KAPLAN MATERNAL-NEWBORN NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Antepartum Care
Intrapartum Care
Postpartum Care
Newborn Care
High-Risk Pregnancy
Reproductive Health
Obstetric Pharmacology
Patient Safety and Legal/Ethical Issues
Introduction
This examination assesses the knowledge and clinical judgment required for safe maternal-newborn
nursing practice. It covers antepartum, intrapartum, postpartum, and neonatal care, including high-risk
conditions, pharmacology, ethics, and legal responsibilities. Questions use multiple-choice and scenario-
based formats to evaluate critical thinking, prioritization, and real-world decision-making. Candidates
must apply foundational theory, professional standards, and evidence-based guidelines to promote
optimal outcomes for birthing individuals and newborns. The exam emphasizes patient safety, cultural
competence, and effective communication across diverse clinical settings.
SECTION ONE: QUESTIONS 1–100
1. A nurse is calculating the GTPAL for a client who is currently 28 weeks pregnant. She has one term
birth, one preterm birth, one miscarriage, and two living children. What is her GTPAL?
A. 3-1-1-1-2
B. 4-1-1-1-2
C. 4-1-1-2-2
🟢 D. 4-1-1-1-2
🔴 RATIONALE: G = 4 pregnancies (1 term + 1 preterm + 1 miscarriage + current). T = 1 term birth. P
= 1 preterm birth. A = 1 miscarriage. L = 2 living children.
2. A client reports her last menstrual period began on June 10. Using Naegele's rule, what is her
estimated date of birth?
A. March 10
🟢 B. March 17
C. March 24
D. April 3
,🔴 RATIONALE: Naegele's rule: subtract 3 months from the first day of the last menstrual period and
add 7 days. June 10 minus 3 months = March 10, plus 7 days = March 17.
3. A nurse is reviewing prenatal laboratory results. Which finding requires immediate follow-up?
A. Hemoglobin 11.5 g/dL
B. Platelet count 250,000/mm³
🟢 C. Rubella titer nonimmune
D. Blood type O positive
🔴 RATIONALE: A nonimmune rubella titer indicates the client is not protected against rubella.
Vaccination is contraindicated during pregnancy and must be given postpartum.
4. A client is Rh-negative and has a negative indirect Coombs test at 28 weeks. Which action should
the nurse anticipate?
🟢 A. Administer Rho(D) immune globulin
B. Prepare for immediate delivery
C. Administer betamethasone
D. Obtain a repeat Coombs test in 1 week
🔴 RATIONALE: Rho(D) immune globulin is given at 28 weeks to prevent Rh sensitization in Rh-
negative unsensitized clients.
5. A nurse is assessing fetal heart tones. Which location is best for a fetus in cephalic presentation
at 36 weeks?
A. Right upper quadrant
🟢 B. Left lower quadrant
C. Right lower quadrant
D. Left upper quadrant
🔴 RATIONALE: In cephalic presentation, fetal heart tones are best heard in the lower abdomen,
typically left or right lower quadrant depending on fetal position.
6. A client in active labor has cervical dilation of 6 cm and contractions every 3 minutes. Which
stage of labor is this?
A. First stage, latent phase
🟢 B. First stage, active phase
C. Second stage
D. Third stage
🔴 RATIONALE: The active phase of the first stage begins at 6 cm dilation and continues until
complete dilation.
7. A nurse notes variable decelerations on the fetal monitor. Which action should the nurse take
first?
, A. Administer oxygen at 10 L/min
B. Increase intravenous fluids
🟢 C. Reposition the client side-lying
D. Notify the healthcare provider
🔴 RATIONALE: Variable decelerations are caused by umbilical cord compression. Repositioning the
client is the first intervention to relieve cord compression.
8. A client has late decelerations on the fetal monitor. Which condition is most likely?
🟢 A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Head compression
D. Maternal fever
🔴 RATIONALE: Late decelerations are caused by uteroplacental insufficiency and indicate fetal
hypoxia. Immediate intervention is required.
9. A nurse is teaching a client about epidural anesthesia. Which adverse effect should the nurse
include?
A. Hypertension
B. Bradycardia
C. Hyperreflexia
🟢 D. Maternal hypotension
🔴 RATIONALE: Epidural anesthesia commonly causes maternal hypotension due to sympathetic
blockade. Intravenous fluids and vasopressors may be needed.
10. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10 breaths/min.
Which action should the nurse take first?
A. Increase the infusion rate
🟢 B. Stop the magnesium infusion
C. Administer oxygen
D. Document the finding
🔴 RATIONALE: Respiratory rate below 12 breaths/min indicates magnesium toxicity. The infusion
must be stopped immediately, and calcium gluconate may be administered.
11. A nurse is caring for a client receiving oxytocin for labor induction. Which finding requires
immediate intervention?
