MATERNAL NEWBORN 2025/ 2026 PROCTORED WITH
NGN EXAM (REAL EXAM) ALL QUESTIONS AND
VERIFIED ANSWERS 100% CORRECT
MATERNAL–NEWBORN NURSING COMPREHENSIVE PRACTICE EXAM
1. A primigravida at 10 weeks’ gestation reports persistent nausea interfering
with oral intake. The nurse’s best first instruction:
A. Take a single large meal at night.
B. Eat small, frequent protein-based snacks throughout the day.
C. Drink large volumes of water with meals.
D. Avoid all carbohydrates.
Answer: B. Rationale: Small, frequent protein snacks reduce nausea and
help maintain nutrition; large meals or excess fluids with meals often worsen
nausea.
2. A woman at 38 weeks with spontaneous ROM and clear fluid asks what to
expect next. The nurse’s best response:
A. You must leave immediately for home rest.
B. Stay for evaluation—risk of infection after ROM; monitor labor and fetal
status.
C. You can ignore it if contractions are absent.
D. Start a tocolytic to delay labor.
Answer: B. Rationale: Rupture of membranes requires assessment for labor
onset and infection risk; observation and monitoring are appropriate.
3. During active labor a patient’s blood pressure falls from 120/76 to 88/54
after epidural placement. The nurse should first:
A. Give oral fluids.
B. Reposition (left lateral), increase IV fluids, and notify anesthesia.
C. Encourage deep breathing.
D. Encourage pushing.
Answer: B. Rationale: Epidural-associated hypotension requires immediate
repositioning, IV bolus, and vasopressor/anaesthesia management to restore
uteroplacental perfusion.
4. A newborn at 6 hours has central cyanosis and weak respiratory effort after
meconium-stained fluid. The immediate action:
A. Routine care.
, B. Intubate and suction trachea as indicated; begin neonatal resuscitation.
C. Delay resuscitation for 30 minutes.
D. Place under phototherapy.
Answer: B. Rationale: Nonvigorous infants with meconium require airway
management and possible intubation per neonatal resuscitation guidelines.
5. A postpartum client 2 hours after vaginal birth with boggy fundus and heavy
lochia—first nursing action:
A. Fundal massage and check bladder.
B. Call family.
C. Apply cold packs only.
D. Ambulate patient.
Answer: A. Rationale: Fundal massage is first-line for uterine atony;
bladder distention can prevent contraction and should be addressed.
6. A 28-week pregnant woman receives betamethasone. The main purpose is
to:
A. Treat maternal infection.
B. Promote fetal lung maturity and surfactant production.
C. Prevent preterm labor permanently.
D. Increase maternal blood pressure.
Answer: B. Rationale: Antenatal corticosteroids accelerate fetal lung
maturity and reduce neonatal RDS risk.
7. A mother with group B strep positive in labor should receive:
A. No antibiotics if asymptomatic.
B. Intrapartum IV penicillin or appropriate alternative.
C. Oral antibiotics post-delivery only.
D. Tocolytics.
Answer: B. Rationale: Intrapartum antibiotics reduce neonatal GBS
transmission and are standard for colonized mothers.
8. A newborn feeding poorly with jitteriness and a glucose of 30 mg/dL should
be:
A. Fed immediately (breast or glucose gel) and recheck glucose.
B. Left to sleep and recheck later.
C. Given insulin.
D. Sent home.
, Answer: A. Rationale: Neonatal hypoglycemia requires prompt feeding or
glucose gel and monitoring; insulin is contraindicated.
9. A pregnant client has painless bright red bleeding at 34 weeks. The nurse
should:
A. Suspect placenta previa and prepare for ultrasound; avoid vaginal exams.
B. Encourage ambulation.
C. Immediately induce labor.
D. Tell her bed rest will stop bleeding.
Answer: A. Rationale: Painless late-gestation bleeding suggests placenta
previa; vaginal exam may cause hemorrhage—ultrasound is indicated.
10. A laboring client has late decelerations with minimal variability. Priority
nursing action:
A. Reposition, give oxygen, IV bolus, stop oxytocin if infusing.
B. Increase oxytocin.
C. Encourage pushing.
D. Document and observe only.
Answer: A. Rationale: Late decelerations indicate uteroplacental
insufficiency; intrauterine resuscitation is priority.
