NUR 202 Exam 3 Maternal-Newborn Nursing
Review Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
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SECTION 1: ANTEPARTUM NURSING Q1 – Q10
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Question 1 of 50
A 28-year-old G1P0 at 16 weeks gestation presents for her prenatal visit. She reports
persistent nausea with 2-3 episodes of vomiting daily, has lost 4 lb since her last visit, and
shows dry mucous membranes. Her urine ketones are moderate. The nurse should anticipate
which provider order?
A. Increase oral fluid intake to 3 L daily
B. Administer IV fluids with thiamine and antiemetics ✓ CORRECT
C. Schedule an immediate ultrasound to assess fetal viability
D. Recommend ginger supplements and small frequent meals
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by weight loss, ketonuria, and
dehydration requiring IV fluid resuscitation with thiamine to prevent Wernicke encephalopathy
and antiemetic therapy per provider order. Ginger supplements and dietary modifications are
appropriate for mild nausea but insufficient when dehydration and ketosis are present. Early
intervention prevents electrolyte imbalances and supports maternal-fetal perfusion.
Question 2 of 50
A 34-year-old G2P1 at 28 weeks gestation arrives for her routine prenatal appointment. Her
blood pressure is 152/96 mmHg, she has 2+ proteinuria on dipstick, and reports a headache
unrelieved by acetaminophen. Fetal heart rate is 140 bpm with moderate variability. Which
nursing action takes priority?
A. Encourage the patient to rest in the left lateral position
B. Obtain a clean-catch urine sample for culture and sensitivity
C. Administer a bolus of magnesium sulfate intravenously
,D. Notify the provider immediately and assess deep tendon reflexes ✓ CORRECT
Correct Answer: D
Rationale: These findings indicate severe-range blood pressures with neurological symptoms
consistent with preeclampsia with severe features, requiring immediate provider notification
and reflex assessment to evaluate for hyperreflexia and impending eclampsia. While left
lateral positioning is supportive, it does not replace urgent provider communication when
severe features are present. Magnesium sulfate requires a provider order and should not be
administered without one.
Question 3 of 50
A 22-year-old G1P0 at 10 weeks gestation is reviewing her prenatal laboratory results with the
nurse. Her rubella titer indicates non-immunity, her blood type is A-negative, and her antibody
screen is negative. Which teaching point is most important for the nurse to include?
A. She will need Rh immune globulin at 28 weeks and postpartum if the baby is Rh-positive ✓
CORRECT
B. She should receive the rubella vaccine immediately to protect the fetus
C. A repeat antibody screen is unnecessary since the first was negative
D. She must avoid all contact with children to prevent rubella exposure
Correct Answer: A
Rationale: Rh-negative patients with a negative antibody screen require RhIG at 28 weeks
gestation and within 72 hours postpartum if the newborn is Rh-positive to prevent
alloimmunization. The rubella vaccine is contraindicated during pregnancy and should be
given postpartum instead. While avoiding sick contacts is reasonable, complete isolation is
impractical and unnecessary.
Question 4 of 50
A 30-year-old G3P2 at 32 weeks gestation with pregestational type 1 diabetes comes to the
clinic. Her fasting blood glucose has ranged 95-110 mg/dL and her 2-hour postprandial values
are 145-160 mg/dL. Fetal ultrasound shows an estimated fetal weight at the 85th percentile
and adequate amniotic fluid. Which nursing intervention is most appropriate?
A. Recommend increasing her current insulin dose by 20% independently
B. Advise the patient to eliminate all carbohydrates from her diet
C. Review glucose logs with the provider to adjust insulin regimen ✓ CORRECT
D. Schedule a non-stress test for the same day due to macrosomia
Correct Answer: C
Rationale: Tight glycemic control in pregestational diabetes requires collaborative insulin
adjustment based on glucose patterns to reduce fetal macrosomia risk without causing
, maternal hypoglycemia. Nurses do not independently titrate insulin doses, and eliminating
carbohydrates is unsafe during pregnancy and can precipitate ketosis. A non-stress test at 32
weeks for an appropriately growing fetus is not indicated without additional concerns.
