MATERNITY CJE EXAMINATION COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR JUST RELEASED
1. During a routine prenatal assessment, which maternal physiological cardiovascular
adaptation most significantly supports increasing fetal oxygen and nutrient requirements
throughout pregnancy?
A. Decreased plasma volume with increased hematocrit
B. Increased cardiac output through higher stroke volume and heart rate
C. Reduced renal blood flow to preserve maternal circulation
D. Decreased blood volume to minimize cardiac workload
Correct Answer: B
Rationale: Pregnancy normally increases cardiac output by approximately 30–50% through
increased stroke volume and heart rate. This adaptation ensures adequate uteroplacental
perfusion and oxygen delivery to the growing fetus.
2. A nurse teaching a newly pregnant patient about folic acid supplementation should
emphasize that adequate daily intake primarily reduces the risk of which fetal complication?
A. Congenital heart disease
B. Neural tube defects
C. Macrosomia
D. Respiratory distress syndrome
Correct Answer: B
Rationale: Folic acid taken before conception and during early pregnancy significantly reduces
neural tube defects such as spina bifida and anencephaly by supporting normal neural tube
closure.
,3. Which assessment finding during the third trimester should prompt the maternity nurse to
notify the healthcare provider immediately because it may indicate preeclampsia
progression?
A. Mild ankle swelling after prolonged standing
B. Persistent severe headache accompanied by visual disturbances
C. Occasional Braxton Hicks contractions
D. Increased urinary frequency without pain
Correct Answer: B
Rationale: Severe headache and visual disturbances are warning signs of severe preeclampsia
and may precede seizures, requiring immediate medical evaluation.
4. While evaluating fetal heart rate patterns during active labor, which tracing most strongly
suggests adequate fetal oxygenation and neurological well-being?
A. Persistent late decelerations
B. Minimal variability throughout labor
C. Moderate variability with periodic accelerations
D. Recurrent prolonged decelerations
Correct Answer: C
Rationale: Moderate variability and accelerations indicate a well-oxygenated fetus with an
intact autonomic nervous system.
5. Which maternal hormone primarily maintains the uterine lining during early pregnancy
until placental hormone production becomes sufficient to sustain gestation?
A. Oxytocin
B. Estrogen
C. Progesterone
D. Prolactin
Correct Answer: C
,Rationale: Progesterone maintains the endometrium, suppresses uterine contractions, and
supports early pregnancy until the placenta assumes hormone production.
6. A laboring patient suddenly develops bright red vaginal bleeding with abdominal pain and
a rigid uterus. Which obstetric complication should the nurse suspect first?
A. Placenta previa
B. Placental abruption
C. Cervical insufficiency
D. Umbilical hernia
Correct Answer: B
Rationale: Placental abruption classically presents with painful vaginal bleeding, uterine
tenderness, and increased uterine tone, requiring emergency intervention.
7. Which nursing intervention is most appropriate immediately after identifying recurrent
late fetal heart rate decelerations during labor?
A. Encourage the patient to ambulate
B. Reposition the patient onto her left side
C. Increase oxytocin infusion
D. Delay further fetal assessment
Correct Answer: B
Rationale: Left lateral positioning improves uteroplacental blood flow and is a priority
intervention for late decelerations indicating uteroplacental insufficiency.
8. During postpartum assessment, which finding requires the nurse's immediate attention
because it may indicate excessive postpartum hemorrhage?
A. Firm uterus positioned at the midline
B. Saturation of a perineal pad within one hour
C. Mild afterpains while breastfeeding
D. Small amount of lochia rubra
, Correct Answer: B
Rationale: Saturating a pad within an hour suggests excessive bleeding and warrants immediate
assessment and intervention.
9. Which newborn assessment finding during the first hour after birth is generally considered
a normal transitional adaptation rather than an emergency?
A. Persistent central cyanosis
B. Respiratory rate of 45 breaths per minute
C. Apnea lasting thirty seconds
D. Heart rate below 80 beats per minute
Correct Answer: B
Rationale: A respiratory rate between 30 and 60 breaths per minute is normal for healthy term
newborns during transition.
10. Which maternal laboratory result obtained during pregnancy most strongly supports the
diagnosis of gestational diabetes requiring further evaluation and management?
A. Elevated one-hour glucose screening result
B. Low hemoglobin concentration
C. Positive urine protein dipstick
D. Elevated white blood cell count
Correct Answer: A
Rationale: An abnormal glucose screening test requires confirmatory oral glucose tolerance
testing for gestational diabetes diagnosis.
11. During the second stage of labor, which maternal action most effectively promotes fetal
descent while minimizing unnecessary maternal exhaustion?
