2026 NCLEX‑Style Maternal & Newborn Nursing Exam
Prep | Verified Rationales | Complete Success Pack for
BSN Pathway Students
100 Questions
1. A nurse is caring for a client at 32 weeks gestation who is experiencing preterm labor. Which
medication should the nurse anticipate administering to promote fetal lung maturity?
A) Magnesium sulfate
B) Betamethasone
C) Nifedipine
D) Terbutaline
🎯CORRECT CHOICE: B) Betamethasone
💡EXPLANATION: Betamethasone is a corticosteroid administered to women at risk for preterm delivery
between 24 and 34 weeks gestation. It crosses the placenta and stimulates fetal lung surfactant
production, reducing the risk of respiratory distress syndrome (RDS) in the newborn.
2. A postpartum client who is Rh-negative has just given birth to an Rh-positive infant. Which medication
should the nurse administer to prevent Rh isoimmunization?
A) Oxytocin
B) Rho(D) immune globulin (RhoGAM)
C) Methylergonovine
D) Misoprostol
🎯CORRECT CHOICE: B) Rho(D) immune globulin (RhoGAM)
💡EXPLANATION: RhoGAM is given to Rh-negative mothers within 72 hours of birth to prevent the
formation of antibodies against Rh-positive fetal blood cells. This prevents hemolytic disease of the
newborn in subsequent pregnancies.
,3. During a prenatal visit, a nurse assesses a client's fundal height. At 20 weeks gestation, where would
the nurse expect to palpate the fundus?
A) At the level of the xiphoid process
B) Halfway between the symphysis pubis and the umbilicus
C) At the level of the umbilicus
D) Two fingerbreadths above the umbilicus
🎯CORRECT CHOICE: C) At the level of the umbilicus
💡EXPLANATION: A standard measurement of fundal height in centimeters roughly correlates with the
weeks of gestation from 18 to 32 weeks. At 20 weeks, the fundal height is typically at the umbilicus,
which is approximately 20 cm from the symphysis pubis.
4. A nurse is assessing a newborn one minute after birth and notes a heart rate of 120 bpm, a strong cry,
active movement, grimacing with stimulation, and acrocyanosis. What is the newborn's Apgar score?
A) 7
B) 8
C) 9
D) 10
🎯CORRECT CHOICE: C) 9
💡EXPLANATION: The newborn receives 2 points for heart rate (>100), 2 for respiratory effort (strong
cry), 2 for muscle tone (active movement), 2 for reflex irritability (grimacing), and 1 for skin color
(acrocyanosis, or blue extremities). A score of 9 is considered good and indicates the newborn is
transitioning well.
5. A client at 39 weeks gestation is admitted with a diagnosis of preeclampsia. Which assessment finding
would be of most concern to the nurse?
A) Blood pressure of 150/90 mmHg
B) 1+ protein in the urine
C) Blood pressure of 160/110 mmHg
D) Mild headache
,🎯CORRECT CHOICE: C) Blood pressure of 160/110 mmHg
💡EXPLANATION: Severe preeclampsia is defined by a systolic BP ≥160 mmHg or a diastolic BP ≥110
mmHg. This finding indicates a worsening of the condition and puts the client and fetus at risk for
complications like eclampsia, stroke, and placental abruption.
6. A nurse is performing Leopold's maneuvers on a client at term. The maneuver in which the nurse
palpates the fetal buttocks or head at the fundus is the:
A) First maneuver (fundal grip)
B) Second maneuver (lateral grip)
C) Third maneuver (Pawlik's grip)
D) Fourth maneuver (pelvic grip)
🎯CORRECT CHOICE: A) First maneuver (fundal grip)
💡EXPLANATION: The first Leopold maneuver determines the fetal presenting part by palpating the
fundus. A firm, round, and hard object indicates the head, while a softer, less-defined mass indicates the
buttocks.
7. A postpartum nurse is assessing a client who had a vaginal delivery two hours ago. Which finding
would indicate a potential postpartum hemorrhage?
