NU143
Maternal Infant Nursing
Midterm Exam Prep
2026
(With Solutions)
Multiple Choice Questions (MCQ)
A 32-week preterm neonate develops respiratory distress syndrome (RDS). Which intervention is
the priority?
a) Administer surfactant replacement therapy
b) Initiate phototherapy
c) Start oral feeding immediately
d) Provide supplemental oxygen by nasal cannula
Answer: a) Administer surfactant replacement therapy
Rationale: Surfactant deficiency leads to RDS in preterm infants. Replacement surfactant reduces
surface tension and improves lung compliance.
A postpartum client has a blood pressure of 150/95 mmHg and new-onset proteinuria at 36
weeks gestation. What is the most appropriate diagnosis?
a) Gestational hypertension
b) Chronic hypertension
c) Preeclampsia
d) Eclampsia
Answer: c) Preeclampsia
Rationale: New-onset hypertension after 20 weeks with proteinuria suggests preeclampsia,
requiring close monitoring and management.
Which medication is contraindicated in a breastfeeding mother with a history of seizure
disorder?
a) Phenytoin
b) Carbamazepine
c) Valproic acid
d) Ethosuximide
,Answer: d) Ethosuximide
Rationale: Ethosuximide has limited safety data for breastfeeding and potential neonatal side
effects; other anticonvulsants listed are considered relatively safe.
A neonate born at 28 weeks shows signs of apnea. What is the most common pathophysiological
cause?
a) Immature respiratory center in the brainstem
b) Obstruction of the airway by mucus
c) Congenital heart disease
d) Surfactant overproduction
Answer: a) Immature respiratory center in the brainstem
Rationale: Central apnea in preterm infants is caused by immature respiratory regulation.
Which test is most definitive for diagnosing gestational diabetes mellitus?
a) Random blood glucose
b) 1-hour glucose challenge test
c) 3-hour oral glucose tolerance test
d) HbA1c
Answer: c) 3-hour oral glucose tolerance test
Rationale: The 3-hour OGTT provides diagnostic criteria based on glucose levels at multiple
time points.
True/False Questions
True or False: Magnesium sulfate is used in preeclampsia primarily for seizure prophylaxis.
Answer: True
Rationale: Magnesium sulfate prevents progression to eclampsia by reducing seizure risk.
True or False: A neonatal Apgar score below 7 at 5 minutes always indicates need for intensive
resuscitation.
Answer: False
Rationale: While a low score suggests distress, clinical context guides resuscitation rather than
Apgar alone.
True or False: Group B Streptococcus colonization in pregnancy requires intrapartum antibiotic
prophylaxis to prevent neonatal sepsis.
Answer: True
Rationale: Antibiotics during labor reduce vertical transmission and early neonatal infection.
True or False: Congenital hypothyroidism usually manifests in the newborn period with
excessive activity.
Answer: False
Rationale: It typically presents with lethargy, poor feeding, and hypotonia.
,True or False: Placenta previa is diagnosed by abdominal palpation alone.
Answer: False
Rationale: Ultrasound imaging is required to confirm placenta previa.
Short Answer Questions
Explain why kangaroo mother care (skin-to-skin contact) benefits preterm infants.
Answer: It stabilizes temperature, improves oxygenation, enhances breastfeeding success, and
promotes bonding, reducing morbidity.
Rationale: Skin-to-skin contact helps regulate physiological parameters critical to preterm infant
survival.
List three maternal complications associated with uncontrolled gestational diabetes.
Answer: Preeclampsia, cesarean section, postpartum hemorrhage.
Rationale: Hyperglycemia affects vascular and metabolic function, increasing maternal risks.
What is the significance of a positive Coombs test in a newborn?
Answer: Indicates hemolytic disease due to maternal antibodies attacking fetal red blood cells.
Rationale: Positive Coombs test requires monitoring for anemia and jaundice.
Describe the main nursing priority when managing a newborn with meconium aspiration
syndrome.
Answer: Ensure airway patency and provide respiratory support to prevent hypoxia.
Rationale: Meconium in airways can cause obstruction and inflammation.
Name two neonatal complications of maternal opioid use during pregnancy.
Answer: Neonatal abstinence syndrome, low birth weight.
Rationale: Opioids cross the placenta affecting fetal development and causing withdrawal
symptoms.
