Maternal Newborn Nursing Test Bank: 200 NCLEX-RN
Style Practice Questions with Correct Answers and
Detailed Rationales– For OB/Maternity Final Exams,
HESI, ATI, and NCLEX Preparation
ABOUT THIS RESOURCE:
Maternity and newborn nursing is a high-stakes content area on the NCLEX-RN, typically
comprising 10–15% of the exam. Questions span the entire childbearing continuum:
antepartum complications, intrapartum emergencies, postpartum hemorrhage, neonatal
resuscitation, congenital disorders, breastfeeding, and discharge teaching. Success
requires not just memorization but clinical judgment—the ability to prioritize, delegate, and
recognize subtle signs of deterioration.
1. A nurse is assessing a client at 34 weeks gestation. Which finding requires
immediate intervention?
A. Blood pressure 136/88 mm Hg
B. Mild ankle edema
C. Urine protein 2+
D. Heartburn after meals
*C. Urine protein 2+*
Proteinuria at 34 weeks suggests preeclampsia. Combined with elevated BP, this
warrants further evaluation for possible severe features.
2. A primigravida at 8 weeks reports dark brown spotting and mild cramping. The
cervix is closed. What is the priority nursing action?
A. Prepare for dilation and curettage
B. Administer Rh immune globulin if mother is Rh-negative
, C. Instruct bed rest with bathroom privileges
D. Assess for passage of tissue
B. Administer Rh immune globulin if mother is Rh-negative
Threatened abortion with bleeding risks fetomaternal hemorrhage. RhIg prevents
isoimmunization in Rh-negative mothers.
3. A nurse teaches a client with gestational diabetes. Which statement shows
correct understanding?
A. "I need to keep my blood glucose below 60 mg/dL before meals."
B. "My baby will be underweight because of diabetes."
C. "I should avoid all carbohydrates."
D. "I will need a glucose tolerance test 6–12 weeks postpartum."
D. "I will need a glucose tolerance test 6–12 weeks postpartum."
Most GDM resolves postpartum, but up to 50% develop type 2 diabetes later.
Repeat OGTT is essential for screening.
4. A client with PROM at 34 weeks has a temperature of 38.9°C (102°F) and foul-
smelling vaginal discharge. What is the nurse's priority?
A. Administer antipyretics
B. Obtain blood cultures
C. Start IV antibiotics as ordered
D. Assess fetal heart rate
C. Start IV antibiotics as ordered
Fever + foul discharge + PROM = chorioamnionitis. Immediate broad-spectrum
antibiotics reduce maternal and neonatal sepsis risk.
5. A nurse cares for a client with placenta previa. Which finding is most
concerning?
A. Painless bright red vaginal bleeding
B. Fundal height 2 cm above expected
C. Irregular mild contractions
D. Fetal heart rate 150 bpm
A. Painless bright red vaginal bleeding
Painless bleeding is hallmark of placenta previa. Any increase in bleeding signals
possible hemorrhage requiring immediate intervention.
6. A client at 29 weeks with preeclampsia has platelets of 85,000/mm³. Which
additional finding indicates HELLP syndrome?
, A. Elevated liver enzymes and hemolysis
B. Proteinuria 1+
C. Deep tendon reflexes 3+
D. Blood pressure 148/94 mm Hg
A. Elevated liver enzymes and hemolysis
HELLP = Hemolysis, Elevated Liver enzymes, Low Platelets. All three must be
present for diagnosis.
7. A nurse administers magnesium sulfate for severe preeclampsia. Which finding
indicates toxicity?
A. Respiratory rate 14 breaths/min
B. Urine output 40 mL/hour
C. Patellar reflexes absent
D. Blood pressure 128/82 mm Hg
C. Patellar reflexes absent
Loss of DTRs is earliest sign of magnesium toxicity. Respiratory depression and
cardiac arrest follow. Calcium gluconate is antidote.
8. A client with incompetent cervix has a cerclage placed at 14 weeks. Post-
procedure teaching should include:
A. "I can resume intercourse in 3 days."
B. "I should report any increase in vaginal discharge or cramping."
C. "The stitch will be removed after I go into labor."
D. "Bed rest is not necessary at all."
B. "I should report any increase in vaginal discharge or cramping."
Increased discharge or cramping may signal infection or preterm labor. Cerclage
does not eliminate these risks.
