NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Comprehensive Final Practice Exam
2026–2027 | 110 ORIGINAL PRACTICE QUESTIONS
Integrated independent comprehensive final practice covering maternal and newborn concepts.
Independent educational study material. These are original practice questions, not official Southern Utah University, ATI,
faculty, or licensing examination materials. Similar core concepts appear in multiple files to reinforce learning.
Clinical safety note: Use institutional protocols and current professional guidance. Questions are designed for learning and
are not a substitute for medical decision-making or individualized orders.
Study map
Domain Questions in this document
Antepartum and prenatal care 22
Labor and delivery 21
Postpartum nursing 19
Newborn assessment and care 21
High-risk and obstetric/neonatal emergencies 27
How to use this resource
Cover the green answer and yellow-highlighted rationale, select A–D, then review the explanation. Mark missed concepts
and revisit the corresponding clinical area. The answer key at the end provides a rapid self-check.
High-yield current guidance checkpoints
• GBS screening: ACOG universal vaginal–rectal culture at 36 0/7–37 6/7 weeks, with intrapartum prophylaxis when
indicated.
• Maternal immunization: Tdap at 27–36 weeks in every pregnancy; Pfizer Abrysvo maternal RSV at 32 0/7–36 6/7 weeks
in the recommended U.S. season.
• Preeclampsia: systolic pressure ≥160 mm Hg or diastolic ≥110 mm Hg is severe range; monitor for headache, visual
symptoms, pulmonary edema and upper-abdominal pain.
• PPH: assess objectively and treat promptly using an integrated protocol; WHO recommends uterine massage,
oxytocic therapy, fluids, IV tranexamic acid when indicated, source assessment and escalation.
• Newborn resuscitation: ventilate for persistent apnea/gasping or HR <100 after initial steps; compress if HR stays <60
after 30 seconds of effective ventilation.
• Jaundice: use bilirubin level, postnatal age in hours, gestational age and neurotoxicity risk factors—not a single
universal phototherapy number.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 1
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Practice Questions with Answers & Rationales
Questions 1–25
1. A newborn has a cephalohematoma. What is an associated concern?
A. Necessarily systemic sepsis
B. Increased bilirubin load as the blood collection resolves
C. Guaranteed skull fracture
D. Immediate prevention of all jaundice
Correct Answer: B. Increased bilirubin load as the blood collection resolves
Rationale: Breakdown of trapped red cells increases bilirubin and may raise jaundice risk.
Incorrect options: A (Necessarily systemic sepsis); C (Guaranteed skull fracture); D (Immediate prevention of all jaundice). These
do not best answer the clinical cue; Breakdown of trapped red cells increases bilirubin and may raise jaundice risk.
2. A pregnant patient reports severe constant abdominal pain, vaginal bleeding, and a tender hypertonic
uterus. What is most concerning?
A. Placental abruption
B. Routine round ligament pain
C. Physiologic leukorrhea
D. Uncomplicated Braxton Hicks contractions
Correct Answer: A. Placental abruption
Rationale: Abruption separates the placenta prematurely and may compromise maternal blood volume and fetal
oxygenation.
Incorrect options: B (Routine round ligament pain); C (Physiologic leukorrhea); D (Uncomplicated Braxton Hicks contractions).
These do not best answer the clinical cue; Abruption separates the placenta prematurely and may compromise maternal blood
volume and fetal oxygenation.
3. A lactating patient has focal breast pain, erythema, and fever. What is the concern?
A. Mastitis requiring clinical evaluation
B. Newborn bilirubin rise
C. Placenta accreta
D. Normal involution of uterus
Correct Answer: A. Mastitis requiring clinical evaluation
Rationale: Fever and focal breast inflammation require assessment for inflammatory or infectious mastitis.
Incorrect options: B (Newborn bilirubin rise); C (Placenta accreta); D (Normal involution of uterus). These do not best answer the
clinical cue; Fever and focal breast inflammation require assessment for inflammatory or infectious mastitis.
4. Which assessment may indicate an abnormal fetal presentation during labor?
A. Moderate baseline variability
B. A reassuring cephalic ultrasound
C. Persistent atypical presenting-part findings on examination or ultrasound
D. Normal vertex palpation
Correct Answer: C. Persistent atypical presenting-part findings on examination or ultrasound
Rationale: Presentation guides delivery planning; breech or transverse lie may affect safety and approach.
