Maternity Nursing Final Exam Practice Q's
questions and 100% verified answers
2025/2026
A client at 28 weeks gestation is admitted to the labor and birth unit. Which test would most likely be
used to assess the client's comprehensive fetal status?
a) Ultrasound for physical structure
b) Nonstress test (NST)
c) Biophysical profile (BPP)
d) Amniocentesis - Answer C.
Biophysical profile is a comprehensive test that would be used to assess the client's fetal status at 28
weeks gestation. Ultrasound for physical structure is limited to identifying the growth and development
of the fetus, and does not assess for other parameters of fetal well-being. Women with a high-risk factor
will probably begin having NSTs at 30-32 weeks gestation and at frequent intervals for the remainder of
the pregnancy. Amniocentesis late in pregnancy is used to test for lung maturity, not overall fetal status
in labor, and when performed earlier it is used to test for specific disorders.
3rd trimester screening - Answer to determine whether intrauterine env't continues to be supportive to
fetus (vs FTS and STS focused on detecting anomalies)
-timing of birth for uteroplacental insufficiency (gradual loss of placental fn => inadequate nutrient
delivery => IUGR => subsequent compromised respiratory fn => fetal hypoxia)
-NST, CST, BPP. **teach 3rd trimester moms how to detect moments and to report/monitor any
decrease (want 6/2h; dec may be due to dec'd placental perfusion)
BPP - Answer real time u/s imaging to determine current and comprehensive fetal well-being via a
detailed ass't of physical and physiological characteristics (normal vs abnormal biophysical responses to
stimuli)
-noninvasive, dynamic; assesses breathing movements, movement, tone, AFV, HR, normal biophysical
activities which indicate normal CNS fn(ex hypoxia should result in inc'd movement, tachycardia, altered
muscle tone)
-done w/o NST score out of 8 vs ww NST out of 10
,AFV - Answer look at fluid pocket volumes to determine amniotic fluid volume and crowding of fetal
limbs vs floating etc
FTS (1st trimester screening) - Answer screens for fetal aneuploidy (Down syndrome and trisomy 18)
-u/s examination of nuchal translucency (NT) + maternal serum biomarkers (PAPP-A, Beta-hCG)
-recommended that women also do neural tube defect (NTD) screen at 18-22w u/s
-limitation to screening: 5% false +, lack of availability in some centres
PAPP-A - Answer maternal serum biomarker (in FTS)
-lower in down syndrome pregnancy
Beta-hCG - Answer maternal serum biomarker (in FTS)
-higher in down syndrome pregnancy
NT - Answer nuchal translucency:
u/s msmt of fluid at nape of neck bw 11-14w gestation to identify abnormalities
-fluid collection > 2.5 mm = abnormal, >3 mm = genetic disorder/physical anomaly
STS (2nd trimester screening) - Answer detect fetal anomalies (NTDs)
-maternal serum alpha fetoprotein (MSAFP) produced x fetal liver and detected in mother's serum when
high levels bw 14-34 weeks; MSAFP if to identify need for more definitive procedures via amniocentesis
and u/s
-can also use amniotic fluid AFP to Dx NTDs (as follow up for elevated maternal levels)
-triple marker test: MSAFP, unconjugated estradiol, hCG along with maternal age (16-18 weeks)
-low MSAFP= down syndrome, high=NTD
IPS - Answer integrated prenatal screening
-FTS + STS serum screening +/- NT
-superior testing method
,-PAPP-A and NT in FTS and quad screen in STS
amniocentesis - Answer AF contains fetal cells
-possible after week 14
-for genetic testing, congenital anomalies (NTD), pulmonary maturity, dx of fetal hemolytic dz,
meconium (fetal stress)
meconium in AF in intrapartum period - Answer -normal physiological fn occurring w/ maturity
(uncommon bw 23-24 weeks, inc'd incidence >38w)
-result of hypoxia-induced peristalsis and sphincter relaxation
-may be sequel to cord compression-induced vaginal stimulation in mature fetus
**thick fresh meconium passed for 1st time in late labour + nonrememdiable severe variable or late FHR
decelerations = ominous sign
CVS - Answer 10-13 weeks gestation
-removal of small tissue specimen from fetal portion of placenta for genetic testing
-danger of abortion/miscarriage, ROM, chorioamnionitis, fetmomaternal hemorrhage (careful with Rh -
moms!!, give immunoglobulin to avoid isoimmunization)
fetal response to hypoxia - Answer clinical basis for antepartum testing with EFM
-redistribution of blood flow favouring vital organs, dec'd total oxygen consumption, switch to anaerobic
glycolysis (supports survival for 30 mins w/o decompensation).
