Maternal-Newborn Nursing Test Bank 2026 | Murray 8th
Edition EXAM with Questions and Answers/Plus a
Rationale Updated 2026 A+/Instant Download PDF
EXAM COVERAGE
1. Reproductive System and Embryonic Development
2. Antepartum Care and Fetal Assessment
3. Labor and Birth Processes
4. Intrapartum Complications and Interventions
5. Postpartum Physiological and Psychological Adaptation
6. Neonatal Assessment and Care
7. High-Risk Pregnancy and Complications
8. Newborn Complications and Respiratory Support
9. Pharmacological Management in Perinatal Nursing
10. Ethics, Legal Considerations, and Professional Practice
1. A G3P2 client at 34 weeks' gestation presents with painless, bright red vaginal bleeding. The
nurse notes the fundal height is larger than gestational age, and the fetus is in a transverse lie.
What is the most appropriate initial nursing intervention?
A. Perform a sterile vaginal exam to assess cervical dilation.
B. Initiate continuous electronic fetal monitoring and maintain bed rest.
C. Administer an oxytocin infusion to evaluate fetal response to contractions.
, D. Encourage the client to ambulate to promote fetal descent.
Answer: B
Rationale: The clinical presentation is classic for placenta previa. Sterile vaginal exams are
contraindicated due to the risk of triggering severe hemorrhage. Continuous monitoring is
essential to assess fetal well-being, and bed rest minimizes mechanical stress on the placenta;
oxytocin and ambulation would be dangerous interventions in this context.
CORRECT ANSWER : B
2. During the active phase of labor, a client's labor progress stalls. The nurse identifies a persistent
occiput posterior (OP) position. Which nursing intervention most effectively promotes fetal
rotation to an occiput anterior (OA) position?
A. Maintaining the client in a supine position to stabilize the pelvis.
B. Assisting the client into a hands-and-knees position.
C. Administering a narcotic analgesic to facilitate pelvic relaxation.
D. Applying fundal pressure to assist the fetus through the birth canal.
Answer: B
Rationale: The hands-and-knees (all-fours) position uses gravity and fetal repositioning to help
the fetal occiput rotate anteriorly. A supine position often worsens OP labor by increasing back
pain; analgesics do not facilitate mechanical rotation, and fundal pressure is contraindicated
due to the risk of uterine rupture.
CORRECT ANSWER : B
3. A neonate born at 32 weeks' gestation develops sudden abdominal distension, heme-positive
stools, and lethargy at 48 hours of life. Which diagnosis should the nurse prioritize?
A. Meconium ileus.
B. Sepsis neonatorum.
C. Necrotizing enterocolitis (NEC).
D. Transient tachypnea of the newborn.
Answer: C
, Rationale: The triad of abdominal distension, bloody stools, and lethargy in a preterm infant is
highly suggestive of NEC. While sepsis is a differential, the specific gastrointestinal findings
point toward necrotic intestinal tissue. Meconium ileus is typically associated with cystic
fibrosis, and transient tachypnea involves respiratory, not abdominal, symptoms.
CORRECT ANSWER : C
4. A client in the third trimester complains of sudden, sharp abdominal pain followed by a rigid,
board-like abdomen and dark red vaginal bleeding. Which assessment finding requires
immediate obstetric intervention?
A. Maternal pulse of 80 beats per minute.
B. Fetal heart rate showing persistent late decelerations.
C. Maternal blood pressure of 120/80 mmHg.
D. Absence of contractions on the tocometer.
Answer: B
Rationale: The symptoms described (rigid abdomen, dark bleeding) indicate placental abruption.
Persistent late decelerations indicate uteroplacental insufficiency and fetal distress, requiring
urgent delivery. The other options suggest a more stable maternal-fetal status, which is not
consistent with an acute abruption.
CORRECT ANSWER : B
5. A postpartum client on the first day after a cesarean section is experiencing tachycardia and
decreased urinary output. Upon assessment, the fundus is firm, but there is significant pooling of
blood on the perineal pad. What is the priority nursing action?