9. A nurse teaches about Rh incompatibility. Which statement by a client requires
correction?
A. "Rh immune globulin is given at 28 weeks and after delivery if baby is Rh-positive."
B. "Rh-negative mothers need the injection after miscarriage."
C. "If I am Rh-negative and my partner is Rh-negative, my baby will need monitoring."
D. "The injection prevents my body from making antibodies."
C. "If I am Rh-negative and my partner is Rh-negative, my baby will need
monitoring."
If both parents are Rh-negative, baby is Rh-negative. No Rh incompatibility, so
RhIg is not indicated.
, 10. A client at 40 weeks calls and reports a gush of clear, odorless fluid from the
vagina. What should the nurse advise?
A. "Come to the hospital for evaluation of possible rupture of membranes."
B. "Stay home until contractions are 5 minutes apart."
C. "Drink 2 liters of water and rest."
D. "Insert a pad and check for fluid every hour."
A. "Come to the hospital for evaluation of possible rupture of membranes."
Any fluid gush at term suggests ROM. Evaluation is needed to confirm rupture and
assess for infection or cord prolapse.
11. A nurse notes late decelerations on the fetal monitor. What is the first action?
A. Turn the client to left lateral position
B. Increase IV oxytocin
C. Prepare for cesarean section
D. Administer oxygen at 2 L/min
A. Turn the client to left lateral position
Late decels indicate uteroplacental insufficiency. Left lateral position improves
uterine blood flow. Oxygen and IV fluids follow.
12. A postpartum client with a third-degree perineal laceration reports no bowel
movement for 4 days. What should the nurse recommend?
A. Bisacodyl suppository
B. Mineral oil enema
C. Stool softener and increased fluids
D. High-fiber diet only
C. Stool softener and increased fluids
Third-degree laceration involves anal sphincter. Straining risks disruption. Stool
softeners prevent constipation.
13. A newborn has Apgar scores of 5 at 1 minute and 7 at 5 minutes. Which
intervention is most likely?
A. Endotracheal intubation
B. Stimulation and drying
C. Chest compressions
D. Epinephrine administration
Style Practice Questions with Correct Answers and
Detailed Rationales– For OB/Maternity Final Exams,
HESI, ATI, and NCLEX Preparation
ABOUT THIS RESOURCE:
Maternity and newborn nursing is a high-stakes content area on the NCLEX-RN, typically
comprising 10–15% of the exam. Questions span the entire childbearing continuum:
antepartum complications, intrapartum emergencies, postpartum hemorrhage, neonatal
resuscitation, congenital disorders, breastfeeding, and discharge teaching. Success
requires not just memorization but clinical judgment—the ability to prioritize, delegate, and
recognize subtle signs of deterioration.
1. A nurse is assessing a client at 34 weeks gestation. Which finding requires
immediate intervention?
A. Blood pressure 136/88 mm Hg
B. Mild ankle edema
C. Urine protein 2+
D. Heartburn after meals
*C. Urine protein 2+*
Proteinuria at 34 weeks suggests preeclampsia. Combined with elevated BP, this
warrants further evaluation for possible severe features.
2. A primigravida at 8 weeks reports dark brown spotting and mild cramping. The
cervix is closed. What is the priority nursing action?
A. Prepare for dilation and curettage
B. Administer Rh immune globulin if mother is Rh-negative
, C. Instruct bed rest with bathroom privileges
D. Assess for passage of tissue
B. Administer Rh immune globulin if mother is Rh-negative
Threatened abortion with bleeding risks fetomaternal hemorrhage. RhIg prevents
isoimmunization in Rh-negative mothers.
3. A nurse teaches a client with gestational diabetes. Which statement shows
correct understanding?
A. "I need to keep my blood glucose below 60 mg/dL before meals."
B. "My baby will be underweight because of diabetes."
C. "I should avoid all carbohydrates."
D. "I will need a glucose tolerance test 6–12 weeks postpartum."
D. "I will need a glucose tolerance test 6–12 weeks postpartum."
Most GDM resolves postpartum, but up to 50% develop type 2 diabetes later.
Repeat OGTT is essential for screening.
