Maternal-Newborn Nursing 2026/2027 | Maternal Newborn
Nursing Study Guide, Practice Questions & Answers, Exam
Prep, Comprehensive Review, Pregnancy & Fetal Development,
Antepartum Nursing, High-Risk Pregnancy, Prenatal
Assessment, Intrapartum Nursing, Labor & Delivery, Fetal
Monitoring, Postpartum Nursing, Newborn Assessment &
Care, Newborn Complications, Hypertensive Disorders,
Gestational Diabetes, Hemorrhage, Breastfeeding,
Contraception, Infertility, Pharmacology, Clinical Judgment,
Prioritization, NCLEX-RN & NCLEX-PN Review, Detailed
Rationales
Question 1: A primigravida at 38 weeks' gestation is admitted in
active labor. Which assessment finding requires immediate
intervention?
A. Contractions every 3 minutes lasting 50 seconds
B. Fetal heart rate baseline of 140 beats per minute
C. Spontaneous rupture of membranes with clear fluid
D. Prolapsed umbilical cord visible at the introitus
CORRECT ANSWER: D. Prolapsed umbilical cord visible at the
introitus
Rationale: A prolapsed umbilical cord is an obstetric emergency because
cord compression compromises fetal oxygenation. The nurse must
immediately relieve pressure by positioning the client knee-chest or
Trendelenburg, call for assistance, and prepare for emergency cesarean
delivery. The other findings are normal in active labor.
Question 2: A client at 36 weeks' gestation presents with painless,
bright red vaginal bleeding. Which condition should the nurse
suspect first?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical polyps
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding in the third trimester. Abruptio placentae typically presents
with painful bleeding and a tense, board-like abdomen. Uterine rupture is
,associated with severe pain and fetal distress. Cervical polyps may cause
bleeding but are not the priority suspicion with this classic presentation.
Question 3: Which medication is administered to a Rh-negative
mother after delivery of an Rh-positive infant to prevent
isoimmunization?
A. Betamethasone
B. Rho(D) immune globulin
C. Magnesium sulfate
D. Oxytocin
CORRECT ANSWER: B. Rho(D) immune globulin
Rationale: Rho(D) immune globulin prevents the Rh-negative mother from
forming antibodies against Rh-positive fetal red blood cells, thereby
preventing hemolytic disease of the newborn in future pregnancies.
Betamethasone enhances fetal lung maturity, magnesium sulfate is used for
seizure prophylaxis in preeclampsia, and oxytocin augments labor.
Question 4: A newborn is assessed at 1 minute of life. Heart rate is
110, respiratory effort is slow and irregular, muscle tone is some
flexion, reflex irritability is grimace, and color is acrocyanotic.
What is the APGAR score?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Heart rate 110 = 2 points, slow irregular respirations = 1 point,
some flexion = 1 point, grimace = 1 point, acrocyanosis = 1 point. Total =
6. This indicates moderate depression requiring continued resuscitation
and reassessment at 5 minutes.
Question 5: Which finding in a postpartum client 24 hours after
vaginal delivery requires immediate nursing action?
A. Lochia rubra with small clots
B. Fundus firm at the umbilicus
C. Saturated perineal pad within 15 minutes
D. Mild afterpains during breastfeeding
,CORRECT ANSWER: C. Saturated perineal pad within 15 minutes
Rationale: Saturating a perineal pad within 15 minutes indicates excessive
bleeding and possible postpartum hemorrhage. The nurse should massage
the fundus, assess for retained placental fragments, and notify the provider.
Lochia rubra with small clots, a firm fundus at the umbilicus, and mild
afterpains are expected findings.
Question 6: A client in labor receiving oxytocin develops uterine
hyperstimulation with fetal decelerations. What is the nurse's first
action?
A. Increase the oxytocin rate
B. Discontinue the oxytocin infusion
C. Administer a bolus of oxytocin
D. Place the client in a supine position
CORRECT ANSWER: B. Discontinue the oxytocin infusion
Rationale: The first action is to stop the oxytocin to reduce uterine activity
and improve fetal oxygenation. The nurse should also reposition the client
laterally, administer oxygen, and notify the provider. Increasing oxytocin
would worsen hyperstimulation.
Question 7: Which neonatal finding is a classic sign of congenital
hip dysplasia?
