MATERNITY NCLEX MASTERY: THE ULTIMATE OBSTETRIC NURSING EXAM
PREP GUIDE
500+ HIGH-YIELD QUESTIONS, ANSWERS, RATIONALES & MEMORY TRICKS FOR
NCLEX SUCCESS
Question 1
A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours.
For which of the following would the nurse be alert?
A. Endometritis
B. Endometriosis
C. Salpingitis
D. Pelvic thrombophlebitis
CORRECT ANSWER
A. Endometritis
NCLEX Rationale
Prolonged labor and prolonged rupture of membranes increase the risk of bacteria ascending
into the uterus, making postpartum endometritis the most likely complication. Signs include
fever, uterine tenderness, foul-smelling lochia, chills, and tachycardia.
Why the Other Options Are Incorrect
• B. Endometriosis: A chronic condition involving endometrial tissue outside the uterus,
not a postpartum infection.
• C. Salpingitis: Infection of the fallopian tubes, usually associated with pelvic
inflammatory disease rather than childbirth.
• D. Pelvic thrombophlebitis: A less common postpartum complication involving infected
pelvic veins.
Memory Tip
PROM + Prolonged Labor = Postpartum Endometritis
Exam Pearl
,Membranes ruptured for more than 18 hours significantly increase the risk of maternal and
neonatal infection.
Question 2
A client at 36 weeks gestation is scheduled for a routine ultrasound prior to amniocentesis.
Which statement indicates the need for further teaching?
A. The ultrasound will help locate the placenta.
B. The ultrasound identifies blood flow through the umbilical cord.
C. The test will determine where to insert the needle.
D. The ultrasound locates a pool of amniotic fluid.
CORRECT ANSWER
B. The ultrasound identifies blood flow through the umbilical cord.
NCLEX Rationale
Routine ultrasound before amniocentesis is used to:
• Locate the placenta.
• Determine fetal position.
• Identify a pocket of amniotic fluid.
• Guide safe needle insertion.
Assessment of blood flow through the umbilical cord requires Doppler ultrasound, not the
routine ultrasound performed for amniocentesis guidance.
Why the Other Options Are Incorrect
• A: Correct use of ultrasound.
• C: Correct use of ultrasound.
• D: Correct use of ultrasound.
Memory Tip
Ultrasound before amniocentesis = Placenta, Position, Pocket, Placement (4 Ps).
, Exam Pearl
Ultrasound guidance reduces the risk of fetal injury during amniocentesis.
Question 3
While the postpartum client is receiving heparin for thrombophlebitis, which medication
reverses heparin if complications develop?
A. Calcium gluconate
B. Protamine sulfate
C. Methylergonovine
D. Nitrofurantoin
CORRECT ANSWER
B. Protamine sulfate
NCLEX Rationale
Protamine sulfate binds to heparin and neutralizes its anticoagulant effect, making it the
antidote for heparin overdose or severe bleeding.
Why the Other Options Are Incorrect
• A. Calcium gluconate: Antidote for magnesium sulfate toxicity.
• C. Methylergonovine: Used to treat postpartum hemorrhage.
• D. Nitrofurantoin: Antibiotic used to treat urinary tract infections.
Memory Tip
• Heparin → Protamine sulfate
• Warfarin → Vitamin K
• Magnesium sulfate → Calcium gluconate
Exam Pearl
Always monitor aPTT and assess for bleeding while a patient is receiving heparin.
, Question 4
When caring for a 3-day-old neonate receiving phototherapy for jaundice, what should the
nurse expect to do?
A. Turn the neonate every 6 hours.
B. Encourage the mother to discontinue breastfeeding.
C. Notify the physician if the skin becomes bronze in color.
D. Check vital signs every 2–4 hours.
CORRECT ANSWER
D. Check vital signs every 2–4 hours
NCLEX Rationale
Infants receiving phototherapy require frequent monitoring of:
• Temperature
• Hydration
• Skin condition
• Bilirubin levels
• Vital signs
Vital signs should be checked every 2–4 hours to detect complications such as dehydration or
temperature instability.
Why the Other Options Are Incorrect
• A: Infants should be repositioned approximately every 2 hours, not every 6 hours.
• B: Breastfeeding should continue to promote hydration and bilirubin excretion.
• C: Bronze discoloration (bronze baby syndrome) may occur but does not automatically
require discontinuation of therapy; the provider should evaluate the infant if it develops.
Memory Tip
Phototherapy = Eyes Covered, Baby Turned, Fluids Increased.
