MATERNITY
NCLEX NURSING EXAM
────────────────────────────────────────
75 Questions with Correct Answers and Rationales
2026/2027 Edition
Comprehensive Maternal-Newborn Nursing
Already Graded A+ | 100% Verified
Aligned with AWHONN, ACOG, AAP, NCSBN, NICHD, and CDC Guidelines
Antepartum through Postpartum — Fetal Monitoring, Pharmacology, Newborn Care, and NCLEX
Prioritization
, Maternity NCLEX Nursing Exam 2026/2027
TABLE OF CONTENTS
INTRODUCTION .................................................................................................................................. 1
Section 1: Antepartum Assessment & Fetal Development ..................................................................... 1
Prenatal Visits, GTPAL, Naegele’s Rule, Fetal Development Milestones, and Maternal
Physiological Changes ........................................................................................................................ 1
Section 2: Intrapartum Management & Labor Stages ............................................................................. 4
Stages of Labor, Cervical Dilation, Bishop Score, Pain Management, and Cesarean Preparation ..... 4
Section 3: Fetal Heart Rate Monitoring & Interpretation ....................................................................... 7
Baseline FHR, Variability, Accelerations, Decelerations, NICHD Categories, and Nursing
Interventions ....................................................................................................................................... 7
Section 4: Postpartum Care & Maternal Recovery ............................................................................... 11
Lochia Stages, Involution, Hemorrhage, Breastfeeding Support, DVT Prevention, and Postpartum
Depression......................................................................................................................................... 11
Section 5: Newborn Assessment & Stabilization ................................................................................. 14
APGAR Scoring, Physical Assessment, Thermoregulation, Phototherapy, and Newborn
Medications ....................................................................................................................................... 14
Section 6: High-Risk Pregnancy Complications ................................................................................... 18
Preeclampsia, HELLP Syndrome, GDM, Preterm Labor, Placenta Previa, and Abruption ............. 18
Section 7: Pharmacology in Maternity Care ......................................................................................... 21
Oxytocin, Magnesium Sulfate, Calcium Gluconate, Tocolytics, Uterotonics, and Neonatal
Medications ....................................................................................................................................... 21
Section 8: Lactation Support, Infant Feeding & Patient Education ...................................................... 24
Breastfeeding, Safe Sleep, Formula Preparation, Discharge Teaching, and Immunizations ............ 24
Section 9: NCLEX-RN Prioritization & Test-Taking Strategies for Maternity.................................... 27
ABC Prioritization, Delegation, SBAR Reporting, Therapeutic Communication, and Legal/Ethical
Scenarios ........................................................................................................................................... 27
ANSWER KEY .................................................................................................................................... 31
Page PAGE_NUMBER
, Maternity NCLEX Nursing Exam 2026/2027
INTRODUCTION
This comprehensive Maternity NCLEX Nursing Exam for 2026/2027 provides 75 expertly crafted,
evidence-based questions with verified correct answers and detailed rationales. The exam covers the
full scope of maternal-newborn nursing across nine systematically organized sections, progressing
from antepartum assessment and fetal development through intrapartum management, fetal
monitoring, postpartum recovery, newborn assessment, high-risk complications, pharmacology,
lactation and patient education, and NCLEX-RN prioritization strategies. Each question is designed to
strengthen the clinical judgment competencies required for safe, competent maternal-newborn nursing
practice and successful licensure examination performance.
Content is aligned with authoritative clinical guidelines from the Association of Women’s Health,
Obstetric and Neonatal Nurses (AWHONN), the American College of Obstetricians and
Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the National Council of State
Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (CJMM), the National Institute
of Child Health and Human Development (NICHD) fetal monitoring terminology, and the Centers for
Disease Control and Prevention (CDC) maternal and newborn guidelines. Questions address prenatal
assessment (Naegele’s rule, GTPAL, screening), labor and delivery (stages, induction, pain
management, cesarean preparation), electronic fetal monitoring interpretation (NICHD three-tier
system), postpartum care (lochia, hemorrhage, depression screening), newborn stabilization (APGAR,
thermoregulation, phototherapy, medications), high-risk conditions (preeclampsia, HELLP, placenta
previa/abruption, GDM, preterm labor), pharmacology (oxytocin, magnesium sulfate, tocolytics,
uterotonics), lactation and infant feeding, and NCLEX prioritization frameworks.
