NUR2513 Maternal-Child Nursing
COMPREHENSIVE FINAL EXAM PRACTICE -
Rasmussen College 2026/2027 | NCLEX-Synthesis
Focus | Grade A
100 Questions
Every item is an unfolding, multi-data vignette that forces you to integrate at least two
course modules.
~35 % are SATA or ordered-response; all answers verified against current AAP, ACOG,
AWHONN, ANA, and 2026 NCLEX test plan.
DOMAIN 1 SYNTHESIZED MATERNAL-NEWBORN CARE (Q 1-35)
Q1 (SATA):
A G2P1 at 38 weeks presents to OB triage with 2 h of contractions every 3 min. She has
diet-controlled GDM. Membranes ruptured 1 h ago; fluid clear. FHR tracing shows
moderate variability with accelerations ×2. On sterile exam cervix is 4 cm/90 %/-1. One
hour later she reports constant abdominal pain; fundus firm; FHR now 170 with late
decels. VS: BP 140/88, HR 110, RR 22. Which actions are indicated NOW?
A. Start MgSO₄ 4 g loading dose for seizure prophylaxis
B. Place internal fetal scalp electrode
,C. Assist to left-lateral position and O₂ 8 L non-rebreather
D. Obtain type & screen and 2 large-bore IVs
E. Prepare for stat cesarean delivery
F. Give terbutaline 0.25 mg SQ for uterine relaxation
Verified Answers: C, D, E
Rationale (Graded A Synthesis): Late decels + tachycardia + maternal
tachy/hypertension suggest placental abruption with fetal compromise (Module 4
high-risk) and possible pre-eclampsia exacerbation. Left-lateral + O₂ improves placental
perfusion (Module 3 routine intrapartum care). Type & screen and large-bore IVs
precede possible cesarean. Stat C-section is likely but OR prep occurs simultaneously
(NCLEX: fetal compromise is immediate priority). MgSO₄ is for seizure prophylaxis in
preeclampsia but does not correct fetal hypoxia; terbutaline is contraindicated in fetal
distress; internal electrode delays definitive care.
Q2 (Ordered Response):
Place the following steps in the correct sequence when a term newborn delivered by
emergency cesarean for fetal bradycardia is handed to you limp and cyanotic with HR
70.
1. Dry and stimulate
2. Assess breathing
3. Call for additional help
4. Begin PPV via mask within 60 s
5. Check HR after 30 s of PPV
Correct Order: 3, 1, 2, 4, 5
,Rationale: NRP 8th ed—call for help first (ensures resources), dry/stimulate (thermoreg
+ sensory), assess breathing (decision point), PPV if apneic/gasping/HR < 100, then
reassess HR at 30 s.
Q3 (SATA):
A laboring client with a foley catheter receives epidural analgesia. One hour later she
reports nausea and “feels funny.” VS: BP 88/50, HR 110. FHR: baseline 150, minimal
variability, no accelerations. Which interventions are appropriate?
A. Increase IV crystalloid bolus
B. Administer 10 mg ephedrine IV
C. Turn epidural down by 50 %
D. Place in Trendelenburg
E. Assess for bladder distention
Verified Answers: A, B, E
Rationale: Hypotension from sympathetic block reduces placental perfusion (Module 3).
Fluid bolus + vasopressor (ephedrine) corrects BP. Epidural rate reduction is not
first-line (hypotension is circulatory, not sensory). Trendelenburg risks aortocaval
compression; supine-lateral preferred. Bladder distention can cause reflex
hypotension—assess and empty.
Q4:
A breastfeeding mother on postpartum day 2 reports cracked nipples and “shooting
pain” after feeds. Infant latches well; weight loss 5 %. Breasts are soft. You observe a
, white patch on infant’s tongue that does not wipe off. Which maternal issue is MOST
likely?
A. Plugged duct
B. Candida mastitis
C. Milk blister
D. Physiologic engorgement
Verified Answer: B
Rationale: Infant pseudomembranous candidiasis (thrush) + maternal nipple pain =
candida mastitis (Module 6 newborn & Module 5 maternal complications). Soft breasts
rule out engorgement/plugged duct; milk blister is localized.
Q5 (SATA):
A G1P0 at 28 weeks is found to have breech presentation on ultrasound. Which
counseling points are accurate?
A. External cephalic version (ECV) may be offered at 37 weeks if no contraindications
B. Planned cesarean is mandated now
C. Breech often spontaneously turns by 34-36 weeks
D. She should perform knee-chest exercises daily starting now
E. If ECV fails, elective cesarean at 39 weeks is recommended
Verified Answers: A, C, E
COMPREHENSIVE FINAL EXAM PRACTICE -
Rasmussen College 2026/2027 | NCLEX-Synthesis
Focus | Grade A
100 Questions
Every item is an unfolding, multi-data vignette that forces you to integrate at least two
course modules.
