Page 1 of 82
MATERNITY, NEWBORN, AND WOMEN'S HEALTH NURSING: A CASE-
BASED APPROACH, 2ND EDITION EXAM QUESTIONS AND CORRECT
ANSWERS LATEST EDITION 2026
Original Practice Questions — Maternity, Newborn, and Women's Health Nursing (2nd
Edition)
Unit 1: Scenarios for Clinical Preparation (Questions 1–100)
Chapter 1: Immediate Postpartum Hemorrhage (Questions 1–8)
1. A pregnant woman is being discharged from the hospital after the placement of a cervical
cerclage because of a history of recurrent pregnancy loss secondary to an incompetent cervix.
Which information regarding postprocedural care should the nurse emphasize in the
discharge teaching?
A) Any vaginal discharge should be immediately reported to her health care provider.
B) The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure
should be reported.
C) The client will need to make arrangements for care at home, because her activity level will be
restricted.
D) The client will be scheduled for a cesarean birth.
Answer: B — The presence of any contractions, rupture of membranes (ROM), or severe
perineal pressure should be reported.
Rationale: Nursing care should stress the importance of monitoring for the signs and symptoms
of preterm labor. Vaginal bleeding needs to be reported to her primary health care provider.
Bed rest is an element of care, but the woman may stand for periods of up to 90 minutes .
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2. In caring for an immediate postpartum client, the nurse notes petechiae and oozing from
her intravenous (IV) site. The client would be closely monitored for which clotting disorder?
A) DIC
B) Amniotic fluid embolism (AFE)
C) Hemorrhage
D) HELLP syndrome
Answer: A — DIC
Rationale: The diagnosis of DIC is made according to clinical findings and laboratory markers. A
physical examination reveals unusual bleeding. Petechiae may appear around a blood pressure
cuff on the arm or from the site of an intravenous catheter .
3. A woman who is 30 weeks of gestation arrives at the health center with bleeding. Which
differential diagnosis would not be applicable for this client?
A) Placenta previa
B) Abruptio placentae
C) Spontaneous abortion
D) Cord insertion
Answer: C — Spontaneous abortion
Rationale: Spontaneous abortion is another name for miscarriage; it occurs, by definition, early
in pregnancy. Placenta previa, abruptio placentae, and cord insertion are bleeding disorders that
can occur late in pregnancy .
4. A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The
fluid consists of bright red blood. Her contractions are consistent with her current stage of
labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to
decline rapidly after the ROM. The nurse should suspect the possibility of what condition?
A) Placenta previa
B) Vasa previa
C) Severe abruptio placentae
D) Disseminated intravascular coagulation (DIC)
Answer: B — Vasa previa
Rationale: Vasa previa is the result of a velamentous insertion of the umbilical cord. The
umbilical blood vessels are at risk for laceration at any time, but laceration occurs most
frequently during ROM. The sudden appearance of bright red blood at the time of ROM and a
sudden change in the FHR should immediately alert the nurse to the possibility of vasa previa .
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5. A woman arrives for evaluation of signs and symptoms that include a missed period,
adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse
notices an ecchymotic blueness around the woman's umbilicus. What does this finding
indicate?
A) Normal integumentary changes associated with pregnancy
B) Turner sign associated with appendicitis
C) Cullen sign associated with a ruptured ectopic pregnancy
D) Chadwick sign associated with early pregnancy
Answer: C — Cullen sign associated with a ruptured ectopic pregnancy
Rationale: Cullen sign, the blue ecchymosis observed in the umbilical area, indicates
hematoperitoneum associated with an undiagnosed ruptured intraabdominal ectopic
pregnancy .
6. The nurse is preparing to administer methotrexate to the client. This hazardous drug is
most often used for which obstetric complication?
A) Complete hydatidiform mole
B) Missed abortion
C) Unruptured ectopic pregnancy
D) Abruptio placentae
Answer: C — Unruptured ectopic pregnancy
Rationale: Methotrexate is an effective nonsurgical treatment option for a hemodynamically
stable woman whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter
.
7. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
diagnostic procedure will the client most likely have performed?
