Comprehensive Exam
Preparation Guide: Maternity
and Pediatric Nursing, 5th
Edition (Ricci, Kyle, &
Carman) for 2026
High-Stakes Licensure
Prepared For: Nursing Candidates, Nurse Educators, and Clinical Instruction Teams Target
Exam Cycle: 2026 Next Generation NCLEX (NGN) and Pediatric/Maternal Certification Boards
Primary Resource Alignment: Maternity and Pediatric Nursing, 5th Edition (Ricci, Kyle, &
Carman) Date: December 28, 2025
Legal Disclaimer
This educational resource is designed as a supplementary study aid for nursing students and
professionals preparing for licensure and certification examinations, specifically aligned with the
2026 test plans. While every effort has been made to ensure the accuracy of clinical information,
pharmacological protocols, and industry guidelines, medical knowledge is constantly evolving.
,The content herein reflects the most current evidence-based practices available at the time of
publication, including 2025/2026 updates regarding respiratory syncytial virus (RSV)
immunizations, obstetric hemorrhage bundles, and pediatric diabetes technology.
However, this guide is not a substitute for the official textbook Maternity and Pediatric Nursing,
5th Edition by Susan Ricci, Theresa Kyle, and Susan Carman. Users should consult the primary
text, official drug handbooks, and institutional protocols for direct patient care decisions. The
author and publisher assume no liability for errors, omissions, or outcomes related to the use of
this information in clinical or examination settings.
Interactive Table of Contents
1. High-Yield Toolkit: Theoretical Foundations
○ The 2026 NGN Clinical Judgment Measurement Model
○ Maternal Health Landscape: 2026 Updates
○ Pediatric Health Landscape: The Respiratory and Immunization Shift
2. Unit I: Reproductive Health and Pregnancy (Questions 1–10)
○ Modules: Dating, Genetics, Physiological Adaptation, and Danger Signs
3. Unit II: Intrapartum and Postpartum Emergencies (Questions 11–20)
○ Modules: Labor Dynamics, Hemorrhage Protocols, and Surgical Complications
4. Unit III: Newborn Adaptation and High-Risk Neonates (Questions 21–30)
○ Modules: Transition to Extrauterine Life, Metabolic Screening, and Sepsis
5. Unit IV: Pediatric Respiratory and Cardiac Disorders (Questions 31–40)
○ Modules: Congenital Defects, Acute Infections, and Chronic Management
6. Unit V: Pediatric Metabolic, Neurological, and Musculoskeletal Disorders
(Questions 41–50)
○ Modules: Structural Defects, GI Emergencies, and Endocrine Technology
7. Unit VI: Psychosocial, Legal, and Ethical Considerations (Questions 51–55)
○ Modules: Developmental Theory, Consent, and Mandatory Reporting
8. Visual Integration Strategy
○ Modules: Fetal Strip Decoding, Cardiac Hemodynamics, and Anatomical defect
visualization
High-Yield Toolkit: Theoretical Foundations
The 2026 NGN Clinical Judgment
Measurement Model (NCJMM)
The pedagogical landscape of nursing licensure has undergone a seismic shift with the full
integration of the Next Generation NCLEX (NGN). The 2026 test plan represents a departure
from rote knowledge recall, pivoting instead toward an evaluation of the entry-level nurse's
cognitive processing power. The Maternity and Pediatric Nursing text aligns with this evolution
by emphasizing "Consider This" case studies and "Developing Clinical Judgment" sections ,
which serve as the substrate for the new item types.
To achieve "S-Tier" performance, the candidate must internalize the six-step NCJMM. This
model is not merely a testing framework but a reflection of safe clinical practice. The case
,studies on the exam, comprising six items each, systematically evaluate the candidate's ability
to navigate this cognitive loop.
NCJMM Step Cognitive Task Application in
Maternity/Pediatrics
1. Recognize Cues Identifying relevant data points Distinguishing between normal
from the clinical environment. physiological variability (e.g.,
variable decelerations) and
pathological distress (e.g., late
decelerations).
2. Analyze Cues Linking data to potential Correlating a "boggy" uterus
complications or clinical with tachycardia to suspect
significance. Class II hemorrhage.
3. Prioritize Hypotheses Ranking the most likely and Determining that airway
most dangerous causes. obstruction in epiglottitis takes
precedence over IV access.
4. Generate Solutions Identifying evidence-based Selecting McRoberts maneuver
interventions. as the first-line intervention for
shoulder dystocia over fundal
pressure.
5. Take Action Implementing the priority Physically elevating the fetal
intervention. head during cord prolapse.
6. Evaluate Outcomes Assessing the patient’s Verifying the return of fetal
response to the intervention. heart rate accelerations
following intrauterine
resuscitation.
This guide structures every "Mechanistic Logic" analysis through this lens, ensuring the user
practices the cognitive steps required for the 18 case study items found on the exam. The
"S-Tier" candidate understands that clinical judgment is an integrated process where multiple
data streams—lab values, vital signs, and patient history—must be synthesized to form a
coherent clinical picture.