A. Positive Babinski reflex
B. Asymmetric gluteal folds
C. Moro reflex present
D. Positive Ortolani sign
CORRECT ANSWER: D. Positive Ortolani sign
Rationale: A positive Ortolani sign is a clunk felt as the dislocated femoral
head is reduced into the acetabulum, a classic sign of developmental
dysplasia of the hip. Asymmetric gluteal folds may also be seen but are less
definitive. Babinski and Moro reflexes are normal neonatal findings.
Question 8: A pregnant client at 32 weeks' gestation reports severe
headache, visual disturbances, and epigastric pain. Blood pressure
is 168/110 mm Hg. Which condition is most likely?
, A. Gestational hypertension
B. Preeclampsia with severe features
C. Chronic hypertension
D. Eclampsia
CORRECT ANSWER: B. Preeclampsia with severe features
Rationale: Severe headache, visual changes, epigastric pain, and BP
≥160/110 mm Hg after 20 weeks' gestation indicate preeclampsia with
severe features. Eclampsia involves seizures. Gestational hypertension lacks
organ dysfunction, and chronic hypertension predates pregnancy.
Question 9: Which vaccine is routinely administered to the
newborn before discharge to prevent hepatitis B infection?
A. Hepatitis A vaccine
B. Hepatitis B vaccine
C. MMR vaccine
D. Varicella vaccine
CORRECT ANSWER: B. Hepatitis B vaccine
Rationale: The hepatitis B vaccine is given within 24 hours of birth to all
newborns to prevent perinatal transmission. MMR and varicella are given
later in infancy. Hepatitis A is not part of the newborn schedule.
Question 10: A client is in the second stage of labor. Which finding
indicates imminent delivery?
A. Cervical dilation of 6 cm
B. Contractions every 5 minutes
C. Bulging perineum and crowning
D. Bloody show
CORRECT ANSWER: C. Bulging perineum and crowning
Rationale: Crowning and a bulging perineum indicate the fetal head is
visible at the introitus, signaling imminent delivery. The nurse should
prepare for birth. Dilation of 6 cm is active phase, and bloody show occurs
earlier in labor.
Question 11: Which intervention is most appropriate for a newborn
with hypoglycemia (blood glucose 35 mg/dL)?
Nursing Study Guide, Practice Questions & Answers, Exam
Prep, Comprehensive Review, Pregnancy & Fetal Development,
Antepartum Nursing, High-Risk Pregnancy, Prenatal
Assessment, Intrapartum Nursing, Labor & Delivery, Fetal
Monitoring, Postpartum Nursing, Newborn Assessment &
Care, Newborn Complications, Hypertensive Disorders,
Gestational Diabetes, Hemorrhage, Breastfeeding,
Contraception, Infertility, Pharmacology, Clinical Judgment,
Prioritization, NCLEX-RN & NCLEX-PN Review, Detailed
Rationales
Question 1: A primigravida at 38 weeks' gestation is admitted in
active labor. Which assessment finding requires immediate
intervention?
A. Contractions every 3 minutes lasting 50 seconds
B. Fetal heart rate baseline of 140 beats per minute
C. Spontaneous rupture of membranes with clear fluid
D. Prolapsed umbilical cord visible at the introitus
CORRECT ANSWER: D. Prolapsed umbilical cord visible at the
introitus
Rationale: A prolapsed umbilical cord is an obstetric emergency because
cord compression compromises fetal oxygenation. The nurse must
immediately relieve pressure by positioning the client knee-chest or
Trendelenburg, call for assistance, and prepare for emergency cesarean
delivery. The other findings are normal in active labor.
Question 2: A client at 36 weeks' gestation presents with painless,
bright red vaginal bleeding. Which condition should the nurse
suspect first?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical polyps
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding in the third trimester. Abruptio placentae typically presents
with painful bleeding and a tense, board-like abdomen. Uterine rupture is
,associated with severe pain and fetal distress. Cervical polyps may cause
bleeding but are not the priority suspicion with this classic presentation.
Question 3: Which medication is administered to a Rh-negative
mother after delivery of an Rh-positive infant to prevent
isoimmunization?
A. Betamethasone
B. Rho(D) immune globulin
C. Magnesium sulfate
D. Oxytocin
CORRECT ANSWER: B. Rho(D) immune globulin
Rationale: Rho(D) immune globulin prevents the Rh-negative mother from
forming antibodies against Rh-positive fetal red blood cells, thereby
preventing hemolytic disease of the newborn in future pregnancies.
