Maternal & Child Health Nursing (8th Ed.)
2026/2027 Final Exam Study Guide – 100 Q&A with
Explanations
Unit 1: Foundations of Maternal-Child Nursing
1. Which hormone is primarily responsible for uterine contractions during labor?
• A) Progesterone
• B) Oxytocin ✓
• C) Estrogen
• D) Prolactin
Explanation: Oxytocin, released from the posterior pituitary, stimulates rhythmic uterine
contractions.
2. The first stage of labor ends when:
• A) The infant is delivered
• B) The placenta is delivered
• C) Cervix is fully dilated ✓
• D) Membranes rupture
Explanation: The first stage of labor begins with regular contractions and ends with full
cervical dilation (10 cm).
3. A pregnant client at 28 weeks gestation has a fundal height at the level of the umbilicus.
This finding suggests:
• A) Appropriate growth
• B) Fetal macrosomia
• C) Possible intrauterine growth restriction ✓
• D) Multiple gestation
Explanation: At 28 weeks, fundal height should be approximately 28 cm (symphysis pubis
to fundus). Umbilical level corresponds to 20–22 weeks.
,Unit 2: High-Risk Pregnancy
4. A client with preeclampsia is receiving magnesium sulfate. Which finding requires
immediate nursing action?
• A) Deep tendon reflexes 2+
• B) Urine output 40 mL/hr
• C) Respiratory rate 10 breaths/min ✓
• D) Mild sedation
Explanation: Magnesium sulfate can cause respiratory depression. A respiratory rate
below 12 warrants immediate assessment and possible antidote (calcium gluconate).
5. In managing gestational diabetes, the primary goal is to:
• A) Maintain normoglycemia to prevent fetal complications ✓
• B) Achieve maternal weight loss
• C) Eliminate need for insulin postpartum
• D) Restrict all carbohydrate intake
Explanation: Tight glycemic control reduces risks of macrosomia, hypoglycemia, and
birth trauma.
Unit 3: Labor & Delivery
6. Which fetal heart rate pattern requires intrauterine resuscitation?
• A) Early decelerations
• B) Accelerations with movement
• C) Late decelerations ✓
• D) Variability 6–10 bpm
Explanation: Late decelerations suggest uteroplacental insufficiency; interventions
include lateral positioning, oxygen, IV fluids, and discontinuing oxytocin.
7. The nurse notes a gush of dark amniotic fluid during labor. This indicates:
• A) Normal finding
, • B) Possible fetal distress ✓
• C) Preterm rupture
• D) Maternal dehydration
Explanation: Meconium-stained fluid may indicate fetal hypoxia, requiring close
monitoring and possible neonatal resuscitation.
Unit 4: Postpartum Care
8. A postpartum client has a temperature of 38.2°C on day 3. The nurse should first:
• A) Administer antipyretics
• B) Notify the provider
• C) Assess uterine tenderness and lochia ✓
• D) Encourage increased fluid intake
Explanation: Postpartum fever may indicate endometritis; assessment for uterine
tenderness/foul lochia guides further intervention.
9. Which finding 24 hours postpartum requires further evaluation?
• A) Diaphoresis
• B) Afterpains during breastfeeding
• C) Saturating a peripad in 1 hour ✓
• D) Fundus firm, 2 cm below umbilicus
Explanation: Saturating a pad in ≤1 hour suggests postpartum hemorrhage; normal
lochial flow is less than saturation of one pad in 2 hours.
Unit 5: Newborn Care
10. A newborn’s blood glucose is 40 mg/dL at 2 hours of life. The nurse should:
• A) Administer IV dextrose
• B) Notify neonatology
• C) Feed the newborn and recheck ✓
, • D) Warm the infant
*Explanation: For asymptomatic newborns, initial treatment is feeding (breast or
formula) with recheck in 30–60 minutes; treatment threshold is typically <45 mg/dL.*
11. The Apgar score assesses which five parameters?
• A) Heart rate, respirations, muscle tone, reflex irritability, color ✓
• B) Heart rate, blood pressure, temperature, cry, color
• C) Respirations, temperature, muscle tone, cry, reflex irritability
• D) Heart rate, oxygen saturation, color, tone, cry
Unit 6: Child Health & Development
12. According to Erikson, the developmental task of infancy is:
• A) Autonomy vs. Shame
• B) Trust vs. Mistrust ✓
• C) Initiative vs. Guilt
• D) Industry vs. Inferiority
13. A 2-year-old with suspected lead poisoning should be assessed for:
• A) Hypertension
• B) Bradycardia
• C) Developmental delays and abdominal pain ✓
• D) Hyperactivity and weight gain
Unit 7: Pediatric Illness & Management
14. Which finding is a late sign of increased intracranial pressure in a child?
• A) Headache
• B) Vomiting
• C) Irritability
2026/2027 Final Exam Study Guide – 100 Q&A with
Explanations
Unit 1: Foundations of Maternal-Child Nursing
1. Which hormone is primarily responsible for uterine contractions during labor?
• A) Progesterone
• B) Oxytocin ✓
• C) Estrogen
• D) Prolactin
Explanation: Oxytocin, released from the posterior pituitary, stimulates rhythmic uterine
contractions.
