Maternal and Newborn Nursing Comprehensive Final
Examination Questions and Answers with Verified Solutions
Latest 2026/2027
Examination Title Maternal and Newborn Nursing Comprehensive Final
Practice Examination
Specialty Coverage Antepartum Assessment, High-Risk Pregnancy,
Intrapartum Care, Fetal Monitoring, Postpartum
Management & Neonatal Transition
Passing Standard 75% Correct Responses ( Correct Responses)
Edition Specification Latest 2026/2027 Master Review Edition
Module 1: Antepartum Health, Prenatal Screening & Fetal Physiology (Questions
1–11)
Question 1
A pregnant woman's last normal menstrual period (LMP) began on May 10, 2026. Using
Naegele's rule, what is her estimated date of delivery (EDD)?
• A) February 10, 2027
• B) February 17, 2027
• C) February 24, 2027
• D) January 17, 2027
Correct Answer: B) February 17, 2027
Naegele's rule calculates EDD by subtracting 3 months from the first day of the last normal menstrual period
and adding 7 days plus 1 year: May 10 minus 3 months equals February 10, plus 7 days equals February 17,
2027.
Question 2
A patient is pregnant for the fourth time. She has one living child born at 39 weeks, experienced
a twin delivery at 34 weeks (both living), and had one spontaneous abortion at 10 weeks. How
should the nurse document her GTPAL?
• A) G4-T1-P1-A1-L3
• B) G4-T1-P2-A1-L3
• C) G3-T2-P1-A1-L3
• D) G4-T2-P1-A0-L3
,Correct Answer: A) G4-T1-P1-A1-L3
G = 4 total pregnancies. T = 1 term delivery (39 weeks). P = 1 preterm delivery event (twins at 34 weeks count
as one preterm pregnancy event). A = 1 abortion (<20 weeks). L = 3 living children (1 term child + 2 twin
children).
Question 3
Which clinical finding represents a positive (diagnostic) sign of pregnancy during an antepartum
examination?
• A) Positive serum beta-hCG pregnancy test
• B) Softening of the lower uterine segment (Hegar sign)
• C) Visualization of the fetus by transabdominal ultrasound
• D) Bluish discoloration of the cervix and vagina (Chadwick sign)
Correct Answer: C) Visualization of the fetus by transabdominal ultrasound
Positive signs are directly attributable to the fetus: ultrasound visualization, fetal heart tones confirmed by
examiner, or active fetal movement felt by examiner. Serum hCG and pelvic changes are probable signs.
Question 4
A primigravida at 16 weeks gestation asks when she should expect to feel initial fetal
movements (quickening). What is the nurse's best response?
• A) Between 10 and 12 weeks
• B) Between 14 and 16 weeks
• C) Between 18 and 20 weeks
• D) Between 22 and 24 weeks
Correct Answer: C) Between 18 and 20 weeks
In a first-time mother (primigravida), quickening is usually perceived between 18 and 20 weeks gestation.
Multigravidas may notice fetal movement earlier, around 14 to 16 weeks.
Question 5
At 28 weeks gestation, an Rh-negative pregnant patient has a negative indirect Coombs test.
Which intervention is indicated at this visit?
• A) Withhold Rh immune globulin because sensitizing antibodies are absent
• B) Administer Rho(D) immune globulin 300 mcg intramuscularly
• C) Administer Rho(D) immune globulin only if direct Coombs test is positive
• D) Schedule amniocentesis to check fetal bilirubin levels
Correct Answer: B) Administer Rho(D) immune globulin 300 mcg intramuscularly
Unsensitized Rh-negative mothers (negative indirect Coombs) receive prophylactic Rho(D) immune globulin
at 28 weeks gestation to prevent isoimmunization against unsuspected fetal erythrocyte transplacental
passage.
Question 6
During a nonstress test (NST) at 34 weeks, the nurse observes two fetal heart rate
accelerations of 15 bpm above baseline lasting 15 seconds within a 20-minute window. How is
this test interpreted?
