Fall Semester 2026–2027 NURS240 Maternal-
Newborn Nursing Updated 2026 | 190+ Questions
and Answers | NURS240 Maternal-Newborn
Nursing Comprehensive Study Guide, Practice
Exam, Exam Prep Test Bank, Pregnancy,
Antepartum Care, Labor & Delivery, Postpartum
Nursing, Newborn Assessment, High-Risk Obstetrics,
Fetal Monitoring, Neonatal Care, NCLEX-RN & Next
Generation NCLEX (NGN), Detailed Rationales and
Complete Revision Material
Question 1: A primigravida at 38 weeks gestation is admitted with a diagnosis
of preeclampsia with severe features. Which assessment finding would
indicate the need for immediate administration of magnesium sulfate?
A. Blood pressure 158/98 mmHg
B. Urinary output of 40 mL in 2 hours
C. Hyperreflexia with 3+ patellar reflexes
D. Visual disturbances including scotomata
CORRECT ANSWER: C. Hyperreflexia with 3+ patellar reflexes
Rationale: Magnesium sulfate is the drug of choice to prevent seizures in preeclampsia
with severe features. Indications for its use include hyperreflexia (indicating central
nervous system irritability), which is a prodromal sign of impending eclampsia. While
elevated blood pressure, oliguria, and visual changes are all concerning findings in
preeclampsia, the presence of hyperreflexia specifically signals an increased risk of
seizures and is a primary indication for initiating magnesium sulfate therapy.
Question 2: A nurse is caring for a postpartum client who is Rh-negative and
has just given birth to an Rh-positive infant. Which medication should the
nurse anticipate administering to prevent isoimmunization in subsequent
pregnancies?
A. Rh immune globulin (RhoGAM)
B. Folic acid supplementation
C. Broad-spectrum antibiotics
D. Corticosteroids
CORRECT ANSWER: A. Rh immune globulin (RhoGAM)
Rationale: Rh immune globulin (RhoGAM) is administered to Rh-negative mothers who
give birth to Rh-positive infants to prevent the development of maternal antibodies
against Rh-positive fetal blood cells. This prevents hemolytic disease of the newborn
(erythroblastosis fetalis) in future pregnancies. Folic acid prevents neural tube defects,
,antibiotics treat infections, and corticosteroids are used to accelerate fetal lung maturity,
none of which prevent isoimmunization.
Question 3: A pregnant client at 32 weeks gestation presents with painless,
bright red vaginal bleeding. The fundal height is 36 cm. What is the priority
nursing intervention?
A. Perform a cervical examination to assess dilation.
B. Administer oxytocin to augment labor.
C. Prepare for a vaginal ultrasound.
D. Assess fetal heart rate and maternal vital signs.
CORRECT ANSWER: D. Assess fetal heart rate and maternal vital signs.
Rationale: The classic signs of placenta previa are painless, bright red vaginal bleeding
and a fundal height that is greater than expected for gestational age. A cervical
examination is strictly contraindicated because it can disrupt the placental attachment
and cause massive hemorrhage. The priority nursing intervention is to assess maternal
stability and fetal well-being via vital signs and fetal heart rate monitoring. A vaginal
ultrasound may be used to diagnose the condition but only in a controlled setting by a
physician, not as the first nursing action.
Question 4: A nurse is providing education to a client who is 10 weeks
pregnant and experiencing nausea and vomiting. Which dietary
recommendation is most appropriate to alleviate these symptoms?
A. Consume high-fat, fried foods to settle the stomach.
B. Eat dry crackers or toast before getting out of bed in the morning.
C. Drink a large glass of orange juice with breakfast.
D. Avoid eating anything until the nausea subsides.
CORRECT ANSWER: B. Eat dry crackers or toast before getting out of bed in
the morning.
Rationale: Nausea and vomiting in early pregnancy (morning sickness) can be alleviated
by consuming dry, starchy foods such as crackers or toast before rising from bed to help
stabilize blood glucose levels and absorb stomach acid. High-fat foods can exacerbate
nausea, and acidic foods like orange juice may irritate the stomach. Prolonged fasting
can worsen nausea due to hypoglycemia; small, frequent meals are recommended
instead.
Question 5: A postpartum client who had a vaginal delivery 6 hours ago has a
boggy uterus displaced to the right of the midline. What is the nurse’s
immediate priority action?