-prolonged asphyxia/sustained hypoxemia: dec CO, dec arterial BP, dec'd perfusion of heart and brain
and characteristic FHR pattern
NST - Answer non-stress test
-FHR accelerations in response to movement (blunted FHR response can be due to hypoxia, acidosis,
medications, sleep, congenital anomalies)
-easy, quick, outpatient setting
-false + due to sleep, smoking, meds, fetal immaturity
, criteria:
-2+ access's of 15 ppm lasting 15 sec over 20 mins
-normal baseline: 110-160
-moderate variability (6-25 bpm)
abnormal: lacking access's after 80 mins or significant abnormalities of baseline HR or variability,
significant decelerations
CST - Answer evaluates fetal response to contractions (contractions educe uterine/placental perfusion. if
significant decrease = fetal hypoxia, FHR decal's starting at peak contraction and persisting after
conclusion aka late deceleration)
-produce3 contractions each lasting 1 min w/i 10 mins to evaluate fetal heart response
-oxytocin or nipple stimulation
-in healthy fetoplacental unit, uterine contraction will not produce late decal's vs uteroplacental
insufficiency
A prenatal client in her second trimester is admitted to the maternity unit with painless, bright red
vaginal bleeding. What test might the physician order?
a)Alpha-fetoprotein (AFP)
b)Contraction stress test (CST)
c)Amniocentesis
d)Ultrasound - Answer D.
An ultrasound for placenta location to rule out placenta previa would be ordered for a client who
presents with painless, bright red vaginal bleeding. The ability to see the lower portion of the uterus and
cervix with ultrasound is particularly important when vaginal bleeding is noted and placenta previa is the
suspected cause. Alpha-fetoprotein (AFP) is a test used to screen for neural tube defects. A contraction
stress test is ordered in the third trimester to evaluate the respiratory function of the placenta.
Amniocentesis is a procedure used for genetic diagnosis or, in later pregnancy, for lung maturity studies.
questions and 100% verified answers
2025/2026
A client at 28 weeks gestation is admitted to the labor and birth unit. Which test would most likely be
used to assess the client's comprehensive fetal status?
a) Ultrasound for physical structure
b) Nonstress test (NST)
c) Biophysical profile (BPP)
d) Amniocentesis - Answer C.
Biophysical profile is a comprehensive test that would be used to assess the client's fetal status at 28
weeks gestation. Ultrasound for physical structure is limited to identifying the growth and development
of the fetus, and does not assess for other parameters of fetal well-being. Women with a high-risk factor
will probably begin having NSTs at 30-32 weeks gestation and at frequent intervals for the remainder of
the pregnancy. Amniocentesis late in pregnancy is used to test for lung maturity, not overall fetal status
in labor, and when performed earlier it is used to test for specific disorders.
3rd trimester screening - Answer to determine whether intrauterine env't continues to be supportive to
fetus (vs FTS and STS focused on detecting anomalies)
-timing of birth for uteroplacental insufficiency (gradual loss of placental fn => inadequate nutrient
delivery => IUGR => subsequent compromised respiratory fn => fetal hypoxia)
-NST, CST, BPP. **teach 3rd trimester moms how to detect moments and to report/monitor any
decrease (want 6/2h; dec may be due to dec'd placental perfusion)
BPP - Answer real time u/s imaging to determine current and comprehensive fetal well-being via a
detailed ass't of physical and physiological characteristics (normal vs abnormal biophysical responses to
stimuli)
-noninvasive, dynamic; assesses breathing movements, movement, tone, AFV, HR, normal biophysical
activities which indicate normal CNS fn(ex hypoxia should result in inc'd movement, tachycardia, altered
muscle tone)
-done w/o NST score out of 8 vs ww NST out of 10
,AFV - Answer look at fluid pocket volumes to determine amniotic fluid volume and crowding of fetal
limbs vs floating etc
FTS (1st trimester screening) - Answer screens for fetal aneuploidy (Down syndrome and trisomy 18)
-u/s examination of nuchal translucency (NT) + maternal serum biomarkers (PAPP-A, Beta-hCG)
-recommended that women also do neural tube defect (NTD) screen at 18-22w u/s
