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NUR 2513 Maternal Child Nursing Exam 2
2025/2026 | Actual Exam | Comprehensive
Maternal-Child
This practice examination is designed to reflect the content and difficulty of the NUR 2513 Maternal
Child Nursing Exam 2. It covers key topics including labor and delivery, intrapartum complications,
postpartum care, newborn assessment, and common maternal-newborn conditions. Each question
includes the correct answer and a detailed rationale to reinforce understanding.
Section 1: Intrapartum Nursing
1. A nurse is assessing a client in active labor. The fetal heart rate (FHR) baseline is 140 bpm with
moderate variability. The nurse notes several late decelerations. Which of the following is the priority
nursing action?
• A) Increase the rate of the IV fluid.
• B) Position the client on her left side.
• C) Administer oxygen at 10 L/min via non-rebreather mask.
• D) Notify the provider.
✔✔ Answer✔✔ B
Rationale: Late decelerations indicate uteroplacental insufficiency. The first action is to change maternal
position (left lateral) to improve placental perfusion. After positioning, administer oxygen and increase IV
fluids, then notify the provider if decelerations persist.
2. A client at 39 weeks gestation is receiving oxytocin (Pitocin) for induction of labor. The nurse notes
that the uterine contractions are lasting 100 seconds with a frequency of 1.5 minutes. Which of the
following is the priority action?
• A) Increase the oxytocin infusion rate.
• B) Place the client in a semi-Fowler’s position.
• C) Discontinue the oxytocin infusion.
• D) Document the findings as normal.
✔✔ Answer✔✔ C
Rationale: Uterine tachysystole (contractions lasting >90 seconds or frequency <2 minutes) can
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compromise fetal oxygenation. Oxytocin should be discontinued immediately. The provider should be
notified.
3. A nurse is assessing a client in labor. The client’s cervix is 6 cm dilated, 90% effaced, and the
presenting part is at 0 station. Which of the following phases of labor is the client experiencing?
• A) Latent phase
• B) Active phase
• C) Transition phase
• D) Second stage
✔✔ Answer✔✔ B
Rationale: The active phase of the first stage of labor is characterized by cervical dilation from 4-7 cm.
Transition is 8-10 cm. Second stage begins at full dilation (10 cm).
4. A nurse is assessing the fetal heart rate tracing and notes variable decelerations that have a “V” shape
and return to baseline quickly. Which of the following is the most likely cause?
• A) Uteroplacental insufficiency
• B) Head compression
• C) Cord compression
• D) Maternal hypotension
✔✔ Answer✔✔ C
Rationale: Variable decelerations are typically caused by umbilical cord compression. Late decelerations
are caused by uteroplacental insufficiency; early decelerations by head compression.
5. A nurse is caring for a client who is receiving epidural anesthesia. Which of the following findings
should the nurse report to the provider immediately?
• A) Maternal temperature of 37.5°C (99.5°F)
• B) Blood pressure of 100/60 mmHg
• C) Maternal report of pruritus
• D) Respiratory rate of 10 breaths/min
✔✔ Answer✔✔ D
Rationale: Respiratory depression (rate <12) can occur with epidural opioids or ascending anesthesia.
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This is a medical emergency requiring immediate intervention. Pruritus is common with opioids; a slight
drop in BP is expected; low-grade fever may be normal.
6. A nurse is performing a vaginal examination on a client in labor. The nurse palpates the fetal skull
sutures and fontanels. Which of the following findings indicates the fetal position is occiput posterior?
• A) The anterior fontanel is palpable on the left side.
• B) The posterior fontanel is palpable in the anterior position.
• C) The sagittal suture is transverse.
• D) The anterior fontanel is diamond-shaped and located anteriorly.
✔✔ Answer✔✔ B
Rationale: In occiput posterior position, the posterior fontanel (triangular) is located toward the anterior
(pubic symphysis). The anterior fontanel is diamond-shaped and larger; in occiput anterior, the posterior
fontanel is posterior.
7. A client in active labor requests pain relief. The nurse notes that the client’s cervix is 8 cm dilated and
100% effaced. The nurse should anticipate which of the following?
• A) Administration of an epidural.
• B) Administration of IV opioids.
• C) Preparation for delivery.
• D) Administration of a spinal block.
✔✔ Answer✔✔ C
Rationale: The transition phase (8-10 cm) indicates that the second stage is approaching. Epidural or
spinal anesthesia may be administered earlier in labor; at this point, the client may be close to delivery.
