OBSTETRIC NURSING PRACTICE EXAM –
2026 UPDATED REVIEW PACK
Comprehensive Maternal-Newborn
Nursing Examination
SECTION 1: ANTEPARTUM CARE AND ASSESSMENT
1. A patient at 12 weeks gestation presents for her first prenatal visit. The nurse should expect which
fundal height measurement?
A) 8-10 cm
B) 10-12 cm
C) 12-14 cm
D) 14-16 cm
Answer: B) 10-12 cm
Rationale: Fundal height corresponds roughly to weeks of gestation between 12-36 weeks. At 12 weeks,
the fundus is palpable at the symphysis pubis, measuring approximately 10-12 cm. After 12 weeks, the
fundus rises above the symphysis and can be palpated abdominally.
2. The nurse is assessing a patient at 28 weeks gestation. Which finding requires immediate
intervention?
A) Mild ankle edema
B) Blood pressure of 150/92 mmHg
C) Fetal heart rate of 140 bpm
D) Weight gain of 1 pound in one week
Answer: B) Blood pressure of 150/92 mmHg
Rationale: Blood pressure ≥ 140/90 mmHg in pregnancy may indicate preeclampsia, a serious condition
requiring immediate evaluation. Mild ankle edema and a fetal heart rate of 140 bpm are normal
findings. A weight gain of 1 pound in one week is within normal range for the third trimester.
,3. The nurse is providing prenatal education to a patient. Which statement indicates correct
understanding of folic acid supplementation?
A) "I should take folic acid only in the first trimester."
B) "Folic acid helps prevent neural tube defects in my baby."
C) "Folic acid is not necessary if I eat a healthy diet."
D) "I can take any amount of folic acid without side effects."
Answer: B) "Folic acid helps prevent neural tube defects in my baby."
Rationale: Folic acid supplementation (400-800 mcg daily) before conception and during early pregnancy
significantly reduces the risk of neural tube defects. It should be taken throughout pregnancy. Dietary
sources alone may not provide adequate amounts. Excessive intake should be avoided without medical
guidance.
4. The nurse is calculating the estimated date of delivery (EDD) for a patient whose last menstrual
period began on January 15. Using Naegele's rule, the EDD is:
A) August 22
B) September 22
C) October 22
D) November 22
Answer: C) October 22
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days. January 15
minus 3 months = October 15, plus 7 days = October 22. This rule assumes a 28-day cycle. Adjustments
may be needed for irregular cycles.
5. The nurse is caring for a patient at 16 weeks gestation. Which finding is considered a normal
physiological change of pregnancy?
A) Decreased heart rate
B) Increased cardiac output
C) Decreased blood volume
D) Increased systemic vascular resistance
Answer: B) Increased cardiac output
Rationale: Cardiac output increases by 30-50% during pregnancy due to increased stroke volume and
heart rate. Blood volume increases by 40-50%. Systemic vascular resistance decreases to accommodate
increased blood volume. Heart rate increases, not decreases.
,6. The nurse is assessing a patient at 10 weeks gestation who reports nausea and vomiting in the
morning. Which intervention is most appropriate?
A) Advise the patient to eat large meals
B) Recommend eating small, frequent meals and dry crackers before rising
C) Prescribe antiemetic medication
D) Advise the patient to avoid all foods
Answer: B) Recommend eating small, frequent meals and dry crackers before rising
Rationale: Nausea and vomiting in pregnancy (morning sickness) is common in the first trimester. Small,
frequent meals, dry crackers before rising, avoiding triggers, and adequate hydration are first-line
interventions. Severe vomiting (hyperemesis gravidarum) requires medical intervention.
7. The nurse is educating a patient about warning signs during pregnancy. Which symptom should be
reported immediately?
A) Mild fatigue
B) Vaginal bleeding
C) Occasional Braxton-Hicks contractions
D) Breast tenderness
Answer: B) Vaginal bleeding
Rationale: Vaginal bleeding is a warning sign that should be reported immediately. Other warning signs
include severe headache, blurred vision, epigastric pain, severe vomiting, fever, decreased fetal
movement, and rupture of membranes. Mild fatigue, Braxton-Hicks contractions, and breast tenderness
are normal.
