MATERNITY NCLEX LATEST 2026 EXAM QUESTIONS AND
ANSWERS RATED A+
✔✔After teaching a class about hepatic system adaptations after birth, the instructor
determines that the teaching was successful when the class identifies which of the
following as the process of changing bilirubin from a fat-soluble product to a water-
soluble product?
A) Hemolysis
B) Conjugation
C) Jaundice
D) Hyperbilirubinemia - ✔✔B
The process in which bilirubin is changed from a fat-soluble product to a water-soluble
product is called conjugation. Hemolysis involves the breakdown of blood cells. In the
newborn, hemolysis of the red blood cells is the principal source of bilirubin. Jaundice is
the manifestation of increased bilirubin in the bloodstream. Hyperbilirubinemia refers to
the increased level of bilirubin in the blood.
✔✔Twenty minutes after birth, a baby begins to move his head from side to side,
making eye contact with the mother, and pushes his tongue out several times. The
nurse interprets this as:
A) A good time to initiate breast-feeding
B) The period of decreased responsiveness preceding sleep
C) The need to be alert for gagging and vomiting
D) Evidence that the newborn is becoming chilled - ✔✔A
The newborn is demonstrating behaviors indicating the first period of reactivity, which
usually begins at birth and lasts for the first 30 minutes. This is a good time to initiate
breast-feeding. Decreased responsiveness occurs from 30 to 120 minutes of age and is
characterized by muscle relaxation and diminished responsiveness to outside stimuli.
There is no indication that the newborn may experience gagging or vomiting. Chilling
would be evidenced by tachypnea, decreased activity, and hypotonia.
✔✔The nurse institutes measure to maintain thermoregulation based on the
understanding that newborns have limited ability to regulate body temperature because
they:
A) Have a smaller body surface compared to body mass
B) Lose more body heat when they sweat than adults
C) Have an abundant amount of subcutaneous fat all over
D) Are unable to shiver effectively to increase heat production - ✔✔D
Newborns have difficulty maintaining their body heat through shivering and other
mechanisms. They have a large body surface area relative to body weight and have
limited sweating ability. Additionally, newborns lack subcutaneous fat to provide
insulation.
,✔✔A new mother is changing the diaper of her 20-hour-old newborn and asks why the
stool is almost black. Which response by the nurse would be most appropriate?
A) "You probably took iron during your pregnancy."
B) "This is meconium stool, normal for a newborn."
C) "I'll take a sample and check it for possible bleeding."
D) "This is unusual and I need to report this." - ✔✔B
Meconium is greenish-black and tarry and usually passed within 12 to 24 hours of birth.
This is a normal finding. Iron can cause stool to turn black, but this would not be the
case here. The stool is a normal occurrence and does not need to be checked for blood
or reported.
✔✔A client expresses concern that her 2-hour-old newborn is sleepy and difficult to
awaken. The nurse explains that this behavior indicates which of the following?
A) Normal progression of behavior
B) Probable hypoglycemia
C) Physiological abnormality
D) Inadequate oxygenation - ✔✔A
From 30 to 120 minutes of age, the newborn enters the second stage of transition, that
of sleep or a decrease in activity. More information would be needed to determine if
hypoglycemia, a physiologic abnormality, or inadequate oxygenation was present.
✔✔After the birth of a newborn, which of the following would the nurse do first to assist
in thermoregulation?
A) Dry the newborn thoroughly.
B) Put a hat on the newborn's head.
C) Check the newborn's temperature.
D) Wrap the newborn in a blanket. - ✔✔A
Drying the newborn immediately after birth using warmed blankets is essential to
prevent heat loss through evaporation. Then the nurse would place a cap on the baby's
head and wrap the newborn. Assessing the newborn's temperature would occur once
these measures were initiated to prevent heat loss.
✔✔Assessment of a newborn reveals rhythmic spontaneous movements. The nurse
interprets this as indicating:
A) Habituation
B) Motor maturity
C) Orientation
D) Social behaviors - ✔✔B
Motor maturity is evidenced by rhythmic, spontaneous movements. Habituation is
manifested by the newborn's ability to respond to the environment appropriately.
