THE COMPLETE MATERNITY JURISPRUDENCE
& CLINICAL NURSING PRACTICE EXAM
BLUEPRINT (QUESTIONS & ANSWERS)
This high-yield exam preparation package contains
comprehensive, actual style multiple-choice questions with
precise answers and detailed rationales for Maternity and
Obstetrics nursing. Expertly structured to mimic actual board
examinations, it bridges the gap between complex clinical labor,
delivery, and postpartum scenarios and legal jurisprudence
regulations. It serves as an essential, top-tier study guide
designed to maximize scores for nursing students preparing for
high-stakes clinical certifications and final course examinations.
1. A nurse is assessing a pregnant client at 12
weeks of gestation. Which of the following
findings is considered a positive sign of
pregnancy?
A. Positive serum pregnancy test
B. Braxton Hicks contractions
C. Fetal heart tones heard via Doppler
D. Chadwick's sign
Answer: C
Rationale: Positive signs of pregnancy are
completely objective and can only be
attributed to the fetus. These include hearing
fetal heart tones, visualizing the fetus via
ultrasound, and palpating fetal movement by
a trained examiner. Options A, B, and D are
objective but are classified as probable signs
because they can occasionally be caused by
, other conditions (e.g., hydatidiform mole or
pelvic congestion).
2. A client at 28 weeks of gestation is diagnosed
with gestational diabetes. The nurse should
instruct the client that this condition increases
the risk for which fetal complication?
A. Fetal growth restriction
B. Congenital hip dysplasia
C. Neonatal macrosomia
D. Premature rupture of membranes
Answer: C
Rationale: Maternal hyperglycemia causes
excess glucose to cross the placenta. The
fetus responds by secreting high levels of
insulin, which acts as a growth hormone,
leading to macrosomia (excessive birth
weight). Fetal growth restriction is more
common in pregnancies complicated by
severe vascular diseases or chronic
hypertension, not uncomplicated gestational
diabetes.
3. A nurse is caring for a client in active labor who
is receiving an intravenous oxytocin infusion.
The nurse notes a pattern of late decelerations
on the fetal monitor strip. Which action should
the nurse take first?
A. Increase the oxytocin infusion rate
, B. Administer oxygen at 2 L/min via nasal
cannula
C. Position the client on her left side
D. Prepare for an emergency forceps delivery
Answer: C
Rationale: Late decelerations indicate
uteroplacental insufficiency. The immediate
priority is to improve placental perfusion,
which is best achieved by turning the client
to her side (preferably left side) to remove
the weight of the uterus from the inferior
vena cava. The oxytocin infusion should be
discontinued immediately, not increased. If
oxygen is given, it is typically administered
at 8–10 L/min via a non-rebreather mask.
4. A postpartum nurse is assessing a client 2 hours
after a vaginal delivery. The nurse notes that the
fundus is boggy and displaced to the right of the
midline. Which of the following is the priority
nursing intervention?
A. Massage the fundus until it is firm
B. Administer a prescribed dose of
methylergonovine
C. Assist the client to empty her bladder
D. Notify the primary healthcare provider
immediately
Answer: C
, Rationale: A fundus that is displaced to the
right and boggy strongly indicates a
distended bladder. A full bladder pushes the
uterus up and out of place, preventing it from
contracting efficiently and increasing the risk
of postpartum hemorrhage. Assisting the
client to void (or straight catheterization if
necessary) will allow the uterus to return to
the midline and contract. Fundal massage is
important, but clearing the bladder resolves
the underlying cause of displacement.
5. A client at 34 weeks of gestation presents to the
triage unit complaining of sudden, severe
abdominal pain accompanied by dark red
vaginal bleeding. The uterus is rigid and tender
to palpation. The nurse suspects which
condition?