Fill in the Blank
The hormone __________ increases during pregnancy and promotes relaxation of pelvic
ligaments and cervix remodeling.
Answer: Relaxin
Rationale: Relaxin softens connective tissue facilitating labor.
A measurement of fetal growth less than the 10th percentile for gestational age is termed
____________.
Answer: Intrauterine growth restriction (IUGR)
Rationale: IUGR indicates suboptimal fetal growth often due to placental insufficiency.
The newborn reflex that causes toes to fan out when the sole of the foot is stroked is called the
__________ reflex.
Answer: Babinski
, Rationale: Babinski reflects neurologic status; normal in infants.
The nurse should monitor the neonate’s blood glucose closely in the first 24 hours to prevent
__________.
Answer: Hypoglycemia
Rationale: Neonates, especially diabetic mothers’ babies, are at risk of low blood sugar.
The drug of choice for treating neonatal seizure is ______________.
Answer: Phenobarbital
Rationale: Phenobarbital is effective and has a well-established safety profile.
Multiple Choice Questions (MCQ) Continued
After cesarean delivery, the nurse notes the uterus is boggy and bleeding is heavy. Which is the
most appropriate action?
a) Administer oxytocin and fundal massage
b) Insert Foley catheter
c) Elevate the legs
d) Start intravenous antibiotics
Answer: a) Administer oxytocin and fundal massage
Rationale: These help stimulate uterine contractions to control bleeding.
Which condition places a newborn at risk for necrotizing enterocolitis (NEC)?
a) Prematurity and formula feeding
b) Full-term and breastfeeding
c) Maternal diabetes only
d) Congenital hypothyroidism
Answer: a) Prematurity and formula feeding
Rationale: Immature gut and formula feeding increase NEC risk.
What does the Bishop Score assess?
a) Fetal heart rate variability
b) Cervical readiness for labor induction
c) Neonatal Apgar score
d) Severity of preeclampsia
Answer: b) Cervical readiness for labor induction
Rationale: Bishop score evaluates cervical dilation, effacement, position, and fetal station.
Which of the following is a sign of magnesium sulfate toxicity?
a) Hyperreflexia
b) Respiratory depression
c) Hypertension
d) Tachycardia
Maternal Infant Nursing
Midterm Exam Prep
2026
(With Solutions)
Multiple Choice Questions (MCQ)
A 32-week preterm neonate develops respiratory distress syndrome (RDS). Which intervention is
the priority?
a) Administer surfactant replacement therapy
b) Initiate phototherapy
c) Start oral feeding immediately
d) Provide supplemental oxygen by nasal cannula
Answer: a) Administer surfactant replacement therapy
Rationale: Surfactant deficiency leads to RDS in preterm infants. Replacement surfactant reduces
surface tension and improves lung compliance.
A postpartum client has a blood pressure of 150/95 mmHg and new-onset proteinuria at 36
weeks gestation. What is the most appropriate diagnosis?
a) Gestational hypertension
b) Chronic hypertension
c) Preeclampsia
d) Eclampsia
Answer: c) Preeclampsia
Rationale: New-onset hypertension after 20 weeks with proteinuria suggests preeclampsia,
requiring close monitoring and management.
Which medication is contraindicated in a breastfeeding mother with a history of seizure
disorder?
a) Phenytoin
b) Carbamazepine
c) Valproic acid
d) Ethosuximide
,Answer: d) Ethosuximide
Rationale: Ethosuximide has limited safety data for breastfeeding and potential neonatal side
effects; other anticonvulsants listed are considered relatively safe.
A neonate born at 28 weeks shows signs of apnea. What is the most common pathophysiological
cause?
a) Immature respiratory center in the brainstem
b) Obstruction of the airway by mucus
c) Congenital heart disease
d) Surfactant overproduction
Answer: a) Immature respiratory center in the brainstem
Rationale: Central apnea in preterm infants is caused by immature respiratory regulation.
Which test is most definitive for diagnosing gestational diabetes mellitus?
a) Random blood glucose
b) 1-hour glucose challenge test
c) 3-hour oral glucose tolerance test
d) HbA1c
Answer: c) 3-hour oral glucose tolerance test
Rationale: The 3-hour OGTT provides diagnostic criteria based on glucose levels at multiple
time points.
True/False Questions
True or False: Magnesium sulfate is used in preeclampsia primarily for seizure prophylaxis.