, Orientation involves the newborn's response to new stimuli, such as turning the head to
a sound. Social behaviors involve cuddling and snuggling into the arms of a parent.
✔✔When teaching new parents about the sensory capabilities of their newborn, which
sense would the nurse identify as being the least mature?
A) Hearing
B) Touch
C) Taste
D) Vision - ✔✔D
Vision is the least mature sense at birth. Hearing is well developed at birth, evidenced
by the newborn's response to noise by turning. Touch is evidenced by the newborn's
ability to respond to tactile stimuli and pain. A newborn can distinguish between sweet
and sour by 72 hours of age.
✔✔The nurse places a warmed blanket on the scale when weighing a newborn to
minimize heat loss via which mechanism?
A) Evaporation
B) Conduction
C) Convection
D) Radiation - ✔✔B
Using a warmed cloth diaper or blanket to cover any cold surface, such as a scale, that
touches a newborn directly helps to prevent heat loss through conduction. Drying a
newborn and promptly changing wet linens, clothes, or diapers help reduce heat loss
via evaporation. Keeping the newborn out of a direct cool draft, working inside an
isolette as much as possible, and minimizing the opening of portholes help prevent heat
loss via convection. Keeping cribs and isolettes away from outside walls, cold windows,
and air conditioners and using radiant warmers while transporting newborns and
performing procedures will help reduce heat loss via radiation.
✔✔Which of the following would alert the nurse to the possibility of respiratory distress
in a newborn?
A) Symmetrical chest movements
B) Periodic breathing
C) Respirations of 40 breaths/minute
D) Sternal retractions - ✔✔D
Sternal retractions, cyanosis, tachypnea, expiratory grunting, and nasal flaring are signs
of respiratory distress in a newborn. Symmetrical chest movements and a respiratory
rate between 30 to 60 breaths/minute are typical newborn findings. Some newborns
may demonstrate periodic breathing (cessation of breathing lasting 5 to 10 seconds
without changes in color or heart rate) in the first few days of life.
ANSWERS RATED A+
✔✔After teaching a class about hepatic system adaptations after birth, the instructor
determines that the teaching was successful when the class identifies which of the
following as the process of changing bilirubin from a fat-soluble product to a water-
soluble product?
A) Hemolysis
B) Conjugation
C) Jaundice
D) Hyperbilirubinemia - ✔✔B
The process in which bilirubin is changed from a fat-soluble product to a water-soluble
product is called conjugation. Hemolysis involves the breakdown of blood cells. In the
newborn, hemolysis of the red blood cells is the principal source of bilirubin. Jaundice is
the manifestation of increased bilirubin in the bloodstream. Hyperbilirubinemia refers to
the increased level of bilirubin in the blood.
✔✔Twenty minutes after birth, a baby begins to move his head from side to side,
making eye contact with the mother, and pushes his tongue out several times. The
nurse interprets this as:
A) A good time to initiate breast-feeding
B) The period of decreased responsiveness preceding sleep
C) The need to be alert for gagging and vomiting
D) Evidence that the newborn is becoming chilled - ✔✔A
The newborn is demonstrating behaviors indicating the first period of reactivity, which
usually begins at birth and lasts for the first 30 minutes. This is a good time to initiate
breast-feeding. Decreased responsiveness occurs from 30 to 120 minutes of age and is
characterized by muscle relaxation and diminished responsiveness to outside stimuli.
There is no indication that the newborn may experience gagging or vomiting. Chilling
would be evidenced by tachypnea, decreased activity, and hypotonia.
✔✔The nurse institutes measure to maintain thermoregulation based on the
understanding that newborns have limited ability to regulate body temperature because
they:
A) Have a smaller body surface compared to body mass
B) Lose more body heat when they sweat than adults
C) Have an abundant amount of subcutaneous fat all over
D) Are unable to shiver effectively to increase heat production - ✔✔D
Newborns have difficulty maintaining their body heat through shivering and other
mechanisms. They have a large body surface area relative to body weight and have
limited sweating ability. Additionally, newborns lack subcutaneous fat to provide
insulation.
