NURS240 MATERNAL-NEWBORN NURSING
2026 EXAM PREP STUDY GUIDE | PRACTICE
QUESTIONS & ANSWERS | MATERNITY,
LABOR, DELIVERY & NEONATAL NURSING
TEST BANK
NURS240 MATERNAL-NEWBORN NURSING 2026 EXAM PREP STUDY GUIDE
PRACTICE QUESTIONS & ANSWERS | MATERNITY, LABOR, DELIVERY &
NEONATAL NURSING TEST BANK
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════════════════
DOCUMENT OVERVIEW:
• This comprehensive study guide contains 200 practice questions designed to
prepare you for the NURS240 Maternal-Newborn Nursing exam, covering prenatal,
intrapartum, postpartum, and neonatal nursing care with detailed EXPERT
RATIONALE for each answer.
• Use this material by reviewing questions daily, focusing on weak topic areas, and
studying the EXPERT RATIONALE thoroughly to understand the "why" behind
correct answers—this strengthens critical thinking and clinical judgment essential
for safe maternal-newborn nursing practice.
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════════════════
1. A 28-year-old primigravida at 12 weeks gestation presents for her first
prenatal visit. Which assessment is the priority at this initial visit?
A) Scheduling ultrasound for fetal anomaly screening
B) Establishing baseline vital signs and obstetric history
C) Performing Leopold maneuvers
D) Assessing fetal heart tones with Doppler
E) Discussing delivery preferences and birth plans
CORRECT ANSWER: B) Establishing baseline vital signs and obstetric history
,EXPERT RATIONALE: At the initial prenatal visit, establishing baseline data
including blood pressure, weight, and a complete obstetric and medical history is
essential for future comparison and risk identification. While other assessments are
important, the baseline vital signs and history provide the foundation for all
subsequent care. Leopold maneuvers are performed in the third trimester, and
fetal heart tones may not be audible at 12 weeks with Doppler.
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════════════════
2. A pregnant client at 16 weeks gestation reports experiencing mild spotting
and mild cramping. What is the nurse's most appropriate initial response?
A) Assure the client this is normal implantation bleeding
B) Perform a speculum examination to assess for cervical abnormalities
C) Instruct the client to report to the emergency department immediately
D) Assess for signs of miscarriage and notify the healthcare provider
E) Recommend bed rest for the remainder of the pregnancy
CORRECT ANSWER: D) Assess for signs of miscarriage and notify the
healthcare provider
EXPERT RATIONALE: Spotting and cramping in the second trimester require
assessment for threatened miscarriage. The nurse should evaluate for severity,
associated symptoms, and notify the provider for evaluation. Implantation bleeding
occurs in the first trimester. A speculum exam may be appropriate but requires
provider evaluation first. Emergency referral is not automatic, and bed rest is not
evidence-based for threatened miscarriage.
═══════════════════════════════════════════════════════
════════════════
3. Which finding would indicate that a pregnant client has developed
preeclampsia?
A) Blood pressure 120/80 mmHg with 1+ proteinuria
B) Blood pressure 140/90 mmHg on two occasions with 3+ proteinuria
,C) Blood pressure 138/88 mmHg with no proteinuria
D) Blood pressure 145/92 mmHg with trace proteinuria
E) Blood pressure 130/85 mmHg with 2+ proteinuria
CORRECT ANSWER: B) Blood pressure 140/90 mmHg on two occasions with 3+
proteinuria
EXPERT RATIONALE: Preeclampsia is diagnosed when blood pressure is ≥140/90
mmHg on two separate occasions at least 4 hours apart AND proteinuria ≥2+ or
≥300 mg/24 hours is present. The combination of both elevated blood pressure
AND significant proteinuria is diagnostic. Isolated blood pressure elevation or trace
proteinuria alone does not indicate preeclampsia.
═══════════════════════════════════════════════════════
════════════════
4. A client at 32 weeks gestation presents with sudden onset of severe
abdominal pain and vaginal bleeding. Fetal heart rate is 90 bpm with minimal
variability. What is the priority nursing diagnosis?
