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NUR 202/ NUR202 Exam 2 – Maternal-Newborn Nursing Review ACTUAL EXAM 2026/2027 | Maternal-Newborn Nursing Review | Verified Q&A | Pass Guaranteed - A+ Graded

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Pass your obstetrics nursing exam with this 2026/2027 complete actual exam for NUR 202 Exam 2 – Maternal-Newborn Nursing Review at Fortis. Covers high-risk antepartum complications, intrapartum emergencies (shoulder dystocia, prolapsed cord), postpartum hemorrhage and infections, neonatal resuscitation and respiratory distress, and gestational diabetes/hypertensive disorders. Includes detailed rationales. Backed by our Pass Guarantee. Download now.

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​ UR 202/ NUR202 Exam 2 –​
N
​Maternal-Newborn Nursing Review​
​ACTUAL EXAM 2026/2027 |​
​Maternal-Newborn Nursing Review |​
​Verified Q&A | Pass Guaranteed - A+​
​Graded​
​ =======================================================================​
=
​======== PART A – MULTIPLE CHOICE (Q1-60)​
​Q1 (Respiratory – COPD oxygen therapy): A 68-year-old patient with severe COPD presents to​
​the emergency department with acute exacerbation. Respiratory rate is 28, SpO₂ is 84% on​
​room air, and ABG shows pH 7.32, PaCO₂ 58 mmHg, HCO₃⁻ 30 mEq/L. Which oxygen delivery​
​target is most appropriate for this patient?​
​A. Maintain SpO₂ ≥ 95% using a non-rebreather mask at 15 L/min​
​B. Maintain SpO₂ 88-92% using nasal cannula at 2-4 L/min​
​C. Maintain SpO₂ 85-88% using nasal cannula at 1-2 L/min​
​D. Maintain SpO₂ 94-98% using Venturi mask at 40% FiO₂​
​[CORRECT] B​
​Rationale: The GOLD 2026 guidelines recommend maintaining SpO₂ 88-92% in patients with​
​COPD and chronic hypercapnia to avoid suppressing the hypoxic respiratory drive, which could​
​worsen CO₂ retention and respiratory acidosis. Option A is incorrect because high-flow oxygen​
​(>92%) in COPD patients with chronic hypercapnia can cause CO₂ narcosis and respiratory​
​failure. Option C is too low and does not provide adequate tissue oxygenation. Option D is​
​inappropriate because the Venturi mask at 40% would overshoot the safe target range. Clinical​
​pearl: Always check ABG after initiating oxygen in COPD; if PaCO₂ rises >10 mmHg or pH​
​drops below 7.25, consider non-invasive positive pressure ventilation (NIPPV).​
​Q2 (Respiratory – Asthma action plan): A 22-year-old with moderate persistent asthma uses a​
​daily inhaled corticosteroid (ICS) and a short-acting beta-agonist (SABA) as needed. During a​
​routine visit, the patient reports using the SABA three times daily for the past week. According to​
​the GINA 2026 guidelines, what is the most appropriate next step?​
​A. Continue current regimen and instruct the patient to use the SABA only before exercise​
​B. Add a long-acting muscarinic antagonist (LAMA) to the current regimen​
​C. Add a low-dose inhaled corticosteroid-formoterol combination as both maintenance and​
​reliever therapy (MART)​
​D. Discontinue the ICS and switch to a leukotriene receptor antagonist alone​

