Comprehensive RN Maternal Newborn 2024 Proctored Exam
with NGN 70 Questions and Ansẉers with Expert-Verified
Explanation 2026 update
,NGN Unfolding Case Study 1 – Placenta Previa (Questions 1–
12)
Scenario: A nurse is caring for a client at 34 weeks gestation
who was admitted with painless, bright red vaginal bleeding.
Ultrasound confirms placenta previa.
1. Which of the following findings is consistent with placenta
previa?
A) Severe abdominal pain with dark red bleeding
B) Painless, bright red vaginal bleeding
C) Uterine tenderness and rigidity
D) Contractions every 2 minutes
Correct Answer: B
Rationale: Placenta previa presents with painless, bright red
vaginal bleeding. Abruptio placentae presents with painful, dark
red bleeding and uterine tenderness.
2. The client asks why she cannot have a vaginal examination.
Which of the following responses should the nurse give?
A) "Vaginal examinations can increase your pain."
B) "Vaginal examinations can cause severe bleeding."
C) "Vaginal examinations are not accurate in your condition."
D) "Vaginal examinations are only done in active labor."
Correct Answer: B
Rationale: Vaginal examinations are contraindicated in
,placenta previa because they can disrupt the placenta and
cause catastrophic hemorrhage.
3. The client asks about the plan for delivery. Which of the
following responses should the nurse give?
A) "You will likely have a vaginal delivery."
B) "You will likely have a cesarean section."
C) "You will need to wait until 40 weeks to deliver."
D) "You will need an amniocentesis before delivery."
Correct Answer: B
Rationale: Placenta previa typically requires cesarean section
because the placenta covers the cervical os, blocking the birth
canal.
4. The client's bleeding increases. The nurse notes that the
client's blood pressure is 90/50 mm Hg and heart rate is 120
bpm. Which of the following is the priority action?
A) Administer oxytocin
B) Prepare for immediate cesarean section
C) Insert a second IV line
D) Administer oxygen
Correct Answer: B
Rationale: The client is showing signs of hemorrhagic shock.
Immediate cesarean section is indicated to deliver the baby and
stop the bleeding.
, 5. The nurse prepares the client for emergency cesarean
section. Which of the following actions should the nurse take
first?
A) Obtain informed consent
B) Insert a urinary catheter
C) Administer preoperative antibiotics
D) Notify the blood bank
Correct Answer: A
Rationale: Informed consent must be obtained before any
surgical procedure. The nurse should obtain consent first, then
perform other preoperative tasks.
6. The client is Rh-negative and her antibody screen is
negative. Which of the following medications should the
nurse anticipate administering after delivery?
A) Betamethasone
B) Rho(D) immune globulin
C) Magnesium sulfate
D) Oxytocin
Correct Answer: B
Rationale: Rho(D) immune globulin is given to Rh-negative
mothers within 72 hours after delivery if the newborn is Rh-
positive.
with NGN 70 Questions and Ansẉers with Expert-Verified
Explanation 2026 update
,NGN Unfolding Case Study 1 – Placenta Previa (Questions 1–
12)
Scenario: A nurse is caring for a client at 34 weeks gestation
who was admitted with painless, bright red vaginal bleeding.
Ultrasound confirms placenta previa.
1. Which of the following findings is consistent with placenta
previa?
A) Severe abdominal pain with dark red bleeding
B) Painless, bright red vaginal bleeding
C) Uterine tenderness and rigidity
D) Contractions every 2 minutes
Correct Answer: B
Rationale: Placenta previa presents with painless, bright red
vaginal bleeding. Abruptio placentae presents with painful, dark
red bleeding and uterine tenderness.
2. The client asks why she cannot have a vaginal examination.
Which of the following responses should the nurse give?
A) "Vaginal examinations can increase your pain."
B) "Vaginal examinations can cause severe bleeding."
C) "Vaginal examinations are not accurate in your condition."
D) "Vaginal examinations are only done in active labor."
Correct Answer: B
Rationale: Vaginal examinations are contraindicated in
,placenta previa because they can disrupt the placenta and
cause catastrophic hemorrhage.
3. The client asks about the plan for delivery. Which of the
following responses should the nurse give?
A) "You will likely have a vaginal delivery."
B) "You will likely have a cesarean section."
C) "You will need to wait until 40 weeks to deliver."
D) "You will need an amniocentesis before delivery."
Correct Answer: B
Rationale: Placenta previa typically requires cesarean section
because the placenta covers the cervical os, blocking the birth
canal.
4. The client's bleeding increases. The nurse notes that the
client's blood pressure is 90/50 mm Hg and heart rate is 120
bpm. Which of the following is the priority action?
A) Administer oxytocin
B) Prepare for immediate cesarean section
C) Insert a second IV line
D) Administer oxygen
Correct Answer: B
Rationale: The client is showing signs of hemorrhagic shock.
Immediate cesarean section is indicated to deliver the baby and
stop the bleeding.
, 5. The nurse prepares the client for emergency cesarean
section. Which of the following actions should the nurse take
first?
A) Obtain informed consent
B) Insert a urinary catheter
C) Administer preoperative antibiotics
D) Notify the blood bank
Correct Answer: A
Rationale: Informed consent must be obtained before any
surgical procedure. The nurse should obtain consent first, then
perform other preoperative tasks.
6. The client is Rh-negative and her antibody screen is
negative. Which of the following medications should the
nurse anticipate administering after delivery?
A) Betamethasone
B) Rho(D) immune globulin
C) Magnesium sulfate
D) Oxytocin
Correct Answer: B
Rationale: Rho(D) immune globulin is given to Rh-negative
mothers within 72 hours after delivery if the newborn is Rh-
positive.
