MATERNAL AND CHILD HEALTH
NURSING
60 Updated Actual Exam Questions and Correct Answers • Verified Solutions
1. A pregnant client at 32 weeks gestation presents with painless, bright red vaginal
bleeding. What condition should the nurse suspect?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Cervical incompetence
Rationale: Painless, bright red vaginal bleeding in the third trimester is the hallmark symptom of
placenta previa. Placental abruption presents with dark red bleeding accompanied by severe
abdominal pain and uterine tenderness.
2. A nurse calculates Naegele's rule for a client whose last menstrual period (LMP) began
on October 10. What is the estimated date of delivery (EDD)?
A) July 17
B) July 10
C) June 17
D) August 17
Rationale: Naegele's rule calculates the estimated date of delivery by subtracting 3 months from the
first day of the LMP and adding 7 days and 1 year (October 10 - 3 months = July 10 + 7 days = July
17).
3. What is the primary purpose of administering Rho(D) immune globulin (RhGAM) to an
Rh-negative pregnant woman?
A) Stimulate fetal red blood cell production
B) Prevent maternal sensitization to Rh-positive fetal red blood cells
C) Treat ABO incompatibility in the newborn
D) Prevent physiological anemia of pregnancy
Rationale: RhGAM prevents the Rh-negative mother's immune system from forming anti-Rh
antibodies against Rh-positive fetal blood cells, protecting future pregnancies from hemolytic disease
, of the newborn.
4. A newborn assessed at 1 minute has a pink body with blue extremities, a heart rate of
110 bpm, prompt withdrawal to stimulation, active flexion of extremities, and a vigorous
cry. What is the APGAR score?
A) 7
B) 8
C) 9
D) 10
Rationale: Appearance = 1 (acrocyanosis), Pulse = 2 (>100 bpm), Grimace = 2 (prompt response),
Activity = 2 (active movement), Respiration = 2 (vigorous cry). Total APGAR score = 9.
5. Which clinical sign in a client receiving IV magnesium sulfate for preeclampsia
indicates magnesium toxicity?
A) Hyperactive deep tendon reflexes (4+)
B) Loss of deep tendon reflexes and respiratory rate below 12 breaths/min
C) Blood pressure of 150/90 mmHg
D) Increased urinary output of 60 mL/hr
Rationale: Early indicators of magnesium toxicity include loss of deep tendon reflexes (patellar reflex),
respiratory depression (<12 breaths/min), and decreased urine output (<30 mL/hr).
6. What is the specific antidote for magnesium sulfate toxicity?
A) Naloxone
B) Calcium gluconate
C) Protamine sulfate
D) Phytonadione (Vitamin K)
Rationale: Intravenous calcium gluconate reverses the neuromuscular blocking effects of excess
magnesium ions and is kept at the bedside during magnesium sulfate infusions.
7. A postpartum client experience severe uterine atony and excessive vaginal bleeding.
What medication is the initial first-line drug of choice?
A) Oxytocin
B) Methylergonovine
, C) Carboprost tromethamine
D) Misoprostol
Rationale: Intravenous or intramuscular oxytocin is the first-line uterotonic agent administered to
stimulate rhythmic uterine contractions and prevent postpartum hemorrhage.
8. Which medication is contraindicated for a postpartum patient experiencing
hemorrhage who has a history of chronic hypertension?
A) Oxytocin
B) Methylergonovine
C) Misoprostol
D) Tranexamic acid
Rationale: Methylergonovine produces intense arterial vasoconstriction, which can cause severe
hypertension, stroke, or hypertensive crisis in clients with pre-existing high blood pressure.
9. What diagnostic test confirms neural tube defects, such as spina bifida, during
prenatal screening?
A) Elevated Maternal Serum Alpha-Fetoprotein (MSAFP)
B) Low Human Chorionic Gonadotropin (hCG)
C) Elevated Unconjugated Estriol
D) Decreased Inhibin-A
Rationale: Elevated levels of MSAFP at 15–20 weeks gestation suggest open neural tube defects or
abdominal wall defects. Low MSAFP levels are associated with Down syndrome.
10. An infant with tetralogy of Fallot develops a sudden hypercyanotic ("tet") spell. What
immediate nursing intervention reduces systemic venous return and improves
pulmonary arterial flow?
A) Place the infant in a supine flat position
B) Flex the infant's knees up to the chest (knee-chest position)
C) Administer IV bolus of normal saline rapidly
D) Apply a tight abdominal binder
Rationale: Placing the infant in a knee-chest position increases systemic vascular resistance
(afterload), reducing the right-to-left shunting of blood and directing more unoxygenated blood into the
pulmonary artery.