11. A breastfeeding mother reports bright red blood in her breast and fever on
day 7 postpartum. The nurse suspects:
A. Mastitis and encourages continued breastfeeding and antibiotic therapy.
B. Engorgement only.
C. Normal change—no treatment.
D. Uterine atony.
Answer: A. Rationale: Localized erythema, tenderness, systemic fever
suggests mastitis; continued milk removal and antibiotics are indicated.
12. A newborn with a positive Ortolani test needs referral for:
A. Developmental dysplasia of the hip—orthopedic follow-up and imaging.
B. Cardiology.
C. ENT.
D. Dermatology.
Answer: A. Rationale: Positive Ortolani indicates hip instability—early
evaluation improves outcomes.
13. A laboring client with oxytocin infusion develops uterine tachysystole with
fetal bradycardia. The nurse should:
, A. Stop oxytocin infusion and begin intrauterine resuscitation.
B. Increase infusion.
C. Encourage pushing.
D. Give antibiotics.
Answer: A. Rationale: Hyperstimulation compromising fetus requires
immediate cessation of oxytocin and resuscitative measures.
14. A postpartum client’s uterus is displaced to the right after delivery and
boggy. The nurse should first:
A. Assist the client to void or catheterize.
B. Apply heat.
C. Increase oral fluids only.
D. Encourage ambulation.
Answer: A. Rationale: A full bladder displaces uterus and leads to atony;
emptying bladder is first step.
15. A newborn at term has jaundice on day 3 with bilirubin 16 mg/dL. The
appropriate action:
A. Evaluate using age-specific phototherapy nomogram and start
phototherapy if threshold met.
B. Ignore as physiologic always.
C. Immediate exchange transfusion.
D. Start antibiotics.
Answer: A. Rationale: Jaundice requires assessment with hour-of-life and
risk factor-based thresholds to decide phototherapy vs other interventions.
16. A pregnant client with preeclampsia has magnesium sulfate infusion—loss
of deep tendon reflexes occurs. The nurse should:
A. Stop magnesium and prepare calcium gluconate.
B. Increase infusion rate.
C. Encourage fluids only.
D. Document and continue.
Answer: A. Rationale: Loss of DTRs is an early sign of magnesium toxicity;
infusion should be stopped and antidote given.
17. A newborn with meconium-stained fluid is vigorous at birth. Management
should be:
A. Routine care and observation.
B. Immediate intubation and suctioning.
NGN EXAM (REAL EXAM) ALL QUESTIONS AND
VERIFIED ANSWERS 100% CORRECT
MATERNAL–NEWBORN NURSING COMPREHENSIVE PRACTICE EXAM
1. A primigravida at 10 weeks’ gestation reports persistent nausea interfering
with oral intake. The nurse’s best first instruction:
A. Take a single large meal at night.
B. Eat small, frequent protein-based snacks throughout the day.
C. Drink large volumes of water with meals.
D. Avoid all carbohydrates.
Answer: B. Rationale: Small, frequent protein snacks reduce nausea and
help maintain nutrition; large meals or excess fluids with meals often worsen
nausea.
2. A woman at 38 weeks with spontaneous ROM and clear fluid asks what to
expect next. The nurse’s best response:
A. You must leave immediately for home rest.
B. Stay for evaluation—risk of infection after ROM; monitor labor and fetal
status.
C. You can ignore it if contractions are absent.
D. Start a tocolytic to delay labor.
Answer: B. Rationale: Rupture of membranes requires assessment for labor
onset and infection risk; observation and monitoring are appropriate.
3. During active labor a patient’s blood pressure falls from 120/76 to 88/54
after epidural placement. The nurse should first:
A. Give oral fluids.
B. Reposition (left lateral), increase IV fluids, and notify anesthesia.
C. Encourage deep breathing.
D. Encourage pushing.
Answer: B. Rationale: Epidural-associated hypotension requires immediate
repositioning, IV bolus, and vasopressor/anaesthesia management to restore
uteroplacental perfusion.
4. A newborn at 6 hours has central cyanosis and weak respiratory effort after
meconium-stained fluid. The immediate action:
A. Routine care.
, B. Intubate and suction trachea as indicated; begin neonatal resuscitation.
C. Delay resuscitation for 30 minutes.
D. Place under phototherapy.
Answer: B. Rationale: Nonvigorous infants with meconium require airway
management and possible intubation per neonatal resuscitation guidelines.
5. A postpartum client 2 hours after vaginal birth with boggy fundus and heavy
lochia—first nursing action:
A. Fundal massage and check bladder.
B. Call family.
C. Apply cold packs only.
D. Ambulate patient.
Answer: A. Rationale: Fundal massage is first-line for uterine atony;
bladder distention can prevent contraction and should be addressed.
