Free Maternal Newborn Nursing examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Maternal Newborn Nursing examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1During review of prenatal records, a nurse sees a positive cell-free DNA screen for trisomy 21 without confirmatory testing. Which test could establish a more definite fetal diagnosis?

   1. A. A repeat cell-free DNA screen
   2. B. Amniocentesis with fetal-cell testing
   3. C. A second-trimester quadruple screen
   4. D. Nuchal translucency screening

   Answer: B

   Explanation: ACOG advises that a positive cell-free DNA screen be "followed by a diagnostic test with amniocentesis or CVS." Amniocentesis tests fetal cells diagnostically; the other options are screening tests.

   Reference: Prenatal Genetic Screening Tests — What is cell-free DNA testing?

2. 2At a postpartum home visit, a nurse evaluates the expected progression of lochia. Which trend is consistent with recovery?

   1. A. Decreasing flow with progressively darker color
   2. B. Decreasing flow with progressively lighter color
   3. C. Increasing flow with progressively darker color
   4. D. Increasing flow with progressively lighter color

   Answer: B

   Explanation: OWH describes lochia as "becoming lighter in flow and color". Increasing bleeding or clot size does not follow this expected pattern.

   Reference: Recovering from Birth — Physical changes — lochia

3. 3During early respiratory transition, inadequate production of which pulmonary substance predisposes a preterm newborn's air spaces to collapse during exhalation?

   1. A. Surfactant
   2. B. Mucin
   3. C. Elastin
   4. D. Collagen

   Answer: A

   Explanation: NHLBI states surfactant "keeps the lungs open so when the baby breathes out, the lungs do not collapse." This supports stable air spaces during early breathing.

   Reference: Newborn Breathing Conditions — Types — Respiratory distress syndrome (RDS) — surfactant

4. 4A postpartum patient with uterine atony has a blood pressure of 168/110 mm Hg. Which ordered uterotonic should the nurse question because hypertension is a listed contraindication?

   1. A. Oxytocin
   2. B. Methylergonovine
   3. C. Misoprostol
   4. D. Carboprost

   Answer: B

   Explanation: The methylergonovine label lists "Hypertension; toxemia; pregnancy; and hypersensitivity." under contraindications. The severe hypertension makes methylergonovine inappropriate; the other agents do not share this listed hypertension contraindication.

   Reference: Methylergonovine Maleate — Prescribing Information — Contraindications

5. 5A term newborn has early tachypnea attributed to delayed clearance of fetal lung fluid. Which diagnosis describes this condition?

   1. A. Respiratory distress syndrome
   2. B. Transient tachypnea of the newborn
   3. C. Meconium aspiration syndrome
   4. D. Persistent pulmonary hypertension

   Answer: B

   Explanation: NHLBI explains that fetal lung fluid sometimes "does not go away as quickly as it should. This causes TTN." Delayed fluid clearance identifies transient tachypnea, rather than surfactant deficiency, aspiration, or persistent elevated pulmonary vascular resistance.

   Reference: Newborn Breathing Conditions — Types — Transient tachypnea of the newborn (TTN)

6. 6A postpartum nurse reviews an antenatal biophysical profile recorded as 6/10 and discusses why additional assessment was arranged. How is that score classified?

   1. A. Reassuring
   2. B. Equivocal
   3. C. Nonreactive
   4. D. Unsatisfactory

   Answer: B

   Explanation: ACOG states that a score of "6 is equivocal". Thus 6/10 is an intermediate BPP result; the other terms do not classify this score.

   Reference: Special Tests for Monitoring Fetal Well-Being — What do the results of a biophysical profile mean?

7. 7A mother reports brief menstrual-like uterine cramps during the first postpartum days. Which activity commonly makes these afterpains more noticeable?

   1. A. Breastfeeding her infant
   2. B. Emptying her bladder
   3. C. Elevating her feet
   4. D. Applying perineal ice

   Answer: A

   Explanation: OWH states, "Menstrual-like cramping is common, especially if you are breastfeeding." The other activities address urinary, dependent-edema, or perineal discomfort rather than provoking the breastfeeding-associated uterine response.

   Reference: Recovering from Birth — Physical changes — cramping

8. 8A term newborn takes effective first breaths. Which pulmonary vascular change normally facilitates oxygen uptake during transition?

   1. A. Falling vascular resistance with increasing pulmonary flow
   2. B. Falling vascular resistance with decreasing pulmonary flow
   3. C. Rising vascular resistance with increasing pulmonary flow
   4. D. Rising vascular resistance with decreasing pulmonary flow

   Answer: A

   Explanation: NHLBI explains that oxygen "helps the blood vessels in the lungs relax." This permits blood to flow through the lungs and acquire oxygen.

   Reference: Newborn Breathing Conditions — Types — Persistent pulmonary hypertension of the newborn — normal transition

9. 9A nurse totals the carboprost already administered for refractory postpartum uterine bleeding. What is the maximum cumulative dose specified for this indication?

   1. A. 1 milligram
   2. B. 4 milligrams
   3. C. 12 milligrams
   4. D. 2 milligrams

   Answer: D

   Explanation: Under refractory postpartum uterine bleeding, the label states, "The total dose of carboprost tromethamine injection should not exceed 2 milligrams (8 doses)." The 12-milligram limit belongs to the abortion regimen and does not apply here.

   Reference: Carboprost Tromethamine Injection — Prescribing Information — Dosage and Administration, 2. For Refractory Postpartum Uterine Bleeding

10. 10A nurse reviews the birth history of a newborn being evaluated for transient tachypnea. Which history is a recognized risk factor for TTN?

    1. A. Cesarean birth before labor begins
    2. B. Vaginal birth after spontaneous labor
    3. C. Vaginal birth after induced labor
    4. D. Cesarean birth after established labor

    Answer: A

    Explanation: NHLBI identifies increased TTN risk with "a cesarean delivery (c-section) without going into labor." The prelabor cesarean history specifically matches that risk; the other histories include labor.

    Reference: Newborn Breathing Conditions — Types — Transient tachypnea of the newborn (TTN)