Maternal-Newborn Nursing Comprehensive Review 2026–2027
NURSING
COMPREHENSIVE
Evidence-Based Content Review + 100 Original Practice
Questions
Clinical Judgment • Prioritization • Assessment • Intervention
Maternal-Newborn Nursing Comprehensive Review 2026–2027
Professor's Note: This review synthesizes
current evidence-based standards, including NRP 9th Edition, ACOG 2026
guidelines, and NICHD fetal monitoring terminology. I have designed the 100
questions to test clinical judgment—not just recall—because at the bedside, you
will need to prioritize, assess, and intervene under pressure. Use the
checklists and high-yield concepts as your pre-exam rapid review.
---
Maternal-Newborn Nursing • 2026–2027 | 1
, Maternal-Newborn Nursing Comprehensive Review 2026–2027
PART ONE: COMPREHENSIVE CONTENT REVIEW
1. Prenatal Assessment
Initial Visit Components: Complete history
(GTPAL, medical, surgical, family, psychosocial), physical exam including
pelvic exam and Pap smear if due, baseline vital signs, and laboratory studies.
Key Laboratory Tests:
Test
Purpose
Normal/Expected
CBC
Anemia, infection, platelet baseline
Hgb ≥ 11 g/dL (1st trimester)
Blood type, Rh, antibody screen
Rh incompatibility risk
Negative antibody screen
Rubella titer
Immunity status
Positive (immune)
Varicella titer
Immunity status
Positive (immune)
Hepatitis B surface antigen
Infection status
Negative
HIV, Syphilis (RPR/VDRL), GC/Chlamydia
STI screening
Maternal-Newborn Nursing • 2026–2027 | 2
, Maternal-Newborn Nursing Comprehensive Review 2026–2027
Negative
TSH
Thyroid function
Normal range
Glucose challenge (24–28 weeks)
GDM screening
< 140 mg/dL (or < 135 per protocol)
Rh-Negative Management: If antibody screen
negative, administer Rho(D) immune globulin at 28 weeks and within 72 hours
postpartum if infant is Rh-positive. Also given after any bleeding event,
amniocentesis, or abortion. RhoGAM prevents Rh sensitization—maternal antibody formation
against fetal Rh-positive RBCs.
Naegele's Rule: EDD = LMP + 1 year − 3 months +
7 days.
GTPAL: Gravida (all pregnancies), Term (≥37
weeks), Preterm (20–36 6/7 weeks), Abortions (<20 weeks), Living children.
---
2. Normal Pregnancy
Physiological Adaptations:
Cardiovascular: Plasma volume increases 40–50%;
RBC mass increases 20–30% (physiologic anemia of pregnancy); heart rate
increases 10–15 bpm; cardiac output increases 30–50%; BP slightly lower in 2nd
trimester then returns to baseline; systemic vascular resistance decreases.
Respiratory: Diaphragm elevates; tidal volume
increases 30–40%; oxygen consumption increases 15–20%; mild respiratory
alkalosis compensated by renal bicarbonate excretion.
Renal: GFR increases 40–50%; renal plasma flow
increases; BUN and creatinine decrease; glucosuria and proteinuria may be
Maternal-Newborn Nursing • 2026–2027 | 3
, Maternal-Newborn Nursing Comprehensive Review 2026–2027
physiologic in trace amounts.
GI: Decreased gastric motility (progesterone
effect); nausea/vomiting in 1st trimester; constipation; heartburn; gallbladder
stasis.
Integumentary: Striae gravidarum, linea nigra,
chloasma, palmar erythema.
Musculoskeletal: Lordosis, joint laxity
(relaxin), diastasis recti.
Endocrine: hCG peaks 8–10 weeks; progesterone
maintains pregnancy; estrogen increases; insulin resistance increases in
2nd–3rd trimesters (human placental lactogen).
Signs of Pregnancy:
Presumptive: Amenorrhea, nausea, breast
tenderness, fatigue, urinary frequency
Probable: Goodell sign (cervical softening),
Chadwick sign (bluish cervix), Hegar sign (uterine softening), Braxton Hicks,
positive pregnancy test
Positive: Fetal heart tones, fetal movement
palpated by examiner, ultrasound visualization
---
3. Prenatal Nutrition
Caloric Needs:
1st trimester: No additional calories
2nd trimester: +340 calories/day
3rd trimester: +450 calories/day
Key Nutrients:
Nutrient
RDA in Pregnancy
Maternal-Newborn Nursing • 2026–2027 | 4
NURSING
COMPREHENSIVE
Evidence-Based Content Review + 100 Original Practice
Questions
Clinical Judgment • Prioritization • Assessment • Intervention
Maternal-Newborn Nursing Comprehensive Review 2026–2027
Professor's Note: This review synthesizes
current evidence-based standards, including NRP 9th Edition, ACOG 2026
guidelines, and NICHD fetal monitoring terminology. I have designed the 100
questions to test clinical judgment—not just recall—because at the bedside, you
will need to prioritize, assess, and intervene under pressure. Use the
checklists and high-yield concepts as your pre-exam rapid review.
