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Comprehensive 440-Question Bank | 8 Complete Versions
Next Generation NCLEX (NGN) Clinical Judgment Integration
================================================================
VERSION 1: FOUNDATIONAL MATERNITY NURSING
================================================================
INSTRUCTIONS:
Select the single best answer for each question unless otherwise indicated.
Select-all-that-apply (SATA) questions require all correct options to be selected for full credit.
NGN case studies require sequential reasoning.
Time allotted: 1 hour per version.
DOMAIN 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT (Questions 1-6)
Q1: A 24-year-old primigravida at 10 weeks gestation presents for her first prenatal visit. She
reports nausea and vomiting, breast tenderness, and fatigue. Which statement requires further
assessment?
A. "I've been nauseous every morning but it goes away after I eat a cracker."
B. "I've been so tired I need to take a nap every afternoon."
C. "My breasts feel tender and my nipples are sore."
D. [CORRECT] "I've been vomiting everything for the past 3 days and can't keep fluids down."
Correct Answer: D
,Rationale: Hyperemesis gravidarum is characterized by severe vomiting leading to dehydration,
ketosis, and electrolyte imbalance.
MATERNITY ALERT: Vomiting that prevents fluid intake for >24 hours requires medical
evaluation.
Q2: A 28-year-old G2P1001 at 24 weeks gestation asks about recommended weight gain. Her
pre-pregnancy BMI was 22 kg/m². Which response is appropriate?
A. "You should gain 11-20 pounds."
B. [CORRECT] "You should gain 25-35 pounds."
C. "You should gain 28-40 pounds."
D. "There is no specific recommendation."
Correct Answer: B
Rationale: Normal BMI (18.5-24.9) recommendation is 25-35 lbs.
Q3: Which physiologic change is attributed to increased progesterone?
A. Increased gastric motility.
B. [CORRECT] Delayed gastric emptying.
C. Decreased basal metabolic rate.
D. Hyperactive deep tendon reflexes.
Correct Answer: B
Rationale: Progesterone relaxes smooth muscle, causing delayed gastric emptying and
constipation.
Q4: (Select-All-That-Apply) Which are presumptive signs of pregnancy?
A. [CORRECT] Amenorrhea.
B. [CORRECT] Nausea.
,C. [CORRECT] Breast tenderness.
D. Chadwick's sign.
Correct Answers: A, B, C
Rationale: Presumptive signs are subjective. Chadwick's is objective (probable).
Q5: A patient at 28 weeks has a 1-hour GCT result of 145 mg/dL. The nurse explains this
indicates:
A. Normal glucose tolerance.
B. [CORRECT] Need for a 3-hour OGTT.
C. Diagnosis of GDM.
D. Immediate insulin.
Correct Answer: B
Rationale: Values >140 mg/dL (threshold varies) require the diagnostic 3-hour test.
Q6: The nurse measures fundal height at 28 weeks as 26 cm. The nurse interprets this as:
A. Incorrect technique.
B. [CORRECT] Within normal limits.
C. IUGR.
D. Polyhydramnios.
Correct Answer: B
Rationale: Fundal height should equal weeks gestation ± 2 cm.
DOMAIN 2: COMPLICATIONS OF PREGNANCY (Questions 7-12)
, Q7: A 32-year-old G1P0 at 36 weeks presents with painless bright red bleeding. Which action is
contraindicated?
A. IV access.
B. [CORRECT] Digital vaginal examination.
C. Ultrasound.
D. Type and screen.
Correct Answer: B
Rationale: Vaginal exams are contraindicated in suspected placenta previa.
Q8: A patient with severe preeclampsia is receiving magnesium sulfate. Which finding indicates
toxicity?
A. DTRs 2+.
B. Respiratory rate 16.
C. [CORRECT] Respiratory rate 10.
D. Urine output 40 mL/hr.
Correct Answer: C
Rationale: RR <12 indicates toxicity.
Q9: (Select-All-That-Apply) Risk factors for placental abruption include:
A. [CORRECT] Maternal hypertension.
B. [CORRECT] Cocaine use.
C. [CORRECT] Abdominal trauma.
D. Previous cesarean.
Correct Answers: A, B, C
Rationale: HTN, trauma, and cocaine are major risks.