,[​CORRECT] C​
​Rationale: GINA 2026 recommends that patients with moderate asthma who require SABA​
​more than twice weekly should be transitioned to an ICS-formoterol combination for​
​maintenance and reliever therapy (MART), which reduces exacerbations and improves control​
​compared to SABA-only reliever therapy. Option A is incorrect because frequent SABA use​
​indicates poor control and increases the risk of exacerbations. Option B is incorrect because​
​LAMA is typically added for severe asthma, not moderate. Option D is incorrect because​
​discontinuing ICS increases the risk of severe exacerbations and asthma-related mortality.​
​Clinical pearl: The SABA-only approach has been de-emphasized in GINA 2026; always pair​
​reliever therapy with ICS to reduce inflammation.​
​Q3 (Respiratory – Pneumonia assessment): A 74-year-old patient is admitted with​
​community-acquired pneumonia (CAP). Vital signs: temperature 38.9°C, HR 110, RR 26, BP​
​118/72. The patient is alert but confused about the date. Labs: WBC 16,000/μL, BUN 28 mg/dL,​
​creatinine 1.4 mg/dL. Using the CURB-65 scoring system, what is this patient's risk class and​
​recommended disposition?​
​A. Score 2 (low risk; outpatient therapy with oral antibiotics)​
​B. Score 3 (moderate risk; brief inpatient observation or short hospital stay)​
​C. Score 4 (severe risk; hospital admission with possible ICU consideration)​
​D. Score 5 (very severe risk; immediate ICU admission)​
​[CORRECT] B​
​Rationale: CURB-65 scoring: Confusion (1 point), Urea >20 mg/dL (1 point), Respiratory rate​
​≥30 (1 point), Blood pressure low (SBP <90 or DBP ≤60 = 0 points here), Age ≥65 (1 point).​
​Total = 3 points, indicating moderate risk (30-day mortality 9%) requiring hospitalization or brief​
​inpatient observation per IDSA/ATS 2026 guidelines. Option A is incorrect because a score of 2​
​would indicate low risk. Option C is incorrect because BP is not hypotensive (SBP >90). Option​
​D is incorrect because this would require all 5 criteria. Clinical pearl: For patients aged 50-64​
​with comorbidities, consider the SMART-COP score for ICU triage, as CURB-65 may​
​underestimate severity in younger patients with significant comorbidities.​
​Q4 (Respiratory – Pulmonary embolism): A 56-year-old postoperative patient suddenly develops​
​dyspnea, pleuritic chest pain, and tachycardia (HR 118). SpO₂ is 90% on 2 L nasal cannula. The​
​Wells score is calculated as 6.5 (moderate probability). What is the next best diagnostic step​
​according to 2026 guidelines?​
​A. Immediately initiate heparin infusion and proceed to CT pulmonary angiography (CTPA)​
​B. Obtain a D-dimer assay; if positive, proceed to CTPA​
​C. Perform a ventilation-perfusion (V/Q) scan as the first-line imaging study​
​D. Obtain a chest X-ray and echocardiogram before any further testing​
​[CORRECT] A​
​Rationale: For patients with intermediate-to-high probability of PE (Wells score >4) and​
​hemodynamic instability or significant symptoms, the 2026 ESC/ERS guidelines recommend​
​immediate anticoagulation while awaiting definitive imaging with CTPA, as the pre-test​
​probability is high enough that D-dimer is not useful (it will be positive in most postoperative​
​patients). Option B is incorrect because D-dimer is not indicated in moderate-to-high probability​
​patients due to poor specificity. Option C is incorrect because V/Q scan is reserved for patients​
​with renal failure or contrast allergy. Option D delays definitive diagnosis and treatment. Clinical​

,​ earl: In massive PE with hemodynamic collapse, bedside echocardiography showing right​
p
​heart strain can support emergent systemic thrombolysis while awaiting CTPA.​
​Q5 (Respiratory – ARDS management): A 42-year-old patient with sepsis-induced ARDS is​
​intubated and mechanically ventilated. Current settings: AC/VC, tidal volume 650 mL, RR 18,​
​FiO₂ 60%, PEEP 8 cmH₂O. Plateau pressure is 35 cmH₂O. Which ventilator adjustment is most​
​appropriate according to the ARDSNet protocol?​
​A. Increase tidal volume to 750 mL to improve minute ventilation and reduce CO₂​
​B. Decrease tidal volume to 450 mL (6 mL/kg predicted body weight) and increase RR to 24​
​C. Maintain current settings and add inhaled nitric oxide​
​D. Switch to pressure-controlled ventilation and increase PEEP to 15 cmH₂O​
​[CORRECT] B​
​Rationale: The ARDSNet low tidal volume ventilation strategy (6 mL/kg predicted body weight)​
​with plateau pressure <30 cmH₂O reduces mortality in ARDS by preventing ventilator-induced​
​lung injury (VILI). The current tidal volume is too high (likely ~8-9 mL/kg), and plateau pressure​
​exceeds 30 cmH₂O. Option A is incorrect because higher tidal volumes increase VILI and​
​mortality. Option C is incorrect because inhaled nitric oxide is reserved for refractory hypoxemia​
​and does not improve mortality. Option D is incorrect because while pressure control is​
​acceptable, arbitrarily increasing PEEP to 15 without following the PEEP/FiO₂ table may cause​
​hemodynamic compromise. Clinical pearl: Permissive hypercapnia is acceptable in ARDS; do​
​not increase tidal volume solely to normalize PaCO₂ if it violates lung-protective strategy.​
​Q6 (Respiratory – COPD pharmacology): A patient with COPD GOLD Group D is prescribed​
​triple therapy. Which combination represents the correct triple therapy regimen?​
​A. Albuterol (SABA) + Ipratropium (SAMA) + Prednisone (oral corticosteroid)​
​B. Fluticasone (ICS) + Salmeterol (LABA) + Tiotropium (LAMA)​
​C. Montelukast (LTRA) + Theophylline (methylxanthine) + Roflumilast (PDE4 inhibitor)​
​D. Budesonide (ICS) + Formoterol (LABA) + Omalizumab (anti-IgE)​
​[CORRECT] B​
​Rationale: GOLD 2026 defines triple therapy as ICS + LABA + LAMA for Group D patients with​
​frequent exacerbations despite dual bronchodilator therapy. The combination of​
​fluticasone/salmeterol (ICS/LABA) plus tiotropium (LAMA) is the standard approach. Option A is​
​incorrect because SABA/SAMA are rescue medications, not maintenance triple therapy, and​
​oral corticosteroids are not for chronic maintenance. Option C is incorrect because these are not​
​first-line triple therapy agents. Option D is incorrect because omalizumab is for allergic asthma,​
​not COPD. Clinical pearl: Triple therapy reduces exacerbations by 25% compared to​
​LABA/LAMA alone in Group D patients but increases pneumonia risk; monitor for signs of​
​respiratory infection.​
​Q7 (Respiratory – Asthma exacerbation): A 19-year-old with asthma presents to the ED with​
​severe exacerbation. HR 128, RR 32, SpO₂ 88% on room air, unable to speak in full sentences.​
​Peak expiratory flow (PEF) is 35% of predicted. After initial treatment with albuterol and​
​ipratropium nebulizers, which is the priority next intervention?​
​A. Administer magnesium sulfate 2 g IV over 20 minutes​
​B. Administer systemic corticosteroids (prednisone 40-60 mg PO or methylprednisolone 125 mg​
​IV)​
​C. Initiate non-invasive positive pressure ventilation (BiPAP)​

