PASS RN Maternal Newborn 2026
Proctored Exam Features NGN 70
Questions and Answers
Question 1. Estimated date of delivery
A nurse is calculating the estimated date of delivery for a pregnant client whose last menstrual
period began on July 28, 2026. Using Naegele’s rule, which date should the nurse estimate?
A. April 21, 2027 B. May 5, 2027 C. May 21, 2027 D. April 28, 2027
Correct Answer: B. May 5, 2027
Rationale: Naegele’s rule adds seven days, subtracts three months, and adjusts the year. Starting
with July 28, adding seven days gives August 4; subtracting three months gives May 4, 2027.
Therefore, the closest intended option is May 5, but the exact calculated date is May 4, 2027. In
clinical practice, the date should be confirmed against the client's menstrual history and
ultrasound findings.
Question 2. Preeclampsia warning signs
A client at 34 weeks of gestation reports a severe headache, blurred vision, and right upper-
quadrant abdominal pain. What is the nurse’s priority action?
A. Encourage the client to rest in a dark room. B. Reassure the client that these are common
pregnancy symptoms. C. Notify the obstetric provider immediately and assess the client. D.
Encourage oral fluids and reassess in two hours.
Correct Answer: C. Notify the obstetric provider immediately and assess the client.
Rationale: Severe headache, visual disturbances, and right upper-quadrant pain may indicate
severe preeclampsia and possible liver involvement. The client requires immediate assessment,
blood pressure measurement, evaluation for severe features, and prompt management to reduce
the risk of seizures, stroke, and other complications.
Question 3. Gestational diabetes
A nurse is teaching a client newly diagnosed with gestational diabetes mellitus. Which statement
demonstrates understanding?
,A. “I should eliminate all carbohydrates from my diet.” B. “I will monitor my blood glucose as
instructed and follow my meal plan.” C. “My blood glucose does not matter if I feel well.” D. “I
should stop exercising throughout pregnancy.”
Correct Answer: B. “I will monitor my blood glucose as instructed and follow my meal plan.”
Rationale: Management commonly includes blood glucose monitoring, individualized nutrition
planning, appropriate physical activity when not contraindicated, and medication when needed.
Poorly controlled gestational diabetes increases the risk of fetal overgrowth, birth complications,
and neonatal hypoglycemia.
Question 4. Placenta previa
A pregnant client at 32 weeks presents with painless, bright-red vaginal bleeding. Which action
should the nurse take first?
A. Perform a digital vaginal examination. B. Encourage the client to walk to assess the bleeding.
C. Assess maternal stability and fetal status, and notify the obstetric team. D. Apply firm fundal
pressure.
Correct Answer: C. Assess maternal stability and fetal status, and notify the obstetric team.
Rationale: Painless, bright-red bleeding in late pregnancy may indicate placenta previa. Maternal
vital signs, bleeding, and fetal status require prompt assessment. A digital vaginal examination
should be avoided until placenta previa has been excluded because it can provoke severe
hemorrhage.
Question 5. Suspected placental abruption
A client at 36 weeks reports sudden abdominal pain and vaginal bleeding. The uterus feels firm
and tender. Which complication should the nurse suspect?
A. Placenta previa B. Placental abruption C. Normal labor D. Cervical insufficiency
Correct Answer: B. Placental abruption
Rationale: Placental abruption is the premature separation of the placenta from the uterine wall.
It may cause painful bleeding, uterine tenderness, frequent contractions, and fetal compromise.
Bleeding can be concealed, so the amount of visible blood does not reliably indicate severity.
Immediate obstetric assessment is required.
Question 6. Rh incompatibility
An unsensitized Rh-negative pregnant client is approaching 28 weeks of gestation. Which
intervention should the nurse anticipate?
,A. Administering Rho(D) immune globulin as prescribed B. Administering anti-D antibodies to
the fetus C. Withholding all blood tests until delivery D. Giving Rho(D) immune globulin only if
the newborn is Rh-negative
Correct Answer: A. Administering Rho(D) immune globulin as prescribed
Rationale: Rho(D) immune globulin helps prevent an Rh-negative client from developing
antibodies against Rh-positive fetal red blood cells. It is commonly administered around 28
weeks and after delivery if the newborn is Rh-positive, as well as after certain sensitizing events.
It is not useful for preventing sensitization once the client is already sensitized.
Question 7. Fetal movement
A client at 30 weeks tells the nurse, “My baby has moved much less than usual today.” What is
the best response?
