Maternal-Newborn Nursing Practice Questions and Answers Updated
2026 | Complete Maternity Nursing Study Guide with Verified Questions,
Detailed Rationales, Antepartum Care, Intrapartum Labor & Delivery,
Postpartum Nursing, Newborn Assessment, High-Risk Pregnancy, Fetal
Monitoring, Obstetric Complications & NGN NCLEX-RN/PN Exam Prep
Question 1: A nurse is assessing a pregnant client at 32 weeks gestation who
reports sudden, severe headache and visual disturbances. Which action should
the nurse prioritize?
A. Administer acetaminophen for pain relief
B. Check blood pressure and assess for proteinuria
C. Encourage the client to rest in a left lateral position
D. Document the findings and schedule a follow-up appointment
CORRECT ANSWER: B. Check blood pressure and assess for proteinuria
Rationale: Sudden severe headache and visual disturbances at 32 weeks gestation are
classic signs of preeclampsia. The nurse's priority is to assess blood pressure and
check for proteinuria to evaluate for hypertensive disorder of pregnancy. Early
identification allows for timely intervention to prevent progression to eclampsia. While
positioning and documentation are important, they are secondary to immediate
assessment for life-threatening complications.
Question 2: During the fourth stage of labor, which assessment finding requires
immediate nursing intervention?
A. Fundus firm and at the umbilicus
B. Lochia rubra with small clots
C. Perineal edema and bruising
D. Saturating a perineal pad in 15 minutes
CORRECT ANSWER: D. Saturating a perineal pad in 15 minutes
Rationale: Saturating a perineal pad in 15 minutes indicates excessive bleeding and
possible postpartum hemorrhage, which is a medical emergency requiring immediate
intervention. Normal lochia rubra may contain small clots, and perineal edema is
expected after vaginal birth. A firm fundus at the umbilicus is an expected finding
immediately postpartum. Rapid blood loss can lead to hypovolemic shock if not
addressed promptly.
Question 3: A newborn is assessed at 1 minute of life with a heart rate of 90 bpm,
slow irregular respirations, some flexion of extremities, grimace to stimulation, and
pink body with blue extremities. What is the newborn's Apgar score?
A. 4
B. 5
C. 6
D. 7
,CORRECT ANSWER: B. 5
Rationale: The Apgar score assesses five criteria: heart rate (1 point for <100 bpm),
respiratory effort (1 point for slow/irregular), muscle tone (1 point for some flexion),
reflex irritability (1 point for grimace), and color (1 point for acrocyanosis). Total =
1+1+1+1+1 = 5. This score indicates the newborn requires some assistance with
transition, such as stimulation or oxygen. Scores 7-10 are reassuring, 4-6 indicate
moderate difficulty, and 0-3 require immediate resuscitation.
Question 4: Which statement by a pregnant client at 10 weeks gestation indicates
understanding of nutritional recommendations?
A. "I will increase my caloric intake by 500 calories per day."
B. "I need to consume 600 mcg of folic acid daily to prevent neural tube defects."
C. "I should avoid all fish to prevent mercury exposure."
D. "I will limit weight gain to 15 pounds throughout pregnancy."
CORRECT ANSWER: B. "I need to consume 600 mcg of folic acid daily to prevent
neural tube defects."
Rationale: Folic acid supplementation of 400-800 mcg daily before conception and
during early pregnancy significantly reduces the risk of neural tube defects. The
recommended daily allowance during pregnancy is 600 mcg. Caloric increase of 500
calories is recommended in the second and third trimesters, not first. Low-mercury fish
are encouraged for omega-3 fatty acids. Weight gain recommendations vary by pre-
pregnancy BMI; 15 pounds is insufficient for most clients.
Question 5: A nurse is preparing to administer Rho(D) immune globulin to a
postpartum client. Which assessment finding is a prerequisite for administration?
A. Mother is Rh-negative and infant is Rh-positive
B. Mother is Rh-positive and infant is Rh-negative
C. Direct Coombs test is positive in the newborn
D. Mother received RhoGAM during the current pregnancy
CORRECT ANSWER: A. Mother is Rh-negative and infant is Rh-positive
Rationale: Rho(D) immune globulin is indicated for Rh-negative mothers who deliver an
Rh-positive infant to prevent isoimmunization in future pregnancies. It works by
neutralizing fetal Rh-positive red blood cells that may have entered maternal
circulation. If the mother is Rh-positive, administration is unnecessary. A positive direct
Coombs in the newborn indicates existing sensitization, making RhoGAM ineffective.
