Chamberlain
Maternal-Newborn
Nursing Exam
Format: NCLEX-style multiple choice with rationales | Focus: NR-327 Maternal-Newborn
Nursing
Section 1: Antepartum Care & Fetal Development
Question 1
A nurse is calculating the estimated date of delivery (EDD) for a client whose last
menstrual period began on March 10. Using Naegele's rule, what is the EDD?
A) December 10
B) December 17
C) December 3
D) December 24
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7
days and 1 year. March 10 → December 10 + 7 days = December 17 .
Question 2
,A client at 12 weeks gestation asks when she should expect to feel fetal movement.
Which response by the nurse is correct?
A) "You should feel movement at 12–14 weeks."
B) "You should feel movement at 18–20 weeks."
C) "You should feel movement at 24–26 weeks."
D) "You should feel movement at 28–30 weeks."
Rationale: Quickening (first perception of fetal movement) typically occurs between 18
and 20 weeks in primigravida clients .
Question 3
A client at 28 weeks gestation is diagnosed with gestational diabetes. Which instruction
is most important for the nurse to include?
A) "Restrict all carbohydrates."
B) "Monitor your blood glucose levels four times daily."
C) "Increase your physical activity to 2 hours daily."
D) "Take insulin before every meal."
Rationale: Blood glucose monitoring is essential for managing gestational diabetes.
Dietary management is first-line, and insulin is added if diet alone is insufficient .
Question 4
A nurse is teaching a pregnant client about folic acid. Which statement
indicates correct understanding?
A) "I should take folic acid only during the first trimester."
B) "I should take 400–800 mcg of folic acid daily to prevent neural tube defects."
C) "Folic acid prevents gestational diabetes."
D) "Folic acid should be started after 20 weeks."
Rationale: Folic acid (400–800 mcg daily) is recommended before conception and
during early pregnancy to prevent neural tube defects .
,Question 5
A client at 36 weeks gestation reports a sudden gush of fluid from the vagina. Which
action should the nurse take first?
A) Perform a sterile vaginal exam
B) Assess the fetal heart rate and check for cord prolapse
C) Prepare the client for delivery
D) Administer antibiotics
Rationale: Rupture of membranes increases the risk of cord prolapse. The priority is
assessing fetal heart rate and checking for cord prolapse .
Section 2: Intrapartum Care
Question 6
A client in labor is 4 cm dilated and 100% effaced. Which stage of labor is the client in?
A) First stage, latent phase
B) First stage, active phase
C) Second stage
D) Third stage
Rationale: The active phase of the first stage of labor is characterized by cervical
dilation of 4–7 cm with rapid dilation and 100% effacement .
Question 7
A nurse is monitoring a client in labor. Which finding indicates fetal distress?
, A) Fetal heart rate of 140 beats/min with variability
B) Fetal heart rate of 130 beats/min
C) Late decelerations with each contraction
D) Early decelerations with each contraction
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia.
They are non-reassuring and require immediate intervention .
Question 8
A client receiving oxytocin for labor induction demonstrates uterine hyperstimulation.
What is the priority action?
A) Continue the infusion and monitor
B) Increase the oxytocin rate
C) Stop the oxytocin infusion
D) Administer pain medication
Rationale: Uterine hyperstimulation can cause fetal distress. Oxytocin must be stopped
immediately, and the provider notified .
Question 9
A client in labor requests epidural anesthesia. Which finding is a contraindication to
epidural placement?
A) Blood pressure of 120/80 mm Hg
B) Fetal heart rate of 140 beats/min
C) Coagulopathy or thrombocytopenia
D) Cervical dilation of 5 cm
Rationale: Coagulopathy or thrombocytopenia increases the risk of spinal hematoma
with epidural placement. It is a contraindication .
Maternal-Newborn
Nursing Exam
Format: NCLEX-style multiple choice with rationales | Focus: NR-327 Maternal-Newborn
Nursing
Section 1: Antepartum Care & Fetal Development
Question 1
A nurse is calculating the estimated date of delivery (EDD) for a client whose last
menstrual period began on March 10. Using Naegele's rule, what is the EDD?
A) December 10
B) December 17
C) December 3
D) December 24
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7
days and 1 year. March 10 → December 10 + 7 days = December 17 .
Question 2
,A client at 12 weeks gestation asks when she should expect to feel fetal movement.
Which response by the nurse is correct?
A) "You should feel movement at 12–14 weeks."
B) "You should feel movement at 18–20 weeks."
C) "You should feel movement at 24–26 weeks."
D) "You should feel movement at 28–30 weeks."
Rationale: Quickening (first perception of fetal movement) typically occurs between 18
and 20 weeks in primigravida clients .
Question 3
A client at 28 weeks gestation is diagnosed with gestational diabetes. Which instruction
is most important for the nurse to include?
A) "Restrict all carbohydrates."
B) "Monitor your blood glucose levels four times daily."
C) "Increase your physical activity to 2 hours daily."
D) "Take insulin before every meal."
Rationale: Blood glucose monitoring is essential for managing gestational diabetes.
Dietary management is first-line, and insulin is added if diet alone is insufficient .
Question 4
A nurse is teaching a pregnant client about folic acid. Which statement
indicates correct understanding?
A) "I should take folic acid only during the first trimester."
B) "I should take 400–800 mcg of folic acid daily to prevent neural tube defects."
C) "Folic acid prevents gestational diabetes."
D) "Folic acid should be started after 20 weeks."
Rationale: Folic acid (400–800 mcg daily) is recommended before conception and
during early pregnancy to prevent neural tube defects .
,Question 5
A client at 36 weeks gestation reports a sudden gush of fluid from the vagina. Which
action should the nurse take first?
A) Perform a sterile vaginal exam
B) Assess the fetal heart rate and check for cord prolapse
C) Prepare the client for delivery
D) Administer antibiotics
Rationale: Rupture of membranes increases the risk of cord prolapse. The priority is
assessing fetal heart rate and checking for cord prolapse .
Section 2: Intrapartum Care
Question 6
A client in labor is 4 cm dilated and 100% effaced. Which stage of labor is the client in?
A) First stage, latent phase
B) First stage, active phase
C) Second stage
D) Third stage
Rationale: The active phase of the first stage of labor is characterized by cervical
dilation of 4–7 cm with rapid dilation and 100% effacement .
Question 7
A nurse is monitoring a client in labor. Which finding indicates fetal distress?
, A) Fetal heart rate of 140 beats/min with variability
B) Fetal heart rate of 130 beats/min
C) Late decelerations with each contraction
D) Early decelerations with each contraction
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia.
They are non-reassuring and require immediate intervention .
Question 8
A client receiving oxytocin for labor induction demonstrates uterine hyperstimulation.
What is the priority action?
A) Continue the infusion and monitor
B) Increase the oxytocin rate
C) Stop the oxytocin infusion
D) Administer pain medication
Rationale: Uterine hyperstimulation can cause fetal distress. Oxytocin must be stopped
immediately, and the provider notified .
Question 9
A client in labor requests epidural anesthesia. Which finding is a contraindication to
epidural placement?
A) Blood pressure of 120/80 mm Hg
B) Fetal heart rate of 140 beats/min
C) Coagulopathy or thrombocytopenia
D) Cervical dilation of 5 cm
Rationale: Coagulopathy or thrombocytopenia increases the risk of spinal hematoma
with epidural placement. It is a contraindication .
