MATERNAL-NEWBORN EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains*
*- Prenatal Care and Assessment*
*- Intrapartum Fetal Monitoring*
*- Complications of Pregnancy*
*- Labor and Delivery Management*
*- Postpartum Physiological Changes*
*- Newborn Transition and Assessment*
*- Maternal-Newborn Ethics and Legal Standards*
*- Medication Administration in Obstetrics*
*Introduction*
*This comprehensive assessment is designed to evaluate clinical proficiency and
theoretical knowledge in maternal-newborn nursing. The examination covers critical
competencies, ranging from prenatal health maintenance to complex intrapartum and
postpartum care. By incorporating both foundational theory and intricate, scenario-based
questions, the exam requires practitioners to apply clinical judgment and evidence-based
decision-making to diverse patient cases. This rigorous structure ensures that examinees
demonstrate the high standards of care, ethical compliance, and technical proficiency
necessary for safe and effective practice in high-acuity maternity and neonatal settings,
ultimately preparing them for real-world clinical challenges.*
Section One: Questions 1–100
1. A nurse is assessing a pregnant client at 28 weeks gestation. Which finding requires
immediate follow-up by the healthcare provider? A. Leg cramps at night B.
Dependent edema in the ankles C. Facial edema and headache D. Increased urinary
frequency C. Facial edema and headache Explanation: Facial edema and
persistent headaches at 28 weeks can be early signs of preeclampsia, a serious
hypertensive disorder that requires immediate evaluation.
2. A newborn is born at 38 weeks gestation. Which reflex should the nurse expect when
touching the side of the newborn’s mouth? A. Moro reflex B. Rooting reflex C.
Babinski reflex D. Grasp reflex B. Rooting reflex Explanation: The rooting
, reflex occurs when the corner of the infant's mouth is touched, causing the infant to
turn their head and open their mouth to seek food.
3. During the transition phase of labor, a client begins to experience hyperventilation.
What is the priority nursing action? A. Encourage the client to breathe into a paper
bag B. Administer oxygen via a non-rebreather mask C. Instruct the client to breathe
into cupped hands D. Notify the anesthesiologist immediately C. Instruct the
client to breathe into cupped hands Explanation: Breathing into cupped hands
helps the client retain carbon dioxide to correct respiratory alkalosis caused by
hyperventilation during labor.
4. A nurse is caring for a client who is receiving magnesium sulfate for preterm labor.
Which finding indicates magnesium toxicity? A. Hyperreflexia B. Respiratory rate of
16 breaths/min C. Absent patellar deep tendon reflexes D. Urinary output of 50
mL/hr C. Absent patellar deep tendon reflexes Explanation: A loss of deep
tendon reflexes is one of the earliest signs of magnesium toxicity and warrants
immediate cessation of the infusion.
5. What is the primary purpose of administering Vitamin K to a newborn shortly after
birth? A. To prevent jaundice B. To stimulate the immune system C. To prevent
hemorrhagic disease D. To promote weight gain C. To prevent hemorrhagic
disease Explanation: Newborns have sterile intestines and cannot synthesize
Vitamin K, which is essential for blood clotting; supplementation prevents potential
life-threatening hemorrhage.
6. A client in the postpartum period is diagnosed with endometritis. Which clinical
manifestation is most characteristic of this condition? A. Foul-smelling lochia B.
Hypertension C. Decreased white blood cell count D. Bradycardia A. Foul-smelling
lochia Explanation: Foul-smelling lochia, combined with fever and uterine
tenderness, is a hallmark sign of postpartum endometritis, an infection of the uterine
lining.
7. Which assessment finding in a laboring client warrants immediate notification of the
provider? A. Regular contractions every 5 minutes B. Fetal heart rate baseline of 150
bpm C. Meconium-stained amniotic fluid D. Cervical dilation of 4 cm C.
Meconium-stained amniotic fluid Explanation: Meconium-stained amniotic fluid
indicates fetal distress and poses a risk for meconium aspiration syndrome,
necessitating careful monitoring and preparation for potential neonatal resuscitation.
8. A nurse is teaching a pregnant client about iron supplementation. Which instruction
is most appropriate? A. Take the iron supplement with milk to decrease stomach
upset B. Expect stools to be light tan in color C. Consume the iron with a glass of
orange juice D. Take the supplement only if you experience dizziness C. Consume
, the iron with a glass of orange juice Explanation: Vitamin C, found in orange
juice, enhances the absorption of non-heme iron in the gastrointestinal tract.
