MATERNITY AND PEDIATRIC NURSING EXAM SCRIPT (2026/2027)
Maternity & Pediatric Nursing Comprehensive Examination Script | Core Domains: Reproductive
Health & Antepartum Care, Intrapartum & Postpartum Management, Newborn Assessment & Care,
Pediatric Growth & Development, Common Pediatric Illnesses & Emergencies, Pediatric Pharmacology
& Medication Safety, Family-Centered Care & Communication, and Health Promotion Across the
Childbearing & Child-Rearing Continuum | Nursing Program Focus | Integrated Clinical Scenario
Exam Script Format
Exam Structure
The Maternity & Pediatric Nursing Exam Script for the 2026/2027 academic cycle is a 100-question,
multiple-choice question (MCQ) examination presented through unfolding clinical scenarios.
Introduction
This Maternity & Pediatric Nursing Exam Script for the 2026/2027 cycle provides a dynamic,
scenario-based assessment of nursing care for childbearing families and pediatric patients. The script
presents integrated clinical cases that test the application of knowledge across maternal-fetal physiology,
newborn adaptation, pediatric development, and acute/chronic pediatric conditions, emphasizing clinical
judgment, prioritization, and evidence-based interventions.
Answer Format
All correct answers and nursing actions must be presented in bold and green, followed by detailed
rationales that analyze the clinical scenario, apply maternal-fetal or pediatric pathophysiology, integrate
developmental milestones, justify pharmacologic and non-pharmacologic interventions, and prioritize
family-centered care within the context of the unfolding case study.
Questions (100 Total)
1. A 28-year-old G1P0 at 36 weeks gestation presents with sudden, painless vaginal
bleeding. Vital signs are stable. Fetal heart rate is 140 bpm.
What is the nurse’s priority action?
A. Perform a vaginal exam to assess cervical dilation
B. Assess vital signs and prepare for ultrasound
C. Administer oxytocin to augment labor
D. Encourage ambulation to stimulate contractions
Rationale: Painless vaginal bleeding in the third trimester suggests placenta previa. Vaginal exams
are contraindicated until placental location is confirmed by ultrasound due to risk of triggering massive
hemorrhage. Monitoring maternal vitals and fetal status is essential. Bed rest and avoiding intercourse
are standard precautions.
2. A newborn is delivered via cesarean section at 39 weeks. At 1 minute, the infant has a
heart rate of 110 bpm, slow and irregular respirations, some flexion of extremities,
grimacing to stimulation, and acrocyanosis.
,What is the Apgar score?
A. 5
B. 6
C. 7
D. 8
Rationale: Apgar scoring: Heart rate >100 = 2; Respiratory effort (slow/irregular) = 1; Muscle tone
(some flexion) = 1; Reflex irritability (grimace) = 1; Color (acrocyanosis) = 1. Total = 6. This indicates
moderate transition difficulty requiring stimulation and monitoring, but not full resuscitation.
3. A 4-year-old child weighs 16 kg and is prescribed amoxicillin 45 mg/kg/day divided every
12 hours. The suspension is 250 mg/5 mL.
How many mL should the nurse administer per dose?
A. 6.2 mL
B. 7.2 mL
C. 8.0 mL
D. 9.0 mL
Rationale: Total daily dose = 45 mg/kg × 16 kg = 720 mg. Divided every 12 hours = 360 mg/dose.
Concentration = 250 mg/5 mL = 50 mg/mL. Volume = 360 ÷ 50 = 7.2 mL. Accurate weight-based
calculation prevents under/over-treatment in pediatric pharmacology.
4. During labor, a client’s fetal heart rate tracing shows recurrent late decelerations with
minimal variability.
What is the nurse’s priority intervention?
A. Administer oxygen via nasal cannula
B. Increase IV fluids
C. Reposition the client to left lateral position
D. Prepare for immediate cesarean delivery
Rationale: Late decelerations indicate uteroplacental insufficiency. The first intervention is to improve
perfusion by repositioning the client to left lateral to relieve pressure on the vena cava. Then administer
oxygen, increase IV fluids, and notify the provider. Cesarean delivery is considered if decelerations
persist despite interventions.
,5. A 2-day-old newborn has jaundice noted on the face and chest. The bilirubin level is 14
mg/dL.
What is the most appropriate action?
A. Discharge with follow-up in 1 week
B. Initiate phototherapy and monitor bilirubin levels
C. Administer IV immunoglobulin
D. Perform exchange transfusion immediately
Rationale: Jaundice appearing after 24 hours is typically physiologic. At 14 mg/dL in a 2-day-old,
phototherapy is indicated per AAP guidelines based on age-specific nomograms. Exchange transfusion
is reserved for very high levels (>25 mg/dL) or signs of kernicterus. IVIG is used in hemolytic disease.
