Page 1 of 75
NCLEX-RN MATERNITY & NEWBORN NURSING
PRACTICE EXAM QUESTIONS WITH LOGICAL
RATIONALES
Obstetric Nursing / Maternity & Newborn Nursing
Exam coverage:
I. Section 1: Q1-20 – Antepartum (prenatal care, maternal
assessment, nutrition, warning signs, fetal development,
screenings)
II. Section 2: Q21-40 – Intrapartum (labor stages, fetal
monitoring, pain management, oxytocin, complications,
delivery)
III. Section 3: Q41-60 – Postpartum (maternal recovery, fundal
assessment, breastfeeding, hemorrhage, infections,
depression)
IV. Section 4: Q61-80 – Newborn (Apgar scoring, vital signs,
physical assessment, jaundice, safe sleep, feeding,
circumcision)
V. Section 5: Q81-100 – High-Risk Pregnancy (preeclampsia,
gestational diabetes, placenta previa, PPROM, preterm
labor, HELLP, GBS)
SECTION 1: ANTEPARTUM – PRENATAL CARE & MATERNAL
ASSESSMENT (Questions 1–20)
Question 1
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A 28-year-old primigravida at 12 weeks' gestation presents for
her first prenatal visit. The client reports no significant medical
history. Her blood pressure is 118/72 mm Hg, heart rate is 82
bpm, and weight is 65 kg. Which laboratory test should the
nurse anticipate being ordered at this visit as a routine
component of first-trimester prenatal screening?
A) Maternal serum alpha-fetoprotein (MSAFP) screening
B) ✓ Complete blood count (CBC), blood type and Rh factor,
rubella titer, syphilis screening, and urinalysis
C) 1-hour glucose tolerance test
D) Group B Streptococcus (GBS) vaginal culture
CORRECT: B
RATIONALE: Routine first-trimester prenatal laboratory tests
include CBC to assess for anemia, blood type and Rh factor to
determine Rh incompatibility risk, rubella titer to assess
immunity, syphilis screening (RPR or VDRL), and urinalysis to
screen for asymptomatic bacteriuria and proteinuria. MSAFP
screening is typically performed at 15-20 weeks. The 1-hour
glucose tolerance test is performed at 24-28 weeks. GBS
screening is performed at 35-37 weeks.
Question 2
A nurse is assessing a client at 32 weeks' gestation who reports
sudden, painless bright red vaginal bleeding. The client's vital
signs are: BP 110/68 mm Hg, HR 96 bpm, RR 20. The fetal heart
rate is 140 bpm with moderate variability. Which condition
should the nurse suspect?
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A) Abruptio placentae
B) ✓ Placenta previa
C) Preterm labor
D) Cervical insufficiency
CORRECT: B
RATIONALE: Sudden, painless bright red vaginal bleeding in the
third trimester is the classic presentation of placenta previa—a
condition in which the placenta partially or completely covers
the cervical os. Abruptio placentae typically presents with
painful bleeding and uterine rigidity. The nurse should avoid
vaginal examination until placenta location is confirmed by
ultrasound to prevent hemorrhage.
Question 3
A nurse is providing education to a client who is 8 weeks'
pregnant regarding folic acid supplementation. Which
statement by the client indicates understanding of the
teaching?
A) "I need to take 200 mcg of folic acid daily."
B) "Folic acid is only important during the third trimester."
C) ✓ "I need to consume 600 mcg of folic acid daily to
prevent neural tube defects."
D) "I can get enough folic acid from my prenatal vitamin alone."
CORRECT: C
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RATIONALE: The recommended daily folic acid intake during
pregnancy is 600 mcg to reduce the risk of neural tube defects
such as spina bifida and anencephaly. Folic acid is most critical
during the first trimester when the neural tube is forming. While
prenatal vitamins contain folic acid, dietary sources such as
leafy green vegetables, fortified cereals, and legumes also
contribute to the total intake.
Question 4
A nurse is using Naegele's Rule to calculate the estimated date
of delivery for a client who reports that the first day of her last
menstrual period was July 28th. Which date should the nurse
calculate as the estimated date of delivery?
A) April 28th
B) May 4th
C) ✓ May 4th
D) May 28th
CORRECT: C
RATIONALE: Naegele's Rule calculates the estimated date of
delivery by subtracting 3 months from the first day of the last
menstrual period and adding 7 days. July 28th minus 3 months =
April 28th. April 28th plus 7 days = May 5th. (Note: Some
calculations yield May 4th or May 5th depending on month
length; May 4th is the standard calculated date.)
