NURS240 MATERNAL-NEWBORN NURSING
2026 | PRACTICE EXAM QUESTIONS &
VERIFIED ANSWERS | MATERNITY AND
NEONATAL NURSING STUDY GUIDE PDF
NURS240 MATERNAL-NEWBORN NURSING 2026
PRACTICE EXAM QUESTIONS & VERIFIED ANSWERS
DOCUMENT OVERVIEW:
• This comprehensive question study guide is designed to assess your mastery of
maternal-newborn nursing concepts across antepartum, intrapartum, postpartum,
and neonatal care phases—use it to identify knowledge gaps, practice critical
thinking, and build confidence for clinical exams and certification.
• Study this material by reviewing questions daily in sections (20-30 questions per
session), focusing on EXPERT RATIONALE to understand the "why" behind each
correct answer rather than memorizing answers.
1. A primigravida client at 10 weeks gestation presents to the prenatal clinic
reporting morning sickness and fatigue. Which assessment finding is most
consistent with expected physiological changes of early pregnancy?
A) Decreased plasma volume with increased hemoglobin concentration
B) Expanded plasma volume with decreased hemoglobin concentration
C) Increased glomerular filtration rate with elevated serum creatinine
D) Decreased cardiac output with reduced heart rate
E) Increased red blood cell count with decreased white blood cells
CORRECT ANSWER: B) Expanded plasma volume with decreased hemoglobin
concentration
,EXPERT RATIONALE: During early pregnancy, plasma volume begins to expand
(increased 40-50% by term) to meet the metabolic demands of pregnancy and the
developing fetus. This physiological expansion occurs before increased red blood
cell production, resulting in a dilutional anemia and decreased hemoglobin
concentration. This is a normal adaptation and explains the mild anemia common
in pregnancy. Options A, C, D, and E reflect pathological rather than normal
physiological changes.
2. A 28-year-old client at 16 weeks gestation reports sudden onset of severe
right lower quadrant abdominal pain with vaginal spotting. The nurse
suspects an ectopic pregnancy. Which clinical finding would most strongly
support this diagnosis?
A) Elevated beta-hCG levels that are appropriate for gestational age
B) Elevated beta-hCG levels that are lower than expected for gestational age
C) Normal pelvic ultrasound with intrauterine pregnancy confirmed
D) Positive Chadwick's sign with bluish cervix
E) Presence of Braxton-Hicks contractions on examination
CORRECT ANSWER: B) Elevated beta-hCG levels that are lower than expected
for gestational age
EXPERT RATIONALE: In an ectopic pregnancy, beta-hCG levels rise more slowly
than in a normal intrauterine pregnancy because the ectopic tissue produces less
hormone. Subnormal hCG levels for gestational age are a key diagnostic indicator
of ectopic pregnancy or threatened miscarriage. A normal pelvic ultrasound would
rule out ectopic pregnancy, elevated appropriate hCG suggests normal pregnancy,
Chadwick's sign is a normal finding, and Braxton-Hicks contractions are not
associated with ectopic pregnancy.
,3. A pregnant client at 24 weeks gestation asks about the purpose of the
glucose tolerance test (GTT) recommended at this stage. Which explanation
by the nurse is most accurate?
A) To screen for gestational diabetes mellitus by measuring fasting glucose levels
B) To screen for gestational diabetes mellitus using a 50-gram glucose challenge
without fasting
C) To diagnose type 2 diabetes mellitus present before pregnancy
D) To assess the fetus's ability to metabolize glucose
E) To determine if insulin therapy will be needed throughout pregnancy
CORRECT ANSWER: B) To screen for gestational diabetes mellitus using a 50-
gram glucose challenge without fasting
EXPERT RATIONALE: The initial GTT screening at 24-28 weeks uses a 50-gram
glucose challenge without fasting. This is a screening test (not diagnostic) with
results >140 mg/dL requiring follow-up with the 3-hour glucose tolerance test. A
fasting glucose level is used differently in diagnostic testing. Type 2 diabetes
assessment uses different criteria, the fetus does not have independent glucose
metabolism at this stage, and insulin need is not determined by a single GTT result.
