NURS_301: Maternity and Pediatric Nursing (Ricci, 4th Edition)
Comprehensive Mother-Baby & Child Health Exam Prep
Course Code: NURS_301
Course Name: Maternity and Pediatric Nursing
Topic: Antepartum Care, Labor & Delivery, Postpartum Complications, Newborn
Assessment, and High-Yield Pediatric Pathologies
Academic Year: 2026/2027
Category: Nursing Practice Question Bank
Critical Intrapartum Electronic Fetal Monitoring (EFM) Archetype
Deceleration Pathophysiological Immediate Clinical Nursing
Pattern Mechanism Action
Fetal head compression Document as normal / benign
Early
triggering a vagal reflex during finding; continue routine labor
Decelerations
uterine contractions. progression tracking.
Uteroplacental insufficiency
Late Discontinue Oxytocin,
causing decreased fetal
Decelerations reposition mother to left side,
myocardial oxygenation.
, apply oxygen via non-
rebreather mask, fluid bolus.
Umbilical cord compression Reposition mother from side
Variable
restricting blood flow between to side, perform sterile vaginal
Decelerations
placenta and fetus. exam to rule out cord prolapse.
Part I: Foundations of Maternal-Newborn Nursing (Questions 1 to 45)
Question 1
A pregnant client at 32 weeks' gestation presents to the triage unit reporting a
sudden onset of painless, bright red vaginal bleeding. Which nursing action is
strictly contraindicated for this client?
A) Initiating continuous electronic fetal monitoring.
B) Performing a digital sterile vaginal examination.
C) Monitoring maternal vital signs and blood loss volume.
D) Obtaining blood samples for type and cross-match.
CORRECT ANSWER: B) Performing a digital sterile vaginal examination.
RATIONALE: The clinical presentation of painless, bright red vaginal bleeding
in the third trimester is highly suggestive of placenta previa (where the placenta
covers all or part of the cervical os). Performing a digital vaginal exam can
puncture or tear the low-lying placenta, triggering catastrophic maternal
hemorrhage. A transvaginal or transabdominal ultrasound must be completed first
to confirm placental placement. Options A, C, and D are essential components of
safe clinical management.
Question 2
A nurse is assessing a postpartum client 4 hours after a vaginal delivery. The nurse
notes that the fundus is firm, shifted to the right of the midline, and located two
fingers above the umbilicus. Which action should the nurse take first?
A) Assist the client to the bathroom to void completely.
B) Perform vigorous fundal massage to express retained clots.
C) Notify the primary care provider regarding suspected uterine inversion.
D) Increase the infusion rate of the intravenous oxytocin line.
, CORRECT ANSWER: A) Assist the client to the bathroom to void
completely.
RATIONALE: A postpartum fundus that is displaced to the right side and
elevated above the umbilicus indicates a distended bladder. A full bladder
mechanically pushes the uterus out of place, preventing the uterine muscles from
contracting efficiently down onto the vascular beds. This increases the risk of
uterine atony and subsequent postpartum hemorrhage. Emptying the bladder
resolves the displacement. Massaging a firm uterus (Option B) is unnecessary and
causes structural discomfort.
Question 3
A client at 38 weeks' gestation is diagnosed with severe preeclampsia and is
receiving a continuous intravenous infusion of Magnesium Sulfate. During
assessment, the nurse notes a respiratory rate of 10 breaths per minute, absent
deep tendon reflexes (DTRs), and urine output of 15 mL over the last hour.
Which medication must the nurse prepare to administer immediately?
A) Terbutaline Sulfate
B) Hydralazine
C) Calcium Gluconate
D) Naloxone
CORRECT ANSWER: C) Calcium Gluconate
RATIONALE: Absent deep tendon reflexes, bradypnea (respiratory rate < 12
breaths/minute), and oliguria are classic toxic signs of magnesium sulfate
toxicity, which can quickly lead to respiratory failure and cardiac arrest. The
specific antidote used to reverse magnesium toxicity by displacing magnesium ions
from neuromuscular junctions is Calcium Gluconate, administered via slow IV
push. Terbutaline (Option A) is a tocolytic. Hydralazine (Option B) is an
antihypertensive.
Question 4
A nurse is performing the initial assessment of a newborn one minute after birth.
The infant displays a pink body with blue extremities, a heart rate of 110 beats
per minute, a vigorous cry, active flexion of all limbs, and sneezes during
nasal suctioning. What Apgar score should the nurse assign to this newborn?
