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MATERNAL-NEWBORN PEDIATRIC NURSING EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
Maternal-Newborn Pediatric Nursing Exam: 250 Practice Questions with Rationales
DOMAIN 1: ANTEPARTUM NURSING CARE (50 Questions)
1. A nurse is caring for a client at 8 weeks gestation who reports "morning
sickness." Which recommendation is most appropriate?
A) Avoid eating dry crackers before getting out of bed
B) Increase intake of high-fat foods to stabilize blood sugar
C) Consume small, frequent meals throughout the day
D) Drink large amounts of fluid with meals to promote digestion
Answer: C) Consume small, frequent meals throughout the day
Rationale: Small, frequent meals prevent hypoglycemia and gastric distension, which
can trigger nausea. Dry crackers before rising help, not hinder. High-fat foods delay
gastric emptying. Fluids should be taken between meals, not with meals, to prevent
bloating .
2. A nurse is reviewing prenatal laboratory results. Which finding requires
immediate notification of the provider?
A) Rubella titer: 1:8
B) Hematocrit: 34%
C) White blood cell count: 12,000/mm³
D) Blood glucose: 85 mg/dL
Answer: A) Rubella titer: 1:8
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Rationale: A Rubella titer less than 1:8 indicates non-immunity. The client requires
vaccination postpartum. While WBCs are slightly elevated in pregnancy (normal), and
Hct 34% is acceptable in the second trimester, the low titer is a critical safety alert to
prevent congenital rubella syndrome in future pregnancies .
3. A nurse is providing teaching about folic acid. The nurse explains that adequate
intake during the first trimester helps prevent:
A) Gestational diabetes
B) Neural tube defects
C) Preterm labor
D) Anemia
Answer: B) Neural tube defects
Rationale: Folic acid (400-800 mcg) is crucial for neural tube closure, which occurs in
the first 28 days of gestation. It prevents spina bifida and anencephaly .
4. A client at 12 weeks gestation is being assessed. Where should the fundus be
palpated?
A) At the symphysis pubis
B) Just above the symphysis pubis
C) At the umbilicus
D) Midway between the symphysis pubis and umbilicus
Answer: B) Just above the symphysis pubis
Rationale: At 12 weeks, the fundus should be just above the symphysis pubis. If it is at
the symphysis, growth may be lagging. At 20 weeks, the fundus is at the umbilicus .
5. A client at 28 weeks gestation reports "leaking fluid." The nurse tests the fluid
with nitrazine paper, which turns blue. This indicates:
A) Urine, as nitrazine turns blue for acidic substances
B) Amniotic fluid, as it is alkaline
C) Normal vaginal discharge
D) A false positive due to blood
Answer: B) Amniotic fluid, as it is alkaline
Rationale: Amniotic fluid has a pH of 7.1–7.3. Nitrazine paper turns blue (alkaline). Urine
is acidic (yellow). This suggests premature rupture of membranes (PROM) .
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6. A nurse is assessing a client at 10 weeks gestation. The fundal height is palpated
at the symphysis pubis. This finding indicates:
A) The gestational age is accurate
B) The client may have a multiple gestation
C) The client may have intrauterine growth restriction (IUGR)
D) The client is further along than estimated
Answer: C) The client may have intrauterine growth restriction (IUGR)
Rationale: At 10 weeks, the fundus is not palpable above the symphysis pubis. If at 12
weeks it is still at the symphysis, growth may be lagging .
7. A client is prescribed Rho(D) immune globulin (RhoGAM). The nurse understands
that this medication is given to prevent:
A) Hemolytic disease of the newborn in a subsequent pregnancy
B) Maternal hemorrhage during delivery
C) Respiratory distress syndrome in the newborn
D) Gestational hypertension
Answer: A) Hemolytic disease of the newborn in a subsequent pregnancy
Rationale: RhoGAM prevents the Rh-negative mother from forming antibodies against
Rh-positive fetal blood. It prevents hemolytic disease of the newborn (erythroblastosis
fetalis) in future pregnancies .
