Maternal Exam 2026 2027
2026-2027
100 Questions
100% VERIFIED
Introduction
The Maternal Exam 2026/2027 is a comprehensive professional nursing certification assessment
designed to evaluate clinical knowledge and competency in maternal-newborn nursing. This
examination encompasses eight essential domains: Antepartum Care, Intrapartum Care,
Postpartum Care, Newborn Care, High-Risk Pregnancies, Fetal Assessment, Pharmacology in
Maternal-Newborn Nursing, and Ethical and Legal Issues in Maternity Care. Proficiency across
these domains is critical for nurses providing evidence-based care to childbearing women and their
neonates. Success in this assessment validates clinical readiness, reinforces best outcomes in
maternal-newborn health, and affirms the professional standards expected in contemporary
obstetric nursing.
Q1. A primigravida at 12 weeks gestation presents for her first prenatal visit. Which finding
would the nurse identify as a presumptive sign of pregnancy?
A. Visualization of the fetus on ultrasound
B. Amenorrhea and breast tenderness
C. Fetal heart tones detected by Doppler
D. Positive urine pregnancy test
Rationale: Presumptive signs are subjective changes reported by the woman, including amenorrhea,
breast tenderness, nausea, and fatigue. A positive pregnancy test is a probable sign, while ultrasound
visualization and fetal heart tones are positive (definitive) signs.
Q2. Using Nagele's rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on March 10, 2026?
A. December 17, 2026
B. January 17, 2027
C. November 17, 2026
D. December 10, 2026
, Rationale: Nagele's rule subtracts 3 months from the LMP and adds 7 days: March 10 minus 3 months
equals December 10, plus 7 days equals December 17, 2026. The other dates result from incorrect
application of the formula.
Q3. At what gestational age is the fundal height typically palpable at the level of the
umbilicus?
A. 36 to 38 weeks
B. 12 to 14 weeks
C. 28 to 30 weeks
D. 20 to 22 weeks
Rationale: The uterine fundus reaches the umbilicus at approximately 20-22 weeks gestation. At 12-14
weeks it is at the symphysis pubis, at 28-30 weeks it is above the umbilicus, and at 36-38 weeks it
reaches the xiphoid process.
Q4. Which laboratory finding during the first prenatal visit would require immediate follow-
up?
A. Hematocrit of 34%
B. Hemoglobin of 11.5 g/dL
C. Rubella titer of 1:6 (non-immune)
D. Blood type A positive
Rationale: A rubella titer below 1:10 indicates non-immunity, and the client should receive the rubella
vaccine postpartum since it is a live vaccine contraindicated during pregnancy. The other findings are
within acceptable ranges for pregnancy.
Q5. A client at 28 weeks gestation is diagnosed with gestational diabetes. Which dietary
recommendation is most appropriate?
A. Distribute carbohydrate intake across three meals and two to three snacks
throughout the day
B. Consume the majority of daily calories at breakfast to boost metabolism
C. Eliminate all carbohydrates from the diet to maintain glycemic control
D. Restrict caloric intake to 1,200 calories per day regardless of weight
Rationale: Evenly distributed carbohydrate intake prevents blood glucose spikes and maintains stable
levels. Eliminating carbohydrates risks ketosis, front-loading calories causes post-breakfast
hyperglycemia, and severe caloric restriction is harmful to fetal growth.
Q6. Which immunization is contraindicated during pregnancy?
A. Inactivated influenza vaccine
, B. Measles, mumps, and rubella (MMR) vaccine
C. Tdap (tetanus, diphtheria, pertussis) vaccine
D. Hepatitis B vaccine
Rationale: The MMR vaccine contains live attenuated viruses and is contraindicated during pregnancy
due to theoretical fetal risk. Influenza (inactivated), Tdap, and Hepatitis B vaccines are safe and
recommended during pregnancy.
Q7. A client at 16 weeks gestation reports persistent nausea and vomiting. The nurse notes a
weight loss of 5 pounds since her first visit. Which condition should the nurse suspect?
A. Gestational trophoblastic disease
B. Gastroesophageal reflux disease
C. Normal first-trimester nausea that will resolve spontaneously
D. Hyperemesis gravidarum
Rationale: Hyperemesis gravidarum is characterized by severe, persistent nausea and vomiting leading
to weight loss, dehydration, and electrolyte imbalances. While mild nausea is common, significant
weight loss distinguishes hyperemesis. The other conditions present differently.
Q8. What is the recommended total weight gain during pregnancy for a client with a pre-
pregnancy BMI of 24 (normal weight)?
A. 25 to 35 pounds
B. 11 to 20 pounds
C. 15 to 25 pounds
D. 28 to 40 pounds
Rationale: The Institute of Medicine recommends 25-35 pounds for normal-weight women (BMI 18.5-
24.9). Overweight women should gain 15-25 pounds, obese women 11-20 pounds, and underweight
women 28-40 pounds.
Q9. A client who is Rh-negative delivers an Rh-positive newborn. What is the primary
purpose of administering Rho(D) immune globulin (RhoGAM)?
