MAT_PED_301: Maternal-Child Nursing (McKinney,
6th Edition) – Complete Growth, Development &
Obstetric Exam prep and Review
Course Code: MAT_PED_301
Course Name: Maternal-Child Nursing (McKinney, 6th Edition)
Topic: Advanced Obstetrics, Fetal Monitoring, Pediatric Growth & Development,
and High-Yield Child Health Interventions
Academic Year: 2026/2027
Category: Nursing Practice Question Bank
Intrapartum Fetal Heart Rate (FHR) Pattern Matrix
Description & Immediate
Primary
FHR Pattern Waveform Nursing Priority
Pathophysiology
Characteristic Action
Symmetrical, gradual Benign finding;
Transient fetal head
decrease that mirrors continue routine
Early compression during a
the contraction curve labor monitoring
Decelerations contraction; vagal
(onset to nadir ≥ 30 without active
nerve stimulation.
seconds). intervention.
Late Symmetrical, gradual Uteroplacental Discontinue
Decelerations decrease where the insufficiency; oxytocin, turn
, nadir occurs after the decreased oxygen patient to left
peak of the transfer across the lateral position,
contraction. placenta. administer O₂,
increase IV fluids.
Change maternal
Abrupt decrease (onset
Umbilical cord position
to nadir < 30 seconds),
Variable compression; immediately to
visually sharp drop
Decelerations transient occlusion of relieve mechanical
resembling a "V", "U",
umbilical vessels. pressure on the
or "W" shape.
cord.
Part I: Core Practice Questions (Questions 1 to 55)
Question 1
A nurse is assessing a pregnant client at 36 weeks of gestation who was admitted
with a complaint of sudden-onset, severe abdominal pain accompanied by dark
vaginal bleeding. The nurse notes that the client's abdomen feels rigid and board-
like upon palpation. Which obstetric complication should the nurse suspect?
A) Placenta previa
B) Placental abruption (Abruptio placentae)
C) Uterine rupture
D) Cervical incompetence
CORRECT ANSWER: B) Placental abruption (Abruptio placentae)
RATIONALE: According to McKinney's Maternal-Child Nursing (6th
Edition), a painful, dark red vaginal bleed coupled with a hypertonic, rigid,
board-like abdomen is the classic presentation of a placental abruption
(premature separation of the placenta). In contrast, placenta previa (Option A)
presents as painless, bright red vaginal bleeding with a soft, non-tender uterus.
Uterine rupture (Option C) features a sudden loss of fetal station and sharp tearing
pain, while cervical incompetence (Option D) causes painless cervical dilation in
the second trimester.
Question 2
,While evaluating an electronic fetal monitoring strip for a laboring client, the nurse
notes a pattern of gradual fetal heart rate decelerations that mirror the uterine
contractions, with the nadir of the deceleration aligning exactly with the peak of
the contraction. How should the nurse interpret this pattern?
A) Umbilical cord compression requiring amnioinfusion.
B) Uteroplacental insufficiency requiring immediate oxygen.
C) Fetal head compression representing a benign tracking finding.
D) Fetal hypoxemia requiring an emergency cesarean section.
CORRECT ANSWER: C) Fetal head compression representing a benign
tracking finding.
RATIONALE: Decelerations that mirror contractions with a gradual onset and
return, aligning their nadir with the contraction's peak, are early decelerations.
These are caused by fetal head compression as the fetus descends into the pelvis,
stimulating a transient vagal response. They are completely benign and do not
indicate distress or require corrective oxygenation or positioning interventions
(Options A, B, and D).
Question 3
A postpartum nurse is monitoring a client who delivered a 9 lb infant 2 hours ago.
The nurse notes that the client's fundus is boggy, displaced upward, and
deviated to the right of the midline. What is the immediate priority nursing
action?
A) Administer a bolus of intravenous oxytocin.
B) Perform vigorous bimanual uterine massage.
C) Assist the client to the bathroom to void completely.
D) Notify the healthcare provider of a suspected hematoma.
CORRECT ANSWER: C) Assist the client to the bathroom to void
completely.