8. A client with hyperemesis gravidarum is admitted. Which laboratory finding is a
priority to report?
A) Potassium 3.2 mEq/L
B) Urine ketones 2+
C) Hematocrit 48%
D) Sodium 135 mEq/L
Answer: A) Potassium 3.2 mEq/L
Rationale: Hypokalemia (normal 3.5-5.0) is a life-threatening electrolyte imbalance that
can cause cardiac dysrhythmias. While ketones and elevated hematocrit are
concerning, potassium imbalance is the priority .
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9. A nurse is teaching a client about the signs of preeclampsia. Which finding
should the client report immediately?
A) Mild ankle edema
B) Visual disturbances
C) Nausea and vomiting
D) Weight gain of 1 pound in 1 week
Answer: B) Visual disturbances
Rationale: Visual disturbances, epigastric pain, and nausea/vomiting are signs of severe
preeclampsia and should be reported immediately .
10. A client at 36 weeks gestation with preeclampsia is receiving magnesium
sulfate. Which assessment finding indicates toxicity?
A) Deep tendon reflexes 2+
B) Urinary output of 20 mL/hour
C) Respiratory rate of 14 breaths per minute
D) Blood pressure of 140/90 mm Hg
Answer: B) Urinary output of 20 mL/hour
Rationale: Magnesium sulfate is excreted renally. Oliguria (<30 mL/hour) indicates
impending toxicity. Loss of patellar reflexes (not 2+) is the first sign of toxicity, followed
by respiratory depression .
11. A client with preeclampsia is receiving magnesium sulfate. Which medication
should the nurse have available for magnesium toxicity?
A) Calcium gluconate
B) Sodium bicarbonate
C) Naloxone
D) Flumazenil
Answer: A) Calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium toxicity. It should be readily
available at the bedside for any client receiving magnesium sulfate .
12. A client with gestational diabetes mellitus (GDM) is having a non-stress test
(NST). The nurse notes a reactive result. Which of the following indicates this?
MATERNAL-NEWBORN PEDIATRIC NURSING EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
Maternal-Newborn Pediatric Nursing Exam: 250 Practice Questions with Rationales
DOMAIN 1: ANTEPARTUM NURSING CARE (50 Questions)
1. A nurse is caring for a client at 8 weeks gestation who reports "morning
sickness." Which recommendation is most appropriate?
A) Avoid eating dry crackers before getting out of bed
B) Increase intake of high-fat foods to stabilize blood sugar
C) Consume small, frequent meals throughout the day
D) Drink large amounts of fluid with meals to promote digestion
Answer: C) Consume small, frequent meals throughout the day
Rationale: Small, frequent meals prevent hypoglycemia and gastric distension, which
can trigger nausea. Dry crackers before rising help, not hinder. High-fat foods delay
gastric emptying. Fluids should be taken between meals, not with meals, to prevent
bloating .
2. A nurse is reviewing prenatal laboratory results. Which finding requires
immediate notification of the provider?
A) Rubella titer: 1:8
B) Hematocrit: 34%
C) White blood cell count: 12,000/mm³
D) Blood glucose: 85 mg/dL
Answer: A) Rubella titer: 1:8
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Rationale: A Rubella titer less than 1:8 indicates non-immunity. The client requires
vaccination postpartum. While WBCs are slightly elevated in pregnancy (normal), and
Hct 34% is acceptable in the second trimester, the low titer is a critical safety alert to
prevent congenital rubella syndrome in future pregnancies .
3. A nurse is providing teaching about folic acid. The nurse explains that adequate
intake during the first trimester helps prevent:
A) Gestational diabetes
B) Neural tube defects
C) Preterm labor
D) Anemia
Answer: B) Neural tube defects
Rationale: Folic acid (400-800 mcg) is crucial for neural tube closure, which occurs in
the first 28 days of gestation. It prevents spina bifida and anencephaly .
4. A client at 12 weeks gestation is being assessed. Where should the fundus be
palpated?