For optimal preparation, candidates should practice applying the ABC-maternal-neonatal
prioritization framework systematically, understanding that maternal hemorrhage and fetal distress are
the highest-priority emergencies requiring immediate intervention. When approaching NCLEX
maternity questions, remember: postpartum hemorrhage (boggy fundus) requires immediate fundal
massage; Category III FHR tracings require preparation for emergency delivery; preeclampsia with
severe features requires seizure precautions (magnesium sulfate); and the ABC framework supersedes
all other prioritization models in acute maternal or neonatal deterioration. This exam has been graded
A+ with 100% verification of all answers and rationales against current evidence-based nursing
practice standards.
Section 1: Antepartum Assessment & Fetal Development
Prenatal Visits, GTPAL, Naegele’s Rule, Fetal Development Milestones, and
Maternal Physiological Changes
Page PAGE_NUMBER
, Maternity NCLEX Nursing Exam 2026/2027
1. A pregnant patient at her first prenatal visit states that her last menstrual period (LMP)
began on March 1. Using Naegele's rule, what is the estimated date of delivery (EDD)?
A) November 8
B) December 8
C) December 1
D) November 1
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from the first day of the LMP and then
adding 7 days (or adding 1 year and subtracting 3 months and adding 7 days). LMP March 1 minus 3 months =
December 1, plus 7 days = December 8. November 8 (A) would result from an incorrect calculation (adding
only 7 months). December 1 (C) subtracts 3 months but forgets to add 7 days. November 1 (D) subtracts 4
months without adding 7 days. Naegele's rule assumes a 28-day menstrual cycle and is the standard method
taught for EDD calculation per ACOG guidelines.
2. The nurse is documenting a patient's obstetrical history using the GTPAL system. The
patient has had two pregnancies, both reaching term, one preterm delivery, two living children,
and no abortions. Which GTPAL notation is correct?
A) G3, T2, P1, A0, L2
B) G2, T2, P0, A0, L2
C) G3, T2, P1, A0, L3
D) G3, T1, P1, A0, L2
Rationale: GTPAL stands for Gravida (total number of pregnancies), Term births (≥37 weeks), Preterm births
(20-36 weeks), Abortions (spontaneous or induced before 20 weeks), and Living children. This patient has 3
total pregnancies (two that reached term plus one preterm), so Gravida = 3. Term births = 2. Preterm births =
1. Abortions = 0. Living children = 2 (the two term births) plus 1 (the preterm infant who survived) = 3. Option
A incorrectly lists L2 instead of L3. Option B lists Gravida as 2, which omits one pregnancy. Option D
incorrectly lists T1 instead of T2. The GTPAL system is essential for accurate obstetrical documentation per
AWHONN standards.
3. A nurse is performing Leopold's maneuvers on a pregnant patient at 34 weeks' gestation. In
the first maneuver, a firm, round, movable mass is palpated in the fundus. What does this
finding indicate?
A) The fetal head is in the fundus, indicating a breech presentation
B) The fetal buttocks are in the fundus, indicating a cephalic presentation
C) The fetal back is along the maternal left side
D) The fetal extremities are palpable on the maternal right side
Rationale: The first Leopold maneuver (fundal grip) involves palpating the fundus to identify what part of the
fetus is present. A firm, round, ballotable mass in the fundus is the fetal head, indicating a breech presentation
(buttocks or feet would be the presenting part). In a cephalic presentation, the fundus would feel soft and
irregular (the buttocks). The second maneuver identifies the fetal back, and the third and fourth maneuvers
determine the presenting part and its engagement. Leopold's maneuvers are a systematic method for assessing
fetal position and presentation and are standard nursing practice per AWHONN.
