KAPLAN NCLEX-PN MATERNAL-NEWBORN NURSING
EXAM PRACTICE | ADVANCED STUDY GUIDE |
COMPREHENSIVE TESTBANK WITH PRACTICE
QUESTIONS & CORRECT ANSWERS | LATEST UPDATE
2026/2027
i. Antepartum Assessment and High-Risk Pregnancy
ii. Pregnancy Complications and Emergency Management
iii. Labor, Delivery, and Fetal Monitoring
iv. Postpartum Assessment and Complications
v. Newborn Assessment and Adaptation
vi. Newborn Complications and Nursing Interventions
vii. Maternal-Newborn Medications, Education, and Professional Judgment
INTRODUCTION
This comprehensive Kaplan NCLEX-PN Maternal-Newborn Nursing practice
examination emphasizes advanced clinical judgment across antepartum,
intrapartum, postpartum, and neonatal care. Questions are designed to challenge
application of nursing principles, prioritization, interpretation of clinical findings,
medication safety, fetal and maternal assessment, emergency recognition, patient
education, and evidence-based professional judgment. The examination reflects the
level of reasoning expected on contemporary practical nursing licensure
examinations and advanced nursing assessments. Students should expect complex
clinical scenarios requiring identification of the most urgent problem, selection of
appropriate nursing interventions, recognition of expected versus abnormal
findings, and evaluation of maternal or newborn responses to treatment. Particular
emphasis is placed on patient safety, complications, delegation, and rapid clinical
decision-making.
Question 1
A client at 34 weeks' gestation presents to the maternity unit with severe headache,
blurred vision, and epigastric pain. Blood pressure is 168/112 mm Hg, and urine
protein is 3+. Which action should the practical nurse prioritize?
,A. Place the client in a supine position and reassess blood pressure in 30 minutes.
B. Initiate seizure precautions and promptly notify the healthcare provider.
C. Encourage oral fluids to increase renal perfusion.
D. Ambulate the client to determine whether symptoms improve.
🔴 Correct Answer: B. Initiate seizure precautions and promptly notify the
healthcare provider.
🔵 Explanation: Severe hypertension accompanied by neurologic symptoms and
epigastric pain indicates severe preeclampsia with risk for eclampsia, stroke, placental
complications, and maternal organ injury. Seizure precautions and immediate
escalation of care are priorities. Supine positioning can decrease venous return, and
ambulation is unsafe. Excessive fluid administration may increase the risk of
pulmonary edema.
Question 2
A client receiving magnesium sulfate for severe preeclampsia has a respiratory rate
of 10/min, absent patellar reflexes, and urine output of 20 mL/hr. Which
intervention is most appropriate?
A. Increase the magnesium sulfate infusion.
B. Administer calcium gluconate as prescribed.
C. Encourage the client to ambulate.
D. Administer an additional dose of an antihypertensive.
🔴 Correct Answer: B. Administer calcium gluconate as prescribed.
🔵 Explanation: Respiratory depression, absent deep-tendon reflexes, and oliguria are
classic findings of magnesium toxicity. The infusion should be stopped and the
provider notified, with calcium gluconate available as the magnesium antagonist.
Reduced renal clearance increases toxicity risk.
Question 3
A pregnant client at 30 weeks reports painless, bright-red vaginal bleeding. The
abdomen is soft and nontender, and fetal heart rate is currently reassuring. Which
nursing action is appropriate?
,A. Perform a digital vaginal examination to assess cervical dilation.
B. Encourage ambulation to determine whether bleeding increases.
C. Avoid vaginal examination and notify the healthcare provider.
D. Apply fundal pressure to assess uterine tenderness.
🔴 Correct Answer: C. Avoid vaginal examination and notify the healthcare
provider.
🔵 Explanation: Painless, bright-red bleeding in the third trimester is highly
concerning for placenta previa. Digital vaginal examination can disrupt the placenta
and precipitate severe hemorrhage. Until placental location is established, vaginal
manipulation should be avoided.