8. The nurse is assessing a patient at 20 weeks gestation. The nurse expects the fundal height to be
approximately:
A) 16 cm
B) 18 cm
C) 20 cm
D) 22 cm
Answer: C) 20 cm
Rationale: Fundal height in centimeters roughly equals weeks of gestation between 12 and 36 weeks. At
, 20 weeks, the fundus is at the level of the umbilicus. Fundal height measurements are used to assess
fetal growth and detect abnormalities such as intrauterine growth restriction or macrosomia.
9. The nurse is providing education about prenatal screening tests. Which test is used to screen for
gestational diabetes?
A) Complete blood count
B) Glucose tolerance test (GTT)
C) Rh factor screening
D) Group B Streptococcus screening
Answer: B) Glucose tolerance test (GTT)
Rationale: The glucose tolerance test is used to screen for gestational diabetes, typically performed
between 24-28 weeks gestation. The patient drinks a glucose solution and blood glucose levels are
measured. Rh factor screening (C) detects Rh incompatibility, and GBS screening (D) is done at 35-37
weeks.
10. The nurse is caring for a patient with Rh-negative blood type at 28 weeks gestation. The nurse
should prepare to administer:
A) Rh immune globulin (RhoGAM)
B) Folic acid supplementation
C) Iron supplementation
D) Antibiotic prophylaxis
Answer: A) Rh immune globulin (RhoGAM)
Rationale: Rh-negative patients should receive Rh immune globulin (RhoGAM) at 28 weeks gestation to
prevent Rh sensitization if the fetus is Rh-positive. It is also given within 72 hours after birth if the
newborn is Rh-positive. This prevents hemolytic disease of the newborn in future pregnancies.
SECTION 2: PRENATAL SCREENING AND DIAGNOSTIC TESTS
11. The nurse is educating a patient about the quad screen. The nurse should explain that this test:
A) Measures four hormones to screen for chromosomal abnormalities
B) Is a diagnostic test for Down syndrome
C) Is done in the third trimester
D) Is only for patients over age 35
2026 UPDATED REVIEW PACK
Comprehensive Maternal-Newborn
Nursing Examination
SECTION 1: ANTEPARTUM CARE AND ASSESSMENT
1. A patient at 12 weeks gestation presents for her first prenatal visit. The nurse should expect which
fundal height measurement?
A) 8-10 cm
B) 10-12 cm
C) 12-14 cm
D) 14-16 cm
Answer: B) 10-12 cm
Rationale: Fundal height corresponds roughly to weeks of gestation between 12-36 weeks. At 12 weeks,
the fundus is palpable at the symphysis pubis, measuring approximately 10-12 cm. After 12 weeks, the
fundus rises above the symphysis and can be palpated abdominally.
2. The nurse is assessing a patient at 28 weeks gestation. Which finding requires immediate
intervention?
A) Mild ankle edema
B) Blood pressure of 150/92 mmHg
C) Fetal heart rate of 140 bpm
D) Weight gain of 1 pound in one week
Answer: B) Blood pressure of 150/92 mmHg
Rationale: Blood pressure ≥ 140/90 mmHg in pregnancy may indicate preeclampsia, a serious condition
requiring immediate evaluation. Mild ankle edema and a fetal heart rate of 140 bpm are normal
findings. A weight gain of 1 pound in one week is within normal range for the third trimester.
,3. The nurse is providing prenatal education to a patient. Which statement indicates correct
understanding of folic acid supplementation?
A) "I should take folic acid only in the first trimester."
B) "Folic acid helps prevent neural tube defects in my baby."
C) "Folic acid is not necessary if I eat a healthy diet."
D) "I can take any amount of folic acid without side effects."
Answer: B) "Folic acid helps prevent neural tube defects in my baby."
Rationale: Folic acid supplementation (400-800 mcg daily) before conception and during early pregnancy
significantly reduces the risk of neural tube defects. It should be taken throughout pregnancy. Dietary
sources alone may not provide adequate amounts. Excessive intake should be avoided without medical
guidance.
