NR-327 MATERNAL-CHILD NURSING EXAM 1 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A |LATEST EXAM UPDATE 2026/2027 CHAMBERLAIN UNIVERSITY..
Core Domains:
• Antepartum Care and Fetal Development
• Physiological and Psychological Changes of Pregnancy
• Prenatal Screening and Diagnostic Testing
• Intrapartum Nursing Management and Labor Stages
• Electronic Fetal Monitoring and Pattern Interpretation
• Postpartum Assessment and Complications
• Newborn Physiological Transition and Care
• High-Risk Maternal Conditions and Nursing Interventions
• Ethical, Legal, and Evidence-Based Practice in Maternal-Child Health
Introduction
This comprehensive assessment is carefully structured to evaluate core competencies, practical skills, and clinical judgment in maternal-
child nursing. Covering critical topics from early gestation through delivery, postpartum adaptation, and neonatal care, this exam measures
the student's ability to synthesize foundational theory with real-world clinical application. The multiple-choice and scenario-based layout
challenges future nursing professionals to prioritize safety, interpret complex clinical data, maintain legal and ethical standards, and make
rapid, defensible clinical decisions. Ultimately, this examination serves as a benchmark for student readiness to provide high-quality, patient-
centered care in diverse maternity and neonatal care settings.
SECTION ONE: QUESTIONS 1–100
A nurse is performing an initial prenatal assessment on a client who is at 8 weeks of gestation. The client states, "I'm just not sure if
I'm ready to be a mother, even though we planned this." Which of the following responses by the nurse is appropriate?
A. Many women feel ambivalent about pregnancy during the first trimester, which is completely normal.
B. You should discuss these feelings with a mental health counselor as soon as possible.
C. Don't worry, once you feel the baby move in the second trimester, these feelings will go away.
D. It sounds like you are experiencing severe postpartum depression before the baby is born.
🟢 🟢 A. Many women feel ambivalent about pregnancy during the first trimester, which is completely normal.
🔴 RATIONALE: Ambivalence is a common and normal psychological response during the first trimester of pregnancy, even when the
pregnancy was planned or desired. Validating these feelings helps establish therapeutic communication.
A nurse is reviewing the laboratory results of a pregnant client at 12 weeks of gestation. The client's hemoglobin is 10.5 g/dL and
hematocrit is 32%. Which of the following conditions explains these findings?
A. Iron deficiency anemia requiring immediate blood transfusion
🟢 B. Physiologic anemia of pregnancy due to increased plasma volume
C. Hemolytic disease caused by Rh incompatibility
,D. Active internal bleeding secondary to a placental issue
🔴 RATIONALE: During pregnancy, plasma volume increases by 40% to 50%, while red blood cell mass increases by only 20% to 30%.
This dilution causes a decrease in hemoglobin and hematocrit, known as physiologic anemia of pregnancy.
A nurse is caring for a client who is in the first stage of labor. The electronic fetal monitor shows a baseline fetal heart rate (FHR) of
140/min with repeated, gradual decelerations that begin after the peak of the uterine contraction and return to baseline after the
contraction ends. Which of the following actions should the nurse take first?
A. Prepare for immediate emergency cesarean delivery.
B. Increase the rate of the oxytocin infusion.
🟢 C. Turn the client onto her left side and initiate oxygen via nonrebreather mask.
D. Perform a vaginal examination to assess for a prolapsed cord.
🔴 RATIONALE: Late decelerations indicate uteroplacental insufficiency. The initial nursing interventions include repositioning the client to
the lateral position to maximize uterine blood flow, administering oxygen, and discontinuing oxytocin if running.
A nurse is assessing a client at 34 weeks of gestation who presents with sudden, severe abdominal pain and dark red vaginal
bleeding. The client's abdomen is rigid and tender to touch. Which of the following complications should the nurse suspect?
A. Placenta previa
🟢 B. Abruptio placentae
C. Cervical insufficiency
D. Ruptured ectopic pregnancy
🔴 RATIONALE: Abruptio placentae is the premature separation of the placenta from the uterine wall, characterized by dark red vaginal
bleeding, severe abdominal pain, and a rigid, board-like abdomen. Placenta previa typically causes painless, bright red bleeding.