Question 5 of 50
A 26-year-old G1P0 at 18 weeks gestation reports a sudden gush of clear fluid from her
vagina while at work. She arrives at the obstetric triage unit. Sterile speculum examination
reveals pooling of fluid in the vaginal vault, ferning is positive, and nitrazine paper turns blue.
Fetal heart rate is 148 bpm. Which is the nurse's priority action?
A. Perform a digital vaginal examination to assess cervical dilation
B. Initiate continuous fetal monitoring and notify the provider ✓ CORRECT
C. Administer betamethasone intramuscularly without delay
D. Position the patient in Trendelenburg to prevent cord prolapse
Correct Answer: B
Rationale: Premature rupture of membranes at 18 weeks requires immediate fetal monitoring
to assess for cord compression or infection while the provider is notified for management
planning. Digital examination is contraindicated with suspected PROM due to infection risk,
and betamethasone requires a provider order and is typically reserved for viable gestations.
Trendelenburg positioning is unnecessary without evidence of cord compression or prolapse.
Question 6 of 50
A 19-year-old G1P0 at 24 weeks gestation is seen in the prenatal clinic. Her hemoglobin is 9.8
g/dL, hematocrit is 30%, and mean corpuscular volume is 78 fL. She reports craving ice and
feeling increasingly fatigued. Which dietary counseling is most appropriate?
A. Increase intake of vitamin C-rich foods to enhance calcium absorption
B. Consume 3-4 servings of dairy products daily for folate supplementation
C. Add more whole grains and citrus fruits to address B12 deficiency
D. Teach iron-rich food sources and recommend iron supplementation ✓ CORRECT
Correct Answer: D
Rationale: The low MCV and pica behavior indicate iron-deficiency anemia, the most common
anemia in pregnancy, requiring iron supplementation and dietary teaching about heme and
non-heme iron sources. Dairy products contain calcium which inhibits iron absorption, and
whole grains with citrus address folate deficiency associated with macrocytic anemia.
Untreated iron-deficiency anemia increases the risk of preterm birth and low birth weight.
Question 7 of 50
Review Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
══════════════════════════════════════
SECTION 1: ANTEPARTUM NURSING Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 28-year-old G1P0 at 16 weeks gestation presents for her prenatal visit. She reports
persistent nausea with 2-3 episodes of vomiting daily, has lost 4 lb since her last visit, and
shows dry mucous membranes. Her urine ketones are moderate. The nurse should anticipate
which provider order?
A. Increase oral fluid intake to 3 L daily
B. Administer IV fluids with thiamine and antiemetics ✓ CORRECT
C. Schedule an immediate ultrasound to assess fetal viability
D. Recommend ginger supplements and small frequent meals
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by weight loss, ketonuria, and
dehydration requiring IV fluid resuscitation with thiamine to prevent Wernicke encephalopathy
and antiemetic therapy per provider order. Ginger supplements and dietary modifications are
appropriate for mild nausea but insufficient when dehydration and ketosis are present. Early
intervention prevents electrolyte imbalances and supports maternal-fetal perfusion.
Question 2 of 50
A 34-year-old G2P1 at 28 weeks gestation arrives for her routine prenatal appointment. Her
blood pressure is 152/96 mmHg, she has 2+ proteinuria on dipstick, and reports a headache
unrelieved by acetaminophen. Fetal heart rate is 140 bpm with moderate variability. Which
nursing action takes priority?
A. Encourage the patient to rest in the left lateral position
B. Obtain a clean-catch urine sample for culture and sensitivity
C. Administer a bolus of magnesium sulfate intravenously
,D. Notify the provider immediately and assess deep tendon reflexes ✓ CORRECT
Correct Answer: D
Rationale: These findings indicate severe-range blood pressures with neurological symptoms
consistent with preeclampsia with severe features, requiring immediate provider notification
and reflex assessment to evaluate for hyperreflexia and impending eclampsia. While left
lateral positioning is supportive, it does not replace urgent provider communication when
severe features are present. Magnesium sulfate requires a provider order and should not be
administered without one.