A) Amniocentesis for fetal lung maturity
B) Transvaginal ultrasound for placental location
C) Contraction stress test (CST)
D) Internal fetal monitoring
Answer: B — Transvaginal ultrasound for placental location
Rationale: The presence of painless bleeding should always alert the health care team to the
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possibility of placenta previa, which can be confirmed through ultrasonography. A CST is not
performed at a preterm gestational age, and bleeding is a contraindication to a CST .
8. With regard to hemorrhagic complications that may occur during pregnancy, what
information is most accurate?
A) An incompetent cervix is usually not diagnosed until the woman has lost one or two
pregnancies.
B) Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques.
C) One ectopic pregnancy does not affect a woman's fertility or her likelihood of having a
normal pregnancy.
D) Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic
malignancies.
Answer: A — An incompetent cervix is usually not diagnosed until the woman has lost one or
two pregnancies.
Rationale: Short labors and recurring losses of pregnancy at progressively earlier gestational
ages are characteristics of reduced cervical competence. One ectopic pregnancy places the
woman at increased risk for another one. GTN is now the most curable gynecologic malignancy .
Chapter 2: Later Postpartum Hemorrhage (Questions 9–16)
9. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and
curettage secondary to a hydatidiform mole. The woman asks why she must take oral
contraceptives for the next 12 months. What is the best response by the nurse?
A) "If you get pregnant within 1 year, the chance of a successful pregnancy is very small."
B) "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only
by the hormone that your body produces during pregnancy. If you were to get pregnant, then it
would make this cancer more difficult to detect."
C) "If you can avoid a pregnancy for the next year, the chance of developing a second molar
pregnancy will improve."
D) "Oral contraceptives are the only form of birth control that will prevent a recurrence of a
molar pregnancy."
Answer: B — "The major risk to you after a molar pregnancy is a type of cancer that can be
diagnosed only by the hormone that your body produces during pregnancy."
Rationale: Beta-human chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year
to ensure that the mole is completely gone. The chance of developing choriocarcinoma after the
4|Page
MATERNITY, NEWBORN, AND WOMEN'S HEALTH NURSING: A CASE-
BASED APPROACH, 2ND EDITION EXAM QUESTIONS AND CORRECT
ANSWERS LATEST EDITION 2026
Original Practice Questions — Maternity, Newborn, and Women's Health Nursing (2nd
Edition)
Unit 1: Scenarios for Clinical Preparation (Questions 1–100)
Chapter 1: Immediate Postpartum Hemorrhage (Questions 1–8)
1. A pregnant woman is being discharged from the hospital after the placement of a cervical
cerclage because of a history of recurrent pregnancy loss secondary to an incompetent cervix.
Which information regarding postprocedural care should the nurse emphasize in the
discharge teaching?
A) Any vaginal discharge should be immediately reported to her health care provider.
B) The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure
should be reported.
C) The client will need to make arrangements for care at home, because her activity level will be
restricted.
D) The client will be scheduled for a cesarean birth.
Answer: B — The presence of any contractions, rupture of membranes (ROM), or severe
perineal pressure should be reported.
Rationale: Nursing care should stress the importance of monitoring for the signs and symptoms
of preterm labor. Vaginal bleeding needs to be reported to her primary health care provider.
Bed rest is an element of care, but the woman may stand for periods of up to 90 minutes .
1|Page
,Page 2 of 82
2. In caring for an immediate postpartum client, the nurse notes petechiae and oozing from
her intravenous (IV) site. The client would be closely monitored for which clotting disorder?
A) DIC
B) Amniotic fluid embolism (AFE)
C) Hemorrhage
D) HELLP syndrome
Answer: A — DIC
Rationale: The diagnosis of DIC is made according to clinical findings and laboratory markers. A
physical examination reveals unusual bleeding. Petechiae may appear around a blood pressure
cuff on the arm or from the site of an intravenous catheter .
3. A woman who is 30 weeks of gestation arrives at the health center with bleeding. Which
differential diagnosis would not be applicable for this client?
