NUR 230 MATERNAL AND NEWBORN
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A pregnant patient at 32 weeks gestation presents with sudden, painless, bright red vaginal
bleeding. Which nursing action is contraindicated?
A. Applying an external fetal monitor
B. Obtaining a blood sample for type and cross-match
C. Initiating intravenous access
D. Performing a sterile vaginal exam to check dilation
Answer: D
Conceptual Explanation: Painless bright red bleeding suggests placenta previa. A vaginal
exam is contraindicated as it can cause massive hemorrhage by disrupting the placenta.
2. A nurse is monitoring a patient receiving Magnesium Sulfate for preeclampsia. Which
finding requires immediate discontinuation of the infusion?
A. Urinary output of 40 mL per hour
B. Blood pressure of 150/95 mmHg
,C. Absence of patellar deep tendon reflexes
D. Patient reports feeling warm and flushed
Answer: C
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
toxicity, which can lead to respiratory depression and cardiac arrest.
3. During the second stage of labor, a nurse notes a ‘turtle sign.’ Which maneuver should the
nurse prepare to assist the provider with first?
A. Leopold maneuvers
B. Fundal pressure
C. Internal version
D. McRoberts maneuver
Answer: D
Conceptual Explanation: The turtle sign indicates shoulder dystocia. McRoberts
maneuver (flexing legs to abdomen) and suprapubic pressure are the first-line
interventions.
4. A newborn is 1 minute old. The heart rate is 110 bpm, there is a weak cry, some flexion of
extremities, the body is pink with blue hands/feet, and the baby grimaces when suctioned.
What is the APGAR score?
A. 6
, B. 5
C. 7
D. 8
Answer: A
Conceptual Explanation: HR >100 (2), Weak cry (1), Flexion (1), Body pink/extremities
blue (1), Grimace (1). Total = 6.
5. A patient at 38 weeks gestation is diagnosed with HELLP syndrome. Which laboratory
result is consistent with this diagnosis?
A. Elevated Hemoglobin and Hematocrit
B. Blood Glucose of 60 mg/dL
C. Decreased serum creatinine
D. Platelet count of 85,000/mm3
Answer: D
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. Platelets below 100,000/mm3 confirm the ‘LP’ part of the syndrome.
6. The nurse identifies late decelerations on the fetal monitor strip. Which is the priority
nursing action?
A. Increase the Oxytocin infusion rate
B. Perform a scalp pH test
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A pregnant patient at 32 weeks gestation presents with sudden, painless, bright red vaginal
bleeding. Which nursing action is contraindicated?
A. Applying an external fetal monitor
B. Obtaining a blood sample for type and cross-match
C. Initiating intravenous access
D. Performing a sterile vaginal exam to check dilation
Answer: D
Conceptual Explanation: Painless bright red bleeding suggests placenta previa. A vaginal
exam is contraindicated as it can cause massive hemorrhage by disrupting the placenta.
2. A nurse is monitoring a patient receiving Magnesium Sulfate for preeclampsia. Which
finding requires immediate discontinuation of the infusion?
A. Urinary output of 40 mL per hour
B. Blood pressure of 150/95 mmHg
,C. Absence of patellar deep tendon reflexes
D. Patient reports feeling warm and flushed
Answer: C
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
toxicity, which can lead to respiratory depression and cardiac arrest.
3. During the second stage of labor, a nurse notes a ‘turtle sign.’ Which maneuver should the
nurse prepare to assist the provider with first?
A. Leopold maneuvers
B. Fundal pressure
C. Internal version
D. McRoberts maneuver
Answer: D
Conceptual Explanation: The turtle sign indicates shoulder dystocia. McRoberts
maneuver (flexing legs to abdomen) and suprapubic pressure are the first-line
interventions.
4. A newborn is 1 minute old. The heart rate is 110 bpm, there is a weak cry, some flexion of
extremities, the body is pink with blue hands/feet, and the baby grimaces when suctioned.
What is the APGAR score?
A. 6
, B. 5
C. 7
D. 8
Answer: A
Conceptual Explanation: HR >100 (2), Weak cry (1), Flexion (1), Body pink/extremities
blue (1), Grimace (1). Total = 6.
5. A patient at 38 weeks gestation is diagnosed with HELLP syndrome. Which laboratory
result is consistent with this diagnosis?
A. Elevated Hemoglobin and Hematocrit
B. Blood Glucose of 60 mg/dL
C. Decreased serum creatinine
D. Platelet count of 85,000/mm3
Answer: D
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. Platelets below 100,000/mm3 confirm the ‘LP’ part of the syndrome.
6. The nurse identifies late decelerations on the fetal monitor strip. Which is the priority
nursing action?
A. Increase the Oxytocin infusion rate
B. Perform a scalp pH test