Answer: True
Rationale: Magnesium sulfate prevents progression to eclampsia by reducing seizure risk.
True or False: A neonatal Apgar score below 7 at 5 minutes always indicates need for intensive
resuscitation.
Answer: False
Rationale: While a low score suggests distress, clinical context guides resuscitation rather than
Apgar alone.
True or False: Group B Streptococcus colonization in pregnancy requires intrapartum antibiotic
prophylaxis to prevent neonatal sepsis.
Answer: True
Rationale: Antibiotics during labor reduce vertical transmission and early neonatal infection.
True or False: Congenital hypothyroidism usually manifests in the newborn period with
excessive activity.
Answer: False
Rationale: It typically presents with lethargy, poor feeding, and hypotonia.
,True or False: Placenta previa is diagnosed by abdominal palpation alone.
Answer: False
Rationale: Ultrasound imaging is required to confirm placenta previa.
Short Answer Questions
Explain why kangaroo mother care (skin-to-skin contact) benefits preterm infants.
Answer: It stabilizes temperature, improves oxygenation, enhances breastfeeding success, and
promotes bonding, reducing morbidity.
Rationale: Skin-to-skin contact helps regulate physiological parameters critical to preterm infant
survival.
List three maternal complications associated with uncontrolled gestational diabetes.
Answer: Preeclampsia, cesarean section, postpartum hemorrhage.
Rationale: Hyperglycemia affects vascular and metabolic function, increasing maternal risks.
What is the significance of a positive Coombs test in a newborn?
Answer: Indicates hemolytic disease due to maternal antibodies attacking fetal red blood cells.
Rationale: Positive Coombs test requires monitoring for anemia and jaundice.
Describe the main nursing priority when managing a newborn with meconium aspiration
syndrome.
Answer: Ensure airway patency and provide respiratory support to prevent hypoxia.
Rationale: Meconium in airways can cause obstruction and inflammation.
Name two neonatal complications of maternal opioid use during pregnancy.
Answer: Neonatal abstinence syndrome, low birth weight.
Rationale: Opioids cross the placenta affecting fetal development and causing withdrawal
symptoms.
Fill in the Blank
The hormone __________ increases during pregnancy and promotes relaxation of pelvic
ligaments and cervix remodeling.
Answer: Relaxin
Rationale: Relaxin softens connective tissue facilitating labor.
A measurement of fetal growth less than the 10th percentile for gestational age is termed
____________.
Answer: Intrauterine growth restriction (IUGR)
Rationale: IUGR indicates suboptimal fetal growth often due to placental insufficiency.
The newborn reflex that causes toes to fan out when the sole of the foot is stroked is called the
__________ reflex.
Answer: Babinski
, Rationale: Babinski reflects neurologic status; normal in infants.
The nurse should monitor the neonate’s blood glucose closely in the first 24 hours to prevent
__________.
Answer: Hypoglycemia
Rationale: Neonates, especially diabetic mothers’ babies, are at risk of low blood sugar.
The drug of choice for treating neonatal seizure is ______________.
Answer: Phenobarbital
Rationale: Phenobarbital is effective and has a well-established safety profile.
Multiple Choice Questions (MCQ) Continued
After cesarean delivery, the nurse notes the uterus is boggy and bleeding is heavy. Which is the
most appropriate action?
a) Administer oxytocin and fundal massage
b) Insert Foley catheter
c) Elevate the legs
d) Start intravenous antibiotics
Answer: a) Administer oxytocin and fundal massage
Rationale: These help stimulate uterine contractions to control bleeding.
Which condition places a newborn at risk for necrotizing enterocolitis (NEC)?
a) Prematurity and formula feeding
b) Full-term and breastfeeding
c) Maternal diabetes only
d) Congenital hypothyroidism
Answer: a) Prematurity and formula feeding
Rationale: Immature gut and formula feeding increase NEC risk.
What does the Bishop Score assess?
a) Fetal heart rate variability
b) Cervical readiness for labor induction
c) Neonatal Apgar score
d) Severity of preeclampsia
Answer: b) Cervical readiness for labor induction
Rationale: Bishop score evaluates cervical dilation, effacement, position, and fetal station.
Which of the following is a sign of magnesium sulfate toxicity?
a) Hyperreflexia
b) Respiratory depression
c) Hypertension
d) Tachycardia
