NUR 2513 Maternal-Child Nursing 2026/2027 | Rasmussen College NUR 2513 Exam 1,
Exam 2, Exam 3 & Final Exam Study Guide | Maternal Child Nursing Practice Questions
& Exam Prep | Antepartum Nursing, Prenatal Care, Pregnancy Assessment, High-Risk
Pregnancy, Fetal Assessment, Fetal Heart Rate Monitoring, Labor & Delivery, Stages
of Labor, Pain Management, Obstetric Complications, Postpartum Nursing Care,
Postpartum Assessment, Postpartum Hemorrhage, Preeclampsia, Newborn
Assessment, APGAR, Newborn Adaptation, Breastfeeding, Pediatric Growth &
Development, Pediatric Health Conditions, Medication Administration, Patient
Education & Nursing Interventions | Practice Questions with Detailed Rationales
Question 1: A client at 38 weeks' gestation is admitted in active labor. The nurse
notes a pattern of fetal heart rate decelerations that begin after the peak of the
contraction and return to baseline after the contraction ends. Which
physiological mechanism best explains this finding?
A. Head compression during descent
B. Umbilical cord compression during contractions
C. Uteroplacental insufficiency during contractions
D. Fetal sleep cycle variation
E. Maternal hypotension from epidural placement
CORRECT ANSWER: C. Uteroplacental insufficiency during contractions
Rationale: Late decelerations are visually apparent, gradual decreases in FHR that
begin after the peak of the uterine contraction and return to baseline after the
contraction ends. They are caused by uteroplacental insufficiency, meaning the
placenta is not delivering adequate oxygen to the fetus during contractions. This
is a non-reassuring pattern that requires intrauterine resuscitation and provider
notification.
Question 2: A postpartum client who delivered 6 hours ago reports perineal
pain and pressure. The nurse observes a large, swollen, bluish-purple mass on
the labia. Which complication should the nurse suspect?
A. Perineal laceration
B. Vulvar hematoma
C. Uterine inversion
D. Cervical tear
E. Normal postpartum edema
CORRECT ANSWER: B. Vulvar hematoma
,Rationale: A vulvar hematoma presents as a painful, swollen, discolored mass in
the vulvar or perineal area following trauma during delivery. The bluish-purple
discoloration indicates pooled blood beneath the skin. This requires prompt
provider notification as the hematoma can expand and compromise circulation.
Question 3: A newborn is delivered at 39 weeks' gestation. At 1 minute of life,
the heart rate is 130 bpm, the infant has a strong cry, active motion with flexed
extremities, grimaces when suctioned, and a pink body with blue hands and
feet. What is the Apgar score?
A. 7
B. 8
C. 9
D. 10
E. 6
CORRECT ANSWER: C. 9
Rationale: Heart rate >100 = 2 points. Strong cry = 2 points. Active motion = 2
points. Grimace = 2 points. Acrocyanosis (pink body, blue extremities) = 1 point.
Total = 9. This indicates the newborn is transitioning well to extrauterine life.
Question 4: A client at 34 weeks' gestation is admitted with preeclampsia. The
provider orders magnesium sulfate infusion. Which assessment finding requires
immediate nursing intervention?
A. Blood pressure of 148/92 mm Hg
B. Deep tendon reflexes of 2+
C. Respiratory rate of 10 breaths per minute
D. Urine output of 35 mL/hr
E. Fetal heart rate of 140 bpm
CORRECT ANSWER: C. Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate toxicity manifests as respiratory depression
(respiratory rate <12 breaths/min), loss of deep tendon reflexes, and oliguria. A
respiratory rate of 10 indicates impending respiratory failure and requires
immediate discontinuation of the infusion and administration of calcium
gluconate, the antidote.
,Question 5: A nurse is teaching a client at 12 weeks' gestation about expected
physiological changes of pregnancy. Which client statement indicates a need for
further teaching?
A. "I may notice my gums bleed when I brush my teeth."
B. "I should expect my blood pressure to decrease slightly."
C. "I need to double my calorie intake immediately."
D. "Heartburn is common due to progesterone relaxing the sphincter."
E. "I may feel dizzy when standing up quickly."
CORRECT ANSWER: C. "I need to double my calorie intake immediately."
Rationale: Calorie needs do not double during pregnancy. The additional caloric
requirement is approximately 340 calories per day in the second trimester and
450 calories per day in the third trimester. Teaching the client that she needs to
double her intake indicates a knowledge deficit requiring correction.
Question 6: A client at 39 weeks' gestation is receiving oxytocin for labor
augmentation. The nurse notes contractions occurring every 90 seconds, lasting
70 seconds, with a resting tone that remains elevated between contractions.
