Maternity and Obstetric Nursing Exam Questions and
Answers with Verified Solutions Latest 2026/2027
Examination Title Maternity and Obstetric Nursing Certification & Board
Review Practice Exam
Specialty Coverage Antepartum Care, Intrapartum Management,
Postpartum Complications, Fetal Monitoring, Newborn
Care
Passing Standard 75% Correct Responses
Edition Specification Latest 2026/2027 Master Review Edition
Module 1: Antepartum Assessment & Maternal-Fetal Health (Questions 1–15)
Question 1
A pregnant client at 10 weeks gestation asks about Naegele's rule to estimate her due date. Her
last normal menstrual period began on March 10. What is her estimated date of delivery (EDD)?
• A) December 10
• B) December 17
• C) December 17
• D) November 17
Correct Answer: C) December 17
Naegele's rule calculates the EDD by taking the first day of the last normal menstrual period, subtracting 3
months, adding 7 days, and adjusting the year (March 10 minus 3 months = December 10, plus 7 days =
December 17).
Question 2
A pregnant woman at 32 weeks gestation experiences sudden, painless, bright red vaginal
bleeding. Which condition should the nurse suspect first?
• A) Abruptio placentae
• B) Placenta previa
• C) Uterine rupture
• D) Marginal sinus rupture
Correct Answer: B) Placenta previa
Painless, bright red vaginal bleeding in the third trimester is the hallmark symptom of placenta previa.
Abruptio placentae typically presents with severe abdominal pain, uterine tenderness, and dark red bleeding.
,Question 3
A client at 34 weeks gestation with severe preeclampsia is receiving a continuous intravenous
infusion of magnesium sulfate. Which assessment finding requires immediate intervention?
• A) Urine output of 45 mL/hour
• B) Deep tendon reflexes rated at 2+
• C) Respiratory rate of 10 breaths per minute
• D) Blood pressure reading of 148/92 mmHg
Correct Answer: C) Respiratory rate of 10 breaths per minute
Magnesium sulfate toxicity causes central nervous system depression. A respiratory rate below 12 breaths
per minute, absent deep tendon reflexes, or urine output below 30 mL/hour indicates toxicity and requires
stopping the infusion and administering calcium gluconate.
Question 4
During a routine prenatal visit at 28 weeks, an Rh-negative client has a negative indirect
Coombs test. What intervention should the nurse anticipate?
• A) Withholding Rh immune globulin until after delivery
• B) Administering intramuscular Rh immune globulin (RhoGAM)
• C) Scheduling an immediate amniocentesis
• D) Ordering an emergency blood transfusion
Correct Answer: B) Administering intramuscular Rh immune globulin (RhoGAM)
Rh immune globulin is routinely administered at 28 weeks gestation to nonsensitized Rh-negative pregnant
women to prevent maternal antibody formation against fetal Rh-positive red blood cells.
Question 5
Which clinical finding observed during an ultrasound at 16 weeks gestation is a presumptive
sign of pregnancy?
• A) Fetal heart tones heard via Doppler
• B) Visualization of the fetus by ultrasound
• C) Client report of quickening
• D) Palpation of fetal movement by the examiner
Correct Answer: C) Client report of quickening
Presumptive signs are subjective feelings experienced by the woman (e.g., amenorrhea, fatigue, quickening).
Fetal heart tones, fetal visualization, and examiner-palpated movement are positive, objective signs of
pregnancy.
Question 6
A prenatal client asks why she needs a group B streptococcus (GBS) screening swab at 36
weeks gestation. What is the nurse's best response?
• A) To check for urinary tract infection before labor begins
• B) To determine if prophylactic antibiotics are needed during labor to protect the newborn
• C) To identify sex-linked genetic abnormalities in the fetus
• D) To evaluate placental blood flow and oxygenation
Correct Answer: B) To determine if prophylactic antibiotics are needed during labor to protect the newborn
GBS colonization is screened at 36-37 weeks. If positive, intravenous penicillin or ampicillin is administered
, during labor to prevent neonatal GBS sepsis, pneumonia, and meningitis.
Question 7
Which dietary source should the nurse recommend to a pregnant client to increase non-heme
iron absorption and prevent maternal anemia?
