NCLEX-PN MATERNAL-NEWBORN
CLINICAL JUDGMENT QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
| INSTANT DOWNLOAD PDF.
Core Domains
1. Antepartum Care and Assessment
2. Intrapartum Care and Fetal Monitoring
3. Postpartum Care and Complications
4. Newborn Assessment and Transition
5. High-Risk Pregnancy and Complications
6. Labor and Delivery Medications
7. Breastfeeding and Newborn Nutrition
8. Postpartum Mood and Mental Health
9. Contraception and Discharge Teaching
10. Clinical Judgment and Prioritization
Introduction
The NCLEX-PN Maternal-Newborn Clinical Judgment Examination
assesses the practical nurse's ability to apply clinical judgment in
the care of childbearing families and newborns. It evaluates
antepartum, intrapartum, postpartum, and neonatal assessment,
recognition of complications, medication administration, patient
teaching, and prioritization of care. Candidates must demonstrate
safe decision-making, effective communication, and adherence to
evidence-based practice. Multiple-choice and scenario-based
items require synthesis of foundational maternal-newborn theory,
real-world application, and critical thinking to ensure safe,
compassionate, and family-centered care.
,Section One: Questions 1–100
1. A pregnant client at 32 weeks' gestation reports a
sudden gush of fluid from the vagina. Which action should
the nurse take first?
A. Perform a sterile speculum examination
B. Check the fetal heart rate
C. Test the fluid with nitrazine paper
D. Place the client in Trendelenburg position
Correct answer: B
RATIONALE: The priority after suspected rupture of
membranes is to assess fetal well-being by checking the fetal
heart rate. Then the nurse can test the fluid and prepare for
further evaluation.
2. A client in active labor has an epidural infusion. Which
finding requires immediate intervention?
A. Blood pressure 100/60 mm Hg
B. Fetal heart rate 150 bpm
C. Urinary output 30 mL/hr
D. Sudden severe headache
Correct answer: D
RATIONALE: Sudden severe headache after epidural may
indicate dural puncture and cerebrospinal fluid leak, requiring
immediate evaluation. The other findings are within normal limits.
3. A postpartum client is 2 hours post-vaginal delivery.
Which assessment finding is most concerning?
A. Lochia rubra saturating one pad in 2 hours
B. Fundus firm at midline
,C. Blood pressure 110/70 mm Hg
D. Heart rate 88 bpm
Correct answer: A
RATIONALE: Saturating one pad in 2 hours is excessive
bleeding and may indicate postpartum hemorrhage. A firm fundus
is expected, and vital signs are normal.
4. A newborn is 1 hour old. Which finding requires
immediate intervention?
A. Respiratory rate 50 breaths/min
B. Heart rate 130 bpm
C. Axillary temperature 97.2°F (36.2°C)
D. Acrocyanosis
Correct answer: C
RATIONALE: A temperature below 97.7°F (36.5°C) indicates
cold stress and requires immediate warming. The other findings
are normal for a newborn.
5. A client at 36 weeks' gestation has a blood pressure of
160/110 mm Hg and 3+ proteinuria. Which action should
the nurse take first?
A. Administer hydralazine as prescribed
B. Assess deep tendon reflexes
C. Obtain a urine sample
D. Place the client in a supine position
Correct answer: B
RATIONALE: Assessing deep tendon reflexes helps evaluate
for hyperreflexia, a sign of worsening preeclampsia. Then
medications can be administered.
, 6. A client in labor is receiving oxytocin. Which finding
requires stopping the infusion?
A. Contractions every 3 minutes lasting 40 seconds
B. Fetal heart rate 140 bpm
C. Contractions lasting 90 seconds with a 30-second rest
D. Blood pressure 120/80 mm Hg
Correct answer: C
RATIONALE: Contractions lasting longer than 90 seconds with
less than 60 seconds rest indicate hyperstimulation and require
stopping oxytocin to prevent fetal distress.
7. A postpartum client is breastfeeding and reports sore
nipples. Which instruction should the nurse provide?
A. Apply alcohol to the nipples after feeding
B. Ensure proper latch and break suction before removing infant
C. Limit feeding to 5 minutes per breast
D. Use soap to wash nipples before feeding
Correct answer: B
RATIONALE: Proper latch and breaking suction are key to
preventing nipple trauma. Alcohol and soap can dry the nipples,
and limiting feeding time may not resolve the issue.
8. A newborn has a bilirubin level of 18 mg/dL at 48 hours
of age. Which intervention should the nurse anticipate?
A. Initiate phototherapy
B. Administer antibiotics
C. Prepare for exchange transfusion
D. Encourage increased oral feedings only
Correct answer: A
CLINICAL JUDGMENT QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
| INSTANT DOWNLOAD PDF.