A) Acute pain
B) Decreased cardiac output related to hemorrhage
C) Risk for impaired fetal oxygenation
D) Anxiety related to unexpected complications
E) Deficient fluid volume
CORRECT ANSWER: C) Risk for impaired fetal oxygenation
EXPERT RATIONALE: The clinical presentation of severe abdominal pain, vaginal
bleeding, decreased fetal heart rate, and minimal variability is consistent with
placental abruption. The priority is fetal well-being because the decreased heart
rate and variability indicate fetal compromise. While the other diagnoses may
apply, fetal oxygenation is the immediate life-threatening concern requiring
emergency intervention.
═══════════════════════════════════════════════════════
════════════════
, 5. During a prenatal visit at 24 weeks, a client is found to have a blood glucose
level of 165 mg/dL on the 1-hour glucose tolerance test. What is the
appropriate next step?
A) Diagnose gestational diabetes mellitus immediately
B) Repeat the test in 1 week
C) Proceed to a 3-hour glucose tolerance test
D) Begin insulin therapy
E) Schedule for a repeat 1-hour test the following week
CORRECT ANSWER: C) Proceed to a 3-hour glucose tolerance test
EXPERT RATIONALE: A 1-hour glucose screen value ≥140 mg/dL (or ≥135 mg/dL
depending on protocol) requires confirmation with a 3-hour GTT. A single elevated
value does not diagnose GDM; the 3-hour test with fasting and multiple samples is
the diagnostic standard. Insulin is not started until GDM is confirmed through the 3-
hour test.
═══════════════════════════════════════════════════════
════════════════
6. A client in active labor is receiving oxytocin (Pitocin) to augment labor. The
nurse notes a contraction lasting 90 seconds with only 30 seconds of
relaxation between contractions. What action should the nurse take?
A) Continue the infusion at the current rate
B) Increase the oxytocin infusion rate
C) Decrease or discontinue the oxytocin infusion
D) Notify the provider that labor is progressing normally
E) Prepare for emergency cesarean delivery
CORRECT ANSWER: C) Decrease or discontinue the oxytocin infusion
EXPERT RATIONALE: Contractions lasting longer than 60 seconds with insufficient
relaxation time (less than 60 seconds) indicate tachysystole, which reduces
2026 EXAM PREP STUDY GUIDE | PRACTICE
QUESTIONS & ANSWERS | MATERNITY,
LABOR, DELIVERY & NEONATAL NURSING
TEST BANK
NURS240 MATERNAL-NEWBORN NURSING 2026 EXAM PREP STUDY GUIDE
PRACTICE QUESTIONS & ANSWERS | MATERNITY, LABOR, DELIVERY &
NEONATAL NURSING TEST BANK
═══════════════════════════════════════════════════════
════════════════
DOCUMENT OVERVIEW:
• This comprehensive study guide contains 200 practice questions designed to
prepare you for the NURS240 Maternal-Newborn Nursing exam, covering prenatal,
intrapartum, postpartum, and neonatal nursing care with detailed EXPERT
RATIONALE for each answer.
• Use this material by reviewing questions daily, focusing on weak topic areas, and
studying the EXPERT RATIONALE thoroughly to understand the "why" behind
correct answers—this strengthens critical thinking and clinical judgment essential
for safe maternal-newborn nursing practice.
═══════════════════════════════════════════════════════
════════════════
1. A 28-year-old primigravida at 12 weeks gestation presents for her first
prenatal visit. Which assessment is the priority at this initial visit?
A) Scheduling ultrasound for fetal anomaly screening
B) Establishing baseline vital signs and obstetric history
C) Performing Leopold maneuvers
D) Assessing fetal heart tones with Doppler
E) Discussing delivery preferences and birth plans
CORRECT ANSWER: B) Establishing baseline vital signs and obstetric history
,EXPERT RATIONALE: At the initial prenatal visit, establishing baseline data
including blood pressure, weight, and a complete obstetric and medical history is
essential for future comparison and risk identification. While other assessments are
important, the baseline vital signs and history provide the foundation for all
subsequent care. Leopold maneuvers are performed in the third trimester, and
fetal heart tones may not be audible at 12 weeks with Doppler.
═══════════════════════════════════════════════════════
════════════════
2. A pregnant client at 16 weeks gestation reports experiencing mild spotting
and mild cramping. What is the nurse's most appropriate initial response?