• A) Drinking a glass of orange juice with iron supplements
• B) Taking iron supplements with a glass of whole milk
• C) Consuming iron supplements with black tea or coffee
• D) Combining iron supplements with calcium carbonate antacids
Correct Answer: A) Drinking a glass of orange juice with iron supplements
Vitamin C (ascorbic acid) significantly enhances non-heme iron absorption. Calcium, milk, tea, and antacids
inhibit iron absorption and should be avoided at the time of iron administration.
Question 8
A non-stress test (NST) performed on a 38-week gestation client reveals two fetal heart rate
accelerations of 15 bpm above baseline lasting 15 seconds over a 20-minute period. How
should the nurse interpret this result?
• A) Non-reactive non-stress test requiring a biophysical profile
• B) Reactive non-stress test indicating fetal well-being
• C) Positive non-stress test indicating fetal hypoxia
• D) Unsatisfactory non-stress test needing immediate retesting
Correct Answer: B) Reactive non-stress test indicating fetal well-being
A reactive NST is a reassuring result defined by at least two accelerations of 15 bpm above baseline for at
least 15 seconds within a 20-minute window in pregnancies beyond 32 weeks.
Question 9
Which maternal physiological cardiovascular adaptation occurs during normal pregnancy?
• A) Decrease in total blood volume by 20%
• B) Increase in plasma volume exceeding red blood cell mass increase, causing physiological anemia
• C) Significant decrease in cardiac output during the second trimester
• D) Permanent elevation of systemic vascular resistance
Correct Answer: B) Increase in plasma volume exceeding red blood cell mass increase, causing
physiological anemia
Plasma volume expands by 40-50% while red cell mass increases by 20-30%. This disproportionate
expansion causes hemodilution, known as physiological anemia of pregnancy.
Question 10
A client at 20 weeks gestation asks where her fundus should be located during physical
examination. Where should the nurse expect to palpate the fundus?
• A) Slightly above the pubic symphysis
• B) At the level of the umbilicus
• C) Midway between the umbilicus and xiphoid process
• D) Directly at the xiphoid process
Correct Answer: B) At the level of the umbilicus
Answers with Verified Solutions Latest 2026/2027
Examination Title Maternity and Obstetric Nursing Certification & Board
Review Practice Exam
Specialty Coverage Antepartum Care, Intrapartum Management,
Postpartum Complications, Fetal Monitoring, Newborn
Care
Passing Standard 75% Correct Responses
Edition Specification Latest 2026/2027 Master Review Edition
Module 1: Antepartum Assessment & Maternal-Fetal Health (Questions 1–15)
Question 1
A pregnant client at 10 weeks gestation asks about Naegele's rule to estimate her due date. Her
last normal menstrual period began on March 10. What is her estimated date of delivery (EDD)?
• A) December 10
• B) December 17
• C) December 17
• D) November 17
Correct Answer: C) December 17
Naegele's rule calculates the EDD by taking the first day of the last normal menstrual period, subtracting 3
months, adding 7 days, and adjusting the year (March 10 minus 3 months = December 10, plus 7 days =
December 17).
Question 2
A pregnant woman at 32 weeks gestation experiences sudden, painless, bright red vaginal
bleeding. Which condition should the nurse suspect first?
• A) Abruptio placentae
• B) Placenta previa
• C) Uterine rupture
• D) Marginal sinus rupture
Correct Answer: B) Placenta previa
Painless, bright red vaginal bleeding in the third trimester is the hallmark symptom of placenta previa.
Abruptio placentae typically presents with severe abdominal pain, uterine tenderness, and dark red bleeding.
,Question 3
A client at 34 weeks gestation with severe preeclampsia is receiving a continuous intravenous
infusion of magnesium sulfate. Which assessment finding requires immediate intervention?
• A) Urine output of 45 mL/hour
• B) Deep tendon reflexes rated at 2+
• C) Respiratory rate of 10 breaths per minute
• D) Blood pressure reading of 148/92 mmHg
Correct Answer: C) Respiratory rate of 10 breaths per minute
Magnesium sulfate toxicity causes central nervous system depression. A respiratory rate below 12 breaths
per minute, absent deep tendon reflexes, or urine output below 30 mL/hour indicates toxicity and requires
stopping the infusion and administering calcium gluconate.