4. A client with PROM at 34 weeks has a temperature of 38.9°C (102°F) and foul-
smelling vaginal discharge. What is the nurse's priority?
A. Administer antipyretics
B. Obtain blood cultures
C. Start IV antibiotics as ordered
D. Assess fetal heart rate
C. Start IV antibiotics as ordered
Fever + foul discharge + PROM = chorioamnionitis. Immediate broad-spectrum
antibiotics reduce maternal and neonatal sepsis risk.
5. A nurse cares for a client with placenta previa. Which finding is most
concerning?
A. Painless bright red vaginal bleeding
B. Fundal height 2 cm above expected
C. Irregular mild contractions
D. Fetal heart rate 150 bpm
A. Painless bright red vaginal bleeding
Painless bleeding is hallmark of placenta previa. Any increase in bleeding signals
possible hemorrhage requiring immediate intervention.
6. A client at 29 weeks with preeclampsia has platelets of 85,000/mm³. Which
additional finding indicates HELLP syndrome?
, A. Elevated liver enzymes and hemolysis
B. Proteinuria 1+
C. Deep tendon reflexes 3+
D. Blood pressure 148/94 mm Hg
A. Elevated liver enzymes and hemolysis
HELLP = Hemolysis, Elevated Liver enzymes, Low Platelets. All three must be
present for diagnosis.
7. A nurse administers magnesium sulfate for severe preeclampsia. Which finding
indicates toxicity?
A. Respiratory rate 14 breaths/min
B. Urine output 40 mL/hour
C. Patellar reflexes absent
D. Blood pressure 128/82 mm Hg
C. Patellar reflexes absent
Loss of DTRs is earliest sign of magnesium toxicity. Respiratory depression and
cardiac arrest follow. Calcium gluconate is antidote.
8. A client with incompetent cervix has a cerclage placed at 14 weeks. Post-
procedure teaching should include:
A. "I can resume intercourse in 3 days."
B. "I should report any increase in vaginal discharge or cramping."
C. "The stitch will be removed after I go into labor."
D. "Bed rest is not necessary at all."
B. "I should report any increase in vaginal discharge or cramping."
Increased discharge or cramping may signal infection or preterm labor. Cerclage
does not eliminate these risks.
9. A nurse teaches about Rh incompatibility. Which statement by a client requires
correction?
A. "Rh immune globulin is given at 28 weeks and after delivery if baby is Rh-positive."
B. "Rh-negative mothers need the injection after miscarriage."
C. "If I am Rh-negative and my partner is Rh-negative, my baby will need monitoring."
D. "The injection prevents my body from making antibodies."
C. "If I am Rh-negative and my partner is Rh-negative, my baby will need
monitoring."
If both parents are Rh-negative, baby is Rh-negative. No Rh incompatibility, so
RhIg is not indicated.
, 10. A client at 40 weeks calls and reports a gush of clear, odorless fluid from the
vagina. What should the nurse advise?
A. "Come to the hospital for evaluation of possible rupture of membranes."
B. "Stay home until contractions are 5 minutes apart."
C. "Drink 2 liters of water and rest."
D. "Insert a pad and check for fluid every hour."
A. "Come to the hospital for evaluation of possible rupture of membranes."
Any fluid gush at term suggests ROM. Evaluation is needed to confirm rupture and
assess for infection or cord prolapse.
11. A nurse notes late decelerations on the fetal monitor. What is the first action?
A. Turn the client to left lateral position
B. Increase IV oxytocin
C. Prepare for cesarean section
D. Administer oxygen at 2 L/min
A. Turn the client to left lateral position
Late decels indicate uteroplacental insufficiency. Left lateral position improves
uterine blood flow. Oxygen and IV fluids follow.
12. A postpartum client with a third-degree perineal laceration reports no bowel
movement for 4 days. What should the nurse recommend?
A. Bisacodyl suppository
B. Mineral oil enema
C. Stool softener and increased fluids
D. High-fiber diet only
C. Stool softener and increased fluids
Third-degree laceration involves anal sphincter. Straining risks disruption. Stool
softeners prevent constipation.
13. A newborn has Apgar scores of 5 at 1 minute and 7 at 5 minutes. Which
intervention is most likely?
A. Endotracheal intubation
B. Stimulation and drying
C. Chest compressions
D. Epinephrine administration
