NURS240 MATERNAL-NEWBORN NURSING ULTIMATE EXAM PREP TEST BANK | FALL 2026–2027 UPDATED EDITION | 200+ NCLEX-RN & NEXT GENERATION NCLEX (NGN) QUESTIONS WITH DETAILED RATIONALES COVERING ANTEPARTUM, INTRAPARTUM, POSTPARTUM, NEWBORN CARE, HIGH-RISK OBSTETRIC

NURS240 MATERNAL-NEWBORN NURSING ULTIMATE EXAM PREP TEST BANK | FALL 2026–2027 UPDATED EDITION | 200+ NCLEX-RN & NEXT GENERATION NCLEX (NGN) QUESTIONS WITH DETAILED RATIONALES COVERING ANTEPARTUM, INTRAPARTUM, POSTPARTUM, NEWBORN CARE, HIGH-RISK OBSTETRICS, FETAL MONITORING, AND PHARMACOLOGY Question 1: A 32-week gestation patient presents with painless, bright red vaginal bleeding. The nurse should prepare for which diagnostic procedure to confirm the suspected diagnosis? A. Transvaginal ultrasound B. Digital cervical examination C. Non-stress test D. Amniocentesis CORRECT ANSWER: A. Transvaginal ultrasound Rationale: Painless bright red bleeding in the third trimester is classic for placenta previa. Digital cervical examination is contraindicated as it can cause massive hemorrhage. Transvaginal ultrasound is the gold standard for confirming placental location. ________________________________________ Question 2: A patient at 28 weeks gestation reports decreased fetal movement. Which initial nursing action is most appropriate? A. Administer a biophysical profile B. Have the patient drink orange juice and rest C. Immediately prepare for emergency cesarean D. Perform a non-stress test CORRECT ANSWER: B. Have the patient drink orange juice and rest Rationale: The initial intervention for decreased fetal movement is to have the mother eat or drink something with sugar and rest, then perform fetal kick counts. If the fetus remains inactive, further evaluation with NST or BPP is indicated. ________________________________________ Question 3: A patient in active labor has an epidural in place. Her blood pressure drops from 120/78 to 88/52 mmHg. What is the priority nursing action? A. Administer ephedrine 5 mg IV B. Place the patient in a left lateral position C. Increase the epidural infusion rate D. Notify the anesthesia provider CORRECT ANSWER: B. Place the patient in a left lateral position Rationale: Epidural analgesia can cause sympathetic blockade leading to hypotension. The immediate priority is to increase venous return by positioning the patient in a left lateral position or with a wedge under the right hip. This relieves aortocaval compression and improves blood pressure. ________________________________________ Question 4: A newborn is diagnosed with hyperbilirubinemia at 48 hours of life. Which finding would indicate pathological jaundice requiring immediate investigation? A. Serum bilirubin of 12 mg/dL B. Jaundice appearing at 24 hours of life C. Jaundice progressing from head to feet D. Conjugated bilirubin of 1.5 mg/dL CORRECT ANSWER: B. Jaundice appearing at 24 hours of life Rationale: Jaundice appearing within the first 24 hours of life is considered pathological and requires immediate investigation for hemolytic disease, sepsis, or other underlying pathology. Physiologic jaundice typically appears after 24 hours. ________________________________________ Question 5: A patient at 16 weeks gestation is scheduled for a maternal serum alpha-fetoprotein (MSAFP) screening. The nurse should instruct the patient that this test screens for which condition? A. Gestational diabetes B. Neural tube defects C. Preterm labor risk D. Preeclampsia CORRECT ANSWER: B. Neural tube defects Rationale: MSAFP screening between 15-20 weeks gestation is used to screen for neural tube defects such as spina bifida and anencephaly. Elevated levels may indicate open neural tube defects, while low levels may indicate chromosomal abnormalities. ________________________________________ Question 6: A patient is receiving magnesium sulfate for severe preeclampsia. Which assessment finding indicates magnesium toxicity? A. Respiratory rate of 14 breaths/min B. Urine output of 40 mL/hr C. Loss of deep tendon reflexes D. Serum magnesium level of 5 mEq/L CORRECT ANSWER: C. Loss of deep tendon reflexes Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, indicating the serum level has exceeded therapeutic range (4-7 mEq/L). Other signs include respiratory depression (12 breaths/min) and oliguria (30 mL/hr). The antidote is calcium gluconate. ________________________________________ Question 7: A patient at 40 weeks gestation is receiving an oxytocin infusion. The fetal heart rate shows late decelerations. What is the priority nursing action? A. Increase the oxytocin infusion rate B. Turn the patient to the left side C. Prepare for immediate cesarean delivery D. Administer IV fluids at a maintenance rate CORRECT ANSWER: B. Turn the patient to the left side Rationale: Late decelerations indicate uteroplacental insufficiency. The priority intervention is to improve placental perfusion by positioning the mother on her left side to relieve aortocaval compression. The oxytocin should be decreased or stopped, and oxygen should be administered. ________________________________________ Question 8: A postpartum patient who delivered 6 hours ago has a fundus that is boggy and displaced to the right. The nurse should first: A. Call the healthcare provider B. Administer oxytocin IV C. Assist the patient to void D. Perform fundal massage CORRECT ANSWER: D. Perform fundal massage Rationale: A boggy, displaced fundus in the immediate postpartum period is most commonly due to a full bladder displacing the uterus. The priority is to perform fundal massage to stimulate uterine contraction and reduce bleeding, then have the patient void to allow the uterus to contract effectively. ________________________________________ Question 9: A patient at 20 weeks gestation is diagnosed with gestational diabetes. Which fetal complication is associated with this condition? A. Intrauterine growth restriction B. Neural tube defects C. Macrosomia D. Oligohydramnios CORRECT ANSWER: C. Macrosomia