Exam Pearl
PREP GUIDE
500+ HIGH-YIELD QUESTIONS, ANSWERS, RATIONALES & MEMORY TRICKS FOR
NCLEX SUCCESS
Question 1
A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours.
For which of the following would the nurse be alert?
A. Endometritis
B. Endometriosis
C. Salpingitis
D. Pelvic thrombophlebitis
CORRECT ANSWER
A. Endometritis
NCLEX Rationale
Prolonged labor and prolonged rupture of membranes increase the risk of bacteria ascending
into the uterus, making postpartum endometritis the most likely complication. Signs include
fever, uterine tenderness, foul-smelling lochia, chills, and tachycardia.
Why the Other Options Are Incorrect
• B. Endometriosis: A chronic condition involving endometrial tissue outside the uterus,
not a postpartum infection.
• C. Salpingitis: Infection of the fallopian tubes, usually associated with pelvic
inflammatory disease rather than childbirth.
• D. Pelvic thrombophlebitis: A less common postpartum complication involving infected
pelvic veins.
Memory Tip
PROM + Prolonged Labor = Postpartum Endometritis
Exam Pearl
,Membranes ruptured for more than 18 hours significantly increase the risk of maternal and
neonatal infection.
Question 2
A client at 36 weeks gestation is scheduled for a routine ultrasound prior to amniocentesis.
Which statement indicates the need for further teaching?
A. The ultrasound will help locate the placenta.
B. The ultrasound identifies blood flow through the umbilical cord.
C. The test will determine where to insert the needle.
D. The ultrasound locates a pool of amniotic fluid.
CORRECT ANSWER
B. The ultrasound identifies blood flow through the umbilical cord.
NCLEX Rationale
Routine ultrasound before amniocentesis is used to:
• Locate the placenta.
• Determine fetal position.
• Identify a pocket of amniotic fluid.
• Guide safe needle insertion.
Assessment of blood flow through the umbilical cord requires Doppler ultrasound, not the
routine ultrasound performed for amniocentesis guidance.
Why the Other Options Are Incorrect
• A: Correct use of ultrasound.
• C: Correct use of ultrasound.
• D: Correct use of ultrasound.
Memory Tip
Ultrasound before amniocentesis = Placenta, Position, Pocket, Placement (4 Ps).
, Exam Pearl
Ultrasound guidance reduces the risk of fetal injury during amniocentesis.
Question 3
While the postpartum client is receiving heparin for thrombophlebitis, which medication
reverses heparin if complications develop?
A. Calcium gluconate
B. Protamine sulfate
C. Methylergonovine
D. Nitrofurantoin
CORRECT ANSWER
B. Protamine sulfate
NCLEX Rationale
Protamine sulfate binds to heparin and neutralizes its anticoagulant effect, making it the
antidote for heparin overdose or severe bleeding.
Why the Other Options Are Incorrect
• A. Calcium gluconate: Antidote for magnesium sulfate toxicity.
• C. Methylergonovine: Used to treat postpartum hemorrhage.
• D. Nitrofurantoin: Antibiotic used to treat urinary tract infections.
Memory Tip
• Heparin → Protamine sulfate
• Warfarin → Vitamin K
• Magnesium sulfate → Calcium gluconate
Exam Pearl
Always monitor aPTT and assess for bleeding while a patient is receiving heparin.
, Question 4
When caring for a 3-day-old neonate receiving phototherapy for jaundice, what should the
nurse expect to do?
A. Turn the neonate every 6 hours.
B. Encourage the mother to discontinue breastfeeding.
C. Notify the physician if the skin becomes bronze in color.
D. Check vital signs every 2–4 hours.
CORRECT ANSWER
D. Check vital signs every 2–4 hours
NCLEX Rationale
Infants receiving phototherapy require frequent monitoring of:
• Temperature
• Hydration
• Skin condition
• Bilirubin levels
• Vital signs
Vital signs should be checked every 2–4 hours to detect complications such as dehydration or
temperature instability.
Why the Other Options Are Incorrect
• A: Infants should be repositioned approximately every 2 hours, not every 6 hours.
• B: Breastfeeding should continue to promote hydration and bilirubin excretion.
• C: Bronze discoloration (bronze baby syndrome) may occur but does not automatically
require discontinuation of therapy; the provider should evaluate the infant if it develops.
Memory Tip
Phototherapy = Eyes Covered, Baby Turned, Fluids Increased.
Exam Pearl