Question 4
During a routine prenatal visit at 28 weeks, an Rh-negative client has a negative indirect
Coombs test. What intervention should the nurse anticipate?
• A) Withholding Rh immune globulin until after delivery
• B) Administering intramuscular Rh immune globulin (RhoGAM)
• C) Scheduling an immediate amniocentesis
• D) Ordering an emergency blood transfusion
Correct Answer: B) Administering intramuscular Rh immune globulin (RhoGAM)
Rh immune globulin is routinely administered at 28 weeks gestation to nonsensitized Rh-negative pregnant
women to prevent maternal antibody formation against fetal Rh-positive red blood cells.
Question 5
Which clinical finding observed during an ultrasound at 16 weeks gestation is a presumptive
sign of pregnancy?
• A) Fetal heart tones heard via Doppler
• B) Visualization of the fetus by ultrasound
• C) Client report of quickening
• D) Palpation of fetal movement by the examiner
Correct Answer: C) Client report of quickening
Presumptive signs are subjective feelings experienced by the woman (e.g., amenorrhea, fatigue, quickening).
Fetal heart tones, fetal visualization, and examiner-palpated movement are positive, objective signs of
pregnancy.
Question 6
A prenatal client asks why she needs a group B streptococcus (GBS) screening swab at 36
weeks gestation. What is the nurse's best response?
• A) To check for urinary tract infection before labor begins
• B) To determine if prophylactic antibiotics are needed during labor to protect the newborn
• C) To identify sex-linked genetic abnormalities in the fetus
• D) To evaluate placental blood flow and oxygenation
Correct Answer: B) To determine if prophylactic antibiotics are needed during labor to protect the newborn
GBS colonization is screened at 36-37 weeks. If positive, intravenous penicillin or ampicillin is administered
, during labor to prevent neonatal GBS sepsis, pneumonia, and meningitis.
Question 7
Which dietary source should the nurse recommend to a pregnant client to increase non-heme
iron absorption and prevent maternal anemia?
• A) Drinking a glass of orange juice with iron supplements
• B) Taking iron supplements with a glass of whole milk
• C) Consuming iron supplements with black tea or coffee
• D) Combining iron supplements with calcium carbonate antacids
Correct Answer: A) Drinking a glass of orange juice with iron supplements
Vitamin C (ascorbic acid) significantly enhances non-heme iron absorption. Calcium, milk, tea, and antacids
inhibit iron absorption and should be avoided at the time of iron administration.
Question 8
A non-stress test (NST) performed on a 38-week gestation client reveals two fetal heart rate
accelerations of 15 bpm above baseline lasting 15 seconds over a 20-minute period. How
should the nurse interpret this result?
• A) Non-reactive non-stress test requiring a biophysical profile
• B) Reactive non-stress test indicating fetal well-being
• C) Positive non-stress test indicating fetal hypoxia
• D) Unsatisfactory non-stress test needing immediate retesting
Correct Answer: B) Reactive non-stress test indicating fetal well-being
A reactive NST is a reassuring result defined by at least two accelerations of 15 bpm above baseline for at
least 15 seconds within a 20-minute window in pregnancies beyond 32 weeks.
Question 9
Which maternal physiological cardiovascular adaptation occurs during normal pregnancy?
• A) Decrease in total blood volume by 20%
• B) Increase in plasma volume exceeding red blood cell mass increase, causing physiological anemia
• C) Significant decrease in cardiac output during the second trimester
• D) Permanent elevation of systemic vascular resistance
Correct Answer: B) Increase in plasma volume exceeding red blood cell mass increase, causing
physiological anemia
Plasma volume expands by 40-50% while red cell mass increases by 20-30%. This disproportionate
expansion causes hemodilution, known as physiological anemia of pregnancy.
Question 10
A client at 20 weeks gestation asks where her fundus should be located during physical
examination. Where should the nurse expect to palpate the fundus?
• A) Slightly above the pubic symphysis
• B) At the level of the umbilicus
• C) Midway between the umbilicus and xiphoid process
• D) Directly at the xiphoid process
Correct Answer: B) At the level of the umbilicus
