RN MATERNAL NEWBORN NURSING TODAY
ASSESSMENT 2025/2026 | VERIFIED
PRACTICE QUESTIONS & DETAILED
RATIONALES | COMPLETE STUDY GUIDE
RN MATERNAL NEWBORN NURSING TODAY ASSESSMENT 2025/2026 | VERIFIED
PRACTICE QUESTIONS & DETAILED RATIONALES | COMPLETE STUDY GUIDE
═══════════════════════════════════════════════════════
════════════════════════════════
OVERVIEW
• This comprehensive study guide contains verified practice questions designed to
strengthen your understanding of maternal-newborn nursing concepts,
assessment skills, and clinical interventions across the full spectrum of care from
pregnancy through the immediate postpartum period.
• Use this material systematically by working through questions section by section,
reviewing detailed rationales for both correct and incorrect options to identify
knowledge gaps and reinforce core nursing competencies tested on certification
and clinical exams.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 1
A 28-year-old primigravida at 12 weeks gestation presents to the clinic for her
first prenatal visit. Which assessment finding would the nurse recognize as a
probable sign of pregnancy?
A) Positive home pregnancy test
B) Breast tenderness and nausea
C) Chadwick's sign
D) Reports of quickening
E) Elevated basal body temperature
CORRECT ANSWER: C) Chadwick's sign
,Rationale: Chadwick's sign (bluish discoloration of the cervix, vagina, and labia due
to increased vascularity) is a probable sign of pregnancy that is objectively observed
by the examiner during physical assessment. While positive home pregnancy tests
and elevated hCG levels are presumptive signs, Chadwick's sign represents tissue
changes visible on examination. Breast tenderness and nausea are presumptive
signs (subjective). Quickening typically occurs after 16-20 weeks, making it later in
pregnancy. Basal body temperature elevation is also presumptive.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 2
During a prenatal assessment, the nurse notes the client's blood pressure is
142/90 mmHg at 20 weeks gestation. The baseline BP at 12 weeks was 118/72
mmHg. What is the most appropriate nursing action?
A) Schedule immediate delivery due to hypertension
B) Recheck BP in both arms after 10 minutes of rest and notify the provider
C) Instruct the client to restrict sodium intake immediately
D) Administer magnesium sulfate to prevent seizures
E) Discontinue prenatal vitamins as they may increase BP
CORRECT ANSWER: B) Recheck BP in both arms after 10 minutes of rest and
notify the provider
Rationale: A systolic increase of 30 mmHg or diastolic increase of 15 mmHg over
baseline may indicate gestational hypertension or preeclampsia and requires
evaluation. The appropriate nursing action is to recheck the BP after the client has
rested in both arms to ensure accuracy and rule out measurement error. The
findings should be reported to the provider for clinical correlation with other signs
and symptoms. Immediate delivery is premature without additional assessment.
Magnesium sulfate is used for seizure prophylaxis in preeclampsia with severe
features, not for initial hypertension. Vitamins and sodium restriction are not first-
line interventions at this stage.
,═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 3
A pregnant client at 16 weeks gestation reports she has been taking
isotretinoin (Accutane) for severe acne prescribed before she realized she was
pregnant. What is the primary concern regarding this medication?
A) Increased risk of gestational diabetes
B) Severe teratogenic effects and spontaneous abortion risk
C) Maternal hyperthyroidism
D) Placental insufficiency
E) Fetal hypothyroidism
CORRECT ANSWER: B) Severe teratogenic effects and spontaneous abortion
risk
Rationale: Isotretinoin is a Category X medication (now called Contraindicated in
Pregnancy) with severe teratogenic effects including cleft palate, cardiac defects,
CNS malformations, thymic aplasia, and intellectual disability. It is highly associated
with spontaneous abortion and severe congenital anomalies. This medication
should never be used during pregnancy, and strict contraception is required for
women of childbearing age taking it. The client should be counseled about risks,
and genetic counseling and detailed fetal ultrasound should be offered. This is a
critical medication safety issue requiring immediate provider notification.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 4
Which finding in a pregnant client at 32 weeks gestation would alert the nurse
to a possible placental abruption?
A) Painless vaginal bleeding with a soft uterus
B) Sudden onset of severe abdominal pain, vaginal bleeding, and uterine
tenderness
, C) Gradual onset of mild cramping with show
D) Vaginal bleeding following cervical examination
E) Bleeding associated with cervical polyps
CORRECT ANSWER: B) Sudden onset of severe abdominal pain, vaginal
bleeding, and uterine tenderness
Rationale: Placental abruption typically presents with the triad of vaginal bleeding,
abdominal/back pain, and uterine tenderness or contractions. The onset is usually
sudden and the uterus is firm or rigid due to the accumulation of blood behind the
placenta. This is a obstetric emergency requiring immediate intervention to prevent
maternal hemorrhage and fetal demise. Painless vaginal bleeding with a soft uterus
is characteristic of placenta previa, not abruption. Gradual cramping with show is
normal labor onset. Bleeding after cervical exam or from polyps is localized. The
classic presentation of abruption is the combination of pain, bleeding, and uterine
irritability.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 5
A client in active labor at 6 cm dilation receives an epidural anesthetic. Which
nursing intervention is most important immediately after epidural
placement?
