NCLEX-RN Maternal & Newborn Nursing 2026
1. A pregnant client at 10 weeks' gestation asks why folic acid is important.
Which response is best?
A. "It prevents gestational diabetes."
B. "It helps reduce the risk of neural tube defects."
C. "It prevents postpartum hemorrhage."
D. "It increases fetal lung maturity."
Answer: B
Rationale: Folic acid supplementation before conception and during early pregnancy helps
reduce the risk of neural tube defects.
2. Which finding should a pregnant client report immediately?
A. Mild ankle swelling at the end of the day
B. Urinary frequency during the first trimester
C. Vaginal bleeding
D. Mild fatigue
Answer: C
Rationale: Vaginal bleeding during pregnancy may indicate a serious complication and requires
prompt evaluation.
3. A client at 32 weeks' gestation reports a severe headache and blurred vision.
What is the priority action?
A. Encourage oral fluids
B. Advise the client to rest and reassess tomorrow
C. Notify the health care provider immediately
D. Encourage ambulation
Answer: C
,Rationale: Severe headache and visual disturbances may indicate severe preeclampsia and
require immediate evaluation.
4. Which laboratory finding is most concerning in a client with preeclampsia?
A. Platelet count of 80,000/mm³
B. Hemoglobin of 12 g/dL
C. Blood glucose of 90 mg/dL
D. Sodium of 140 mEq/L
Answer: A
Rationale: Thrombocytopenia may indicate worsening preeclampsia or HELLP syndrome.
5. A nurse is teaching a client with gestational diabetes about fetal surveillance.
Which statement indicates understanding?
A. "I should ignore fetal movement because the fetus is monitored at appointments."
B. "I should report a significant decrease in fetal movement."
C. "Fetal movement should stop near term."
D. "Only painful movement should be reported."
Answer: B
Rationale: A significant decrease in fetal movement can indicate fetal compromise and should be
evaluated promptly.
6. Which finding is expected during pregnancy?
A. Decreased blood volume
B. Increased cardiac output
C. Decreased heart rate
D. Decreased renal blood flow
Answer: B
Rationale: Maternal cardiac output increases during pregnancy to meet maternal and fetal
metabolic demands.
,7. A pregnant client is Rh-negative and unsensitized. Which intervention should
the nurse anticipate?
A. Administration of Rho(D) immune globulin as indicated
B. Administration of a live vaccine during pregnancy
C. Permanent anticoagulation
D. Daily insulin therapy
Answer: A
Rationale: Rho(D) immune globulin helps prevent Rh sensitization in eligible Rh-negative
clients.
8. A client at 34 weeks' gestation has painless, bright-red vaginal bleeding. Which
condition is most likely?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Chorioamnionitis
Answer: A
Rationale: Placenta previa commonly presents with painless, bright-red vaginal bleeding.
9. Which finding is most consistent with placental abruption?
A. Painless bleeding
B. Abdominal pain and uterine tenderness
C. Increased fetal movement
D. Soft, nontender uterus
Answer: B
Rationale: Placental abruption commonly causes painful vaginal bleeding, uterine tenderness,
and increased uterine tone.
10. A client has hyperemesis gravidarum. Which finding is most concerning?
, A. Weight loss and dehydration
B. Mild nausea
C. Increased appetite
D. Increased fetal movement
Answer: A
Rationale: Persistent vomiting can cause dehydration, electrolyte imbalance, and significant
weight loss.
11. A pregnant client should avoid which food?
A. Pasteurized yogurt
B. Fully cooked chicken
C. Unpasteurized dairy products
D. Washed vegetables
Answer: C
Rationale: Unpasteurized dairy products may contain pathogens that can cause serious infection
during pregnancy.
12. Which statement by a pregnant client indicates correct understanding of
prenatal vitamins?
A. "I can take more than prescribed if I feel tired."
B. "I should take them only when I remember."
C. "I should take them as prescribed."
D. "They replace a healthy diet."
Answer: C
Rationale: Prenatal vitamins supplement nutritional intake but should be taken as prescribed
and do not replace a balanced diet.
13. A pregnant client reports dizziness when lying flat. Which instruction should
the nurse provide?
