NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Labor & Delivery Nursing Practice Exam
2026–2027 | 110 ORIGINAL PRACTICE QUESTIONS
Emphasizes labor progress, fetal-heart tracings, induction safety, delivery and intrapartum emergencies.
Independent educational study material. These are original practice questions, not official Southern Utah University, ATI,
faculty, or licensing examination materials. Similar core concepts appear in multiple files to reinforce learning.
Clinical safety note: Use institutional protocols and current professional guidance. Questions are designed for learning and
are not a substitute for medical decision-making or individualized orders.
Study map
Domain Questions in this document
Antepartum and prenatal care 15
Labor and delivery 42
Postpartum nursing 14
High-risk and obstetric/neonatal emergencies 39
How to use this resource
Cover the green answer and yellow-highlighted rationale, select A–D, then review the explanation. Mark missed concepts
and revisit the corresponding clinical area. The answer key at the end provides a rapid self-check.
High-yield current guidance checkpoints
• GBS screening: ACOG universal vaginal–rectal culture at 36 0/7–37 6/7 weeks, with intrapartum prophylaxis when
indicated.
• Maternal immunization: Tdap at 27–36 weeks in every pregnancy; Pfizer Abrysvo maternal RSV at 32 0/7–36 6/7 weeks
in the recommended U.S. season.
• Preeclampsia: systolic pressure ≥160 mm Hg or diastolic ≥110 mm Hg is severe range; monitor for headache, visual
symptoms, pulmonary edema and upper-abdominal pain.
• PPH: assess objectively and treat promptly using an integrated protocol; WHO recommends uterine massage,
oxytocic therapy, fluids, IV tranexamic acid when indicated, source assessment and escalation.
• Newborn resuscitation: ventilate for persistent apnea/gasping or HR <100 after initial steps; compress if HR stays <60
after 30 seconds of effective ventilation.
• Jaundice: use bilirubin level, postnatal age in hours, gestational age and neurotoxicity risk factors—not a single
universal phototherapy number.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 1
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Practice Questions with Answers & Rationales
Questions 1–25
1. Which finding during labor most urgently prompts rapid provider notification?
A. Normal baseline of 135 beats per minute
B. Contractions spaced four minutes apart in active labor
C. A brief acceleration with movement
D. Sustained fetal bradycardia with poor variability
Correct Answer: D. Sustained fetal bradycardia with poor variability
Rationale: Persistent bradycardia with additional tracing abnormalities may signal fetal compromise.
Incorrect options: A (Normal baseline of 135 beats per minute); B (Contractions spaced four minutes apart in active labor); C (A
brief acceleration with movement). These do not best answer the clinical cue; Persistent bradycardia with additional tracing
abnormalities may signal fetal compromise.
2. At 10 weeks' gestation a patient has severe vomiting, weight loss, and dehydration. Which concern is most
appropriate?
A. Placenta previa as the only cause
B. Hyperemesis gravidarum requiring assessment of hydration and electrolytes
C. Routine physiologic edema
D. Normal nausea that never needs treatment
Correct Answer: B. Hyperemesis gravidarum requiring assessment of hydration and electrolytes
Rationale: Persistent vomiting with weight loss and dehydration exceeds typical pregnancy nausea and needs
medical assessment.
Incorrect options: A (Placenta previa as the only cause); C (Routine physiologic edema); D (Normal nausea that never needs
treatment). These do not best answer the clinical cue; Persistent vomiting with weight loss and dehydration exceeds typical
pregnancy nausea and needs medical assessment.
3. A parent asks when postpartum warning signs can occur. Best teaching?
A. Bleeding is never serious after one week
B. All danger ends 24 hours after birth
C. Serious complications can occur after hospital discharge, so new red flags need urgent help
D. Only cesarean patients have risks
Correct Answer: C. Serious complications can occur after hospital discharge, so new red flags need urgent help
Rationale: Postpartum risk continues for weeks; worsening headache, heavy bleeding, fever, or dyspnea need
timely evaluation.