Question 3 of 50
A 22-year-old G1P0 at 10 weeks gestation is reviewing her prenatal laboratory results with the
nurse. Her rubella titer indicates non-immunity, her blood type is A-negative, and her antibody
screen is negative. Which teaching point is most important for the nurse to include?
A. She will need Rh immune globulin at 28 weeks and postpartum if the baby is Rh-positive ✓
CORRECT
B. She should receive the rubella vaccine immediately to protect the fetus
C. A repeat antibody screen is unnecessary since the first was negative
D. She must avoid all contact with children to prevent rubella exposure
Correct Answer: A
Rationale: Rh-negative patients with a negative antibody screen require RhIG at 28 weeks
gestation and within 72 hours postpartum if the newborn is Rh-positive to prevent
alloimmunization. The rubella vaccine is contraindicated during pregnancy and should be
given postpartum instead. While avoiding sick contacts is reasonable, complete isolation is
impractical and unnecessary.
Question 4 of 50
A 30-year-old G3P2 at 32 weeks gestation with pregestational type 1 diabetes comes to the
clinic. Her fasting blood glucose has ranged 95-110 mg/dL and her 2-hour postprandial values
are 145-160 mg/dL. Fetal ultrasound shows an estimated fetal weight at the 85th percentile
and adequate amniotic fluid. Which nursing intervention is most appropriate?
A. Recommend increasing her current insulin dose by 20% independently
B. Advise the patient to eliminate all carbohydrates from her diet
C. Review glucose logs with the provider to adjust insulin regimen ✓ CORRECT
D. Schedule a non-stress test for the same day due to macrosomia
Correct Answer: C
Rationale: Tight glycemic control in pregestational diabetes requires collaborative insulin
adjustment based on glucose patterns to reduce fetal macrosomia risk without causing
, maternal hypoglycemia. Nurses do not independently titrate insulin doses, and eliminating
carbohydrates is unsafe during pregnancy and can precipitate ketosis. A non-stress test at 32
weeks for an appropriately growing fetus is not indicated without additional concerns.
Question 5 of 50
A 26-year-old G1P0 at 18 weeks gestation reports a sudden gush of clear fluid from her
vagina while at work. She arrives at the obstetric triage unit. Sterile speculum examination
reveals pooling of fluid in the vaginal vault, ferning is positive, and nitrazine paper turns blue.
Fetal heart rate is 148 bpm. Which is the nurse's priority action?
A. Perform a digital vaginal examination to assess cervical dilation
B. Initiate continuous fetal monitoring and notify the provider ✓ CORRECT
C. Administer betamethasone intramuscularly without delay
D. Position the patient in Trendelenburg to prevent cord prolapse
Correct Answer: B
Rationale: Premature rupture of membranes at 18 weeks requires immediate fetal monitoring
to assess for cord compression or infection while the provider is notified for management
planning. Digital examination is contraindicated with suspected PROM due to infection risk,
and betamethasone requires a provider order and is typically reserved for viable gestations.
Trendelenburg positioning is unnecessary without evidence of cord compression or prolapse.
Question 6 of 50
A 19-year-old G1P0 at 24 weeks gestation is seen in the prenatal clinic. Her hemoglobin is 9.8
g/dL, hematocrit is 30%, and mean corpuscular volume is 78 fL. She reports craving ice and
feeling increasingly fatigued. Which dietary counseling is most appropriate?
A. Increase intake of vitamin C-rich foods to enhance calcium absorption
B. Consume 3-4 servings of dairy products daily for folate supplementation
C. Add more whole grains and citrus fruits to address B12 deficiency
D. Teach iron-rich food sources and recommend iron supplementation ✓ CORRECT
Correct Answer: D
Rationale: The low MCV and pica behavior indicate iron-deficiency anemia, the most common
anemia in pregnancy, requiring iron supplementation and dietary teaching about heme and
non-heme iron sources. Dairy products contain calcium which inhibits iron absorption, and
whole grains with citrus address folate deficiency associated with macrocytic anemia.
Untreated iron-deficiency anemia increases the risk of preterm birth and low birth weight.
Question 7 of 50