RATIONALE: A postpartum fundus that is boggy and displaced upward or
deviated to the right is a classic indication of a distended bladder. A full bladder
mechanically pushes the uterus out of place and prevents the myometrium from
contracting effectively, which significantly increases the risk of uterine atony and
postpartum hemorrhage. Emptying the bladder allows the uterus to return to the
midline and contract naturally. Massage (Option B) and oxytocin (Option A) may
, be utilized afterward if the bogginess persists once the bladder is completely
empty.
Question 4
A nurse is assessing a 12-month-old infant during a well-child checkup. Which
developmental milestone achievement should the nurse expect to observe in this
child?
A) Building a tower of six distinct blocks.
B) Walking independently or with one hand held.
C) Speaking in complete sentences of 3 to 4 words.
D) Using a neat pincer grasp to pick up small objects.
CORRECT ANSWER: B) Walking independently or with one hand held.
RATIONALE: By 12 months of age, a typically developing infant should be
walking with one hand held, cruising along furniture, or taking independent
steps. Building a six-block tower (Option A) is a 24-month milestone. Speaking
sentences (Option C) is expected around 2 to 3 years. While a crude pincer grasp
develops around 9 months, a highly refined, neat pincer grasp is solidified by 10
to 12 months, but independent ambulation or standing is the standout gross motor
standard evaluated at the 12-month junction.
Question 5
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute
glomerulonephritis. Which clinical manifestation should the nurse anticipate
finding during the baseline physical assessment?
A) Massive generalized edema and severe hypotension.
B) Periorbital edema, gross hematuria (tea-colored urine), and hypertension.
C) Severe wasting, profuse watery diarrhea, and steatorrhea.
D) High fever, dynamic skin rash, and generalized lymphadenopathy.
CORRECT ANSWER: B) Periorbital edema, gross hematuria (tea-colored
urine), and hypertension.
RATIONALE: Acute post-streptococcal glomerulonephritis (APSGN) is an
immune-complex disease that damages the glomeruli. Classic manifestations
include periorbital edema (especially prominent upon awakening), gross
hematuria yielding tea-colored or smoky-brown urine due to filtered red blood
cells, oliguria, and circulatory overload causing hypertension. Massive
6th Edition) – Complete Growth, Development &
Obstetric Exam prep and Review
Course Code: MAT_PED_301
Course Name: Maternal-Child Nursing (McKinney, 6th Edition)
Topic: Advanced Obstetrics, Fetal Monitoring, Pediatric Growth & Development,
and High-Yield Child Health Interventions
Academic Year: 2026/2027
Category: Nursing Practice Question Bank
Intrapartum Fetal Heart Rate (FHR) Pattern Matrix
Description & Immediate
Primary
FHR Pattern Waveform Nursing Priority
Pathophysiology
Characteristic Action
Symmetrical, gradual Benign finding;
Transient fetal head
decrease that mirrors continue routine
Early compression during a
the contraction curve labor monitoring
Decelerations contraction; vagal
(onset to nadir ≥ 30 without active
nerve stimulation.
seconds). intervention.
Late Symmetrical, gradual Uteroplacental Discontinue
Decelerations decrease where the insufficiency; oxytocin, turn
, nadir occurs after the decreased oxygen patient to left
peak of the transfer across the lateral position,
contraction. placenta. administer O₂,
increase IV fluids.
Change maternal
Abrupt decrease (onset
Umbilical cord position
to nadir < 30 seconds),
Variable compression; immediately to
visually sharp drop
Decelerations transient occlusion of relieve mechanical
resembling a "V", "U",
umbilical vessels. pressure on the
or "W" shape.
cord.
Part I: Core Practice Questions (Questions 1 to 55)
Question 1
A nurse is assessing a pregnant client at 36 weeks of gestation who was admitted
with a complaint of sudden-onset, severe abdominal pain accompanied by dark
vaginal bleeding. The nurse notes that the client's abdomen feels rigid and board-
like upon palpation. Which obstetric complication should the nurse suspect?
