NCLEX-RN MATERNITY & NEWBORN NURSING
PRACTICE EXAMINATION 2026–2027 —
COMPREHENSIVE STUDY GUIDE | LATEST UPDATE
2026/2027 | ACTUAL EXAM PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS
1. A nurse is reviewing the GTPAL for a client who is currently pregnant. She
has a 4-year-old born at 39 weeks, twins born at 33 weeks, and one
miscarriage at 8 weeks. What is the correct GTPAL?
A) G4 T1 P1 A1 L3
B) G5 T1 P1 A1 L3
C) G4 T1 P2 A1 L3
D) G5 T2 P1 A1 L3
Correct Answer: A
Gravida = total pregnancies = 4 (current + 4-year-old + twins + miscarriage). Term
= 1 (39-week delivery). Preterm = 1 (twins at 33 weeks; multiple gestation counts
as one pregnancy). Abortions = 1 (miscarriage). Living = 3 (one 4-year-old + twins).
Option B adds one gravida incorrectly; C counts twins as two preterm pregnancies;
D misclassifies term/preterm.
2. A nurse is interpreting a nonstress test. Which finding indicates a reactive
NST for a term fetus?
A) One acceleration of 10 bpm lasting 10 seconds in 20 minutes
B) Two accelerations of 15 bpm above baseline lasting 15 seconds within 20
minutes
C) No accelerations but moderate variability
D) Fetal heart rate decelerations with contractions
Correct Answer: B
A reactive NST requires at least two accelerations of 15 bpm above baseline
,lasting 15 seconds within a 20-minute period for a term fetus. One acceleration of
10 seconds is insufficient. No accelerations indicates nonreactive. Decelerations
with contractions are evaluated with a contraction stress test.
3. A client at 29 weeks' gestation is admitted with painless, bright red vaginal
bleeding. The uterus is soft and non-tender. Which condition does the nurse
suspect?
A) Abruptio placentae
B) Placenta previa
C) Uterine rupture
D) Preterm labor
Correct Answer: B
Painless, bright red bleeding in the third trimester with a soft, non-tender uterus is
classic for placenta previa. Abruptio placentae presents with painful, dark bleeding
and a rigid, tender uterus. Uterine rupture causes severe pain and fetal distress.
Preterm labor involves contractions and cervical change.
4. A nurse is caring for a client receiving magnesium sulfate for severe
preeclampsia. Which assessment finding indicates magnesium toxicity?
A) Respiratory rate 16 breaths/min
B) Deep tendon reflexes 2+
C) Respiratory rate 10 breaths/min and absent patellar reflexes
D) Urine output 35 mL/hr
Correct Answer: C
Magnesium toxicity causes respiratory depression (<12 breaths/min) and loss of
deep tendon reflexes, followed by cardiac arrest. The antidote is calcium
gluconate. Reflexes 2+ and urine output 35 mL/hr are acceptable. Respiratory rate
16 is normal.
5. A nurse is caring for a newborn 30 minutes after birth. The nurse notes
acrocyanosis, heart rate 130 bpm, and respiratory rate 50 breaths/min.
What is the nurse’s priority action?
A) Administer oxygen via mask
, B) Document the findings as normal transitional changes
C) Notify the provider immediately
D) Place the newborn under a radiant warmer only
Correct Answer: B
Acrocyanosis, heart rate >100 bpm, and respiratory rate 40–60 are normal
newborn findings during transition. Oxygen is not needed unless cyanosis is central
or respiratory distress is present. The provider does not need to be notified. A
radiant warmer may be used to prevent hypothermia, but the priority is
documentation/assessment.
6. A nurse is teaching a postpartum client about lochia. Which client
statement indicates a need for further teaching?
A) “Lochia rubra is red and lasts 1–3 days.”
B) “Lochia serosa is pinkish-brown and lasts from day 4 to day 10.”
C) “Lochia alba is white and can last up to 6 weeks.”
D) “Lochia alba indicates an infection and should be reported.”