6. A 28-week pregnant woman receives betamethasone. The main purpose is
to:
A. Treat maternal infection.
B. Promote fetal lung maturity and surfactant production.
C. Prevent preterm labor permanently.
D. Increase maternal blood pressure.
Answer: B. Rationale: Antenatal corticosteroids accelerate fetal lung
maturity and reduce neonatal RDS risk.
7. A mother with group B strep positive in labor should receive:
A. No antibiotics if asymptomatic.
B. Intrapartum IV penicillin or appropriate alternative.
C. Oral antibiotics post-delivery only.
D. Tocolytics.
Answer: B. Rationale: Intrapartum antibiotics reduce neonatal GBS
transmission and are standard for colonized mothers.
8. A newborn feeding poorly with jitteriness and a glucose of 30 mg/dL should
be:
A. Fed immediately (breast or glucose gel) and recheck glucose.
B. Left to sleep and recheck later.
C. Given insulin.
D. Sent home.
, Answer: A. Rationale: Neonatal hypoglycemia requires prompt feeding or
glucose gel and monitoring; insulin is contraindicated.
9. A pregnant client has painless bright red bleeding at 34 weeks. The nurse
should:
A. Suspect placenta previa and prepare for ultrasound; avoid vaginal exams.
B. Encourage ambulation.
C. Immediately induce labor.
D. Tell her bed rest will stop bleeding.
Answer: A. Rationale: Painless late-gestation bleeding suggests placenta
previa; vaginal exam may cause hemorrhage—ultrasound is indicated.
10. A laboring client has late decelerations with minimal variability. Priority
nursing action:
A. Reposition, give oxygen, IV bolus, stop oxytocin if infusing.
B. Increase oxytocin.
C. Encourage pushing.
D. Document and observe only.
Answer: A. Rationale: Late decelerations indicate uteroplacental
insufficiency; intrauterine resuscitation is priority.
11. A breastfeeding mother reports bright red blood in her breast and fever on
day 7 postpartum. The nurse suspects:
A. Mastitis and encourages continued breastfeeding and antibiotic therapy.
B. Engorgement only.
C. Normal change—no treatment.
D. Uterine atony.
Answer: A. Rationale: Localized erythema, tenderness, systemic fever
suggests mastitis; continued milk removal and antibiotics are indicated.
12. A newborn with a positive Ortolani test needs referral for:
A. Developmental dysplasia of the hip—orthopedic follow-up and imaging.
B. Cardiology.
C. ENT.
D. Dermatology.
Answer: A. Rationale: Positive Ortolani indicates hip instability—early
evaluation improves outcomes.
13. A laboring client with oxytocin infusion develops uterine tachysystole with
fetal bradycardia. The nurse should:
, A. Stop oxytocin infusion and begin intrauterine resuscitation.
B. Increase infusion.
C. Encourage pushing.
D. Give antibiotics.
Answer: A. Rationale: Hyperstimulation compromising fetus requires
immediate cessation of oxytocin and resuscitative measures.
14. A postpartum client’s uterus is displaced to the right after delivery and
boggy. The nurse should first:
A. Assist the client to void or catheterize.
B. Apply heat.
C. Increase oral fluids only.
D. Encourage ambulation.
Answer: A. Rationale: A full bladder displaces uterus and leads to atony;
emptying bladder is first step.
15. A newborn at term has jaundice on day 3 with bilirubin 16 mg/dL. The
appropriate action:
A. Evaluate using age-specific phototherapy nomogram and start
phototherapy if threshold met.
B. Ignore as physiologic always.
C. Immediate exchange transfusion.
D. Start antibiotics.
Answer: A. Rationale: Jaundice requires assessment with hour-of-life and
risk factor-based thresholds to decide phototherapy vs other interventions.
16. A pregnant client with preeclampsia has magnesium sulfate infusion—loss
of deep tendon reflexes occurs. The nurse should:
A. Stop magnesium and prepare calcium gluconate.
B. Increase infusion rate.
C. Encourage fluids only.
D. Document and continue.
Answer: A. Rationale: Loss of DTRs is an early sign of magnesium toxicity;
infusion should be stopped and antidote given.
17. A newborn with meconium-stained fluid is vigorous at birth. Management
should be:
A. Routine care and observation.
B. Immediate intubation and suctioning.