Incorrect options: A (Moderate baseline variability); B (A reassuring cephalic ultrasound); D (Normal vertex palpation). These do
not best answer the clinical cue; Presentation guides delivery planning; breech or transverse lie may affect safety and approach.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 2
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
5. A first-time pregnant patient asks about expected labor timing. What is the best teaching?
A. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
B. All contractions mean active labor
C. Rupture of membranes is harmless for days
D. Labor always begins exactly at 40 weeks
Correct Answer: A. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
Incorrect options: B (All contractions mean active labor); C (Rupture of membranes is harmless for days); D (Labor always begins
exactly at 40 weeks). These do not best answer the clinical cue; Estimated due dates are approximate; red flags such as bleeding,
ruptured membranes, or decreased movement require assessment.
6. What is important when discussing postpartum contraception?
A. Assume everyone wants the same method
B. Offer individualized shared decision-making including lactation and thrombosis considerations
C. State pregnancy cannot occur before menses returns
D. Withhold all options until one year postpartum
Correct Answer: B. Offer individualized shared decision-making including lactation and thrombosis considerations
Rationale: Fertility can return before the first period; method selection should reflect preferences and medical
eligibility.
Incorrect options: A (Assume everyone wants the same method); C (State pregnancy cannot occur before menses returns); D
(Withhold all options until one year postpartum). These do not best answer the clinical cue; Fertility can return before the first
period; method selection should reflect preferences and medical eligibility.
7. Which wound-assessment feature suggests a post-cesarean infection?
A. Gradual reduction in tenderness
B. A clean dry incision
C. Increasing erythema, warmth, purulent drainage, and fever
D. Approximated wound edges
Correct Answer: C. Increasing erythema, warmth, purulent drainage, and fever
Rationale: Infection signs require prompt evaluation; normal healing usually shows decreasing inflammation.
Incorrect options: A (Gradual reduction in tenderness); B (A clean dry incision); D (Approximated wound edges). These do not best
answer the clinical cue; Infection signs require prompt evaluation; normal healing usually shows decreasing inflammation.
8. Which postpartum lochia progression is generally expected?
A. Green foul drainage throughout recovery
B. No discharge from the first hour
C. Rubra initially, then serosa, then alba over time
D. Alba immediately followed by bright red heavy bleeding
Correct Answer: C. Rubra initially, then serosa, then alba over time
Rationale: Normal lochia changes from red to pink/brown to pale as uterine healing continues.
Incorrect options: A (Green foul drainage throughout recovery); B (No discharge from the first hour); D (Alba immediately followed
by bright red heavy bleeding). These do not best answer the clinical cue; Normal lochia changes from red to pink/brown to pale as
uterine healing continues.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 3
Comprehensive Final Practice Exam
2026–2027 | 110 ORIGINAL PRACTICE QUESTIONS
Integrated independent comprehensive final practice covering maternal and newborn concepts.
Independent educational study material. These are original practice questions, not official Southern Utah University, ATI,
faculty, or licensing examination materials. Similar core concepts appear in multiple files to reinforce learning.
Clinical safety note: Use institutional protocols and current professional guidance. Questions are designed for learning and
are not a substitute for medical decision-making or individualized orders.
Study map
Domain Questions in this document
Antepartum and prenatal care 22
Labor and delivery 21
Postpartum nursing 19
Newborn assessment and care 21
High-risk and obstetric/neonatal emergencies 27
How to use this resource
Cover the green answer and yellow-highlighted rationale, select A–D, then review the explanation. Mark missed concepts
and revisit the corresponding clinical area. The answer key at the end provides a rapid self-check.
High-yield current guidance checkpoints
• GBS screening: ACOG universal vaginal–rectal culture at 36 0/7–37 6/7 weeks, with intrapartum prophylaxis when
indicated.
• Maternal immunization: Tdap at 27–36 weeks in every pregnancy; Pfizer Abrysvo maternal RSV at 32 0/7–36 6/7 weeks
in the recommended U.S. season.
• Preeclampsia: systolic pressure ≥160 mm Hg or diastolic ≥110 mm Hg is severe range; monitor for headache, visual
symptoms, pulmonary edema and upper-abdominal pain.
• PPH: assess objectively and treat promptly using an integrated protocol; WHO recommends uterine massage,
oxytocic therapy, fluids, IV tranexamic acid when indicated, source assessment and escalation.
• Newborn resuscitation: ventilate for persistent apnea/gasping or HR <100 after initial steps; compress if HR stays <60
after 30 seconds of effective ventilation.
• Jaundice: use bilirubin level, postnatal age in hours, gestational age and neurotoxicity risk factors—not a single
universal phototherapy number.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 1
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Practice Questions with Answers & Rationales
Questions 1–25
1. A newborn has a cephalohematoma. What is an associated concern?
A. Necessarily systemic sepsis
B. Increased bilirubin load as the blood collection resolves
C. Guaranteed skull fracture
D. Immediate prevention of all jaundice
Correct Answer: B. Increased bilirubin load as the blood collection resolves
Rationale: Breakdown of trapped red cells increases bilirubin and may raise jaundice risk.