A) At the symphysis pubis
B) Just above the symphysis pubis
C) At the umbilicus
D) Midway between the symphysis pubis and umbilicus
Answer: B) Just above the symphysis pubis
Rationale: At 12 weeks, the fundus should be just above the symphysis pubis. If it is at
the symphysis, growth may be lagging. At 20 weeks, the fundus is at the umbilicus .
5. A client at 28 weeks gestation reports "leaking fluid." The nurse tests the fluid
with nitrazine paper, which turns blue. This indicates:
A) Urine, as nitrazine turns blue for acidic substances
B) Amniotic fluid, as it is alkaline
C) Normal vaginal discharge
D) A false positive due to blood
Answer: B) Amniotic fluid, as it is alkaline
Rationale: Amniotic fluid has a pH of 7.1–7.3. Nitrazine paper turns blue (alkaline). Urine
is acidic (yellow). This suggests premature rupture of membranes (PROM) .
, Page 3 of 78
6. A nurse is assessing a client at 10 weeks gestation. The fundal height is palpated
at the symphysis pubis. This finding indicates:
A) The gestational age is accurate
B) The client may have a multiple gestation
C) The client may have intrauterine growth restriction (IUGR)
D) The client is further along than estimated
Answer: C) The client may have intrauterine growth restriction (IUGR)
Rationale: At 10 weeks, the fundus is not palpable above the symphysis pubis. If at 12
weeks it is still at the symphysis, growth may be lagging .
7. A client is prescribed Rho(D) immune globulin (RhoGAM). The nurse understands
that this medication is given to prevent:
A) Hemolytic disease of the newborn in a subsequent pregnancy
B) Maternal hemorrhage during delivery
C) Respiratory distress syndrome in the newborn
D) Gestational hypertension
Answer: A) Hemolytic disease of the newborn in a subsequent pregnancy
Rationale: RhoGAM prevents the Rh-negative mother from forming antibodies against
Rh-positive fetal blood. It prevents hemolytic disease of the newborn (erythroblastosis
fetalis) in future pregnancies .
8. A client with hyperemesis gravidarum is admitted. Which laboratory finding is a
priority to report?
A) Potassium 3.2 mEq/L
B) Urine ketones 2+
C) Hematocrit 48%
D) Sodium 135 mEq/L
Answer: A) Potassium 3.2 mEq/L
Rationale: Hypokalemia (normal 3.5-5.0) is a life-threatening electrolyte imbalance that
can cause cardiac dysrhythmias. While ketones and elevated hematocrit are
concerning, potassium imbalance is the priority .
, Page 4 of 78
9. A nurse is teaching a client about the signs of preeclampsia. Which finding
should the client report immediately?
A) Mild ankle edema
B) Visual disturbances
C) Nausea and vomiting
D) Weight gain of 1 pound in 1 week
Answer: B) Visual disturbances
Rationale: Visual disturbances, epigastric pain, and nausea/vomiting are signs of severe
preeclampsia and should be reported immediately .
10. A client at 36 weeks gestation with preeclampsia is receiving magnesium
sulfate. Which assessment finding indicates toxicity?
A) Deep tendon reflexes 2+
B) Urinary output of 20 mL/hour
C) Respiratory rate of 14 breaths per minute
D) Blood pressure of 140/90 mm Hg
Answer: B) Urinary output of 20 mL/hour
Rationale: Magnesium sulfate is excreted renally. Oliguria (<30 mL/hour) indicates
impending toxicity. Loss of patellar reflexes (not 2+) is the first sign of toxicity, followed
by respiratory depression .
11. A client with preeclampsia is receiving magnesium sulfate. Which medication
should the nurse have available for magnesium toxicity?
A) Calcium gluconate
B) Sodium bicarbonate
C) Naloxone
D) Flumazenil
Answer: A) Calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium toxicity. It should be readily
available at the bedside for any client receiving magnesium sulfate .
12. A client with gestational diabetes mellitus (GDM) is having a non-stress test
(NST). The nurse notes a reactive result. Which of the following indicates this?