A. Contractions every 3 minutes
B. Fetal heart rate 140 bpm
🟢 C. Contractions lasting 90 seconds
D. Cervical dilation of 4 cm
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Antepartum Care
Intrapartum Care
Postpartum Care
Newborn Care
High-Risk Pregnancy
Reproductive Health
Obstetric Pharmacology
Patient Safety and Legal/Ethical Issues
Introduction
This examination assesses the knowledge and clinical judgment required for safe maternal-newborn
nursing practice. It covers antepartum, intrapartum, postpartum, and neonatal care, including high-risk
conditions, pharmacology, ethics, and legal responsibilities. Questions use multiple-choice and scenario-
based formats to evaluate critical thinking, prioritization, and real-world decision-making. Candidates
must apply foundational theory, professional standards, and evidence-based guidelines to promote
optimal outcomes for birthing individuals and newborns. The exam emphasizes patient safety, cultural
competence, and effective communication across diverse clinical settings.
SECTION ONE: QUESTIONS 1–100
1. A nurse is calculating the GTPAL for a client who is currently 28 weeks pregnant. She has one term
birth, one preterm birth, one miscarriage, and two living children. What is her GTPAL?
A. 3-1-1-1-2
B. 4-1-1-1-2
C. 4-1-1-2-2
🟢 D. 4-1-1-1-2
🔴 RATIONALE: G = 4 pregnancies (1 term + 1 preterm + 1 miscarriage + current). T = 1 term birth. P
= 1 preterm birth. A = 1 miscarriage. L = 2 living children.
2. A client reports her last menstrual period began on June 10. Using Naegele's rule, what is her
estimated date of birth?
A. March 10
🟢 B. March 17
C. March 24
D. April 3
,🔴 RATIONALE: Naegele's rule: subtract 3 months from the first day of the last menstrual period and
add 7 days. June 10 minus 3 months = March 10, plus 7 days = March 17.
3. A nurse is reviewing prenatal laboratory results. Which finding requires immediate follow-up?
A. Hemoglobin 11.5 g/dL
B. Platelet count 250,000/mm³
🟢 C. Rubella titer nonimmune
D. Blood type O positive
🔴 RATIONALE: A nonimmune rubella titer indicates the client is not protected against rubella.
Vaccination is contraindicated during pregnancy and must be given postpartum.
4. A client is Rh-negative and has a negative indirect Coombs test at 28 weeks. Which action should
the nurse anticipate?
🟢 A. Administer Rho(D) immune globulin
B. Prepare for immediate delivery
C. Administer betamethasone
D. Obtain a repeat Coombs test in 1 week
🔴 RATIONALE: Rho(D) immune globulin is given at 28 weeks to prevent Rh sensitization in Rh-
negative unsensitized clients.
5. A nurse is assessing fetal heart tones. Which location is best for a fetus in cephalic presentation
at 36 weeks?
A. Right upper quadrant
🟢 B. Left lower quadrant
C. Right lower quadrant
D. Left upper quadrant
🔴 RATIONALE: In cephalic presentation, fetal heart tones are best heard in the lower abdomen,
typically left or right lower quadrant depending on fetal position.
6. A client in active labor has cervical dilation of 6 cm and contractions every 3 minutes. Which
stage of labor is this?
A. First stage, latent phase
🟢 B. First stage, active phase
C. Second stage
D. Third stage
🔴 RATIONALE: The active phase of the first stage begins at 6 cm dilation and continues until
complete dilation.
7. A nurse notes variable decelerations on the fetal monitor. Which action should the nurse take
first?
, A. Administer oxygen at 10 L/min
B. Increase intravenous fluids
🟢 C. Reposition the client side-lying
D. Notify the healthcare provider
🔴 RATIONALE: Variable decelerations are caused by umbilical cord compression. Repositioning the
client is the first intervention to relieve cord compression.
8. A client has late decelerations on the fetal monitor. Which condition is most likely?
🟢 A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Head compression
D. Maternal fever
🔴 RATIONALE: Late decelerations are caused by uteroplacental insufficiency and indicate fetal
hypoxia. Immediate intervention is required.
9. A nurse is teaching a client about epidural anesthesia. Which adverse effect should the nurse
include?
A. Hypertension
B. Bradycardia
C. Hyperreflexia
🟢 D. Maternal hypotension
🔴 RATIONALE: Epidural anesthesia commonly causes maternal hypotension due to sympathetic
blockade. Intravenous fluids and vasopressors may be needed.
10. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10 breaths/min.
Which action should the nurse take first?
A. Increase the infusion rate
🟢 B. Stop the magnesium infusion
C. Administer oxygen
D. Document the finding
🔴 RATIONALE: Respiratory rate below 12 breaths/min indicates magnesium toxicity. The infusion
must be stopped immediately, and calcium gluconate may be administered.
11. A nurse is caring for a client receiving oxytocin for labor induction. Which finding requires
immediate intervention?
A. Contractions every 3 minutes
B. Fetal heart rate 140 bpm
🟢 C. Contractions lasting 90 seconds
D. Cervical dilation of 4 cm
