Maternal & Child Nursing: Comprehensive
Exam Prep Guide
Questions with Evidence-Based Answers (2024-2025
Edition)
Based on AWHONN 2024-2025 Standards, AAP 2025 Guidelines, and AHA/AAP 2025
Neonatal Resuscitation Guidelines
SECTION 1: ANTEPARTUM CARE (Questions 1-25)
Question 1
What is the recommended folic acid supplementation for women planning pregnancy?
Answer: Women planning pregnancy should take 400-800 mcg (0.4-0.8 mg) of folic acid
daily, starting at least one month before conception and continuing through the first trimester.
Women with a history of neural tube defects should take 4 mg daily. This reduces the risk of
neural tube defects by up to 70%.
Question 2
At what gestational age should the first ultrasound be performed for accurate dating?
Answer: The most accurate dating ultrasound should be performed during the first trimester,
ideally between 8-13 weeks gestation. Crown-rump length measurement during this period
provides dating accuracy within 5-7 days. After 22 weeks, ultrasound dating becomes less
accurate.
Question 3
What are the current blood pressure thresholds for diagnosing gestational hypertension?
,Answer: Gestational hypertension is diagnosed when blood pressure is ≥140/90 mmHg on two
occasions at least 4 hours apart after 20 weeks gestation in a previously normotensive woman,
without proteinuria or signs of end-organ dysfunction.
Question 4
What is the definition of preeclampsia with severe features?
Answer: Preeclampsia with severe features includes: systolic BP ≥160 mmHg or diastolic BP
≥110 mmHg, thrombocytopenia (<100,000/μL), elevated liver enzymes (twice normal), severe
persistent right upper quadrant or epigastric pain, renal insufficiency (creatinine >1.1 mg/dL),
pulmonary edema, or new-onset headache unresponsive to medication or visual disturbances.
Question 5
What is the first-line antihypertensive medication for acute severe hypertension in
pregnancy?
Answer: Labetalol (IV) is the first-line medication, given as 20 mg IV bolus initially, then 40
mg, then 80 mg every 10 minutes (max 220 mg). Alternative options include hydralazine 5-10
mg IV every 20 minutes or immediate-release nifedipine 10-20 mg orally every 20 minutes.
Question 6
What is the recommended magnesium sulfate dosing for seizure prophylaxis in
preeclampsia?
Answer: Loading dose: 4-6 grams IV over 15-20 minutes. Maintenance: 1-2 grams/hour
continuous IV infusion. Continue for 24 hours postpartum or 24 hours after last seizure.
Monitor deep tendon reflexes, respiratory rate (>12/min), and urine output (>30 mL/hr).
Antidote: Calcium gluconate 1 gram IV.
Question 7
What are the signs of magnesium toxicity?
,Answer: Loss of deep tendon reflexes (first sign, occurs at 7-10 mEq/L), respiratory depression
(<12 breaths/min at 10-12 mEq/L), cardiac arrest (>12 mEq/L), decreased urine output (<30
mL/hr), flushing, warmth, and altered mental status. Therapeutic level is 4-7 mEq/L.
Question 8
When should Group B Streptococcus (GBS) screening be performed?
Answer: GBS screening should be performed between 36 0/7 and 37 6/7 weeks gestation using
vaginal-rectal swab culture. Women with GBS bacteriuria during pregnancy or previous infant
with GBS disease should receive intrapartum antibiotic prophylaxis (IAP) without screening.
Question 9
What is the recommended intrapartum antibiotic prophylaxis for GBS-positive women?
Answer: Penicillin G 5 million units IV loading dose, then 2.5-3 million units IV every 4 hours
until delivery. Alternative: Ampicillin 2 grams IV loading dose, then 1 gram IV every 4 hours.
For penicillin allergy (low risk): Cefazolin 2 grams IV, then 1 gram every 8 hours. For severe
allergy: Clindamycin or vancomycin based on susceptibility testing.
Question 10
What is the definition of gestational diabetes mellitus (GDM)?