Comprehensive 440-Question Bank | 8 Complete Versions
Next Generation NCLEX (NGN) Clinical Judgment Integration
================================================================
VERSION 1: FOUNDATIONAL MATERNITY NURSING
================================================================
INSTRUCTIONS:
Select the single best answer for each question unless otherwise indicated.
Select-all-that-apply (SATA) questions require all correct options to be selected for full credit.
NGN case studies require sequential reasoning.
Time allotted: 1 hour per version.
DOMAIN 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT (Questions 1-6)
Q1: A 24-year-old primigravida at 10 weeks gestation presents for her first prenatal visit. She
reports nausea and vomiting, breast tenderness, and fatigue. Which statement requires further
assessment?
A. "I've been nauseous every morning but it goes away after I eat a cracker."
B. "I've been so tired I need to take a nap every afternoon."
C. "My breasts feel tender and my nipples are sore."
D. [CORRECT] "I've been vomiting everything for the past 3 days and can't keep fluids down."
Correct Answer: D
,Rationale: Hyperemesis gravidarum is characterized by severe vomiting leading to dehydration,
ketosis, and electrolyte imbalance.
MATERNITY ALERT: Vomiting that prevents fluid intake for >24 hours requires medical
evaluation.
Q2: A 28-year-old G2P1001 at 24 weeks gestation asks about recommended weight gain. Her
pre-pregnancy BMI was 22 kg/m². Which response is appropriate?
A. "You should gain 11-20 pounds."
B. [CORRECT] "You should gain 25-35 pounds."
C. "You should gain 28-40 pounds."
D. "There is no specific recommendation."
Correct Answer: B
Rationale: Normal BMI (18.5-24.9) recommendation is 25-35 lbs.
Q3: Which physiologic change is attributed to increased progesterone?
A. Increased gastric motility.
B. [CORRECT] Delayed gastric emptying.
C. Decreased basal metabolic rate.
D. Hyperactive deep tendon reflexes.
Correct Answer: B
Rationale: Progesterone relaxes smooth muscle, causing delayed gastric emptying and
constipation.
Q4: (Select-All-That-Apply) Which are presumptive signs of pregnancy?
A. [CORRECT] Amenorrhea.
B. [CORRECT] Nausea.
,C. [CORRECT] Breast tenderness.
D. Chadwick's sign.
Correct Answers: A, B, C
Rationale: Presumptive signs are subjective. Chadwick's is objective (probable).
Q5: A patient at 28 weeks has a 1-hour GCT result of 145 mg/dL. The nurse explains this
indicates:
A. Normal glucose tolerance.
B. [CORRECT] Need for a 3-hour OGTT.
C. Diagnosis of GDM.
D. Immediate insulin.
Correct Answer: B
Rationale: Values >140 mg/dL (threshold varies) require the diagnostic 3-hour test.
Q6: The nurse measures fundal height at 28 weeks as 26 cm. The nurse interprets this as:
A. Incorrect technique.
B. [CORRECT] Within normal limits.
C. IUGR.
D. Polyhydramnios.
Correct Answer: B
Rationale: Fundal height should equal weeks gestation ± 2 cm.
DOMAIN 2: COMPLICATIONS OF PREGNANCY (Questions 7-12)
, Q7: A 32-year-old G1P0 at 36 weeks presents with painless bright red bleeding. Which action is
contraindicated?
A. IV access.
B. [CORRECT] Digital vaginal examination.
C. Ultrasound.
D. Type and screen.
Correct Answer: B
Rationale: Vaginal exams are contraindicated in suspected placenta previa.
Q8: A patient with severe preeclampsia is receiving magnesium sulfate. Which finding indicates
toxicity?
A. DTRs 2+.
B. Respiratory rate 16.
C. [CORRECT] Respiratory rate 10.
D. Urine output 40 mL/hr.
Correct Answer: C
Rationale: RR <12 indicates toxicity.
Q9: (Select-All-That-Apply) Risk factors for placental abruption include:
A. [CORRECT] Maternal hypertension.
B. [CORRECT] Cocaine use.
C. [CORRECT] Abdominal trauma.
D. Previous cesarean.
Correct Answers: A, B, C
Rationale: HTN, trauma, and cocaine are major risks.