Question 4
A client at 35 weeks' gestation presents with sudden severe abdominal pain, a rigid
tender uterus, and dark vaginal bleeding. The fetal heart rate demonstrates
recurrent late decelerations. Which condition should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Gestational hypertension
D. Preterm premature rupture of membranes
🔴 Correct Answer: B. Abruptio placentae
🔵 Explanation: Painful vaginal bleeding accompanied by uterine tenderness or
rigidity and fetal compromise is characteristic of placental abruption. Placenta previa
typically causes painless bleeding. Abruption can rapidly result in maternal
hemorrhage, disseminated intravascular coagulation, and fetal hypoxia.
Question 5
A client with gestational diabetes is prescribed insulin therapy. During teaching,
which statement requires immediate correction?
A. “I should carry a rapidly absorbed source of glucose.”
B. “I should monitor my blood glucose according to my prescribed schedule.”
C. “If my appetite decreases, I should automatically take the full insulin dose
without contacting anyone.”
, D. “I should recognize sweating, tremors, and confusion as possible signs of
hypoglycemia.”
🔴 Correct Answer: C. “If my appetite decreases, I should automatically take the
full insulin dose without contacting anyone.”
🔵 Explanation: Reduced food intake can increase the risk of hypoglycemia when
insulin is administered. Insulin adjustments depend on the prescribed regimen and
glucose measurements; the client should follow individualized sick-day instructions
and contact the healthcare team when intake is significantly reduced. Hypoglycemia
requires prompt recognition and treatment.
Question 6
A client at 39 weeks' gestation reports a sudden gush of clear fluid from the vagina.
Which assessment is most important initially?
A. Maternal dietary intake
B. Fetal heart rate
C. Cervical effacement only
D. Maternal deep-tendon reflexes
🔴 Correct Answer: B. Fetal heart rate
🔵 Explanation: Following suspected rupture of membranes, fetal heart rate
assessment is a priority because cord prolapse or compression can occur, producing
acute fetal compromise. Further assessment can determine the characteristics of the
fluid and confirm rupture while minimizing unnecessary vaginal examinations.
Question 7
A laboring client receiving oxytocin develops recurrent late fetal heart-rate
decelerations. Which intervention should the nurse perform first?
A. Increase the oxytocin infusion.
B. Reposition the client laterally.
C. Encourage the client to begin pushing.
D. Perform a vaginal examination before intervening.
🔴 Correct Answer: B. Reposition the client laterally.
EXAM PRACTICE | ADVANCED STUDY GUIDE |
COMPREHENSIVE TESTBANK WITH PRACTICE
QUESTIONS & CORRECT ANSWERS | LATEST UPDATE
2026/2027
i. Antepartum Assessment and High-Risk Pregnancy
ii. Pregnancy Complications and Emergency Management
iii. Labor, Delivery, and Fetal Monitoring
iv. Postpartum Assessment and Complications
v. Newborn Assessment and Adaptation
vi. Newborn Complications and Nursing Interventions
vii. Maternal-Newborn Medications, Education, and Professional Judgment
INTRODUCTION
This comprehensive Kaplan NCLEX-PN Maternal-Newborn Nursing practice
examination emphasizes advanced clinical judgment across antepartum,
intrapartum, postpartum, and neonatal care. Questions are designed to challenge
application of nursing principles, prioritization, interpretation of clinical findings,
medication safety, fetal and maternal assessment, emergency recognition, patient
education, and evidence-based professional judgment. The examination reflects the
level of reasoning expected on contemporary practical nursing licensure
examinations and advanced nursing assessments. Students should expect complex
clinical scenarios requiring identification of the most urgent problem, selection of
appropriate nursing interventions, recognition of expected versus abnormal
findings, and evaluation of maternal or newborn responses to treatment. Particular
emphasis is placed on patient safety, complications, delegation, and rapid clinical
decision-making.
Question 1
A client at 34 weeks' gestation presents to the maternity unit with severe headache,
blurred vision, and epigastric pain. Blood pressure is 168/112 mm Hg, and urine
protein is 3+. Which action should the practical nurse prioritize?
,A. Place the client in a supine position and reassess blood pressure in 30 minutes.
B. Initiate seizure precautions and promptly notify the healthcare provider.
C. Encourage oral fluids to increase renal perfusion.
D. Ambulate the client to determine whether symptoms improve.
🔴 Correct Answer: B. Initiate seizure precautions and promptly notify the
healthcare provider.
