1
Maternal/Newborn Nursing Exam Prep | 120 Advanced
Practice Questions with Verified Answers & Detailed
Rationales | Complete Review for Nursing Students |
NCLEX-Aligned | Graded A+
SECTION 1: ANTEPARTUM CARE (Questions 1–25)
1. A nurse is providing education to a client who is 8 weeks pregnant. The client asks about
the expected weight gain during pregnancy. What is the recommended weight gain for a client
with a normal pre-pregnancy BMI (18.5–24.9)?
A. 15–25 lb (6.8–11.3 kg)
B. 25–35 lb (11.3–15.9 kg)
C. 28–40 lb (12.7–18.1 kg)
D. 11–20 lb (5.0–9.1 kg)
Correct Answer: B
Rationale: The recommended weight gain for a client with a normal BMI is 25–35 lb.
Underweight clients (BMI <18.5) should gain 28–40 lb, overweight clients (BMI 25–29.9) should
gain 15–25 lb, and obese clients (BMI ≥30) should gain 11–20 lb. Proper weight gain supports
fetal growth and reduces complications.
2. A nurse is assessing a client at 12 weeks gestation. Which physiological change of
pregnancy is expected?
A. Decreased respiratory rate
B. Decreased cardiac output
C. Increased blood volume
D. Decreased glomerular filtration rate
Correct Answer: C
Rationale: Blood volume increases by approximately 40–50% during pregnancy, peaking at 32–
34 weeks. This increase supports fetal perfusion and prepares for blood loss at delivery.
, 2
Respiratory rate may increase slightly, cardiac output increases, and glomerular filtration rate
increases.
3. A nurse is teaching a client about folic acid supplementation during pregnancy. Which
amount is recommended daily?
A. 200 mcg
B. 400 mcg
C. 600 mcg
D. 1000 mcg
Correct Answer: C
Rationale: The recommended daily folic acid intake during pregnancy is 600 mcg. Folic acid is
crucial for preventing neural tube defects. Women should begin supplementation before
conception and continue through the first trimester.
4. A nurse is assessing a client who is 14 weeks pregnant. Which presumptive sign of
pregnancy is the client most likely to report?
A. Positive pregnancy test
B. Fetal heart tones
C. Amenorrhea
D. Goodell's sign
Correct Answer: C
Rationale: Amenorrhea (absence of menstruation) is a presumptive sign of pregnancy.
Presumptive signs are subjective and can be caused by other conditions. Positive pregnancy test
is a probable sign, fetal heart tones are a positive sign, and Goodell's sign (softening of the
cervix) is a probable sign.
5. A nurse is auscultating fetal heart tones at a client's 20-week prenatal visit. Where should
the nurse place the Doppler ultrasound device?
A. Above the umbilicus
B. At the level of the umbilicus
C. Below the umbilicus in the midline
D. In the right upper quadrant
, 3
Correct Answer: C
Rationale: At 20 weeks gestation, the fundus is at the level of the umbilicus, and fetal heart
tones are best auscultated below the umbilicus in the midline. As pregnancy progresses, the
location of fetal heart tones depends on fetal position.
6. A nurse is providing education about danger signs during pregnancy. Which symptom
should the nurse instruct the client to report immediately?
A. Nausea in the first trimester
B. Breast tenderness
C. Blurred vision
D. Frequent urination
Correct Answer: C
Rationale: Blurred vision is a danger sign that may indicate preeclampsia, a serious hypertensive
disorder of pregnancy that requires immediate evaluation. Nausea, breast tenderness, and
frequent urination are expected discomforts of pregnancy.
7. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule for a client
whose last menstrual period (LMP) was March 10. What is the EDD?
A. December 3
B. December 17
C. January 3
D. January 17
Correct Answer: B
Rationale: Naegele's rule: add 7 days to the first day of the LMP and subtract 3 months. March
10 + 7 days = March 17; subtract 3 months = December 17.
8. A nurse is assessing a client at 16 weeks gestation. Which finding should the nurse
recognize as an expected cardiovascular change?
A. Decreased pulse rate
B. Increased blood pressure
, 4
C. Systolic ejection murmur
D. Jugular venous distention
Correct Answer: C
Rationale: A systolic ejection murmur is an expected finding during pregnancy due to increased
blood volume and cardiac output. Pulse rate increases by 10–15 beats per minute. Blood
pressure typically decreases in the second trimester. Jugular venous distention is abnormal.
9. A nurse is teaching a group of prenatal clients about nutrition. Which dietary instruction
should the nurse include?
A. Increase calcium intake to 1000 mg daily
B. Increase iron intake to 27 mg daily
C. Avoid all fish during pregnancy
D. Limit caffeine to 400 mg daily
Correct Answer: B
Rationale: Iron requirements increase to 27 mg daily during pregnancy to support maternal red
blood cell production and fetal iron stores. Calcium requirement is 1000–1300 mg daily. Fish
should be limited but not completely avoided; caffeine should be limited to <200 mg daily.
10. A nurse is assessing a client at 10 weeks gestation who reports persistent nausea and
vomiting. Which intervention should the nurse recommend?
A. Eat large meals three times daily
B. Drink fluids with meals
C. Eat dry crackers before getting out of bed
D. Avoid all carbohydrates
Correct Answer: C
Rationale: Eating dry crackers or toast before getting out of bed can help alleviate morning
sickness. Small, frequent meals are recommended; fluids should be taken between meals, not
with meals. Carbohydrates should not be avoided entirely.
11. A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. What is the
purpose of the first maneuver?
