NURS 306: Maternal-Newborn Nursing Study Bank
with Detailed Rationales
Course Code: NURS 306
Course Name: Maternal-Newborn Nursing
Topic: Advanced Obstetric Nursing, Complications of Pregnancy, Intrapartum
Triage, and Neonatal Physiology
Academic Year: 2026/2027
1. A nurse is caring for a client who is anemic at 32 weeks of gestation and is in
preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the
following outcomes should the nurse expect?
A. A reduction in respiratory distress in the newborn
B. Immediate cessation of uterine contractions
C. Rapid elevation of maternal hemoglobin levels
D. Prevention of maternal postpartum hemorrhage
CORRECT ANSWER: A
RATIONALE: Betamethasone is a synthetic corticosteroid administered
intramuscularly to clients in preterm labor between 24 and 34 weeks of gestation.
It functions by accelerating fetal lung maturation and stimulating the synthesis of
surfactant in the fetal alveoli, resulting in a reduction in respiratory distress
syndrome (RDS), intraventricular hemorrhage, and neonatal mortality.
Betamethasone possesses no tocolytic properties to arrest uterine contractions,
does not treat maternal anemia, and has no direct effect on postpartum blood loss.
2. A nurse is caring for a client who is at 15 weeks of gestation, is Rh-negative,
and has just had an amniocentesis. Which of the following interventions is the
nurse's priority following the procedure?
A. Monitor the fetal heart rate (FHR).
B. Administer Rho(D) immune globulin.
C. Assess the maternal blood pressure.
D. Cleanse the abdominal puncture site.
CORRECT ANSWER: A
RATIONALE: Following an invasive antepartum procedure such as an
amniocentesis, the nurse's immediate priority framework is to ensure fetal stability
,by monitoring the fetal heart rate (FHR) and uterine activity. This helps identify
early signs of fetal distress, accidental placental perforation, or uterine trauma.
While administering Rho(D) immune globulin is essential to prevent Rh
isoimmunization in an Rh-negative client following a procedure with risk of fetal-
maternal hemorrhage, ensuring immediate fetal viability takes clinical precedence
over prophylactic immunizations. Maternal vital signs and local wound care are
routine post-procedural tasks performed after establishing a reassuring fetal
profile.
3. A nurse in an antepartum clinic is assessing a client who is at 32 weeks of
gestation. Which of the following findings should the nurse report to the provider?
A. Nonpitting 1+ pedal edema at the end of the day
B. Reports of decreased fetal movement
C. Hyperpigmentation across the cheeks (chloasma)
D. Braxton Hicks contractions felt in the lower abdomen
CORRECT ANSWER: B
RATIONALE: A report of decreased fetal movement (fewer than 10 kicks
within a 2-hour window) is a potential warning sign of fetal compromise or
uteroplacental insufficiency and must be reported immediately for further
evaluation, such as a non-stress test (NST). Minor nonpitting lower extremity
edema, chloasma (the "mask of pregnancy"), and sporadic, painless Braxton Hicks
contractions are expected physiological findings during the third trimester that do
not indicate an emergency.
4. A nurse is admitting a client to the labor and delivery unit when the client states,
"My water just broke." Which of the following interventions is the nurse's
priority?
A. Perform a nitrazine paper test to confirm fluid identity.
B. Begin fetal heart rate (FHR) monitoring.
C. Assess the maternal temperature.
D. Estimate the volume of the amniotic fluid.
CORRECT ANSWER: B
RATIONALE: The immediate risk associated with the spontaneous or
artificial rupture of membranes is umbilical cord prolapse, where the cord is
swept downward ahead of the presenting part, leading to mechanical compression
, and acute fetal hypoxia. The nurse's highest priority action must be to begin fetal
heart rate (FHR) monitoring to screen for variable decelerations or profound
bradycardia. Confirming the fluid identity with nitrazine, monitoring maternal
temperature for chorioamnionitis, and documenting fluid characteristics are
standard secondary steps performed after establishing fetal safety.
5. A nurse is caring for a client who is at 36 weeks of gestation and has a positive
contraction stress test. The nurse should plan to prepare the client for which of the
following diagnostic tests?
A. Biophysical profile (BPP)
B. Chorionic villus sampling (CVS)
C. Maternal serum alpha-fetoprotein (MSAFP) screening
D. Percutaneous umbilical blood sampling (PUBS)
CORRECT ANSWER: A
RATIONALE: A positive contraction stress test (CST) indicates the presence
of late decelerations with at least 50% of contractions, signaling fetal intolerance to
labor and compromised uteroplacental reserves. The nurse should anticipate
preparing the client for a biophysical profile (BPP) to evaluate fetal well-being
further across five variables (fetal breathing, movements, tone, amniotic fluid
volume, and NST). Chorionic villus sampling and MSAFP are early gestational
genetic screens. Percutaneous umbilical blood sampling (PUBS) is an invasive
procedure utilized for direct fetal blood access, not standard third-trimester distress
evaluations.
6. A nurse is preparing to administer magnesium sulfate 2 g/hr IV to a client who is
in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5%
in water (D5W). The nurse should set the IV infusion pump to deliver how many
mL/hr?
