OpenStax Maternal–Newborn Nursing:
Comprehensive Examination Guide (2026–
2027 Edition) WITH CORRECT ANSWERS.
SECTION 1: FOUNDATIONS OF MATERNAL-NEWBORN NURSING (Questions 1-30)
Question 1:
A nurse is providing preconception counseling to a 28-year-old woman who is planning
pregnancy. Which of the following recommendations is most important to include?
A) Take 400 mcg of folic acid daily
B) Avoid all physical exercise
C) Eliminate all dietary fat
D) Take vitamin B12 supplements weekly
CORRECT ANSWER: A
Rationale: The CDC recommends that all women of reproductive age consume 400
mcg of folic acid daily to reduce the risk of neural tube defects. Option B is incorrect
because moderate exercise is encouraged. Option C is incorrect as dietary fat is
essential for fetal development. Option D is incorrect because vitamin B12
supplementation is not routinely recommended for all preconception women.
Question 2:
A 34-year-old primigravida at 10 weeks gestation asks the nurse about recommended
weight gain during pregnancy. She has a BMI of 26.5 kg/m². What is the appropriate
weight gain recommendation?
A) 25-35 pounds
B) 15-25 pounds
C) 28-40 pounds
,D) 11-20 pounds
CORRECT ANSWER: B
Rationale: The patient has a BMI of 26.5 kg/m², which falls in the overweight category
(25-29.9). The recommended weight gain for overweight women is 15-25 pounds.
Option A is for normal BMI women. Option C is for underweight women. Option D is for
obese women.
Question 3:
A nurse is assessing fetal heart rate at 12 weeks gestation. Which of the following
findings would be considered normal?
A) 90 beats per minute
B) 110 beats per minute
C) 160 beats per minute
D) 180 beats per minute
CORRECT ANSWER: C
Rationale: The normal fetal heart rate at 12 weeks is 120-160 beats per minute. Option C
(160 bpm) falls within this range. Option A (90 bpm) is bradycardic. Option B (110 bpm)
is below the normal range. Option D (180 bpm) is tachycardic.
Question 4:
A 24-year-old woman presents for her first prenatal visit at 8 weeks gestation. Which of
the following maternal serum markers would be elevated at this stage?
A) Alpha-fetoprotein (AFP)
B) Human chorionic gonadotropin (hCG)
C) Estriol
,D) Inhibin A
CORRECT ANSWER: B
Rationale: hCG peaks at 8-10 weeks gestation, making it elevated in early pregnancy.
AFP, estriol, and inhibin A are typically measured during the second trimester as part of
quadruple screening.
Question 5:
The nurse instructs a pregnant client about the signs of preterm labor. Which of the
following symptoms should the client report immediately?
A) Backache that improves with rest
B) Menstrual-like cramping that occurs every 8-10 minutes
C) Braxton-Hicks contractions that are irregular
D) Mild swelling of the feet at end of day
CORRECT ANSWER: B
Rationale: Regular contractions occurring every 8-10 minutes may indicate preterm
labor and require immediate evaluation. Option A is nonspecific and may improve with
rest. Option C describes normal Braxton-Hicks contractions. Option D describes
common dependent edema.
Question 6:
A nurse is performing a pelvic examination on a pregnant client. The cervix is dilated to
3 cm, 50% effaced, and the presenting part is at -2 station. Which of the following
correctly interprets these findings?
A) Active labor with fetal descent
B) Early labor with the fetus still high in the pelvis
, C) Second stage of labor
D) Imminent delivery
CORRECT ANSWER: B
Rationale: -2 station indicates the fetal presenting part is 2 cm above the ischial spines,
meaning the fetus is still high in the pelvis. The cervix is 3 cm dilated and 50% effaced,
consistent with early (latent) labor. Option A is incorrect because active labor typically
begins at 4-5 cm dilation. Option C is incorrect because second stage is complete
dilation (10 cm). Option D is incorrect as delivery is not imminent.
Question 7:
A 32-year-old pregnant woman at 36 weeks gestation asks the nurse about signs that
indicate labor is approaching. Which of the following is considered a reliable indicator?
A) Nesting instinct
B) Cervical changes
C) Increased vaginal discharge
D) Braxton-Hicks contractions
CORRECT ANSWER: B
Rationale: Cervical changes (softening, effacement, and dilation) are the most reliable
indicators of approaching labor. Options A, C, and D are common but not reliable
predictors.
Question 8:
A nurse is evaluating a fetal monitoring strip. Which of the following patterns is
associated with uteroplacental insufficiency?