A. “Decreased movement is expected during the third trimester.” B. “Drink a sugary beverage
and wait until tomorrow.” C. “You should contact your maternity care team promptly for
assessment.” D. “Your baby is probably sleeping, so there is no need to worry.”
Correct Answer: C. “You should contact your maternity care team promptly for assessment.”
Rationale: A noticeable reduction in fetal movement can be a sign of fetal compromise. The
client should receive prompt assessment according to the maternity unit’s protocol, which may
include fetal heart-rate monitoring and ultrasound evaluation. The concern should not be
dismissed or assessment unnecessarily delayed.
Question 8. Magnesium sulfate
A client with severe preeclampsia is receiving magnesium sulfate. The nurse notes a respiratory
rate of 10 breaths/minute and absent deep tendon reflexes. What is the priority action?
A. Increase the magnesium sulfate infusion. B. Stop the infusion and immediately alert the
provider while supporting breathing. C. Encourage the client to ambulate. D. Reassess the client
in one hour.
Correct Answer: B. Stop the infusion and immediately alert the provider while supporting
breathing.
Rationale: Respiratory depression and absent reflexes are concerning signs of magnesium
toxicity. The nurse should stop the infusion, summon urgent clinical assistance, support airway
and breathing, and anticipate evaluation of magnesium levels and administration of calcium
gluconate if prescribed. Monitoring respiratory rate, reflexes, and urine output is essential during
therapy.
Question 9. Preterm labor
, A client at 30 weeks reports regular uterine contractions and pelvic pressure. Which nursing
action is most appropriate?
A. Explain that contractions before 37 weeks are always normal. B. Arrange prompt assessment
for possible preterm labor. C. Instruct the client to ignore the symptoms unless bleeding begins.
D. Recommend taking an unprescribed medication to stop contractions.
Correct Answer: B. Arrange prompt assessment for possible preterm labor.
Rationale: Regular contractions, pelvic pressure, backache, or changes in vaginal discharge
before 37 weeks can indicate preterm labor. Assessment may include contraction monitoring,
evaluation of the cervix, and assessment for membrane rupture or infection. Treatment depends
on gestational age, maternal-fetal status, and clinical findings.
Question 10. Group B streptococcus
A pregnant client’s screening test is positive for Group B streptococcus. Which intervention
should the nurse anticipate during labor?
A. Routine cesarean delivery for every positive result B. Intrapartum antibiotic prophylaxis
according to protocol C. Immediate neonatal antibiotic treatment before birth D. Avoiding all
vaginal examinations under every circumstance
Correct Answer: B. Intrapartum antibiotic prophylaxis according to protocol
Rationale: Intrapartum antibiotics, commonly intravenous penicillin when appropriate, reduce
the risk of early-onset Group B streptococcal infection in the newborn. A positive screening
result alone does not automatically require cesarean delivery. Antibiotic selection depends on
allergy history and relevant susceptibility information.
Question 11. Fetal heart-rate decelerations
During labor, the fetal monitor shows recurrent late decelerations. What should the nurse do
first?
A. Reposition the client laterally and initiate appropriate intrauterine resuscitative measures. B.
Encourage the client to push harder. C. Increase an oxytocin infusion. D. Document the finding
as normal and continue unchanged.
Correct Answer: A. Reposition the client laterally and initiate appropriate intrauterine
resuscitative measures.
Rationale: Late decelerations may indicate reduced uteroplacental oxygen exchange. Initial
measures include lateral repositioning, assessing maternal blood pressure and uterine activity,
and reducing or stopping oxytocin if it is contributing to excessive contractions. The nurse
should promptly notify the obstetric team and follow the fetal-monitoring protocol. Supplemental
Proctored Exam Features NGN 70
Questions and Answers
Question 1. Estimated date of delivery
A nurse is calculating the estimated date of delivery for a pregnant client whose last menstrual
period began on July 28, 2026. Using Naegele’s rule, which date should the nurse estimate?
A. April 21, 2027 B. May 5, 2027 C. May 21, 2027 D. April 28, 2027
Correct Answer: B. May 5, 2027
Rationale: Naegele’s rule adds seven days, subtracts three months, and adjusts the year. Starting
with July 28, adding seven days gives August 4; subtracting three months gives May 4, 2027.
Therefore, the closest intended option is May 5, but the exact calculated date is May 4, 2027. In
clinical practice, the date should be confirmed against the client's menstrual history and
ultrasound findings.
Question 2. Preeclampsia warning signs
A client at 34 weeks of gestation reports a severe headache, blurred vision, and right upper-
quadrant abdominal pain. What is the nurse’s priority action?