,A. Encourage the client to ambulate to the bathroom.
B. Administer prescribed analgesia for afterbirth pains.
C. Assess for a distended bladder and assist the client to void.
D. Massage the uterus firmly until it contracts.
CORRECT ANSWER: C. Assess for a distended bladder and assist the client to
void.
Rationale: A boggy uterus displaced to the right is a classic sign of a distended bladder.
The displaced uterus cannot contract effectively, leading to uterine atony and an
increased risk of postpartum hemorrhage. The immediate priority is to assess for
bladder distention and assist the client in voiding, which will allow the uterus to return
to the midline and contract. While uterine massage is indicated for a boggy uterus, it is
ineffective if a distended bladder is the underlying cause.
Question 6: A client at 28 weeks gestation is screened for gestational diabetes
mellitus (GDM) with a 50-g oral glucose challenge test (OGCT). The result is
155 mg/dL. What is the nurse's next action?
A. Diagnose the client with gestational diabetes.
B. Instruct the client to begin a strict low-carbohydrate diet.
C. Schedule a 100-g, 3-hour oral glucose tolerance test (OGTT).
D. Notify the provider to begin insulin therapy.
CORRECT ANSWER: C. Schedule a 100-g, 3-hour oral glucose tolerance test
(OGTT).
Rationale: The 50-g OGCT is a screening test, not a diagnostic test. A result of 155
mg/dL is above the typical threshold of 130-140 mg/dL and is considered a positive
screen. This indicates the need for a diagnostic test, which is the 100-g, 3-hour OGTT. A
diagnosis of GDM is made based on the results of the 3-hour OGTT, and treatment such
as diet modification or insulin is not initiated until a diagnosis is confirmed.
Question 7: During the active phase of labor, a client’s cervix is 6 cm dilated,
100% effaced, and the fetal presenting part is at 0 station. The fetal heart rate
(FHR) shows recurrent late decelerations. What is the priority nursing action?
A. Apply a fetal scalp electrode.
B. Administer oxygen at 8-10 L/min via non-rebreather mask.
C. Increase the rate of the oxytocin infusion.
D. Prepare the client for immediate cesarean section.
CORRECT ANSWER: B. Administer oxygen at 8-10 L/min via non-rebreather
mask.
, Rationale: Late decelerations are indicative of uteroplacental insufficiency, leading to
fetal hypoxia. The priority nursing intervention is to maximize maternal oxygenation by
administering oxygen at 8-10 L/min via a non-rebreather mask. Other interventions
include changing the mother's position (preferably left lateral), discontinuing oxytocin if
infusing, and increasing intravenous fluids. While a cesarean section may become
necessary if the FHR pattern does not improve, oxygen administration is the immediate
priority.
Question 8: A client who is 24 hours post-cesarean section complains of
sudden chest pain and shortness of breath. Her respiratory rate is 28/min, and
heart rate is 120 bpm. What condition should the nurse suspect?
A. Atelectasis
B. Wound infection
C. Pulmonary embolism
D. Uterine atony
CORRECT ANSWER: C. Pulmonary embolism
Rationale: The postpartum period, especially following a cesarean section, carries an
increased risk of venous thromboembolism. Sudden onset chest pain, tachypnea, and
tachycardia are classic symptoms of a pulmonary embolism. Atelectasis typically
presents with a low-grade fever and crackles, not acute chest pain. Wound infection
presents with localized pain and erythema. Uterine atony presents with a boggy uterus
and vaginal bleeding.
Question 9: A newborn has an Apgar score of 6 at 1 minute of life. The nurse is
preparing to assign the 5-minute Apgar score. Which finding would result in a
score of 0 for the "Respiration" category?
A. The newborn is crying vigorously.
B. The newborn is grunting with irregular respirations.
C. The newborn is not breathing.
D. The newborn has a slow, weak cry.
CORRECT ANSWER: C. The newborn is not breathing.
Rationale: In the Apgar scoring system, each of the five categories (Appearance, Pulse,
Grimace, Activity, Respiration) is scored 0, 1, or 2. For Respiration, a score of 0 is given
if the infant is apneic (not breathing). A score of 1 is given for a slow, weak cry or
irregular respirations (grunting). A score of 2 is given for a vigorous cry. The nurse must
accurately assess and score the newborn's respirations to guide resuscitation efforts.
