FLORIDA BOARD OF NURSING MATERNAL-NEWBORN
NURSING CERTIFICATION EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS, PLUS
EXPLAINED RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A woman at 39 weeks’ gestation is admitted in active labor. Her
membranes have ruptured, and the fetal heart rate tracing suddenly
shows recurrent variable decelerations with moderate variability.
Which nursing intervention should be performed first?
A. Administer oxygen at 10 L/min by nonrebreather mask
B. Reposition the client to a lateral position
C. Increase the oxytocin infusion
D. Prepare the client for immediate cesarean birth
Answer: B. Reposition the client to a lateral position
Rationale: Recurrent variable decelerations are commonly caused by
umbilical cord compression. Maternal repositioning, particularly to a
lateral or other position that relieves cord compression, is an
immediate intrauterine resuscitation intervention. Increasing oxytocin
could worsen fetal stress. Oxygen is not routinely the first intervention
when maternal oxygenation is adequate, and cesarean birth is not
automatically indicated when variability remains moderate and the
tracing can respond to corrective measures.
2. A pregnant client at 34 weeks has blood pressure of 168/112 mm
Hg, severe headache, blurred vision, and hyperreflexia with clonus.
Which medication should the nurse anticipate administering to
prevent the most immediate serious complication?
1
,A. Betamethasone
B. Magnesium sulfate
C. Methylergonovine
D. Terbutaline
Answer: B. Magnesium sulfate
Rationale: Severe-range hypertension accompanied by neurologic
symptoms places the client at high risk for eclampsia. Magnesium
sulfate is administered for seizure prophylaxis. Antihypertensive
therapy is also required for severe hypertension, while corticosteroids
may be administered when preterm birth is anticipated to enhance
fetal lung maturity. Methylergonovine is contraindicated in significant
hypertension, and terbutaline is not used for seizure prevention.
3. A client receiving magnesium sulfate for severe preeclampsia has
a respiratory rate of 10/min, urine output of 20 mL/hr, and absent
patellar reflexes. What is the nurse’s priority action?
A. Increase the magnesium sulfate infusion
B. Administer calcium gluconate as prescribed
C. Encourage oral fluids
D. Place the client in Trendelenburg position
Answer: B. Administer calcium gluconate as prescribed
Rationale: Respiratory depression, oliguria, and loss of deep tendon
reflexes are manifestations of magnesium toxicity. Magnesium should
be stopped and the prescribed antidote, calcium gluconate, should be
administered. Renal impairment increases magnesium accumulation
because magnesium is primarily excreted by the kidneys.
4. A woman receiving oxytocin during labor develops contractions
occurring every 1 minute, lasting 90 seconds, with recurrent late
2
,fetal heart rate decelerations. Which intervention is most
appropriate?
A. Increase the oxytocin rate
B. Stop the oxytocin infusion
C. Encourage pushing
D. Administer methylergonovine
Answer: B. Stop the oxytocin infusion
Rationale: Excessive uterine activity can decrease uteroplacental
perfusion and produce fetal hypoxia manifested by recurrent late
decelerations. The oxytocin infusion should be stopped immediately.
Additional intrauterine resuscitation measures include maternal
repositioning, assessment of maternal blood pressure, and other
interventions according to the clinical situation.
5. A postpartum client has heavy vaginal bleeding and a boggy
uterus. Her fundus is above the umbilicus and displaced to the right.
Which intervention should the nurse perform first?
A. Administer oxytocin immediately without further assessment
B. Massage the uterine fundus
C. Insert a urinary catheter before touching the uterus
D. Place the client in high-Fowler position
Answer: B. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, the most common
cause of early postpartum hemorrhage. Fundal massage stimulates
uterine contraction and is an immediate nursing intervention. A
displaced fundus can also indicate bladder distention, so bladder
emptying may subsequently be necessary, but the boggy uterus
requires immediate intervention.
3
, 6. A newborn is delivered at 40 weeks and is initially apneic with a
heart rate of 80/min after drying and stimulation. What should the
nurse do next?
A. Begin chest compressions immediately
B. Provide positive-pressure ventilation
C. Administer epinephrine immediately
D. Perform deep suctioning for 60 seconds
Answer: B. Provide positive-pressure ventilation
Rationale: Positive-pressure ventilation is indicated for a newborn
who is apneic or gasping or whose heart rate remains below 100/min
after initial steps. Chest compressions are initiated when the heart rate
remains below 60/min despite effective ventilation. Epinephrine is
reserved for persistent severe bradycardia after adequate ventilation
and chest compressions. Routine deep suctioning is not recommended.
7. A newborn has a heart rate of 52/min after 30 seconds of effective
positive-pressure ventilation. What is the priority intervention?
A. Continue routine observation
B. Begin chest compressions coordinated with ventilation
C. Give oral glucose
D. Place the newborn skin-to-skin with the mother
Answer: B. Begin chest compressions coordinated with ventilation
Rationale: If the newborn's heart rate remains below 60/min despite
effective positive-pressure ventilation, coordinated chest compressions
and ventilation are indicated. Ventilation remains the most important
intervention because neonatal bradycardia is usually caused by
inadequate oxygenation.
