NURS240 MATERNAL-NEWBORN NURSING 2026 EXAM
PREP STUDY GUIDE| ACCURATE REAL EXAM QUESTION
AND ANSWERS | EXPERT VERIFIED FOR GUARANTEED
PASS | GRADED A
- This comprehensive study guide contains 300 practice scenarios designed to
prepare you for the NURS240 Maternal-Newborn Nursing exam, covering prenatal,
intrapartum, postpartum, and neonatal nursing care with detailed EXPERT RATIONALE for each
answer.
- Use this material by reviewing scenarios daily, focusing on weak topic areas,
and studying the EXPERT RATIONALE thoroughly to understand the "why" behind correct
answers—this strengthens critical thinking and clinical judgment
essential for safe maternal-newborn nursing practice.
SECTION 1: ANTEPARTUM NURSING (Prenatal Care & Pregnancy Complications)
Numbers 1–80
1. A 28-year-old primigravida at 12 weeks gestation presents for her first prenatal
visit. Which assessment is the priority at this initial visit?
A) Scheduling ultrasound for fetal anomaly screening
B) Establishing baseline vital signs and obstetric history
C) Performing Leopold maneuvers
D) Assessing fetal heart tones with Doppler
E) Discussing delivery preferences and birth plans
CORRECT ANSWER: B) Establishing baseline vital signs and obstetric history
EXPERT RATIONALE: The initial prenatal visit establishes a comprehensive baseline
for ongoing care. Vital signs and obstetric history are essential to identify risk
factors, calculate gestational age, and guide subsequent care. Leopold maneuvers
are performed later in pregnancy (third trimester). Fetal heart tones may not be
consistently audible by Doppler at 12 weeks. Delivery planning is important but
not the priority at the first visit.
1|Page
,2. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule
for a client whose last menstrual period (LMP) began on May 10. Which date is
correct?
A) February 3
B) February 17
C) March 3
D) March 17
E) April 3
CORRECT ANSWER: B) February 17
EXPERT RATIONALE: Naegele's rule: subtract 3 months from LMP and add 7 days.
May 10 → subtract 3 months = February 10 → add 7 days = February 17. This
calculation assumes a 28-day cycle and is a standard dating method.
3. A client at 16 weeks gestation asks about the purpose of the maternal serum
alpha-fetoprotein (MSAFP) screening. Which response by the nurse is most
accurate?
A) It confirms the baby's gender
B) It screens for neural tube defects and chromosomal abnormalities
C) It measures amniotic fluid volume
D) It evaluates fetal lung maturity
E) It detects maternal diabetes
CORRECT ANSWER: B) It screens for neural tube defects and chromosomal
abnormalities
EXPERT RATIONALE: MSAFP is a maternal blood test performed at 15–20 weeks to
screen for open neural tube defects (e.g., spina bifida) and chromosomal
abnormalities (e.g., Down syndrome). It is a screening tool, not diagnostic. Fetal
lung maturity is assessed via amniocentesis later in pregnancy.
4. A primigravida at 38 weeks gestation reports sudden, severe abdominal pain
with a rigid, board-like uterus. The fetal heart rate is 110 bpm with late
decelerations. Which condition should the nurse suspect first?
A) Normal labor contractions
B) Placental abruption
2|Page
,C) Uterine rupture
D) Preterm labor
E) Round ligament pain
CORRECT ANSWER: B) Placental abruption
EXPERT RATIONALE: Sudden severe abdominal pain with a board-like uterus and
fetal distress (late decelerations) are classic signs of placental abruption—
premature separation of the placenta from the uterine wall. Uterine rupture is
also possible but less common; abruption is the priority suspicion. Normal
contractions are not associated with a rigid abdomen or fetal distress.
5. A client at 24 weeks gestation has a positive 1-hour glucose challenge test
(GCT) with a result of 155 mg/dL. What is the nurse's next action?
A) Diagnose gestational diabetes
B) Schedule a 3-hour oral glucose tolerance test (OGTT)
C) Instruct the client to begin a low-carbohydrate diet
D) Repeat the 1-hour GCT in 2 weeks
E) Notify the provider for insulin prescription
CORRECT ANSWER: B) Schedule a 3-hour oral glucose tolerance test (OGTT)
EXPERT RATIONALE: A 1-hour GCT result of 130–140 mg/dL or higher (depending
on institution) is abnormal and requires follow-up with a 3-hour OGTT for
definitive diagnosis of gestational diabetes. Diagnosis is not made from the
screening test alone. Dietary changes and insulin are initiated only after
confirmation.
