
C. Delay cord clamping for 5 minutes
D. Bathe immediately to prevent infection
EXAM SOLVED
Maternity & Pediatric Nursing Intensive Drill Examination | Core Domains: Antepartum, Intrapartum
& Postpartum Complications, High-Risk Newborn Care, Pediatric Emergency & Critical Conditions,
Pediatric Infectious Diseases & Immunizations, Pediatric Chronic Illness Management, Maternal &
Pediatric Pharmacology, and Family Crisis & Bereavement Support | Nursing Program Focus |
High-Acuity & Complication-Focused Drill Exam Format
Exam Structure
The Maternity & Pediatric Nursing Drill Exam for the 2026/2027 academic cycle is an 80-question,
multiple-choice question (MCQ) examination.
Introduction
This Maternity & Pediatric Nursing Drill Exam for the 2026/2027 cycle provides intensive,
scenario-based practice focusing on complications, emergencies, and high-acuity situations in
maternal-child health. The content emphasizes rapid assessment, critical decision-making, and
evidence-based interventions for life-threatening maternal, neonatal and pediatric conditions, preparing
nurses for high-stakes clinical situations.
Answer Format
All correct answers and priority interventions must be presented in bold and green, followed by
detailed rationales that apply emergency protocols (e.g., neonatal resuscitation, eclampsia management),
explain pathophysiological crises, justify time-sensitive pharmacologic interventions, and prioritize
actions based on maternal-fetal or pediatric clinical stability.
Questions (80 Total)
1. A pregnant client at 36 weeks suddenly develops seizures. What is the nurse’s priority action?
A. Administer oral antihypertensives
B. Maintain airway and administer magnesium sulfate IV
C. Prepare for immediate vaginal delivery
D. Place in Trendelenburg position
Rationale: This is eclampsia—a medical emergency. Priority is maternal airway protection and
seizure control. Magnesium sulfate is the first-line anticonvulsant. Do not restrain or place anything in
the mouth. After stabilization, delivery is definitive treatment, but airway and seizure control come first
per ACOG guidelines.
2. A newborn is not breathing at birth. After initial steps (warm, dry, stimulate), there is no respiratory
effort. What is the next action?
A. Administer epinephrine
,B. Begin positive-pressure ventilation (PPV) with a bag-mask device
C. Perform chest compressions
D. Delay intervention for 1 more minute
Rationale: Per Neonatal Resuscitation Program (NRP) 2025 guidelines, if a newborn remains apneic
after initial steps, PPV is initiated immediately. Heart rate determines next steps: if HR <60 after 30 sec
of effective PPV, start compressions. Epinephrine is given only if HR remains <60 after PPV and
compressions.
3. A 2-year-old presents with stridor, drooling, and sitting upright leaning forward. What condition is
suspected?
A. Croup
B. Epiglottitis
C. Asthma
D. Foreign body aspiration
Rationale: Epiglottitis is a life-threatening bacterial infection (often H. influenzae type B, though rare
post-vaccine) causing supraglottic swelling. Classic triad: drooling, dysphagia, and distress in tripod
position. Do NOT examine the throat—this can trigger complete airway obstruction. Prepare for
possible intubation or tracheostomy in controlled setting.
4. A postpartum client 24 hours after delivery has a boggy uterus and heavy lochia. What is the priority
intervention?
A. Administer oxytocin IV
B. Massage the fundus until firm
C. Increase oral fluids
D. Apply ice pack to perineum
Rationale: Uterine atony is the leading cause of postpartum hemorrhage. Fundal massage stimulates
contraction and is the immediate bedside action. Oxytocin is also given, but massage is first. Assess
bladder distension—full bladder displaces uterus and prevents contraction.
5. A 6-month-old with bronchiolitis has a respiratory rate of 70/min, nasal flaring, and grunting. What is
the priority concern?
A. Dehydration
B. Impending respiratory failure
C. Fever
, D. Ear infection
Rationale: Tachypnea >60, nasal flaring, and grunting are signs of respiratory distress. Grunting is a
compensatory mechanism to maintain FRC. These indicate progression toward respiratory failure.
Monitor oxygen saturation closely; prepare for possible CPAP or intubation. Hydration is important but
secondary to airway.
6. A child with type 1 diabetes has blood glucose of 52 mg/dL and is lethargic but responsive. What should
the nurse administer?
A. Glucagon IM
B. Oral glucose gel or juice
C. IV dextrose 50%
D. Subcutaneous insulin
Rationale: For a conscious, responsive child with hypoglycemia, fast-acting carbohydrate (e.g., 15 g
glucose gel, juice) is first-line. Glucagon or IV dextrose is reserved for unconscious/unresponsive
patients. Insulin would worsen hypoglycemia. Recheck glucose in 15 minutes (Rule of 15).
7. A pregnant client with preeclampsia has a platelet count of 80,000/mm³, elevated LFTs, and RUQ
pain. What complication is developing?
A. Gestational diabetes
B. HELLP syndrome
C. Placenta previa
D. Ectopic pregnancy
Rationale: HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of
preeclampsia. RUQ or epigastric pain suggests hepatic capsular distension. It is a medical emergency
requiring delivery and supportive care. Platelets <100,000, AST/ALT >70, and LDH elevation confirm
diagnosis.
8. A newborn delivered at 28 weeks gestation is cyanotic with weak respiratory effort. What is the first
intervention?
A. Administer vitamin K
B. Initiate positive-pressure ventilation with 21–30% oxygen
C. Delay cord clamping for 5 minutes
D. Bathe immediately to prevent infection
