NR 465 Exam 3 Maternal Newborn Nursing
V2 Questions and Answers 2026 | Regis
University Study Guide | Verified Solutions
PDF
NR 465 EXAM 3 MATERNAL NEWBORN NURSING V2 - REGIS UNIVERSITY
COMPREHENSIVE STUDY GUIDE | VERIFIED QUESTIONS
DOCUMENT OVERVIEW
• This comprehensive question exam covers all essential maternal-newborn nursing
content including pregnancy physiology, labor/delivery management, postpartum
care, newborn assessment, high-risk conditions, and clinical decision-making
required for RN competency.
• Use this guide to identify knowledge gaps through systematic review, reinforce
clinical priorities through repeated practice, and build confidence in applying
maternal-newborn concepts to real-world patient scenarios.
QUESTION 1
A 28-year-old primigravida presents at 10 weeks gestation with complaint of
nausea and vomiting. Which of the following physiological changes is
responsible for morning sickness during early pregnancy?
A) Decreased gastric motility and relaxation of the esophageal sphincter
B) Increased levels of human chorionic gonadotropin (hCG) and altered taste
perception
C) Elevated progesterone causing delayed gastric emptying
D) Decreased stomach acid production and increased gastric pH
E) Rapid increase in estrogen levels causing esophageal irritation
✓ B) Increased levels of human chorionic gonadotropin (hCG) and altered
taste perception
,Morning sickness is primarily attributed to elevated hCG levels in early pregnancy,
which peaks between 8-12 weeks gestation. hCG directly stimulates the
chemoreceptor trigger zone in the brain, triggering nausea and vomiting.
Additionally, pregnant women experience altered taste perception (dysgeusia),
where metallic tastes are common. While progesterone does relax smooth muscle,
this occurs later and contributes more to constipation than nausea. This timing and
mechanism make hCG the primary culprit in first-trimester nausea.
QUESTION 2
A 32-year-old multiparous woman at 22 weeks gestation reports sudden onset
of severe abdominal pain and vaginal bleeding. What is the priority nursing
action?
A) Encourage ambulation to assess fetal heart tones
B) Place client in left lateral position and establish IV access for potential emergent
intervention
C) Obtain a detailed history of the bleeding characteristics
D) Perform a thorough vaginal examination to determine cervical dilation
E) Administer oxygen at 2 L/min and monitor vital signs
✓ B) Place client in left lateral position and establish IV access for potential
emergent intervention
This clinical presentation suggests possible placental abruption or other obstetric
emergency. The priority is to stabilize the mother by establishing IV access for fluid
resuscitation and medication administration. The left lateral position optimizes
placental perfusion by relieving aortocaval compression caused by the gravid
uterus. This positioning improves cardiac output and uterine blood flow. A vaginal
exam is contraindicated until placenta previa is ruled out via ultrasound.
Ambulation is dangerous with heavy bleeding and acute abdominal pain. Oxygen
may be needed but IV access takes priority.
,QUESTION 3
During a prenatal visit at 28 weeks gestation, a client's blood pressure is
158/102 mmHg with 2+ proteinuria and complaint of right upper quadrant
pain. Which laboratory finding would most strongly suggest preeclampsia
with severe features?
A) Platelet count of 150,000/μL
B) Serum creatinine of 0.8 mg/dL
C) Platelet count of 80,000/μL with elevated liver enzymes (AST 120 U/L)
D) Hemoglobin of 11.5 g/dL
E) Serum albumin of 3.2 g/dL
✓ C) Platelet count of 80,000/μL with elevated liver enzymes (AST 120 U/L)
This combination indicates HELLP syndrome (Hemolysis, Elevated Liver enzymes,
Low Platelets), which represents preeclampsia with severe features. Platelet counts
below 100,000/μL (thrombocytopenia) and elevated liver enzymes reflect the
microangiopathic hemolytic anemia characteristic of severe preeclampsia. The right
upper quadrant pain indicates hepatic subcapsular edema or hemorrhage, a
medical emergency. While a normal creatinine and mild anemia are common in
pregnancy, they do not indicate severe disease. Albumin of 3.2 g/dL reflects only
mild hypoproteinemia.