9. When evaluating a fetal heart rate tracing, the nurse notes early decelerations. What
is the most likely cause? A. Umbilical cord compression B. Uteroplacental
insufficiency C. Head compression D. Fetal sleep cycle C. Head compression
Explanation: Early decelerations are benign findings caused by pressure on the fetal
head during contractions, which stimulates the vagus nerve.
10. A client at 36 weeks gestation reports a sudden gush of clear fluid from the vagina.
What is the first priority? A. Check the fetal heart rate B. Perform a sterile vaginal
exam C. Instruct the client to walk to the bathroom D. Administer a sedative A.
Check the fetal heart rate Explanation: Rupture of membranes carries a risk of
umbilical cord prolapse; checking the fetal heart rate is essential to ensure the fetus
is not in distress.
11. Which immunization is contraindicated during pregnancy? A. Tetanus, diphtheria,
and acellular pertussis (Tdap) B. Influenza (inactivated) C. Rubella D. Hepatitis B
C. Rubella Explanation: The rubella vaccine is a live attenuated virus and is
contraindicated during pregnancy due to the risk of teratogenic effects on the fetus.
12. A nurse is assessing a newborn and notes a bluish discoloration of the hands and
feet. This is referred to as: A. Jaundice B. Acrocyanosis C. Lanugo D. Erythema
toxicum B. Acrocyanosis Explanation: Acrocyanosis is a normal finding in
newborns during the first 24 to 48 hours of life due to vasomotor instability.
13. What is the goal of administering betamethasone to a pregnant client at 32 weeks
gestation? A. To stop uterine contractions B. To treat gestational hypertension C. To
accelerate fetal lung maturity D. To prevent group B streptococcus infection C. To
accelerate fetal lung maturity Explanation: Betamethasone is a corticosteroid
given to promote the production of fetal surfactant, which helps prevent respiratory
distress syndrome in preterm infants.
14. A postpartum client reports severe perineal pain. Upon assessment, the nurse notes
a firm, tender, bluish-colored mass. The nurse should suspect: A. Hemorrhoids B.
Perineal hematoma C. Uterine atony D. Episiotomy infection B. Perineal
hematoma Explanation: A hematoma is a collection of blood in the tissues,
characterized by intense pain and a bluish or purple firm mass in the perineal area.
15. During the active phase of labor, the fetal heart rate drops to 100 bpm during a
contraction and remains low after the contraction ends. This is a: A. Late deceleration
B. Variable deceleration C. Early deceleration D. Acceleration A. Late deceleration
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains*
*- Prenatal Care and Assessment*
*- Intrapartum Fetal Monitoring*
*- Complications of Pregnancy*
*- Labor and Delivery Management*
*- Postpartum Physiological Changes*
*- Newborn Transition and Assessment*
*- Maternal-Newborn Ethics and Legal Standards*
*- Medication Administration in Obstetrics*
*Introduction*
*This comprehensive assessment is designed to evaluate clinical proficiency and
theoretical knowledge in maternal-newborn nursing. The examination covers critical
competencies, ranging from prenatal health maintenance to complex intrapartum and
postpartum care. By incorporating both foundational theory and intricate, scenario-based
questions, the exam requires practitioners to apply clinical judgment and evidence-based
decision-making to diverse patient cases. This rigorous structure ensures that examinees
demonstrate the high standards of care, ethical compliance, and technical proficiency
necessary for safe and effective practice in high-acuity maternity and neonatal settings,
ultimately preparing them for real-world clinical challenges.*
Section One: Questions 1–100
1. A nurse is assessing a pregnant client at 28 weeks gestation. Which finding requires
immediate follow-up by the healthcare provider? A. Leg cramps at night B.
Dependent edema in the ankles C. Facial edema and headache D. Increased urinary
frequency C. Facial edema and headache Explanation: Facial edema and
persistent headaches at 28 weeks can be early signs of preeclampsia, a serious
hypertensive disorder that requires immediate evaluation.
2. A newborn is born at 38 weeks gestation. Which reflex should the nurse expect when
touching the side of the newborn’s mouth? A. Moro reflex B. Rooting reflex C.
Babinski reflex D. Grasp reflex B. Rooting reflex Explanation: The rooting
, reflex occurs when the corner of the infant's mouth is touched, causing the infant to
turn their head and open their mouth to seek food.
3. During the transition phase of labor, a client begins to experience hyperventilation.
What is the priority nursing action? A. Encourage the client to breathe into a paper
bag B. Administer oxygen via a non-rebreather mask C. Instruct the client to breathe
into cupped hands D. Notify the anesthesiologist immediately C. Instruct the
client to breathe into cupped hands Explanation: Breathing into cupped hands
helps the client retain carbon dioxide to correct respiratory alkalosis caused by
hyperventilation during labor.