Which is the priority nursing action?
A. Increase the oxytocin rate to strengthen contractions
B. Discontinue the oxytocin infusion
C. Administer an analgesic for pain
D. Document the finding and continue monitoring
E. Perform a sterile vaginal examination
CORRECT ANSWER: B. Discontinue the oxytocin infusion
Rationale: Hypertonic uterine contractions (tachysystole) are characterized by
contractions occurring more frequently than every 2 minutes, lasting longer than
60 seconds, and/or with elevated resting tone. This pattern reduces placental
perfusion and can cause fetal hypoxia. The oxytocin must be discontinued
immediately.
Question 7: A newborn is 24 hours old. The nurse notes a yellowish tint to the
skin on the face and trunk. The infant is breastfeeding well and has adequate
urine output. Which is the most appropriate nursing action?
, A. Initiate phototherapy immediately
B. Notify the provider for a bilirubin level
C. Continue monitoring and encourage frequent feeding
D. Prepare for exchange transfusion
E. Administer intravenous fluids
CORRECT ANSWER: C. Continue monitoring and encourage frequent feeding
Rationale: Physiological jaundice typically appears after 24 hours of life and
progresses cephalocaudally. In a feeding, well-appearing infant with adequate
output, frequent breastfeeding helps promote bilirubin excretion through
meconium and urine. The nurse should continue monitoring and notify the
provider if jaundice worsens or extends to the extremities.
Question 8: A client who is 2 days postpartum reports pain and redness in the
left breast accompanied by flu-like symptoms. The nurse notes a warm, tender,
reddened area on the upper outer quadrant. Which condition should the nurse
suspect?
A. Engorgement
B. Mastitis
C. Plugged duct
D. Breast abscess
E. Normal postpartum breast changes
CORRECT ANSWER: B. Mastitis
Rationale: Mastitis presents with a tender, red, warm, wedge-shaped area on the
breast, often accompanied by fever and flu-like symptoms. It typically occurs after
the first week postpartum but can occur earlier. Treatment includes continued
breastfeeding or pumping, antibiotics, and supportive care.
Question 9: A nurse is assessing a newborn and notes a single transverse palmar
crease, flattened facial features, and poor muscle tone. The nurse should
suspect which chromosomal abnormality?
A. Trisomy 18
B. Trisomy 21
C. Turner syndrome
Exam 2, Exam 3 & Final Exam Study Guide | Maternal Child Nursing Practice Questions
& Exam Prep | Antepartum Nursing, Prenatal Care, Pregnancy Assessment, High-Risk
Pregnancy, Fetal Assessment, Fetal Heart Rate Monitoring, Labor & Delivery, Stages
of Labor, Pain Management, Obstetric Complications, Postpartum Nursing Care,
Postpartum Assessment, Postpartum Hemorrhage, Preeclampsia, Newborn
Assessment, APGAR, Newborn Adaptation, Breastfeeding, Pediatric Growth &
Development, Pediatric Health Conditions, Medication Administration, Patient
Education & Nursing Interventions | Practice Questions with Detailed Rationales
Question 1: A client at 38 weeks' gestation is admitted in active labor. The nurse
notes a pattern of fetal heart rate decelerations that begin after the peak of the
contraction and return to baseline after the contraction ends. Which
physiological mechanism best explains this finding?
A. Head compression during descent
B. Umbilical cord compression during contractions
C. Uteroplacental insufficiency during contractions
D. Fetal sleep cycle variation
E. Maternal hypotension from epidural placement
CORRECT ANSWER: C. Uteroplacental insufficiency during contractions
Rationale: Late decelerations are visually apparent, gradual decreases in FHR that
begin after the peak of the uterine contraction and return to baseline after the
contraction ends. They are caused by uteroplacental insufficiency, meaning the
placenta is not delivering adequate oxygen to the fetus during contractions. This
is a non-reassuring pattern that requires intrauterine resuscitation and provider
notification.
Question 2: A postpartum client who delivered 6 hours ago reports perineal
pain and pressure. The nurse observes a large, swollen, bluish-purple mass on
the labia. Which complication should the nurse suspect?
A. Perineal laceration
B. Vulvar hematoma
C. Uterine inversion
D. Cervical tear
E. Normal postpartum edema
CORRECT ANSWER: B. Vulvar hematoma
,Rationale: A vulvar hematoma presents as a painful, swollen, discolored mass in
the vulvar or perineal area following trauma during delivery. The bluish-purple
discoloration indicates pooled blood beneath the skin. This requires prompt
provider notification as the hematoma can expand and compromise circulation.