A nurse is assessing a client who is 12 hr postpartum following a spontaneous vaginal delivery. The nurse notes that the fundus is
firm, midline, and located at the level of the umbilicus. Which of the following actions should the nurse take?
🟢 A. Document the finding as normal and continue to monitor.
B. Massage the fundus vigorously to prevent postpartum hemorrhage.
C. Catheterize the client immediately for suspected urinary retention.
D. Notify the health care provider of potential uterine subinvolution.
🔴 RATIONALE: At 12 hours postpartum, it is an expected and normal finding for the fundus to be firm, midline, and at or slightly below the
level of the umbilicus. No aggressive intervention is required.
A client at 36 weeks of gestation is diagnosed with gestational hypertension. Which of the following assessments is the priority for the
nurse to perform to screen for preeclampsia?
A. Assess for lower extremity pitting edema.
🟢 B. Check the client's urine for protein and assess for hyperreflexia.
C. Evaluate the client's dietary intake of sodium.
D. Obtain a 24-hour dietary recall for caloric intake.
, 🔴 RATIONALE: Gestational hypertension can progress to preeclampsia, which is formally identified by protein in the urine (proteinuria) and
signs of central nervous system irritability such as hyperreflexia or clonus.
A nurse is preparing to administer intramuscular phytonadione (vitamin K) to a newborn. The parents ask why their baby needs this
injection. Which of the following explanations should the nurse provide?
A. It stimulates the baby's immune system to prevent early infections.
B. It assists with the breakdown of bilirubin and prevents jaundice.
🟢 C. Newborns lack the intestinal bacteria necessary to synthesize vitamin K, increasing their risk for bleeding.
D. It helps mature the newborn's lungs by producing adequate surfactant.
🔴 RATIONALE: Newborns are born with a sterile gut lacking the bacteria required to synthesize vitamin K, which is essential for the
activation of clotting factors. Administering vitamin K prevents vitamin K deficiency bleeding (VKDB).
A nurse is providing discharge teaching to a postpartum client who is breastfeeding. Which of the following instructions should the
nurse include regarding calorie intake?
A. You should decrease your daily caloric intake by 200 calories compared to your pre-pregnancy diet.
B. You need to consume an additional 1,000 calories per day to maintain milk supply.
🟢 C. You should increase your daily caloric intake by approximately 330 to 400 calories above pre-pregnancy needs.
D. Your caloric intake should remain exactly the same as it was during your third trimester.
🔴 RATIONALE: Breastfeeding clients require an increase of roughly 330 to 400 calories per day above their pre-pregnancy baseline during
the first six months of lactation to support milk production without depleting maternal nutritional stores.
A nurse is caring for a newborn immediately following delivery. Which of the following actions is the priority to prevent heat loss
through evaporation?
🟢 A. Dry the newborn thoroughly with a warm blanket.
B. Place the newborn close to a cold window or external wall.
C. Position a radiant warmer directly over the newborn's crib.
D. Ensure the nursery room temperature is maintained at 68°F (20°C).
🔴 RATIONALE: Evaporative heat loss occurs when wet amniotic fluid evaporates from the newborn's skin. Drying the infant immediately
after birth is the primary intervention to prevent heat loss from evaporation.
A nurse is caring for a client at 28 weeks of gestation who is Rh-negative. The client's indirect Coombs test is negative. Which of the
following actions should the nurse expect to take?
A. Administer RhO(D) immune globulin to the newborn within 72 hr after birth.
B. Schedule the client for an amniocentesis to check for fetal hemolytic disease.
🟢 C. Administer RhO(D) immune globulin intramuscularly to the client now.
D. Inform the client that no treatment is needed since the test is negative.
🔴 RATIONALE: RhO(D) immune globulin is administered prophylactically at 28 weeks of gestation to Rh-negative clients who are
unsensitized (negative indirect Coombs test) to prevent antibody formation against Rh-positive fetal blood.
