SAFE MATERNITY & PEDIATRIC NURSING CARE
COMPREHENSIVE EXAM PREP (2026/2027) COMPLETE WITH
VERIFIED ANSWERS
Question 1: A pregnant patient in her second trimester reports
occasional episodes of lightheadedness when lying flat on her back.
Which physiological mechanism explains this finding?
A. Increased cardiac output
B. Vena cava compression by the gravid uterus
C. Decreased blood volume
D. Hyperventilation of pregnancy
CORRECT ANSWER: B. Vena cava compression by the gravid uterus
Rationale: Supine hypotensive syndrome occurs when the weight of the
gravid uterus compresses the inferior vena cava, reducing venous return
and cardiac output, leading to lightheadedness. The patient should be
advised to lie on her left side.
Question 2: A nurse is assessing a laboring patient who is 8 cm dilated.
The patient suddenly screams, "I feel like I need to push!" What is the
priority nursing action?
A. Tell the patient to hold her breath and push.
B. Assess for cervical dilation.
C. Administer an epidural bolus.
D. Prepare for immediate delivery.
CORRECT ANSWER: B. Assess for cervical dilation.
Rationale: The urge to push can indicate full dilation. However, pushing
,before full dilation can cause cervical edema and tearing. The nurse
must assess the cervix first to confirm complete dilation before
encouraging pushing.
Question 3: A 2-day postpartum patient is experiencing heavy vaginal
bleeding. The nurse notes a boggy uterus. After massaging the fundus,
what is the next priority action?
A. Administer IV oxytocin.
B. Assess the bladder for distention.
C. Notify the provider.
D. Weigh the perineal pads.
CORRECT ANSWER: B. Assess the bladder for distention.
Rationale: A full bladder displaces the uterus and prevents it from
contracting effectively. Assessing and emptying the bladder is a crucial
step in managing uterine atony after massaging the fundus.
Question 4: A newborn is delivered at 39 weeks gestation. Which
assessment finding requires immediate intervention?
A. Acrocyanosis
B. Respiratory rate of 70 breaths per minute
C. Heart rate of 130 beats per minute
D. Passage of meconium within the first 12 hours
CORRECT ANSWER: B. Respiratory rate of 70 breaths per minute
Rationale: A respiratory rate greater than 60 breaths per minute in a
newborn indicates tachypnea, which may suggest respiratory distress
syndrome or transient tachypnea of the newborn. Immediate
assessment and intervention are required.
Question 5: A 6-month-old infant is brought to the clinic for a well-
child visit. Which developmental milestone should the nurse expect
,the infant to achieve?
A. Rolling from back to stomach
B. Sitting without support
C. Transferring objects from hand to hand
D. Pulling to a standing position
CORRECT ANSWER: A. Rolling from back to stomach
Rationale: Rolling from back to stomach is a gross motor milestone
typically achieved around 6 months. Sitting without support usually
occurs at 8 months, transferring objects at 7 months, and pulling to
stand at 9-10 months.
Question 6: A nurse is caring for a child diagnosed with epiglottitis.
Which action should the nurse take first?
A. Obtain a throat culture.
B. Inspect the throat with a tongue depressor.
C. Prepare for emergency intubation.
D. Administer oral antibiotics.
CORRECT ANSWER: C. Prepare for emergency intubation.
Rationale: Epiglottitis can cause rapid airway obstruction. Inspecting the
throat with a tongue depressor can trigger laryngospasm. Maintaining a
patent airway is the priority, which often requires immediate
intubation.
Question 7: A 4-year-old child is hospitalized with acute
glomerulonephritis. Which finding should the nurse report to the
provider immediately?
A. Blood pressure of 110/70 mm Hg
B. Urine output of 20 mL/hr
C. Weight gain of 2 kg in 24 hours
D. Hematuria
, CORRECT ANSWER: C. Weight gain of 2 kg in 24 hours
Rationale: Acute glomerulonephritis often causes fluid retention and
hypertension. A sudden weight gain of 2 kg in 24 hours indicates
significant fluid overload, putting the child at risk for hypertensive
encephalopathy or pulmonary edema, and requires immediate
reporting.
Question 8: A nurse is triaging patients in a pediatric emergency
department. Which patient should the nurse assess first?
A. A 2-year-old with a barking cough and inspiratory stridor.
B. A 5-year-old with a fever of 101°F and a sore throat.
C. An 8-year-old with a closed arm fracture and a 4/10 pain score.
D. A 12-year-old with nausea and vomiting for 12 hours.
CORRECT ANSWER: A. A 2-year-old with a barking cough and inspiratory
stridor.
Rationale: This presentation is classic for croup. Inspiratory stridor
indicates upper airway obstruction and impending respiratory failure.
This patient requires immediate assessment and intervention,
prioritizing airway over the other non-life-threatening conditions.
Question 9: A pregnant patient at 34 weeks gestation is diagnosed
with preeclampsia. Which clinical manifestation indicates that the
condition has progressed to severe preeclampsia?
A. 1+ proteinuria
B. Blood pressure of 140/90 mm Hg
C. Platelet count of 90,000/mm3
D. Mild dependent edema
CORRECT ANSWER: C. Platelet count of 90,000/mm3
Rationale: Thrombocytopenia (platelet count less than 100,000/mm3) is
a diagnostic criterion for severe preeclampsia, indicating systemic organ
COMPREHENSIVE EXAM PREP (2026/2027) COMPLETE WITH
VERIFIED ANSWERS
Question 1: A pregnant patient in her second trimester reports
occasional episodes of lightheadedness when lying flat on her back.