Betamethasone enhances fetal lung maturity, magnesium sulfate is used for
seizure prophylaxis in preeclampsia, and oxytocin augments labor.
Question 4: A newborn is assessed at 1 minute of life. Heart rate is
110, respiratory effort is slow and irregular, muscle tone is some
flexion, reflex irritability is grimace, and color is acrocyanotic.
What is the APGAR score?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Heart rate 110 = 2 points, slow irregular respirations = 1 point,
some flexion = 1 point, grimace = 1 point, acrocyanosis = 1 point. Total =
6. This indicates moderate depression requiring continued resuscitation
and reassessment at 5 minutes.
Question 5: Which finding in a postpartum client 24 hours after
vaginal delivery requires immediate nursing action?
A. Lochia rubra with small clots
B. Fundus firm at the umbilicus
C. Saturated perineal pad within 15 minutes
D. Mild afterpains during breastfeeding
,CORRECT ANSWER: C. Saturated perineal pad within 15 minutes
Rationale: Saturating a perineal pad within 15 minutes indicates excessive
bleeding and possible postpartum hemorrhage. The nurse should massage
the fundus, assess for retained placental fragments, and notify the provider.
Lochia rubra with small clots, a firm fundus at the umbilicus, and mild
afterpains are expected findings.
Question 6: A client in labor receiving oxytocin develops uterine
hyperstimulation with fetal decelerations. What is the nurse's first
action?
A. Increase the oxytocin rate
B. Discontinue the oxytocin infusion
C. Administer a bolus of oxytocin
D. Place the client in a supine position
CORRECT ANSWER: B. Discontinue the oxytocin infusion
Rationale: The first action is to stop the oxytocin to reduce uterine activity
and improve fetal oxygenation. The nurse should also reposition the client
laterally, administer oxygen, and notify the provider. Increasing oxytocin
would worsen hyperstimulation.
Question 7: Which neonatal finding is a classic sign of congenital
hip dysplasia?
A. Positive Babinski reflex
B. Asymmetric gluteal folds
C. Moro reflex present
D. Positive Ortolani sign
CORRECT ANSWER: D. Positive Ortolani sign
Rationale: A positive Ortolani sign is a clunk felt as the dislocated femoral
head is reduced into the acetabulum, a classic sign of developmental
dysplasia of the hip. Asymmetric gluteal folds may also be seen but are less
definitive. Babinski and Moro reflexes are normal neonatal findings.
Question 8: A pregnant client at 32 weeks' gestation reports severe
headache, visual disturbances, and epigastric pain. Blood pressure
is 168/110 mm Hg. Which condition is most likely?
, A. Gestational hypertension
B. Preeclampsia with severe features
C. Chronic hypertension
D. Eclampsia
CORRECT ANSWER: B. Preeclampsia with severe features
Rationale: Severe headache, visual changes, epigastric pain, and BP
≥160/110 mm Hg after 20 weeks' gestation indicate preeclampsia with
severe features. Eclampsia involves seizures. Gestational hypertension lacks
organ dysfunction, and chronic hypertension predates pregnancy.
Question 9: Which vaccine is routinely administered to the
newborn before discharge to prevent hepatitis B infection?
A. Hepatitis A vaccine
B. Hepatitis B vaccine
C. MMR vaccine
D. Varicella vaccine
CORRECT ANSWER: B. Hepatitis B vaccine
Rationale: The hepatitis B vaccine is given within 24 hours of birth to all
newborns to prevent perinatal transmission. MMR and varicella are given
later in infancy. Hepatitis A is not part of the newborn schedule.
Question 10: A client is in the second stage of labor. Which finding
indicates imminent delivery?
A. Cervical dilation of 6 cm
B. Contractions every 5 minutes
C. Bulging perineum and crowning
D. Bloody show
CORRECT ANSWER: C. Bulging perineum and crowning
Rationale: Crowning and a bulging perineum indicate the fetal head is
visible at the introitus, signaling imminent delivery. The nurse should
prepare for birth. Dilation of 6 cm is active phase, and bloody show occurs
earlier in labor.
Question 11: Which intervention is most appropriate for a newborn
with hypoglycemia (blood glucose 35 mg/dL)?