, ​ . Intubate and initiate mechanical ventilation immediately​
D
​[CORRECT] B​
​Rationale: Systemic corticosteroids are the cornerstone of treatment for moderate-to-severe​
​asthma exacerbations and should be administered within the first hour of presentation to reduce​
​airway inflammation and prevent progression. Option A is incorrect because magnesium sulfate​
​is adjunctive therapy for severe exacerbations not responding to initial bronchodilator therapy,​
​not the first priority. Option C is incorrect because BiPAP is generally avoided in asthma due to​
​risk of barotrauma and dynamic hyperinflation unless the patient is fatiguing and CO₂ is rising​
​despite maximal medical therapy. Option D is incorrect because intubation is reserved for​
​impending respiratory arrest or altered mental status. Clinical pearl: Early corticosteroid​
​administration reduces hospitalization rates by 50%; never delay steroids while waiting for​
​response to bronchodilators.​
​Q8 (Respiratory – Oxygen delivery devices): A patient with pneumonia and hypoxemia (SpO₂​
​86%) requires oxygen supplementation. The patient has a history of nasal trauma and cannot​
​tolerate nasal cannula. Which oxygen delivery device is most appropriate to achieve a target​
​SpO₂ of 92-94%?​
​A. Simple face mask at 5-8 L/min​
​B. Non-rebreather mask at 10-15 L/min​
​C. Venturi mask at 28% FiO₂​
​D. High-flow nasal cannula (HFNC) at 40 L/min, 40% FiO₂​
​[CORRECT] A​
​Rationale: A simple face mask delivers 35-50% oxygen at 5-10 L/min and is appropriate for​
​patients who cannot tolerate nasal cannula but require moderate oxygen supplementation to​
​achieve SpO₂ 92-94%. Option B is incorrect because a non-rebreather delivers 60-90% oxygen,​
​which is excessive for this target and may cause oxygen toxicity or CO₂ retention in susceptible​
​patients. Option C is incorrect because 28% FiO₂ may be insufficient to achieve the target.​
​Option D is incorrect because HFNC is typically reserved for patients with hypoxemic respiratory​
​failure requiring precise FiO₂ and positive pressure support, and the patient cannot tolerate​
​nasal cannula. Clinical pearl: Minimum flow for simple face mask is 5 L/min to prevent​
​rebreathing CO₂; always ensure the reservoir bag does not deflate completely during inspiration.​
​Q9 (Cardiovascular – Hypertension first-line therapy): A 55-year-old African American patient is​
​newly diagnosed with Stage 1 hypertension (BP 142/88 mmHg). The patient has no diabetes,​
​CKD, or cardiovascular disease. According to the 2026 ACC/AHA hypertension guidelines,​
​which medication class is recommended as first-line therapy?​
​A. Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB)​
​B. Thiazide-like diuretic or calcium channel blocker (CCB)​
​C. Beta-blocker (metoprolol)​
​D. Direct renin inhibitor (aliskiren)​
​[CORRECT] B​
​Rationale: The 2026 ACC/AHA guidelines recommend thiazide-like diuretics or calcium channel​
​blockers as first-line therapy for Black patients without compelling indications (diabetes, CKD,​
​heart failure) because these classes provide superior BP reduction and cardiovascular​
​outcomes in this population compared to ACEIs/ARBs alone. Option A is incorrect because​
​ACEIs/ARBs are less effective as monotherapy in Black patients without compelling indications.​

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