Incorrect options: A (Bleeding is never serious after one week); B (All danger ends 24 hours after birth); D (Only cesarean patients
have risks). These do not best answer the clinical cue; Postpartum risk continues for weeks; worsening headache, heavy bleeding,
fever, or dyspnea need timely evaluation.
4. During a shoulder dystocia, which maneuver is generally part of the immediate response?
A. McRoberts maneuver with coordinated team assistance
B. Sustained fundal pressure
C. Forceful head traction
D. Delay all calls for help
Correct Answer: A. McRoberts maneuver with coordinated team assistance
Rationale: McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
Incorrect options: B (Sustained fundal pressure); C (Forceful head traction); D (Delay all calls for help). These do not best answer
the clinical cue; McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 2
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
5. Which prenatal statement about alcohol is best supported?
A. Only binge drinking poses any risk
B. Alcohol is harmless after organogenesis
C. Avoid alcohol during pregnancy because no safe amount is established
D. Beer is safe because it is low alcohol
Correct Answer: C. Avoid alcohol during pregnancy because no safe amount is established
Rationale: Prenatal alcohol exposure can harm fetal development; abstinence is recommended.
Incorrect options: A (Only binge drinking poses any risk); B (Alcohol is harmless after organogenesis); D (Beer is safe because it is
low alcohol). These do not best answer the clinical cue; Prenatal alcohol exposure can harm fetal development; abstinence is
recommended.
6. A postpartum patient describes voices ordering harm to the infant. What is the immediate response?
A. Discharge with no follow-up
B. Recommend sleep only without risk assessment
C. Normalize the voices as mild baby blues
D. Ensure infant and parental safety and obtain emergency psychiatric evaluation
Correct Answer: D. Ensure infant and parental safety and obtain emergency psychiatric evaluation
Rationale: Psychotic symptoms in the postpartum period create an urgent safety situation requiring specialized
care.
Incorrect options: A (Discharge with no follow-up); B (Recommend sleep only without risk assessment); C (Normalize the voices
as mild baby blues). These do not best answer the clinical cue; Psychotic symptoms in the postpartum period create an urgent
safety situation requiring specialized care.
7. Which information is most useful when evaluating labor progress?
A. Only the number of visitors
B. Maternal eye color
C. Serial cervical changes, station, contraction pattern, and fetal status
D. Only elapsed clock time
Correct Answer: C. Serial cervical changes, station, contraction pattern, and fetal status
Rationale: Labor progress is multidimensional; management depends on dilation, descent, contractions, and
maternal-fetal condition.
Incorrect options: A (Only the number of visitors); B (Maternal eye color); D (Only elapsed clock time). These do not best answer
the clinical cue; Labor progress is multidimensional; management depends on dilation, descent, contractions, and maternal-fetal
condition.
8. Which statement accurately reflects routine maternal RSV vaccination guidance in most of the continental
United States?
A. Any RSV vaccine can be given at 12 weeks
B. Pfizer Abrysvo is given at 32 through 36 weeks during the recommended seasonal window
C. Vaccination is recommended after 37 weeks in all cases
D. Every newborn routinely needs both maternal vaccine and an antibody
Correct Answer: B. Pfizer Abrysvo is given at 32 through 36 weeks during the recommended seasonal window
Rationale: Maternal Abrysvo at 32 0/7 to 36 6/7 weeks during the seasonal window can help protect infants; most do
not need both preventive approaches.
Incorrect options: A (Any RSV vaccine can be given at 12 weeks); C (Vaccination is recommended after 37 weeks in all cases); D
(Every newborn routinely needs both maternal vaccine and an antibody). These do not best answer the clinical cue; Maternal
Abrysvo at 32 0/7 to 36 6/7 weeks during the seasonal window can help protect infants; most do not need both preventive
approaches.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 3
Labor & Delivery Nursing Practice Exam
2026–2027 | 110 ORIGINAL PRACTICE QUESTIONS
Emphasizes labor progress, fetal-heart tracings, induction safety, delivery and intrapartum emergencies.
