Maternity CJE Actual Exam: 200
Practice Questions with Answers &
Rationales
This comprehensive practice exam is designed to help you prepare for the
Maternity Clinical Judgment Exam (CJE). It covers key topics including
antepartum, intrapartum, postpartum, newborn care, and high-risk
pregnancy management.
SECTION 1: ANTEPARTUM CARE & MATERNAL
HEALTH (Questions 1-40)
Question 1
A pregnant client at 10 weeks' gestation reports severe nausea and
vomiting, weight loss, and ketones in the urine. Which prescription should
the nurse question?
A. NPO with IV lactated Ringer's
B. Ondansetron IV as prescribed
C. Promethazine IM as prescribed
D. Discharge home with oral fluids and crackers
Answer: D
Rationale: Discharge home with oral fluids is inappropriate for a client with
hyperemesis gravidarum who has ketones and weight loss. IV fluids and
,antiemetics are necessary. Discharging her with oral fluids could lead to
continued dehydration and electrolyte imbalance.
Question 2
Which of the following is the most important preconception
recommendation to reduce the risk of neural-tube defects?
A. Daily iron supplementation
B. Daily folic acid 400 µg
C. Calcium-rich diet
D. Avoidance of caffeine
Answer: B
Rationale: Folic acid taken before conception and during early pregnancy
reduces the incidence of neural-tube defects such as spina bifida. The
recommended dose is 400–800 mcg daily.
Question 3
A client at 38 weeks' gestation reports a sudden gush of fluid from the
vagina. Which is the priority nursing action?
A. Check fetal heart rate
B. Test fluid with nitrazine paper
C. Inspect perineum for crowning
D. Ask when she last voided
Answer: A
,Rationale: Priority is to assess fetal well-being. A sudden gush of fluid may
be accompanied by umbilical cord prolapse, which compromises fetal
oxygenation. FHR assessment must be done immediately.
Question 4
A client at 32 weeks' gestation has painless, bright red vaginal bleeding.
Which condition does the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Threatened abortion
D. Ectopic pregnancy
Answer: A
Rationale: Painless bright red bleeding in the third trimester is the classic
presentation of placenta previa. Abruptio placentae typically presents with
painful dark bleeding.
Question 5
A client is diagnosed with gestational hypertension and is receiving
magnesium sulfate. Which finding would the nurse interpret as indicating a
therapeutic level of medication?
A. Urinary output of 20 mL per hour
B. Respiratory rate of 10 breaths/minute
C. Deep tendon reflexes 2+
D. Difficulty in arousing
Answer: C
, Rationale: With magnesium sulfate, deep tendon reflexes of 2+ are normal
and indicate a therapeutic level. Urinary output <30 mL/hr, respiratory rate
<12, and diminished arousal indicate magnesium toxicity.
Question 6
A nurse is teaching a client about non-stress tests (NST). Which statement
indicates understanding?
A. "This test measures how strong my contractions are."
B. "This test evaluates my baby's heart rate in response to its own
movements."
C. "This test requires me to have an IV line placed."
D. "This test is done to check for uterine infections."
Answer: B
Rationale: A non-stress test evaluates fetal well-being by assessing the
fetal heart rate response to fetal movement. Accelerations indicate a
healthy, reactive fetus.
Question 7
Using Nägele's rule, if a client's LMP was August 19, 2025, what is the EDB?
A. May 12, 2026
B. May 26, 2026
C. May 19, 2026
D. June 2, 2026
Answer: B
Practice Questions with Answers &
Rationales
This comprehensive practice exam is designed to help you prepare for the
Maternity Clinical Judgment Exam (CJE). It covers key topics including
antepartum, intrapartum, postpartum, newborn care, and high-risk
pregnancy management.
SECTION 1: ANTEPARTUM CARE & MATERNAL
HEALTH (Questions 1-40)
Question 1
A pregnant client at 10 weeks' gestation reports severe nausea and
vomiting, weight loss, and ketones in the urine. Which prescription should
the nurse question?
A. NPO with IV lactated Ringer's
B. Ondansetron IV as prescribed
C. Promethazine IM as prescribed
D. Discharge home with oral fluids and crackers
Answer: D
Rationale: Discharge home with oral fluids is inappropriate for a client with
hyperemesis gravidarum who has ketones and weight loss. IV fluids and
,antiemetics are necessary. Discharging her with oral fluids could lead to
continued dehydration and electrolyte imbalance.
Question 2
Which of the following is the most important preconception
recommendation to reduce the risk of neural-tube defects?
A. Daily iron supplementation
B. Daily folic acid 400 µg
C. Calcium-rich diet
D. Avoidance of caffeine
Answer: B
Rationale: Folic acid taken before conception and during early pregnancy
reduces the incidence of neural-tube defects such as spina bifida. The
recommended dose is 400–800 mcg daily.
Question 3
A client at 38 weeks' gestation reports a sudden gush of fluid from the
vagina. Which is the priority nursing action?
A. Check fetal heart rate
B. Test fluid with nitrazine paper
C. Inspect perineum for crowning
D. Ask when she last voided
Answer: A
,Rationale: Priority is to assess fetal well-being. A sudden gush of fluid may
be accompanied by umbilical cord prolapse, which compromises fetal
oxygenation. FHR assessment must be done immediately.
Question 4
A client at 32 weeks' gestation has painless, bright red vaginal bleeding.
Which condition does the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Threatened abortion
D. Ectopic pregnancy
Answer: A
Rationale: Painless bright red bleeding in the third trimester is the classic
presentation of placenta previa. Abruptio placentae typically presents with
painful dark bleeding.
Question 5
A client is diagnosed with gestational hypertension and is receiving
magnesium sulfate. Which finding would the nurse interpret as indicating a
therapeutic level of medication?
A. Urinary output of 20 mL per hour
B. Respiratory rate of 10 breaths/minute
C. Deep tendon reflexes 2+
D. Difficulty in arousing
Answer: C
, Rationale: With magnesium sulfate, deep tendon reflexes of 2+ are normal
and indicate a therapeutic level. Urinary output <30 mL/hr, respiratory rate
<12, and diminished arousal indicate magnesium toxicity.
Question 6
A nurse is teaching a client about non-stress tests (NST). Which statement
indicates understanding?
A. "This test measures how strong my contractions are."
B. "This test evaluates my baby's heart rate in response to its own
movements."
C. "This test requires me to have an IV line placed."
D. "This test is done to check for uterine infections."
Answer: B
Rationale: A non-stress test evaluates fetal well-being by assessing the
fetal heart rate response to fetal movement. Accelerations indicate a
healthy, reactive fetus.
Question 7
Using Nägele's rule, if a client's LMP was August 19, 2025, what is the EDB?
A. May 12, 2026
B. May 26, 2026
C. May 19, 2026
D. June 2, 2026
Answer: B
