NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Maternal-Newborn Nursing Comprehensive Study
Guide
2026–2027 | 110 ORIGINAL PRACTICE QUESTIONS
Foundational review of pregnancy, intrapartum care, postpartum recovery, neonates, and emergency priorities.
Independent educational study material. These are original practice questions, not official Southern Utah University, ATI,
faculty, or licensing examination materials. Similar core concepts appear in multiple files to reinforce learning.
Clinical safety note: Use institutional protocols and current professional guidance. Questions are designed for learning and
are not a substitute for medical decision-making or individualized orders.
Study map
Domain Questions in this document
Antepartum and prenatal care 24
Labor and delivery 21
Postpartum nursing 18
Newborn assessment and care 21
High-risk and obstetric/neonatal emergencies 26
How to use this resource
Cover the green answer and yellow-highlighted rationale, select A–D, then review the explanation. Mark missed concepts
and revisit the corresponding clinical area. The answer key at the end provides a rapid self-check.
High-yield current guidance checkpoints
• GBS screening: ACOG universal vaginal–rectal culture at 36 0/7–37 6/7 weeks, with intrapartum prophylaxis when
indicated.
• Maternal immunization: Tdap at 27–36 weeks in every pregnancy; Pfizer Abrysvo maternal RSV at 32 0/7–36 6/7 weeks
in the recommended U.S. season.
• Preeclampsia: systolic pressure ≥160 mm Hg or diastolic ≥110 mm Hg is severe range; monitor for headache, visual
symptoms, pulmonary edema and upper-abdominal pain.
• PPH: assess objectively and treat promptly using an integrated protocol; WHO recommends uterine massage,
oxytocic therapy, fluids, IV tranexamic acid when indicated, source assessment and escalation.
• Newborn resuscitation: ventilate for persistent apnea/gasping or HR <100 after initial steps; compress if HR stays <60
after 30 seconds of effective ventilation.
• Jaundice: use bilirubin level, postnatal age in hours, gestational age and neurotoxicity risk factors—not a single
universal phototherapy number.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 1
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Practice Questions with Answers & Rationales
Questions 1–25
1. Which symptom may represent an early pregnancy loss or other urgent pregnancy complication?
A. Occasional aversion to odors
B. Vaginal bleeding with increasing cramping or pain
C. Increased frequency of urination alone
D. Mild intermittent fatigue
Correct Answer: B. Vaginal bleeding with increasing cramping or pain
Rationale: Bleeding with pain warrants assessment to distinguish miscarriage, ectopic pregnancy, and other
causes.
Incorrect options: A (Occasional aversion to odors); C (Increased frequency of urination alone); D (Mild intermittent fatigue).
These do not best answer the clinical cue; Bleeding with pain warrants assessment to distinguish miscarriage, ectopic pregnancy,
and other causes.
2. What does a fundal height that differs notably from gestational age suggest?
A. No follow-up is ever needed
B. Automatic confirmation of fetal anomalies
C. Further evaluation of dating, growth, or fluid volume may be needed
D. Immediate elective birth in all cases
Correct Answer: C. Further evaluation of dating, growth, or fluid volume may be needed
Rationale: Fundal height is a screening tool; unexpected measurement differences require contextual assessment.
Incorrect options: A (No follow-up is ever needed); B (Automatic confirmation of fetal anomalies); D (Immediate elective birth in all
cases). These do not best answer the clinical cue; Fundal height is a screening tool; unexpected measurement differences require
contextual assessment.
3. Which finding after epidural placement needs immediate nursing assessment?
A. Sudden maternal hypotension with fetal-heart changes
B. Warmth in the lower body without instability
C. Reduced perception of contraction pain
D. Ability to rest between contractions
Correct Answer: A. Sudden maternal hypotension with fetal-heart changes
Rationale: Neuraxial blockade can reduce maternal vascular tone and uteroplacental perfusion if blood pressure
falls.
Incorrect options: B (Warmth in the lower body without instability); C (Reduced perception of contraction pain); D (Ability to rest
between contractions). These do not best answer the clinical cue; Neuraxial blockade can reduce maternal vascular tone and
uteroplacental perfusion if blood pressure falls.
4. Which assessment is most helpful for recognizing maternal hemorrhagic shock early?
A. Newborn hearing screening
B. Single visual estimate only
C. Repeated pulse, blood pressure, mentation, perfusion, and quantified bleeding
D. Breast exam alone
Correct Answer: C. Repeated pulse, blood pressure, mentation, perfusion, and quantified bleeding
Rationale: Shock may progress while estimated loss seems modest; dynamic multi-parameter assessment
supports timely action.
