NUR 301: Advanced NCLEX Maternal-Child &
Pharmacological Practice Exam Bank
Course Code: NUR 301
Course Name: Advanced Maternal-Child Nursing and Clinical Pharmacology
Topic: Prioritization, Dosage Calculations, Maternal-Fetal Physiology, Select-All-
That-Apply (SATA) Bangers, High-Alert Med Calculations, Critical Neonatal
Interventions
Academic Year: 2026/2027
1. The nurse is caring for a multigravida patient at 38 weeks of gestation who
is receiving a continuous intravenous oxytocin (Pitocin) infusion for labor
induction. The telemetry strip suddenly reveals repetitive late decelerations
associated with a baseline fetal heart rate of 110 beats per minute and uterine
tachysystole (6 contractions in 10 minutes). Which sequence of interventions
must the nurse execute immediately to maximize fetal oxygenation?
A. Increase the oxytocin infusion rate, apply a non-rebreather mask at 2
L/min, and place the patient supine.
B. Stop the oxytocin infusion immediately, reposition the patient to a
lateral side-lying position, apply oxygen via non-rebreather at 10 L/min,
and increase main line IV fluids.
C. Perform an immediate vaginal exam, administer oral glucose, and prepare
the patient for a vacuum-assisted delivery.
D. Document the late decelerations as a normal variant of advanced labor
and reassess the monitor in 30 minutes.
CORRECT ANSWER: B
RATIONALE: Late decelerations indicate uteroplacental insufficiency, which
is being exacerbated here by uterine tachysystole caused by oxytocin (Pitocin)
stimulation. The immediate, non-negotiable priority sequence is to stop the
oxytocin infusion to relieve uterine hyperstimulation, turn the patient to a
lateral side-lying position to maximize uterine blood flow, apply high-flow
oxygen via a non-rebreather mask at 10 L/min, and open up the main line IV
,fluids to restore maternal blood volume and fetal perfusion. Increasing oxytocin or
keeping the patient supine will worsen fetal hypoxia.
2. A pediatric patient weighing 44 pounds (lbs) is admitted with severe
dehydration secondary to gastroenteritis. The healthcare provider prescribes
furosemide (Lasix) 1 mg/kg intravenously STAT. The available vial is
labeled Furosemide 10 mg/mL. How many milliliters (mL) of the
medication should the nurse administer to deliver the exact prescribed dose?
A. 1.0 mL
B. 2.0 mL
C. 4.4 mL
D. 20.0 mL
CORRECT ANSWER: B
RATIONALE: To calculate the correct pharmacological dosage, the nurse must
first convert the child's weight from pounds to kilograms: 44 lbs ÷ 2.2 = 20 kg.
Next, calculate the total mg dose prescribed: 20 kg × 1 mg/kg = 20 mg. Finally,
calculate the volume to administer based on the concentration on hand: 20 mg ÷ 10
mg/mL = 2.0 mL.
3. A nurse is assigned to the labor and delivery triage unit and receives four
pregnant patients simultaneously. Utilizing the principles of clinical
prioritization, which patient must the nurse evaluate first?
A. A 39-week primigravida reporting regular uterine contractions occurring
every 5 minutes and loss of the mucous plug.
B. A 32-week multigravida with a history of chronic hypertension who
complains of a sudden, severe, pounding headache and blurred vision.
C. A 36-week patient reporting a mild, localized aching lower back pain and
increased white vaginal discharge.
D. A 40-week patient who states her membranes ruptured 4 hours ago and
the amniotic fluid is clear without any foul odor.
CORRECT ANSWER: B
RATIONALE: Following the framework of prioritizing life-threatening
complications, the 32-week patient presenting with a severe headache and
blurred vision displays classic warning signs of worsening preeclampsia or
impending eclampsia. This patient is at high risk for immediate seizures, placental
,abruption, or maternal stroke, taking priority over stable patients in active labor,
normal membrane ruptures, or non-specific lower back pain.
4. The nurse is conducting a comprehensive discharge teaching session for a
postpartum mother who delivered an infant 3 days ago. The mother is
breastfeeding and asks about neonatal clinical indicators that confirm
adequate nutritional intake. Which signs should the nurse instruct the mother
to monitor? (Select All That Apply)
• The infant exhibits a minimum of 6 to 8 wet diapers daily.
• The infant passes 3 or more loose, yellow, seedy stools per day.
• The infant makes audible swallowing sounds frequently during each feeding
session.
• The infant's birth weight drops by a total of 15% within the first week of life.
• The infant appears content, satisfied, and sleeps for 2 to 3 hours between
feedings.