Newborn Nursing Updated 2026 | 190+ Questions
and Answers | NURS240 Maternal-Newborn
Nursing Comprehensive Study Guide, Practice
Exam, Exam Prep Test Bank, Pregnancy,
Antepartum Care, Labor & Delivery, Postpartum
Nursing, Newborn Assessment, High-Risk Obstetrics,
Fetal Monitoring, Neonatal Care, NCLEX-RN & Next
Generation NCLEX (NGN), Detailed Rationales and
Complete Revision Material
Question 1: A primigravida at 38 weeks gestation is admitted with a diagnosis
of preeclampsia with severe features. Which assessment finding would
indicate the need for immediate administration of magnesium sulfate?
A. Blood pressure 158/98 mmHg
B. Urinary output of 40 mL in 2 hours
C. Hyperreflexia with 3+ patellar reflexes
D. Visual disturbances including scotomata
CORRECT ANSWER: C. Hyperreflexia with 3+ patellar reflexes
Rationale: Magnesium sulfate is the drug of choice to prevent seizures in preeclampsia
with severe features. Indications for its use include hyperreflexia (indicating central
nervous system irritability), which is a prodromal sign of impending eclampsia. While
elevated blood pressure, oliguria, and visual changes are all concerning findings in
preeclampsia, the presence of hyperreflexia specifically signals an increased risk of
seizures and is a primary indication for initiating magnesium sulfate therapy.
Question 2: A nurse is caring for a postpartum client who is Rh-negative and
has just given birth to an Rh-positive infant. Which medication should the
nurse anticipate administering to prevent isoimmunization in subsequent
pregnancies?
A. Rh immune globulin (RhoGAM)
B. Folic acid supplementation
C. Broad-spectrum antibiotics
D. Corticosteroids
CORRECT ANSWER: A. Rh immune globulin (RhoGAM)
Rationale: Rh immune globulin (RhoGAM) is administered to Rh-negative mothers who
give birth to Rh-positive infants to prevent the development of maternal antibodies
against Rh-positive fetal blood cells. This prevents hemolytic disease of the newborn
(erythroblastosis fetalis) in future pregnancies. Folic acid prevents neural tube defects,
,antibiotics treat infections, and corticosteroids are used to accelerate fetal lung maturity,
none of which prevent isoimmunization.
Question 3: A pregnant client at 32 weeks gestation presents with painless,
bright red vaginal bleeding. The fundal height is 36 cm. What is the priority
nursing intervention?
A. Perform a cervical examination to assess dilation.
B. Administer oxytocin to augment labor.
C. Prepare for a vaginal ultrasound.
D. Assess fetal heart rate and maternal vital signs.
CORRECT ANSWER: D. Assess fetal heart rate and maternal vital signs.
Rationale: The classic signs of placenta previa are painless, bright red vaginal bleeding
and a fundal height that is greater than expected for gestational age. A cervical
examination is strictly contraindicated because it can disrupt the placental attachment
and cause massive hemorrhage. The priority nursing intervention is to assess maternal
stability and fetal well-being via vital signs and fetal heart rate monitoring. A vaginal
ultrasound may be used to diagnose the condition but only in a controlled setting by a
physician, not as the first nursing action.
Question 4: A nurse is providing education to a client who is 10 weeks
pregnant and experiencing nausea and vomiting. Which dietary
recommendation is most appropriate to alleviate these symptoms?
A. Consume high-fat, fried foods to settle the stomach.
B. Eat dry crackers or toast before getting out of bed in the morning.
C. Drink a large glass of orange juice with breakfast.
D. Avoid eating anything until the nausea subsides.
CORRECT ANSWER: B. Eat dry crackers or toast before getting out of bed in
the morning.
Rationale: Nausea and vomiting in early pregnancy (morning sickness) can be alleviated
by consuming dry, starchy foods such as crackers or toast before rising from bed to help
stabilize blood glucose levels and absorb stomach acid. High-fat foods can exacerbate
nausea, and acidic foods like orange juice may irritate the stomach. Prolonged fasting
can worsen nausea due to hypoglycemia; small, frequent meals are recommended
instead.
Question 5: A postpartum client who had a vaginal delivery 6 hours ago has a
boggy uterus displaced to the right of the midline. What is the nurse’s
immediate priority action?
