COMPREHENSIVE NCLEX-RN
NURSING MIDWIFERY
350 High-Yield Exam Practice Questions with Detailed Answers & Rationales
NCLEX-RN & NCK Licensure Standard
Master Maternal-Newborn Nursing & Midwifery: This comprehensive
study bank features 350 rigorously vetted NCLEX-style practice questions
covering antepartum care, intrapartum labor management, postpartum
recovery, neonatal assessment, and high-risk obstetric emergencies. Each
item includes detailed distractor rationales to ensure deep clinical mastery
and exam success.
Content Domains: Antepartum, Intrapartum, Postpartum, Neonatal, & High-Risk Obstetric Care
Format: Complete Questions, Options, Correct Answers, & Clinical Rationales
© Professional Nursing Licensure Series
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 1 of 142
, Table of Contents & Domain Breakdown
Domain 1: Antepartum Care Questions
& Fetal Monitoring (Q1 – 1–90
Q90)
Domain 2: Intrapartum Questions
Care & Labor Management 91–175
(Q91 – Q175)
Domain 3: Postpartum Questions
Care & Complications 176–250
(Q176 – Q250)
Domain 4: Newborn Questions
Assessment & Neonatal 251–310
Care (Q251 – Q310)
Domain 5: High-Risk Questions
Pregnancy & Obstetric 311–350
Emergencies (Q311 – Q350)
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 2 of 142
, DOMAIN 1: ANTEPARTUM CARE & FETAL MONITORING
Question 1 of 350
A pregnant client at 28 weeks gestation presents for a routine prenatal visit. Her blood pressure is
138/88 mmHg, urine dipstick shows negative protein, and fundal height is 28 cm. Which intervention is
most appropriate by the nurse?
A. Reassess blood pressure after 15 minutes of quiet rest.
B. Immediately administer IV hydralazine.
C. Order a STAT 24-hour urine collection for protein.
D. Prepare the client for immediate emergency delivery.
Correct Answer: Option A
Clinical Rationale: A single elevated reading of 138/88 mmHg without proteinuria or systemic symptoms does
not satisfy criteria for preeclampsia. Blood pressure should be rechecked after a resting period in a lateral
recumbent position to obtain an accurate baseline before initiating invasive diagnostics or medications.
Expanded NCLEX rationale emphasizes monitoring maternal stability, fetal heart rate parameters, and timely
intervention protocols to prevent maternal-fetal morbidity.
Question 2 of 350
A nurse is performing Leopold's maneuvers on a primigravida at 36 weeks gestation. While palpating
the fundus, the nurse feels a firm, round, hard, and ballottable mass. How should the nurse document
the fetal presentation?
A. Cephalic presentation
B. Breech presentation
C. Transverse lie
D. Oblique lie
Correct Answer: Option B
Clinical Rationale: A firm, hard, round, and ballottable object in the uterine fundus indicates the fetal head is
at the upper pole, which confirms a breech presentation. In a vertex/cephalic presentation, the softer, less
symmetrical fetal buttocks are felt in the fundus. Expanded NCLEX rationale emphasizes monitoring maternal
stability, fetal heart rate parameters, and timely intervention protocols to prevent maternal-fetal morbidity.
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 3 of 142
, Question 3 of 350
A pregnant patient at 32 weeks gestation diagnosed with severe preeclampsia is receiving an
intravenous magnesium sulfate infusion. Which assessment finding requires immediate cessation of
the infusion?
A. Patellar reflex rated as 2+
B. Respiratory rate of 10 breaths/min
C. Urinary output of 40 mL/hr
D. Serum magnesium level of 5.5 mEq/L
Correct Answer: Option B
Clinical Rationale: Magnesium sulfate toxicity causes central nervous system depression. A respiratory rate
below 12 breaths/minute, absence of deep tendon reflexes, and oliguria (<30 mL/hr) are signs of toxicity
requiring immediate discontinuation of the infusion and administration of calcium gluconate. Expanded
NCLEX rationale emphasizes monitoring maternal stability, fetal heart rate parameters, and timely
intervention protocols to prevent maternal-fetal morbidity.
Question 4 of 350
A nurse is interpreting a fetal heart rate (FHR) monitor strip for a laboring client. The strip
demonstrates variable decelerations. What is the physiological cause of variable decelerations?
A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Head compression during contractions
D. Fetal hypoxia due to maternal hypotension
Correct Answer: Option B
Clinical Rationale: Variable decelerations are abrupt decreases in FHR caused by umbilical cord compression.
Early decelerations are caused by fetal head compression, and late decelerations indicate uteroplacental
insufficiency. Expanded NCLEX rationale emphasizes monitoring maternal stability, fetal heart rate
parameters, and timely intervention protocols to prevent maternal-fetal morbidity.
Question 5 of 350
A postpartum woman 12 hours after an uncomplicated vaginal delivery reports feeling faint when
standing. Her vital signs are BP 92/58 mmHg, HR 108 bpm, and fundus is firm at the umbilicus. What is
the initial nursing action?
A. Assist the patient back to bed and assess lochia amount and blood pressure.
B. Administer IV oxytocin immediately.
C. Perform vigorous uterine massage.
D. Notify the physician of impending hypovolemic shock.
Correct Answer: Option A
Clinical Rationale: Orthostatic hypotension is common in early postpartum due to splanchnic engorgement.
Safety is primary: assist her back to bed to prevent falls, then evaluate vital signs and lochia to rule out
concealed or unrecognized postpartum hemorrhage. Expanded NCLEX rationale emphasizes monitoring
maternal stability, fetal heart rate parameters, and timely intervention protocols to prevent maternal-fetal
morbidity.