A) A fundus that is firm and at the umbilicus
B) A fundus that is boggy and displaced to the right
C) Moderate lochia rubra
D) Maternal pulse rate of 80 bpm
🎯CORRECT CHOICE: B) A fundus that is boggy and displaced to the right
💡EXPLANATION: A boggy (soft) uterus is a sign of uterine atony, the most common cause of postpartum
hemorrhage. Displacement to the right often indicates a full bladder, which can prevent the uterus from
contracting effectively.
8. A client with gestational diabetes is scheduled for a nonstress test (NST). What is the primary purpose
of this test?
, A) To assess fetal lung maturity
B) To evaluate fetal well-being by assessing fetal heart rate reactivity
C) To measure amniotic fluid volume
D) To determine fetal position
🎯CORRECT CHOICE: B) To evaluate fetal well-being by assessing fetal heart rate reactivity
💡EXPLANATION: An NST assesses fetal heart rate accelerations in response to fetal movement. A
reactive NST (at least two accelerations in 20 minutes) indicates an intact fetal autonomic nervous
system and adequate oxygenation.
9. A nurse is educating a new mother on the signs of effective breastfeeding. What is the most
important indicator that the infant is receiving enough milk?
A) The infant sleeps through the night
B) The infant has at least 6-8 wet diapers per day by day 5 of life
C) The infant cries after feeding
D) The infant feeds for exactly 10 minutes on each breast
🎯CORRECT CHOICE: B) The infant has at least 6-8 wet diapers per day by day 5 of life
💡EXPLANATION: Adequate urine output is the best indicator of sufficient fluid intake. By the fifth day, a
well-hydrated infant will have 6-8 or more wet diapers, indicating the newborn is getting enough milk.
10. A client in active labor is receiving an epidural for pain management. Which assessment finding
would require immediate intervention by the nurse?
A) Maternal hypotension (systolic BP < 100 mmHg)
B) Maternal temperature of 99.0°F
C) Fetal heart rate of 140 bpm
D) Client reports mild nausea
🎯CORRECT CHOICE: A) Maternal hypotension (systolic BP < 100 mmHg)
Prep | Verified Rationales | Complete Success Pack for
BSN Pathway Students
100 Questions
1. A nurse is caring for a client at 32 weeks gestation who is experiencing preterm labor. Which
medication should the nurse anticipate administering to promote fetal lung maturity?
A) Magnesium sulfate
B) Betamethasone
C) Nifedipine
D) Terbutaline
🎯CORRECT CHOICE: B) Betamethasone
💡EXPLANATION: Betamethasone is a corticosteroid administered to women at risk for preterm delivery
between 24 and 34 weeks gestation. It crosses the placenta and stimulates fetal lung surfactant
production, reducing the risk of respiratory distress syndrome (RDS) in the newborn.
2. A postpartum client who is Rh-negative has just given birth to an Rh-positive infant. Which medication
should the nurse administer to prevent Rh isoimmunization?
A) Oxytocin
B) Rho(D) immune globulin (RhoGAM)
C) Methylergonovine
D) Misoprostol
🎯CORRECT CHOICE: B) Rho(D) immune globulin (RhoGAM)
💡EXPLANATION: RhoGAM is given to Rh-negative mothers within 72 hours of birth to prevent the
formation of antibodies against Rh-positive fetal blood cells. This prevents hemolytic disease of the
newborn in subsequent pregnancies.
,3. During a prenatal visit, a nurse assesses a client's fundal height. At 20 weeks gestation, where would
the nurse expect to palpate the fundus?
A) At the level of the xiphoid process
B) Halfway between the symphysis pubis and the umbilicus
C) At the level of the umbilicus
D) Two fingerbreadths above the umbilicus
🎯CORRECT CHOICE: C) At the level of the umbilicus
💡EXPLANATION: A standard measurement of fundal height in centimeters roughly correlates with the
weeks of gestation from 18 to 32 weeks. At 20 weeks, the fundal height is typically at the umbilicus,
which is approximately 20 cm from the symphysis pubis.
