LPN/LVN Maternal-Newborn
Competency Exam — Code: LPN-MN-
COMP | 100-Question Advanced
Practice Exam 2026 | Questions &
Answers with Detailed Rationales |
Complete Exam Prep & Study Guide
1.
A client at 32 weeks’ gestation reports a sudden gush of clear fluid from the
vagina. Which nursing action is the priority?
A. Perform a digital vaginal examination
B. Obtain a clean-catch urine specimen
C. Assess fetal heart rate
D. Encourage the client to ambulate
Answer: C. Assess fetal heart rate
Rationale: Rupture of membranes can be associated with umbilical cord
prolapse or fetal compromise. Fetal heart rate assessment is the immediate
,priority before other interventions. Digital vaginal examinations should be
avoided unless necessary because they increase infection risk.
2.
A pregnant client with severe preeclampsia is receiving magnesium sulfate. Which
finding requires immediate intervention?
A. Respiratory rate of 10/min
B. Urine output of 40 mL/hr
C. Patellar reflexes 2+
D. Blood pressure of 150/96 mm Hg
Answer: A. Respiratory rate of 10/min
Rationale: Magnesium toxicity can cause respiratory depression, diminished
reflexes, and cardiac arrest. A respiratory rate below 12/min is an urgent
finding. Magnesium sulfate should be stopped and calcium gluconate prepared
according to protocol.
3.
A client receiving oxytocin develops uterine contractions every 1 minute lasting
100 seconds, with recurrent late fetal heart rate decelerations. What is the
priority nursing action?
A. Increase the oxytocin infusion
B. Stop the oxytocin infusion
C. Encourage pushing
D. Place the client supine
Answer: B. Stop the oxytocin infusion
Rationale: Excessive uterine activity can reduce placental perfusion and cause
fetal hypoxia. Oxytocin should be stopped immediately, followed by intrauterine
resuscitation measures such as repositioning and IV fluid administration.
4.
,A postpartum client has a boggy uterus and heavy vaginal bleeding. What should
the nurse do first?
A. Notify the provider
B. Administer methylergonovine
C. Massage the uterine fundus
D. Insert an indwelling catheter
Answer: C. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, a major cause of postpartum
hemorrhage. Fundal massage stimulates uterine contraction and is an
immediate nursing intervention.
5.
A newborn develops grunting, nasal flaring, and intercostal retractions shortly
after birth. Which condition is most concerning?
A. Normal transition
B. Respiratory distress
C. Physiologic jaundice
D. Hypothermia only
Answer: B. Respiratory distress
Rationale: Grunting, nasal flaring, and retractions are signs of increased
respiratory effort and require immediate assessment and intervention.
6.
A newborn of a diabetic mother is jittery and lethargic. Which assessment should
the nurse prioritize?
A. Head circumference
B. Blood glucose level
C. Hearing screening
D. Moro reflex
, Answer: B. Blood glucose level
Rationale: Infants of diabetic mothers are at increased risk for neonatal
hypoglycemia because of fetal hyperinsulinemia. Jitteriness and lethargy are
common manifestations.
7.
A client at 34 weeks’ gestation has painless bright-red vaginal bleeding. Which
condition is most likely?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Answer: B. Placenta previa
Rationale: Placenta previa classically presents with painless, bright-red vaginal
bleeding during the second half of pregnancy. Vaginal examination should be
avoided until placenta previa has been excluded.
8.
A client at 36 weeks’ gestation develops sudden abdominal pain, a rigid uterus,
and dark vaginal bleeding. Which condition is most likely?
A. Placenta previa
B. Placental abruption
C. Cervical insufficiency
D. Hyperemesis gravidarum
Answer: B. Placental abruption
Rationale: Placental abruption commonly presents with painful vaginal
bleeding, uterine tenderness or rigidity, and possible fetal distress.
9.
Competency Exam — Code: LPN-MN-
COMP | 100-Question Advanced
Practice Exam 2026 | Questions &
Answers with Detailed Rationales |
Complete Exam Prep & Study Guide
1.
A client at 32 weeks’ gestation reports a sudden gush of clear fluid from the
vagina. Which nursing action is the priority?
A. Perform a digital vaginal examination
B. Obtain a clean-catch urine specimen
C. Assess fetal heart rate
D. Encourage the client to ambulate
Answer: C. Assess fetal heart rate
Rationale: Rupture of membranes can be associated with umbilical cord
prolapse or fetal compromise. Fetal heart rate assessment is the immediate
,priority before other interventions. Digital vaginal examinations should be
avoided unless necessary because they increase infection risk.
2.
A pregnant client with severe preeclampsia is receiving magnesium sulfate. Which
finding requires immediate intervention?
A. Respiratory rate of 10/min
B. Urine output of 40 mL/hr
C. Patellar reflexes 2+
D. Blood pressure of 150/96 mm Hg
Answer: A. Respiratory rate of 10/min
Rationale: Magnesium toxicity can cause respiratory depression, diminished
reflexes, and cardiac arrest. A respiratory rate below 12/min is an urgent
finding. Magnesium sulfate should be stopped and calcium gluconate prepared
according to protocol.
3.
A client receiving oxytocin develops uterine contractions every 1 minute lasting
100 seconds, with recurrent late fetal heart rate decelerations. What is the
priority nursing action?
A. Increase the oxytocin infusion
B. Stop the oxytocin infusion
C. Encourage pushing
D. Place the client supine
Answer: B. Stop the oxytocin infusion
Rationale: Excessive uterine activity can reduce placental perfusion and cause
fetal hypoxia. Oxytocin should be stopped immediately, followed by intrauterine
resuscitation measures such as repositioning and IV fluid administration.
4.
,A postpartum client has a boggy uterus and heavy vaginal bleeding. What should
the nurse do first?
A. Notify the provider
B. Administer methylergonovine
C. Massage the uterine fundus
D. Insert an indwelling catheter
Answer: C. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, a major cause of postpartum
hemorrhage. Fundal massage stimulates uterine contraction and is an
immediate nursing intervention.
5.
A newborn develops grunting, nasal flaring, and intercostal retractions shortly
after birth. Which condition is most concerning?
A. Normal transition
B. Respiratory distress
C. Physiologic jaundice
D. Hypothermia only
Answer: B. Respiratory distress
Rationale: Grunting, nasal flaring, and retractions are signs of increased
respiratory effort and require immediate assessment and intervention.
6.
A newborn of a diabetic mother is jittery and lethargic. Which assessment should
the nurse prioritize?
A. Head circumference
B. Blood glucose level
C. Hearing screening
D. Moro reflex
, Answer: B. Blood glucose level
Rationale: Infants of diabetic mothers are at increased risk for neonatal
hypoglycemia because of fetal hyperinsulinemia. Jitteriness and lethargy are
common manifestations.
7.
A client at 34 weeks’ gestation has painless bright-red vaginal bleeding. Which
condition is most likely?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Answer: B. Placenta previa
Rationale: Placenta previa classically presents with painless, bright-red vaginal
bleeding during the second half of pregnancy. Vaginal examination should be
avoided until placenta previa has been excluded.
8.
A client at 36 weeks’ gestation develops sudden abdominal pain, a rigid uterus,
and dark vaginal bleeding. Which condition is most likely?
A. Placenta previa
B. Placental abruption
C. Cervical insufficiency
D. Hyperemesis gravidarum
Answer: B. Placental abruption
Rationale: Placental abruption commonly presents with painful vaginal
bleeding, uterine tenderness or rigidity, and possible fetal distress.
9.