QUESTION 4
A 24-year-old G2P1 at 16 weeks gestation asks about the purpose of the
maternal serum quad screen. Which statement best explains this screening
test?
A) It definitively diagnoses chromosomal abnormalities and fetal malformations
B) It measures four maternal serum markers to calculate risk for Down syndrome,
Edwards syndrome, and neural tube defects
C) It requires amniocentesis to obtain fetal cells for analysis
, D) It provides information about maternal kidney and liver function during
pregnancy
E) It screens for gestational diabetes and maternal glucose intolerance
✓ B) It measures four maternal serum markers to calculate risk for Down
syndrome, Edwards syndrome, and neural tube defects
The quad screen (quadruple marker screen) performed between 15-22 weeks
measures: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG),
unconjugated estriol (uE3), and inhibin A. These markers combined with maternal
age calculate risk for Down syndrome (Trisomy 21), Edwards syndrome (Trisomy
18), and neural tube defects. This is a SCREENING test, not diagnostic—it identifies
which pregnancies warrant further testing like amniocentesis. The results help
guide counseling and decision-making but do not confirm diagnoses. This is distinct
from glucose screening and does not assess maternal organ function.
QUESTION 5
A pregnant client at 30 weeks gestation reports sudden onset of shortness of
breath, chest pain, and tachycardia. The nurse suspects amniotic fluid
embolism (AFE). Which pathophysiological mechanism best explains the
client's respiratory distress?
A) Amniotic fluid enters the maternal systemic circulation, triggering anaphylactic-
type reaction and pulmonary vasoconstriction
B) Excess amniotic fluid causes increased intravascular pressure in the lungs
C) Dehydration from increased insensible losses reduces pulmonary perfusion
D) Compression of the diaphragm by the gravid uterus restricts lung expansion
E) Severe anxiety and hyperventilation deplete maternal oxygen reserves
✓ A) Amniotic fluid enters the maternal systemic circulation, triggering
anaphylactic-type reaction and pulmonary vasoconstriction
V2 Questions and Answers 2026 | Regis
University Study Guide | Verified Solutions
NR 465 EXAM 3 MATERNAL NEWBORN NURSING V2 - REGIS UNIVERSITY
COMPREHENSIVE STUDY GUIDE | VERIFIED QUESTIONS
DOCUMENT OVERVIEW
• This comprehensive question exam covers all essential maternal-newborn nursing
content including pregnancy physiology, labor/delivery management, postpartum
care, newborn assessment, high-risk conditions, and clinical decision-making
required for RN competency.
• Use this guide to identify knowledge gaps through systematic review, reinforce
clinical priorities through repeated practice, and build confidence in applying
maternal-newborn concepts to real-world patient scenarios.
QUESTION 1
A 28-year-old primigravida presents at 10 weeks gestation with complaint of
nausea and vomiting. Which of the following physiological changes is
responsible for morning sickness during early pregnancy?
A) Decreased gastric motility and relaxation of the esophageal sphincter
B) Increased levels of human chorionic gonadotropin (hCG) and altered taste
perception
C) Elevated progesterone causing delayed gastric emptying
D) Decreased stomach acid production and increased gastric pH
E) Rapid increase in estrogen levels causing esophageal irritation
✓ B) Increased levels of human chorionic gonadotropin (hCG) and altered
taste perception
,Morning sickness is primarily attributed to elevated hCG levels in early pregnancy,
which peaks between 8-12 weeks gestation. hCG directly stimulates the
chemoreceptor trigger zone in the brain, triggering nausea and vomiting.
Additionally, pregnant women experience altered taste perception (dysgeusia),
where metallic tastes are common. While progesterone does relax smooth muscle,
this occurs later and contributes more to constipation than nausea. This timing and
mechanism make hCG the primary culprit in first-trimester nausea.
QUESTION 2
A 32-year-old multiparous woman at 22 weeks gestation reports sudden onset
of severe abdominal pain and vaginal bleeding. What is the priority nursing
action?
