RNSG 1517 Maternity Exam | Concept Study Guide & Clinical
Practice Questions (Latest 2026-2028)
Pass your RNSG 1517 Maternity Assessment on your very first attempt with this
comprehensive, high-yield nursing study package. This clinical resource delivers a deep
dive into maternal-newborn concepts, including stages of labor, fetal monitoring
patterns, postpartum complications, and neonatal assessment parameters. Eliminate
testing anxiety and master high-stakes NCLEX-style priority items using realistic
obstetrical vignettes modeled directly after the official nursing curriculum blueprint.
1. A client at 39 weeks gestation is in active labor. The nurse notes that the fetal
heart rate baseline is 135 bpm with moderate variability and occasional early
decelerations. Which of the following is the most appropriate nursing action?
• A) Notify the provider immediately
• B) Continue to monitor; these are reassuring findings
• C) Administer oxygen via face mask
• D) Prepare for an emergency cesarean section
Correct Answer: B) Continue to monitor; these are reassuring findings
Rationale: A fetal heart rate of 135 bpm is within the normal range (110-160 bpm).
Moderate variability (6-25 bpm amplitude) is reassuring and indicates an intact fetal
nervous system. Early decelerations are benign and caused by fetal head compression. No
intervention is needed; continued monitoring is appropriate.
2. A client at 32 weeks gestation is diagnosed with preeclampsia. Which of the
following laboratory findings would indicate the presence of HELLP syndrome?
• A) Elevated platelet count
• B) Decreased liver enzymes
• C) Hemolysis (elevated LDH and indirect bilirubin)
• D) Elevated serum glucose
Correct Answer: C) Hemolysis (elevated LDH and indirect bilirubin)
,Rationale: HELLP syndrome is characterized by Hemolysis (elevated LDH, indirect bilirubin,
low haptoglobin), Elevated Liver enzymes (AST, ALT), and Low Platelets (<100,000/mm³).
Hemolysis with elevated LDH and indirect bilirubin is a key finding. Platelets would be
decreased, not elevated, and liver enzymes would be elevated.
3. A postpartum client is 4 hours after a vaginal delivery. Her fundus is firm,
midline, and 1 cm above the umbilicus. She has saturated two perineal pads in the
last hour. What is the most appropriate nursing action?
• A) Document the findings as normal
• B) Massage the fundus vigorously
• C) Notify the provider immediately
• D) Administer oxytocin as ordered
Correct Answer: C) Notify the provider immediately
Rationale: Saturation of two perineal pads in one hour indicates excessive bleeding (>500
mL for vaginal delivery). A fundus 1 cm above the umbilicus is also slightly elevated. These
findings suggest possible postpartum hemorrhage. The provider should be notified
immediately, and the nurse should prepare for interventions (oxytocin, fundal massage,
etc.).
4. A client at 28 weeks gestation is Rh-negative and her partner is Rh-positive. She
has a negative antibody screen. Which of the following interventions is indicated
at this time?
• A) Administer RhIG (RhoGAM) at 28 weeks
• B) Administer RhIG within 72 hours of delivery only
• C) No intervention is needed if the antibody screen is negative
• D) Administer RhIG at 32 weeks
Correct Answer: A) Administer RhIG (RhoGAM) at 28 weeks
Rationale: Rh-negative clients with a negative antibody screen should receive RhIG at 28
weeks gestation to prevent maternal sensitization. RhIG should also be administered
,within 72 hours of delivery if the newborn is Rh-positive. The 28-week dose is a standard
prophylactic measure.
5. A client at 37 weeks gestation is in labor and has a history of a previous
cesarean section with a low transverse incision. She is attempting a vaginal birth
after cesarean (VBAC). Which of the following findings would indicate a uterine
rupture?
• A) Contractions every 2-3 minutes
• B) Fetal heart rate of 140 bpm with moderate variability
• C) Sudden cessation of contractions and severe abdominal pain
• D) Maternal blood pressure of 130/80 mmHg
Correct Answer: C) Sudden cessation of contractions and severe abdominal pain
Rationale: Signs of uterine rupture include sudden cessation of contractions (due to loss of
uterine integrity), severe abdominal pain, vaginal bleeding, fetal heart rate decelerations,
and signs of maternal hypovolemic shock. The client may also present with a change in
fetal station or palpation of fetal parts through the abdominal wall.