Prior antenatal RhoGAM does not eliminate the need for postpartum dosing if criteria
are met.
Question 6: Which finding in a 24-hour-old newborn requires immediate
notification of the healthcare provider?
,A. Respiratory rate of 55 breaths per minute
B. Temperature of 97.8°F (36.6°C) axillary
C. Absent bowel sounds in all quadrants
D. Passage of meconium within first 8 hours
CORRECT ANSWER: C. Absent bowel sounds in all quadrants
Rationale: Absent bowel sounds in a newborn may indicate intestinal obstruction,
necrotizing enterocolitis, or other serious gastrointestinal pathology requiring urgent
evaluation. Normal newborn respiratory rate is 30-60 breaths/min. Axillary temperature
of 97.8°F is within acceptable range (97.7-99.5°F). Passage of meconium within 24-48
hours is expected; earlier passage is normal. Persistent absent bowel sounds warrant
immediate assessment.
Question 7: A client in active labor has an external fetal monitor showing late
decelerations. Which nursing intervention is most appropriate?
A. Increase the oxytocin infusion rate
B. Assist the client to a left lateral position
C. Prepare for immediate cesarean birth
D. Administer terbutaline 0.25 mg subcutaneously
CORRECT ANSWER: B. Assist the client to a left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia.
The first nursing intervention is to improve placental perfusion by positioning the mother
in left lateral position to relieve vena cava compression. Additional interventions
include discontinuing oxytocin, administering oxygen, and increasing IV fluids.
Terbutaline may be used for uterine hyperstimulation but is not first-line. Immediate
cesarean is reserved for persistent, severe decelerations unresponsive to conservative
measures.
Question 8: Which assessment finding in a postpartum client at 2 days after
cesarean birth indicates a potential complication?
A. Temperature of 100.4°F (38°C) orally
B. Moderate lochia rubra with small clots
C. Incisional pain rated 6/10 with movement
D. Absence of flatus or bowel movement
CORRECT ANSWER: A. Temperature of 100.4°F (38°C) orally
Rationale: A temperature of 100.4°F (38°C) or higher after the first 24 hours postpartum
may indicate infection, such as endometritis, wound infection, or urinary tract infection,
especially after cesarean birth. Low-grade fever in the first 24 hours may be due to
dehydration. Lochia rubra with small clots, incisional pain with movement, and delayed
return of bowel function are expected findings after cesarean birth. Persistent fever
requires further assessment and possible antibiotic therapy.
, Question 9: A nurse is teaching a pregnant client about signs of preterm labor.
Which statement by the client indicates effective teaching?
A. "I should call my provider if I have more than four contractions in one hour."
B. "Backache that goes away with rest is not concerning."
C. "Fluid leakage is only a problem if it is bright red."
D. "Pelvic pressure is normal and does not need evaluation."
CORRECT ANSWER: A. "I should call my provider if I have more than four
contractions in one hour."
Rationale: Regular contractions (more than 4-6 per hour) before 37 weeks gestation are
a key sign of preterm labor requiring evaluation. Persistent low backache, fluid leakage
(possible rupture of membranes), and pelvic pressure are also warning signs that
warrant immediate assessment. Teaching clients to recognize and report these
symptoms promptly can facilitate interventions to delay preterm birth or prepare for
neonatal care.
Question 10: Which intervention should a nurse include in the plan of care for a
newborn diagnosed with hyperbilirubinemia receiving phototherapy?
A. Apply lotion to prevent skin dryness
B. Cover the newborn's eyes with opaque patches
C. Limit fluid intake to prevent fluid overload
D. Dress the newborn in lightweight clothing under lights
CORRECT ANSWER: B. Cover the newborn's eyes with opaque patches
Rationale: During phototherapy, the newborn's eyes must be covered with opaque
patches to prevent retinal damage from intense light. Skin should be exposed maximally
(diaper only) to enhance bilirubin breakdown; lotion can increase light absorption and
risk of burns. Adequate hydration is essential to promote bilirubin excretion; fluids
should be encouraged, not limited. Clothing under phototherapy lights reduces
treatment efficacy.
Question 11: A client at 36 weeks gestation reports painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
CORRECT ANSWER: B. Placenta previa
Rationale: Painless, bright red vaginal bleeding in the third trimester is classic for
placenta previa, where the placenta implants over or near the cervical os. Placental
abruption typically presents with painful, dark red bleeding and uterine tenderness.
