CMS RN Maternal Newborn 2026 Proctored
Assessment 70 NGN Questions and Correct
Answers
1. A nurse is assessing a client at 36 weeks gestation who reports a sudden gush
of fluid from the vagina. Which action should the nurse take first?
A. Perform a sterile vaginal exam
B. Check the fetal heart rate
C. Obtain a urine specimen
D. Place the client in Trendelenburg position
Correct Answer: B. Check the fetal heart rate
Rationale: The priority after suspected rupture of membranes is to assess fetal
well-being by checking the fetal heart rate. A sterile vaginal exam is avoided until
the provider is notified due to risk of infection and cord prolapse. Urine specimen
and Trendelenburg are not immediate priorities.
2. A client in active labor is 8 cm dilated and requests epidural anesthesia.
Which finding should the nurse report to the provider before epidural
placement?
A. Blood pressure 118/76 mm Hg
B. Platelet count 85,000/mm³
C. Fetal heart rate 140 bpm
D. Respiratory rate 18/min
Correct Answer: B. Platelet count 85,000/mm³
Rationale: A platelet count below 100,000/mm³ increases the risk of spinal
hematoma with epidural placement. The provider must be notified. The other
findings are within normal limits.
,3. A nurse is caring for a newborn immediately after delivery. Which assessment
finding requires immediate intervention?
A. Acrocyanosis
B. Respiratory rate 50/min
C. Nasal flaring and grunting
D. Heart rate 130 bpm
Correct Answer: C. Nasal flaring and grunting
Rationale: Nasal flaring and grunting are signs of respiratory distress in a
newborn and require immediate intervention. Acrocyanosis is normal in the first
hours. RR 50/min and HR 130 bpm are within normal newborn ranges.
4. A postpartum client is 12 hours post-vaginal delivery. The nurse notes a boggy
uterus and heavy lochia rubra. Which action should the nurse take first?
A. Administer methylergonovine
B. Massage the fundus
C. Notify the provider
D. Insert an indwelling urinary catheter
Correct Answer: B. Massage the fundus
Rationale: A boggy uterus indicates uterine atony. The first intervention is to
massage the fundus to stimulate contraction. If unsuccessful, medications or
provider notification follow. Catheterization may be needed if bladder distention is
the cause.
5. A nurse is teaching a pregnant client about folic acid supplementation. Which
statement indicates understanding?
,A. “I should take 400 mcg daily before and during early pregnancy.”
B. “I only need folic acid after 20 weeks.”
C. “Folic acid prevents gestational diabetes.”
D. “I should take 4000 mcg daily regardless of risk factors.”
Correct Answer: A. “I should take 400 mcg daily before and during early
pregnancy.”
Rationale: Folic acid 400 mcg daily is recommended for all women of
childbearing age to prevent neural tube defects. Higher doses (4 mg) are for high-
risk women. It does not prevent gestational diabetes.
6. A client at 32 weeks gestation is diagnosed with preterm labor. Which
medication does the nurse anticipate administering to promote fetal lung
maturity?
A. Betamethasone
B. Magnesium sulfate
C. Nifedipine
D. Oxytocin
Correct Answer: A. Betamethasone
Rationale: Betamethasone is a corticosteroid given to promote fetal lung
maturity between 24–34 weeks gestation. Magnesium sulfate is a tocolytic.
Nifedipine is also a tocolytic. Oxytocin induces labor.
7. A nurse is assessing a client with severe preeclampsia. Which finding indicates
worsening condition?
A. Blood pressure 150/90 mm Hg
B. 2+ proteinuria
C. Hyperreflexia and clonus
D. Weight gain of 1 kg
, Correct Answer: C. Hyperreflexia and clonus
Rationale: Hyperreflexia and clonus indicate CNS irritability and increased risk
for seizures in preeclampsia. The other findings are consistent with preeclampsia
but do not indicate immediate worsening.
8. A newborn is 1 hour old. The nurse notes a blood glucose level of 40 mg/dL.
Which action should the nurse take?
A. Administer IV dextrose
B. Feed the newborn breast milk or formula
C. Recheck glucose in 4 hours
D. Notify the provider immediately
Correct Answer: B. Feed the newborn breast milk or formula
Rationale: A glucose level of 40 mg/dL is within normal range for a newborn
(≥40 mg/dL). Feeding is appropriate if asymptomatic. IV dextrose is for
symptomatic or very low glucose. Rechecking in 4 hours is too long if concerns
exist.
9. A client is receiving magnesium sulfate for preeclampsia. Which finding
indicates magnesium toxicity?
A. Respiratory rate 16/min
B. Deep tendon reflexes 2+
C. Urine output 20 mL/hr
D. Respiratory rate 10/min
Correct Answer: D. Respiratory rate 10/min
Rationale: Respiratory depression (RR <12/min) is a sign of magnesium
toxicity. The antidote is calcium gluconate. Urine output should be ≥30 mL/hr.
