FLORIDA BOARD OF NURSING PERINATAL
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 32-year-old G2P1 at 34 weeks' gestation presents to the labor
and delivery triage unit with severe headache, blurred vision, and
right upper-quadrant abdominal pain. Her blood pressure is
168/112 mmHg, and repeat measurement 15 minutes later is 170/110
mmHg. Urinalysis demonstrates significant proteinuria. Which
nursing action is the priority?
A. Encourage oral fluids and place the patient in a supine position
B. Initiate seizure precautions, notify the obstetric provider, and prepare
for magnesium sulfate therapy
C. Administer oxytocin to initiate labor immediately
D. Encourage ambulation to improve circulation
Answer: B. Initiate seizure precautions, notify the obstetric
provider, and prepare for magnesium sulfate therapy
Rationale: Severe-range hypertension accompanied by neurologic
symptoms and right-upper-quadrant pain indicates severe
preeclampsia with a high risk for cerebral complications, stroke,
placental abruption, and eclampsia. Magnesium sulfate is used for
seizure prophylaxis, while severe hypertension requires prompt
treatment according to the obstetric emergency protocol. Seizure
precautions and close maternal-fetal monitoring are essential. A
1
,supine position can worsen vena caval compression, and ambulation is
unsafe. Immediate delivery may ultimately be necessary, but
stabilization of the mother takes priority.
2. A pregnant patient receiving magnesium sulfate for severe
preeclampsia has a respiratory rate of 9/min, urine output of 20
mL/hr, absent patellar reflexes, and increasing lethargy. Which
medication should the nurse anticipate administering?
A. Naloxone
B. Calcium gluconate
C. Protamine sulfate
D. Vitamin K
Answer: B. Calcium gluconate
Rationale: These findings strongly indicate magnesium toxicity.
Respiratory depression, diminished or absent deep-tendon reflexes,
oliguria, and altered level of consciousness are classic warning signs.
Calcium gluconate is the antidote for clinically significant magnesium
toxicity. The nurse should stop the magnesium infusion, maintain
airway and respiratory support, notify the provider, and prepare the
prescribed antidote.
3. A woman at 30 weeks' gestation reports painless bright-red
vaginal bleeding. She denies contractions and abdominal tenderness.
Which condition should the nurse suspect first?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Answer: B. Placenta previa
2
,Rationale: Placenta previa classically presents with painless, bright-
red vaginal bleeding during the second half of pregnancy. Placental
abruption more commonly causes painful bleeding accompanied by
uterine tenderness, abdominal pain, or a rigid uterus, although
bleeding may occasionally be concealed. Digital vaginal examination
should be avoided until placenta previa has been excluded because
manipulation can provoke severe hemorrhage.
4. A patient with suspected placenta previa arrives with significant
vaginal bleeding. Which nursing action should be avoided?
A. Establishing large-bore IV access
B. Monitoring maternal vital signs
C. Applying continuous fetal monitoring
D. Performing a digital vaginal examination
Answer: D. Performing a digital vaginal examination
Rationale: Digital vaginal examination is contraindicated when
placenta previa is suspected because the examiner can disrupt the
placenta and cause catastrophic hemorrhage. Maternal stabilization,
fetal assessment, IV access, laboratory testing, and preparation for
possible delivery are appropriate.
5. A patient at 37 weeks' gestation presents with severe abdominal
pain, vaginal bleeding, uterine tenderness, and frequent
contractions. The fetal heart rate shows recurrent late decelerations.
Which condition is most likely?
A. Placenta previa
B. Placental abruption
C. Cervical insufficiency
D. Hyperemesis gravidarum
3
, Answer: B. Placental abruption
Rationale: Placental abruption involves premature separation of the
placenta from the uterine wall and commonly presents with painful
vaginal bleeding, uterine tenderness, abdominal pain, contractions,
and fetal compromise. Bleeding can be concealed, so the amount of
visible blood may underestimate the severity of maternal blood loss.
The combination of maternal pain and fetal distress is particularly
concerning.
6. A laboring patient receiving oxytocin develops contractions
occurring every 90 seconds, lasting 100 seconds each, with minimal
uterine relaxation between contractions. The fetal heart tracing
demonstrates recurrent late decelerations. What is the nurse's
priority action?
A. Increase the oxytocin infusion
B. Stop or reduce oxytocin and initiate intrauterine resuscitative
measures
C. Encourage the patient to push
D. Place the patient flat on her back
Answer: B. Stop or reduce oxytocin and initiate intrauterine
resuscitative measures
Rationale: Excessive uterine activity can reduce uteroplacental
perfusion and produce fetal hypoxia. Oxytocin should be stopped or
reduced according to protocol, and intrauterine resuscitative measures
should begin, including maternal repositioning, assessment of
maternal blood pressure, and additional interventions as indicated.
Increasing oxytocin would worsen uterine tachysystole and fetal
compromise.