A) Placenta previa
B) Placental abruption (Abruptio placentae)
C) Uterine rupture
D) Cervical incompetence
CORRECT ANSWER: B) Placental abruption (Abruptio placentae)
RATIONALE: According to McKinney's Maternal-Child Nursing (6th
Edition), a painful, dark red vaginal bleed coupled with a hypertonic, rigid,
board-like abdomen is the classic presentation of a placental abruption
(premature separation of the placenta). In contrast, placenta previa (Option A)
presents as painless, bright red vaginal bleeding with a soft, non-tender uterus.
Uterine rupture (Option C) features a sudden loss of fetal station and sharp tearing
pain, while cervical incompetence (Option D) causes painless cervical dilation in
the second trimester.
Question 2
,While evaluating an electronic fetal monitoring strip for a laboring client, the nurse
notes a pattern of gradual fetal heart rate decelerations that mirror the uterine
contractions, with the nadir of the deceleration aligning exactly with the peak of
the contraction. How should the nurse interpret this pattern?
A) Umbilical cord compression requiring amnioinfusion.
B) Uteroplacental insufficiency requiring immediate oxygen.
C) Fetal head compression representing a benign tracking finding.
D) Fetal hypoxemia requiring an emergency cesarean section.
CORRECT ANSWER: C) Fetal head compression representing a benign
tracking finding.
RATIONALE: Decelerations that mirror contractions with a gradual onset and
return, aligning their nadir with the contraction's peak, are early decelerations.
These are caused by fetal head compression as the fetus descends into the pelvis,
stimulating a transient vagal response. They are completely benign and do not
indicate distress or require corrective oxygenation or positioning interventions
(Options A, B, and D).
Question 3
A postpartum nurse is monitoring a client who delivered a 9 lb infant 2 hours ago.
The nurse notes that the client's fundus is boggy, displaced upward, and
deviated to the right of the midline. What is the immediate priority nursing
action?
A) Administer a bolus of intravenous oxytocin.
B) Perform vigorous bimanual uterine massage.
C) Assist the client to the bathroom to void completely.
D) Notify the healthcare provider of a suspected hematoma.
CORRECT ANSWER: C) Assist the client to the bathroom to void
completely.
RATIONALE: A postpartum fundus that is boggy and displaced upward or
deviated to the right is a classic indication of a distended bladder. A full bladder
mechanically pushes the uterus out of place and prevents the myometrium from
contracting effectively, which significantly increases the risk of uterine atony and
postpartum hemorrhage. Emptying the bladder allows the uterus to return to the
midline and contract naturally. Massage (Option B) and oxytocin (Option A) may
, be utilized afterward if the bogginess persists once the bladder is completely
empty.
Question 4
A nurse is assessing a 12-month-old infant during a well-child checkup. Which
developmental milestone achievement should the nurse expect to observe in this
child?
A) Building a tower of six distinct blocks.
B) Walking independently or with one hand held.
C) Speaking in complete sentences of 3 to 4 words.
D) Using a neat pincer grasp to pick up small objects.
CORRECT ANSWER: B) Walking independently or with one hand held.
RATIONALE: By 12 months of age, a typically developing infant should be
walking with one hand held, cruising along furniture, or taking independent
steps. Building a six-block tower (Option A) is a 24-month milestone. Speaking
sentences (Option C) is expected around 2 to 3 years. While a crude pincer grasp
develops around 9 months, a highly refined, neat pincer grasp is solidified by 10
to 12 months, but independent ambulation or standing is the standout gross motor
standard evaluated at the 12-month junction.
Question 5
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute
glomerulonephritis. Which clinical manifestation should the nurse anticipate
finding during the baseline physical assessment?
A) Massive generalized edema and severe hypotension.
B) Periorbital edema, gross hematuria (tea-colored urine), and hypertension.
C) Severe wasting, profuse watery diarrhea, and steatorrhea.
D) High fever, dynamic skin rash, and generalized lymphadenopathy.
CORRECT ANSWER: B) Periorbital edema, gross hematuria (tea-colored
urine), and hypertension.
RATIONALE: Acute post-streptococcal glomerulonephritis (APSGN) is an
immune-complex disease that damages the glomeruli. Classic manifestations
include periorbital edema (especially prominent upon awakening), gross
hematuria yielding tea-colored or smoky-brown urine due to filtered red blood
cells, oliguria, and circulatory overload causing hypertension. Massive
