Maternal-Newborn
Nursing & Women's
Health Examination
2026/2027
**Question 1**
The nurse is assessing a pregnant client at 38 weeks gestation. Which finding should the nurse report to
the healthcare provider immediately?
A. Blood pressure of 142/92 mmHg
B. Mild ankle edema
C. Fetal heart rate of 140 bpm
D. Braxton-Hicks contractions
,💫RATIONALE✔️✔️: A blood pressure of 142/92 mmHg is elevated and may indicate preeclampsia, a
serious pregnancy complication. This requires immediate further evaluation. Mild ankle edema, a fetal
heart rate of 140 bpm, and Braxton-Hicks contractions are normal findings in late pregnancy.
💫ANSWER✔️✔️: A. Blood pressure of 142/92 mmHg
---
**Question 2**
The nurse is caring for a client in active labor. The fetal heart rate shows late decelerations. Which
action should the nurse take first?
A. Reposition the client on her left side
B. Administer oxygen via face mask
C. Increase the rate of IV fluids
D. Prepare for emergency cesarean section
💫RATIONALE✔️✔️: Late decelerations indicate uteroplacental insufficiency. The first intervention is
to reposition the client to her left side to improve blood flow to the placenta. If this does not resolve the
decelerations, the nurse should then administer oxygen and increase IV fluids. The provider should be
notified for further interventions.
💫ANSWER✔️✔️: A. Reposition the client on her left side
---
**Question 3**
,The nurse is assessing a newborn immediately after birth. Which finding is considered normal?
A. Heart rate of 120 bpm
B. Respiratory rate of 30 breaths per minute
C. Grunting respirations
D. Acrocyanosis of the hands and feet
💫RATIONALE✔️✔️: Acrocyanosis (blueness of the hands and feet) is a normal finding in the first 24
hours of life due to immature peripheral circulation. A heart rate of 120 bpm is within normal range
(110-160 bpm). Grunting respirations are a sign of respiratory distress and should be reported.
💫ANSWER✔️✔️: D. Acrocyanosis of the hands and feet
---
**Question 4**
The nurse is providing education to a client who is 32 weeks pregnant and has gestational diabetes.
Which instruction is most important?
A. "You should monitor your blood glucose levels as prescribed."
B. "You can eat unlimited carbohydrates."
C. "You should gain at least 30 pounds during this pregnancy."
D. "You should avoid all physical activity."
, 💫RATIONALE✔️✔️: Clients with gestational diabetes should monitor their blood glucose levels as
prescribed to manage their condition and prevent complications. Carbohydrates should be controlled,
weight gain should be appropriate for pre-pregnancy BMI, and moderate exercise is recommended.
💫ANSWER✔️✔️: A. "You should monitor your blood glucose levels as prescribed."
---
**Question 5**
The nurse is caring for a postpartum client who is 2 hours post-vaginal delivery. The nurse notes a
saturated perineal pad within 15 minutes. Which action should the nurse take first?
A. Assess the client's vital signs
B. Massage the fundus
C. Notify the healthcare provider
D. Document the finding
💫RATIONALE✔️✔️: Saturation of a perineal pad within 15 minutes indicates postpartum
hemorrhage. The nurse should first assess the client's vital signs to determine the severity of blood loss
and then massage the fundus to promote uterine contraction. The provider should be notified
immediately.
💫ANSWER✔️✔️: A. Assess the client's vital signs
---
**Question 6**
Nursing & Women's
Health Examination
2026/2027
**Question 1**
The nurse is assessing a pregnant client at 38 weeks gestation. Which finding should the nurse report to
the healthcare provider immediately?
A. Blood pressure of 142/92 mmHg
B. Mild ankle edema
C. Fetal heart rate of 140 bpm
D. Braxton-Hicks contractions
,💫RATIONALE✔️✔️: A blood pressure of 142/92 mmHg is elevated and may indicate preeclampsia, a
serious pregnancy complication. This requires immediate further evaluation. Mild ankle edema, a fetal
heart rate of 140 bpm, and Braxton-Hicks contractions are normal findings in late pregnancy.
💫ANSWER✔️✔️: A. Blood pressure of 142/92 mmHg
---
**Question 2**
The nurse is caring for a client in active labor. The fetal heart rate shows late decelerations. Which
action should the nurse take first?
A. Reposition the client on her left side
B. Administer oxygen via face mask
C. Increase the rate of IV fluids
D. Prepare for emergency cesarean section
💫RATIONALE✔️✔️: Late decelerations indicate uteroplacental insufficiency. The first intervention is
to reposition the client to her left side to improve blood flow to the placenta. If this does not resolve the
decelerations, the nurse should then administer oxygen and increase IV fluids. The provider should be
notified for further interventions.
💫ANSWER✔️✔️: A. Reposition the client on her left side
---
**Question 3**
,The nurse is assessing a newborn immediately after birth. Which finding is considered normal?
A. Heart rate of 120 bpm
B. Respiratory rate of 30 breaths per minute
C. Grunting respirations
D. Acrocyanosis of the hands and feet
💫RATIONALE✔️✔️: Acrocyanosis (blueness of the hands and feet) is a normal finding in the first 24
hours of life due to immature peripheral circulation. A heart rate of 120 bpm is within normal range
(110-160 bpm). Grunting respirations are a sign of respiratory distress and should be reported.
💫ANSWER✔️✔️: D. Acrocyanosis of the hands and feet
---
**Question 4**
The nurse is providing education to a client who is 32 weeks pregnant and has gestational diabetes.
Which instruction is most important?
A. "You should monitor your blood glucose levels as prescribed."
B. "You can eat unlimited carbohydrates."
C. "You should gain at least 30 pounds during this pregnancy."
D. "You should avoid all physical activity."
, 💫RATIONALE✔️✔️: Clients with gestational diabetes should monitor their blood glucose levels as
prescribed to manage their condition and prevent complications. Carbohydrates should be controlled,
weight gain should be appropriate for pre-pregnancy BMI, and moderate exercise is recommended.
💫ANSWER✔️✔️: A. "You should monitor your blood glucose levels as prescribed."
---
**Question 5**
The nurse is caring for a postpartum client who is 2 hours post-vaginal delivery. The nurse notes a
saturated perineal pad within 15 minutes. Which action should the nurse take first?
A. Assess the client's vital signs
B. Massage the fundus
C. Notify the healthcare provider
D. Document the finding
💫RATIONALE✔️✔️: Saturation of a perineal pad within 15 minutes indicates postpartum
hemorrhage. The nurse should first assess the client's vital signs to determine the severity of blood loss
and then massage the fundus to promote uterine contraction. The provider should be notified
immediately.
💫ANSWER✔️✔️: A. Assess the client's vital signs
---
**Question 6**