,Maternal Health Landscape: 2026 Updates
The 2026 landscape for maternal health is defined by a rigorous focus on reducing morbidity
and mortality, specifically regarding hypertensive disorders and hemorrhage. The 5th edition of
Ricci, Kyle, and Carman integrates these themes, but recent federal and global updates must
be layered on top for optimal preparation.
Postpartum Hemorrhage (PPH) Bundles: The historical reliance on subjective assessments
like the "woody" or "boggy" uterus has been superseded by rigorous quantification. The 2025
protocols emphasize quantitative blood loss (QBL) measurement over estimation to prevent the
underestimation of blood loss that frequently leads to delayed intervention. Interventions are
now bundled into rapid response teams that initiate antifibrinolytics (Tranexamic Acid) and
massive transfusion protocols earlier than in previous decades. The "MOTIVE" bundle
(Massage, Oxytocin, Tranexamic acid, IV fluids, and Examination) is the standard of care.
,Hypertensive Disorders: The definitions of severe features in preeclampsia remain critical.
The therapeutic window for Magnesium Sulfate is narrow (4–7 mEq/L), requiring vigilant
monitoring of deep tendon reflexes (DTRs) and respiratory status. The 2026 guidelines
underscore the necessity of rapid treatment of severe hypertension (systolic BP ≥160 or
diastolic BP ≥110) within 60 minutes to prevent stroke.
Pediatric Health Landscape: The Respiratory and
Immunization Shift
Pediatric nursing in 2026 is heavily influenced by new immunization landscapes. The
"tripledemic" threats of RSV, Influenza, and COVID-19 have altered the standard schedule and
anticipated seasonal spikes.
RSV Immunization Paradigm Shift: Historically, Palivizumab (Synagis) was the only option,
reserved for high-risk preemies. As of 2025/2026, the landscape includes Nirsevimab
(Beyfortus) for all infants entering their first RSV season and maternal vaccination (Abrysvo)
, during pregnancy. This requires nurses to distinguish between active and passive immunity
strategies and identify eligibility windows (e.g., maternal vaccine at 32–36 weeks). The
guidelines now incorporate specific cutoff dates (e.g., infants born shortly before or during the
season) to maximize protection.
Pediatric Diabetes Technology: The management of Type 1 Diabetes in children has moved
rapidly toward automation. The 2026 Standards of Care emphasize the use of Automated
Insulin Delivery (AID) systems and Continuous Glucose Monitoring (CGM) from diagnosis.
Nurses must be adept at interpreting trend arrows and time-in-range metrics rather than relying
solely on A1C or fingerstick values.
Preparation Guide: Maternity
and Pediatric Nursing, 5th
Edition (Ricci, Kyle, &
Carman) for 2026
High-Stakes Licensure
Prepared For: Nursing Candidates, Nurse Educators, and Clinical Instruction Teams Target
Exam Cycle: 2026 Next Generation NCLEX (NGN) and Pediatric/Maternal Certification Boards
Primary Resource Alignment: Maternity and Pediatric Nursing, 5th Edition (Ricci, Kyle, &
Carman) Date: December 28, 2025
Legal Disclaimer
This educational resource is designed as a supplementary study aid for nursing students and
professionals preparing for licensure and certification examinations, specifically aligned with the
2026 test plans. While every effort has been made to ensure the accuracy of clinical information,
pharmacological protocols, and industry guidelines, medical knowledge is constantly evolving.
,The content herein reflects the most current evidence-based practices available at the time of
publication, including 2025/2026 updates regarding respiratory syncytial virus (RSV)
immunizations, obstetric hemorrhage bundles, and pediatric diabetes technology.
However, this guide is not a substitute for the official textbook Maternity and Pediatric Nursing,
5th Edition by Susan Ricci, Theresa Kyle, and Susan Carman. Users should consult the primary
text, official drug handbooks, and institutional protocols for direct patient care decisions. The
author and publisher assume no liability for errors, omissions, or outcomes related to the use of
this information in clinical or examination settings.
Interactive Table of Contents
1. High-Yield Toolkit: Theoretical Foundations
○ The 2026 NGN Clinical Judgment Measurement Model
○ Maternal Health Landscape: 2026 Updates
○ Pediatric Health Landscape: The Respiratory and Immunization Shift
2. Unit I: Reproductive Health and Pregnancy (Questions 1–10)
○ Modules: Dating, Genetics, Physiological Adaptation, and Danger Signs
3. Unit II: Intrapartum and Postpartum Emergencies (Questions 11–20)
○ Modules: Labor Dynamics, Hemorrhage Protocols, and Surgical Complications
4. Unit III: Newborn Adaptation and High-Risk Neonates (Questions 21–30)
○ Modules: Transition to Extrauterine Life, Metabolic Screening, and Sepsis
5. Unit IV: Pediatric Respiratory and Cardiac Disorders (Questions 31–40)
○ Modules: Congenital Defects, Acute Infections, and Chronic Management
6. Unit V: Pediatric Metabolic, Neurological, and Musculoskeletal Disorders
(Questions 41–50)
○ Modules: Structural Defects, GI Emergencies, and Endocrine Technology
7. Unit VI: Psychosocial, Legal, and Ethical Considerations (Questions 51–55)
○ Modules: Developmental Theory, Consent, and Mandatory Reporting
8. Visual Integration Strategy
○ Modules: Fetal Strip Decoding, Cardiac Hemodynamics, and Anatomical defect
visualization
High-Yield Toolkit: Theoretical Foundations
The 2026 NGN Clinical Judgment
Measurement Model (NCJMM)
The pedagogical landscape of nursing licensure has undergone a seismic shift with the full
integration of the Next Generation NCLEX (NGN). The 2026 test plan represents a departure
from rote knowledge recall, pivoting instead toward an evaluation of the entry-level nurse's
cognitive processing power. The Maternity and Pediatric Nursing text aligns with this evolution
by emphasizing "Consider This" case studies and "Developing Clinical Judgment" sections ,
which serve as the substrate for the new item types.