4
NURSING CERTIFICATION EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS, PLUS
EXPLAINED RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A woman at 39 weeks’ gestation is admitted in active labor. Her
membranes have ruptured, and the fetal heart rate tracing suddenly
shows recurrent variable decelerations with moderate variability.
Which nursing intervention should be performed first?
A. Administer oxygen at 10 L/min by nonrebreather mask
B. Reposition the client to a lateral position
C. Increase the oxytocin infusion
D. Prepare the client for immediate cesarean birth
Answer: B. Reposition the client to a lateral position
Rationale: Recurrent variable decelerations are commonly caused by
umbilical cord compression. Maternal repositioning, particularly to a
lateral or other position that relieves cord compression, is an
immediate intrauterine resuscitation intervention. Increasing oxytocin
could worsen fetal stress. Oxygen is not routinely the first intervention
when maternal oxygenation is adequate, and cesarean birth is not
automatically indicated when variability remains moderate and the
tracing can respond to corrective measures.
2. A pregnant client at 34 weeks has blood pressure of 168/112 mm
Hg, severe headache, blurred vision, and hyperreflexia with clonus.
Which medication should the nurse anticipate administering to
prevent the most immediate serious complication?
1
,A. Betamethasone
B. Magnesium sulfate
C. Methylergonovine
D. Terbutaline
Answer: B. Magnesium sulfate
Rationale: Severe-range hypertension accompanied by neurologic
symptoms places the client at high risk for eclampsia. Magnesium
sulfate is administered for seizure prophylaxis. Antihypertensive
therapy is also required for severe hypertension, while corticosteroids
may be administered when preterm birth is anticipated to enhance
fetal lung maturity. Methylergonovine is contraindicated in significant
hypertension, and terbutaline is not used for seizure prevention.
3. A client receiving magnesium sulfate for severe preeclampsia has
a respiratory rate of 10/min, urine output of 20 mL/hr, and absent
patellar reflexes. What is the nurse’s priority action?
A. Increase the magnesium sulfate infusion
B. Administer calcium gluconate as prescribed
C. Encourage oral fluids
D. Place the client in Trendelenburg position
Answer: B. Administer calcium gluconate as prescribed
Rationale: Respiratory depression, oliguria, and loss of deep tendon
reflexes are manifestations of magnesium toxicity. Magnesium should
be stopped and the prescribed antidote, calcium gluconate, should be
administered. Renal impairment increases magnesium accumulation
because magnesium is primarily excreted by the kidneys.
4. A woman receiving oxytocin during labor develops contractions
occurring every 1 minute, lasting 90 seconds, with recurrent late
2
,fetal heart rate decelerations. Which intervention is most
appropriate?
A. Increase the oxytocin rate
B. Stop the oxytocin infusion
C. Encourage pushing
D. Administer methylergonovine
Answer: B. Stop the oxytocin infusion
Rationale: Excessive uterine activity can decrease uteroplacental
perfusion and produce fetal hypoxia manifested by recurrent late
decelerations. The oxytocin infusion should be stopped immediately.
Additional intrauterine resuscitation measures include maternal
repositioning, assessment of maternal blood pressure, and other
interventions according to the clinical situation.
5. A postpartum client has heavy vaginal bleeding and a boggy
uterus. Her fundus is above the umbilicus and displaced to the right.
Which intervention should the nurse perform first?
A. Administer oxytocin immediately without further assessment
B. Massage the uterine fundus
C. Insert a urinary catheter before touching the uterus
D. Place the client in high-Fowler position
Answer: B. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, the most common
cause of early postpartum hemorrhage. Fundal massage stimulates
uterine contraction and is an immediate nursing intervention. A
displaced fundus can also indicate bladder distention, so bladder
emptying may subsequently be necessary, but the boggy uterus
requires immediate intervention.
3
, 6. A newborn is delivered at 40 weeks and is initially apneic with a
heart rate of 80/min after drying and stimulation. What should the
nurse do next?
A. Begin chest compressions immediately
B. Provide positive-pressure ventilation
C. Administer epinephrine immediately
D. Perform deep suctioning for 60 seconds
Answer: B. Provide positive-pressure ventilation
Rationale: Positive-pressure ventilation is indicated for a newborn
who is apneic or gasping or whose heart rate remains below 100/min
after initial steps. Chest compressions are initiated when the heart rate
remains below 60/min despite effective ventilation. Epinephrine is
reserved for persistent severe bradycardia after adequate ventilation
and chest compressions. Routine deep suctioning is not recommended.
7. A newborn has a heart rate of 52/min after 30 seconds of effective
positive-pressure ventilation. What is the priority intervention?
A. Continue routine observation
B. Begin chest compressions coordinated with ventilation
C. Give oral glucose
D. Place the newborn skin-to-skin with the mother
Answer: B. Begin chest compressions coordinated with ventilation
Rationale: If the newborn's heart rate remains below 60/min despite
effective positive-pressure ventilation, coordinated chest compressions
and ventilation are indicated. Ventilation remains the most important
intervention because neonatal bradycardia is usually caused by
inadequate oxygenation.
4