Core Domains
1. Antepartum Care and Assessment
2. Intrapartum Care and Fetal Monitoring
3. Postpartum Care and Complications
4. Newborn Assessment and Transition
5. High-Risk Pregnancy and Complications
6. Labor and Delivery Medications
7. Breastfeeding and Newborn Nutrition
8. Postpartum Mood and Mental Health
9. Contraception and Discharge Teaching
10. Clinical Judgment and Prioritization
Introduction
The NCLEX-PN Maternal-Newborn Clinical Judgment Examination
assesses the practical nurse's ability to apply clinical judgment in
the care of childbearing families and newborns. It evaluates
antepartum, intrapartum, postpartum, and neonatal assessment,
recognition of complications, medication administration, patient
teaching, and prioritization of care. Candidates must demonstrate
safe decision-making, effective communication, and adherence to
evidence-based practice. Multiple-choice and scenario-based
items require synthesis of foundational maternal-newborn theory,
real-world application, and critical thinking to ensure safe,
compassionate, and family-centered care.
,Section One: Questions 1–100
1. A pregnant client at 32 weeks' gestation reports a
sudden gush of fluid from the vagina. Which action should
the nurse take first?
A. Perform a sterile speculum examination
B. Check the fetal heart rate
C. Test the fluid with nitrazine paper
D. Place the client in Trendelenburg position
Correct answer: B
RATIONALE: The priority after suspected rupture of
membranes is to assess fetal well-being by checking the fetal
heart rate. Then the nurse can test the fluid and prepare for
further evaluation.
2. A client in active labor has an epidural infusion. Which
finding requires immediate intervention?
A. Blood pressure 100/60 mm Hg
B. Fetal heart rate 150 bpm
C. Urinary output 30 mL/hr
D. Sudden severe headache
Correct answer: D
RATIONALE: Sudden severe headache after epidural may
indicate dural puncture and cerebrospinal fluid leak, requiring
immediate evaluation. The other findings are within normal limits.
3. A postpartum client is 2 hours post-vaginal delivery.
Which assessment finding is most concerning?
A. Lochia rubra saturating one pad in 2 hours
B. Fundus firm at midline
,C. Blood pressure 110/70 mm Hg
D. Heart rate 88 bpm
Correct answer: A
RATIONALE: Saturating one pad in 2 hours is excessive
bleeding and may indicate postpartum hemorrhage. A firm fundus
is expected, and vital signs are normal.
4. A newborn is 1 hour old. Which finding requires
immediate intervention?
A. Respiratory rate 50 breaths/min
B. Heart rate 130 bpm
C. Axillary temperature 97.2°F (36.2°C)
D. Acrocyanosis
Correct answer: C
RATIONALE: A temperature below 97.7°F (36.5°C) indicates
cold stress and requires immediate warming. The other findings
are normal for a newborn.
5. A client at 36 weeks' gestation has a blood pressure of
160/110 mm Hg and 3+ proteinuria. Which action should
the nurse take first?
A. Administer hydralazine as prescribed
B. Assess deep tendon reflexes
C. Obtain a urine sample
D. Place the client in a supine position
Correct answer: B
RATIONALE: Assessing deep tendon reflexes helps evaluate
for hyperreflexia, a sign of worsening preeclampsia. Then
medications can be administered.
, 6. A client in labor is receiving oxytocin. Which finding
requires stopping the infusion?
A. Contractions every 3 minutes lasting 40 seconds
B. Fetal heart rate 140 bpm
C. Contractions lasting 90 seconds with a 30-second rest
D. Blood pressure 120/80 mm Hg
Correct answer: C
RATIONALE: Contractions lasting longer than 90 seconds with
less than 60 seconds rest indicate hyperstimulation and require
stopping oxytocin to prevent fetal distress.
7. A postpartum client is breastfeeding and reports sore
nipples. Which instruction should the nurse provide?
A. Apply alcohol to the nipples after feeding
B. Ensure proper latch and break suction before removing infant
C. Limit feeding to 5 minutes per breast
D. Use soap to wash nipples before feeding
Correct answer: B
RATIONALE: Proper latch and breaking suction are key to
preventing nipple trauma. Alcohol and soap can dry the nipples,
and limiting feeding time may not resolve the issue.
8. A newborn has a bilirubin level of 18 mg/dL at 48 hours
of age. Which intervention should the nurse anticipate?
A. Initiate phototherapy
B. Administer antibiotics
C. Prepare for exchange transfusion
D. Encourage increased oral feedings only
Correct answer: A