A. 25 mL/hr
B. 50 mL/hr
C. 100 mL/hr
D. 200 mL/hr
CORRECT ANSWER: B
RATIONALE: To calculate the accurate continuous infusion pump rate in
milliliters per hour (mL/hr), use the standard dimensional analysis or the
with Detailed Rationales
Course Code: NURS 306
Course Name: Maternal-Newborn Nursing
Topic: Advanced Obstetric Nursing, Complications of Pregnancy, Intrapartum
Triage, and Neonatal Physiology
Academic Year: 2026/2027
1. A nurse is caring for a client who is anemic at 32 weeks of gestation and is in
preterm labor. The provider prescribed betamethasone 12 mg IM. Which of the
following outcomes should the nurse expect?
A. A reduction in respiratory distress in the newborn
B. Immediate cessation of uterine contractions
C. Rapid elevation of maternal hemoglobin levels
D. Prevention of maternal postpartum hemorrhage
CORRECT ANSWER: A
RATIONALE: Betamethasone is a synthetic corticosteroid administered
intramuscularly to clients in preterm labor between 24 and 34 weeks of gestation.
It functions by accelerating fetal lung maturation and stimulating the synthesis of
surfactant in the fetal alveoli, resulting in a reduction in respiratory distress
syndrome (RDS), intraventricular hemorrhage, and neonatal mortality.
Betamethasone possesses no tocolytic properties to arrest uterine contractions,
does not treat maternal anemia, and has no direct effect on postpartum blood loss.
2. A nurse is caring for a client who is at 15 weeks of gestation, is Rh-negative,
and has just had an amniocentesis. Which of the following interventions is the
nurse's priority following the procedure?
A. Monitor the fetal heart rate (FHR).
B. Administer Rho(D) immune globulin.
C. Assess the maternal blood pressure.
D. Cleanse the abdominal puncture site.
CORRECT ANSWER: A
RATIONALE: Following an invasive antepartum procedure such as an
amniocentesis, the nurse's immediate priority framework is to ensure fetal stability
,by monitoring the fetal heart rate (FHR) and uterine activity. This helps identify
early signs of fetal distress, accidental placental perforation, or uterine trauma.
While administering Rho(D) immune globulin is essential to prevent Rh
isoimmunization in an Rh-negative client following a procedure with risk of fetal-
maternal hemorrhage, ensuring immediate fetal viability takes clinical precedence
over prophylactic immunizations. Maternal vital signs and local wound care are
routine post-procedural tasks performed after establishing a reassuring fetal
profile.
3. A nurse in an antepartum clinic is assessing a client who is at 32 weeks of
gestation. Which of the following findings should the nurse report to the provider?
A. Nonpitting 1+ pedal edema at the end of the day
B. Reports of decreased fetal movement
C. Hyperpigmentation across the cheeks (chloasma)
D. Braxton Hicks contractions felt in the lower abdomen
CORRECT ANSWER: B
RATIONALE: A report of decreased fetal movement (fewer than 10 kicks
within a 2-hour window) is a potential warning sign of fetal compromise or
uteroplacental insufficiency and must be reported immediately for further
evaluation, such as a non-stress test (NST). Minor nonpitting lower extremity
edema, chloasma (the "mask of pregnancy"), and sporadic, painless Braxton Hicks
contractions are expected physiological findings during the third trimester that do
not indicate an emergency.
4. A nurse is admitting a client to the labor and delivery unit when the client states,
"My water just broke." Which of the following interventions is the nurse's
priority?
A. Perform a nitrazine paper test to confirm fluid identity.
B. Begin fetal heart rate (FHR) monitoring.
C. Assess the maternal temperature.
D. Estimate the volume of the amniotic fluid.
CORRECT ANSWER: B
RATIONALE: The immediate risk associated with the spontaneous or
artificial rupture of membranes is umbilical cord prolapse, where the cord is
swept downward ahead of the presenting part, leading to mechanical compression
, and acute fetal hypoxia. The nurse's highest priority action must be to begin fetal
heart rate (FHR) monitoring to screen for variable decelerations or profound
bradycardia. Confirming the fluid identity with nitrazine, monitoring maternal
temperature for chorioamnionitis, and documenting fluid characteristics are
standard secondary steps performed after establishing fetal safety.
5. A nurse is caring for a client who is at 36 weeks of gestation and has a positive
contraction stress test. The nurse should plan to prepare the client for which of the
following diagnostic tests?
A. Biophysical profile (BPP)
B. Chorionic villus sampling (CVS)
C. Maternal serum alpha-fetoprotein (MSAFP) screening
D. Percutaneous umbilical blood sampling (PUBS)
CORRECT ANSWER: A
RATIONALE: A positive contraction stress test (CST) indicates the presence
of late decelerations with at least 50% of contractions, signaling fetal intolerance to
labor and compromised uteroplacental reserves. The nurse should anticipate
preparing the client for a biophysical profile (BPP) to evaluate fetal well-being
further across five variables (fetal breathing, movements, tone, amniotic fluid
volume, and NST). Chorionic villus sampling and MSAFP are early gestational
genetic screens. Percutaneous umbilical blood sampling (PUBS) is an invasive
procedure utilized for direct fetal blood access, not standard third-trimester distress
evaluations.
6. A nurse is preparing to administer magnesium sulfate 2 g/hr IV to a client who is
in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5%
in water (D5W). The nurse should set the IV infusion pump to deliver how many
mL/hr?
A. 25 mL/hr
B. 50 mL/hr
C. 100 mL/hr
D. 200 mL/hr
CORRECT ANSWER: B
RATIONALE: To calculate the accurate continuous infusion pump rate in
milliliters per hour (mL/hr), use the standard dimensional analysis or the