Answer: GDM is diabetes diagnosed during pregnancy that is not clearly overt diabetes.
Screening is performed at 24-28 weeks using either one-step (75-gram OGTT) or two-step (50-
gram screening followed by 100-gram OGTT) approach. Diagnostic criteria for 75g OGTT:
fasting ≥92 mg/dL, 1-hour ≥180 mg/dL, or 2-hour ≥153 mg/dL.
Question 11
What are the target blood glucose levels for women with gestational diabetes?
Answer: Fasting glucose <95 mg/dL, 1-hour postprandial <140 mg/dL, or 2-hour postprandial
<120 mg/dL. If unable to maintain targets with diet and exercise, insulin or metformin therapy
is indicated.
, Question 12
What is the recommended frequency of prenatal visits for uncomplicated pregnancies?
Answer: Every 4 weeks until 28 weeks, every 2 weeks from 28-36 weeks, and weekly from
36 weeks until delivery. High-risk pregnancies may require more frequent visits.
Question 13
What vaccines are recommended during pregnancy?
Answer: Tdap vaccine (between 27-36 weeks gestation, preferably early in this window),
inactivated influenza vaccine (any trimester during flu season), COVID-19 vaccine (any
trimester), and RSV vaccine (32-36 weeks during RSV season, September-January). Live
vaccines are contraindicated.
Question 14
What is the recommended weight gain during pregnancy based on pre-pregnancy BMI?
Answer: Underweight (BMI <18.5): 28-40 lbs; Normal weight (BMI 18.5-24.9): 25-35 lbs;
Overweight (BMI 25-29.9): 15-25 lbs; Obese (BMI ≥30): 11-20 lbs. Twin pregnancies require
higher weight gain.
Question 15
When should fetal movement counting (kick counts) begin?
Answer: Fetal movement counting should begin at 28 weeks gestation. Women should count
movements daily. A normal pattern is 10 movements in 2 hours. Decreased fetal movement
requires immediate evaluation with non-stress test (NST) and possible ultrasound.
Question 16
What is the definition of oligohydramnios and polyhydramnios?
Exam Prep Guide
Questions with Evidence-Based Answers (2024-2025
Edition)
Based on AWHONN 2024-2025 Standards, AAP 2025 Guidelines, and AHA/AAP 2025
Neonatal Resuscitation Guidelines
SECTION 1: ANTEPARTUM CARE (Questions 1-25)
Question 1
What is the recommended folic acid supplementation for women planning pregnancy?
Answer: Women planning pregnancy should take 400-800 mcg (0.4-0.8 mg) of folic acid
daily, starting at least one month before conception and continuing through the first trimester.
Women with a history of neural tube defects should take 4 mg daily. This reduces the risk of
neural tube defects by up to 70%.
Question 2
At what gestational age should the first ultrasound be performed for accurate dating?
Answer: The most accurate dating ultrasound should be performed during the first trimester,
ideally between 8-13 weeks gestation. Crown-rump length measurement during this period
provides dating accuracy within 5-7 days. After 22 weeks, ultrasound dating becomes less
accurate.
Question 3
What are the current blood pressure thresholds for diagnosing gestational hypertension?
,Answer: Gestational hypertension is diagnosed when blood pressure is ≥140/90 mmHg on two
occasions at least 4 hours apart after 20 weeks gestation in a previously normotensive woman,
without proteinuria or signs of end-organ dysfunction.
Question 4
What is the definition of preeclampsia with severe features?
Answer: Preeclampsia with severe features includes: systolic BP ≥160 mmHg or diastolic BP
≥110 mmHg, thrombocytopenia (<100,000/μL), elevated liver enzymes (twice normal), severe
persistent right upper quadrant or epigastric pain, renal insufficiency (creatinine >1.1 mg/dL),
pulmonary edema, or new-onset headache unresponsive to medication or visual disturbances.
Question 5
What is the first-line antihypertensive medication for acute severe hypertension in
pregnancy?