A. Massage the fundus vigorously.
B. Assess for hematoma or hidden lacerations and notify the provider.
C. Encourage the client to void using the bedpan.
D. Increase the rate of intravenous fluids to address tachycardia.
Answer: B
Rationale: If the fundus is firm, the bleeding is likely not due to uterine atony, suggesting a
laceration or hematoma that requires provider assessment. Massaging a firm fundus is
ineffective and painful, and while fluids are important, they do not address the source of
hemorrhage; immediate identification of the bleeding site is paramount.
, CORRECT ANSWER : B
6. A nurse is caring for a client at 38 weeks' gestation receiving intravenous magnesium sulfate for
severe preeclampsia. Which finding requires immediate discontinuation of the infusion?
A. Maternal respiratory rate of 16 breaths/min.
B. Loss of patellar deep tendon reflexes.
C. Presence of 1+ pitting edema in the lower extremities.
D. Maternal blood pressure of 145/95 mmHg.
Answer: B
Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, indicating the
need to stop the infusion immediately to prevent respiratory depression. A respiratory rate of 16
is normal, 1+ edema is expected in late pregnancy, and the blood pressure remains within the
target range for a preeclamptic client.
CORRECT ANSWER : B
7. A nurse is teaching a client about the use of phototherapy for neonatal jaundice. Which statement
indicates the need for further education?
A. "I will ensure my baby's eyes are completely covered while under the lights."
B. "I should discontinue breastfeeding until the jaundice resolves."
C. "I will monitor the baby's temperature frequently during therapy."
D. "I need to ensure the baby is repositioned every two hours."
Answer: B
Rationale: Breastfeeding should continue during phototherapy to provide hydration and promote
bilirubin excretion via stool; stopping breastfeeding is unnecessary and counterproductive.
Covering the eyes prevents retinal damage, frequent temperature monitoring prevents
hypothermia/hyperthermia, and repositioning ensures skin exposure.
CORRECT ANSWER : B
8. A client at 28 weeks' gestation is diagnosed with preterm labor. The provider orders nifedipine.
What is the nurse's priority monitoring goal?
A. Monitoring for maternal hypotension and tachycardia.
Edition EXAM with Questions and Answers/Plus a
Rationale Updated 2026 A+/Instant Download PDF
EXAM COVERAGE
1. Reproductive System and Embryonic Development
2. Antepartum Care and Fetal Assessment
3. Labor and Birth Processes
4. Intrapartum Complications and Interventions
5. Postpartum Physiological and Psychological Adaptation
6. Neonatal Assessment and Care
7. High-Risk Pregnancy and Complications
8. Newborn Complications and Respiratory Support
9. Pharmacological Management in Perinatal Nursing
10. Ethics, Legal Considerations, and Professional Practice
1. A G3P2 client at 34 weeks' gestation presents with painless, bright red vaginal bleeding. The
nurse notes the fundal height is larger than gestational age, and the fetus is in a transverse lie.
What is the most appropriate initial nursing intervention?
A. Perform a sterile vaginal exam to assess cervical dilation.
B. Initiate continuous electronic fetal monitoring and maintain bed rest.
C. Administer an oxytocin infusion to evaluate fetal response to contractions.
, D. Encourage the client to ambulate to promote fetal descent.
Answer: B
Rationale: The clinical presentation is classic for placenta previa. Sterile vaginal exams are
contraindicated due to the risk of triggering severe hemorrhage. Continuous monitoring is
essential to assess fetal well-being, and bed rest minimizes mechanical stress on the placenta;
oxytocin and ambulation would be dangerous interventions in this context.
CORRECT ANSWER : B
2. During the active phase of labor, a client's labor progress stalls. The nurse identifies a persistent
occiput posterior (OP) position. Which nursing intervention most effectively promotes fetal
rotation to an occiput anterior (OA) position?
A. Maintaining the client in a supine position to stabilize the pelvis.
B. Assisting the client into a hands-and-knees position.
C. Administering a narcotic analgesic to facilitate pelvic relaxation.
D. Applying fundal pressure to assist the fetus through the birth canal.
Answer: B
Rationale: The hands-and-knees (all-fours) position uses gravity and fetal repositioning to help
the fetal occiput rotate anteriorly. A supine position often worsens OP labor by increasing back
pain; analgesics do not facilitate mechanical rotation, and fundal pressure is contraindicated
due to the risk of uterine rupture.
