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TI RN Maternal Newborn Exam 2025 –
A
Updated Case Scenarios & Dosage Calculation
Questions & Answers in Full | 100% Verified
Student Name:______________________ Date:_______________
Time Limit:90 minutesTotal Questions:70
Instructions
omplete all 70 questions within the 90-minute time limit. Questions include multiple-choice (MCQ),
C
select-all-that-apply (SATA), and dosage calculation formats, reflecting real-life OB scenarios. Read each
question carefully, select the single best answer for MCQs, all correct options for SATA, and show work
for calculations. Topics cover Labor & Delivery Complications, Postpartum Assessment, Newborn Safety
& Reflexes, and Medication Administration. Calculators are permitted for dosage calculations. Good
luck!
Labor & Delivery Complications (Questions 1–20)
Question 1
client at 39 weeks gestation presents with sudden, severe abdominal pain and vaginal bleeding. What
A
should the nurse suspect?
A.Placental abruption
B. Preterm labor
C. Uterine rupture
D. Normal labor progression
orrect Answer:A. Placental abruption
C
Rationale: Sudden, severe abdominal pain with vaginalbleeding suggests placental abruption, a medical
,e mergency. Preterm labor (B) occurs before 37 weeks, uterine rupture (C) is less common and often
associated with prior cesarean, and normal labor (D) doesn’t present with these symptoms.
Question 2
client in active labor has a fetal heart rate (FHR) of 90 bpm with late decelerations. What is the nurse’s
A
priority action?
A. Continue monitoring the FHR
B.Reposition the client and administer oxygen
C. Document the findings as normal
D. Encourage pushing to expedite delivery
orrect Answer:B. Reposition the client and administeroxygen
C
Rationale: Late decelerations with bradycardia (90bpm) indicate uteroplacental insufficiency, requiring
immediate interventions like repositioning and oxygen to improve fetal oxygenation. Monitoring alone
(A), documenting as normal (C), or pushing (D) is unsafe.
Question 3 (SATA)
hich interventions should the nurse implement for a client with preterm labor at 34 weeks gestation?
W
(Select all that apply.)
A.Administer betamethasone as prescribed
B.Monitor fetal heart rate continuously
C. Encourage ambulation to progress labor
D.Administer tocolytics as prescribed
E.Assess for signs of infection
orrect Answers:A, B, D, E
C
Rationale: Betamethasone (A) promotes fetal lungmaturity, continuous FHR monitoring (B) assesses
fetal status, tocolytics (D) delay labor, and infection assessment (E) identifies risks. Ambulation (C) may
worsen preterm labor.
Question 4
client in labor has a prolonged deceleration to 80 bpm lasting 3 minutes. What should the nurse do
A
first?
A.Notify the healthcare provider immediately
B. Continue monitoring for improvement
, . Administer IV fluids without an order
C
D. Document the finding and reassess
orrect Answer:A. Notify the healthcare provider immediately
C
Rationale: A prolonged deceleration to 80 bpm indicatesfetal distress, requiring immediate provider
notification for potential intervention. Monitoring alone (B), administering fluids without orders (C), or
documenting (D) delays critical action.
Question 5
client at 37 weeks gestation reports a sudden gush of fluid. The nurse notes clear fluid and a normal
A
FHR. What is the next action?
A.Assess cervical dilation and prepare for delivery
B. Administer antibiotics immediately
C. Document as a normal finding
D. Perform a sterile speculum exam
orrect Answer:A. Assess cervical dilation and preparefor delivery
C
Rationale: A gush of clear fluid at 37 weeks suggestsrupture of membranes, requiring assessment of
labor progression (cervical dilation) and delivery preparation. Antibiotics (B) are for GBS or infection,
documenting alone (C) is insufficient, and a speculum exam (D) is provider-led.
Question 6
client in labor receives an epidural. Which complication should the nurse monitor for?
A
A.Hypotension
B. Hyperglycemia
C. Tachycardia
D. Fever
orrect Answer:A. Hypotension
C
Rationale: Epidurals can cause vasodilation, leadingto hypotension. Hyperglycemia (B), tachycardia
(C), and fever (D) are not primary epidural complications.
Question 7 (Dosage Calculation)
client in preterm labor is prescribed magnesium sulfate 2 grams IV bolus over 30 minutes, followed by
A
a maintenance dose of 1 gram/hour. The pharmacy provides a 40 grams/500 mL solution. How many
mL/hour should the nurse set the IV pump for the maintenance dose?