Page PAGE_NUMBER
NCLEX NURSING EXAM
────────────────────────────────────────
75 Questions with Correct Answers and Rationales
2026/2027 Edition
Comprehensive Maternal-Newborn Nursing
Already Graded A+ | 100% Verified
Aligned with AWHONN, ACOG, AAP, NCSBN, NICHD, and CDC Guidelines
Antepartum through Postpartum — Fetal Monitoring, Pharmacology, Newborn Care, and NCLEX
Prioritization
, Maternity NCLEX Nursing Exam 2026/2027
TABLE OF CONTENTS
INTRODUCTION .................................................................................................................................. 1
Section 1: Antepartum Assessment & Fetal Development ..................................................................... 1
Prenatal Visits, GTPAL, Naegele’s Rule, Fetal Development Milestones, and Maternal
Physiological Changes ........................................................................................................................ 1
Section 2: Intrapartum Management & Labor Stages ............................................................................. 4
Stages of Labor, Cervical Dilation, Bishop Score, Pain Management, and Cesarean Preparation ..... 4
Section 3: Fetal Heart Rate Monitoring & Interpretation ....................................................................... 7
Baseline FHR, Variability, Accelerations, Decelerations, NICHD Categories, and Nursing
Interventions ....................................................................................................................................... 7
Section 4: Postpartum Care & Maternal Recovery ............................................................................... 11
Lochia Stages, Involution, Hemorrhage, Breastfeeding Support, DVT Prevention, and Postpartum
Depression......................................................................................................................................... 11
Section 5: Newborn Assessment & Stabilization ................................................................................. 14
APGAR Scoring, Physical Assessment, Thermoregulation, Phototherapy, and Newborn
Medications ....................................................................................................................................... 14
Section 6: High-Risk Pregnancy Complications ................................................................................... 18
Preeclampsia, HELLP Syndrome, GDM, Preterm Labor, Placenta Previa, and Abruption ............. 18
Section 7: Pharmacology in Maternity Care ......................................................................................... 21
Oxytocin, Magnesium Sulfate, Calcium Gluconate, Tocolytics, Uterotonics, and Neonatal
Medications ....................................................................................................................................... 21
Section 8: Lactation Support, Infant Feeding & Patient Education ...................................................... 24
Breastfeeding, Safe Sleep, Formula Preparation, Discharge Teaching, and Immunizations ............ 24
Section 9: NCLEX-RN Prioritization & Test-Taking Strategies for Maternity.................................... 27
ABC Prioritization, Delegation, SBAR Reporting, Therapeutic Communication, and Legal/Ethical
Scenarios ........................................................................................................................................... 27
ANSWER KEY .................................................................................................................................... 31
Page PAGE_NUMBER
, Maternity NCLEX Nursing Exam 2026/2027
INTRODUCTION
This comprehensive Maternity NCLEX Nursing Exam for 2026/2027 provides 75 expertly crafted,
evidence-based questions with verified correct answers and detailed rationales. The exam covers the
full scope of maternal-newborn nursing across nine systematically organized sections, progressing
from antepartum assessment and fetal development through intrapartum management, fetal
monitoring, postpartum recovery, newborn assessment, high-risk complications, pharmacology,
lactation and patient education, and NCLEX-RN prioritization strategies. Each question is designed to
strengthen the clinical judgment competencies required for safe, competent maternal-newborn nursing
practice and successful licensure examination performance.
Content is aligned with authoritative clinical guidelines from the Association of Women’s Health,
Obstetric and Neonatal Nurses (AWHONN), the American College of Obstetricians and
Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the National Council of State
Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (CJMM), the National Institute
of Child Health and Human Development (NICHD) fetal monitoring terminology, and the Centers for
Disease Control and Prevention (CDC) maternal and newborn guidelines. Questions address prenatal
assessment (Naegele’s rule, GTPAL, screening), labor and delivery (stages, induction, pain
management, cesarean preparation), electronic fetal monitoring interpretation (NICHD three-tier
system), postpartum care (lochia, hemorrhage, depression screening), newborn stabilization (APGAR,
thermoregulation, phototherapy, medications), high-risk conditions (preeclampsia, HELLP, placenta
previa/abruption, GDM, preterm labor), pharmacology (oxytocin, magnesium sulfate, tocolytics,
uterotonics), lactation and infant feeding, and NCLEX prioritization frameworks.