Uterine rupture is a catastrophic event with severe pain, fetal distress, and maternal
2026 | Complete Maternity Nursing Study Guide with Verified Questions,
Detailed Rationales, Antepartum Care, Intrapartum Labor & Delivery,
Postpartum Nursing, Newborn Assessment, High-Risk Pregnancy, Fetal
Monitoring, Obstetric Complications & NGN NCLEX-RN/PN Exam Prep
Question 1: A nurse is assessing a pregnant client at 32 weeks gestation who
reports sudden, severe headache and visual disturbances. Which action should
the nurse prioritize?
A. Administer acetaminophen for pain relief
B. Check blood pressure and assess for proteinuria
C. Encourage the client to rest in a left lateral position
D. Document the findings and schedule a follow-up appointment
CORRECT ANSWER: B. Check blood pressure and assess for proteinuria
Rationale: Sudden severe headache and visual disturbances at 32 weeks gestation are
classic signs of preeclampsia. The nurse's priority is to assess blood pressure and
check for proteinuria to evaluate for hypertensive disorder of pregnancy. Early
identification allows for timely intervention to prevent progression to eclampsia. While
positioning and documentation are important, they are secondary to immediate
assessment for life-threatening complications.
Question 2: During the fourth stage of labor, which assessment finding requires
immediate nursing intervention?
A. Fundus firm and at the umbilicus
B. Lochia rubra with small clots
C. Perineal edema and bruising
D. Saturating a perineal pad in 15 minutes
CORRECT ANSWER: D. Saturating a perineal pad in 15 minutes
Rationale: Saturating a perineal pad in 15 minutes indicates excessive bleeding and
possible postpartum hemorrhage, which is a medical emergency requiring immediate
intervention. Normal lochia rubra may contain small clots, and perineal edema is
expected after vaginal birth. A firm fundus at the umbilicus is an expected finding
immediately postpartum. Rapid blood loss can lead to hypovolemic shock if not
addressed promptly.
Question 3: A newborn is assessed at 1 minute of life with a heart rate of 90 bpm,
slow irregular respirations, some flexion of extremities, grimace to stimulation, and
pink body with blue extremities. What is the newborn's Apgar score?
A. 4
B. 5
C. 6
D. 7
,CORRECT ANSWER: B. 5
Rationale: The Apgar score assesses five criteria: heart rate (1 point for <100 bpm),
respiratory effort (1 point for slow/irregular), muscle tone (1 point for some flexion),
reflex irritability (1 point for grimace), and color (1 point for acrocyanosis). Total =
1+1+1+1+1 = 5. This score indicates the newborn requires some assistance with
transition, such as stimulation or oxygen. Scores 7-10 are reassuring, 4-6 indicate
moderate difficulty, and 0-3 require immediate resuscitation.
Question 4: Which statement by a pregnant client at 10 weeks gestation indicates
understanding of nutritional recommendations?
A. "I will increase my caloric intake by 500 calories per day."
B. "I need to consume 600 mcg of folic acid daily to prevent neural tube defects."
C. "I should avoid all fish to prevent mercury exposure."
D. "I will limit weight gain to 15 pounds throughout pregnancy."
CORRECT ANSWER: B. "I need to consume 600 mcg of folic acid daily to prevent
neural tube defects."
Rationale: Folic acid supplementation of 400-800 mcg daily before conception and
during early pregnancy significantly reduces the risk of neural tube defects. The
recommended daily allowance during pregnancy is 600 mcg. Caloric increase of 500
calories is recommended in the second and third trimesters, not first. Low-mercury fish
are encouraged for omega-3 fatty acids. Weight gain recommendations vary by pre-
pregnancy BMI; 15 pounds is insufficient for most clients.
Question 5: A nurse is preparing to administer Rho(D) immune globulin to a
postpartum client. Which assessment finding is a prerequisite for administration?
A. Mother is Rh-negative and infant is Rh-positive
B. Mother is Rh-positive and infant is Rh-negative
C. Direct Coombs test is positive in the newborn
D. Mother received RhoGAM during the current pregnancy
CORRECT ANSWER: A. Mother is Rh-negative and infant is Rh-positive
Rationale: Rho(D) immune globulin is indicated for Rh-negative mothers who deliver an
Rh-positive infant to prevent isoimmunization in future pregnancies. It works by
neutralizing fetal Rh-positive red blood cells that may have entered maternal
circulation. If the mother is Rh-positive, administration is unnecessary. A positive direct
Coombs in the newborn indicates existing sensitization, making RhoGAM ineffective.
