Maternal Newborn Nursing: The Critical Components of
Nursing Care 3rd Edition (Durham & Chapman) EXAM with
Questions and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. Maternal and Newborn Health Assessment
2. Reproductive Anatomy and Physiology
3. Conception, Fetal Development, and Genetics
4. Physiological and Psychological Changes of Pregnancy
5. Antepartum Nursing Care and Risk Management
6. Intrapartum Nursing Care and Labor Support
7. Pharmacological Management during Labor and Birth
8. Postpartum Physical and Psychosocial Adaptation
9. Newborn Assessment and Care Transitions
10. High-Risk Antepartum, Intrapartum, and Postpartum Conditions
1. A client at 32 weeks gestation presents with sudden onset of severe abdominal pain and a firm,
non-relaxing uterus. The fetal heart rate (FHR) shows late decelerations. Which action is the
priority?
A. Perform a vaginal examination to determine cervical dilation.
B. Prepare for an immediate emergency cesarean birth.
, C. Place the client in a side-lying position and administer oxygen.
D. Anticipate the administration of tocolytics to stop contractions.
Answer: B
CORRECT ANSWER : B
Rationale: The clinical presentation of severe pain, rigid abdomen, and non-reassuring FHR is
characteristic of placental abruption. Immediate delivery is indicated to save the fetus and
prevent maternal coagulopathy; vaginal exams are contraindicated, and tocolytics are unsafe.
2. A nurse is evaluating a client at 38 weeks gestation receiving a magnesium sulfate infusion for
severe preeclampsia. The nurse finds the deep tendon reflexes (DTRs) are absent. What is the
next priority?
A. Increase the magnesium sulfate infusion rate.
B. Discontinue the magnesium sulfate infusion immediately.
C. Administer oral calcium gluconate.
D. Assess the client’s blood pressure and respiration.
Answer: B
CORRECT ANSWER : B
Rationale: Absent DTRs are an early sign of magnesium toxicity. The immediate nursing action
is to stop the infusion to prevent respiratory depression or cardiac arrest; calcium gluconate (the
antidote) is given intravenously, not orally, once the infusion is stopped.
3. A multiparous client is in the transition phase of labor. The nurse notes decelerations that begin
after the peak of the contraction and return to baseline well after the contraction ends. What is
the clinical significance?
A. Cord compression requiring a position change.
B. Uteroplacental insufficiency requiring immediate intervention.
C. Normal labor progression with head compression.
D. Fetal stress due to rapid descent.
Answer: B
, CORRECT ANSWER : B
Rationale: These are late decelerations, which indicate impaired blood flow to the fetus
(uteroplacental insufficiency). They are not normal and require interventions such as side-lying,
IV fluids, and oxygen; cord compression is represented by variable decelerations, and head
compression by early decelerations.
4. A postpartum client at 6 hours post-vaginal birth has a saturated perineal pad within 15 minutes.
The fundus is boggy and deviated to the right. What is the primary nursing intervention?
A. Administer methylergonovine immediately.
B. Assist the client to void and then massage the fundus.
C. Perform a bimanual uterine compression.
D. Increase the IV infusion rate of oxytocin.
Answer: B
CORRECT ANSWER : B
Rationale: A deviated, boggy fundus often indicates a full bladder preventing uterine
contraction. Emptying the bladder is the first mechanical step to allow the uterus to contract;
massage and medication follow if the uterus remains atonic after bladder evacuation.
5. A newborn at 1 hour of age has a respiratory rate of 70, nasal flaring, and mild grunting. What
should the nurse assess next?
A. Blood glucose level to rule out hypoglycemia.
B. The Apgar score again to determine status.
C. A chest X-ray for pneumothorax.
D. Maternal history for infection.
Answer: A
CORRECT ANSWER : B
Rationale: Respiratory distress in a newborn can be a presenting sign of metabolic issues,
specifically hypoglycemia. While infection is a concern, assessing blood glucose is a quick, non-
invasive priority before more invasive diagnostic testing.
, 6. A client at 28 weeks gestation is diagnosed with preterm labor. The provider orders nifedipine.
What is the nurse's primary responsibility regarding this medication?
A. Monitor the fetal heart rate for bradycardia.
B. Monitor the client's blood pressure for hypotension.
C. Ensure the client does not consume grapefruit juice.
D. Assess for pulmonary edema.
Answer: B
CORRECT ANSWER : B
Rationale: Nifedipine is a calcium channel blocker used as a tocolytic; a common side effect is
maternal hypotension. While fetal monitoring is important for all preterm labors, the specific
hemodynamic risk with nifedipine is low blood pressure, not fetal bradycardia (which is a risk
with beta-blockers).
7. A nurse is caring for a client with a history of gestational diabetes. At 36 weeks, the fetus shows
signs of macrosomia. What is the most likely complication during labor?
A. Shoulder dystocia.
B. Precipitous delivery.
C. Fetal tachycardia.
D. Uterine rupture.
Answer: A
CORRECT ANSWER : B
Rationale: Macrosomia (birth weight >4,000g) significantly increases the risk of shoulder
dystocia, where the fetal shoulders become impacted behind the maternal symphysis pubis.
Precipitous delivery and rupture are not direct outcomes of fetal size, and tachycardia is non-
specific.
8. A client is requesting an epidural. The nurse notes the client’s platelet count is 80,000/mm³.
What is the appropriate action?