,A. Encourage the client to ambulate to the bathroom.
B. Administer prescribed analgesia for afterbirth pains.
C. Assess for a distended bladder and assist the client to void.
D. Massage the uterus firmly until it contracts.
CORRECT ANSWER: C. Assess for a distended bladder and assist the client to
void.
Rationale: A boggy uterus displaced to the right is a classic sign of a distended bladder.
The displaced uterus cannot contract effectively, leading to uterine atony and an
increased risk of postpartum hemorrhage. The immediate priority is to assess for
bladder distention and assist the client in voiding, which will allow the uterus to return
to the midline and contract. While uterine massage is indicated for a boggy uterus, it is
ineffective if a distended bladder is the underlying cause.
Question 6: A client at 28 weeks gestation is screened for gestational diabetes
mellitus (GDM) with a 50-g oral glucose challenge test (OGCT). The result is
155 mg/dL. What is the nurse's next action?
A. Diagnose the client with gestational diabetes.
B. Instruct the client to begin a strict low-carbohydrate diet.
C. Schedule a 100-g, 3-hour oral glucose tolerance test (OGTT).
D. Notify the provider to begin insulin therapy.
CORRECT ANSWER: C. Schedule a 100-g, 3-hour oral glucose tolerance test
(OGTT).
Rationale: The 50-g OGCT is a screening test, not a diagnostic test. A result of 155
mg/dL is above the typical threshold of 130-140 mg/dL and is considered a positive
screen. This indicates the need for a diagnostic test, which is the 100-g, 3-hour OGTT. A
diagnosis of GDM is made based on the results of the 3-hour OGTT, and treatment such
as diet modification or insulin is not initiated until a diagnosis is confirmed.
Question 7: During the active phase of labor, a client’s cervix is 6 cm dilated,
100% effaced, and the fetal presenting part is at 0 station. The fetal heart rate
(FHR) shows recurrent late decelerations. What is the priority nursing action?
A. Apply a fetal scalp electrode.
B. Administer oxygen at 8-10 L/min via non-rebreather mask.
C. Increase the rate of the oxytocin infusion.
D. Prepare the client for immediate cesarean section.
CORRECT ANSWER: B. Administer oxygen at 8-10 L/min via non-rebreather
mask.
, Rationale: Late decelerations are indicative of uteroplacental insufficiency, leading to
fetal hypoxia. The priority nursing intervention is to maximize maternal oxygenation by
administering oxygen at 8-10 L/min via a non-rebreather mask. Other interventions
include changing the mother's position (preferably left lateral), discontinuing oxytocin if
infusing, and increasing intravenous fluids. While a cesarean section may become
necessary if the FHR pattern does not improve, oxygen administration is the immediate
priority.
Question 8: A client who is 24 hours post-cesarean section complains of
sudden chest pain and shortness of breath. Her respiratory rate is 28/min, and
heart rate is 120 bpm. What condition should the nurse suspect?
A. Atelectasis
B. Wound infection
C. Pulmonary embolism
D. Uterine atony
CORRECT ANSWER: C. Pulmonary embolism
Rationale: The postpartum period, especially following a cesarean section, carries an
increased risk of venous thromboembolism. Sudden onset chest pain, tachypnea, and
tachycardia are classic symptoms of a pulmonary embolism. Atelectasis typically
presents with a low-grade fever and crackles, not acute chest pain. Wound infection
presents with localized pain and erythema. Uterine atony presents with a boggy uterus
and vaginal bleeding.
Question 9: A newborn has an Apgar score of 6 at 1 minute of life. The nurse is
preparing to assign the 5-minute Apgar score. Which finding would result in a
score of 0 for the "Respiration" category?
A. The newborn is crying vigorously.
B. The newborn is grunting with irregular respirations.
C. The newborn is not breathing.
D. The newborn has a slow, weak cry.
CORRECT ANSWER: C. The newborn is not breathing.
Rationale: In the Apgar scoring system, each of the five categories (Appearance, Pulse,
Grimace, Activity, Respiration) is scored 0, 1, or 2. For Respiration, a score of 0 is given
if the infant is apneic (not breathing). A score of 1 is given for a slow, weak cry or
irregular respirations (grunting). A score of 2 is given for a vigorous cry. The nurse must
accurately assess and score the newborn's respirations to guide resuscitation efforts.