CORRECT ANSWER : B
3. A neonate born at 32 weeks' gestation develops sudden abdominal distension, heme-positive
stools, and lethargy at 48 hours of life. Which diagnosis should the nurse prioritize?
A. Meconium ileus.
B. Sepsis neonatorum.
C. Necrotizing enterocolitis (NEC).
D. Transient tachypnea of the newborn.
Answer: C
, Rationale: The triad of abdominal distension, bloody stools, and lethargy in a preterm infant is
highly suggestive of NEC. While sepsis is a differential, the specific gastrointestinal findings
point toward necrotic intestinal tissue. Meconium ileus is typically associated with cystic
fibrosis, and transient tachypnea involves respiratory, not abdominal, symptoms.
CORRECT ANSWER : C
4. A client in the third trimester complains of sudden, sharp abdominal pain followed by a rigid,
board-like abdomen and dark red vaginal bleeding. Which assessment finding requires
immediate obstetric intervention?
A. Maternal pulse of 80 beats per minute.
B. Fetal heart rate showing persistent late decelerations.
C. Maternal blood pressure of 120/80 mmHg.
D. Absence of contractions on the tocometer.
Answer: B
Rationale: The symptoms described (rigid abdomen, dark bleeding) indicate placental abruption.
Persistent late decelerations indicate uteroplacental insufficiency and fetal distress, requiring
urgent delivery. The other options suggest a more stable maternal-fetal status, which is not
consistent with an acute abruption.
CORRECT ANSWER : B
5. A postpartum client on the first day after a cesarean section is experiencing tachycardia and
decreased urinary output. Upon assessment, the fundus is firm, but there is significant pooling of
blood on the perineal pad. What is the priority nursing action?
A. Massage the fundus vigorously.
B. Assess for hematoma or hidden lacerations and notify the provider.
C. Encourage the client to void using the bedpan.
D. Increase the rate of intravenous fluids to address tachycardia.
Answer: B
Rationale: If the fundus is firm, the bleeding is likely not due to uterine atony, suggesting a
laceration or hematoma that requires provider assessment. Massaging a firm fundus is
ineffective and painful, and while fluids are important, they do not address the source of
hemorrhage; immediate identification of the bleeding site is paramount.
, CORRECT ANSWER : B
6. A nurse is caring for a client at 38 weeks' gestation receiving intravenous magnesium sulfate for
severe preeclampsia. Which finding requires immediate discontinuation of the infusion?
A. Maternal respiratory rate of 16 breaths/min.
B. Loss of patellar deep tendon reflexes.
C. Presence of 1+ pitting edema in the lower extremities.
D. Maternal blood pressure of 145/95 mmHg.
Answer: B
Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, indicating the
need to stop the infusion immediately to prevent respiratory depression. A respiratory rate of 16
is normal, 1+ edema is expected in late pregnancy, and the blood pressure remains within the
target range for a preeclamptic client.
CORRECT ANSWER : B
7. A nurse is teaching a client about the use of phototherapy for neonatal jaundice. Which statement
indicates the need for further education?
A. "I will ensure my baby's eyes are completely covered while under the lights."
B. "I should discontinue breastfeeding until the jaundice resolves."
C. "I will monitor the baby's temperature frequently during therapy."
D. "I need to ensure the baby is repositioned every two hours."
Answer: B
Rationale: Breastfeeding should continue during phototherapy to provide hydration and promote
bilirubin excretion via stool; stopping breastfeeding is unnecessary and counterproductive.
Covering the eyes prevents retinal damage, frequent temperature monitoring prevents
hypothermia/hyperthermia, and repositioning ensures skin exposure.
CORRECT ANSWER : B
8. A client at 28 weeks' gestation is diagnosed with preterm labor. The provider orders nifedipine.
What is the nurse's priority monitoring goal?
A. Monitoring for maternal hypotension and tachycardia.