Independent educational study material. These are original practice questions, not official Southern Utah University, ATI,
faculty, or licensing examination materials. Similar core concepts appear in multiple files to reinforce learning.
Clinical safety note: Use institutional protocols and current professional guidance. Questions are designed for learning and
are not a substitute for medical decision-making or individualized orders.
Study map
Domain Questions in this document
Antepartum and prenatal care 15
Labor and delivery 42
Postpartum nursing 14
High-risk and obstetric/neonatal emergencies 39
How to use this resource
Cover the green answer and yellow-highlighted rationale, select A–D, then review the explanation. Mark missed concepts
and revisit the corresponding clinical area. The answer key at the end provides a rapid self-check.
High-yield current guidance checkpoints
• GBS screening: ACOG universal vaginal–rectal culture at 36 0/7–37 6/7 weeks, with intrapartum prophylaxis when
indicated.
• Maternal immunization: Tdap at 27–36 weeks in every pregnancy; Pfizer Abrysvo maternal RSV at 32 0/7–36 6/7 weeks
in the recommended U.S. season.
• Preeclampsia: systolic pressure ≥160 mm Hg or diastolic ≥110 mm Hg is severe range; monitor for headache, visual
symptoms, pulmonary edema and upper-abdominal pain.
• PPH: assess objectively and treat promptly using an integrated protocol; WHO recommends uterine massage,
oxytocic therapy, fluids, IV tranexamic acid when indicated, source assessment and escalation.
• Newborn resuscitation: ventilate for persistent apnea/gasping or HR <100 after initial steps; compress if HR stays <60
after 30 seconds of effective ventilation.
• Jaundice: use bilirubin level, postnatal age in hours, gestational age and neurotoxicity risk factors—not a single
universal phototherapy number.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 1
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Practice Questions with Answers & Rationales
Questions 1–25
1. Which finding during labor most urgently prompts rapid provider notification?
A. Normal baseline of 135 beats per minute
B. Contractions spaced four minutes apart in active labor
C. A brief acceleration with movement
D. Sustained fetal bradycardia with poor variability
Correct Answer: D. Sustained fetal bradycardia with poor variability
Rationale: Persistent bradycardia with additional tracing abnormalities may signal fetal compromise.
Incorrect options: A (Normal baseline of 135 beats per minute); B (Contractions spaced four minutes apart in active labor); C (A
brief acceleration with movement). These do not best answer the clinical cue; Persistent bradycardia with additional tracing
abnormalities may signal fetal compromise.
2. At 10 weeks' gestation a patient has severe vomiting, weight loss, and dehydration. Which concern is most
appropriate?
A. Placenta previa as the only cause
B. Hyperemesis gravidarum requiring assessment of hydration and electrolytes
C. Routine physiologic edema
D. Normal nausea that never needs treatment
Correct Answer: B. Hyperemesis gravidarum requiring assessment of hydration and electrolytes
Rationale: Persistent vomiting with weight loss and dehydration exceeds typical pregnancy nausea and needs
medical assessment.
Incorrect options: A (Placenta previa as the only cause); C (Routine physiologic edema); D (Normal nausea that never needs
treatment). These do not best answer the clinical cue; Persistent vomiting with weight loss and dehydration exceeds typical
pregnancy nausea and needs medical assessment.
3. A parent asks when postpartum warning signs can occur. Best teaching?
A. Bleeding is never serious after one week
B. All danger ends 24 hours after birth
C. Serious complications can occur after hospital discharge, so new red flags need urgent help
D. Only cesarean patients have risks
Correct Answer: C. Serious complications can occur after hospital discharge, so new red flags need urgent help
Rationale: Postpartum risk continues for weeks; worsening headache, heavy bleeding, fever, or dyspnea need
timely evaluation.