~35 % are SATA or ordered-response; all answers verified against current AAP, ACOG,
AWHONN, ANA, and 2026 NCLEX test plan.
DOMAIN 1 SYNTHESIZED MATERNAL-NEWBORN CARE (Q 1-35)
Q1 (SATA):
A G2P1 at 38 weeks presents to OB triage with 2 h of contractions every 3 min. She has
diet-controlled GDM. Membranes ruptured 1 h ago; fluid clear. FHR tracing shows
moderate variability with accelerations ×2. On sterile exam cervix is 4 cm/90 %/-1. One
hour later she reports constant abdominal pain; fundus firm; FHR now 170 with late
decels. VS: BP 140/88, HR 110, RR 22. Which actions are indicated NOW?
A. Start MgSO₄ 4 g loading dose for seizure prophylaxis
B. Place internal fetal scalp electrode
,C. Assist to left-lateral position and O₂ 8 L non-rebreather
D. Obtain type & screen and 2 large-bore IVs
E. Prepare for stat cesarean delivery
F. Give terbutaline 0.25 mg SQ for uterine relaxation
Verified Answers: C, D, E
Rationale (Graded A Synthesis): Late decels + tachycardia + maternal
tachy/hypertension suggest placental abruption with fetal compromise (Module 4
high-risk) and possible pre-eclampsia exacerbation. Left-lateral + O₂ improves placental
perfusion (Module 3 routine intrapartum care). Type & screen and large-bore IVs
precede possible cesarean. Stat C-section is likely but OR prep occurs simultaneously
(NCLEX: fetal compromise is immediate priority). MgSO₄ is for seizure prophylaxis in
preeclampsia but does not correct fetal hypoxia; terbutaline is contraindicated in fetal
distress; internal electrode delays definitive care.
Q2 (Ordered Response):
Place the following steps in the correct sequence when a term newborn delivered by
emergency cesarean for fetal bradycardia is handed to you limp and cyanotic with HR
70.
1. Dry and stimulate
2. Assess breathing
3. Call for additional help
4. Begin PPV via mask within 60 s
5. Check HR after 30 s of PPV
Correct Order: 3, 1, 2, 4, 5
,Rationale: NRP 8th ed—call for help first (ensures resources), dry/stimulate (thermoreg
+ sensory), assess breathing (decision point), PPV if apneic/gasping/HR < 100, then
reassess HR at 30 s.
Q3 (SATA):
A laboring client with a foley catheter receives epidural analgesia. One hour later she
reports nausea and “feels funny.” VS: BP 88/50, HR 110. FHR: baseline 150, minimal
variability, no accelerations. Which interventions are appropriate?
A. Increase IV crystalloid bolus
B. Administer 10 mg ephedrine IV
C. Turn epidural down by 50 %
D. Place in Trendelenburg
E. Assess for bladder distention
Verified Answers: A, B, E
Rationale: Hypotension from sympathetic block reduces placental perfusion (Module 3).
Fluid bolus + vasopressor (ephedrine) corrects BP. Epidural rate reduction is not
first-line (hypotension is circulatory, not sensory). Trendelenburg risks aortocaval
compression; supine-lateral preferred. Bladder distention can cause reflex
hypotension—assess and empty.
Q4:
A breastfeeding mother on postpartum day 2 reports cracked nipples and “shooting
pain” after feeds. Infant latches well; weight loss 5 %. Breasts are soft. You observe a
, white patch on infant’s tongue that does not wipe off. Which maternal issue is MOST
likely?
A. Plugged duct
B. Candida mastitis
C. Milk blister
D. Physiologic engorgement
Verified Answer: B
Rationale: Infant pseudomembranous candidiasis (thrush) + maternal nipple pain =
candida mastitis (Module 6 newborn & Module 5 maternal complications). Soft breasts
rule out engorgement/plugged duct; milk blister is localized.
Q5 (SATA):
A G1P0 at 28 weeks is found to have breech presentation on ultrasound. Which
counseling points are accurate?
A. External cephalic version (ECV) may be offered at 37 weeks if no contraindications
B. Planned cesarean is mandated now
C. Breech often spontaneously turns by 34-36 weeks
D. She should perform knee-chest exercises daily starting now
E. If ECV fails, elective cesarean at 39 weeks is recommended
Verified Answers: A, C, E