Incorrect options: A (Necessarily systemic sepsis); C (Guaranteed skull fracture); D (Immediate prevention of all jaundice). These
do not best answer the clinical cue; Breakdown of trapped red cells increases bilirubin and may raise jaundice risk.
2. A pregnant patient reports severe constant abdominal pain, vaginal bleeding, and a tender hypertonic
uterus. What is most concerning?
A. Placental abruption
B. Routine round ligament pain
C. Physiologic leukorrhea
D. Uncomplicated Braxton Hicks contractions
Correct Answer: A. Placental abruption
Rationale: Abruption separates the placenta prematurely and may compromise maternal blood volume and fetal
oxygenation.
Incorrect options: B (Routine round ligament pain); C (Physiologic leukorrhea); D (Uncomplicated Braxton Hicks contractions).
These do not best answer the clinical cue; Abruption separates the placenta prematurely and may compromise maternal blood
volume and fetal oxygenation.
3. A lactating patient has focal breast pain, erythema, and fever. What is the concern?
A. Mastitis requiring clinical evaluation
B. Newborn bilirubin rise
C. Placenta accreta
D. Normal involution of uterus
Correct Answer: A. Mastitis requiring clinical evaluation
Rationale: Fever and focal breast inflammation require assessment for inflammatory or infectious mastitis.
Incorrect options: B (Newborn bilirubin rise); C (Placenta accreta); D (Normal involution of uterus). These do not best answer the
clinical cue; Fever and focal breast inflammation require assessment for inflammatory or infectious mastitis.
4. Which assessment may indicate an abnormal fetal presentation during labor?
A. Moderate baseline variability
B. A reassuring cephalic ultrasound
C. Persistent atypical presenting-part findings on examination or ultrasound
D. Normal vertex palpation
Correct Answer: C. Persistent atypical presenting-part findings on examination or ultrasound
Rationale: Presentation guides delivery planning; breech or transverse lie may affect safety and approach.
Incorrect options: A (Moderate baseline variability); B (A reassuring cephalic ultrasound); D (Normal vertex palpation). These do
not best answer the clinical cue; Presentation guides delivery planning; breech or transverse lie may affect safety and approach.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 2
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
5. A first-time pregnant patient asks about expected labor timing. What is the best teaching?
A. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
B. All contractions mean active labor
C. Rupture of membranes is harmless for days
D. Labor always begins exactly at 40 weeks
Correct Answer: A. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
Incorrect options: B (All contractions mean active labor); C (Rupture of membranes is harmless for days); D (Labor always begins
exactly at 40 weeks). These do not best answer the clinical cue; Estimated due dates are approximate; red flags such as bleeding,
ruptured membranes, or decreased movement require assessment.
6. What is important when discussing postpartum contraception?
A. Assume everyone wants the same method
B. Offer individualized shared decision-making including lactation and thrombosis considerations
C. State pregnancy cannot occur before menses returns
D. Withhold all options until one year postpartum
Correct Answer: B. Offer individualized shared decision-making including lactation and thrombosis considerations
Rationale: Fertility can return before the first period; method selection should reflect preferences and medical
eligibility.
Incorrect options: A (Assume everyone wants the same method); C (State pregnancy cannot occur before menses returns); D
(Withhold all options until one year postpartum). These do not best answer the clinical cue; Fertility can return before the first
period; method selection should reflect preferences and medical eligibility.
7. Which wound-assessment feature suggests a post-cesarean infection?
A. Gradual reduction in tenderness
B. A clean dry incision
C. Increasing erythema, warmth, purulent drainage, and fever
D. Approximated wound edges
Correct Answer: C. Increasing erythema, warmth, purulent drainage, and fever
Rationale: Infection signs require prompt evaluation; normal healing usually shows decreasing inflammation.
Incorrect options: A (Gradual reduction in tenderness); B (A clean dry incision); D (Approximated wound edges). These do not best
answer the clinical cue; Infection signs require prompt evaluation; normal healing usually shows decreasing inflammation.
8. Which postpartum lochia progression is generally expected?
A. Green foul drainage throughout recovery
B. No discharge from the first hour
C. Rubra initially, then serosa, then alba over time
D. Alba immediately followed by bright red heavy bleeding
Correct Answer: C. Rubra initially, then serosa, then alba over time
Rationale: Normal lochia changes from red to pink/brown to pale as uterine healing continues.
Incorrect options: A (Green foul drainage throughout recovery); B (No discharge from the first hour); D (Alba immediately followed
by bright red heavy bleeding). These do not best answer the clinical cue; Normal lochia changes from red to pink/brown to pale as
uterine healing continues.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 3