For optimal preparation, candidates should practice applying the ABC-maternal-neonatal
prioritization framework systematically, understanding that maternal hemorrhage and fetal distress are
the highest-priority emergencies requiring immediate intervention. When approaching NCLEX
maternity questions, remember: postpartum hemorrhage (boggy fundus) requires immediate fundal
massage; Category III FHR tracings require preparation for emergency delivery; preeclampsia with
severe features requires seizure precautions (magnesium sulfate); and the ABC framework supersedes
all other prioritization models in acute maternal or neonatal deterioration. This exam has been graded
A+ with 100% verification of all answers and rationales against current evidence-based nursing
practice standards.
Section 1: Antepartum Assessment & Fetal Development
Prenatal Visits, GTPAL, Naegele’s Rule, Fetal Development Milestones, and
Maternal Physiological Changes
Page PAGE_NUMBER
, Maternity NCLEX Nursing Exam 2026/2027
1. A pregnant patient at her first prenatal visit states that her last menstrual period (LMP)
began on March 1. Using Naegele's rule, what is the estimated date of delivery (EDD)?
A) November 8
B) December 8
C) December 1
D) November 1
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from the first day of the LMP and then
adding 7 days (or adding 1 year and subtracting 3 months and adding 7 days). LMP March 1 minus 3 months =
December 1, plus 7 days = December 8. November 8 (A) would result from an incorrect calculation (adding
only 7 months). December 1 (C) subtracts 3 months but forgets to add 7 days. November 1 (D) subtracts 4
months without adding 7 days. Naegele's rule assumes a 28-day menstrual cycle and is the standard method
taught for EDD calculation per ACOG guidelines.
2. The nurse is documenting a patient's obstetrical history using the GTPAL system. The
patient has had two pregnancies, both reaching term, one preterm delivery, two living children,
and no abortions. Which GTPAL notation is correct?
A) G3, T2, P1, A0, L2
B) G2, T2, P0, A0, L2
C) G3, T2, P1, A0, L3
D) G3, T1, P1, A0, L2
Rationale: GTPAL stands for Gravida (total number of pregnancies), Term births (≥37 weeks), Preterm births
(20-36 weeks), Abortions (spontaneous or induced before 20 weeks), and Living children. This patient has 3
total pregnancies (two that reached term plus one preterm), so Gravida = 3. Term births = 2. Preterm births =
1. Abortions = 0. Living children = 2 (the two term births) plus 1 (the preterm infant who survived) = 3. Option
A incorrectly lists L2 instead of L3. Option B lists Gravida as 2, which omits one pregnancy. Option D
incorrectly lists T1 instead of T2. The GTPAL system is essential for accurate obstetrical documentation per
AWHONN standards.
3. A nurse is performing Leopold's maneuvers on a pregnant patient at 34 weeks' gestation. In
the first maneuver, a firm, round, movable mass is palpated in the fundus. What does this
finding indicate?
A) The fetal head is in the fundus, indicating a breech presentation
B) The fetal buttocks are in the fundus, indicating a cephalic presentation
C) The fetal back is along the maternal left side
D) The fetal extremities are palpable on the maternal right side
Rationale: The first Leopold maneuver (fundal grip) involves palpating the fundus to identify what part of the
fetus is present. A firm, round, ballotable mass in the fundus is the fetal head, indicating a breech presentation
(buttocks or feet would be the presenting part). In a cephalic presentation, the fundus would feel soft and
irregular (the buttocks). The second maneuver identifies the fetal back, and the third and fourth maneuvers
determine the presenting part and its engagement. Leopold's maneuvers are a systematic method for assessing
fetal position and presentation and are standard nursing practice per AWHONN.
Page PAGE_NUMBER
