MATERNITY AND PEDIATRIC NURSING
FINAL EXAM PREP 100 HIGHLY
CHALLENGING Q AND A WITH
COMPREHENSIVE RATIONALES AND
EXPERT EXPLANATIONS UPDATED FOR
2026
Maternity and Pediatric Nursing Final Exam Questions
1–100
1. A 26-year-old multigravida at 34 weeks gestation presents to
the triage unit complaining of a sudden onset of severe
abdominal pain followed by dark red vaginal bleeding. Her
abdomen is rigid and tender to palpation. Which of the
following conditions should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Cervical incompetence
D. Hydatidiform mole
CORRECT ANSWER: B
RATiONAlE: Abruptio placentae is the premature
separation of a normally implanted placenta from the
uterine wall. Classic manifestations include dark red
vaginal bleeding, severe abdominal pain, and a rigid,
board-like abdomen. Placenta previa typically presents
with painless, bright red vaginal bleeding.
,2. A nurse is caring for a client in active labor who is receiving
an intravenous oxytocin infusion. The nurse notes that the
fetal heart rate (FHR) monitor shows late decelerations.
Which action should the nurse take first?
A. Increase the oxytocin infusion rate.
B. Turn the client onto her left side.
C. Administer oxygen via nasal cannula at 2 L/min.
D. Prepare the client for an immediate amniotomy.
CORRECT ANSWER: B
RATiONAlE: Late decelerations indicate uteroplacental
insufficiency. The immediate priority is to improve
placental blood flow, which is achieved by turning the client
onto her side (preferably left side) to relieve vena cava
compression. Oxytocin should be discontinued, not
increased, and oxygen should be administered via non-
rebreather mask at 8–10 L/min.
3. A nurse is performing an assessment on a 12-hour-old
newborn. Which of the following findings requires
immediate clinical intervention?
A. Acrocyanosis in the hands and feet
B. Harlequin color change on one side of the body
C. Jaundice on the face and sclera
D. Erythema toxicum on the chest
CORRECT ANSWER: C
RATiONAlE: Jaundice occurring within the first 24
hours of life is considered pathological and requires
immediate investigation, as it may indicate hemolytic
disease. Acrocyanosis, harlequin color change, and
, erythema toxicum are normal, benign findings in a
newborn.
4. A 6-year-old child is admitted to the pediatric unit with a
diagnosis of acute post-streptococcal glomerulonephritis
(APSGN). Which clinical manifestation should the nurse
expect to observe?
A. Hypotension and polyuria
B. Gross hematuria and periorbital edema
C. Generalized rash and severe pruritus
D. Profuse watery diarrhea and weight loss
CORRECT ANSWER: B
RATiONAlE: APSGN is characterized by the sudden
onset of hematuria (often described as tea-colored or smoky
urine), proteinuria, periorbital edema, and hypertension
due to decreased glomerular filtration.
5. A client at 32 weeks gestation is admitted to the high-risk
unit with preeclampsia. The physician orders a continuous
magnesium sulfate infusion. Which of the following findings
would indicate to the nurse that the client is experiencing
magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10 breaths per minute
C. Urinary output of 40 mL over the last hour
D. Blood pressure of 140/90 mmHg
CORRECT ANSWER: B
RATiONAlE: Signs of magnesium sulfate toxicity include
central nervous system depression, which manifests as a
respiratory rate below 12 breaths per minute, loss of deep
, tendon reflexes, and decreased urinary output (less than 30
mL/hr).
6. A nurse is evaluating the developmental milestones of an 8-
month-old infant during a well-child checkup. Which skill
should the infant be able to perform?
A. Walking while holding onto furniture
B. Sitting steadily without support
C. Saying three to five words with meaning
D. Building a tower of two blocks
CORRECT ANSWER: B
RATiONAlE: Most infants can sit steadily without
support by 8 months of age. Walking while holding onto
furniture (cruising) occurs around 10–11 months. Saying
words with meaning and stacking blocks are milestones for
older infants and toddlers.
7. A postpartum client who delivered 4 days ago calls the clinic
complaining of exhaustion, tearfulness, and feeling
overwhelmed. She states, "I love my baby, but I just can't
stop crying." How should the nurse interpret these findings?