Incorrect options: A (Newborn hearing screening); B (Single visual estimate only); D (Breast exam alone). These do not best answer
the clinical cue; Shock may progress while estimated loss seems modest; dynamic multi-parameter assessment supports timely
action.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 2
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
5. What is the clearest immediate indicator of effective positive-pressure ventilation in a newborn?
A. Cord separation
B. Rising heart rate
C. Improving diaper output at 24 hours
D. Eye opening alone
Correct Answer: B. Rising heart rate
Rationale: Improvement in heart rate is the primary sign that ventilation is effective during newborn resuscitation.
Incorrect options: A (Cord separation); C (Improving diaper output at 24 hours); D (Eye opening alone). These do not best answer
the clinical cue; Improvement in heart rate is the primary sign that ventilation is effective during newborn resuscitation.
6. Which postpartum symptom may indicate pulmonary embolism?
A. Transient hunger
B. Expected uterine cramping
C. Sudden shortness of breath and chest pain
D. Mild sweating with breastfeeding
Correct Answer: C. Sudden shortness of breath and chest pain
Rationale: The postpartum period is hypercoagulable; abrupt respiratory symptoms require emergency evaluation.
Incorrect options: A (Transient hunger); B (Expected uterine cramping); D (Mild sweating with breastfeeding). These do not best
answer the clinical cue; The postpartum period is hypercoagulable; abrupt respiratory symptoms require emergency evaluation.
7. During a shoulder dystocia, which maneuver is generally part of the immediate response?
A. Sustained fundal pressure
B. McRoberts maneuver with coordinated team assistance
C. Forceful head traction
D. Delay all calls for help
Correct Answer: B. McRoberts maneuver with coordinated team assistance
Rationale: McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
Incorrect options: A (Sustained fundal pressure); C (Forceful head traction); D (Delay all calls for help). These do not best answer
the clinical cue; McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
8. Which finding should be reported promptly when a pregnant patient with known diabetes becomes ill?
A. Persistent hyperglycemia with vomiting or ketones
B. One normal glucose check
C. A scheduled nutrition appointment
D. Mild increased appetite
Correct Answer: A. Persistent hyperglycemia with vomiting or ketones
Rationale: Illness with hyperglycemia and ketones may indicate evolving ketoacidosis, which can threaten parent
and fetus.
Incorrect options: B (One normal glucose check); C (A scheduled nutrition appointment); D (Mild increased appetite). These do not
best answer the clinical cue; Illness with hyperglycemia and ketones may indicate evolving ketoacidosis, which can threaten
parent and fetus.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 3
Maternal-Newborn Nursing Comprehensive Study
Guide
2026–2027 | 110 ORIGINAL PRACTICE QUESTIONS
Foundational review of pregnancy, intrapartum care, postpartum recovery, neonates, and emergency priorities.
Independent educational study material. These are original practice questions, not official Southern Utah University, ATI,
faculty, or licensing examination materials. Similar core concepts appear in multiple files to reinforce learning.
Clinical safety note: Use institutional protocols and current professional guidance. Questions are designed for learning and
are not a substitute for medical decision-making or individualized orders.
Study map
Domain Questions in this document
Antepartum and prenatal care 24
Labor and delivery 21
Postpartum nursing 18
Newborn assessment and care 21
High-risk and obstetric/neonatal emergencies 26
How to use this resource
Cover the green answer and yellow-highlighted rationale, select A–D, then review the explanation. Mark missed concepts
and revisit the corresponding clinical area. The answer key at the end provides a rapid self-check.
High-yield current guidance checkpoints
• GBS screening: ACOG universal vaginal–rectal culture at 36 0/7–37 6/7 weeks, with intrapartum prophylaxis when
indicated.
• Maternal immunization: Tdap at 27–36 weeks in every pregnancy; Pfizer Abrysvo maternal RSV at 32 0/7–36 6/7 weeks
in the recommended U.S. season.
• Preeclampsia: systolic pressure ≥160 mm Hg or diastolic ≥110 mm Hg is severe range; monitor for headache, visual
symptoms, pulmonary edema and upper-abdominal pain.
• PPH: assess objectively and treat promptly using an integrated protocol; WHO recommends uterine massage,
oxytocic therapy, fluids, IV tranexamic acid when indicated, source assessment and escalation.
• Newborn resuscitation: ventilate for persistent apnea/gasping or HR <100 after initial steps; compress if HR stays <60
after 30 seconds of effective ventilation.
• Jaundice: use bilirubin level, postnatal age in hours, gestational age and neurotoxicity risk factors—not a single
universal phototherapy number.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 1
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
Practice Questions with Answers & Rationales
Questions 1–25
1. Which symptom may represent an early pregnancy loss or other urgent pregnancy complication?
A. Occasional aversion to odors
B. Vaginal bleeding with increasing cramping or pain
C. Increased frequency of urination alone
D. Mild intermittent fatigue
Correct Answer: B. Vaginal bleeding with increasing cramping or pain
Rationale: Bleeding with pain warrants assessment to distinguish miscarriage, ectopic pregnancy, and other
causes.