, • A) Nonreactive nonstress test
• B) Reactive nonstress test
• C) Unsatisfactory monitoring trace
• D) Positive contraction stress test
Correct Answer: B) Reactive nonstress test
A reactive NST after 32 weeks gestation requires at least two fetal heart rate accelerations reaching 15 bpm
above baseline and lasting at least 15 seconds within a 20-minute recording window, confirming intact fetal
autonomic nervous system function.
Question 7
A pregnant patient at 36 weeks lies supine for abdominal palpation and becomes lightheaded,
pale, and diaphoretic with a drop in blood pressure. What immediate nursing action is required?
• A) Administer oxygen at 10 L/min via non-rebreather mask
• B) Elevate the head of the bed to a High Fowler position
• C) Turn the patient onto her left lateral side
• D) Infuse an immediate 500 mL bolus of normal saline
Correct Answer: C) Turn the patient onto her left lateral side
Supine hypotensive syndrome results from heavy gravid uterine compression of the inferior vena cava
against the spine. Positioning the patient on her left lateral side shifts the uterus, restoring venous return,
cardiac output, and arterial pressure.
Question 8
Which physiological change occurring during normal pregnancy explains maternal physiological
anemia?
• A) Decreased erythrocyte production by bone marrow
• B) Plasma volume expanding proportionately more than red blood cell mass
• C) Excessive renal excretion of essential amino acids
• D) Rapid destruction of circulating fetal red blood cells
Correct Answer: B) Plasma volume expanding proportionately more than red blood cell mass
Maternal blood volume expands by 40–50%. Because plasma volume increases significantly more (40–50%)
than erythrocyte volume (20–30%), hemodilution occurs, resulting in physiological anemia of pregnancy.
Question 9
What fundal height measurement in centimeters is anticipated upon abdominal palpation in a
healthy singleton pregnancy at 24 weeks gestation?
• A) 18 cm
• B) 20 cm
• C) 24 cm
• D) 30 cm
Correct Answer: C) 24 cm
Between 18 and 30 weeks gestation, the fundal height measured in centimeters from the symphysis pubis to
the top of the uterine fundus matches the gestational age in weeks (+/- 2 cm) when the bladder is empty.
Question 10
Examination Questions and Answers with Verified Solutions
Latest 2026/2027
Examination Title Maternal and Newborn Nursing Comprehensive Final
Practice Examination
Specialty Coverage Antepartum Assessment, High-Risk Pregnancy,
Intrapartum Care, Fetal Monitoring, Postpartum
Management & Neonatal Transition
Passing Standard 75% Correct Responses ( Correct Responses)
Edition Specification Latest 2026/2027 Master Review Edition
Module 1: Antepartum Health, Prenatal Screening & Fetal Physiology (Questions
1–11)
Question 1
A pregnant woman's last normal menstrual period (LMP) began on May 10, 2026. Using
Naegele's rule, what is her estimated date of delivery (EDD)?
• A) February 10, 2027
• B) February 17, 2027
• C) February 24, 2027
• D) January 17, 2027
Correct Answer: B) February 17, 2027
Naegele's rule calculates EDD by subtracting 3 months from the first day of the last normal menstrual period
and adding 7 days plus 1 year: May 10 minus 3 months equals February 10, plus 7 days equals February 17,
2027.
Question 2
A patient is pregnant for the fourth time. She has one living child born at 39 weeks, experienced
a twin delivery at 34 weeks (both living), and had one spontaneous abortion at 10 weeks. How
should the nurse document her GTPAL?
• A) G4-T1-P1-A1-L3
• B) G4-T1-P2-A1-L3
• C) G3-T2-P1-A1-L3
• D) G4-T2-P1-A0-L3
,Correct Answer: A) G4-T1-P1-A1-L3
G = 4 total pregnancies. T = 1 term delivery (39 weeks). P = 1 preterm delivery event (twins at 34 weeks count
as one preterm pregnancy event). A = 1 abortion (<20 weeks). L = 3 living children (1 term child + 2 twin
children).
Question 3
Which clinical finding represents a positive (diagnostic) sign of pregnancy during an antepartum
examination?