Prior antenatal RhoGAM does not eliminate the need for postpartum dosing if criteria
are met.
Question 6: Which finding in a 24-hour-old newborn requires immediate
notification of the healthcare provider?
,A. Respiratory rate of 55 breaths per minute
B. Temperature of 97.8°F (36.6°C) axillary
C. Absent bowel sounds in all quadrants
D. Passage of meconium within first 8 hours
CORRECT ANSWER: C. Absent bowel sounds in all quadrants
Rationale: Absent bowel sounds in a newborn may indicate intestinal obstruction,
necrotizing enterocolitis, or other serious gastrointestinal pathology requiring urgent
evaluation. Normal newborn respiratory rate is 30-60 breaths/min. Axillary temperature
of 97.8°F is within acceptable range (97.7-99.5°F). Passage of meconium within 24-48
hours is expected; earlier passage is normal. Persistent absent bowel sounds warrant
immediate assessment.
Question 7: A client in active labor has an external fetal monitor showing late
decelerations. Which nursing intervention is most appropriate?
A. Increase the oxytocin infusion rate
B. Assist the client to a left lateral position
C. Prepare for immediate cesarean birth
D. Administer terbutaline 0.25 mg subcutaneously
CORRECT ANSWER: B. Assist the client to a left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia.
The first nursing intervention is to improve placental perfusion by positioning the mother
in left lateral position to relieve vena cava compression. Additional interventions
include discontinuing oxytocin, administering oxygen, and increasing IV fluids.
Terbutaline may be used for uterine hyperstimulation but is not first-line. Immediate
cesarean is reserved for persistent, severe decelerations unresponsive to conservative
measures.
Question 8: Which assessment finding in a postpartum client at 2 days after
cesarean birth indicates a potential complication?
A. Temperature of 100.4°F (38°C) orally
B. Moderate lochia rubra with small clots
C. Incisional pain rated 6/10 with movement
D. Absence of flatus or bowel movement
CORRECT ANSWER: A. Temperature of 100.4°F (38°C) orally
Rationale: A temperature of 100.4°F (38°C) or higher after the first 24 hours postpartum
may indicate infection, such as endometritis, wound infection, or urinary tract infection,
especially after cesarean birth. Low-grade fever in the first 24 hours may be due to
dehydration. Lochia rubra with small clots, incisional pain with movement, and delayed
return of bowel function are expected findings after cesarean birth. Persistent fever
requires further assessment and possible antibiotic therapy.
, Question 9: A nurse is teaching a pregnant client about signs of preterm labor.
Which statement by the client indicates effective teaching?
A. "I should call my provider if I have more than four contractions in one hour."
B. "Backache that goes away with rest is not concerning."
C. "Fluid leakage is only a problem if it is bright red."
D. "Pelvic pressure is normal and does not need evaluation."
CORRECT ANSWER: A. "I should call my provider if I have more than four
contractions in one hour."
Rationale: Regular contractions (more than 4-6 per hour) before 37 weeks gestation are
a key sign of preterm labor requiring evaluation. Persistent low backache, fluid leakage
(possible rupture of membranes), and pelvic pressure are also warning signs that
warrant immediate assessment. Teaching clients to recognize and report these
symptoms promptly can facilitate interventions to delay preterm birth or prepare for
neonatal care.
Question 10: Which intervention should a nurse include in the plan of care for a
newborn diagnosed with hyperbilirubinemia receiving phototherapy?
A. Apply lotion to prevent skin dryness
B. Cover the newborn's eyes with opaque patches
C. Limit fluid intake to prevent fluid overload
D. Dress the newborn in lightweight clothing under lights
CORRECT ANSWER: B. Cover the newborn's eyes with opaque patches
Rationale: During phototherapy, the newborn's eyes must be covered with opaque
patches to prevent retinal damage from intense light. Skin should be exposed maximally
(diaper only) to enhance bilirubin breakdown; lotion can increase light absorption and
risk of burns. Adequate hydration is essential to promote bilirubin excretion; fluids
should be encouraged, not limited. Clothing under phototherapy lights reduces
treatment efficacy.
Question 11: A client at 36 weeks gestation reports painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
CORRECT ANSWER: B. Placenta previa
Rationale: Painless, bright red vaginal bleeding in the third trimester is classic for
placenta previa, where the placenta implants over or near the cervical os. Placental
abruption typically presents with painful, dark red bleeding and uterine tenderness.
Uterine rupture is a catastrophic event with severe pain, fetal distress, and maternal