6. A postpartum client 4 days after vaginal delivery reports feeling tearful, overwhelmed,
and fatigued but is bonding with her infant.
What is the most likely diagnosis?
A. Postpartum psychosis
B. Postpartum blues
C. Postpartum depression
D. Bipolar disorder
Rationale: Postpartum blues affect 50–80% of new mothers, peak at days 3–5, and resolve within 2
weeks. Symptoms include mood swings, crying, fatigue, and anxiety—but the mother remains oriented
and bonded to the infant. Depression is more severe and persistent; psychosis includes
delusions/hallucinations.
7. A 2-year-old toddler is hospitalized with dehydration from gastroenteritis. The parent
asks when toilet training should begin.
What is the best response?
A. “Start immediately to establish routine.”
B. “Look for readiness signs like staying dry for 2 hours and showing interest.”
C. “Wait until age 5 to avoid regression.”
D. “Only start if the child requests it.”
Rationale: Toilet training readiness typically occurs between 18–30 months and includes physical
(bladder control), cognitive (understanding instructions), and emotional (desire to please) milestones.
, Pushing too early causes frustration. Erikson’s autonomy stage (1–3 years) supports encouraging
independence when ready.
8. A pregnant client at 28 weeks has a blood pressure of 148/94 mm Hg and 2+ proteinuria
on dipstick.
What condition is suspected?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Eclampsia
Rationale: Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks with
proteinuria (≥1+ on dipstick or PCR ≥0.3). Eclampsia includes seizures. Immediate monitoring for
HELLP syndrome and fetal well-being is essential. Delivery is the only cure.
9. Parents of a newborn ask about car seat safety.
What instruction should the nurse provide?
A. “Forward-facing is acceptable after 1 month.”
B. “Keep your baby rear-facing in the back seat until at least age 2.”
C. “Use a booster seat immediately.”
D. “The front passenger seat is safe with airbag off.”
Rationale: AAP recommends infants remain rear-facing in the back seat until at least age 2 or until
they reach the car seat’s height/weight limit. Airbags can cause fatal injury to rear-facing infants in the
front seat. Booster seats are for older children (typically >40 lb).
10. A 6-month-old infant is admitted with bronchiolitis. The respiratory rate is 68/min,
with nasal flaring and intercostal retractions.
What is the priority concern?
A. Dehydration
B. Impending respiratory failure
C. Fever
D. Ear infection
Maternity & Pediatric Nursing Comprehensive Examination Script | Core Domains: Reproductive
Health & Antepartum Care, Intrapartum & Postpartum Management, Newborn Assessment & Care,
Pediatric Growth & Development, Common Pediatric Illnesses & Emergencies, Pediatric Pharmacology
& Medication Safety, Family-Centered Care & Communication, and Health Promotion Across the
Childbearing & Child-Rearing Continuum | Nursing Program Focus | Integrated Clinical Scenario
Exam Script Format
Exam Structure
The Maternity & Pediatric Nursing Exam Script for the 2026/2027 academic cycle is a 100-question,
multiple-choice question (MCQ) examination presented through unfolding clinical scenarios.
Introduction
This Maternity & Pediatric Nursing Exam Script for the 2026/2027 cycle provides a dynamic,
scenario-based assessment of nursing care for childbearing families and pediatric patients. The script
presents integrated clinical cases that test the application of knowledge across maternal-fetal physiology,
newborn adaptation, pediatric development, and acute/chronic pediatric conditions, emphasizing clinical
judgment, prioritization, and evidence-based interventions.
Answer Format
All correct answers and nursing actions must be presented in bold and green, followed by detailed
rationales that analyze the clinical scenario, apply maternal-fetal or pediatric pathophysiology, integrate
developmental milestones, justify pharmacologic and non-pharmacologic interventions, and prioritize
family-centered care within the context of the unfolding case study.
Questions (100 Total)
1. A 28-year-old G1P0 at 36 weeks gestation presents with sudden, painless vaginal
bleeding. Vital signs are stable. Fetal heart rate is 140 bpm.
What is the nurse’s priority action?
A. Perform a vaginal exam to assess cervical dilation
B. Assess vital signs and prepare for ultrasound
C. Administer oxytocin to augment labor
D. Encourage ambulation to stimulate contractions
Rationale: Painless vaginal bleeding in the third trimester suggests placenta previa. Vaginal exams
are contraindicated until placental location is confirmed by ultrasound due to risk of triggering massive
hemorrhage. Monitoring maternal vitals and fetal status is essential. Bed rest and avoiding intercourse
are standard precautions.
2. A newborn is delivered via cesarean section at 39 weeks. At 1 minute, the infant has a
heart rate of 110 bpm, slow and irregular respirations, some flexion of extremities,
grimacing to stimulation, and acrocyanosis.