A. Continuous pushing regardless of contraction timing
B. Coordinated pushing during contractions with adequate rest between efforts
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR JUST RELEASED
1. During a routine prenatal assessment, which maternal physiological cardiovascular
adaptation most significantly supports increasing fetal oxygen and nutrient requirements
throughout pregnancy?
A. Decreased plasma volume with increased hematocrit
B. Increased cardiac output through higher stroke volume and heart rate
C. Reduced renal blood flow to preserve maternal circulation
D. Decreased blood volume to minimize cardiac workload
Correct Answer: B
Rationale: Pregnancy normally increases cardiac output by approximately 30–50% through
increased stroke volume and heart rate. This adaptation ensures adequate uteroplacental
perfusion and oxygen delivery to the growing fetus.
2. A nurse teaching a newly pregnant patient about folic acid supplementation should
emphasize that adequate daily intake primarily reduces the risk of which fetal complication?
A. Congenital heart disease
B. Neural tube defects
C. Macrosomia
D. Respiratory distress syndrome
Correct Answer: B
Rationale: Folic acid taken before conception and during early pregnancy significantly reduces
neural tube defects such as spina bifida and anencephaly by supporting normal neural tube
closure.
,3. Which assessment finding during the third trimester should prompt the maternity nurse to
notify the healthcare provider immediately because it may indicate preeclampsia
progression?
A. Mild ankle swelling after prolonged standing
B. Persistent severe headache accompanied by visual disturbances
C. Occasional Braxton Hicks contractions
D. Increased urinary frequency without pain
Correct Answer: B
Rationale: Severe headache and visual disturbances are warning signs of severe preeclampsia
and may precede seizures, requiring immediate medical evaluation.
4. While evaluating fetal heart rate patterns during active labor, which tracing most strongly
suggests adequate fetal oxygenation and neurological well-being?
A. Persistent late decelerations
B. Minimal variability throughout labor
C. Moderate variability with periodic accelerations
D. Recurrent prolonged decelerations
Correct Answer: C
Rationale: Moderate variability and accelerations indicate a well-oxygenated fetus with an
intact autonomic nervous system.
5. Which maternal hormone primarily maintains the uterine lining during early pregnancy
until placental hormone production becomes sufficient to sustain gestation?
A. Oxytocin
B. Estrogen
C. Progesterone
D. Prolactin
Correct Answer: C
,Rationale: Progesterone maintains the endometrium, suppresses uterine contractions, and
supports early pregnancy until the placenta assumes hormone production.
6. A laboring patient suddenly develops bright red vaginal bleeding with abdominal pain and
a rigid uterus. Which obstetric complication should the nurse suspect first?
A. Placenta previa
B. Placental abruption
C. Cervical insufficiency
D. Umbilical hernia
Correct Answer: B
Rationale: Placental abruption classically presents with painful vaginal bleeding, uterine
tenderness, and increased uterine tone, requiring emergency intervention.
7. Which nursing intervention is most appropriate immediately after identifying recurrent
late fetal heart rate decelerations during labor?
A. Encourage the patient to ambulate
B. Reposition the patient onto her left side
C. Increase oxytocin infusion
D. Delay further fetal assessment
Correct Answer: B
Rationale: Left lateral positioning improves uteroplacental blood flow and is a priority
intervention for late decelerations indicating uteroplacental insufficiency.
8. During postpartum assessment, which finding requires the nurse's immediate attention
because it may indicate excessive postpartum hemorrhage?
A. Firm uterus positioned at the midline
B. Saturation of a perineal pad within one hour
C. Mild afterpains while breastfeeding
D. Small amount of lochia rubra
, Correct Answer: B
Rationale: Saturating a pad within an hour suggests excessive bleeding and warrants immediate
assessment and intervention.
9. Which newborn assessment finding during the first hour after birth is generally considered
a normal transitional adaptation rather than an emergency?
A. Persistent central cyanosis
B. Respiratory rate of 45 breaths per minute
C. Apnea lasting thirty seconds
D. Heart rate below 80 beats per minute
Correct Answer: B
Rationale: A respiratory rate between 30 and 60 breaths per minute is normal for healthy term
newborns during transition.
10. Which maternal laboratory result obtained during pregnancy most strongly supports the
diagnosis of gestational diabetes requiring further evaluation and management?
A. Elevated one-hour glucose screening result
B. Low hemoglobin concentration
C. Positive urine protein dipstick
D. Elevated white blood cell count
Correct Answer: A
Rationale: An abnormal glucose screening test requires confirmatory oral glucose tolerance
testing for gestational diabetes diagnosis.
11. During the second stage of labor, which maternal action most effectively promotes fetal
descent while minimizing unnecessary maternal exhaustion?
A. Continuous pushing regardless of contraction timing
B. Coordinated pushing during contractions with adequate rest between efforts