A. To prevent the mother from developing antibodies against Rh-positive blood cells in
future pregnancies
B. To treat the newborn's hemolytic disease
C. To increase the mother's red blood cell count
D. To prevent infection in the postpartum period
2026-2027
100 Questions
100% VERIFIED
Introduction
The Maternal Exam 2026/2027 is a comprehensive professional nursing certification assessment
designed to evaluate clinical knowledge and competency in maternal-newborn nursing. This
examination encompasses eight essential domains: Antepartum Care, Intrapartum Care,
Postpartum Care, Newborn Care, High-Risk Pregnancies, Fetal Assessment, Pharmacology in
Maternal-Newborn Nursing, and Ethical and Legal Issues in Maternity Care. Proficiency across
these domains is critical for nurses providing evidence-based care to childbearing women and their
neonates. Success in this assessment validates clinical readiness, reinforces best outcomes in
maternal-newborn health, and affirms the professional standards expected in contemporary
obstetric nursing.
Q1. A primigravida at 12 weeks gestation presents for her first prenatal visit. Which finding
would the nurse identify as a presumptive sign of pregnancy?
A. Visualization of the fetus on ultrasound
B. Amenorrhea and breast tenderness
C. Fetal heart tones detected by Doppler
D. Positive urine pregnancy test
Rationale: Presumptive signs are subjective changes reported by the woman, including amenorrhea,
breast tenderness, nausea, and fatigue. A positive pregnancy test is a probable sign, while ultrasound
visualization and fetal heart tones are positive (definitive) signs.
Q2. Using Nagele's rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on March 10, 2026?
A. December 17, 2026
B. January 17, 2027
C. November 17, 2026
D. December 10, 2026
, Rationale: Nagele's rule subtracts 3 months from the LMP and adds 7 days: March 10 minus 3 months
equals December 10, plus 7 days equals December 17, 2026. The other dates result from incorrect
application of the formula.
Q3. At what gestational age is the fundal height typically palpable at the level of the
umbilicus?
A. 36 to 38 weeks
B. 12 to 14 weeks
C. 28 to 30 weeks
D. 20 to 22 weeks
Rationale: The uterine fundus reaches the umbilicus at approximately 20-22 weeks gestation. At 12-14
weeks it is at the symphysis pubis, at 28-30 weeks it is above the umbilicus, and at 36-38 weeks it
reaches the xiphoid process.
Q4. Which laboratory finding during the first prenatal visit would require immediate follow-
up?
A. Hematocrit of 34%
B. Hemoglobin of 11.5 g/dL
C. Rubella titer of 1:6 (non-immune)
D. Blood type A positive
Rationale: A rubella titer below 1:10 indicates non-immunity, and the client should receive the rubella
vaccine postpartum since it is a live vaccine contraindicated during pregnancy. The other findings are
within acceptable ranges for pregnancy.
Q5. A client at 28 weeks gestation is diagnosed with gestational diabetes. Which dietary
recommendation is most appropriate?
A. Distribute carbohydrate intake across three meals and two to three snacks
throughout the day
B. Consume the majority of daily calories at breakfast to boost metabolism
C. Eliminate all carbohydrates from the diet to maintain glycemic control
D. Restrict caloric intake to 1,200 calories per day regardless of weight
Rationale: Evenly distributed carbohydrate intake prevents blood glucose spikes and maintains stable
levels. Eliminating carbohydrates risks ketosis, front-loading calories causes post-breakfast
hyperglycemia, and severe caloric restriction is harmful to fetal growth.
Q6. Which immunization is contraindicated during pregnancy?
A. Inactivated influenza vaccine
, B. Measles, mumps, and rubella (MMR) vaccine
C. Tdap (tetanus, diphtheria, pertussis) vaccine
D. Hepatitis B vaccine
Rationale: The MMR vaccine contains live attenuated viruses and is contraindicated during pregnancy
due to theoretical fetal risk. Influenza (inactivated), Tdap, and Hepatitis B vaccines are safe and
recommended during pregnancy.
Q7. A client at 16 weeks gestation reports persistent nausea and vomiting. The nurse notes a
weight loss of 5 pounds since her first visit. Which condition should the nurse suspect?
A. Gestational trophoblastic disease
B. Gastroesophageal reflux disease
C. Normal first-trimester nausea that will resolve spontaneously
D. Hyperemesis gravidarum
Rationale: Hyperemesis gravidarum is characterized by severe, persistent nausea and vomiting leading
to weight loss, dehydration, and electrolyte imbalances. While mild nausea is common, significant
weight loss distinguishes hyperemesis. The other conditions present differently.
Q8. What is the recommended total weight gain during pregnancy for a client with a pre-
pregnancy BMI of 24 (normal weight)?
A. 25 to 35 pounds
B. 11 to 20 pounds
C. 15 to 25 pounds
D. 28 to 40 pounds
Rationale: The Institute of Medicine recommends 25-35 pounds for normal-weight women (BMI 18.5-
24.9). Overweight women should gain 15-25 pounds, obese women 11-20 pounds, and underweight
women 28-40 pounds.
Q9. A client who is Rh-negative delivers an Rh-positive newborn. What is the primary
purpose of administering Rho(D) immune globulin (RhoGAM)?
A. To prevent the mother from developing antibodies against Rh-positive blood cells in
future pregnancies
B. To treat the newborn's hemolytic disease
C. To increase the mother's red blood cell count
D. To prevent infection in the postpartum period