• A) Positive serum beta-hCG pregnancy test
• B) Softening of the lower uterine segment (Hegar sign)
• C) Visualization of the fetus by transabdominal ultrasound
• D) Bluish discoloration of the cervix and vagina (Chadwick sign)
Correct Answer: C) Visualization of the fetus by transabdominal ultrasound
Positive signs are directly attributable to the fetus: ultrasound visualization, fetal heart tones confirmed by
examiner, or active fetal movement felt by examiner. Serum hCG and pelvic changes are probable signs.
Question 4
A primigravida at 16 weeks gestation asks when she should expect to feel initial fetal
movements (quickening). What is the nurse's best response?
• A) Between 10 and 12 weeks
• B) Between 14 and 16 weeks
• C) Between 18 and 20 weeks
• D) Between 22 and 24 weeks
Correct Answer: C) Between 18 and 20 weeks
In a first-time mother (primigravida), quickening is usually perceived between 18 and 20 weeks gestation.
Multigravidas may notice fetal movement earlier, around 14 to 16 weeks.
Question 5
At 28 weeks gestation, an Rh-negative pregnant patient has a negative indirect Coombs test.
Which intervention is indicated at this visit?
• A) Withhold Rh immune globulin because sensitizing antibodies are absent
• B) Administer Rho(D) immune globulin 300 mcg intramuscularly
• C) Administer Rho(D) immune globulin only if direct Coombs test is positive
• D) Schedule amniocentesis to check fetal bilirubin levels
Correct Answer: B) Administer Rho(D) immune globulin 300 mcg intramuscularly
Unsensitized Rh-negative mothers (negative indirect Coombs) receive prophylactic Rho(D) immune globulin
at 28 weeks gestation to prevent isoimmunization against unsuspected fetal erythrocyte transplacental
passage.
Question 6
During a nonstress test (NST) at 34 weeks, the nurse observes two fetal heart rate
accelerations of 15 bpm above baseline lasting 15 seconds within a 20-minute window. How is
this test interpreted?
, • A) Nonreactive nonstress test
• B) Reactive nonstress test
• C) Unsatisfactory monitoring trace
• D) Positive contraction stress test
Correct Answer: B) Reactive nonstress test
A reactive NST after 32 weeks gestation requires at least two fetal heart rate accelerations reaching 15 bpm
above baseline and lasting at least 15 seconds within a 20-minute recording window, confirming intact fetal
autonomic nervous system function.
Question 7
A pregnant patient at 36 weeks lies supine for abdominal palpation and becomes lightheaded,
pale, and diaphoretic with a drop in blood pressure. What immediate nursing action is required?
• A) Administer oxygen at 10 L/min via non-rebreather mask
• B) Elevate the head of the bed to a High Fowler position
• C) Turn the patient onto her left lateral side
• D) Infuse an immediate 500 mL bolus of normal saline
Correct Answer: C) Turn the patient onto her left lateral side
Supine hypotensive syndrome results from heavy gravid uterine compression of the inferior vena cava
against the spine. Positioning the patient on her left lateral side shifts the uterus, restoring venous return,
cardiac output, and arterial pressure.
Question 8
Which physiological change occurring during normal pregnancy explains maternal physiological
anemia?
• A) Decreased erythrocyte production by bone marrow
• B) Plasma volume expanding proportionately more than red blood cell mass
• C) Excessive renal excretion of essential amino acids
• D) Rapid destruction of circulating fetal red blood cells
Correct Answer: B) Plasma volume expanding proportionately more than red blood cell mass
Maternal blood volume expands by 40–50%. Because plasma volume increases significantly more (40–50%)
than erythrocyte volume (20–30%), hemodilution occurs, resulting in physiological anemia of pregnancy.
Question 9
What fundal height measurement in centimeters is anticipated upon abdominal palpation in a
healthy singleton pregnancy at 24 weeks gestation?
• A) 18 cm
• B) 20 cm
• C) 24 cm
• D) 30 cm
Correct Answer: C) 24 cm
Between 18 and 30 weeks gestation, the fundal height measured in centimeters from the symphysis pubis to
the top of the uterine fundus matches the gestational age in weeks (+/- 2 cm) when the bladder is empty.
Question 10