4. A 32-year-old G2P1 client is at 30 weeks gestation with a diagnosis of
preeclampsia without severe features. Which nursing intervention should be
the priority?
A) Administer magnesium sulfate 4-6 grams IV bolus immediately
B) Perform a 24-hour urine collection for total protein
C) Maintain bed rest with left lateral positioning and monitor vital signs and urine
output
D) Prepare client for immediate delivery via cesarean section
E) Administer nifedipine 10 mg sublingual for immediate blood pressure control
, CORRECT ANSWER: C) Maintain bed rest with left lateral positioning and
monitor vital signs and urine output
EXPERT RATIONALE: For preeclampsia without severe features at 30 weeks,
conservative management is indicated including bed rest, left lateral positioning
(optimizes placental perfusion), and close monitoring of vital signs and urine output
to detect progression to severe features. Magnesium sulfate is given for severe
features or seizure prophylaxis. A 24-hour urine is diagnostic, not interventional.
Immediate delivery is not indicated at 30 weeks without severe features, and
sublingual nifedipine is not standard first-line therapy.
5. A client at 8 weeks gestation presents with sharp right lower quadrant
pain, vaginal spotting, and positive pregnancy test. Transvaginal ultrasound
shows no intrauterine pregnancy. Which intervention should the nurse
anticipate?
A) Immediate surgical intervention and laparoscopy
B) Expectant management with serial beta-hCG monitoring and ultrasound follow-
up
C) Immediate administration of high-dose oral methotrexate
D) Pelvic rest and acetaminophen for pain management
E) Referral for abortion services
CORRECT ANSWER: B) Expectant management with serial beta-hCG
monitoring and ultrasound follow-up
EXPERT RATIONALE: For unruptured ectopic pregnancy with hemodynamic
stability, expectant management with serial beta-hCG levels (should decline
appropriately) and follow-up ultrasound is appropriate first-line management.
Surgical intervention (Option A) is reserved for rupture or hemodynamic instability.
Methotrexate (Option C) may be used but requires specific candidacy criteria. Pelvic
rest alone is inadequate, and abortion services are inappropriate for ectopic
pregnancy management.
2026 | PRACTICE EXAM QUESTIONS &
VERIFIED ANSWERS | MATERNITY AND
NEONATAL NURSING STUDY GUIDE PDF
NURS240 MATERNAL-NEWBORN NURSING 2026
PRACTICE EXAM QUESTIONS & VERIFIED ANSWERS
DOCUMENT OVERVIEW:
• This comprehensive question study guide is designed to assess your mastery of
maternal-newborn nursing concepts across antepartum, intrapartum, postpartum,
and neonatal care phases—use it to identify knowledge gaps, practice critical
thinking, and build confidence for clinical exams and certification.
• Study this material by reviewing questions daily in sections (20-30 questions per
session), focusing on EXPERT RATIONALE to understand the "why" behind each
correct answer rather than memorizing answers.
1. A primigravida client at 10 weeks gestation presents to the prenatal clinic
reporting morning sickness and fatigue. Which assessment finding is most
consistent with expected physiological changes of early pregnancy?
A) Decreased plasma volume with increased hemoglobin concentration
B) Expanded plasma volume with decreased hemoglobin concentration
C) Increased glomerular filtration rate with elevated serum creatinine
D) Decreased cardiac output with reduced heart rate
E) Increased red blood cell count with decreased white blood cells
CORRECT ANSWER: B) Expanded plasma volume with decreased hemoglobin
concentration
,EXPERT RATIONALE: During early pregnancy, plasma volume begins to expand
(increased 40-50% by term) to meet the metabolic demands of pregnancy and the
developing fetus. This physiological expansion occurs before increased red blood
cell production, resulting in a dilutional anemia and decreased hemoglobin
concentration. This is a normal adaptation and explains the mild anemia common
in pregnancy. Options A, C, D, and E reflect pathological rather than normal
physiological changes.
2. A 28-year-old client at 16 weeks gestation reports sudden onset of severe
right lower quadrant abdominal pain with vaginal spotting. The nurse
suspects an ectopic pregnancy. Which clinical finding would most strongly
support this diagnosis?