Incorrect options: A (Bleeding is never serious after one week); B (All danger ends 24 hours after birth); D (Only cesarean patients
have risks). These do not best answer the clinical cue; Postpartum risk continues for weeks; worsening headache, heavy bleeding,
fever, or dyspnea need timely evaluation.
4. During a shoulder dystocia, which maneuver is generally part of the immediate response?
A. McRoberts maneuver with coordinated team assistance
B. Sustained fundal pressure
C. Forceful head traction
D. Delay all calls for help
Correct Answer: A. McRoberts maneuver with coordinated team assistance
Rationale: McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
Incorrect options: B (Sustained fundal pressure); C (Forceful head traction); D (Delay all calls for help). These do not best answer
the clinical cue; McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 2
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
5. Which prenatal statement about alcohol is best supported?
A. Only binge drinking poses any risk
B. Alcohol is harmless after organogenesis
C. Avoid alcohol during pregnancy because no safe amount is established
D. Beer is safe because it is low alcohol
Correct Answer: C. Avoid alcohol during pregnancy because no safe amount is established
Rationale: Prenatal alcohol exposure can harm fetal development; abstinence is recommended.
Incorrect options: A (Only binge drinking poses any risk); B (Alcohol is harmless after organogenesis); D (Beer is safe because it is
low alcohol). These do not best answer the clinical cue; Prenatal alcohol exposure can harm fetal development; abstinence is
recommended.
6. A postpartum patient describes voices ordering harm to the infant. What is the immediate response?
A. Discharge with no follow-up
B. Recommend sleep only without risk assessment
C. Normalize the voices as mild baby blues
D. Ensure infant and parental safety and obtain emergency psychiatric evaluation
Correct Answer: D. Ensure infant and parental safety and obtain emergency psychiatric evaluation
Rationale: Psychotic symptoms in the postpartum period create an urgent safety situation requiring specialized
care.
Incorrect options: A (Discharge with no follow-up); B (Recommend sleep only without risk assessment); C (Normalize the voices
as mild baby blues). These do not best answer the clinical cue; Psychotic symptoms in the postpartum period create an urgent
safety situation requiring specialized care.
7. Which information is most useful when evaluating labor progress?
A. Only the number of visitors
B. Maternal eye color
C. Serial cervical changes, station, contraction pattern, and fetal status
D. Only elapsed clock time
Correct Answer: C. Serial cervical changes, station, contraction pattern, and fetal status
Rationale: Labor progress is multidimensional; management depends on dilation, descent, contractions, and
maternal-fetal condition.
Incorrect options: A (Only the number of visitors); B (Maternal eye color); D (Only elapsed clock time). These do not best answer
the clinical cue; Labor progress is multidimensional; management depends on dilation, descent, contractions, and maternal-fetal
condition.
8. Which statement accurately reflects routine maternal RSV vaccination guidance in most of the continental
United States?
A. Any RSV vaccine can be given at 12 weeks
B. Pfizer Abrysvo is given at 32 through 36 weeks during the recommended seasonal window
C. Vaccination is recommended after 37 weeks in all cases
D. Every newborn routinely needs both maternal vaccine and an antibody
Correct Answer: B. Pfizer Abrysvo is given at 32 through 36 weeks during the recommended seasonal window
Rationale: Maternal Abrysvo at 32 0/7 to 36 6/7 weeks during the seasonal window can help protect infants; most do
not need both preventive approaches.
Incorrect options: A (Any RSV vaccine can be given at 12 weeks); C (Vaccination is recommended after 37 weeks in all cases); D
(Every newborn routinely needs both maternal vaccine and an antibody). These do not best answer the clinical cue; Maternal
Abrysvo at 32 0/7 to 36 6/7 weeks during the seasonal window can help protect infants; most do not need both preventive
approaches.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 3