A. 1, 2, and 4
B. 1, 3, and 5
C. 1, 2, 3, and 5
D. All of the above
CORRECT ANSWER: C
RATIONALE: Indicators of successful breastfeeding and adequate infant intake
include 6 to 8 wet diapers per day, 3 or more yellow, seedy stools daily, audible
swallowing sounds during active nursing, and an infant who is content and
sleeps between sessions. A birth weight drop of 15% is a highly pathological
finding; newborns should lose no more than 7% to 10% of their birth weight within
the first week of life and should regain it by 10 to 14 days.
5. A healthcare provider prescribes a continuous intravenous heparin infusion
for a postpartum patient diagnosed with a deep vein thrombosis (DVT). The
order reads: Infuse 1,200 units of heparin per hour. The available IV bag
contains Heparin 25,000 units dissolved in 500 mL of 5% Dextrose in Water
(D₅W). At what rate should the nurse program the electronic infusion pump
in milliliters per hour (mL/hr)?
A. 12 mL/hr
, B. 24 mL/hr
C. 48 mL/hr
D. 50 mL/hr
CORRECT ANSWER: B
RATIONALE: To solve this pharmacological calculation, utilize the standard
ratio formula: (Prescribed Amount per hour ÷ Total Amount on hand) × Total
Volume = Hourly Flow Rate. Plugging in the values: (1,200 units/hr ÷ 25,000
units) × 500 mL = 0.048 × 500 = 24 mL/hr.
6. A pediatric nurse is preparing to administer routine immunizations to a
healthy 2-month-old infant at a well-child checkup. Which combination of
vaccines matches the current standard clinical schedule for this age
milestone? (Select All That Apply)
• Rotavirus (RV)
• Diphtheria, Tetanus, and acellular Pertussis (DTaP)
• Haemophilus influenzae type b (Hib)
• Pneumococcal conjugate (PCV13)
• Measles, Mumps, and Rubella (MMR)
• Inactivated Poliovirus (IPV)
A. 1, 2, 3, and 5
B. 2, 4, 5, and 6
C. 1, 2, 3, 4, and 6
D. All of the above
CORRECT ANSWER: C
RATIONALE: The standard immunization schedule for a 2-month-old infant
includes Rotavirus (RV), DTaP, Hib, PCV13, and Inactivated Poliovirus
(IPV), along with the second dose of the Hepatitis B vaccine. The Measles,
Mumps, and Rubella (MMR) vaccine is a live virus immunization that is strictly
contraindicated in early infancy and is not administered until a child reaches a
minimum age of 12 months.
7. A patient who is 12 hours postpartum following a prolonged, vacuum-
assisted delivery is being evaluated by the nurse. Upon palpation of the
Pharmacological Practice Exam Bank
Course Code: NUR 301
Course Name: Advanced Maternal-Child Nursing and Clinical Pharmacology
Topic: Prioritization, Dosage Calculations, Maternal-Fetal Physiology, Select-All-
That-Apply (SATA) Bangers, High-Alert Med Calculations, Critical Neonatal
Interventions
Academic Year: 2026/2027
1. The nurse is caring for a multigravida patient at 38 weeks of gestation who
is receiving a continuous intravenous oxytocin (Pitocin) infusion for labor
induction. The telemetry strip suddenly reveals repetitive late decelerations
associated with a baseline fetal heart rate of 110 beats per minute and uterine
tachysystole (6 contractions in 10 minutes). Which sequence of interventions
must the nurse execute immediately to maximize fetal oxygenation?
A. Increase the oxytocin infusion rate, apply a non-rebreather mask at 2
L/min, and place the patient supine.
B. Stop the oxytocin infusion immediately, reposition the patient to a
lateral side-lying position, apply oxygen via non-rebreather at 10 L/min,
and increase main line IV fluids.
C. Perform an immediate vaginal exam, administer oral glucose, and prepare
the patient for a vacuum-assisted delivery.
D. Document the late decelerations as a normal variant of advanced labor
and reassess the monitor in 30 minutes.
CORRECT ANSWER: B
RATIONALE: Late decelerations indicate uteroplacental insufficiency, which
is being exacerbated here by uterine tachysystole caused by oxytocin (Pitocin)
stimulation. The immediate, non-negotiable priority sequence is to stop the
oxytocin infusion to relieve uterine hyperstimulation, turn the patient to a
lateral side-lying position to maximize uterine blood flow, apply high-flow
oxygen via a non-rebreather mask at 10 L/min, and open up the main line IV
,fluids to restore maternal blood volume and fetal perfusion. Increasing oxytocin or
keeping the patient supine will worsen fetal hypoxia.
2. A pediatric patient weighing 44 pounds (lbs) is admitted with severe
dehydration secondary to gastroenteritis. The healthcare provider prescribes
furosemide (Lasix) 1 mg/kg intravenously STAT. The available vial is
labeled Furosemide 10 mg/mL. How many milliliters (mL) of the
medication should the nurse administer to deliver the exact prescribed dose?