4. The nurse is calculating the estimated date of delivery (EDD) for a patient whose last menstrual
period began on January 15. Using Naegele's rule, the EDD is:
A) August 22
B) September 22
C) October 22
D) November 22
Answer: C) October 22
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days. January 15
minus 3 months = October 15, plus 7 days = October 22. This rule assumes a 28-day cycle. Adjustments
may be needed for irregular cycles.
5. The nurse is caring for a patient at 16 weeks gestation. Which finding is considered a normal
physiological change of pregnancy?
A) Decreased heart rate
B) Increased cardiac output
C) Decreased blood volume
D) Increased systemic vascular resistance
Answer: B) Increased cardiac output
Rationale: Cardiac output increases by 30-50% during pregnancy due to increased stroke volume and
heart rate. Blood volume increases by 40-50%. Systemic vascular resistance decreases to accommodate
increased blood volume. Heart rate increases, not decreases.
,6. The nurse is assessing a patient at 10 weeks gestation who reports nausea and vomiting in the
morning. Which intervention is most appropriate?
A) Advise the patient to eat large meals
B) Recommend eating small, frequent meals and dry crackers before rising
C) Prescribe antiemetic medication
D) Advise the patient to avoid all foods
Answer: B) Recommend eating small, frequent meals and dry crackers before rising
Rationale: Nausea and vomiting in pregnancy (morning sickness) is common in the first trimester. Small,
frequent meals, dry crackers before rising, avoiding triggers, and adequate hydration are first-line
interventions. Severe vomiting (hyperemesis gravidarum) requires medical intervention.
7. The nurse is educating a patient about warning signs during pregnancy. Which symptom should be
reported immediately?
A) Mild fatigue
B) Vaginal bleeding
C) Occasional Braxton-Hicks contractions
D) Breast tenderness
Answer: B) Vaginal bleeding
Rationale: Vaginal bleeding is a warning sign that should be reported immediately. Other warning signs
include severe headache, blurred vision, epigastric pain, severe vomiting, fever, decreased fetal
movement, and rupture of membranes. Mild fatigue, Braxton-Hicks contractions, and breast tenderness
are normal.
8. The nurse is assessing a patient at 20 weeks gestation. The nurse expects the fundal height to be
approximately:
A) 16 cm
B) 18 cm
C) 20 cm
D) 22 cm
Answer: C) 20 cm
Rationale: Fundal height in centimeters roughly equals weeks of gestation between 12 and 36 weeks. At
, 20 weeks, the fundus is at the level of the umbilicus. Fundal height measurements are used to assess
fetal growth and detect abnormalities such as intrauterine growth restriction or macrosomia.
9. The nurse is providing education about prenatal screening tests. Which test is used to screen for
gestational diabetes?
A) Complete blood count
B) Glucose tolerance test (GTT)
C) Rh factor screening
D) Group B Streptococcus screening
Answer: B) Glucose tolerance test (GTT)
Rationale: The glucose tolerance test is used to screen for gestational diabetes, typically performed
between 24-28 weeks gestation. The patient drinks a glucose solution and blood glucose levels are
measured. Rh factor screening (C) detects Rh incompatibility, and GBS screening (D) is done at 35-37
weeks.
10. The nurse is caring for a patient with Rh-negative blood type at 28 weeks gestation. The nurse
should prepare to administer:
A) Rh immune globulin (RhoGAM)
B) Folic acid supplementation
C) Iron supplementation
D) Antibiotic prophylaxis
Answer: A) Rh immune globulin (RhoGAM)
Rationale: Rh-negative patients should receive Rh immune globulin (RhoGAM) at 28 weeks gestation to
prevent Rh sensitization if the fetus is Rh-positive. It is also given within 72 hours after birth if the
newborn is Rh-positive. This prevents hemolytic disease of the newborn in future pregnancies.
SECTION 2: PRENATAL SCREENING AND DIAGNOSTIC TESTS
11. The nurse is educating a patient about the quad screen. The nurse should explain that this test:
A) Measures four hormones to screen for chromosomal abnormalities
B) Is a diagnostic test for Down syndrome
C) Is done in the third trimester
D) Is only for patients over age 35