A) Assure the client this is normal implantation bleeding
B) Perform a speculum examination to assess for cervical abnormalities
C) Instruct the client to report to the emergency department immediately
D) Assess for signs of miscarriage and notify the healthcare provider
E) Recommend bed rest for the remainder of the pregnancy
CORRECT ANSWER: D) Assess for signs of miscarriage and notify the
healthcare provider
EXPERT RATIONALE: Spotting and cramping in the second trimester require
assessment for threatened miscarriage. The nurse should evaluate for severity,
associated symptoms, and notify the provider for evaluation. Implantation bleeding
occurs in the first trimester. A speculum exam may be appropriate but requires
provider evaluation first. Emergency referral is not automatic, and bed rest is not
evidence-based for threatened miscarriage.
═══════════════════════════════════════════════════════
════════════════
3. Which finding would indicate that a pregnant client has developed
preeclampsia?
A) Blood pressure 120/80 mmHg with 1+ proteinuria
B) Blood pressure 140/90 mmHg on two occasions with 3+ proteinuria
,C) Blood pressure 138/88 mmHg with no proteinuria
D) Blood pressure 145/92 mmHg with trace proteinuria
E) Blood pressure 130/85 mmHg with 2+ proteinuria
CORRECT ANSWER: B) Blood pressure 140/90 mmHg on two occasions with 3+
proteinuria
EXPERT RATIONALE: Preeclampsia is diagnosed when blood pressure is ≥140/90
mmHg on two separate occasions at least 4 hours apart AND proteinuria ≥2+ or
≥300 mg/24 hours is present. The combination of both elevated blood pressure
AND significant proteinuria is diagnostic. Isolated blood pressure elevation or trace
proteinuria alone does not indicate preeclampsia.
═══════════════════════════════════════════════════════
════════════════
4. A client at 32 weeks gestation presents with sudden onset of severe
abdominal pain and vaginal bleeding. Fetal heart rate is 90 bpm with minimal
variability. What is the priority nursing diagnosis?
A) Acute pain
B) Decreased cardiac output related to hemorrhage
C) Risk for impaired fetal oxygenation
D) Anxiety related to unexpected complications
E) Deficient fluid volume
CORRECT ANSWER: C) Risk for impaired fetal oxygenation
EXPERT RATIONALE: The clinical presentation of severe abdominal pain, vaginal
bleeding, decreased fetal heart rate, and minimal variability is consistent with
placental abruption. The priority is fetal well-being because the decreased heart
rate and variability indicate fetal compromise. While the other diagnoses may
apply, fetal oxygenation is the immediate life-threatening concern requiring
emergency intervention.
═══════════════════════════════════════════════════════
════════════════
, 5. During a prenatal visit at 24 weeks, a client is found to have a blood glucose
level of 165 mg/dL on the 1-hour glucose tolerance test. What is the
appropriate next step?
A) Diagnose gestational diabetes mellitus immediately
B) Repeat the test in 1 week
C) Proceed to a 3-hour glucose tolerance test
D) Begin insulin therapy
E) Schedule for a repeat 1-hour test the following week
CORRECT ANSWER: C) Proceed to a 3-hour glucose tolerance test
EXPERT RATIONALE: A 1-hour glucose screen value ≥140 mg/dL (or ≥135 mg/dL
depending on protocol) requires confirmation with a 3-hour GTT. A single elevated
value does not diagnose GDM; the 3-hour test with fasting and multiple samples is
the diagnostic standard. Insulin is not started until GDM is confirmed through the 3-
hour test.
═══════════════════════════════════════════════════════
════════════════
6. A client in active labor is receiving oxytocin (Pitocin) to augment labor. The
nurse notes a contraction lasting 90 seconds with only 30 seconds of
relaxation between contractions. What action should the nurse take?
A) Continue the infusion at the current rate
B) Increase the oxytocin infusion rate
C) Decrease or discontinue the oxytocin infusion
D) Notify the provider that labor is progressing normally
E) Prepare for emergency cesarean delivery
CORRECT ANSWER: C) Decrease or discontinue the oxytocin infusion
EXPERT RATIONALE: Contractions lasting longer than 60 seconds with insufficient
relaxation time (less than 60 seconds) indicate tachysystole, which reduces
