NCLEX-RN Maternal-Newborn Nursing
Exam 2 Practice Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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1. A nurse is assessing a pregnant client at 32 weeks of gestation. Which finding
should the nurse report immediately?
A. Mild ankle edema at the end of the day
B. Urinary frequency
C. Blood pressure of 168/110 mmHg
D. Increased fetal movement
Answer: Blood pressure of 168/110 mmHg
Rationale: Severe hypertension during pregnancy may indicate preeclampsia
with severe features and requires immediate evaluation to prevent
complications.
2. A nurse is teaching a pregnant client about fetal movement counting. Which
instruction is appropriate?
A. Count movements after meals when the fetus is often active
B. Count only movements that cause discomfort
,C. Perform counts once a month
D. Stop counting after 28 weeks
Answer: Count movements after meals when the fetus is often active
Rationale: Fetal movement counts are commonly performed when the fetus is
usually active, often after meals, to monitor fetal well-being.
3. A nurse is caring for a client receiving oxytocin during labor. Which
assessment finding requires immediate intervention?
A. Contractions every 3 minutes
B. Cervical dilation of 6 cm
C. Uterine contractions lasting 90 seconds with minimal relaxation
D. Increased bloody show
Answer: Uterine contractions lasting 90 seconds with minimal relaxation
Rationale: Excessively frequent or prolonged contractions can reduce
uteroplacental perfusion and cause fetal distress.
4. A nurse is teaching a pregnant client about nutrition. Which food is the best
source of folic acid?
A. Cheese
B. Leafy green vegetables
C. Chicken
D. Fish
Answer: Leafy green vegetables
Rationale: Folate-rich foods help prevent neural tube defects during fetal
development.
,5. A newborn has an Apgar score of 4 at 1 minute. What is the nurse’s priority
action?
A. Begin immediate newborn resuscitation measures
B. Bathe the newborn
C. Initiate breastfeeding
D. Obtain a newborn weight
Answer: Begin immediate newborn resuscitation measures
Rationale: A low Apgar score indicates the need for prompt assessment and
possible resuscitation interventions.
6. A nurse assesses a postpartum client 2 hours after delivery. Which finding
requires immediate attention?
A. Fundus firm and midline
B. Scant lochia rubra
C. Boggy uterus with heavy vaginal bleeding
D. Mild perineal discomfort
Answer: Boggy uterus with heavy vaginal bleeding
Rationale: A boggy uterus indicates uterine atony, the most common cause of
postpartum hemorrhage.
7. A nurse is caring for a client receiving magnesium sulfate for preeclampsia.
Which finding indicates toxicity?
A. Respiratory rate of 10/min
B. Blood pressure of 140/90 mmHg
C. Increased urine output
D. Hyperactive reflexes
Answer: Respiratory rate of 10/min
, Rationale: Respiratory depression is a sign of magnesium toxicity and requires
immediate intervention.
8. Which assessment finding is expected in a healthy newborn?
A. Heart rate of 80 beats/min
B. Acrocyanosis during the first hours after birth
C. Absent reflexes
D. Persistent central cyanosis
Answer: Acrocyanosis during the first hours after birth
Rationale: Bluish discoloration of the hands and feet is common shortly after
birth due to immature circulation.
9. A nurse is caring for a client in labor with an epidural anesthesia. Which
assessment is priority?
A. Hair texture
B. Blood pressure
C. Appetite
D. Skin pigmentation
Answer: Blood pressure
Rationale: Epidural anesthesia can cause hypotension, which may decrease
uteroplacental perfusion.
10. A nurse teaches a postpartum client about lochia. Which statement indicates
understanding?
A. “Lochia should become heavier each day.”
B. “Lochia rubra occurs during the first few days after birth.”
Exam 2 Practice Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A nurse is assessing a pregnant client at 32 weeks of gestation. Which finding
should the nurse report immediately?
A. Mild ankle edema at the end of the day
B. Urinary frequency
C. Blood pressure of 168/110 mmHg
D. Increased fetal movement
Answer: Blood pressure of 168/110 mmHg
Rationale: Severe hypertension during pregnancy may indicate preeclampsia
with severe features and requires immediate evaluation to prevent
complications.
2. A nurse is teaching a pregnant client about fetal movement counting. Which
instruction is appropriate?
A. Count movements after meals when the fetus is often active
B. Count only movements that cause discomfort
,C. Perform counts once a month
D. Stop counting after 28 weeks
Answer: Count movements after meals when the fetus is often active
Rationale: Fetal movement counts are commonly performed when the fetus is
usually active, often after meals, to monitor fetal well-being.
3. A nurse is caring for a client receiving oxytocin during labor. Which
assessment finding requires immediate intervention?
A. Contractions every 3 minutes
B. Cervical dilation of 6 cm
C. Uterine contractions lasting 90 seconds with minimal relaxation
D. Increased bloody show
Answer: Uterine contractions lasting 90 seconds with minimal relaxation
Rationale: Excessively frequent or prolonged contractions can reduce
uteroplacental perfusion and cause fetal distress.
4. A nurse is teaching a pregnant client about nutrition. Which food is the best
source of folic acid?
A. Cheese
B. Leafy green vegetables
C. Chicken
D. Fish
Answer: Leafy green vegetables
Rationale: Folate-rich foods help prevent neural tube defects during fetal
development.
,5. A newborn has an Apgar score of 4 at 1 minute. What is the nurse’s priority
action?
A. Begin immediate newborn resuscitation measures
B. Bathe the newborn
C. Initiate breastfeeding
D. Obtain a newborn weight
Answer: Begin immediate newborn resuscitation measures
Rationale: A low Apgar score indicates the need for prompt assessment and
possible resuscitation interventions.
6. A nurse assesses a postpartum client 2 hours after delivery. Which finding
requires immediate attention?
A. Fundus firm and midline
B. Scant lochia rubra
C. Boggy uterus with heavy vaginal bleeding
D. Mild perineal discomfort
Answer: Boggy uterus with heavy vaginal bleeding
Rationale: A boggy uterus indicates uterine atony, the most common cause of
postpartum hemorrhage.
7. A nurse is caring for a client receiving magnesium sulfate for preeclampsia.
Which finding indicates toxicity?
A. Respiratory rate of 10/min
B. Blood pressure of 140/90 mmHg
C. Increased urine output
D. Hyperactive reflexes
Answer: Respiratory rate of 10/min
, Rationale: Respiratory depression is a sign of magnesium toxicity and requires
immediate intervention.
8. Which assessment finding is expected in a healthy newborn?
A. Heart rate of 80 beats/min
B. Acrocyanosis during the first hours after birth
C. Absent reflexes
D. Persistent central cyanosis
Answer: Acrocyanosis during the first hours after birth
Rationale: Bluish discoloration of the hands and feet is common shortly after
birth due to immature circulation.
9. A nurse is caring for a client in labor with an epidural anesthesia. Which
assessment is priority?
A. Hair texture
B. Blood pressure
C. Appetite
D. Skin pigmentation
Answer: Blood pressure
Rationale: Epidural anesthesia can cause hypotension, which may decrease
uteroplacental perfusion.
10. A nurse teaches a postpartum client about lochia. Which statement indicates
understanding?
A. “Lochia should become heavier each day.”
B. “Lochia rubra occurs during the first few days after birth.”