4. A nurse is caring for a client who is receiving magnesium sulfate for preterm labor.
Which finding indicates magnesium toxicity? A. Hyperreflexia B. Respiratory rate of
16 breaths/min C. Absent patellar deep tendon reflexes D. Urinary output of 50
mL/hr C. Absent patellar deep tendon reflexes Explanation: A loss of deep
tendon reflexes is one of the earliest signs of magnesium toxicity and warrants
immediate cessation of the infusion.
5. What is the primary purpose of administering Vitamin K to a newborn shortly after
birth? A. To prevent jaundice B. To stimulate the immune system C. To prevent
hemorrhagic disease D. To promote weight gain C. To prevent hemorrhagic
disease Explanation: Newborns have sterile intestines and cannot synthesize
Vitamin K, which is essential for blood clotting; supplementation prevents potential
life-threatening hemorrhage.
6. A client in the postpartum period is diagnosed with endometritis. Which clinical
manifestation is most characteristic of this condition? A. Foul-smelling lochia B.
Hypertension C. Decreased white blood cell count D. Bradycardia A. Foul-smelling
lochia Explanation: Foul-smelling lochia, combined with fever and uterine
tenderness, is a hallmark sign of postpartum endometritis, an infection of the uterine
lining.
7. Which assessment finding in a laboring client warrants immediate notification of the
provider? A. Regular contractions every 5 minutes B. Fetal heart rate baseline of 150
bpm C. Meconium-stained amniotic fluid D. Cervical dilation of 4 cm C.
Meconium-stained amniotic fluid Explanation: Meconium-stained amniotic fluid
indicates fetal distress and poses a risk for meconium aspiration syndrome,
necessitating careful monitoring and preparation for potential neonatal resuscitation.
8. A nurse is teaching a pregnant client about iron supplementation. Which instruction
is most appropriate? A. Take the iron supplement with milk to decrease stomach
upset B. Expect stools to be light tan in color C. Consume the iron with a glass of
orange juice D. Take the supplement only if you experience dizziness C. Consume
, the iron with a glass of orange juice Explanation: Vitamin C, found in orange
juice, enhances the absorption of non-heme iron in the gastrointestinal tract.
9. When evaluating a fetal heart rate tracing, the nurse notes early decelerations. What
is the most likely cause? A. Umbilical cord compression B. Uteroplacental
insufficiency C. Head compression D. Fetal sleep cycle C. Head compression
Explanation: Early decelerations are benign findings caused by pressure on the fetal
head during contractions, which stimulates the vagus nerve.
10. A client at 36 weeks gestation reports a sudden gush of clear fluid from the vagina.
What is the first priority? A. Check the fetal heart rate B. Perform a sterile vaginal
exam C. Instruct the client to walk to the bathroom D. Administer a sedative A.
Check the fetal heart rate Explanation: Rupture of membranes carries a risk of
umbilical cord prolapse; checking the fetal heart rate is essential to ensure the fetus
is not in distress.
11. Which immunization is contraindicated during pregnancy? A. Tetanus, diphtheria,
and acellular pertussis (Tdap) B. Influenza (inactivated) C. Rubella D. Hepatitis B
C. Rubella Explanation: The rubella vaccine is a live attenuated virus and is
contraindicated during pregnancy due to the risk of teratogenic effects on the fetus.
12. A nurse is assessing a newborn and notes a bluish discoloration of the hands and
feet. This is referred to as: A. Jaundice B. Acrocyanosis C. Lanugo D. Erythema
toxicum B. Acrocyanosis Explanation: Acrocyanosis is a normal finding in
newborns during the first 24 to 48 hours of life due to vasomotor instability.
13. What is the goal of administering betamethasone to a pregnant client at 32 weeks
gestation? A. To stop uterine contractions B. To treat gestational hypertension C. To
accelerate fetal lung maturity D. To prevent group B streptococcus infection C. To
accelerate fetal lung maturity Explanation: Betamethasone is a corticosteroid
given to promote the production of fetal surfactant, which helps prevent respiratory
distress syndrome in preterm infants.
14. A postpartum client reports severe perineal pain. Upon assessment, the nurse notes
a firm, tender, bluish-colored mass. The nurse should suspect: A. Hemorrhoids B.
Perineal hematoma C. Uterine atony D. Episiotomy infection B. Perineal
hematoma Explanation: A hematoma is a collection of blood in the tissues,
characterized by intense pain and a bluish or purple firm mass in the perineal area.
15. During the active phase of labor, the fetal heart rate drops to 100 bpm during a
contraction and remains low after the contraction ends. This is a: A. Late deceleration
B. Variable deceleration C. Early deceleration D. Acceleration A. Late deceleration