A. Proceed with the epidural as scheduled.
B. Notify the anesthesia provider, as this is a contraindication.
Nursing Care 3rd Edition (Durham & Chapman) EXAM with
Questions and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. Maternal and Newborn Health Assessment
2. Reproductive Anatomy and Physiology
3. Conception, Fetal Development, and Genetics
4. Physiological and Psychological Changes of Pregnancy
5. Antepartum Nursing Care and Risk Management
6. Intrapartum Nursing Care and Labor Support
7. Pharmacological Management during Labor and Birth
8. Postpartum Physical and Psychosocial Adaptation
9. Newborn Assessment and Care Transitions
10. High-Risk Antepartum, Intrapartum, and Postpartum Conditions
1. A client at 32 weeks gestation presents with sudden onset of severe abdominal pain and a firm,
non-relaxing uterus. The fetal heart rate (FHR) shows late decelerations. Which action is the
priority?
A. Perform a vaginal examination to determine cervical dilation.
B. Prepare for an immediate emergency cesarean birth.
, C. Place the client in a side-lying position and administer oxygen.
D. Anticipate the administration of tocolytics to stop contractions.
Answer: B
CORRECT ANSWER : B
Rationale: The clinical presentation of severe pain, rigid abdomen, and non-reassuring FHR is
characteristic of placental abruption. Immediate delivery is indicated to save the fetus and
prevent maternal coagulopathy; vaginal exams are contraindicated, and tocolytics are unsafe.
2. A nurse is evaluating a client at 38 weeks gestation receiving a magnesium sulfate infusion for
severe preeclampsia. The nurse finds the deep tendon reflexes (DTRs) are absent. What is the
next priority?
A. Increase the magnesium sulfate infusion rate.
B. Discontinue the magnesium sulfate infusion immediately.
C. Administer oral calcium gluconate.
D. Assess the client’s blood pressure and respiration.
Answer: B
CORRECT ANSWER : B
Rationale: Absent DTRs are an early sign of magnesium toxicity. The immediate nursing action
is to stop the infusion to prevent respiratory depression or cardiac arrest; calcium gluconate (the
antidote) is given intravenously, not orally, once the infusion is stopped.
3. A multiparous client is in the transition phase of labor. The nurse notes decelerations that begin
after the peak of the contraction and return to baseline well after the contraction ends. What is
the clinical significance?
A. Cord compression requiring a position change.
B. Uteroplacental insufficiency requiring immediate intervention.
C. Normal labor progression with head compression.
D. Fetal stress due to rapid descent.
Answer: B
, CORRECT ANSWER : B
Rationale: These are late decelerations, which indicate impaired blood flow to the fetus
(uteroplacental insufficiency). They are not normal and require interventions such as side-lying,
IV fluids, and oxygen; cord compression is represented by variable decelerations, and head
compression by early decelerations.
4. A postpartum client at 6 hours post-vaginal birth has a saturated perineal pad within 15 minutes.
The fundus is boggy and deviated to the right. What is the primary nursing intervention?
A. Administer methylergonovine immediately.
B. Assist the client to void and then massage the fundus.
C. Perform a bimanual uterine compression.
D. Increase the IV infusion rate of oxytocin.
Answer: B
CORRECT ANSWER : B
Rationale: A deviated, boggy fundus often indicates a full bladder preventing uterine
contraction. Emptying the bladder is the first mechanical step to allow the uterus to contract;
massage and medication follow if the uterus remains atonic after bladder evacuation.
5. A newborn at 1 hour of age has a respiratory rate of 70, nasal flaring, and mild grunting. What
should the nurse assess next?
A. Blood glucose level to rule out hypoglycemia.
B. The Apgar score again to determine status.
C. A chest X-ray for pneumothorax.
D. Maternal history for infection.
Answer: A
CORRECT ANSWER : B
Rationale: Respiratory distress in a newborn can be a presenting sign of metabolic issues,
specifically hypoglycemia. While infection is a concern, assessing blood glucose is a quick, non-
invasive priority before more invasive diagnostic testing.
, 6. A client at 28 weeks gestation is diagnosed with preterm labor. The provider orders nifedipine.
What is the nurse's primary responsibility regarding this medication?
A. Monitor the fetal heart rate for bradycardia.
B. Monitor the client's blood pressure for hypotension.
C. Ensure the client does not consume grapefruit juice.
D. Assess for pulmonary edema.
Answer: B
CORRECT ANSWER : B
Rationale: Nifedipine is a calcium channel blocker used as a tocolytic; a common side effect is
maternal hypotension. While fetal monitoring is important for all preterm labors, the specific
hemodynamic risk with nifedipine is low blood pressure, not fetal bradycardia (which is a risk
with beta-blockers).
7. A nurse is caring for a client with a history of gestational diabetes. At 36 weeks, the fetus shows
signs of macrosomia. What is the most likely complication during labor?
A. Shoulder dystocia.
B. Precipitous delivery.
C. Fetal tachycardia.
D. Uterine rupture.
Answer: A
CORRECT ANSWER : B
Rationale: Macrosomia (birth weight >4,000g) significantly increases the risk of shoulder
dystocia, where the fetal shoulders become impacted behind the maternal symphysis pubis.
Precipitous delivery and rupture are not direct outcomes of fetal size, and tachycardia is non-
specific.
8. A client is requesting an epidural. The nurse notes the client’s platelet count is 80,000/mm³.
What is the appropriate action?
A. Proceed with the epidural as scheduled.
B. Notify the anesthesia provider, as this is a contraindication.
