BSN Maternal-Newborn Nursing Practice Exam 2026
UPDATED ACTUAL Questions and CORRECT Answers
1. A nurse is caring for a client receiving magnesium sulfate for preeclampsia.
Which of the following findings should the nurse identify as a sign of magnesium
toxicity?
A. Hyperreflexia
B. Respiratory rate of 10/min
C. Urine output of 40 mL/hr
D. Blood pressure of 150/100 mmHg
Answer: B
Rationale: Magnesium toxicity is characterized by central nervous system depression,
which manifests as a decreased respiratory rate (less than 12/min), loss of deep tendon
reflexes, and decreased urine output.
2. A nurse is monitoring a client in labor and observes late decelerations on the
fetal heart rate monitor. Which of the following actions should the nurse take
first?
A. Administer oxygen at 10 L/min via nonrebreather mask
B. Assist the client into a side-lying position
C. Increase the rate of the maintenance IV fluid
D. Notify the provider
Answer: B
Rationale: The first action is to reposition the client to a side-lying position to improve
uteroplacental perfusion. Oxygen and IV fluids are subsequent steps.
,3. Which of the following findings is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive pregnancy test
C. Quickening
D. Fetal heart tones heard by Doppler
Answer: D
Rationale: Positive signs of pregnancy are those that can be attributed only to the
presence of a fetus, such as fetal heart tones, ultrasound visualization, or palpation of fetal
movement by an examiner.
4. A nurse is teaching a postpartum client about breastfeeding. Which of the
following instructions should the nurse include?
A. Ensure the baby’s mouth covers the entire areola
B. Wait at least 4 hours between feedings
C. Apply soap to the nipples daily during bathing
D. Use a nipple shield for every feeding
Answer: A
Rationale: A proper latch involves the infant taking in the entire areola to prevent nipple
trauma and ensure effective milk transfer.
5. A client at 34 weeks gestation reports a sudden onset of painless, bright red
vaginal bleeding. Which of the following conditions should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Preterm labor
Answer: A
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester.
, 6. Which medication is administered to a newborn within 1 hour of birth to
prevent ophthalmia neonatorum?
A. Vitamin K
B. Erythromycin ophthalmic ointment
C. Hepatitis B vaccine
D. Triple dye
Answer: B
Rationale: Erythromycin ointment is used prophylactically to prevent blindness caused by
gonorrhea or chlamydia contracted during birth.
7. A nurse is caring for a client who is 2 hours postpartum. The nurse notes the
fundus is firm, midline, and two fingerbreadths below the umbilicus. What
should the nurse conclude?
A. The uterus is not involuting properly
B. The client has a full bladder
C. The client is at risk for hemorrhage
D. This is a normal finding
Answer: D
Rationale: Immediately after birth, the fundus should be firm and at the level of the
umbilicus. Within a few hours, it descends below the umbilicus. A firm, midline fundus is a
normal finding.
8. A nurse is assessing a newborn and notes a blue-black pigmented area on the
sacrum. How should the nurse document this finding?
A. Telangiectatic nevi
B. Mongolian spots
C. Nevus flammeus
D. Erythema toxicum
Answer: B
UPDATED ACTUAL Questions and CORRECT Answers
1. A nurse is caring for a client receiving magnesium sulfate for preeclampsia.
Which of the following findings should the nurse identify as a sign of magnesium
toxicity?
A. Hyperreflexia
B. Respiratory rate of 10/min
C. Urine output of 40 mL/hr
D. Blood pressure of 150/100 mmHg
Answer: B
Rationale: Magnesium toxicity is characterized by central nervous system depression,
which manifests as a decreased respiratory rate (less than 12/min), loss of deep tendon
reflexes, and decreased urine output.
2. A nurse is monitoring a client in labor and observes late decelerations on the
fetal heart rate monitor. Which of the following actions should the nurse take
first?
A. Administer oxygen at 10 L/min via nonrebreather mask
B. Assist the client into a side-lying position
C. Increase the rate of the maintenance IV fluid
D. Notify the provider
Answer: B
Rationale: The first action is to reposition the client to a side-lying position to improve
uteroplacental perfusion. Oxygen and IV fluids are subsequent steps.
,3. Which of the following findings is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive pregnancy test
C. Quickening
D. Fetal heart tones heard by Doppler
Answer: D
Rationale: Positive signs of pregnancy are those that can be attributed only to the
presence of a fetus, such as fetal heart tones, ultrasound visualization, or palpation of fetal
movement by an examiner.
4. A nurse is teaching a postpartum client about breastfeeding. Which of the
following instructions should the nurse include?
A. Ensure the baby’s mouth covers the entire areola
B. Wait at least 4 hours between feedings
C. Apply soap to the nipples daily during bathing
D. Use a nipple shield for every feeding
Answer: A
Rationale: A proper latch involves the infant taking in the entire areola to prevent nipple
trauma and ensure effective milk transfer.
5. A client at 34 weeks gestation reports a sudden onset of painless, bright red
vaginal bleeding. Which of the following conditions should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Preterm labor
Answer: A
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester.
, 6. Which medication is administered to a newborn within 1 hour of birth to
prevent ophthalmia neonatorum?
A. Vitamin K
B. Erythromycin ophthalmic ointment
C. Hepatitis B vaccine
D. Triple dye
Answer: B
Rationale: Erythromycin ointment is used prophylactically to prevent blindness caused by
gonorrhea or chlamydia contracted during birth.
7. A nurse is caring for a client who is 2 hours postpartum. The nurse notes the
fundus is firm, midline, and two fingerbreadths below the umbilicus. What
should the nurse conclude?
A. The uterus is not involuting properly
B. The client has a full bladder
C. The client is at risk for hemorrhage
D. This is a normal finding
Answer: D
Rationale: Immediately after birth, the fundus should be firm and at the level of the
umbilicus. Within a few hours, it descends below the umbilicus. A firm, midline fundus is a
normal finding.
8. A nurse is assessing a newborn and notes a blue-black pigmented area on the
sacrum. How should the nurse document this finding?
A. Telangiectatic nevi
B. Mongolian spots
C. Nevus flammeus
D. Erythema toxicum
Answer: B
