NUR 272 / NURS 272
Exam 2 Midterm - Maternal-Newborn
Nursing
75 Original Exam-Aligned Questions • Full Answers • Rationales • 5 Dosage Calculations
Medgar Evers College (CUNY) • 2026/2027 Updated
Coverage: PROM/PPROM • Electronic fetal monitoring • Labor stages and fetal position • Operative birth •
Obstetric emergencies • Pain management • Postpartum assessment and hemorrhage • Perinatal mental
health • Normal newborn • Hyperbilirubinemia • Feeding and teaching • Uterotonics, tocolytics,
anticoagulation concepts • 5 dosage-calculation items
Important: This is an independently written review resource aligned to the supplied Medgar Evers NUR 272 midterm outline and current
evidence-based obstetric/newborn guidance. It is not an official college examination and does not reproduce ATI or faculty test items.
,Alignment and Research Method
The supplied Midterm Outline explicitly identifies a 75-question assessment with 5 dosage-calculation questions. Its
topic map spans early-onset/preterm labor and membrane rupture, fetal monitoring, fetal position and cardinal
movements, stages of labor, procedures assisting labor and delivery, labor complications, pain management,
postpartum assessment, perinatal mental health, postpartum complications, normal newborn assessment, newborn
care/feeding, uterotonics, tocolytics, anticoagulants, and five calculation items.
The official Medgar Evers College catalog describes NUR 272 as a 6-credit course integrating childbearing and
child-rearing nursing, pharmacology, nutrition, growth and development, biological/physical/behavioral sciences,
problem-solving, and critical thinking. The question set below therefore emphasizes scenario-based nursing judgment
rather than simple recall.
2026 Evidence Reconciliation
Topic Outline language Current evidence used here
Active labor Traditional 4-7 cm active phase ACOG currently uses 6 cm as the start of active labor.
Fetal resuscitation Routine oxygen appears in older Routine supplemental oxygen is not recommended
oxygen fetal-monitoring teaching when maternal oxygen saturation is normal.
Meconium Older suctioning language appears in the AHA/AAP 2025 guidance: no routine
outline oral/nasal/endotracheal suctioning solely for meconium;
prioritize standard resuscitation and ventilation.
Exam Blueprint
Domain Questions
PROM/PPROM & fetal monitoring 1-11
Fetal position, labor progress & nursing care 12-20
Procedures, operative birth & emergencies 21-30
Postpartum assessment, hemorrhage & mental health 31-44
Normal newborn, bilirubin, feeding & teaching 45-56
Medications, cesarean/VBAC & integrated priorities 57-70
Dosage calculations 71-75
NUR 272/NURS 272 Exam 2 Midterm - Original Exam-Aligned Review Page 2
,I. PROM/PPROM and Fetal Monitoring
1. [MCQ] A client at 33 weeks reports a sudden gush of clear fluid from the vagina but has no regular
contractions. Which description best fits this finding?
A. Preterm prelabor rupture of membranes (PPROM)
B. Placenta previa
C. Normal leukorrhea of pregnancy
D. Abruptio placentae
Correct Answer: A
Rationale: PPROM is rupture of the amniotic membranes before labor and before 37 weeks of gestation. A gush or
persistent leakage of clear fluid is a classic presentation. Placenta previa and abruption involve bleeding rather than
isolated clear fluid leakage.
2. [MCQ] Which history most increases concern for PPROM in a current pregnancy?
A. Prior spontaneous preterm birth
B. Daily prenatal vitamin use
C. Normal pre-pregnancy BMI
D. First pregnancy at age 25
Correct Answer: A
Rationale: A prior preterm birth is an established risk factor for recurrent preterm birth and PPROM. Other recognized
risks include infection, cervical shortening, bleeding in the second or third trimester, tobacco/substance use, and low BMI.
3. [Priority] A client with suspected PPROM is admitted for evaluation. Which nursing action is most
appropriate?
A. Perform frequent digital vaginal examinations
B. Limit digital vaginal examinations and monitor maternal temperature
C. Encourage ambulation to stimulate labor
D. Delay fetal heart-rate assessment until contractions begin
Correct Answer: B
Rationale: Digital vaginal examinations are limited after membrane rupture because they can increase ascending
infection risk. Maternal temperature, fetal status, uterine activity, and signs of infection are monitored closely.
4. [MCQ] Why may antenatal betamethasone be prescribed for a client at risk for preterm birth?