To achieve "S-Tier" performance, the candidate must internalize the six-step NCJMM. This
model is not merely a testing framework but a reflection of safe clinical practice. The case
,studies on the exam, comprising six items each, systematically evaluate the candidate's ability
to navigate this cognitive loop.
NCJMM Step Cognitive Task Application in
Maternity/Pediatrics
1. Recognize Cues Identifying relevant data points Distinguishing between normal
from the clinical environment. physiological variability (e.g.,
variable decelerations) and
pathological distress (e.g., late
decelerations).
2. Analyze Cues Linking data to potential Correlating a "boggy" uterus
complications or clinical with tachycardia to suspect
significance. Class II hemorrhage.
3. Prioritize Hypotheses Ranking the most likely and Determining that airway
most dangerous causes. obstruction in epiglottitis takes
precedence over IV access.
4. Generate Solutions Identifying evidence-based Selecting McRoberts maneuver
interventions. as the first-line intervention for
shoulder dystocia over fundal
pressure.
5. Take Action Implementing the priority Physically elevating the fetal
intervention. head during cord prolapse.
6. Evaluate Outcomes Assessing the patient’s Verifying the return of fetal
response to the intervention. heart rate accelerations
following intrauterine
resuscitation.
This guide structures every "Mechanistic Logic" analysis through this lens, ensuring the user
practices the cognitive steps required for the 18 case study items found on the exam. The
"S-Tier" candidate understands that clinical judgment is an integrated process where multiple
data streams—lab values, vital signs, and patient history—must be synthesized to form a
coherent clinical picture.
,Maternal Health Landscape: 2026 Updates
The 2026 landscape for maternal health is defined by a rigorous focus on reducing morbidity
and mortality, specifically regarding hypertensive disorders and hemorrhage. The 5th edition of
Ricci, Kyle, and Carman integrates these themes, but recent federal and global updates must
be layered on top for optimal preparation.
Postpartum Hemorrhage (PPH) Bundles: The historical reliance on subjective assessments
like the "woody" or "boggy" uterus has been superseded by rigorous quantification. The 2025
protocols emphasize quantitative blood loss (QBL) measurement over estimation to prevent the
underestimation of blood loss that frequently leads to delayed intervention. Interventions are
now bundled into rapid response teams that initiate antifibrinolytics (Tranexamic Acid) and
massive transfusion protocols earlier than in previous decades. The "MOTIVE" bundle
(Massage, Oxytocin, Tranexamic acid, IV fluids, and Examination) is the standard of care.
,Hypertensive Disorders: The definitions of severe features in preeclampsia remain critical.
The therapeutic window for Magnesium Sulfate is narrow (4–7 mEq/L), requiring vigilant
monitoring of deep tendon reflexes (DTRs) and respiratory status. The 2026 guidelines
underscore the necessity of rapid treatment of severe hypertension (systolic BP ≥160 or
diastolic BP ≥110) within 60 minutes to prevent stroke.
Pediatric Health Landscape: The Respiratory and
Immunization Shift
Pediatric nursing in 2026 is heavily influenced by new immunization landscapes. The
"tripledemic" threats of RSV, Influenza, and COVID-19 have altered the standard schedule and
anticipated seasonal spikes.
RSV Immunization Paradigm Shift: Historically, Palivizumab (Synagis) was the only option,
reserved for high-risk preemies. As of 2025/2026, the landscape includes Nirsevimab
(Beyfortus) for all infants entering their first RSV season and maternal vaccination (Abrysvo)
, during pregnancy. This requires nurses to distinguish between active and passive immunity
strategies and identify eligibility windows (e.g., maternal vaccine at 32–36 weeks). The
guidelines now incorporate specific cutoff dates (e.g., infants born shortly before or during the
season) to maximize protection.
Pediatric Diabetes Technology: The management of Type 1 Diabetes in children has moved
rapidly toward automation. The 2026 Standards of Care emphasize the use of Automated
Insulin Delivery (AID) systems and Continuous Glucose Monitoring (CGM) from diagnosis.
Nurses must be adept at interpreting trend arrows and time-in-range metrics rather than relying
solely on A1C or fingerstick values.