A. Lie completely flat
B. Turn to a side-lying position
1. A pregnant client at 10 weeks' gestation asks why folic acid is important.
Which response is best?
A. "It prevents gestational diabetes."
B. "It helps reduce the risk of neural tube defects."
C. "It prevents postpartum hemorrhage."
D. "It increases fetal lung maturity."
Answer: B
Rationale: Folic acid supplementation before conception and during early pregnancy helps
reduce the risk of neural tube defects.
2. Which finding should a pregnant client report immediately?
A. Mild ankle swelling at the end of the day
B. Urinary frequency during the first trimester
C. Vaginal bleeding
D. Mild fatigue
Answer: C
Rationale: Vaginal bleeding during pregnancy may indicate a serious complication and requires
prompt evaluation.
3. A client at 32 weeks' gestation reports a severe headache and blurred vision.
What is the priority action?
A. Encourage oral fluids
B. Advise the client to rest and reassess tomorrow
C. Notify the health care provider immediately
D. Encourage ambulation
Answer: C
,Rationale: Severe headache and visual disturbances may indicate severe preeclampsia and
require immediate evaluation.
4. Which laboratory finding is most concerning in a client with preeclampsia?
A. Platelet count of 80,000/mm³
B. Hemoglobin of 12 g/dL
C. Blood glucose of 90 mg/dL
D. Sodium of 140 mEq/L
Answer: A
Rationale: Thrombocytopenia may indicate worsening preeclampsia or HELLP syndrome.
5. A nurse is teaching a client with gestational diabetes about fetal surveillance.
Which statement indicates understanding?
A. "I should ignore fetal movement because the fetus is monitored at appointments."
B. "I should report a significant decrease in fetal movement."
C. "Fetal movement should stop near term."
D. "Only painful movement should be reported."
Answer: B
Rationale: A significant decrease in fetal movement can indicate fetal compromise and should be
evaluated promptly.
6. Which finding is expected during pregnancy?
A. Decreased blood volume
B. Increased cardiac output
C. Decreased heart rate
D. Decreased renal blood flow
Answer: B
Rationale: Maternal cardiac output increases during pregnancy to meet maternal and fetal
metabolic demands.
,7. A pregnant client is Rh-negative and unsensitized. Which intervention should
the nurse anticipate?
A. Administration of Rho(D) immune globulin as indicated
B. Administration of a live vaccine during pregnancy
C. Permanent anticoagulation
D. Daily insulin therapy
Answer: A
Rationale: Rho(D) immune globulin helps prevent Rh sensitization in eligible Rh-negative
clients.
8. A client at 34 weeks' gestation has painless, bright-red vaginal bleeding. Which
condition is most likely?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Chorioamnionitis
Answer: A
Rationale: Placenta previa commonly presents with painless, bright-red vaginal bleeding.
9. Which finding is most consistent with placental abruption?
A. Painless bleeding
B. Abdominal pain and uterine tenderness
C. Increased fetal movement
D. Soft, nontender uterus
Answer: B
Rationale: Placental abruption commonly causes painful vaginal bleeding, uterine tenderness,
and increased uterine tone.
10. A client has hyperemesis gravidarum. Which finding is most concerning?
, A. Weight loss and dehydration
B. Mild nausea
C. Increased appetite
D. Increased fetal movement
Answer: A
Rationale: Persistent vomiting can cause dehydration, electrolyte imbalance, and significant
weight loss.
11. A pregnant client should avoid which food?
A. Pasteurized yogurt
B. Fully cooked chicken
C. Unpasteurized dairy products
D. Washed vegetables
Answer: C
Rationale: Unpasteurized dairy products may contain pathogens that can cause serious infection
during pregnancy.
12. Which statement by a pregnant client indicates correct understanding of
prenatal vitamins?
A. "I can take more than prescribed if I feel tired."
B. "I should take them only when I remember."
C. "I should take them as prescribed."
D. "They replace a healthy diet."
Answer: C
Rationale: Prenatal vitamins supplement nutritional intake but should be taken as prescribed
and do not replace a balanced diet.
13. A pregnant client reports dizziness when lying flat. Which instruction should
the nurse provide?
A. Lie completely flat
B. Turn to a side-lying position
