NCLEX Maternity & Newborn Practice Questions

15 free NCLEX-RN maternal & newborn questions with answers and rationales — perfect for maternity nclex questions practice. Want them as an interactive timed quiz?

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1. A 28-year-old primigravida at 38 weeks of gestation presents to the labor and delivery unit with complaints of severe headache and visual disturbances. Her blood pressure is 160/110 mmHg. What is the BEST initial nursing action?
- A. Administer magnesium sulfate as prescribed.
- B. Place the client on bed rest in a quiet environment.
- C. Prepare the client for immediate delivery.
- D. Notify the healthcare provider immediately. ✓
Answer: D. Notify the healthcare provider immediately. — The client's symptoms and elevated blood pressure are indicative of severe preeclampsia, which requires urgent medical attention. Notifying the healthcare provider immediately ensures prompt evaluation and management to prevent complications.
2. A newborn is delivered at 42 weeks of gestation. On examination, the nurse notes dry, peeling skin and long nails. What is the MOST likely reason for these findings?
- A. Postmaturity syndrome. ✓
- B. Gestational diabetes.
- C. Prematurity.
- D. Congenital infection.
Answer: A. Postmaturity syndrome. — The signs of dry, peeling skin and long nails are consistent with postmaturity syndrome, which occurs in babies born after 42 weeks of gestation.
3. A client in labor is experiencing late decelerations on the fetal monitor. What is the PRIORITY nursing action?
- A. Continue to monitor the fetal heart rate.
- B. Increase the rate of the oxytocin infusion.
- C. Position the client on her left side. ✓
- D. Prepare for an emergency cesarean section.
Answer: C. Position the client on her left side. — Late decelerations indicate uteroplacental insufficiency. Positioning the client on her left side improves uteroplacental blood flow and oxygenation to the fetus.
4. A postpartum client is Rh-negative and delivered an Rh-positive baby. When should Rho(D) immune globulin (RhoGAM) be administered?
- A. Within 72 hours after delivery. ✓
- B. Immediately after delivery.
- C. During the next prenatal visit.
- D. Only if the mother plans to have more children.
Answer: A. Within 72 hours after delivery. — Rho(D) immune globulin should be administered within 72 hours after delivery to prevent Rh sensitization in the Rh-negative mother who has delivered an Rh-positive infant.
5. A client at 32 weeks of gestation is admitted with preterm labor. The healthcare provider prescribes betamethasone. What is the purpose of this medication?
- A. To reduce maternal hypertension.
- B. To improve fetal lung maturity. ✓
- C. To halt uterine contractions.
- D. To prevent infection.
Answer: B. To improve fetal lung maturity. — Betamethasone is a corticosteroid given to improve fetal lung maturity and reduce the risk of respiratory distress syndrome in preterm infants.
6. A 24-hour-old newborn is being assessed. The nurse notes a yellowish tinge to the skin and sclera. What is the MOST likely diagnosis?
- A. Physiological jaundice.
- B. Kernicterus.
- C. Pathological jaundice. ✓
- D. Biliary atresia.
Answer: C. Pathological jaundice. — Jaundice appearing within the first 24 hours is considered pathological and may indicate underlying issues like hemolytic disease. Physiological jaundice typically appears after 24 hours.
7. A client is 2 hours postpartum after a vaginal delivery. She reports feeling lightheaded and you notice a large amount of lochia rubra on the pad. What is the FIRST nursing action?
- A. Call the healthcare provider.
- B. Measure the client's blood pressure.
- C. Massage the uterine fundus. ✓
- D. Start an IV infusion of normal saline.
Answer: C. Massage the uterine fundus. — Massaging the uterine fundus can help contract the uterus and reduce bleeding, which is critical in the immediate postpartum period when the risk of hemorrhage is high.
8. A pregnant client with gestational diabetes is concerned about how her condition might affect the baby. What is the nurse's BEST response?