A. Postpartum psychosis
B. Postpartum depression
C. Postpartum blues
D. Normal maternal adjustment
CORRECT ANSWER: C
RATiONAlE: Postpartum blues (or "baby blues") occur
in up to 80% of women, typically peaking around
postpartum days 3 to 5 and resolving spontaneously within
2 weeks. It is characterized by tearfulness, anxiety, and
FINAL EXAM PREP 100 HIGHLY
CHALLENGING Q AND A WITH
COMPREHENSIVE RATIONALES AND
EXPERT EXPLANATIONS UPDATED FOR
2026
Maternity and Pediatric Nursing Final Exam Questions
1–100
1. A 26-year-old multigravida at 34 weeks gestation presents to
the triage unit complaining of a sudden onset of severe
abdominal pain followed by dark red vaginal bleeding. Her
abdomen is rigid and tender to palpation. Which of the
following conditions should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Cervical incompetence
D. Hydatidiform mole
CORRECT ANSWER: B
RATiONAlE: Abruptio placentae is the premature
separation of a normally implanted placenta from the
uterine wall. Classic manifestations include dark red
vaginal bleeding, severe abdominal pain, and a rigid,
board-like abdomen. Placenta previa typically presents
with painless, bright red vaginal bleeding.
,2. A nurse is caring for a client in active labor who is receiving
an intravenous oxytocin infusion. The nurse notes that the
fetal heart rate (FHR) monitor shows late decelerations.
Which action should the nurse take first?
A. Increase the oxytocin infusion rate.
B. Turn the client onto her left side.
C. Administer oxygen via nasal cannula at 2 L/min.
D. Prepare the client for an immediate amniotomy.
CORRECT ANSWER: B
RATiONAlE: Late decelerations indicate uteroplacental
insufficiency. The immediate priority is to improve
placental blood flow, which is achieved by turning the client
onto her side (preferably left side) to relieve vena cava
compression. Oxytocin should be discontinued, not
increased, and oxygen should be administered via non-
rebreather mask at 8–10 L/min.
3. A nurse is performing an assessment on a 12-hour-old
newborn. Which of the following findings requires
immediate clinical intervention?
A. Acrocyanosis in the hands and feet
B. Harlequin color change on one side of the body
C. Jaundice on the face and sclera
D. Erythema toxicum on the chest
CORRECT ANSWER: C
RATiONAlE: Jaundice occurring within the first 24
hours of life is considered pathological and requires
immediate investigation, as it may indicate hemolytic
disease. Acrocyanosis, harlequin color change, and
, erythema toxicum are normal, benign findings in a
newborn.
4. A 6-year-old child is admitted to the pediatric unit with a
diagnosis of acute post-streptococcal glomerulonephritis
(APSGN). Which clinical manifestation should the nurse
expect to observe?
A. Hypotension and polyuria
B. Gross hematuria and periorbital edema
C. Generalized rash and severe pruritus
D. Profuse watery diarrhea and weight loss
CORRECT ANSWER: B
RATiONAlE: APSGN is characterized by the sudden
onset of hematuria (often described as tea-colored or smoky
urine), proteinuria, periorbital edema, and hypertension
due to decreased glomerular filtration.
5. A client at 32 weeks gestation is admitted to the high-risk
unit with preeclampsia. The physician orders a continuous
magnesium sulfate infusion. Which of the following findings
would indicate to the nurse that the client is experiencing
magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10 breaths per minute
C. Urinary output of 40 mL over the last hour
D. Blood pressure of 140/90 mmHg
CORRECT ANSWER: B
RATiONAlE: Signs of magnesium sulfate toxicity include
central nervous system depression, which manifests as a
respiratory rate below 12 breaths per minute, loss of deep
, tendon reflexes, and decreased urinary output (less than 30
mL/hr).
6. A nurse is evaluating the developmental milestones of an 8-
month-old infant during a well-child checkup. Which skill
should the infant be able to perform?
A. Walking while holding onto furniture
B. Sitting steadily without support
C. Saying three to five words with meaning
D. Building a tower of two blocks
CORRECT ANSWER: B
RATiONAlE: Most infants can sit steadily without
support by 8 months of age. Walking while holding onto
furniture (cruising) occurs around 10–11 months. Saying
words with meaning and stacking blocks are milestones for
older infants and toddlers.
7. A postpartum client who delivered 4 days ago calls the clinic
complaining of exhaustion, tearfulness, and feeling
overwhelmed. She states, "I love my baby, but I just can't
stop crying." How should the nurse interpret these findings?
A. Postpartum psychosis
B. Postpartum depression
C. Postpartum blues
D. Normal maternal adjustment
CORRECT ANSWER: C
RATiONAlE: Postpartum blues (or "baby blues") occur
in up to 80% of women, typically peaking around
postpartum days 3 to 5 and resolving spontaneously within
2 weeks. It is characterized by tearfulness, anxiety, and