Question 3: A newborn is delivered at 39 weeks' gestation. At 1 minute of life,
the heart rate is 130 bpm, the infant has a strong cry, active motion with flexed
extremities, grimaces when suctioned, and a pink body with blue hands and
feet. What is the Apgar score?
A. 7
B. 8
C. 9
D. 10
E. 6
CORRECT ANSWER: C. 9
Rationale: Heart rate >100 = 2 points. Strong cry = 2 points. Active motion = 2
points. Grimace = 2 points. Acrocyanosis (pink body, blue extremities) = 1 point.
Total = 9. This indicates the newborn is transitioning well to extrauterine life.
Question 4: A client at 34 weeks' gestation is admitted with preeclampsia. The
provider orders magnesium sulfate infusion. Which assessment finding requires
immediate nursing intervention?
A. Blood pressure of 148/92 mm Hg
B. Deep tendon reflexes of 2+
C. Respiratory rate of 10 breaths per minute
D. Urine output of 35 mL/hr
E. Fetal heart rate of 140 bpm
CORRECT ANSWER: C. Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate toxicity manifests as respiratory depression
(respiratory rate <12 breaths/min), loss of deep tendon reflexes, and oliguria. A
respiratory rate of 10 indicates impending respiratory failure and requires
immediate discontinuation of the infusion and administration of calcium
gluconate, the antidote.
,Question 5: A nurse is teaching a client at 12 weeks' gestation about expected
physiological changes of pregnancy. Which client statement indicates a need for
further teaching?
A. "I may notice my gums bleed when I brush my teeth."
B. "I should expect my blood pressure to decrease slightly."
C. "I need to double my calorie intake immediately."
D. "Heartburn is common due to progesterone relaxing the sphincter."
E. "I may feel dizzy when standing up quickly."
CORRECT ANSWER: C. "I need to double my calorie intake immediately."
Rationale: Calorie needs do not double during pregnancy. The additional caloric
requirement is approximately 340 calories per day in the second trimester and
450 calories per day in the third trimester. Teaching the client that she needs to
double her intake indicates a knowledge deficit requiring correction.
Question 6: A client at 39 weeks' gestation is receiving oxytocin for labor
augmentation. The nurse notes contractions occurring every 90 seconds, lasting
70 seconds, with a resting tone that remains elevated between contractions.
Which is the priority nursing action?
A. Increase the oxytocin rate to strengthen contractions
B. Discontinue the oxytocin infusion
C. Administer an analgesic for pain
D. Document the finding and continue monitoring
E. Perform a sterile vaginal examination
CORRECT ANSWER: B. Discontinue the oxytocin infusion
Rationale: Hypertonic uterine contractions (tachysystole) are characterized by
contractions occurring more frequently than every 2 minutes, lasting longer than
60 seconds, and/or with elevated resting tone. This pattern reduces placental
perfusion and can cause fetal hypoxia. The oxytocin must be discontinued
immediately.
Question 7: A newborn is 24 hours old. The nurse notes a yellowish tint to the
skin on the face and trunk. The infant is breastfeeding well and has adequate
urine output. Which is the most appropriate nursing action?
, A. Initiate phototherapy immediately
B. Notify the provider for a bilirubin level
C. Continue monitoring and encourage frequent feeding
D. Prepare for exchange transfusion
E. Administer intravenous fluids
CORRECT ANSWER: C. Continue monitoring and encourage frequent feeding
Rationale: Physiological jaundice typically appears after 24 hours of life and
progresses cephalocaudally. In a feeding, well-appearing infant with adequate
output, frequent breastfeeding helps promote bilirubin excretion through
meconium and urine. The nurse should continue monitoring and notify the
provider if jaundice worsens or extends to the extremities.
Question 8: A client who is 2 days postpartum reports pain and redness in the
left breast accompanied by flu-like symptoms. The nurse notes a warm, tender,
reddened area on the upper outer quadrant. Which condition should the nurse
suspect?
A. Engorgement
B. Mastitis
C. Plugged duct
D. Breast abscess
E. Normal postpartum breast changes
CORRECT ANSWER: B. Mastitis
Rationale: Mastitis presents with a tender, red, warm, wedge-shaped area on the
breast, often accompanied by fever and flu-like symptoms. It typically occurs after
the first week postpartum but can occur earlier. Treatment includes continued
breastfeeding or pumping, antibiotics, and supportive care.
Question 9: A nurse is assessing a newborn and notes a single transverse palmar
crease, flattened facial features, and poor muscle tone. The nurse should
suspect which chromosomal abnormality?
A. Trisomy 18
B. Trisomy 21
C. Turner syndrome