A) Placenta previa
B) Abruptio placentae
C) Spontaneous abortion
D) Cord insertion
Answer: C — Spontaneous abortion
Rationale: Spontaneous abortion is another name for miscarriage; it occurs, by definition, early
in pregnancy. Placenta previa, abruptio placentae, and cord insertion are bleeding disorders that
can occur late in pregnancy .
4. A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The
fluid consists of bright red blood. Her contractions are consistent with her current stage of
labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to
decline rapidly after the ROM. The nurse should suspect the possibility of what condition?
A) Placenta previa
B) Vasa previa
C) Severe abruptio placentae
D) Disseminated intravascular coagulation (DIC)
Answer: B — Vasa previa
Rationale: Vasa previa is the result of a velamentous insertion of the umbilical cord. The
umbilical blood vessels are at risk for laceration at any time, but laceration occurs most
frequently during ROM. The sudden appearance of bright red blood at the time of ROM and a
sudden change in the FHR should immediately alert the nurse to the possibility of vasa previa .
2|Page
,Page 3 of 82
5. A woman arrives for evaluation of signs and symptoms that include a missed period,
adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse
notices an ecchymotic blueness around the woman's umbilicus. What does this finding
indicate?
A) Normal integumentary changes associated with pregnancy
B) Turner sign associated with appendicitis
C) Cullen sign associated with a ruptured ectopic pregnancy
D) Chadwick sign associated with early pregnancy
Answer: C — Cullen sign associated with a ruptured ectopic pregnancy
Rationale: Cullen sign, the blue ecchymosis observed in the umbilical area, indicates
hematoperitoneum associated with an undiagnosed ruptured intraabdominal ectopic
pregnancy .
6. The nurse is preparing to administer methotrexate to the client. This hazardous drug is
most often used for which obstetric complication?
A) Complete hydatidiform mole
B) Missed abortion
C) Unruptured ectopic pregnancy
D) Abruptio placentae
Answer: C — Unruptured ectopic pregnancy
Rationale: Methotrexate is an effective nonsurgical treatment option for a hemodynamically
stable woman whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter
.
7. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
diagnostic procedure will the client most likely have performed?
A) Amniocentesis for fetal lung maturity
B) Transvaginal ultrasound for placental location
C) Contraction stress test (CST)
D) Internal fetal monitoring
Answer: B — Transvaginal ultrasound for placental location
Rationale: The presence of painless bleeding should always alert the health care team to the
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, Page 4 of 82
possibility of placenta previa, which can be confirmed through ultrasonography. A CST is not
performed at a preterm gestational age, and bleeding is a contraindication to a CST .
8. With regard to hemorrhagic complications that may occur during pregnancy, what
information is most accurate?
A) An incompetent cervix is usually not diagnosed until the woman has lost one or two
pregnancies.
B) Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques.
C) One ectopic pregnancy does not affect a woman's fertility or her likelihood of having a
normal pregnancy.
D) Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic
malignancies.
Answer: A — An incompetent cervix is usually not diagnosed until the woman has lost one or
two pregnancies.
Rationale: Short labors and recurring losses of pregnancy at progressively earlier gestational
ages are characteristics of reduced cervical competence. One ectopic pregnancy places the
woman at increased risk for another one. GTN is now the most curable gynecologic malignancy .
Chapter 2: Later Postpartum Hemorrhage (Questions 9–16)
9. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and
curettage secondary to a hydatidiform mole. The woman asks why she must take oral
contraceptives for the next 12 months. What is the best response by the nurse?
A) "If you get pregnant within 1 year, the chance of a successful pregnancy is very small."
B) "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only
by the hormone that your body produces during pregnancy. If you were to get pregnant, then it
would make this cancer more difficult to detect."
C) "If you can avoid a pregnancy for the next year, the chance of developing a second molar
pregnancy will improve."
D) "Oral contraceptives are the only form of birth control that will prevent a recurrence of a
molar pregnancy."
Answer: B — "The major risk to you after a molar pregnancy is a type of cancer that can be
diagnosed only by the hormone that your body produces during pregnancy."
Rationale: Beta-human chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year
to ensure that the mole is completely gone. The chance of developing choriocarcinoma after the
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