6. A client at 32 weeks gestation with preeclampsia is receiving magnesium
sulfate. Which assessment finding indicates magnesium toxicity requiring
immediate intervention?
A) Respiratory rate of 16 breaths/min
B) Urine output of 40 mL/hr
C) Deep tendon reflexes 2+
D) Serum magnesium level of 9 mEq/L
E) Blood pressure of 140/90 mmHg
CORRECT ANSWER: D) Serum magnesium level of 9 mEq/L
3|Page
, EXPERT RATIONALE: Therapeutic magnesium level is 4–7 mEq/L. A level of 9
mEq/L indicates toxicity. Signs include respiratory depression (<12 breaths/min),
absent reflexes, and oliguria (<30 mL/hr). Option A (16) is normal; B (40 mL/hr) is
adequate; C (2+) is normal; E is elevated but expected in preeclampsia.
7. A nurse is providing education to a client at 10 weeks gestation about common
discomforts of pregnancy. Which statement by the client indicates understanding
of managing nausea?
A) I should eat large meals three times a day
B) I will drink fluids with meals to stay hydrated
C) I should eat small, frequent meals and avoid greasy foods
D) I will lie down immediately after eating
E) I can take over-the-counter antiemetics daily
CORRECT ANSWER: C) I should eat small, frequent meals and avoid greasy foods
EXPERT RATIONALE: Small, frequent meals prevent hypoglycemia and gastric
distension, which worsen nausea. Avoiding greasy, spicy, or strong-smelling foods
is also helpful. Fluids should be taken between meals, not with meals, to reduce
gastric fullness. Lying down after eating promotes reflux. OTC antiemetics should
not be taken without provider approval.
8. A client at 20 weeks gestation reports quickening for the first time. What does
this finding indicate?
A) The fetus is in distress
B) The client is experiencing Braxton-Hicks contractions
C) The client is perceiving fetal movement
D) The client is experiencing round ligament pain
E) The fetus has engaged in the pelvis
CORRECT ANSWER: C) The client is perceiving fetal movement
EXPERT RATIONALE: Quickening is the maternal perception of fetal movement,
typically felt between 16–22 weeks in primigravidas and earlier in multigravidas. It
is a normal milestone indicating fetal viability and activity. It does not indicate
distress, contractions, or engagement.
4|Page
PREP STUDY GUIDE| ACCURATE REAL EXAM QUESTION
AND ANSWERS | EXPERT VERIFIED FOR GUARANTEED
PASS | GRADED A
- This comprehensive study guide contains 300 practice scenarios designed to
prepare you for the NURS240 Maternal-Newborn Nursing exam, covering prenatal,
intrapartum, postpartum, and neonatal nursing care with detailed EXPERT RATIONALE for each
answer.
- Use this material by reviewing scenarios daily, focusing on weak topic areas,
and studying the EXPERT RATIONALE thoroughly to understand the "why" behind correct
answers—this strengthens critical thinking and clinical judgment
essential for safe maternal-newborn nursing practice.
SECTION 1: ANTEPARTUM NURSING (Prenatal Care & Pregnancy Complications)
Numbers 1–80
1. A 28-year-old primigravida at 12 weeks gestation presents for her first prenatal
visit. Which assessment is the priority at this initial visit?
A) Scheduling ultrasound for fetal anomaly screening
B) Establishing baseline vital signs and obstetric history
C) Performing Leopold maneuvers
D) Assessing fetal heart tones with Doppler
E) Discussing delivery preferences and birth plans
CORRECT ANSWER: B) Establishing baseline vital signs and obstetric history
EXPERT RATIONALE: The initial prenatal visit establishes a comprehensive baseline
for ongoing care. Vital signs and obstetric history are essential to identify risk
factors, calculate gestational age, and guide subsequent care. Leopold maneuvers
are performed later in pregnancy (third trimester). Fetal heart tones may not be
consistently audible by Doppler at 12 weeks. Delivery planning is important but
not the priority at the first visit.
1|Page
,2. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule
for a client whose last menstrual period (LMP) began on May 10. Which date is
correct?
A) February 3
B) February 17
C) March 3
D) March 17
E) April 3
CORRECT ANSWER: B) February 17
EXPERT RATIONALE: Naegele's rule: subtract 3 months from LMP and add 7 days.
May 10 → subtract 3 months = February 10 → add 7 days = February 17. This
calculation assumes a 28-day cycle and is a standard dating method.
3. A client at 16 weeks gestation asks about the purpose of the maternal serum
alpha-fetoprotein (MSAFP) screening. Which response by the nurse is most
accurate?