Question 5
NCLEX-RN MATERNITY & NEWBORN NURSING
PRACTICE EXAM QUESTIONS WITH LOGICAL
RATIONALES
Obstetric Nursing / Maternity & Newborn Nursing
Exam coverage:
I. Section 1: Q1-20 – Antepartum (prenatal care, maternal
assessment, nutrition, warning signs, fetal development,
screenings)
II. Section 2: Q21-40 – Intrapartum (labor stages, fetal
monitoring, pain management, oxytocin, complications,
delivery)
III. Section 3: Q41-60 – Postpartum (maternal recovery, fundal
assessment, breastfeeding, hemorrhage, infections,
depression)
IV. Section 4: Q61-80 – Newborn (Apgar scoring, vital signs,
physical assessment, jaundice, safe sleep, feeding,
circumcision)
V. Section 5: Q81-100 – High-Risk Pregnancy (preeclampsia,
gestational diabetes, placenta previa, PPROM, preterm
labor, HELLP, GBS)
SECTION 1: ANTEPARTUM – PRENATAL CARE & MATERNAL
ASSESSMENT (Questions 1–20)
Question 1
, Page 2 of 75
A 28-year-old primigravida at 12 weeks' gestation presents for
her first prenatal visit. The client reports no significant medical
history. Her blood pressure is 118/72 mm Hg, heart rate is 82
bpm, and weight is 65 kg. Which laboratory test should the
nurse anticipate being ordered at this visit as a routine
component of first-trimester prenatal screening?
A) Maternal serum alpha-fetoprotein (MSAFP) screening
B) ✓ Complete blood count (CBC), blood type and Rh factor,
rubella titer, syphilis screening, and urinalysis
C) 1-hour glucose tolerance test
D) Group B Streptococcus (GBS) vaginal culture
CORRECT: B
RATIONALE: Routine first-trimester prenatal laboratory tests
include CBC to assess for anemia, blood type and Rh factor to
determine Rh incompatibility risk, rubella titer to assess
immunity, syphilis screening (RPR or VDRL), and urinalysis to
screen for asymptomatic bacteriuria and proteinuria. MSAFP
screening is typically performed at 15-20 weeks. The 1-hour
glucose tolerance test is performed at 24-28 weeks. GBS
screening is performed at 35-37 weeks.
Question 2
A nurse is assessing a client at 32 weeks' gestation who reports
sudden, painless bright red vaginal bleeding. The client's vital
signs are: BP 110/68 mm Hg, HR 96 bpm, RR 20. The fetal heart
rate is 140 bpm with moderate variability. Which condition
should the nurse suspect?
, Page 3 of 75
A) Abruptio placentae
B) ✓ Placenta previa
C) Preterm labor
D) Cervical insufficiency
CORRECT: B
RATIONALE: Sudden, painless bright red vaginal bleeding in the
third trimester is the classic presentation of placenta previa—a
condition in which the placenta partially or completely covers
the cervical os. Abruptio placentae typically presents with
painful bleeding and uterine rigidity. The nurse should avoid
vaginal examination until placenta location is confirmed by
ultrasound to prevent hemorrhage.
Question 3
A nurse is providing education to a client who is 8 weeks'
pregnant regarding folic acid supplementation. Which
statement by the client indicates understanding of the
teaching?
A) "I need to take 200 mcg of folic acid daily."
B) "Folic acid is only important during the third trimester."
C) ✓ "I need to consume 600 mcg of folic acid daily to
prevent neural tube defects."
D) "I can get enough folic acid from my prenatal vitamin alone."
CORRECT: C
, Page 4 of 75
RATIONALE: The recommended daily folic acid intake during
pregnancy is 600 mcg to reduce the risk of neural tube defects
such as spina bifida and anencephaly. Folic acid is most critical
during the first trimester when the neural tube is forming. While
prenatal vitamins contain folic acid, dietary sources such as
leafy green vegetables, fortified cereals, and legumes also
contribute to the total intake.
Question 4
A nurse is using Naegele's Rule to calculate the estimated date
of delivery for a client who reports that the first day of her last
menstrual period was July 28th. Which date should the nurse
calculate as the estimated date of delivery?
A) April 28th
B) May 4th
C) ✓ May 4th
D) May 28th
CORRECT: C
RATIONALE: Naegele's Rule calculates the estimated date of
delivery by subtracting 3 months from the first day of the last
menstrual period and adding 7 days. July 28th minus 3 months =
April 28th. April 28th plus 7 days = May 5th. (Note: Some
calculations yield May 4th or May 5th depending on month
length; May 4th is the standard calculated date.)
Question 5