A. 10 mL/hour
TI RN Maternal Newborn Exam 2025 –
A
Updated Case Scenarios & Dosage Calculation
Questions & Answers in Full | 100% Verified
Student Name:______________________ Date:_______________
Time Limit:90 minutesTotal Questions:70
Instructions
omplete all 70 questions within the 90-minute time limit. Questions include multiple-choice (MCQ),
C
select-all-that-apply (SATA), and dosage calculation formats, reflecting real-life OB scenarios. Read each
question carefully, select the single best answer for MCQs, all correct options for SATA, and show work
for calculations. Topics cover Labor & Delivery Complications, Postpartum Assessment, Newborn Safety
& Reflexes, and Medication Administration. Calculators are permitted for dosage calculations. Good
luck!
Labor & Delivery Complications (Questions 1–20)
Question 1
client at 39 weeks gestation presents with sudden, severe abdominal pain and vaginal bleeding. What
A
should the nurse suspect?
A.Placental abruption
B. Preterm labor
C. Uterine rupture
D. Normal labor progression
orrect Answer:A. Placental abruption
C
Rationale: Sudden, severe abdominal pain with vaginalbleeding suggests placental abruption, a medical
,e mergency. Preterm labor (B) occurs before 37 weeks, uterine rupture (C) is less common and often
associated with prior cesarean, and normal labor (D) doesn’t present with these symptoms.
Question 2
client in active labor has a fetal heart rate (FHR) of 90 bpm with late decelerations. What is the nurse’s
A
priority action?
A. Continue monitoring the FHR
B.Reposition the client and administer oxygen
C. Document the findings as normal
D. Encourage pushing to expedite delivery
orrect Answer:B. Reposition the client and administeroxygen
C
Rationale: Late decelerations with bradycardia (90bpm) indicate uteroplacental insufficiency, requiring
immediate interventions like repositioning and oxygen to improve fetal oxygenation. Monitoring alone
(A), documenting as normal (C), or pushing (D) is unsafe.
Question 3 (SATA)
hich interventions should the nurse implement for a client with preterm labor at 34 weeks gestation?
W
(Select all that apply.)
A.Administer betamethasone as prescribed
B.Monitor fetal heart rate continuously
C. Encourage ambulation to progress labor
D.Administer tocolytics as prescribed
E.Assess for signs of infection
orrect Answers:A, B, D, E
C
Rationale: Betamethasone (A) promotes fetal lungmaturity, continuous FHR monitoring (B) assesses
fetal status, tocolytics (D) delay labor, and infection assessment (E) identifies risks. Ambulation (C) may
worsen preterm labor.
Question 4
client in labor has a prolonged deceleration to 80 bpm lasting 3 minutes. What should the nurse do
A
first?
A.Notify the healthcare provider immediately
B. Continue monitoring for improvement
, . Administer IV fluids without an order
C
D. Document the finding and reassess
orrect Answer:A. Notify the healthcare provider immediately
C
Rationale: A prolonged deceleration to 80 bpm indicatesfetal distress, requiring immediate provider
notification for potential intervention. Monitoring alone (B), administering fluids without orders (C), or
documenting (D) delays critical action.
Question 5
client at 37 weeks gestation reports a sudden gush of fluid. The nurse notes clear fluid and a normal
A
FHR. What is the next action?
A.Assess cervical dilation and prepare for delivery
B. Administer antibiotics immediately
C. Document as a normal finding
D. Perform a sterile speculum exam
orrect Answer:A. Assess cervical dilation and preparefor delivery
C
Rationale: A gush of clear fluid at 37 weeks suggestsrupture of membranes, requiring assessment of
labor progression (cervical dilation) and delivery preparation. Antibiotics (B) are for GBS or infection,
documenting alone (C) is insufficient, and a speculum exam (D) is provider-led.
Question 6
client in labor receives an epidural. Which complication should the nurse monitor for?
A
A.Hypotension
B. Hyperglycemia
C. Tachycardia
D. Fever
orrect Answer:A. Hypotension
C
Rationale: Epidurals can cause vasodilation, leadingto hypotension. Hyperglycemia (B), tachycardia
(C), and fever (D) are not primary epidural complications.
Question 7 (Dosage Calculation)
client in preterm labor is prescribed magnesium sulfate 2 grams IV bolus over 30 minutes, followed by
A
a maintenance dose of 1 gram/hour. The pharmacy provides a 40 grams/500 mL solution. How many
mL/hour should the nurse set the IV pump for the maintenance dose?
A. 10 mL/hour