A. 1.0 mL
B. 2.0 mL
C. 4.4 mL
D. 20.0 mL
CORRECT ANSWER: B
RATIONALE: To calculate the correct pharmacological dosage, the nurse must
first convert the child's weight from pounds to kilograms: 44 lbs ÷ 2.2 = 20 kg.
Next, calculate the total mg dose prescribed: 20 kg × 1 mg/kg = 20 mg. Finally,
calculate the volume to administer based on the concentration on hand: 20 mg ÷ 10
mg/mL = 2.0 mL.
3. A nurse is assigned to the labor and delivery triage unit and receives four
pregnant patients simultaneously. Utilizing the principles of clinical
prioritization, which patient must the nurse evaluate first?
A. A 39-week primigravida reporting regular uterine contractions occurring
every 5 minutes and loss of the mucous plug.
B. A 32-week multigravida with a history of chronic hypertension who
complains of a sudden, severe, pounding headache and blurred vision.
C. A 36-week patient reporting a mild, localized aching lower back pain and
increased white vaginal discharge.
D. A 40-week patient who states her membranes ruptured 4 hours ago and
the amniotic fluid is clear without any foul odor.
CORRECT ANSWER: B
RATIONALE: Following the framework of prioritizing life-threatening
complications, the 32-week patient presenting with a severe headache and
blurred vision displays classic warning signs of worsening preeclampsia or
impending eclampsia. This patient is at high risk for immediate seizures, placental
,abruption, or maternal stroke, taking priority over stable patients in active labor,
normal membrane ruptures, or non-specific lower back pain.
4. The nurse is conducting a comprehensive discharge teaching session for a
postpartum mother who delivered an infant 3 days ago. The mother is
breastfeeding and asks about neonatal clinical indicators that confirm
adequate nutritional intake. Which signs should the nurse instruct the mother
to monitor? (Select All That Apply)
• The infant exhibits a minimum of 6 to 8 wet diapers daily.
• The infant passes 3 or more loose, yellow, seedy stools per day.
• The infant makes audible swallowing sounds frequently during each feeding
session.
• The infant's birth weight drops by a total of 15% within the first week of life.
• The infant appears content, satisfied, and sleeps for 2 to 3 hours between
feedings.
A. 1, 2, and 4
B. 1, 3, and 5
C. 1, 2, 3, and 5
D. All of the above
CORRECT ANSWER: C
RATIONALE: Indicators of successful breastfeeding and adequate infant intake
include 6 to 8 wet diapers per day, 3 or more yellow, seedy stools daily, audible
swallowing sounds during active nursing, and an infant who is content and
sleeps between sessions. A birth weight drop of 15% is a highly pathological
finding; newborns should lose no more than 7% to 10% of their birth weight within
the first week of life and should regain it by 10 to 14 days.
5. A healthcare provider prescribes a continuous intravenous heparin infusion
for a postpartum patient diagnosed with a deep vein thrombosis (DVT). The
order reads: Infuse 1,200 units of heparin per hour. The available IV bag
contains Heparin 25,000 units dissolved in 500 mL of 5% Dextrose in Water
(D₅W). At what rate should the nurse program the electronic infusion pump
in milliliters per hour (mL/hr)?
A. 12 mL/hr
, B. 24 mL/hr
C. 48 mL/hr
D. 50 mL/hr
CORRECT ANSWER: B
RATIONALE: To solve this pharmacological calculation, utilize the standard
ratio formula: (Prescribed Amount per hour ÷ Total Amount on hand) × Total
Volume = Hourly Flow Rate. Plugging in the values: (1,200 units/hr ÷ 25,000
units) × 500 mL = 0.048 × 500 = 24 mL/hr.
6. A pediatric nurse is preparing to administer routine immunizations to a
healthy 2-month-old infant at a well-child checkup. Which combination of
vaccines matches the current standard clinical schedule for this age
milestone? (Select All That Apply)
• Rotavirus (RV)
• Diphtheria, Tetanus, and acellular Pertussis (DTaP)
• Haemophilus influenzae type b (Hib)
• Pneumococcal conjugate (PCV13)
• Measles, Mumps, and Rubella (MMR)
• Inactivated Poliovirus (IPV)
A. 1, 2, 3, and 5
B. 2, 4, 5, and 6
C. 1, 2, 3, 4, and 6
D. All of the above
CORRECT ANSWER: C
RATIONALE: The standard immunization schedule for a 2-month-old infant
includes Rotavirus (RV), DTaP, Hib, PCV13, and Inactivated Poliovirus
(IPV), along with the second dose of the Hepatitis B vaccine. The Measles,
Mumps, and Rubella (MMR) vaccine is a live virus immunization that is strictly
contraindicated in early infancy and is not administered until a child reaches a
minimum age of 12 months.
7. A patient who is 12 hours postpartum following a prolonged, vacuum-
assisted delivery is being evaluated by the nurse. Upon palpation of the