Correct Answer: D
Lochia rubra (red, 1–3 days), serosa (pinkish-brown, 4–10 days), and alba (white,
up to 6 weeks) are normal. Lochia alba does not indicate infection; it is a normal
progression. The other statements are correct.
7. A nurse is performing a newborn assessment. Which finding requires
immediate intervention?
A) Anterior fontanel flat and soft
B) Central cyanosis
C) Milia on the nose
D) Molding of the head
Correct Answer: B
Central cyanosis indicates inadequate oxygenation and requires immediate
intervention. Flat fontanel, milia, and molding are normal newborn findings.
8. A client at 39 weeks' gestation is in active labor. The nurse notes recurrent
late decelerations. The client is in left lateral position, IV fluids are infusing,
, and oxygen is at 10 L/min via nonrebreather mask. What is the next action?
A) Prepare for immediate cesarean delivery
B) Notify the provider and continue intrauterine resuscitation
C) Increase oxytocin infusion
D) Administer terbutaline
Correct Answer: B
After initiating intrauterine resuscitation (position, fluids, oxygen), the provider
must be notified. Increasing oxytocin would worsen fetal distress. Terbutaline is for
tachysystole, not late decelerations. Immediate cesarean may be needed if
decelerations persist despite interventions.
9. A nurse is preparing to administer betamethasone to a client at 30 weeks'
gestation in preterm labor. What is the purpose?
A) To stop uterine contractions
B) To accelerate fetal lung maturity
C) To treat infection
D) To lower maternal blood pressure
Correct Answer: B
Betamethasone is a corticosteroid given to accelerate fetal lung maturity and
reduce respiratory distress syndrome. It does not stop contractions, treat infection,
or lower blood pressure.
10.A newborn is 1 hour old and has a blood glucose of 35 mg/dL. Which sign
would the nurse expect?
A) Jitteriness and poor feeding
B) Hypertonia and fever
C) Projectile vomiting
D) Bulging fontanel
Correct Answer: A
Hypoglycemia in a newborn may present with jitteriness, poor feeding, lethargy,
and temperature instability. Hypertonia, fever, vomiting, and bulging fontanel are
not typical signs of hypoglycemia.
PRACTICE EXAMINATION 2026–2027 —
COMPREHENSIVE STUDY GUIDE | LATEST UPDATE
2026/2027 | ACTUAL EXAM PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS
1. A nurse is reviewing the GTPAL for a client who is currently pregnant. She
has a 4-year-old born at 39 weeks, twins born at 33 weeks, and one
miscarriage at 8 weeks. What is the correct GTPAL?
A) G4 T1 P1 A1 L3
B) G5 T1 P1 A1 L3
C) G4 T1 P2 A1 L3
D) G5 T2 P1 A1 L3
Correct Answer: A
Gravida = total pregnancies = 4 (current + 4-year-old + twins + miscarriage). Term
= 1 (39-week delivery). Preterm = 1 (twins at 33 weeks; multiple gestation counts
as one pregnancy). Abortions = 1 (miscarriage). Living = 3 (one 4-year-old + twins).
Option B adds one gravida incorrectly; C counts twins as two preterm pregnancies;
D misclassifies term/preterm.
2. A nurse is interpreting a nonstress test. Which finding indicates a reactive
NST for a term fetus?
A) One acceleration of 10 bpm lasting 10 seconds in 20 minutes
B) Two accelerations of 15 bpm above baseline lasting 15 seconds within 20
minutes
C) No accelerations but moderate variability
D) Fetal heart rate decelerations with contractions
Correct Answer: B
A reactive NST requires at least two accelerations of 15 bpm above baseline
,lasting 15 seconds within a 20-minute period for a term fetus. One acceleration of
10 seconds is insufficient. No accelerations indicates nonreactive. Decelerations
with contractions are evaluated with a contraction stress test.
3. A client at 29 weeks' gestation is admitted with painless, bright red vaginal
bleeding. The uterus is soft and non-tender. Which condition does the nurse
suspect?
A) Abruptio placentae
B) Placenta previa
C) Uterine rupture
D) Preterm labor
Correct Answer: B
Painless, bright red bleeding in the third trimester with a soft, non-tender uterus is
classic for placenta previa. Abruptio placentae presents with painful, dark bleeding
and a rigid, tender uterus. Uterine rupture causes severe pain and fetal distress.