Maternal/Newborn Nursing Exam Prep | 120 Advanced
Practice Questions with Verified Answers & Detailed
Rationales | Complete Review for Nursing Students |
NCLEX-Aligned | Graded A+
SECTION 1: ANTEPARTUM CARE (Questions 1–25)
1. A nurse is providing education to a client who is 8 weeks pregnant. The client asks about
the expected weight gain during pregnancy. What is the recommended weight gain for a client
with a normal pre-pregnancy BMI (18.5–24.9)?
A. 15–25 lb (6.8–11.3 kg)
B. 25–35 lb (11.3–15.9 kg)
C. 28–40 lb (12.7–18.1 kg)
D. 11–20 lb (5.0–9.1 kg)
Correct Answer: B
Rationale: The recommended weight gain for a client with a normal BMI is 25–35 lb.
Underweight clients (BMI <18.5) should gain 28–40 lb, overweight clients (BMI 25–29.9) should
gain 15–25 lb, and obese clients (BMI ≥30) should gain 11–20 lb. Proper weight gain supports
fetal growth and reduces complications.
2. A nurse is assessing a client at 12 weeks gestation. Which physiological change of
pregnancy is expected?
A. Decreased respiratory rate
B. Decreased cardiac output
C. Increased blood volume
D. Decreased glomerular filtration rate
Correct Answer: C
Rationale: Blood volume increases by approximately 40–50% during pregnancy, peaking at 32–
34 weeks. This increase supports fetal perfusion and prepares for blood loss at delivery.
, 2
Respiratory rate may increase slightly, cardiac output increases, and glomerular filtration rate
increases.
3. A nurse is teaching a client about folic acid supplementation during pregnancy. Which
amount is recommended daily?
A. 200 mcg
B. 400 mcg
C. 600 mcg
D. 1000 mcg
Correct Answer: C
Rationale: The recommended daily folic acid intake during pregnancy is 600 mcg. Folic acid is
crucial for preventing neural tube defects. Women should begin supplementation before
conception and continue through the first trimester.
4. A nurse is assessing a client who is 14 weeks pregnant. Which presumptive sign of
pregnancy is the client most likely to report?
A. Positive pregnancy test
B. Fetal heart tones
C. Amenorrhea
D. Goodell's sign
Correct Answer: C
Rationale: Amenorrhea (absence of menstruation) is a presumptive sign of pregnancy.
Presumptive signs are subjective and can be caused by other conditions. Positive pregnancy test
is a probable sign, fetal heart tones are a positive sign, and Goodell's sign (softening of the
cervix) is a probable sign.
5. A nurse is auscultating fetal heart tones at a client's 20-week prenatal visit. Where should
the nurse place the Doppler ultrasound device?
A. Above the umbilicus
B. At the level of the umbilicus
C. Below the umbilicus in the midline
D. In the right upper quadrant
, 3
Correct Answer: C
Rationale: At 20 weeks gestation, the fundus is at the level of the umbilicus, and fetal heart
tones are best auscultated below the umbilicus in the midline. As pregnancy progresses, the
location of fetal heart tones depends on fetal position.
6. A nurse is providing education about danger signs during pregnancy. Which symptom
should the nurse instruct the client to report immediately?
A. Nausea in the first trimester
B. Breast tenderness
C. Blurred vision
D. Frequent urination
Correct Answer: C
Rationale: Blurred vision is a danger sign that may indicate preeclampsia, a serious hypertensive
disorder of pregnancy that requires immediate evaluation. Nausea, breast tenderness, and
frequent urination are expected discomforts of pregnancy.
7. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule for a client
whose last menstrual period (LMP) was March 10. What is the EDD?
A. December 3
B. December 17
C. January 3
D. January 17
Correct Answer: B
Rationale: Naegele's rule: add 7 days to the first day of the LMP and subtract 3 months. March
10 + 7 days = March 17; subtract 3 months = December 17.
8. A nurse is assessing a client at 16 weeks gestation. Which finding should the nurse
recognize as an expected cardiovascular change?
A. Decreased pulse rate
B. Increased blood pressure
, 4
C. Systolic ejection murmur
D. Jugular venous distention
Correct Answer: C
Rationale: A systolic ejection murmur is an expected finding during pregnancy due to increased
blood volume and cardiac output. Pulse rate increases by 10–15 beats per minute. Blood
pressure typically decreases in the second trimester. Jugular venous distention is abnormal.
9. A nurse is teaching a group of prenatal clients about nutrition. Which dietary instruction
should the nurse include?
A. Increase calcium intake to 1000 mg daily
B. Increase iron intake to 27 mg daily
C. Avoid all fish during pregnancy
D. Limit caffeine to 400 mg daily
Correct Answer: B
Rationale: Iron requirements increase to 27 mg daily during pregnancy to support maternal red
blood cell production and fetal iron stores. Calcium requirement is 1000–1300 mg daily. Fish
should be limited but not completely avoided; caffeine should be limited to <200 mg daily.
10. A nurse is assessing a client at 10 weeks gestation who reports persistent nausea and
vomiting. Which intervention should the nurse recommend?
A. Eat large meals three times daily
B. Drink fluids with meals
C. Eat dry crackers before getting out of bed
D. Avoid all carbohydrates
Correct Answer: C
Rationale: Eating dry crackers or toast before getting out of bed can help alleviate morning
sickness. Small, frequent meals are recommended; fluids should be taken between meals, not
with meals. Carbohydrates should not be avoided entirely.
11. A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. What is the
purpose of the first maneuver?