NURSING
60 Updated Actual Exam Questions and Correct Answers • Verified Solutions
1. A pregnant client at 32 weeks gestation presents with painless, bright red vaginal
bleeding. What condition should the nurse suspect?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Cervical incompetence
Rationale: Painless, bright red vaginal bleeding in the third trimester is the hallmark symptom of
placenta previa. Placental abruption presents with dark red bleeding accompanied by severe
abdominal pain and uterine tenderness.
2. A nurse calculates Naegele's rule for a client whose last menstrual period (LMP) began
on October 10. What is the estimated date of delivery (EDD)?
A) July 17
B) July 10
C) June 17
D) August 17
Rationale: Naegele's rule calculates the estimated date of delivery by subtracting 3 months from the
first day of the LMP and adding 7 days and 1 year (October 10 - 3 months = July 10 + 7 days = July
17).
3. What is the primary purpose of administering Rho(D) immune globulin (RhGAM) to an
Rh-negative pregnant woman?
A) Stimulate fetal red blood cell production
B) Prevent maternal sensitization to Rh-positive fetal red blood cells
C) Treat ABO incompatibility in the newborn
D) Prevent physiological anemia of pregnancy
Rationale: RhGAM prevents the Rh-negative mother's immune system from forming anti-Rh
antibodies against Rh-positive fetal blood cells, protecting future pregnancies from hemolytic disease
, of the newborn.
4. A newborn assessed at 1 minute has a pink body with blue extremities, a heart rate of
110 bpm, prompt withdrawal to stimulation, active flexion of extremities, and a vigorous
cry. What is the APGAR score?
A) 7
B) 8
C) 9
D) 10
Rationale: Appearance = 1 (acrocyanosis), Pulse = 2 (>100 bpm), Grimace = 2 (prompt response),
Activity = 2 (active movement), Respiration = 2 (vigorous cry). Total APGAR score = 9.
5. Which clinical sign in a client receiving IV magnesium sulfate for preeclampsia
indicates magnesium toxicity?
A) Hyperactive deep tendon reflexes (4+)
B) Loss of deep tendon reflexes and respiratory rate below 12 breaths/min
C) Blood pressure of 150/90 mmHg
D) Increased urinary output of 60 mL/hr
Rationale: Early indicators of magnesium toxicity include loss of deep tendon reflexes (patellar reflex),
respiratory depression (<12 breaths/min), and decreased urine output (<30 mL/hr).
6. What is the specific antidote for magnesium sulfate toxicity?
A) Naloxone
B) Calcium gluconate
C) Protamine sulfate
D) Phytonadione (Vitamin K)
Rationale: Intravenous calcium gluconate reverses the neuromuscular blocking effects of excess
magnesium ions and is kept at the bedside during magnesium sulfate infusions.
7. A postpartum client experience severe uterine atony and excessive vaginal bleeding.
What medication is the initial first-line drug of choice?
A) Oxytocin
B) Methylergonovine
, C) Carboprost tromethamine
D) Misoprostol
Rationale: Intravenous or intramuscular oxytocin is the first-line uterotonic agent administered to
stimulate rhythmic uterine contractions and prevent postpartum hemorrhage.
8. Which medication is contraindicated for a postpartum patient experiencing
hemorrhage who has a history of chronic hypertension?
A) Oxytocin
B) Methylergonovine
C) Misoprostol
D) Tranexamic acid
Rationale: Methylergonovine produces intense arterial vasoconstriction, which can cause severe
hypertension, stroke, or hypertensive crisis in clients with pre-existing high blood pressure.
9. What diagnostic test confirms neural tube defects, such as spina bifida, during
prenatal screening?
A) Elevated Maternal Serum Alpha-Fetoprotein (MSAFP)
B) Low Human Chorionic Gonadotropin (hCG)
C) Elevated Unconjugated Estriol
D) Decreased Inhibin-A
Rationale: Elevated levels of MSAFP at 15–20 weeks gestation suggest open neural tube defects or
abdominal wall defects. Low MSAFP levels are associated with Down syndrome.
10. An infant with tetralogy of Fallot develops a sudden hypercyanotic ("tet") spell. What
immediate nursing intervention reduces systemic venous return and improves
pulmonary arterial flow?
A) Place the infant in a supine flat position
B) Flex the infant's knees up to the chest (knee-chest position)
C) Administer IV bolus of normal saline rapidly
D) Apply a tight abdominal binder
Rationale: Placing the infant in a knee-chest position increases systemic vascular resistance
(afterload), reducing the right-to-left shunting of blood and directing more unoxygenated blood into the
pulmonary artery.