A) 8
B) 9
Comprehensive Mother-Baby & Child Health Exam Prep
Course Code: NURS_301
Course Name: Maternity and Pediatric Nursing
Topic: Antepartum Care, Labor & Delivery, Postpartum Complications, Newborn
Assessment, and High-Yield Pediatric Pathologies
Academic Year: 2026/2027
Category: Nursing Practice Question Bank
Critical Intrapartum Electronic Fetal Monitoring (EFM) Archetype
Deceleration Pathophysiological Immediate Clinical Nursing
Pattern Mechanism Action
Fetal head compression Document as normal / benign
Early
triggering a vagal reflex during finding; continue routine labor
Decelerations
uterine contractions. progression tracking.
Uteroplacental insufficiency
Late Discontinue Oxytocin,
causing decreased fetal
Decelerations reposition mother to left side,
myocardial oxygenation.
, apply oxygen via non-
rebreather mask, fluid bolus.
Umbilical cord compression Reposition mother from side
Variable
restricting blood flow between to side, perform sterile vaginal
Decelerations
placenta and fetus. exam to rule out cord prolapse.
Part I: Foundations of Maternal-Newborn Nursing (Questions 1 to 45)
Question 1
A pregnant client at 32 weeks' gestation presents to the triage unit reporting a
sudden onset of painless, bright red vaginal bleeding. Which nursing action is
strictly contraindicated for this client?
A) Initiating continuous electronic fetal monitoring.
B) Performing a digital sterile vaginal examination.
C) Monitoring maternal vital signs and blood loss volume.
D) Obtaining blood samples for type and cross-match.
CORRECT ANSWER: B) Performing a digital sterile vaginal examination.
RATIONALE: The clinical presentation of painless, bright red vaginal bleeding
in the third trimester is highly suggestive of placenta previa (where the placenta
covers all or part of the cervical os). Performing a digital vaginal exam can
puncture or tear the low-lying placenta, triggering catastrophic maternal
hemorrhage. A transvaginal or transabdominal ultrasound must be completed first
to confirm placental placement. Options A, C, and D are essential components of
safe clinical management.
Question 2
A nurse is assessing a postpartum client 4 hours after a vaginal delivery. The nurse
notes that the fundus is firm, shifted to the right of the midline, and located two
fingers above the umbilicus. Which action should the nurse take first?
A) Assist the client to the bathroom to void completely.
B) Perform vigorous fundal massage to express retained clots.
C) Notify the primary care provider regarding suspected uterine inversion.
D) Increase the infusion rate of the intravenous oxytocin line.
, CORRECT ANSWER: A) Assist the client to the bathroom to void
completely.
RATIONALE: A postpartum fundus that is displaced to the right side and
elevated above the umbilicus indicates a distended bladder. A full bladder
mechanically pushes the uterus out of place, preventing the uterine muscles from
contracting efficiently down onto the vascular beds. This increases the risk of
uterine atony and subsequent postpartum hemorrhage. Emptying the bladder
resolves the displacement. Massaging a firm uterus (Option B) is unnecessary and
causes structural discomfort.
Question 3
A client at 38 weeks' gestation is diagnosed with severe preeclampsia and is
receiving a continuous intravenous infusion of Magnesium Sulfate. During
assessment, the nurse notes a respiratory rate of 10 breaths per minute, absent
deep tendon reflexes (DTRs), and urine output of 15 mL over the last hour.
Which medication must the nurse prepare to administer immediately?
A) Terbutaline Sulfate
B) Hydralazine
C) Calcium Gluconate
D) Naloxone
CORRECT ANSWER: C) Calcium Gluconate
RATIONALE: Absent deep tendon reflexes, bradypnea (respiratory rate < 12
breaths/minute), and oliguria are classic toxic signs of magnesium sulfate
toxicity, which can quickly lead to respiratory failure and cardiac arrest. The
specific antidote used to reverse magnesium toxicity by displacing magnesium ions
from neuromuscular junctions is Calcium Gluconate, administered via slow IV
push. Terbutaline (Option A) is a tocolytic. Hydralazine (Option B) is an
antihypertensive.
Question 4
A nurse is performing the initial assessment of a newborn one minute after birth.
The infant displays a pink body with blue extremities, a heart rate of 110 beats
per minute, a vigorous cry, active flexion of all limbs, and sneezes during
nasal suctioning. What Apgar score should the nurse assign to this newborn?
A) 8
B) 9