-limitation to screening: 5% false +, lack of availability in some centres
PAPP-A - Answer maternal serum biomarker (in FTS)
-lower in down syndrome pregnancy
Beta-hCG - Answer maternal serum biomarker (in FTS)
-higher in down syndrome pregnancy
NT - Answer nuchal translucency:
u/s msmt of fluid at nape of neck bw 11-14w gestation to identify abnormalities
-fluid collection > 2.5 mm = abnormal, >3 mm = genetic disorder/physical anomaly
STS (2nd trimester screening) - Answer detect fetal anomalies (NTDs)
-maternal serum alpha fetoprotein (MSAFP) produced x fetal liver and detected in mother's serum when
high levels bw 14-34 weeks; MSAFP if to identify need for more definitive procedures via amniocentesis
and u/s
-can also use amniotic fluid AFP to Dx NTDs (as follow up for elevated maternal levels)
-triple marker test: MSAFP, unconjugated estradiol, hCG along with maternal age (16-18 weeks)
-low MSAFP= down syndrome, high=NTD
IPS - Answer integrated prenatal screening
-FTS + STS serum screening +/- NT
-superior testing method
,-PAPP-A and NT in FTS and quad screen in STS
amniocentesis - Answer AF contains fetal cells
-possible after week 14
-for genetic testing, congenital anomalies (NTD), pulmonary maturity, dx of fetal hemolytic dz,
meconium (fetal stress)
meconium in AF in intrapartum period - Answer -normal physiological fn occurring w/ maturity
(uncommon bw 23-24 weeks, inc'd incidence >38w)
-result of hypoxia-induced peristalsis and sphincter relaxation
-may be sequel to cord compression-induced vaginal stimulation in mature fetus
**thick fresh meconium passed for 1st time in late labour + nonrememdiable severe variable or late FHR
decelerations = ominous sign
CVS - Answer 10-13 weeks gestation
-removal of small tissue specimen from fetal portion of placenta for genetic testing
-danger of abortion/miscarriage, ROM, chorioamnionitis, fetmomaternal hemorrhage (careful with Rh -
moms!!, give immunoglobulin to avoid isoimmunization)
fetal response to hypoxia - Answer clinical basis for antepartum testing with EFM
-redistribution of blood flow favouring vital organs, dec'd total oxygen consumption, switch to anaerobic
glycolysis (supports survival for 30 mins w/o decompensation).
-prolonged asphyxia/sustained hypoxemia: dec CO, dec arterial BP, dec'd perfusion of heart and brain
and characteristic FHR pattern
NST - Answer non-stress test
-FHR accelerations in response to movement (blunted FHR response can be due to hypoxia, acidosis,
medications, sleep, congenital anomalies)
-easy, quick, outpatient setting
-false + due to sleep, smoking, meds, fetal immaturity
, criteria:
-2+ access's of 15 ppm lasting 15 sec over 20 mins
-normal baseline: 110-160
-moderate variability (6-25 bpm)
abnormal: lacking access's after 80 mins or significant abnormalities of baseline HR or variability,
significant decelerations
CST - Answer evaluates fetal response to contractions (contractions educe uterine/placental perfusion. if
significant decrease = fetal hypoxia, FHR decal's starting at peak contraction and persisting after
conclusion aka late deceleration)
-produce3 contractions each lasting 1 min w/i 10 mins to evaluate fetal heart response
-oxytocin or nipple stimulation
-in healthy fetoplacental unit, uterine contraction will not produce late decal's vs uteroplacental
insufficiency
A prenatal client in her second trimester is admitted to the maternity unit with painless, bright red
vaginal bleeding. What test might the physician order?
a)Alpha-fetoprotein (AFP)
b)Contraction stress test (CST)
c)Amniocentesis
d)Ultrasound - Answer D.
An ultrasound for placenta location to rule out placenta previa would be ordered for a client who
presents with painless, bright red vaginal bleeding. The ability to see the lower portion of the uterus and
cervix with ultrasound is particularly important when vaginal bleeding is noted and placenta previa is the
suspected cause. Alpha-fetoprotein (AFP) is a test used to screen for neural tube defects. A contraction
stress test is ordered in the third trimester to evaluate the respiratory function of the placenta.
Amniocentesis is a procedure used for genetic diagnosis or, in later pregnancy, for lung maturity studies.