6. A newborn is 2 hours old and has a respiratory rate of 70 breaths per minute
with nasal flaring and grunting. What is the priority nursing action?
• A) Suction the airway
• B) Notify the provider immediately
• C) Place the newborn in a prone position
• D) Administer oxygen via nasal cannula
Correct Answer: B) Notify the provider immediately
Rationale: A respiratory rate of 70 bpm with nasal flaring and grunting indicates
respiratory distress. The provider should be notified immediately. Grunting is a sign of
alveolar collapse and the newborn is using expiratory pressure to maintain lung volume.
Oxygen and other interventions may be needed based on the provider's orders.
, 7. A client at 16 weeks gestation is scheduled for a maternal serum alpha-
fetoprotein (MSAFP) screening. An elevated MSAFP level is associated with which
of the following conditions?
• A) Down syndrome (Trisomy 21)
• B) Neural tube defects
• C) Trisomy 18
• D) Gestational diabetes
Correct Answer: B) Neural tube defects
Rationale: Elevated maternal serum alpha-fetoprotein (MSAFP) is associated with neural
tube defects (e.g., spina bifida, anencephaly) and abdominal wall defects (e.g.,
omphalocele, gastroschisis). Low MSAFP is associated with Down syndrome and trisomy
18. MSAFP is part of the triple or quad screen.
8. A client at 40 weeks gestation is in active labor. She has a cervix that is 7 cm
dilated, 100% effaced, and the fetus is at station +1. Which of the following is the
most appropriate nursing action?
• A) Prepare for delivery
• B) Encourage the client to push
• C) Continue to monitor; the client is in active labor
• D) Notify the provider of impending delivery
Correct Answer: C) Continue to monitor; the client is in active labor
Rationale: The client is in the active phase of labor (4-7 cm dilation). The fetus is at +1
station (1 cm below the ischial spines), which is engaged. There is no indication for
pushing (second stage begins at 10 cm) or immediate delivery. Continued monitoring is
appropriate.
Practice Questions (Latest 2026-2028)
Pass your RNSG 1517 Maternity Assessment on your very first attempt with this
comprehensive, high-yield nursing study package. This clinical resource delivers a deep
dive into maternal-newborn concepts, including stages of labor, fetal monitoring
patterns, postpartum complications, and neonatal assessment parameters. Eliminate
testing anxiety and master high-stakes NCLEX-style priority items using realistic
obstetrical vignettes modeled directly after the official nursing curriculum blueprint.
1. A client at 39 weeks gestation is in active labor. The nurse notes that the fetal
heart rate baseline is 135 bpm with moderate variability and occasional early
decelerations. Which of the following is the most appropriate nursing action?
• A) Notify the provider immediately
• B) Continue to monitor; these are reassuring findings
• C) Administer oxygen via face mask
• D) Prepare for an emergency cesarean section
Correct Answer: B) Continue to monitor; these are reassuring findings
Rationale: A fetal heart rate of 135 bpm is within the normal range (110-160 bpm).
Moderate variability (6-25 bpm amplitude) is reassuring and indicates an intact fetal
nervous system. Early decelerations are benign and caused by fetal head compression. No
intervention is needed; continued monitoring is appropriate.
2. A client at 32 weeks gestation is diagnosed with preeclampsia. Which of the
following laboratory findings would indicate the presence of HELLP syndrome?
• A) Elevated platelet count
• B) Decreased liver enzymes
• C) Hemolysis (elevated LDH and indirect bilirubin)
• D) Elevated serum glucose
Correct Answer: C) Hemolysis (elevated LDH and indirect bilirubin)
,Rationale: HELLP syndrome is characterized by Hemolysis (elevated LDH, indirect bilirubin,
low haptoglobin), Elevated Liver enzymes (AST, ALT), and Low Platelets (<100,000/mm³).
Hemolysis with elevated LDH and indirect bilirubin is a key finding. Platelets would be
decreased, not elevated, and liver enzymes would be elevated.