🔵 Explanation: Severe hypertension accompanied by neurologic symptoms and
epigastric pain indicates severe preeclampsia with risk for eclampsia, stroke, placental
complications, and maternal organ injury. Seizure precautions and immediate
escalation of care are priorities. Supine positioning can decrease venous return, and
ambulation is unsafe. Excessive fluid administration may increase the risk of
pulmonary edema.
Question 2
A client receiving magnesium sulfate for severe preeclampsia has a respiratory rate
of 10/min, absent patellar reflexes, and urine output of 20 mL/hr. Which
intervention is most appropriate?
A. Increase the magnesium sulfate infusion.
B. Administer calcium gluconate as prescribed.
C. Encourage the client to ambulate.
D. Administer an additional dose of an antihypertensive.
🔴 Correct Answer: B. Administer calcium gluconate as prescribed.
🔵 Explanation: Respiratory depression, absent deep-tendon reflexes, and oliguria are
classic findings of magnesium toxicity. The infusion should be stopped and the
provider notified, with calcium gluconate available as the magnesium antagonist.
Reduced renal clearance increases toxicity risk.
Question 3
A pregnant client at 30 weeks reports painless, bright-red vaginal bleeding. The
abdomen is soft and nontender, and fetal heart rate is currently reassuring. Which
nursing action is appropriate?
,A. Perform a digital vaginal examination to assess cervical dilation.
B. Encourage ambulation to determine whether bleeding increases.
C. Avoid vaginal examination and notify the healthcare provider.
D. Apply fundal pressure to assess uterine tenderness.
🔴 Correct Answer: C. Avoid vaginal examination and notify the healthcare
provider.
🔵 Explanation: Painless, bright-red bleeding in the third trimester is highly
concerning for placenta previa. Digital vaginal examination can disrupt the placenta
and precipitate severe hemorrhage. Until placental location is established, vaginal
manipulation should be avoided.
Question 4
A client at 35 weeks' gestation presents with sudden severe abdominal pain, a rigid
tender uterus, and dark vaginal bleeding. The fetal heart rate demonstrates
recurrent late decelerations. Which condition should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Gestational hypertension
D. Preterm premature rupture of membranes
🔴 Correct Answer: B. Abruptio placentae
🔵 Explanation: Painful vaginal bleeding accompanied by uterine tenderness or
rigidity and fetal compromise is characteristic of placental abruption. Placenta previa
typically causes painless bleeding. Abruption can rapidly result in maternal
hemorrhage, disseminated intravascular coagulation, and fetal hypoxia.
Question 5
A client with gestational diabetes is prescribed insulin therapy. During teaching,
which statement requires immediate correction?
A. “I should carry a rapidly absorbed source of glucose.”
B. “I should monitor my blood glucose according to my prescribed schedule.”
C. “If my appetite decreases, I should automatically take the full insulin dose
without contacting anyone.”
, D. “I should recognize sweating, tremors, and confusion as possible signs of
hypoglycemia.”
🔴 Correct Answer: C. “If my appetite decreases, I should automatically take the
full insulin dose without contacting anyone.”
🔵 Explanation: Reduced food intake can increase the risk of hypoglycemia when
insulin is administered. Insulin adjustments depend on the prescribed regimen and
glucose measurements; the client should follow individualized sick-day instructions
and contact the healthcare team when intake is significantly reduced. Hypoglycemia
requires prompt recognition and treatment.
Question 6
A client at 39 weeks' gestation reports a sudden gush of clear fluid from the vagina.
Which assessment is most important initially?
A. Maternal dietary intake
B. Fetal heart rate
C. Cervical effacement only
D. Maternal deep-tendon reflexes
🔴 Correct Answer: B. Fetal heart rate
🔵 Explanation: Following suspected rupture of membranes, fetal heart rate
assessment is a priority because cord prolapse or compression can occur, producing
acute fetal compromise. Further assessment can determine the characteristics of the
fluid and confirm rupture while minimizing unnecessary vaginal examinations.
Question 7
A laboring client receiving oxytocin develops recurrent late fetal heart-rate
decelerations. Which intervention should the nurse perform first?
A. Increase the oxytocin infusion.
B. Reposition the client laterally.
C. Encourage the client to begin pushing.
D. Perform a vaginal examination before intervening.
🔴 Correct Answer: B. Reposition the client laterally.