A. To stop postpartum bleeding
B. To accelerate fetal lung maturation
C. To treat maternal hypertension
D. To prevent Rh sensitization
Correct Answer: B
Rationale: Antenatal corticosteroids such as betamethasone promote fetal lung maturation and surfactant production
when preterm birth is anticipated within an appropriate gestational-age window.
NUR 272/NURS 272 Exam 2 Midterm - Original Exam-Aligned Review Page 3
, 5. [MCQ] Which finding after membrane rupture most strongly suggests developing intra-amniotic
infection and requires prompt evaluation?
A. Maternal fever with uterine tenderness
B. Mild ankle edema at the end of the day
C. Fetal hiccups
D. Increased appetite
Correct Answer: A
Rationale: Maternal fever, uterine tenderness, maternal or fetal tachycardia, and foul-smelling fluid raise concern for
intra-amniotic infection. Infection after ROM can progress rapidly and requires prompt provider evaluation.
6. [MCQ] A fetal heart tracing shows abrupt drops in fetal heart rate that vary in timing and shape from
one contraction to the next. What is the most likely cause?
A. Fetal head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Fetal sleep cycle
Correct Answer: B
Rationale: Variable decelerations are classically associated with umbilical cord compression. They may occur with
oligohydramnios, a nuchal cord, a short cord, or cord prolapse.
7. [Priority] Recurrent variable decelerations appear while oxytocin is infusing. Which nursing action is
appropriate first?
A. Increase the oxytocin rate
B. Reposition the client and stop or reduce oxytocin while assessing the cause
C. Encourage pushing regardless of dilation
D. Place the client flat on the back
Correct Answer: B
Rationale: Initial intrauterine resuscitation for recurrent variable decelerations includes maternal repositioning, reducing
uterine stimulation by stopping oxytocin when indicated, and assessing for causes such as cord prolapse. Additional
measures depend on the clinical situation.
8. [MCQ] Early decelerations most commonly result from which physiologic event?
A. Fetal head compression
B. Maternal hypoglycemia
C. Placental insufficiency
D. Umbilical cord prolapse
Correct Answer: A
Rationale: Early decelerations mirror contractions and are generally caused by fetal head compression with vagal
stimulation. They are usually benign in an otherwise reassuring tracing.
NUR 272/NURS 272 Exam 2 Midterm - Original Exam-Aligned Review Page 4
Exam 2 Midterm - Maternal-Newborn
Nursing
75 Original Exam-Aligned Questions • Full Answers • Rationales • 5 Dosage Calculations
Medgar Evers College (CUNY) • 2026/2027 Updated
Coverage: PROM/PPROM • Electronic fetal monitoring • Labor stages and fetal position • Operative birth •
Obstetric emergencies • Pain management • Postpartum assessment and hemorrhage • Perinatal mental
health • Normal newborn • Hyperbilirubinemia • Feeding and teaching • Uterotonics, tocolytics,
anticoagulation concepts • 5 dosage-calculation items
Important: This is an independently written review resource aligned to the supplied Medgar Evers NUR 272 midterm outline and current
evidence-based obstetric/newborn guidance. It is not an official college examination and does not reproduce ATI or faculty test items.
,Alignment and Research Method
The supplied Midterm Outline explicitly identifies a 75-question assessment with 5 dosage-calculation questions. Its
topic map spans early-onset/preterm labor and membrane rupture, fetal monitoring, fetal position and cardinal
movements, stages of labor, procedures assisting labor and delivery, labor complications, pain management,
postpartum assessment, perinatal mental health, postpartum complications, normal newborn assessment, newborn
care/feeding, uterotonics, tocolytics, anticoagulants, and five calculation items.
The official Medgar Evers College catalog describes NUR 272 as a 6-credit course integrating childbearing and
child-rearing nursing, pharmacology, nutrition, growth and development, biological/physical/behavioral sciences,
problem-solving, and critical thinking. The question set below therefore emphasizes scenario-based nursing judgment
rather than simple recall.
2026 Evidence Reconciliation
Topic Outline language Current evidence used here
Active labor Traditional 4-7 cm active phase ACOG currently uses 6 cm as the start of active labor.
Fetal resuscitation Routine oxygen appears in older Routine supplemental oxygen is not recommended
oxygen fetal-monitoring teaching when maternal oxygen saturation is normal.
Meconium Older suctioning language appears in the AHA/AAP 2025 guidance: no routine
outline oral/nasal/endotracheal suctioning solely for meconium;
prioritize standard resuscitation and ventilation.