A) Elevated beta-hCG levels that are appropriate for gestational age
B) Elevated beta-hCG levels that are lower than expected for gestational age
C) Normal pelvic ultrasound with intrauterine pregnancy confirmed
D) Positive Chadwick's sign with bluish cervix
E) Presence of Braxton-Hicks contractions on examination
CORRECT ANSWER: B) Elevated beta-hCG levels that are lower than expected
for gestational age
EXPERT RATIONALE: In an ectopic pregnancy, beta-hCG levels rise more slowly
than in a normal intrauterine pregnancy because the ectopic tissue produces less
hormone. Subnormal hCG levels for gestational age are a key diagnostic indicator
of ectopic pregnancy or threatened miscarriage. A normal pelvic ultrasound would
rule out ectopic pregnancy, elevated appropriate hCG suggests normal pregnancy,
Chadwick's sign is a normal finding, and Braxton-Hicks contractions are not
associated with ectopic pregnancy.
,3. A pregnant client at 24 weeks gestation asks about the purpose of the
glucose tolerance test (GTT) recommended at this stage. Which explanation
by the nurse is most accurate?
A) To screen for gestational diabetes mellitus by measuring fasting glucose levels
B) To screen for gestational diabetes mellitus using a 50-gram glucose challenge
without fasting
C) To diagnose type 2 diabetes mellitus present before pregnancy
D) To assess the fetus's ability to metabolize glucose
E) To determine if insulin therapy will be needed throughout pregnancy
CORRECT ANSWER: B) To screen for gestational diabetes mellitus using a 50-
gram glucose challenge without fasting
EXPERT RATIONALE: The initial GTT screening at 24-28 weeks uses a 50-gram
glucose challenge without fasting. This is a screening test (not diagnostic) with
results >140 mg/dL requiring follow-up with the 3-hour glucose tolerance test. A
fasting glucose level is used differently in diagnostic testing. Type 2 diabetes
assessment uses different criteria, the fetus does not have independent glucose
metabolism at this stage, and insulin need is not determined by a single GTT result.
4. A 32-year-old G2P1 client is at 30 weeks gestation with a diagnosis of
preeclampsia without severe features. Which nursing intervention should be
the priority?
A) Administer magnesium sulfate 4-6 grams IV bolus immediately
B) Perform a 24-hour urine collection for total protein
C) Maintain bed rest with left lateral positioning and monitor vital signs and urine
output
D) Prepare client for immediate delivery via cesarean section
E) Administer nifedipine 10 mg sublingual for immediate blood pressure control
, CORRECT ANSWER: C) Maintain bed rest with left lateral positioning and
monitor vital signs and urine output
EXPERT RATIONALE: For preeclampsia without severe features at 30 weeks,
conservative management is indicated including bed rest, left lateral positioning
(optimizes placental perfusion), and close monitoring of vital signs and urine output
to detect progression to severe features. Magnesium sulfate is given for severe
features or seizure prophylaxis. A 24-hour urine is diagnostic, not interventional.
Immediate delivery is not indicated at 30 weeks without severe features, and
sublingual nifedipine is not standard first-line therapy.
5. A client at 8 weeks gestation presents with sharp right lower quadrant
pain, vaginal spotting, and positive pregnancy test. Transvaginal ultrasound
shows no intrauterine pregnancy. Which intervention should the nurse
anticipate?
A) Immediate surgical intervention and laparoscopy
B) Expectant management with serial beta-hCG monitoring and ultrasound follow-
up
C) Immediate administration of high-dose oral methotrexate
D) Pelvic rest and acetaminophen for pain management
E) Referral for abortion services
CORRECT ANSWER: B) Expectant management with serial beta-hCG
monitoring and ultrasound follow-up
EXPERT RATIONALE: For unruptured ectopic pregnancy with hemodynamic
stability, expectant management with serial beta-hCG levels (should decline
appropriately) and follow-up ultrasound is appropriate first-line management.
Surgical intervention (Option A) is reserved for rupture or hemodynamic instability.
Methotrexate (Option C) may be used but requires specific candidacy criteria. Pelvic
rest alone is inadequate, and abortion services are inappropriate for ectopic
pregnancy management.