A. Placenta previa
B. Abruptio placentae
C. Cervical incompetence
D. Ectopic pregnancy
Answer: B
Rationale: Classic signs of abruptio
placentae (premature separation of the
placenta) include sudden onset of severe
abdominal pain, a rigid or board-like
abdomen, uterine tenderness, and dark red
& CLINICAL NURSING PRACTICE EXAM
BLUEPRINT (QUESTIONS & ANSWERS)
This high-yield exam preparation package contains
comprehensive, actual style multiple-choice questions with
precise answers and detailed rationales for Maternity and
Obstetrics nursing. Expertly structured to mimic actual board
examinations, it bridges the gap between complex clinical labor,
delivery, and postpartum scenarios and legal jurisprudence
regulations. It serves as an essential, top-tier study guide
designed to maximize scores for nursing students preparing for
high-stakes clinical certifications and final course examinations.
1. A nurse is assessing a pregnant client at 12
weeks of gestation. Which of the following
findings is considered a positive sign of
pregnancy?
A. Positive serum pregnancy test
B. Braxton Hicks contractions
C. Fetal heart tones heard via Doppler
D. Chadwick's sign
Answer: C
Rationale: Positive signs of pregnancy are
completely objective and can only be
attributed to the fetus. These include hearing
fetal heart tones, visualizing the fetus via
ultrasound, and palpating fetal movement by
a trained examiner. Options A, B, and D are
objective but are classified as probable signs
because they can occasionally be caused by
, other conditions (e.g., hydatidiform mole or
pelvic congestion).
2. A client at 28 weeks of gestation is diagnosed
with gestational diabetes. The nurse should
instruct the client that this condition increases
the risk for which fetal complication?
A. Fetal growth restriction
B. Congenital hip dysplasia
C. Neonatal macrosomia
D. Premature rupture of membranes
Answer: C
Rationale: Maternal hyperglycemia causes
excess glucose to cross the placenta. The
fetus responds by secreting high levels of
insulin, which acts as a growth hormone,
leading to macrosomia (excessive birth
weight). Fetal growth restriction is more
common in pregnancies complicated by
severe vascular diseases or chronic
hypertension, not uncomplicated gestational
diabetes.
3. A nurse is caring for a client in active labor who
is receiving an intravenous oxytocin infusion.
The nurse notes a pattern of late decelerations
on the fetal monitor strip. Which action should
the nurse take first?
A. Increase the oxytocin infusion rate
, B. Administer oxygen at 2 L/min via nasal
cannula
C. Position the client on her left side
D. Prepare for an emergency forceps delivery
Answer: C
Rationale: Late decelerations indicate
uteroplacental insufficiency. The immediate
priority is to improve placental perfusion,
which is best achieved by turning the client
to her side (preferably left side) to remove
the weight of the uterus from the inferior
vena cava. The oxytocin infusion should be
discontinued immediately, not increased. If
oxygen is given, it is typically administered
at 8–10 L/min via a non-rebreather mask.
4. A postpartum nurse is assessing a client 2 hours
after a vaginal delivery. The nurse notes that the
fundus is boggy and displaced to the right of the
midline. Which of the following is the priority
nursing intervention?
A. Massage the fundus until it is firm
B. Administer a prescribed dose of
methylergonovine
C. Assist the client to empty her bladder
D. Notify the primary healthcare provider
immediately
Answer: C
, Rationale: A fundus that is displaced to the
right and boggy strongly indicates a
distended bladder. A full bladder pushes the
uterus up and out of place, preventing it from
contracting efficiently and increasing the risk
of postpartum hemorrhage. Assisting the
client to void (or straight catheterization if
necessary) will allow the uterus to return to
the midline and contract. Fundal massage is
important, but clearing the bladder resolves
the underlying cause of displacement.
5. A client at 34 weeks of gestation presents to the
triage unit complaining of sudden, severe
abdominal pain accompanied by dark red
vaginal bleeding. The uterus is rigid and tender
to palpation. The nurse suspects which
condition?
A. Placenta previa
B. Abruptio placentae
C. Cervical incompetence
D. Ectopic pregnancy
Answer: B
Rationale: Classic signs of abruptio
placentae (premature separation of the
placenta) include sudden onset of severe
abdominal pain, a rigid or board-like
abdomen, uterine tenderness, and dark red