4. A nurse is assessing a newborn one minute after birth and notes a heart rate of 120 bpm, a strong cry,
active movement, grimacing with stimulation, and acrocyanosis. What is the newborn's Apgar score?
A) 7
B) 8
C) 9
D) 10
🎯CORRECT CHOICE: C) 9
💡EXPLANATION: The newborn receives 2 points for heart rate (>100), 2 for respiratory effort (strong
cry), 2 for muscle tone (active movement), 2 for reflex irritability (grimacing), and 1 for skin color
(acrocyanosis, or blue extremities). A score of 9 is considered good and indicates the newborn is
transitioning well.
5. A client at 39 weeks gestation is admitted with a diagnosis of preeclampsia. Which assessment finding
would be of most concern to the nurse?
A) Blood pressure of 150/90 mmHg
B) 1+ protein in the urine
C) Blood pressure of 160/110 mmHg
D) Mild headache
,🎯CORRECT CHOICE: C) Blood pressure of 160/110 mmHg
💡EXPLANATION: Severe preeclampsia is defined by a systolic BP ≥160 mmHg or a diastolic BP ≥110
mmHg. This finding indicates a worsening of the condition and puts the client and fetus at risk for
complications like eclampsia, stroke, and placental abruption.
6. A nurse is performing Leopold's maneuvers on a client at term. The maneuver in which the nurse
palpates the fetal buttocks or head at the fundus is the:
A) First maneuver (fundal grip)
B) Second maneuver (lateral grip)
C) Third maneuver (Pawlik's grip)
D) Fourth maneuver (pelvic grip)
🎯CORRECT CHOICE: A) First maneuver (fundal grip)
💡EXPLANATION: The first Leopold maneuver determines the fetal presenting part by palpating the
fundus. A firm, round, and hard object indicates the head, while a softer, less-defined mass indicates the
buttocks.
7. A postpartum nurse is assessing a client who had a vaginal delivery two hours ago. Which finding
would indicate a potential postpartum hemorrhage?
A) A fundus that is firm and at the umbilicus
B) A fundus that is boggy and displaced to the right
C) Moderate lochia rubra
D) Maternal pulse rate of 80 bpm
🎯CORRECT CHOICE: B) A fundus that is boggy and displaced to the right
💡EXPLANATION: A boggy (soft) uterus is a sign of uterine atony, the most common cause of postpartum
hemorrhage. Displacement to the right often indicates a full bladder, which can prevent the uterus from
contracting effectively.
8. A client with gestational diabetes is scheduled for a nonstress test (NST). What is the primary purpose
of this test?
, A) To assess fetal lung maturity
B) To evaluate fetal well-being by assessing fetal heart rate reactivity
C) To measure amniotic fluid volume
D) To determine fetal position
🎯CORRECT CHOICE: B) To evaluate fetal well-being by assessing fetal heart rate reactivity
💡EXPLANATION: An NST assesses fetal heart rate accelerations in response to fetal movement. A
reactive NST (at least two accelerations in 20 minutes) indicates an intact fetal autonomic nervous
system and adequate oxygenation.
9. A nurse is educating a new mother on the signs of effective breastfeeding. What is the most
important indicator that the infant is receiving enough milk?
A) The infant sleeps through the night
B) The infant has at least 6-8 wet diapers per day by day 5 of life
C) The infant cries after feeding
D) The infant feeds for exactly 10 minutes on each breast
🎯CORRECT CHOICE: B) The infant has at least 6-8 wet diapers per day by day 5 of life
💡EXPLANATION: Adequate urine output is the best indicator of sufficient fluid intake. By the fifth day, a
well-hydrated infant will have 6-8 or more wet diapers, indicating the newborn is getting enough milk.
10. A client in active labor is receiving an epidural for pain management. Which assessment finding
would require immediate intervention by the nurse?
A) Maternal hypotension (systolic BP < 100 mmHg)
B) Maternal temperature of 99.0°F
C) Fetal heart rate of 140 bpm
D) Client reports mild nausea
🎯CORRECT CHOICE: A) Maternal hypotension (systolic BP < 100 mmHg)