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 32-year-old G2P1 at 34 weeks' gestation presents to the labor
and delivery triage unit with severe headache, blurred vision, and
right upper-quadrant abdominal pain. Her blood pressure is
168/112 mmHg, and repeat measurement 15 minutes later is 170/110
mmHg. Urinalysis demonstrates significant proteinuria. Which
nursing action is the priority?
A. Encourage oral fluids and place the patient in a supine position
B. Initiate seizure precautions, notify the obstetric provider, and prepare
for magnesium sulfate therapy
C. Administer oxytocin to initiate labor immediately
D. Encourage ambulation to improve circulation
Answer: B. Initiate seizure precautions, notify the obstetric
provider, and prepare for magnesium sulfate therapy
Rationale: Severe-range hypertension accompanied by neurologic
symptoms and right-upper-quadrant pain indicates severe
preeclampsia with a high risk for cerebral complications, stroke,
placental abruption, and eclampsia. Magnesium sulfate is used for
seizure prophylaxis, while severe hypertension requires prompt
treatment according to the obstetric emergency protocol. Seizure
precautions and close maternal-fetal monitoring are essential. A
1
,supine position can worsen vena caval compression, and ambulation is
unsafe. Immediate delivery may ultimately be necessary, but
stabilization of the mother takes priority.
2. A pregnant patient receiving magnesium sulfate for severe
preeclampsia has a respiratory rate of 9/min, urine output of 20
mL/hr, absent patellar reflexes, and increasing lethargy. Which
medication should the nurse anticipate administering?
A. Naloxone
B. Calcium gluconate
C. Protamine sulfate
D. Vitamin K
Answer: B. Calcium gluconate
Rationale: These findings strongly indicate magnesium toxicity.
Respiratory depression, diminished or absent deep-tendon reflexes,
oliguria, and altered level of consciousness are classic warning signs.
Calcium gluconate is the antidote for clinically significant magnesium
toxicity. The nurse should stop the magnesium infusion, maintain
airway and respiratory support, notify the provider, and prepare the
prescribed antidote.
3. A woman at 30 weeks' gestation reports painless bright-red
vaginal bleeding. She denies contractions and abdominal tenderness.
Which condition should the nurse suspect first?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Answer: B. Placenta previa
2
,Rationale: Placenta previa classically presents with painless, bright-
red vaginal bleeding during the second half of pregnancy. Placental
abruption more commonly causes painful bleeding accompanied by
uterine tenderness, abdominal pain, or a rigid uterus, although
bleeding may occasionally be concealed. Digital vaginal examination
should be avoided until placenta previa has been excluded because
manipulation can provoke severe hemorrhage.
4. A patient with suspected placenta previa arrives with significant
vaginal bleeding. Which nursing action should be avoided?
A. Establishing large-bore IV access
B. Monitoring maternal vital signs
C. Applying continuous fetal monitoring
D. Performing a digital vaginal examination
Answer: D. Performing a digital vaginal examination
Rationale: Digital vaginal examination is contraindicated when
placenta previa is suspected because the examiner can disrupt the
placenta and cause catastrophic hemorrhage. Maternal stabilization,
fetal assessment, IV access, laboratory testing, and preparation for
possible delivery are appropriate.
5. A patient at 37 weeks' gestation presents with severe abdominal
pain, vaginal bleeding, uterine tenderness, and frequent
contractions. The fetal heart rate shows recurrent late decelerations.
Which condition is most likely?
A. Placenta previa
B. Placental abruption
C. Cervical insufficiency
D. Hyperemesis gravidarum
3
, Answer: B. Placental abruption
Rationale: Placental abruption involves premature separation of the
placenta from the uterine wall and commonly presents with painful
vaginal bleeding, uterine tenderness, abdominal pain, contractions,
and fetal compromise. Bleeding can be concealed, so the amount of
visible blood may underestimate the severity of maternal blood loss.
The combination of maternal pain and fetal distress is particularly
concerning.
6. A laboring patient receiving oxytocin develops contractions
occurring every 90 seconds, lasting 100 seconds each, with minimal
uterine relaxation between contractions. The fetal heart tracing
demonstrates recurrent late decelerations. What is the nurse's
priority action?
A. Increase the oxytocin infusion
B. Stop or reduce oxytocin and initiate intrauterine resuscitative
measures
C. Encourage the patient to push
D. Place the patient flat on her back
Answer: B. Stop or reduce oxytocin and initiate intrauterine
resuscitative measures
Rationale: Excessive uterine activity can reduce uteroplacental
perfusion and produce fetal hypoxia. Oxytocin should be stopped or
reduced according to protocol, and intrauterine resuscitative measures
should begin, including maternal repositioning, assessment of
maternal blood pressure, and additional interventions as indicated.
Increasing oxytocin would worsen uterine tachysystole and fetal
compromise.
4