A) Late decelerations
Comprehensive Examination Guide (2026–
2027 Edition) WITH CORRECT ANSWERS.
SECTION 1: FOUNDATIONS OF MATERNAL-NEWBORN NURSING (Questions 1-30)
Question 1:
A nurse is providing preconception counseling to a 28-year-old woman who is planning
pregnancy. Which of the following recommendations is most important to include?
A) Take 400 mcg of folic acid daily
B) Avoid all physical exercise
C) Eliminate all dietary fat
D) Take vitamin B12 supplements weekly
CORRECT ANSWER: A
Rationale: The CDC recommends that all women of reproductive age consume 400
mcg of folic acid daily to reduce the risk of neural tube defects. Option B is incorrect
because moderate exercise is encouraged. Option C is incorrect as dietary fat is
essential for fetal development. Option D is incorrect because vitamin B12
supplementation is not routinely recommended for all preconception women.
Question 2:
A 34-year-old primigravida at 10 weeks gestation asks the nurse about recommended
weight gain during pregnancy. She has a BMI of 26.5 kg/m². What is the appropriate
weight gain recommendation?
A) 25-35 pounds
B) 15-25 pounds
C) 28-40 pounds
,D) 11-20 pounds
CORRECT ANSWER: B
Rationale: The patient has a BMI of 26.5 kg/m², which falls in the overweight category
(25-29.9). The recommended weight gain for overweight women is 15-25 pounds.
Option A is for normal BMI women. Option C is for underweight women. Option D is for
obese women.
Question 3:
A nurse is assessing fetal heart rate at 12 weeks gestation. Which of the following
findings would be considered normal?
A) 90 beats per minute
B) 110 beats per minute
C) 160 beats per minute
D) 180 beats per minute
CORRECT ANSWER: C
Rationale: The normal fetal heart rate at 12 weeks is 120-160 beats per minute. Option C
(160 bpm) falls within this range. Option A (90 bpm) is bradycardic. Option B (110 bpm)
is below the normal range. Option D (180 bpm) is tachycardic.
Question 4:
A 24-year-old woman presents for her first prenatal visit at 8 weeks gestation. Which of
the following maternal serum markers would be elevated at this stage?
A) Alpha-fetoprotein (AFP)
B) Human chorionic gonadotropin (hCG)
C) Estriol
,D) Inhibin A
CORRECT ANSWER: B
Rationale: hCG peaks at 8-10 weeks gestation, making it elevated in early pregnancy.
AFP, estriol, and inhibin A are typically measured during the second trimester as part of
quadruple screening.
Question 5:
The nurse instructs a pregnant client about the signs of preterm labor. Which of the
following symptoms should the client report immediately?
A) Backache that improves with rest
B) Menstrual-like cramping that occurs every 8-10 minutes
C) Braxton-Hicks contractions that are irregular
D) Mild swelling of the feet at end of day
CORRECT ANSWER: B
Rationale: Regular contractions occurring every 8-10 minutes may indicate preterm
labor and require immediate evaluation. Option A is nonspecific and may improve with
rest. Option C describes normal Braxton-Hicks contractions. Option D describes
common dependent edema.
Question 6:
A nurse is performing a pelvic examination on a pregnant client. The cervix is dilated to
3 cm, 50% effaced, and the presenting part is at -2 station. Which of the following
correctly interprets these findings?
A) Active labor with fetal descent
B) Early labor with the fetus still high in the pelvis
, C) Second stage of labor
D) Imminent delivery
CORRECT ANSWER: B
Rationale: -2 station indicates the fetal presenting part is 2 cm above the ischial spines,
meaning the fetus is still high in the pelvis. The cervix is 3 cm dilated and 50% effaced,
consistent with early (latent) labor. Option A is incorrect because active labor typically
begins at 4-5 cm dilation. Option C is incorrect because second stage is complete
dilation (10 cm). Option D is incorrect as delivery is not imminent.
Question 7:
A 32-year-old pregnant woman at 36 weeks gestation asks the nurse about signs that
indicate labor is approaching. Which of the following is considered a reliable indicator?
A) Nesting instinct
B) Cervical changes
C) Increased vaginal discharge
D) Braxton-Hicks contractions
CORRECT ANSWER: B
Rationale: Cervical changes (softening, effacement, and dilation) are the most reliable
indicators of approaching labor. Options A, C, and D are common but not reliable
predictors.
Question 8:
A nurse is evaluating a fetal monitoring strip. Which of the following patterns is
associated with uteroplacental insufficiency?
A) Late decelerations