8. A nurse is monitoring a client receiving magnesium sulfate for preeclampsia. Which of the following
findings indicates magnesium toxicity?
• A) Respiratory rate of 16 breaths/min
• B) Deep tendon reflexes 2+
• C) Urine output of 30 mL/hour
• D) Absent deep tendon reflexes
✔✔ Answer✔✔ D
*Rationale: Magnesium toxicity causes loss of deep tendon reflexes (hyporeflexia), respiratory
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depression, and decreased urine output. Normal reflexes are 2+; normal urine output is ≥30 mL/hour;
respiratory rate <12 is concerning.*
9. A nurse is caring for a client with a diagnosis of placenta previa. Which of the following findings
should the nurse expect?
• A) Painless, bright red vaginal bleeding
• B) Severe abdominal pain with dark red bleeding
• C) Uterine tenderness and hypertonus
• D) Fetal distress and maternal hypotension
✔✔ Answer✔✔ A
Rationale: Placenta previa presents with painless, bright red bleeding. Abruptio placentae presents with
painful, dark bleeding and uterine tenderness.
10. A nurse is assessing a client who is 2 hours postpartum. The client’s fundus is firm, midline, and at
the level of the umbilicus. Which of the following actions is appropriate?
• A) Massage the fundus.
• B) Notify the provider.
• C) Document the finding.
• D) Assist the client to void.
✔✔ Answer✔✔ C
Rationale: At 2 hours postpartum, a firm fundus at the umbilicus is expected. Massage is not needed
unless the fundus is boggy. Voiding may be needed if the fundus is displaced, but this finding is normal.
11. A nurse is caring for a client who is receiving oxytocin for labor augmentation. Which of the following
is a contraindication to oxytocin use?
• A) Gestational hypertension
• B) Premature rupture of membranes
• C) Previous cesarean section
• D) Placenta previa
✔✔ Answer✔✔ D
Rationale: Oxytocin is contraindicated in placenta previa because uterine contractions can cause massive
hemorrhage. Previous cesarean section is not an absolute contraindication (TOLAC may be attempted).
NUR 2513 Maternal Child Nursing Exam 2
2025/2026 | Actual Exam | Comprehensive
Maternal-Child
This practice examination is designed to reflect the content and difficulty of the NUR 2513 Maternal
Child Nursing Exam 2. It covers key topics including labor and delivery, intrapartum complications,
postpartum care, newborn assessment, and common maternal-newborn conditions. Each question
includes the correct answer and a detailed rationale to reinforce understanding.
Section 1: Intrapartum Nursing
1. A nurse is assessing a client in active labor. The fetal heart rate (FHR) baseline is 140 bpm with
moderate variability. The nurse notes several late decelerations. Which of the following is the priority
nursing action?
• A) Increase the rate of the IV fluid.
• B) Position the client on her left side.
• C) Administer oxygen at 10 L/min via non-rebreather mask.
• D) Notify the provider.
✔✔ Answer✔✔ B
Rationale: Late decelerations indicate uteroplacental insufficiency. The first action is to change maternal
position (left lateral) to improve placental perfusion. After positioning, administer oxygen and increase IV
fluids, then notify the provider if decelerations persist.
2. A client at 39 weeks gestation is receiving oxytocin (Pitocin) for induction of labor. The nurse notes
that the uterine contractions are lasting 100 seconds with a frequency of 1.5 minutes. Which of the
following is the priority action?
• A) Increase the oxytocin infusion rate.
• B) Place the client in a semi-Fowler’s position.
• C) Discontinue the oxytocin infusion.
• D) Document the findings as normal.
✔✔ Answer✔✔ C
Rationale: Uterine tachysystole (contractions lasting >90 seconds or frequency <2 minutes) can
,2
compromise fetal oxygenation. Oxytocin should be discontinued immediately. The provider should be
notified.
3. A nurse is assessing a client in labor. The client’s cervix is 6 cm dilated, 90% effaced, and the
presenting part is at 0 station. Which of the following phases of labor is the client experiencing?
• A) Latent phase
• B) Active phase
• C) Transition phase
• D) Second stage
✔✔ Answer✔✔ B
Rationale: The active phase of the first stage of labor is characterized by cervical dilation from 4-7 cm.