Answer: Labetalol (IV) is the first-line medication, given as 20 mg IV bolus initially, then 40
mg, then 80 mg every 10 minutes (max 220 mg). Alternative options include hydralazine 5-10
mg IV every 20 minutes or immediate-release nifedipine 10-20 mg orally every 20 minutes.
Question 6
What is the recommended magnesium sulfate dosing for seizure prophylaxis in
preeclampsia?
Answer: Loading dose: 4-6 grams IV over 15-20 minutes. Maintenance: 1-2 grams/hour
continuous IV infusion. Continue for 24 hours postpartum or 24 hours after last seizure.
Monitor deep tendon reflexes, respiratory rate (>12/min), and urine output (>30 mL/hr).
Antidote: Calcium gluconate 1 gram IV.
Question 7
What are the signs of magnesium toxicity?
,Answer: Loss of deep tendon reflexes (first sign, occurs at 7-10 mEq/L), respiratory depression
(<12 breaths/min at 10-12 mEq/L), cardiac arrest (>12 mEq/L), decreased urine output (<30
mL/hr), flushing, warmth, and altered mental status. Therapeutic level is 4-7 mEq/L.
Question 8
When should Group B Streptococcus (GBS) screening be performed?
Answer: GBS screening should be performed between 36 0/7 and 37 6/7 weeks gestation using
vaginal-rectal swab culture. Women with GBS bacteriuria during pregnancy or previous infant
with GBS disease should receive intrapartum antibiotic prophylaxis (IAP) without screening.
Question 9
What is the recommended intrapartum antibiotic prophylaxis for GBS-positive women?
Answer: Penicillin G 5 million units IV loading dose, then 2.5-3 million units IV every 4 hours
until delivery. Alternative: Ampicillin 2 grams IV loading dose, then 1 gram IV every 4 hours.
For penicillin allergy (low risk): Cefazolin 2 grams IV, then 1 gram every 8 hours. For severe
allergy: Clindamycin or vancomycin based on susceptibility testing.
Question 10
What is the definition of gestational diabetes mellitus (GDM)?
Answer: GDM is diabetes diagnosed during pregnancy that is not clearly overt diabetes.
Screening is performed at 24-28 weeks using either one-step (75-gram OGTT) or two-step (50-
gram screening followed by 100-gram OGTT) approach. Diagnostic criteria for 75g OGTT:
fasting ≥92 mg/dL, 1-hour ≥180 mg/dL, or 2-hour ≥153 mg/dL.
Question 11
What are the target blood glucose levels for women with gestational diabetes?
Answer: Fasting glucose <95 mg/dL, 1-hour postprandial <140 mg/dL, or 2-hour postprandial
<120 mg/dL. If unable to maintain targets with diet and exercise, insulin or metformin therapy
is indicated.
, Question 12
What is the recommended frequency of prenatal visits for uncomplicated pregnancies?
Answer: Every 4 weeks until 28 weeks, every 2 weeks from 28-36 weeks, and weekly from
36 weeks until delivery. High-risk pregnancies may require more frequent visits.
Question 13
What vaccines are recommended during pregnancy?
Answer: Tdap vaccine (between 27-36 weeks gestation, preferably early in this window),
inactivated influenza vaccine (any trimester during flu season), COVID-19 vaccine (any
trimester), and RSV vaccine (32-36 weeks during RSV season, September-January). Live
vaccines are contraindicated.
Question 14
What is the recommended weight gain during pregnancy based on pre-pregnancy BMI?
Answer: Underweight (BMI <18.5): 28-40 lbs; Normal weight (BMI 18.5-24.9): 25-35 lbs;
Overweight (BMI 25-29.9): 15-25 lbs; Obese (BMI ≥30): 11-20 lbs. Twin pregnancies require
higher weight gain.
Question 15
When should fetal movement counting (kick counts) begin?
Answer: Fetal movement counting should begin at 28 weeks gestation. Women should count
movements daily. A normal pattern is 10 movements in 2 hours. Decreased fetal movement
requires immediate evaluation with non-stress test (NST) and possible ultrasound.
Question 16
What is the definition of oligohydramnios and polyhydramnios?