Reflexes should be present.
Assessment 70 NGN Questions and Correct
Answers
1. A nurse is assessing a client at 36 weeks gestation who reports a sudden gush
of fluid from the vagina. Which action should the nurse take first?
A. Perform a sterile vaginal exam
B. Check the fetal heart rate
C. Obtain a urine specimen
D. Place the client in Trendelenburg position
Correct Answer: B. Check the fetal heart rate
Rationale: The priority after suspected rupture of membranes is to assess fetal
well-being by checking the fetal heart rate. A sterile vaginal exam is avoided until
the provider is notified due to risk of infection and cord prolapse. Urine specimen
and Trendelenburg are not immediate priorities.
2. A client in active labor is 8 cm dilated and requests epidural anesthesia.
Which finding should the nurse report to the provider before epidural
placement?
A. Blood pressure 118/76 mm Hg
B. Platelet count 85,000/mm³
C. Fetal heart rate 140 bpm
D. Respiratory rate 18/min
Correct Answer: B. Platelet count 85,000/mm³
Rationale: A platelet count below 100,000/mm³ increases the risk of spinal
hematoma with epidural placement. The provider must be notified. The other
findings are within normal limits.
,3. A nurse is caring for a newborn immediately after delivery. Which assessment
finding requires immediate intervention?
A. Acrocyanosis
B. Respiratory rate 50/min
C. Nasal flaring and grunting
D. Heart rate 130 bpm
Correct Answer: C. Nasal flaring and grunting
Rationale: Nasal flaring and grunting are signs of respiratory distress in a
newborn and require immediate intervention. Acrocyanosis is normal in the first
hours. RR 50/min and HR 130 bpm are within normal newborn ranges.
4. A postpartum client is 12 hours post-vaginal delivery. The nurse notes a boggy
uterus and heavy lochia rubra. Which action should the nurse take first?
A. Administer methylergonovine
B. Massage the fundus
C. Notify the provider
D. Insert an indwelling urinary catheter
Correct Answer: B. Massage the fundus
Rationale: A boggy uterus indicates uterine atony. The first intervention is to
massage the fundus to stimulate contraction. If unsuccessful, medications or
provider notification follow. Catheterization may be needed if bladder distention is
the cause.
5. A nurse is teaching a pregnant client about folic acid supplementation. Which
statement indicates understanding?
,A. “I should take 400 mcg daily before and during early pregnancy.”
B. “I only need folic acid after 20 weeks.”
C. “Folic acid prevents gestational diabetes.”
D. “I should take 4000 mcg daily regardless of risk factors.”
Correct Answer: A. “I should take 400 mcg daily before and during early
pregnancy.”
Rationale: Folic acid 400 mcg daily is recommended for all women of
childbearing age to prevent neural tube defects. Higher doses (4 mg) are for high-
risk women. It does not prevent gestational diabetes.
6. A client at 32 weeks gestation is diagnosed with preterm labor. Which
medication does the nurse anticipate administering to promote fetal lung
maturity?
A. Betamethasone
B. Magnesium sulfate
C. Nifedipine
D. Oxytocin
Correct Answer: A. Betamethasone
Rationale: Betamethasone is a corticosteroid given to promote fetal lung
maturity between 24–34 weeks gestation. Magnesium sulfate is a tocolytic.
Nifedipine is also a tocolytic. Oxytocin induces labor.
7. A nurse is assessing a client with severe preeclampsia. Which finding indicates
worsening condition?
A. Blood pressure 150/90 mm Hg
B. 2+ proteinuria
C. Hyperreflexia and clonus
D. Weight gain of 1 kg
, Correct Answer: C. Hyperreflexia and clonus
Rationale: Hyperreflexia and clonus indicate CNS irritability and increased risk
for seizures in preeclampsia. The other findings are consistent with preeclampsia
but do not indicate immediate worsening.
8. A newborn is 1 hour old. The nurse notes a blood glucose level of 40 mg/dL.
Which action should the nurse take?
A. Administer IV dextrose
B. Feed the newborn breast milk or formula
C. Recheck glucose in 4 hours
D. Notify the provider immediately
Correct Answer: B. Feed the newborn breast milk or formula
Rationale: A glucose level of 40 mg/dL is within normal range for a newborn
(≥40 mg/dL). Feeding is appropriate if asymptomatic. IV dextrose is for
symptomatic or very low glucose. Rechecking in 4 hours is too long if concerns
exist.
9. A client is receiving magnesium sulfate for preeclampsia. Which finding
indicates magnesium toxicity?
A. Respiratory rate 16/min
B. Deep tendon reflexes 2+
C. Urine output 20 mL/hr
D. Respiratory rate 10/min
Correct Answer: D. Respiratory rate 10/min
Rationale: Respiratory depression (RR <12/min) is a sign of magnesium
toxicity. The antidote is calcium gluconate. Urine output should be ≥30 mL/hr.
Reflexes should be present.