Transition is 8-10 cm. Second stage begins at full dilation (10 cm).
4. A nurse is assessing the fetal heart rate tracing and notes variable decelerations that have a “V” shape
and return to baseline quickly. Which of the following is the most likely cause?
• A) Uteroplacental insufficiency
• B) Head compression
• C) Cord compression
• D) Maternal hypotension
✔✔ Answer✔✔ C
Rationale: Variable decelerations are typically caused by umbilical cord compression. Late decelerations
are caused by uteroplacental insufficiency; early decelerations by head compression.
5. A nurse is caring for a client who is receiving epidural anesthesia. Which of the following findings
should the nurse report to the provider immediately?
• A) Maternal temperature of 37.5°C (99.5°F)
• B) Blood pressure of 100/60 mmHg
• C) Maternal report of pruritus
• D) Respiratory rate of 10 breaths/min
✔✔ Answer✔✔ D
Rationale: Respiratory depression (rate <12) can occur with epidural opioids or ascending anesthesia.
,3
This is a medical emergency requiring immediate intervention. Pruritus is common with opioids; a slight
drop in BP is expected; low-grade fever may be normal.
6. A nurse is performing a vaginal examination on a client in labor. The nurse palpates the fetal skull
sutures and fontanels. Which of the following findings indicates the fetal position is occiput posterior?
• A) The anterior fontanel is palpable on the left side.
• B) The posterior fontanel is palpable in the anterior position.
• C) The sagittal suture is transverse.
• D) The anterior fontanel is diamond-shaped and located anteriorly.
✔✔ Answer✔✔ B
Rationale: In occiput posterior position, the posterior fontanel (triangular) is located toward the anterior
(pubic symphysis). The anterior fontanel is diamond-shaped and larger; in occiput anterior, the posterior
fontanel is posterior.
7. A client in active labor requests pain relief. The nurse notes that the client’s cervix is 8 cm dilated and
100% effaced. The nurse should anticipate which of the following?
• A) Administration of an epidural.
• B) Administration of IV opioids.
• C) Preparation for delivery.
• D) Administration of a spinal block.
✔✔ Answer✔✔ C
Rationale: The transition phase (8-10 cm) indicates that the second stage is approaching. Epidural or
spinal anesthesia may be administered earlier in labor; at this point, the client may be close to delivery.
8. A nurse is monitoring a client receiving magnesium sulfate for preeclampsia. Which of the following
findings indicates magnesium toxicity?
• A) Respiratory rate of 16 breaths/min
• B) Deep tendon reflexes 2+
• C) Urine output of 30 mL/hour
• D) Absent deep tendon reflexes
✔✔ Answer✔✔ D
*Rationale: Magnesium toxicity causes loss of deep tendon reflexes (hyporeflexia), respiratory
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depression, and decreased urine output. Normal reflexes are 2+; normal urine output is ≥30 mL/hour;
respiratory rate <12 is concerning.*
9. A nurse is caring for a client with a diagnosis of placenta previa. Which of the following findings
should the nurse expect?
• A) Painless, bright red vaginal bleeding
• B) Severe abdominal pain with dark red bleeding
• C) Uterine tenderness and hypertonus
• D) Fetal distress and maternal hypotension
✔✔ Answer✔✔ A
Rationale: Placenta previa presents with painless, bright red bleeding. Abruptio placentae presents with
painful, dark bleeding and uterine tenderness.
10. A nurse is assessing a client who is 2 hours postpartum. The client’s fundus is firm, midline, and at
the level of the umbilicus. Which of the following actions is appropriate?
• A) Massage the fundus.
• B) Notify the provider.
• C) Document the finding.
• D) Assist the client to void.
✔✔ Answer✔✔ C
Rationale: At 2 hours postpartum, a firm fundus at the umbilicus is expected. Massage is not needed
unless the fundus is boggy. Voiding may be needed if the fundus is displaced, but this finding is normal.
11. A nurse is caring for a client who is receiving oxytocin for labor augmentation. Which of the following
is a contraindication to oxytocin use?
• A) Gestational hypertension
• B) Premature rupture of membranes
• C) Previous cesarean section
• D) Placenta previa
✔✔ Answer✔✔ D
Rationale: Oxytocin is contraindicated in placenta previa because uterine contractions can cause massive
hemorrhage. Previous cesarean section is not an absolute contraindication (TOLAC may be attempted).