Incorrect options: A (Occasional aversion to odors); C (Increased frequency of urination alone); D (Mild intermittent fatigue).
These do not best answer the clinical cue; Bleeding with pain warrants assessment to distinguish miscarriage, ectopic pregnancy,
and other causes.
2. What does a fundal height that differs notably from gestational age suggest?
A. No follow-up is ever needed
B. Automatic confirmation of fetal anomalies
C. Further evaluation of dating, growth, or fluid volume may be needed
D. Immediate elective birth in all cases
Correct Answer: C. Further evaluation of dating, growth, or fluid volume may be needed
Rationale: Fundal height is a screening tool; unexpected measurement differences require contextual assessment.
Incorrect options: A (No follow-up is ever needed); B (Automatic confirmation of fetal anomalies); D (Immediate elective birth in all
cases). These do not best answer the clinical cue; Fundal height is a screening tool; unexpected measurement differences require
contextual assessment.
3. Which finding after epidural placement needs immediate nursing assessment?
A. Sudden maternal hypotension with fetal-heart changes
B. Warmth in the lower body without instability
C. Reduced perception of contraction pain
D. Ability to rest between contractions
Correct Answer: A. Sudden maternal hypotension with fetal-heart changes
Rationale: Neuraxial blockade can reduce maternal vascular tone and uteroplacental perfusion if blood pressure
falls.
Incorrect options: B (Warmth in the lower body without instability); C (Reduced perception of contraction pain); D (Ability to rest
between contractions). These do not best answer the clinical cue; Neuraxial blockade can reduce maternal vascular tone and
uteroplacental perfusion if blood pressure falls.
4. Which assessment is most helpful for recognizing maternal hemorrhagic shock early?
A. Newborn hearing screening
B. Single visual estimate only
C. Repeated pulse, blood pressure, mentation, perfusion, and quantified bleeding
D. Breast exam alone
Correct Answer: C. Repeated pulse, blood pressure, mentation, perfusion, and quantified bleeding
Rationale: Shock may progress while estimated loss seems modest; dynamic multi-parameter assessment
supports timely action.
Incorrect options: A (Newborn hearing screening); B (Single visual estimate only); D (Breast exam alone). These do not best answer
the clinical cue; Shock may progress while estimated loss seems modest; dynamic multi-parameter assessment supports timely
action.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 2
, NURS 4322 | MATERNAL–NEWBORN NURSING | 2026–2027
5. What is the clearest immediate indicator of effective positive-pressure ventilation in a newborn?
A. Cord separation
B. Rising heart rate
C. Improving diaper output at 24 hours
D. Eye opening alone
Correct Answer: B. Rising heart rate
Rationale: Improvement in heart rate is the primary sign that ventilation is effective during newborn resuscitation.
Incorrect options: A (Cord separation); C (Improving diaper output at 24 hours); D (Eye opening alone). These do not best answer
the clinical cue; Improvement in heart rate is the primary sign that ventilation is effective during newborn resuscitation.
6. Which postpartum symptom may indicate pulmonary embolism?
A. Transient hunger
B. Expected uterine cramping
C. Sudden shortness of breath and chest pain
D. Mild sweating with breastfeeding
Correct Answer: C. Sudden shortness of breath and chest pain
Rationale: The postpartum period is hypercoagulable; abrupt respiratory symptoms require emergency evaluation.
Incorrect options: A (Transient hunger); B (Expected uterine cramping); D (Mild sweating with breastfeeding). These do not best
answer the clinical cue; The postpartum period is hypercoagulable; abrupt respiratory symptoms require emergency evaluation.
7. During a shoulder dystocia, which maneuver is generally part of the immediate response?
A. Sustained fundal pressure
B. McRoberts maneuver with coordinated team assistance
C. Forceful head traction
D. Delay all calls for help
Correct Answer: B. McRoberts maneuver with coordinated team assistance
Rationale: McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
Incorrect options: A (Sustained fundal pressure); C (Forceful head traction); D (Delay all calls for help). These do not best answer
the clinical cue; McRoberts positioning is a recognized initial maneuver; fundal pressure is contraindicated.
8. Which finding should be reported promptly when a pregnant patient with known diabetes becomes ill?
A. Persistent hyperglycemia with vomiting or ketones
B. One normal glucose check
C. A scheduled nutrition appointment
D. Mild increased appetite
Correct Answer: A. Persistent hyperglycemia with vomiting or ketones
Rationale: Illness with hyperglycemia and ketones may indicate evolving ketoacidosis, which can threaten parent
and fetus.
Incorrect options: B (One normal glucose check); C (A scheduled nutrition appointment); D (Mild increased appetite). These do not
best answer the clinical cue; Illness with hyperglycemia and ketones may indicate evolving ketoacidosis, which can threaten
parent and fetus.
INDEPENDENT PRACTICE RESOURCE • NURS 4322 • Page 3