2026 Q&A |LATEST EXAM UPDATE 2026/2027 CHAMBERLAIN UNIVERSITY..
Core Domains:
• Antepartum Care and Fetal Development
• Physiological and Psychological Changes of Pregnancy
• Prenatal Screening and Diagnostic Testing
• Intrapartum Nursing Management and Labor Stages
• Electronic Fetal Monitoring and Pattern Interpretation
• Postpartum Assessment and Complications
• Newborn Physiological Transition and Care
• High-Risk Maternal Conditions and Nursing Interventions
• Ethical, Legal, and Evidence-Based Practice in Maternal-Child Health
Introduction
This comprehensive assessment is carefully structured to evaluate core competencies, practical skills, and clinical judgment in maternal-
child nursing. Covering critical topics from early gestation through delivery, postpartum adaptation, and neonatal care, this exam measures
the student's ability to synthesize foundational theory with real-world clinical application. The multiple-choice and scenario-based layout
challenges future nursing professionals to prioritize safety, interpret complex clinical data, maintain legal and ethical standards, and make
rapid, defensible clinical decisions. Ultimately, this examination serves as a benchmark for student readiness to provide high-quality, patient-
centered care in diverse maternity and neonatal care settings.
SECTION ONE: QUESTIONS 1–100
A nurse is performing an initial prenatal assessment on a client who is at 8 weeks of gestation. The client states, "I'm just not sure if
I'm ready to be a mother, even though we planned this." Which of the following responses by the nurse is appropriate?
A. Many women feel ambivalent about pregnancy during the first trimester, which is completely normal.
B. You should discuss these feelings with a mental health counselor as soon as possible.
C. Don't worry, once you feel the baby move in the second trimester, these feelings will go away.
D. It sounds like you are experiencing severe postpartum depression before the baby is born.
🟢 🟢 A. Many women feel ambivalent about pregnancy during the first trimester, which is completely normal.
🔴 RATIONALE: Ambivalence is a common and normal psychological response during the first trimester of pregnancy, even when the
pregnancy was planned or desired. Validating these feelings helps establish therapeutic communication.
A nurse is reviewing the laboratory results of a pregnant client at 12 weeks of gestation. The client's hemoglobin is 10.5 g/dL and
hematocrit is 32%. Which of the following conditions explains these findings?
A. Iron deficiency anemia requiring immediate blood transfusion
🟢 B. Physiologic anemia of pregnancy due to increased plasma volume
C. Hemolytic disease caused by Rh incompatibility
,D. Active internal bleeding secondary to a placental issue
🔴 RATIONALE: During pregnancy, plasma volume increases by 40% to 50%, while red blood cell mass increases by only 20% to 30%.
This dilution causes a decrease in hemoglobin and hematocrit, known as physiologic anemia of pregnancy.
A nurse is caring for a client who is in the first stage of labor. The electronic fetal monitor shows a baseline fetal heart rate (FHR) of
140/min with repeated, gradual decelerations that begin after the peak of the uterine contraction and return to baseline after the
contraction ends. Which of the following actions should the nurse take first?
A. Prepare for immediate emergency cesarean delivery.
B. Increase the rate of the oxytocin infusion.
🟢 C. Turn the client onto her left side and initiate oxygen via nonrebreather mask.
D. Perform a vaginal examination to assess for a prolapsed cord.
🔴 RATIONALE: Late decelerations indicate uteroplacental insufficiency. The initial nursing interventions include repositioning the client to
the lateral position to maximize uterine blood flow, administering oxygen, and discontinuing oxytocin if running.
A nurse is assessing a client at 34 weeks of gestation who presents with sudden, severe abdominal pain and dark red vaginal
bleeding. The client's abdomen is rigid and tender to touch. Which of the following complications should the nurse suspect?
A. Placenta previa
🟢 B. Abruptio placentae
C. Cervical insufficiency
D. Ruptured ectopic pregnancy
🔴 RATIONALE: Abruptio placentae is the premature separation of the placenta from the uterine wall, characterized by dark red vaginal
bleeding, severe abdominal pain, and a rigid, board-like abdomen. Placenta previa typically causes painless, bright red bleeding.