- A. Your baby might be smaller than average.
- B. There is a risk of your baby developing diabetes after birth.
- C. Your baby might have low blood sugar after birth. ✓
- D. Your baby could be born with a congenital anomaly.
Answer: C. Your baby might have low blood sugar after birth. — Infants of mothers with gestational diabetes are at risk for hypoglycemia after birth due to elevated insulin levels in response to maternal hyperglycemia.
9. A client at 36 weeks of gestation presents with painless vaginal bleeding. What is the MOST likely condition?
- A. Placenta previa. ✓
- B. Placental abruption.
- C. Preterm labor.
- D. Urinary tract infection.
Answer: A. Placenta previa. — Painless vaginal bleeding in the third trimester is often indicative of placenta previa, where the placenta covers the cervical os.
10. A newborn is noted to have a heart rate of 95 beats per minute, weak cry, and blue extremities. What is the MOST appropriate Apgar score for this newborn?
- A. 4 ✓
- B. 6
- C. 3
- D. 7
Answer: A. 4 — An Apgar score of 4 indicates moderate distress. The newborn is assessed as follows: heart rate under 100 bpm (1 point), weak cry (1 point), and blue extremities (1 point), plus 1 more point for reflex irritability or muscle tone, totaling 4.
11. A client at 30 weeks of gestation is concerned about feeling less fetal movement than usual. What should the nurse advise the client to do FIRST?
- A. Perform a fetal kick count. ✓
- B. Come to the clinic for an immediate ultrasound.
- C. Increase physical activity to stimulate the fetus.
- D. Wait until the next prenatal visit to discuss this.
Answer: A. Perform a fetal kick count. — Performing a fetal kick count is a non-invasive way to monitor fetal well-being. A decrease in fetal movements can indicate fetal distress, warranting further evaluation if the count is low.
12. A postpartum client is breastfeeding her newborn and reports sore nipples. What is the MOST effective nursing recommendation to relieve her discomfort?
- A. Use a lanolin-based cream after each feeding. ✓
- B. Apply ice packs to the nipples before feeding.
- C. Limit breastfeeding sessions to 5 minutes.
- D. Use a breast pump instead of nursing.
Answer: A. Use a lanolin-based cream after each feeding. — Lanolin-based creams provide a moisture barrier and help soothe and heal sore nipples without the need to remove it before breastfeeding.
13. A client in active labor is requesting pain relief. She is 7 cm dilated. What is the BEST pain relief option at this stage of labor?
- A. Epidural anesthesia. ✓
- B. Administering nitrous oxide.
- C. IV opioid administration.
- D. Breathing and relaxation techniques.
Answer: A. Epidural anesthesia. — Epidural anesthesia is effective for pain relief during active labor and can be administered at 7 cm dilation, providing continuous pain relief without affecting the consciousness of the mother.
14. A client is in the first stage of labor and reports feeling the urge to push. The nurse examines her and finds that she is 8 cm dilated. What should the nurse do NEXT?
- A. Instruct the client to start pushing.
- B. Encourage the client to use pant-blow breathing techniques. ✓
- C. Prepare for delivery.
- D. Administer analgesics to reduce pain.
Answer: B. Encourage the client to use pant-blow breathing techniques. — Pant-blow breathing techniques help the client manage the urge to push when full dilation has not yet been achieved, reducing the risk of cervical edema or injury.
15. A client at 10 weeks of gestation visits the clinic with severe nausea and vomiting, weight loss, and dehydration. What is the MOST likely diagnosis?
- A. Hyperemesis gravidarum. ✓
- B. Molar pregnancy.
- C. Ectopic pregnancy.
- D. Normal morning sickness.
Answer: A. Hyperemesis gravidarum. — The symptoms of severe nausea, vomiting, weight loss, and dehydration are indicative of hyperemesis gravidarum, a severe form of morning sickness requiring medical intervention.

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NCLEX Maternity & Newborn Practice Questions

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