A) It confirms the baby's gender
B) It screens for neural tube defects and chromosomal abnormalities
C) It measures amniotic fluid volume
D) It evaluates fetal lung maturity
E) It detects maternal diabetes
CORRECT ANSWER: B) It screens for neural tube defects and chromosomal
abnormalities
EXPERT RATIONALE: MSAFP is a maternal blood test performed at 15–20 weeks to
screen for open neural tube defects (e.g., spina bifida) and chromosomal
abnormalities (e.g., Down syndrome). It is a screening tool, not diagnostic. Fetal
lung maturity is assessed via amniocentesis later in pregnancy.
4. A primigravida at 38 weeks gestation reports sudden, severe abdominal pain
with a rigid, board-like uterus. The fetal heart rate is 110 bpm with late
decelerations. Which condition should the nurse suspect first?
A) Normal labor contractions
B) Placental abruption
2|Page
,C) Uterine rupture
D) Preterm labor
E) Round ligament pain
CORRECT ANSWER: B) Placental abruption
EXPERT RATIONALE: Sudden severe abdominal pain with a board-like uterus and
fetal distress (late decelerations) are classic signs of placental abruption—
premature separation of the placenta from the uterine wall. Uterine rupture is
also possible but less common; abruption is the priority suspicion. Normal
contractions are not associated with a rigid abdomen or fetal distress.
5. A client at 24 weeks gestation has a positive 1-hour glucose challenge test
(GCT) with a result of 155 mg/dL. What is the nurse's next action?
A) Diagnose gestational diabetes
B) Schedule a 3-hour oral glucose tolerance test (OGTT)
C) Instruct the client to begin a low-carbohydrate diet
D) Repeat the 1-hour GCT in 2 weeks
E) Notify the provider for insulin prescription
CORRECT ANSWER: B) Schedule a 3-hour oral glucose tolerance test (OGTT)
EXPERT RATIONALE: A 1-hour GCT result of 130–140 mg/dL or higher (depending
on institution) is abnormal and requires follow-up with a 3-hour OGTT for
definitive diagnosis of gestational diabetes. Diagnosis is not made from the
screening test alone. Dietary changes and insulin are initiated only after
confirmation.
6. A client at 32 weeks gestation with preeclampsia is receiving magnesium
sulfate. Which assessment finding indicates magnesium toxicity requiring
immediate intervention?
A) Respiratory rate of 16 breaths/min
B) Urine output of 40 mL/hr
C) Deep tendon reflexes 2+
D) Serum magnesium level of 9 mEq/L
E) Blood pressure of 140/90 mmHg
CORRECT ANSWER: D) Serum magnesium level of 9 mEq/L
3|Page
, EXPERT RATIONALE: Therapeutic magnesium level is 4–7 mEq/L. A level of 9
mEq/L indicates toxicity. Signs include respiratory depression (<12 breaths/min),
absent reflexes, and oliguria (<30 mL/hr). Option A (16) is normal; B (40 mL/hr) is
adequate; C (2+) is normal; E is elevated but expected in preeclampsia.
7. A nurse is providing education to a client at 10 weeks gestation about common
discomforts of pregnancy. Which statement by the client indicates understanding
of managing nausea?
A) I should eat large meals three times a day
B) I will drink fluids with meals to stay hydrated
C) I should eat small, frequent meals and avoid greasy foods
D) I will lie down immediately after eating
E) I can take over-the-counter antiemetics daily
CORRECT ANSWER: C) I should eat small, frequent meals and avoid greasy foods
EXPERT RATIONALE: Small, frequent meals prevent hypoglycemia and gastric
distension, which worsen nausea. Avoiding greasy, spicy, or strong-smelling foods
is also helpful. Fluids should be taken between meals, not with meals, to reduce
gastric fullness. Lying down after eating promotes reflux. OTC antiemetics should
not be taken without provider approval.
8. A client at 20 weeks gestation reports quickening for the first time. What does
this finding indicate?
A) The fetus is in distress
B) The client is experiencing Braxton-Hicks contractions
C) The client is perceiving fetal movement
D) The client is experiencing round ligament pain
E) The fetus has engaged in the pelvis
CORRECT ANSWER: C) The client is perceiving fetal movement
EXPERT RATIONALE: Quickening is the maternal perception of fetal movement,
typically felt between 16–22 weeks in primigravidas and earlier in multigravidas. It
is a normal milestone indicating fetal viability and activity. It does not indicate
distress, contractions, or engagement.
4|Page