Preterm labor involves contractions and cervical change.
4. A nurse is caring for a client receiving magnesium sulfate for severe
preeclampsia. Which assessment finding indicates magnesium toxicity?
A) Respiratory rate 16 breaths/min
B) Deep tendon reflexes 2+
C) Respiratory rate 10 breaths/min and absent patellar reflexes
D) Urine output 35 mL/hr
Correct Answer: C
Magnesium toxicity causes respiratory depression (<12 breaths/min) and loss of
deep tendon reflexes, followed by cardiac arrest. The antidote is calcium
gluconate. Reflexes 2+ and urine output 35 mL/hr are acceptable. Respiratory rate
16 is normal.
5. A nurse is caring for a newborn 30 minutes after birth. The nurse notes
acrocyanosis, heart rate 130 bpm, and respiratory rate 50 breaths/min.
What is the nurse’s priority action?
A) Administer oxygen via mask
, B) Document the findings as normal transitional changes
C) Notify the provider immediately
D) Place the newborn under a radiant warmer only
Correct Answer: B
Acrocyanosis, heart rate >100 bpm, and respiratory rate 40–60 are normal
newborn findings during transition. Oxygen is not needed unless cyanosis is central
or respiratory distress is present. The provider does not need to be notified. A
radiant warmer may be used to prevent hypothermia, but the priority is
documentation/assessment.
6. A nurse is teaching a postpartum client about lochia. Which client
statement indicates a need for further teaching?
A) “Lochia rubra is red and lasts 1–3 days.”
B) “Lochia serosa is pinkish-brown and lasts from day 4 to day 10.”
C) “Lochia alba is white and can last up to 6 weeks.”
D) “Lochia alba indicates an infection and should be reported.”
Correct Answer: D
Lochia rubra (red, 1–3 days), serosa (pinkish-brown, 4–10 days), and alba (white,
up to 6 weeks) are normal. Lochia alba does not indicate infection; it is a normal
progression. The other statements are correct.
7. A nurse is performing a newborn assessment. Which finding requires
immediate intervention?
A) Anterior fontanel flat and soft
B) Central cyanosis
C) Milia on the nose
D) Molding of the head
Correct Answer: B
Central cyanosis indicates inadequate oxygenation and requires immediate
intervention. Flat fontanel, milia, and molding are normal newborn findings.
8. A client at 39 weeks' gestation is in active labor. The nurse notes recurrent
late decelerations. The client is in left lateral position, IV fluids are infusing,
, and oxygen is at 10 L/min via nonrebreather mask. What is the next action?
A) Prepare for immediate cesarean delivery
B) Notify the provider and continue intrauterine resuscitation
C) Increase oxytocin infusion
D) Administer terbutaline
Correct Answer: B
After initiating intrauterine resuscitation (position, fluids, oxygen), the provider
must be notified. Increasing oxytocin would worsen fetal distress. Terbutaline is for
tachysystole, not late decelerations. Immediate cesarean may be needed if
decelerations persist despite interventions.
9. A nurse is preparing to administer betamethasone to a client at 30 weeks'
gestation in preterm labor. What is the purpose?
A) To stop uterine contractions
B) To accelerate fetal lung maturity
C) To treat infection
D) To lower maternal blood pressure
Correct Answer: B
Betamethasone is a corticosteroid given to accelerate fetal lung maturity and
reduce respiratory distress syndrome. It does not stop contractions, treat infection,
or lower blood pressure.
10.A newborn is 1 hour old and has a blood glucose of 35 mg/dL. Which sign
would the nurse expect?
A) Jitteriness and poor feeding
B) Hypertonia and fever
C) Projectile vomiting
D) Bulging fontanel
Correct Answer: A
Hypoglycemia in a newborn may present with jitteriness, poor feeding, lethargy,
and temperature instability. Hypertonia, fever, vomiting, and bulging fontanel are
not typical signs of hypoglycemia.