A) Encourage ambulation to assess fetal heart tones
B) Place client in left lateral position and establish IV access for potential emergent
intervention
C) Obtain a detailed history of the bleeding characteristics
D) Perform a thorough vaginal examination to determine cervical dilation
E) Administer oxygen at 2 L/min and monitor vital signs
✓ B) Place client in left lateral position and establish IV access for potential
emergent intervention
This clinical presentation suggests possible placental abruption or other obstetric
emergency. The priority is to stabilize the mother by establishing IV access for fluid
resuscitation and medication administration. The left lateral position optimizes
placental perfusion by relieving aortocaval compression caused by the gravid
uterus. This positioning improves cardiac output and uterine blood flow. A vaginal
exam is contraindicated until placenta previa is ruled out via ultrasound.
Ambulation is dangerous with heavy bleeding and acute abdominal pain. Oxygen
may be needed but IV access takes priority.
,QUESTION 3
During a prenatal visit at 28 weeks gestation, a client's blood pressure is
158/102 mmHg with 2+ proteinuria and complaint of right upper quadrant
pain. Which laboratory finding would most strongly suggest preeclampsia
with severe features?
A) Platelet count of 150,000/μL
B) Serum creatinine of 0.8 mg/dL
C) Platelet count of 80,000/μL with elevated liver enzymes (AST 120 U/L)
D) Hemoglobin of 11.5 g/dL
E) Serum albumin of 3.2 g/dL
✓ C) Platelet count of 80,000/μL with elevated liver enzymes (AST 120 U/L)
This combination indicates HELLP syndrome (Hemolysis, Elevated Liver enzymes,
Low Platelets), which represents preeclampsia with severe features. Platelet counts
below 100,000/μL (thrombocytopenia) and elevated liver enzymes reflect the
microangiopathic hemolytic anemia characteristic of severe preeclampsia. The right
upper quadrant pain indicates hepatic subcapsular edema or hemorrhage, a
medical emergency. While a normal creatinine and mild anemia are common in
pregnancy, they do not indicate severe disease. Albumin of 3.2 g/dL reflects only
mild hypoproteinemia.
QUESTION 4
A 24-year-old G2P1 at 16 weeks gestation asks about the purpose of the
maternal serum quad screen. Which statement best explains this screening
test?
A) It definitively diagnoses chromosomal abnormalities and fetal malformations
B) It measures four maternal serum markers to calculate risk for Down syndrome,
Edwards syndrome, and neural tube defects
C) It requires amniocentesis to obtain fetal cells for analysis
, D) It provides information about maternal kidney and liver function during
pregnancy
E) It screens for gestational diabetes and maternal glucose intolerance
✓ B) It measures four maternal serum markers to calculate risk for Down
syndrome, Edwards syndrome, and neural tube defects
The quad screen (quadruple marker screen) performed between 15-22 weeks
measures: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG),
unconjugated estriol (uE3), and inhibin A. These markers combined with maternal
age calculate risk for Down syndrome (Trisomy 21), Edwards syndrome (Trisomy
18), and neural tube defects. This is a SCREENING test, not diagnostic—it identifies
which pregnancies warrant further testing like amniocentesis. The results help
guide counseling and decision-making but do not confirm diagnoses. This is distinct
from glucose screening and does not assess maternal organ function.
QUESTION 5
A pregnant client at 30 weeks gestation reports sudden onset of shortness of
breath, chest pain, and tachycardia. The nurse suspects amniotic fluid
embolism (AFE). Which pathophysiological mechanism best explains the
client's respiratory distress?
A) Amniotic fluid enters the maternal systemic circulation, triggering anaphylactic-
type reaction and pulmonary vasoconstriction
B) Excess amniotic fluid causes increased intravascular pressure in the lungs
C) Dehydration from increased insensible losses reduces pulmonary perfusion
D) Compression of the diaphragm by the gravid uterus restricts lung expansion
E) Severe anxiety and hyperventilation deplete maternal oxygen reserves
✓ A) Amniotic fluid enters the maternal systemic circulation, triggering
anaphylactic-type reaction and pulmonary vasoconstriction