---
Maternal-Newborn Nursing • 2026–2027 | 1
, Maternal-Newborn Nursing Comprehensive Review 2026–2027
PART ONE: COMPREHENSIVE CONTENT REVIEW
1. Prenatal Assessment
Initial Visit Components: Complete history
(GTPAL, medical, surgical, family, psychosocial), physical exam including
pelvic exam and Pap smear if due, baseline vital signs, and laboratory studies.
Key Laboratory Tests:
Test
Purpose
Normal/Expected
CBC
Anemia, infection, platelet baseline
Hgb ≥ 11 g/dL (1st trimester)
Blood type, Rh, antibody screen
Rh incompatibility risk
Negative antibody screen
Rubella titer
Immunity status
Positive (immune)
Varicella titer
Immunity status
Positive (immune)
Hepatitis B surface antigen
Infection status
Negative
HIV, Syphilis (RPR/VDRL), GC/Chlamydia
STI screening
Maternal-Newborn Nursing • 2026–2027 | 2
, Maternal-Newborn Nursing Comprehensive Review 2026–2027
Negative
TSH
Thyroid function
Normal range
Glucose challenge (24–28 weeks)
GDM screening
< 140 mg/dL (or < 135 per protocol)
Rh-Negative Management: If antibody screen
negative, administer Rho(D) immune globulin at 28 weeks and within 72 hours
postpartum if infant is Rh-positive. Also given after any bleeding event,
amniocentesis, or abortion. RhoGAM prevents Rh sensitization—maternal antibody formation
against fetal Rh-positive RBCs.
Naegele's Rule: EDD = LMP + 1 year − 3 months +
7 days.
GTPAL: Gravida (all pregnancies), Term (≥37
weeks), Preterm (20–36 6/7 weeks), Abortions (<20 weeks), Living children.
---
2. Normal Pregnancy
Physiological Adaptations:
Cardiovascular: Plasma volume increases 40–50%;
RBC mass increases 20–30% (physiologic anemia of pregnancy); heart rate
increases 10–15 bpm; cardiac output increases 30–50%; BP slightly lower in 2nd
trimester then returns to baseline; systemic vascular resistance decreases.
Respiratory: Diaphragm elevates; tidal volume
increases 30–40%; oxygen consumption increases 15–20%; mild respiratory
alkalosis compensated by renal bicarbonate excretion.
Renal: GFR increases 40–50%; renal plasma flow
increases; BUN and creatinine decrease; glucosuria and proteinuria may be
Maternal-Newborn Nursing • 2026–2027 | 3
, Maternal-Newborn Nursing Comprehensive Review 2026–2027
physiologic in trace amounts.
GI: Decreased gastric motility (progesterone
effect); nausea/vomiting in 1st trimester; constipation; heartburn; gallbladder
stasis.
Integumentary: Striae gravidarum, linea nigra,
chloasma, palmar erythema.
Musculoskeletal: Lordosis, joint laxity
(relaxin), diastasis recti.
Endocrine: hCG peaks 8–10 weeks; progesterone
maintains pregnancy; estrogen increases; insulin resistance increases in
2nd–3rd trimesters (human placental lactogen).
Signs of Pregnancy:
Presumptive: Amenorrhea, nausea, breast
tenderness, fatigue, urinary frequency
Probable: Goodell sign (cervical softening),
Chadwick sign (bluish cervix), Hegar sign (uterine softening), Braxton Hicks,
positive pregnancy test
Positive: Fetal heart tones, fetal movement
palpated by examiner, ultrasound visualization
---
3. Prenatal Nutrition
Caloric Needs:
1st trimester: No additional calories
2nd trimester: +340 calories/day
3rd trimester: +450 calories/day
Key Nutrients:
Nutrient
RDA in Pregnancy
Maternal-Newborn Nursing • 2026–2027 | 4