3. A postpartum client is 4 hours after a vaginal delivery. Her fundus is firm,
midline, and 1 cm above the umbilicus. She has saturated two perineal pads in the
last hour. What is the most appropriate nursing action?
• A) Document the findings as normal
• B) Massage the fundus vigorously
• C) Notify the provider immediately
• D) Administer oxytocin as ordered
Correct Answer: C) Notify the provider immediately
Rationale: Saturation of two perineal pads in one hour indicates excessive bleeding (>500
mL for vaginal delivery). A fundus 1 cm above the umbilicus is also slightly elevated. These
findings suggest possible postpartum hemorrhage. The provider should be notified
immediately, and the nurse should prepare for interventions (oxytocin, fundal massage,
etc.).
4. A client at 28 weeks gestation is Rh-negative and her partner is Rh-positive. She
has a negative antibody screen. Which of the following interventions is indicated
at this time?
• A) Administer RhIG (RhoGAM) at 28 weeks
• B) Administer RhIG within 72 hours of delivery only
• C) No intervention is needed if the antibody screen is negative
• D) Administer RhIG at 32 weeks
Correct Answer: A) Administer RhIG (RhoGAM) at 28 weeks
Rationale: Rh-negative clients with a negative antibody screen should receive RhIG at 28
weeks gestation to prevent maternal sensitization. RhIG should also be administered
,within 72 hours of delivery if the newborn is Rh-positive. The 28-week dose is a standard
prophylactic measure.
5. A client at 37 weeks gestation is in labor and has a history of a previous
cesarean section with a low transverse incision. She is attempting a vaginal birth
after cesarean (VBAC). Which of the following findings would indicate a uterine
rupture?
• A) Contractions every 2-3 minutes
• B) Fetal heart rate of 140 bpm with moderate variability
• C) Sudden cessation of contractions and severe abdominal pain
• D) Maternal blood pressure of 130/80 mmHg
Correct Answer: C) Sudden cessation of contractions and severe abdominal pain
Rationale: Signs of uterine rupture include sudden cessation of contractions (due to loss of
uterine integrity), severe abdominal pain, vaginal bleeding, fetal heart rate decelerations,
and signs of maternal hypovolemic shock. The client may also present with a change in
fetal station or palpation of fetal parts through the abdominal wall.
6. A newborn is 2 hours old and has a respiratory rate of 70 breaths per minute
with nasal flaring and grunting. What is the priority nursing action?
• A) Suction the airway
• B) Notify the provider immediately
• C) Place the newborn in a prone position
• D) Administer oxygen via nasal cannula
Correct Answer: B) Notify the provider immediately
Rationale: A respiratory rate of 70 bpm with nasal flaring and grunting indicates
respiratory distress. The provider should be notified immediately. Grunting is a sign of
alveolar collapse and the newborn is using expiratory pressure to maintain lung volume.
Oxygen and other interventions may be needed based on the provider's orders.
, 7. A client at 16 weeks gestation is scheduled for a maternal serum alpha-
fetoprotein (MSAFP) screening. An elevated MSAFP level is associated with which
of the following conditions?
• A) Down syndrome (Trisomy 21)
• B) Neural tube defects
• C) Trisomy 18
• D) Gestational diabetes
Correct Answer: B) Neural tube defects
Rationale: Elevated maternal serum alpha-fetoprotein (MSAFP) is associated with neural
tube defects (e.g., spina bifida, anencephaly) and abdominal wall defects (e.g.,
omphalocele, gastroschisis). Low MSAFP is associated with Down syndrome and trisomy
18. MSAFP is part of the triple or quad screen.
8. A client at 40 weeks gestation is in active labor. She has a cervix that is 7 cm
dilated, 100% effaced, and the fetus is at station +1. Which of the following is the
most appropriate nursing action?
• A) Prepare for delivery
• B) Encourage the client to push
• C) Continue to monitor; the client is in active labor
• D) Notify the provider of impending delivery
Correct Answer: C) Continue to monitor; the client is in active labor
Rationale: The client is in the active phase of labor (4-7 cm dilation). The fetus is at +1
station (1 cm below the ischial spines), which is engaged. There is no indication for
pushing (second stage begins at 10 cm) or immediate delivery. Continued monitoring is
appropriate.