,✔✔A new mother is changing the diaper of her 20-hour-old newborn and asks why the
stool is almost black. Which response by the nurse would be most appropriate?
A) "You probably took iron during your pregnancy."
B) "This is meconium stool, normal for a newborn."
C) "I'll take a sample and check it for possible bleeding."
D) "This is unusual and I need to report this." - ✔✔B
Meconium is greenish-black and tarry and usually passed within 12 to 24 hours of birth.
This is a normal finding. Iron can cause stool to turn black, but this would not be the
case here. The stool is a normal occurrence and does not need to be checked for blood
or reported.
✔✔A client expresses concern that her 2-hour-old newborn is sleepy and difficult to
awaken. The nurse explains that this behavior indicates which of the following?
A) Normal progression of behavior
B) Probable hypoglycemia
C) Physiological abnormality
D) Inadequate oxygenation - ✔✔A
From 30 to 120 minutes of age, the newborn enters the second stage of transition, that
of sleep or a decrease in activity. More information would be needed to determine if
hypoglycemia, a physiologic abnormality, or inadequate oxygenation was present.
✔✔After the birth of a newborn, which of the following would the nurse do first to assist
in thermoregulation?
A) Dry the newborn thoroughly.
B) Put a hat on the newborn's head.
C) Check the newborn's temperature.
D) Wrap the newborn in a blanket. - ✔✔A
Drying the newborn immediately after birth using warmed blankets is essential to
prevent heat loss through evaporation. Then the nurse would place a cap on the baby's
head and wrap the newborn. Assessing the newborn's temperature would occur once
these measures were initiated to prevent heat loss.
✔✔Assessment of a newborn reveals rhythmic spontaneous movements. The nurse
interprets this as indicating:
A) Habituation
B) Motor maturity
C) Orientation
D) Social behaviors - ✔✔B
Motor maturity is evidenced by rhythmic, spontaneous movements. Habituation is
manifested by the newborn's ability to respond to the environment appropriately.
, Orientation involves the newborn's response to new stimuli, such as turning the head to
a sound. Social behaviors involve cuddling and snuggling into the arms of a parent.
✔✔When teaching new parents about the sensory capabilities of their newborn, which
sense would the nurse identify as being the least mature?
A) Hearing
B) Touch
C) Taste
D) Vision - ✔✔D
Vision is the least mature sense at birth. Hearing is well developed at birth, evidenced
by the newborn's response to noise by turning. Touch is evidenced by the newborn's
ability to respond to tactile stimuli and pain. A newborn can distinguish between sweet
and sour by 72 hours of age.
✔✔The nurse places a warmed blanket on the scale when weighing a newborn to
minimize heat loss via which mechanism?
A) Evaporation
B) Conduction
C) Convection
D) Radiation - ✔✔B
Using a warmed cloth diaper or blanket to cover any cold surface, such as a scale, that
touches a newborn directly helps to prevent heat loss through conduction. Drying a
newborn and promptly changing wet linens, clothes, or diapers help reduce heat loss
via evaporation. Keeping the newborn out of a direct cool draft, working inside an
isolette as much as possible, and minimizing the opening of portholes help prevent heat
loss via convection. Keeping cribs and isolettes away from outside walls, cold windows,
and air conditioners and using radiant warmers while transporting newborns and
performing procedures will help reduce heat loss via radiation.
✔✔Which of the following would alert the nurse to the possibility of respiratory distress
in a newborn?
A) Symmetrical chest movements
B) Periodic breathing
C) Respirations of 40 breaths/minute
D) Sternal retractions - ✔✔D
Sternal retractions, cyanosis, tachypnea, expiratory grunting, and nasal flaring are signs
of respiratory distress in a newborn. Symmetrical chest movements and a respiratory
rate between 30 to 60 breaths/minute are typical newborn findings. Some newborns
may demonstrate periodic breathing (cessation of breathing lasting 5 to 10 seconds
without changes in color or heart rate) in the first few days of life.