2. The first stage of labor ends when:
• A) The infant is delivered
• B) The placenta is delivered
• C) Cervix is fully dilated ✓
• D) Membranes rupture
Explanation: The first stage of labor begins with regular contractions and ends with full
cervical dilation (10 cm).
3. A pregnant client at 28 weeks gestation has a fundal height at the level of the umbilicus.
This finding suggests:
• A) Appropriate growth
• B) Fetal macrosomia
• C) Possible intrauterine growth restriction ✓
• D) Multiple gestation
Explanation: At 28 weeks, fundal height should be approximately 28 cm (symphysis pubis
to fundus). Umbilical level corresponds to 20–22 weeks.
,Unit 2: High-Risk Pregnancy
4. A client with preeclampsia is receiving magnesium sulfate. Which finding requires
immediate nursing action?
• A) Deep tendon reflexes 2+
• B) Urine output 40 mL/hr
• C) Respiratory rate 10 breaths/min ✓
• D) Mild sedation
Explanation: Magnesium sulfate can cause respiratory depression. A respiratory rate
below 12 warrants immediate assessment and possible antidote (calcium gluconate).
5. In managing gestational diabetes, the primary goal is to:
• A) Maintain normoglycemia to prevent fetal complications ✓
• B) Achieve maternal weight loss
• C) Eliminate need for insulin postpartum
• D) Restrict all carbohydrate intake
Explanation: Tight glycemic control reduces risks of macrosomia, hypoglycemia, and
birth trauma.
Unit 3: Labor & Delivery
6. Which fetal heart rate pattern requires intrauterine resuscitation?
• A) Early decelerations
• B) Accelerations with movement
• C) Late decelerations ✓
• D) Variability 6–10 bpm
Explanation: Late decelerations suggest uteroplacental insufficiency; interventions
include lateral positioning, oxygen, IV fluids, and discontinuing oxytocin.
7. The nurse notes a gush of dark amniotic fluid during labor. This indicates:
• A) Normal finding
, • B) Possible fetal distress ✓
• C) Preterm rupture
• D) Maternal dehydration
Explanation: Meconium-stained fluid may indicate fetal hypoxia, requiring close
monitoring and possible neonatal resuscitation.
Unit 4: Postpartum Care
8. A postpartum client has a temperature of 38.2°C on day 3. The nurse should first:
• A) Administer antipyretics
• B) Notify the provider
• C) Assess uterine tenderness and lochia ✓
• D) Encourage increased fluid intake
Explanation: Postpartum fever may indicate endometritis; assessment for uterine
tenderness/foul lochia guides further intervention.
9. Which finding 24 hours postpartum requires further evaluation?
• A) Diaphoresis
• B) Afterpains during breastfeeding
• C) Saturating a peripad in 1 hour ✓
• D) Fundus firm, 2 cm below umbilicus
Explanation: Saturating a pad in ≤1 hour suggests postpartum hemorrhage; normal
lochial flow is less than saturation of one pad in 2 hours.
Unit 5: Newborn Care
10. A newborn’s blood glucose is 40 mg/dL at 2 hours of life. The nurse should:
• A) Administer IV dextrose
• B) Notify neonatology
• C) Feed the newborn and recheck ✓
, • D) Warm the infant
*Explanation: For asymptomatic newborns, initial treatment is feeding (breast or
formula) with recheck in 30–60 minutes; treatment threshold is typically <45 mg/dL.*
11. The Apgar score assesses which five parameters?
• A) Heart rate, respirations, muscle tone, reflex irritability, color ✓
• B) Heart rate, blood pressure, temperature, cry, color
• C) Respirations, temperature, muscle tone, cry, reflex irritability
• D) Heart rate, oxygen saturation, color, tone, cry
Unit 6: Child Health & Development
12. According to Erikson, the developmental task of infancy is:
• A) Autonomy vs. Shame
• B) Trust vs. Mistrust ✓
• C) Initiative vs. Guilt
• D) Industry vs. Inferiority
13. A 2-year-old with suspected lead poisoning should be assessed for:
• A) Hypertension
• B) Bradycardia
• C) Developmental delays and abdominal pain ✓
• D) Hyperactivity and weight gain
Unit 7: Pediatric Illness & Management
14. Which finding is a late sign of increased intracranial pressure in a child?
• A) Headache
• B) Vomiting
• C) Irritability