A nurse is assessing a client who is 12 hr postpartum following a spontaneous vaginal delivery. The nurse notes that the fundus is
firm, midline, and located at the level of the umbilicus. Which of the following actions should the nurse take?
🟢 A. Document the finding as normal and continue to monitor.
B. Massage the fundus vigorously to prevent postpartum hemorrhage.
C. Catheterize the client immediately for suspected urinary retention.
D. Notify the health care provider of potential uterine subinvolution.
🔴 RATIONALE: At 12 hours postpartum, it is an expected and normal finding for the fundus to be firm, midline, and at or slightly below the
level of the umbilicus. No aggressive intervention is required.
A client at 36 weeks of gestation is diagnosed with gestational hypertension. Which of the following assessments is the priority for the
nurse to perform to screen for preeclampsia?
A. Assess for lower extremity pitting edema.
🟢 B. Check the client's urine for protein and assess for hyperreflexia.
C. Evaluate the client's dietary intake of sodium.
D. Obtain a 24-hour dietary recall for caloric intake.
, 🔴 RATIONALE: Gestational hypertension can progress to preeclampsia, which is formally identified by protein in the urine (proteinuria) and
signs of central nervous system irritability such as hyperreflexia or clonus.
A nurse is preparing to administer intramuscular phytonadione (vitamin K) to a newborn. The parents ask why their baby needs this
injection. Which of the following explanations should the nurse provide?
A. It stimulates the baby's immune system to prevent early infections.
B. It assists with the breakdown of bilirubin and prevents jaundice.
🟢 C. Newborns lack the intestinal bacteria necessary to synthesize vitamin K, increasing their risk for bleeding.
D. It helps mature the newborn's lungs by producing adequate surfactant.
🔴 RATIONALE: Newborns are born with a sterile gut lacking the bacteria required to synthesize vitamin K, which is essential for the
activation of clotting factors. Administering vitamin K prevents vitamin K deficiency bleeding (VKDB).
A nurse is providing discharge teaching to a postpartum client who is breastfeeding. Which of the following instructions should the
nurse include regarding calorie intake?
A. You should decrease your daily caloric intake by 200 calories compared to your pre-pregnancy diet.
B. You need to consume an additional 1,000 calories per day to maintain milk supply.
🟢 C. You should increase your daily caloric intake by approximately 330 to 400 calories above pre-pregnancy needs.
D. Your caloric intake should remain exactly the same as it was during your third trimester.
🔴 RATIONALE: Breastfeeding clients require an increase of roughly 330 to 400 calories per day above their pre-pregnancy baseline during
the first six months of lactation to support milk production without depleting maternal nutritional stores.
A nurse is caring for a newborn immediately following delivery. Which of the following actions is the priority to prevent heat loss
through evaporation?
🟢 A. Dry the newborn thoroughly with a warm blanket.
B. Place the newborn close to a cold window or external wall.
C. Position a radiant warmer directly over the newborn's crib.
D. Ensure the nursery room temperature is maintained at 68°F (20°C).
🔴 RATIONALE: Evaporative heat loss occurs when wet amniotic fluid evaporates from the newborn's skin. Drying the infant immediately
after birth is the primary intervention to prevent heat loss from evaporation.
A nurse is caring for a client at 28 weeks of gestation who is Rh-negative. The client's indirect Coombs test is negative. Which of the
following actions should the nurse expect to take?
A. Administer RhO(D) immune globulin to the newborn within 72 hr after birth.
B. Schedule the client for an amniocentesis to check for fetal hemolytic disease.
🟢 C. Administer RhO(D) immune globulin intramuscularly to the client now.
D. Inform the client that no treatment is needed since the test is negative.
🔴 RATIONALE: RhO(D) immune globulin is administered prophylactically at 28 weeks of gestation to Rh-negative clients who are
unsensitized (negative indirect Coombs test) to prevent antibody formation against Rh-positive fetal blood.