Exam Blueprint
Domain Questions
PROM/PPROM & fetal monitoring 1-11
Fetal position, labor progress & nursing care 12-20
Procedures, operative birth & emergencies 21-30
Postpartum assessment, hemorrhage & mental health 31-44
Normal newborn, bilirubin, feeding & teaching 45-56
Medications, cesarean/VBAC & integrated priorities 57-70
Dosage calculations 71-75
NUR 272/NURS 272 Exam 2 Midterm - Original Exam-Aligned Review Page 2
,I. PROM/PPROM and Fetal Monitoring
1. [MCQ] A client at 33 weeks reports a sudden gush of clear fluid from the vagina but has no regular
contractions. Which description best fits this finding?
A. Preterm prelabor rupture of membranes (PPROM)
B. Placenta previa
C. Normal leukorrhea of pregnancy
D. Abruptio placentae
Correct Answer: A
Rationale: PPROM is rupture of the amniotic membranes before labor and before 37 weeks of gestation. A gush or
persistent leakage of clear fluid is a classic presentation. Placenta previa and abruption involve bleeding rather than
isolated clear fluid leakage.
2. [MCQ] Which history most increases concern for PPROM in a current pregnancy?
A. Prior spontaneous preterm birth
B. Daily prenatal vitamin use
C. Normal pre-pregnancy BMI
D. First pregnancy at age 25
Correct Answer: A
Rationale: A prior preterm birth is an established risk factor for recurrent preterm birth and PPROM. Other recognized
risks include infection, cervical shortening, bleeding in the second or third trimester, tobacco/substance use, and low BMI.
3. [Priority] A client with suspected PPROM is admitted for evaluation. Which nursing action is most
appropriate?
A. Perform frequent digital vaginal examinations
B. Limit digital vaginal examinations and monitor maternal temperature
C. Encourage ambulation to stimulate labor
D. Delay fetal heart-rate assessment until contractions begin
Correct Answer: B
Rationale: Digital vaginal examinations are limited after membrane rupture because they can increase ascending
infection risk. Maternal temperature, fetal status, uterine activity, and signs of infection are monitored closely.
4. [MCQ] Why may antenatal betamethasone be prescribed for a client at risk for preterm birth?
A. To stop postpartum bleeding
B. To accelerate fetal lung maturation
C. To treat maternal hypertension
D. To prevent Rh sensitization
Correct Answer: B
Rationale: Antenatal corticosteroids such as betamethasone promote fetal lung maturation and surfactant production
when preterm birth is anticipated within an appropriate gestational-age window.
NUR 272/NURS 272 Exam 2 Midterm - Original Exam-Aligned Review Page 3
, 5. [MCQ] Which finding after membrane rupture most strongly suggests developing intra-amniotic
infection and requires prompt evaluation?
A. Maternal fever with uterine tenderness
B. Mild ankle edema at the end of the day
C. Fetal hiccups
D. Increased appetite
Correct Answer: A
Rationale: Maternal fever, uterine tenderness, maternal or fetal tachycardia, and foul-smelling fluid raise concern for
intra-amniotic infection. Infection after ROM can progress rapidly and requires prompt provider evaluation.
6. [MCQ] A fetal heart tracing shows abrupt drops in fetal heart rate that vary in timing and shape from
one contraction to the next. What is the most likely cause?
A. Fetal head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Fetal sleep cycle
Correct Answer: B
Rationale: Variable decelerations are classically associated with umbilical cord compression. They may occur with
oligohydramnios, a nuchal cord, a short cord, or cord prolapse.
7. [Priority] Recurrent variable decelerations appear while oxytocin is infusing. Which nursing action is
appropriate first?
A. Increase the oxytocin rate
B. Reposition the client and stop or reduce oxytocin while assessing the cause
C. Encourage pushing regardless of dilation
D. Place the client flat on the back
Correct Answer: B
Rationale: Initial intrauterine resuscitation for recurrent variable decelerations includes maternal repositioning, reducing
uterine stimulation by stopping oxytocin when indicated, and assessing for causes such as cord prolapse. Additional
measures depend on the clinical situation.
8. [MCQ] Early decelerations most commonly result from which physiologic event?
A. Fetal head compression
B. Maternal hypoglycemia
C. Placental insufficiency
D. Umbilical cord prolapse
Correct Answer: A
Rationale: Early decelerations mirror contractions and are generally caused by fetal head compression with vagal
stimulation. They are usually benign in an otherwise reassuring tracing.
NUR 272/NURS 272 Exam 2 Midterm - Original Exam-Aligned Review Page 4