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 4 of 142
NURSING MIDWIFERY
350 High-Yield Exam Practice Questions with Detailed Answers & Rationales
NCLEX-RN & NCK Licensure Standard
Master Maternal-Newborn Nursing & Midwifery: This comprehensive
study bank features 350 rigorously vetted NCLEX-style practice questions
covering antepartum care, intrapartum labor management, postpartum
recovery, neonatal assessment, and high-risk obstetric emergencies. Each
item includes detailed distractor rationales to ensure deep clinical mastery
and exam success.
Content Domains: Antepartum, Intrapartum, Postpartum, Neonatal, & High-Risk Obstetric Care
Format: Complete Questions, Options, Correct Answers, & Clinical Rationales
© Professional Nursing Licensure Series
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 1 of 142
, Table of Contents & Domain Breakdown
Domain 1: Antepartum Care Questions
& Fetal Monitoring (Q1 – 1–90
Q90)
Domain 2: Intrapartum Questions
Care & Labor Management 91–175
(Q91 – Q175)
Domain 3: Postpartum Questions
Care & Complications 176–250
(Q176 – Q250)
Domain 4: Newborn Questions
Assessment & Neonatal 251–310
Care (Q251 – Q310)
Domain 5: High-Risk Questions
Pregnancy & Obstetric 311–350
Emergencies (Q311 – Q350)
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 2 of 142
, DOMAIN 1: ANTEPARTUM CARE & FETAL MONITORING
Question 1 of 350
A pregnant client at 28 weeks gestation presents for a routine prenatal visit. Her blood pressure is
138/88 mmHg, urine dipstick shows negative protein, and fundal height is 28 cm. Which intervention is
most appropriate by the nurse?
A. Reassess blood pressure after 15 minutes of quiet rest.
B. Immediately administer IV hydralazine.
C. Order a STAT 24-hour urine collection for protein.
D. Prepare the client for immediate emergency delivery.
Correct Answer: Option A
Clinical Rationale: A single elevated reading of 138/88 mmHg without proteinuria or systemic symptoms does
not satisfy criteria for preeclampsia. Blood pressure should be rechecked after a resting period in a lateral
recumbent position to obtain an accurate baseline before initiating invasive diagnostics or medications.
Expanded NCLEX rationale emphasizes monitoring maternal stability, fetal heart rate parameters, and timely
intervention protocols to prevent maternal-fetal morbidity.
Question 2 of 350
A nurse is performing Leopold's maneuvers on a primigravida at 36 weeks gestation. While palpating
the fundus, the nurse feels a firm, round, hard, and ballottable mass. How should the nurse document
the fetal presentation?
A. Cephalic presentation
B. Breech presentation
C. Transverse lie
D. Oblique lie
Correct Answer: Option B
Clinical Rationale: A firm, hard, round, and ballottable object in the uterine fundus indicates the fetal head is
at the upper pole, which confirms a breech presentation. In a vertex/cephalic presentation, the softer, less
symmetrical fetal buttocks are felt in the fundus. Expanded NCLEX rationale emphasizes monitoring maternal
stability, fetal heart rate parameters, and timely intervention protocols to prevent maternal-fetal morbidity.
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 3 of 142
, Question 3 of 350
A pregnant patient at 32 weeks gestation diagnosed with severe preeclampsia is receiving an
intravenous magnesium sulfate infusion. Which assessment finding requires immediate cessation of
the infusion?
A. Patellar reflex rated as 2+
B. Respiratory rate of 10 breaths/min
C. Urinary output of 40 mL/hr
D. Serum magnesium level of 5.5 mEq/L
Correct Answer: Option B
Clinical Rationale: Magnesium sulfate toxicity causes central nervous system depression. A respiratory rate
below 12 breaths/minute, absence of deep tendon reflexes, and oliguria (<30 mL/hr) are signs of toxicity
requiring immediate discontinuation of the infusion and administration of calcium gluconate. Expanded
NCLEX rationale emphasizes monitoring maternal stability, fetal heart rate parameters, and timely
intervention protocols to prevent maternal-fetal morbidity.
Question 4 of 350
A nurse is interpreting a fetal heart rate (FHR) monitor strip for a laboring client. The strip
demonstrates variable decelerations. What is the physiological cause of variable decelerations?
A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Head compression during contractions
D. Fetal hypoxia due to maternal hypotension
Correct Answer: Option B
Clinical Rationale: Variable decelerations are abrupt decreases in FHR caused by umbilical cord compression.
Early decelerations are caused by fetal head compression, and late decelerations indicate uteroplacental
insufficiency. Expanded NCLEX rationale emphasizes monitoring maternal stability, fetal heart rate
parameters, and timely intervention protocols to prevent maternal-fetal morbidity.
Question 5 of 350
A postpartum woman 12 hours after an uncomplicated vaginal delivery reports feeling faint when
standing. Her vital signs are BP 92/58 mmHg, HR 108 bpm, and fundus is firm at the umbilicus. What is
the initial nursing action?
A. Assist the patient back to bed and assess lochia amount and blood pressure.
B. Administer IV oxytocin immediately.
C. Perform vigorous uterine massage.
D. Notify the physician of impending hypovolemic shock.
Correct Answer: Option A
Clinical Rationale: Orthostatic hypotension is common in early postpartum due to splanchnic engorgement.
Safety is primary: assist her back to bed to prevent falls, then evaluate vital signs and lochia to rule out
concealed or unrecognized postpartum hemorrhage. Expanded NCLEX rationale emphasizes monitoring
maternal stability, fetal heart rate parameters, and timely intervention protocols to prevent maternal-fetal
morbidity.
NCLEX-RN Nursing Midwifery Examination Prep | 350 Question Bank Page 4 of 142
