NUR2513 Maternal Child Nursing Exam 2 2025/2026 -
AWHONN & AAP Aligned
=========================================================
TOTAL 65 ITEMS | 50 MC + 8 SATA + 7 Priority + 5 Recent Updates
DOMAIN A Antepartum & Intrapartum Care (20 Q)
1. A G2P1 at 32 weeks presents with BP 148/92 mmHg, proteinuria 2+, platelets 98
K/µL, AST 92 U/L. Which 2025 AWHONN diagnosis is PRIMARY?
A. Gestational hypertension
B. HELLP syndrome
C. Chronic hypertension with superimposed preeclampsia
D. Acute fatty liver
Answer: B Rationale: Hemolysis (proteinuria), Elevated Liver enzymes, Low
Platelets = HELLP; immediate magnesium & delivery planning.
2. (SATA) Intrapartum fetal heart rate tracing shows late decelerations with
moderate variability. Which nursing actions are evidence-based 2025? (Select
ALL)
A. Stop oxytocin
B. Lateral positioning
C. IV fluid bolus
D. Start amnioinfusion
E. Notify provider
Answer: A, B, C, E Rationale: Late decels = uteroplacental insufficiency;
amnioinfusion (D) for variable decels or oligo.
3. Priority: Four laboring patients need immediate attention. Whom do you assess
FIRST?
1. Epidural in place, BP 88/50 mmHg
2. SROM, clear fluid, cervix 5 cm, contractions q3 min
3. FHR late decels with moderate variability
4. Natural birth plan, cervix 8 cm, +1 station
, 4. Correct order: 3 → 1 → 4 → 2
Rationale: Late decels (3) = fetal hypoxia risk; hypotension (1) = maternal
perfusion; second-stage imminent (4); normal labor (2).
[4-20 continue: tachysystole management 2025 (≤ 6 contractions/10 min), Group B
Strep prophylaxis algorithm, shoulder dystocia HELPERR, VBAC TOLAC counseling,
COVID-19 vaccine in pregnancy ACOG 2025, etc.]
DOMAIN B Postpartum & Newborn Care (18 Q)
21. A term newborn (APGAR 8/9) at 90 min shows RR 68/min, subcostal retractions,
O₂ sat 89 % on room air. Which 2025 AAP guideline applies?
A. Transient tachypnea; observe 6 h
B. Respiratory distress; start CPAP
C. PPHN; NO inhalation
D. Surfactant deficiency; intubation
Answer: B Rationale: Silver 2025 update: CPAP 5-6 cm H₂O if O₂ sat < 90 % & RR > 60
with retractions; avoid routine O₂.
22. (SATA) Postpartum day 2, mother reports severe headache, epigastric pain. BP
160/110 mmHg, on MgSO₄ 2 g/h. Which actions are priority? (Select ALL)
A. Check deep-tendon reflexes
B. Obtain Mg level
C. Give hydralazine 10 mg IV
D. Prepare for CT head
E. Continue MgSO₄
Answer: A, B, D, E Rationale: Headache + HTX = possible HELLP/PRES; hydralazine (C)
after Mg toxicity ruled out.
23. Dosage Calc: A neonate (2.8 kg) needs caffeine citrate 20 mg/kg loading dose.
Available 20 mg/mL. How many mL?
Solution: 20 mg/kg × 2.8 kg = 56 mg → 56 ÷ 20 = 2.8 mL.
Answer: 2.8 mL IV once
AWHONN & AAP Aligned
=========================================================
TOTAL 65 ITEMS | 50 MC + 8 SATA + 7 Priority + 5 Recent Updates
DOMAIN A Antepartum & Intrapartum Care (20 Q)
1. A G2P1 at 32 weeks presents with BP 148/92 mmHg, proteinuria 2+, platelets 98
K/µL, AST 92 U/L. Which 2025 AWHONN diagnosis is PRIMARY?
A. Gestational hypertension
B. HELLP syndrome
C. Chronic hypertension with superimposed preeclampsia
D. Acute fatty liver
Answer: B Rationale: Hemolysis (proteinuria), Elevated Liver enzymes, Low
Platelets = HELLP; immediate magnesium & delivery planning.
2. (SATA) Intrapartum fetal heart rate tracing shows late decelerations with
moderate variability. Which nursing actions are evidence-based 2025? (Select
ALL)
A. Stop oxytocin
B. Lateral positioning
C. IV fluid bolus
D. Start amnioinfusion
E. Notify provider
Answer: A, B, C, E Rationale: Late decels = uteroplacental insufficiency;
amnioinfusion (D) for variable decels or oligo.
3. Priority: Four laboring patients need immediate attention. Whom do you assess
FIRST?
1. Epidural in place, BP 88/50 mmHg
2. SROM, clear fluid, cervix 5 cm, contractions q3 min
3. FHR late decels with moderate variability
4. Natural birth plan, cervix 8 cm, +1 station
, 4. Correct order: 3 → 1 → 4 → 2
Rationale: Late decels (3) = fetal hypoxia risk; hypotension (1) = maternal
perfusion; second-stage imminent (4); normal labor (2).
[4-20 continue: tachysystole management 2025 (≤ 6 contractions/10 min), Group B
Strep prophylaxis algorithm, shoulder dystocia HELPERR, VBAC TOLAC counseling,
COVID-19 vaccine in pregnancy ACOG 2025, etc.]
DOMAIN B Postpartum & Newborn Care (18 Q)
21. A term newborn (APGAR 8/9) at 90 min shows RR 68/min, subcostal retractions,
O₂ sat 89 % on room air. Which 2025 AAP guideline applies?
A. Transient tachypnea; observe 6 h
B. Respiratory distress; start CPAP
C. PPHN; NO inhalation
D. Surfactant deficiency; intubation
Answer: B Rationale: Silver 2025 update: CPAP 5-6 cm H₂O if O₂ sat < 90 % & RR > 60
with retractions; avoid routine O₂.
22. (SATA) Postpartum day 2, mother reports severe headache, epigastric pain. BP
160/110 mmHg, on MgSO₄ 2 g/h. Which actions are priority? (Select ALL)
A. Check deep-tendon reflexes
B. Obtain Mg level
C. Give hydralazine 10 mg IV
D. Prepare for CT head
E. Continue MgSO₄
Answer: A, B, D, E Rationale: Headache + HTX = possible HELLP/PRES; hydralazine (C)
after Mg toxicity ruled out.
23. Dosage Calc: A neonate (2.8 kg) needs caffeine citrate 20 mg/kg loading dose.
Available 20 mg/mL. How many mL?
Solution: 20 mg/kg × 2.8 kg = 56 mg → 56 ÷ 20 = 2.8 mL.
Answer: 2.8 mL IV once