A) Encourage ambulation to promote labor progression
B) Place the client supine to optimize medication distribution
C) Establish IV access and monitor BP, place on continuous fetal monitoring
D) Increase oxytocin infusion to compensate for pain relief
E) Allow the client to void independently
CORRECT ANSWER: C) Establish IV access and monitor BP, place on continuous
fetal monitoring
ASSESSMENT 2025/2026 | VERIFIED
PRACTICE QUESTIONS & DETAILED
RATIONALES | COMPLETE STUDY GUIDE
RN MATERNAL NEWBORN NURSING TODAY ASSESSMENT 2025/2026 | VERIFIED
PRACTICE QUESTIONS & DETAILED RATIONALES | COMPLETE STUDY GUIDE
═══════════════════════════════════════════════════════
════════════════════════════════
OVERVIEW
• This comprehensive study guide contains verified practice questions designed to
strengthen your understanding of maternal-newborn nursing concepts,
assessment skills, and clinical interventions across the full spectrum of care from
pregnancy through the immediate postpartum period.
• Use this material systematically by working through questions section by section,
reviewing detailed rationales for both correct and incorrect options to identify
knowledge gaps and reinforce core nursing competencies tested on certification
and clinical exams.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 1
A 28-year-old primigravida at 12 weeks gestation presents to the clinic for her
first prenatal visit. Which assessment finding would the nurse recognize as a
probable sign of pregnancy?
A) Positive home pregnancy test
B) Breast tenderness and nausea
C) Chadwick's sign
D) Reports of quickening
E) Elevated basal body temperature
CORRECT ANSWER: C) Chadwick's sign
,Rationale: Chadwick's sign (bluish discoloration of the cervix, vagina, and labia due
to increased vascularity) is a probable sign of pregnancy that is objectively observed
by the examiner during physical assessment. While positive home pregnancy tests
and elevated hCG levels are presumptive signs, Chadwick's sign represents tissue
changes visible on examination. Breast tenderness and nausea are presumptive
signs (subjective). Quickening typically occurs after 16-20 weeks, making it later in
pregnancy. Basal body temperature elevation is also presumptive.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 2
During a prenatal assessment, the nurse notes the client's blood pressure is
142/90 mmHg at 20 weeks gestation. The baseline BP at 12 weeks was 118/72
mmHg. What is the most appropriate nursing action?
A) Schedule immediate delivery due to hypertension
B) Recheck BP in both arms after 10 minutes of rest and notify the provider
C) Instruct the client to restrict sodium intake immediately
D) Administer magnesium sulfate to prevent seizures
E) Discontinue prenatal vitamins as they may increase BP
CORRECT ANSWER: B) Recheck BP in both arms after 10 minutes of rest and
notify the provider
Rationale: A systolic increase of 30 mmHg or diastolic increase of 15 mmHg over
baseline may indicate gestational hypertension or preeclampsia and requires
evaluation. The appropriate nursing action is to recheck the BP after the client has
rested in both arms to ensure accuracy and rule out measurement error. The
findings should be reported to the provider for clinical correlation with other signs
and symptoms. Immediate delivery is premature without additional assessment.
Magnesium sulfate is used for seizure prophylaxis in preeclampsia with severe
features, not for initial hypertension. Vitamins and sodium restriction are not first-
line interventions at this stage.
,═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 3
A pregnant client at 16 weeks gestation reports she has been taking
isotretinoin (Accutane) for severe acne prescribed before she realized she was
pregnant. What is the primary concern regarding this medication?
A) Increased risk of gestational diabetes
B) Severe teratogenic effects and spontaneous abortion risk
C) Maternal hyperthyroidism
D) Placental insufficiency
E) Fetal hypothyroidism
CORRECT ANSWER: B) Severe teratogenic effects and spontaneous abortion
risk
Rationale: Isotretinoin is a Category X medication (now called Contraindicated in
Pregnancy) with severe teratogenic effects including cleft palate, cardiac defects,
CNS malformations, thymic aplasia, and intellectual disability. It is highly associated
with spontaneous abortion and severe congenital anomalies. This medication
should never be used during pregnancy, and strict contraception is required for
women of childbearing age taking it. The client should be counseled about risks,
and genetic counseling and detailed fetal ultrasound should be offered. This is a
critical medication safety issue requiring immediate provider notification.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 4
Which finding in a pregnant client at 32 weeks gestation would alert the nurse
to a possible placental abruption?
A) Painless vaginal bleeding with a soft uterus
B) Sudden onset of severe abdominal pain, vaginal bleeding, and uterine
tenderness
, C) Gradual onset of mild cramping with show
D) Vaginal bleeding following cervical examination
E) Bleeding associated with cervical polyps
CORRECT ANSWER: B) Sudden onset of severe abdominal pain, vaginal
bleeding, and uterine tenderness
Rationale: Placental abruption typically presents with the triad of vaginal bleeding,
abdominal/back pain, and uterine tenderness or contractions. The onset is usually
sudden and the uterus is firm or rigid due to the accumulation of blood behind the
placenta. This is a obstetric emergency requiring immediate intervention to prevent
maternal hemorrhage and fetal demise. Painless vaginal bleeding with a soft uterus
is characteristic of placenta previa, not abruption. Gradual cramping with show is
normal labor onset. Bleeding after cervical exam or from polyps is localized. The
classic presentation of abruption is the combination of pain, bleeding, and uterine
irritability.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 5
A client in active labor at 6 cm dilation receives an epidural anesthetic. Which
nursing intervention is most important immediately after epidural
placement?
A) Encourage ambulation to promote labor progression
B) Place the client supine to optimize medication distribution
C) Establish IV access and monitor BP, place on continuous fetal monitoring
D) Increase oxytocin infusion to compensate for pain relief
E) Allow the client to void independently
CORRECT ANSWER: C) Establish IV access and monitor BP, place on continuous
fetal monitoring