,What is the Apgar score?
A. 5
B. 6
C. 7
D. 8
Rationale: Apgar scoring: Heart rate >100 = 2; Respiratory effort (slow/irregular) = 1; Muscle tone
(some flexion) = 1; Reflex irritability (grimace) = 1; Color (acrocyanosis) = 1. Total = 6. This indicates
moderate transition difficulty requiring stimulation and monitoring, but not full resuscitation.
3. A 4-year-old child weighs 16 kg and is prescribed amoxicillin 45 mg/kg/day divided every
12 hours. The suspension is 250 mg/5 mL.
How many mL should the nurse administer per dose?
A. 6.2 mL
B. 7.2 mL
C. 8.0 mL
D. 9.0 mL
Rationale: Total daily dose = 45 mg/kg × 16 kg = 720 mg. Divided every 12 hours = 360 mg/dose.
Concentration = 250 mg/5 mL = 50 mg/mL. Volume = 360 ÷ 50 = 7.2 mL. Accurate weight-based
calculation prevents under/over-treatment in pediatric pharmacology.
4. During labor, a client’s fetal heart rate tracing shows recurrent late decelerations with
minimal variability.
What is the nurse’s priority intervention?
A. Administer oxygen via nasal cannula
B. Increase IV fluids
C. Reposition the client to left lateral position
D. Prepare for immediate cesarean delivery
Rationale: Late decelerations indicate uteroplacental insufficiency. The first intervention is to improve
perfusion by repositioning the client to left lateral to relieve pressure on the vena cava. Then administer
oxygen, increase IV fluids, and notify the provider. Cesarean delivery is considered if decelerations
persist despite interventions.
,5. A 2-day-old newborn has jaundice noted on the face and chest. The bilirubin level is 14
mg/dL.
What is the most appropriate action?
A. Discharge with follow-up in 1 week
B. Initiate phototherapy and monitor bilirubin levels
C. Administer IV immunoglobulin
D. Perform exchange transfusion immediately
Rationale: Jaundice appearing after 24 hours is typically physiologic. At 14 mg/dL in a 2-day-old,
phototherapy is indicated per AAP guidelines based on age-specific nomograms. Exchange transfusion
is reserved for very high levels (>25 mg/dL) or signs of kernicterus. IVIG is used in hemolytic disease.
6. A postpartum client 4 days after vaginal delivery reports feeling tearful, overwhelmed,
and fatigued but is bonding with her infant.
What is the most likely diagnosis?
A. Postpartum psychosis
B. Postpartum blues
C. Postpartum depression
D. Bipolar disorder
Rationale: Postpartum blues affect 50–80% of new mothers, peak at days 3–5, and resolve within 2
weeks. Symptoms include mood swings, crying, fatigue, and anxiety—but the mother remains oriented
and bonded to the infant. Depression is more severe and persistent; psychosis includes
delusions/hallucinations.
7. A 2-year-old toddler is hospitalized with dehydration from gastroenteritis. The parent
asks when toilet training should begin.
What is the best response?
A. “Start immediately to establish routine.”
B. “Look for readiness signs like staying dry for 2 hours and showing interest.”
C. “Wait until age 5 to avoid regression.”
D. “Only start if the child requests it.”
Rationale: Toilet training readiness typically occurs between 18–30 months and includes physical
(bladder control), cognitive (understanding instructions), and emotional (desire to please) milestones.
, Pushing too early causes frustration. Erikson’s autonomy stage (1–3 years) supports encouraging
independence when ready.
8. A pregnant client at 28 weeks has a blood pressure of 148/94 mm Hg and 2+ proteinuria
on dipstick.
What condition is suspected?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Eclampsia
Rationale: Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks with
proteinuria (≥1+ on dipstick or PCR ≥0.3). Eclampsia includes seizures. Immediate monitoring for
HELLP syndrome and fetal well-being is essential. Delivery is the only cure.
9. Parents of a newborn ask about car seat safety.
What instruction should the nurse provide?
A. “Forward-facing is acceptable after 1 month.”
B. “Keep your baby rear-facing in the back seat until at least age 2.”
C. “Use a booster seat immediately.”
D. “The front passenger seat is safe with airbag off.”
Rationale: AAP recommends infants remain rear-facing in the back seat until at least age 2 or until
they reach the car seat’s height/weight limit. Airbags can cause fatal injury to rear-facing infants in the
front seat. Booster seats are for older children (typically >40 lb).
10. A 6-month-old infant is admitted with bronchiolitis. The respiratory rate is 68/min,
with nasal flaring and intercostal retractions.
What is the priority concern?
A. Dehydration
B. Impending respiratory failure
C. Fever
D. Ear infection