Which physiological mechanism explains this finding?
A. Increased cardiac output
B. Vena cava compression by the gravid uterus
C. Decreased blood volume
D. Hyperventilation of pregnancy
CORRECT ANSWER: B. Vena cava compression by the gravid uterus
Rationale: Supine hypotensive syndrome occurs when the weight of the
gravid uterus compresses the inferior vena cava, reducing venous return
and cardiac output, leading to lightheadedness. The patient should be
advised to lie on her left side.
Question 2: A nurse is assessing a laboring patient who is 8 cm dilated.
The patient suddenly screams, "I feel like I need to push!" What is the
priority nursing action?
A. Tell the patient to hold her breath and push.
B. Assess for cervical dilation.
C. Administer an epidural bolus.
D. Prepare for immediate delivery.
CORRECT ANSWER: B. Assess for cervical dilation.
Rationale: The urge to push can indicate full dilation. However, pushing
,before full dilation can cause cervical edema and tearing. The nurse
must assess the cervix first to confirm complete dilation before
encouraging pushing.
Question 3: A 2-day postpartum patient is experiencing heavy vaginal
bleeding. The nurse notes a boggy uterus. After massaging the fundus,
what is the next priority action?
A. Administer IV oxytocin.
B. Assess the bladder for distention.
C. Notify the provider.
D. Weigh the perineal pads.
CORRECT ANSWER: B. Assess the bladder for distention.
Rationale: A full bladder displaces the uterus and prevents it from
contracting effectively. Assessing and emptying the bladder is a crucial
step in managing uterine atony after massaging the fundus.
Question 4: A newborn is delivered at 39 weeks gestation. Which
assessment finding requires immediate intervention?
A. Acrocyanosis
B. Respiratory rate of 70 breaths per minute
C. Heart rate of 130 beats per minute
D. Passage of meconium within the first 12 hours
CORRECT ANSWER: B. Respiratory rate of 70 breaths per minute
Rationale: A respiratory rate greater than 60 breaths per minute in a
newborn indicates tachypnea, which may suggest respiratory distress
syndrome or transient tachypnea of the newborn. Immediate
assessment and intervention are required.
Question 5: A 6-month-old infant is brought to the clinic for a well-
child visit. Which developmental milestone should the nurse expect
,the infant to achieve?
A. Rolling from back to stomach
B. Sitting without support
C. Transferring objects from hand to hand
D. Pulling to a standing position
CORRECT ANSWER: A. Rolling from back to stomach
Rationale: Rolling from back to stomach is a gross motor milestone
typically achieved around 6 months. Sitting without support usually
occurs at 8 months, transferring objects at 7 months, and pulling to
stand at 9-10 months.
Question 6: A nurse is caring for a child diagnosed with epiglottitis.
Which action should the nurse take first?
A. Obtain a throat culture.
B. Inspect the throat with a tongue depressor.
C. Prepare for emergency intubation.
D. Administer oral antibiotics.
CORRECT ANSWER: C. Prepare for emergency intubation.
Rationale: Epiglottitis can cause rapid airway obstruction. Inspecting the
throat with a tongue depressor can trigger laryngospasm. Maintaining a
patent airway is the priority, which often requires immediate
intubation.
Question 7: A 4-year-old child is hospitalized with acute
glomerulonephritis. Which finding should the nurse report to the
provider immediately?
A. Blood pressure of 110/70 mm Hg
B. Urine output of 20 mL/hr
C. Weight gain of 2 kg in 24 hours
D. Hematuria
, CORRECT ANSWER: C. Weight gain of 2 kg in 24 hours
Rationale: Acute glomerulonephritis often causes fluid retention and
hypertension. A sudden weight gain of 2 kg in 24 hours indicates
significant fluid overload, putting the child at risk for hypertensive
encephalopathy or pulmonary edema, and requires immediate
reporting.
Question 8: A nurse is triaging patients in a pediatric emergency
department. Which patient should the nurse assess first?
A. A 2-year-old with a barking cough and inspiratory stridor.
B. A 5-year-old with a fever of 101°F and a sore throat.
C. An 8-year-old with a closed arm fracture and a 4/10 pain score.
D. A 12-year-old with nausea and vomiting for 12 hours.
CORRECT ANSWER: A. A 2-year-old with a barking cough and inspiratory
stridor.
Rationale: This presentation is classic for croup. Inspiratory stridor
indicates upper airway obstruction and impending respiratory failure.
This patient requires immediate assessment and intervention,
prioritizing airway over the other non-life-threatening conditions.
Question 9: A pregnant patient at 34 weeks gestation is diagnosed
with preeclampsia. Which clinical manifestation indicates that the
condition has progressed to severe preeclampsia?
A. 1+ proteinuria
B. Blood pressure of 140/90 mm Hg
C. Platelet count of 90,000/mm3
D. Mild dependent edema
CORRECT ANSWER: C. Platelet count of 90,000/mm3
Rationale: Thrombocytopenia (platelet count less than 100,000/mm3) is
a diagnostic criterion for severe preeclampsia, indicating systemic organ