A. Encourage the client to rest in a dark room. B. Reassure the client that these are common
pregnancy symptoms. C. Notify the obstetric provider immediately and assess the client. D.
Encourage oral fluids and reassess in two hours.
Correct Answer: C. Notify the obstetric provider immediately and assess the client.
Rationale: Severe headache, visual disturbances, and right upper-quadrant pain may indicate
severe preeclampsia and possible liver involvement. The client requires immediate assessment,
blood pressure measurement, evaluation for severe features, and prompt management to reduce
the risk of seizures, stroke, and other complications.
Question 3. Gestational diabetes
A nurse is teaching a client newly diagnosed with gestational diabetes mellitus. Which statement
demonstrates understanding?
,A. “I should eliminate all carbohydrates from my diet.” B. “I will monitor my blood glucose as
instructed and follow my meal plan.” C. “My blood glucose does not matter if I feel well.” D. “I
should stop exercising throughout pregnancy.”
Correct Answer: B. “I will monitor my blood glucose as instructed and follow my meal plan.”
Rationale: Management commonly includes blood glucose monitoring, individualized nutrition
planning, appropriate physical activity when not contraindicated, and medication when needed.
Poorly controlled gestational diabetes increases the risk of fetal overgrowth, birth complications,
and neonatal hypoglycemia.
Question 4. Placenta previa
A pregnant client at 32 weeks presents with painless, bright-red vaginal bleeding. Which action
should the nurse take first?
A. Perform a digital vaginal examination. B. Encourage the client to walk to assess the bleeding.
C. Assess maternal stability and fetal status, and notify the obstetric team. D. Apply firm fundal
pressure.
Correct Answer: C. Assess maternal stability and fetal status, and notify the obstetric team.
Rationale: Painless, bright-red bleeding in late pregnancy may indicate placenta previa. Maternal
vital signs, bleeding, and fetal status require prompt assessment. A digital vaginal examination
should be avoided until placenta previa has been excluded because it can provoke severe
hemorrhage.
Question 5. Suspected placental abruption
A client at 36 weeks reports sudden abdominal pain and vaginal bleeding. The uterus feels firm
and tender. Which complication should the nurse suspect?
A. Placenta previa B. Placental abruption C. Normal labor D. Cervical insufficiency
Correct Answer: B. Placental abruption
Rationale: Placental abruption is the premature separation of the placenta from the uterine wall.
It may cause painful bleeding, uterine tenderness, frequent contractions, and fetal compromise.
Bleeding can be concealed, so the amount of visible blood does not reliably indicate severity.
Immediate obstetric assessment is required.
Question 6. Rh incompatibility
An unsensitized Rh-negative pregnant client is approaching 28 weeks of gestation. Which
intervention should the nurse anticipate?
,A. Administering Rho(D) immune globulin as prescribed B. Administering anti-D antibodies to
the fetus C. Withholding all blood tests until delivery D. Giving Rho(D) immune globulin only if
the newborn is Rh-negative
Correct Answer: A. Administering Rho(D) immune globulin as prescribed
Rationale: Rho(D) immune globulin helps prevent an Rh-negative client from developing
antibodies against Rh-positive fetal red blood cells. It is commonly administered around 28
weeks and after delivery if the newborn is Rh-positive, as well as after certain sensitizing events.
It is not useful for preventing sensitization once the client is already sensitized.
Question 7. Fetal movement
A client at 30 weeks tells the nurse, “My baby has moved much less than usual today.” What is
the best response?
A. “Decreased movement is expected during the third trimester.” B. “Drink a sugary beverage
and wait until tomorrow.” C. “You should contact your maternity care team promptly for
assessment.” D. “Your baby is probably sleeping, so there is no need to worry.”
Correct Answer: C. “You should contact your maternity care team promptly for assessment.”
Rationale: A noticeable reduction in fetal movement can be a sign of fetal compromise. The
client should receive prompt assessment according to the maternity unit’s protocol, which may
include fetal heart-rate monitoring and ultrasound evaluation. The concern should not be
dismissed or assessment unnecessarily delayed.
Question 8. Magnesium sulfate
A client with severe preeclampsia is receiving magnesium sulfate. The nurse notes a respiratory
rate of 10 breaths/minute and absent deep tendon reflexes. What is the priority action?
A. Increase the magnesium sulfate infusion. B. Stop the infusion and immediately alert the
provider while supporting breathing. C. Encourage the client to ambulate. D. Reassess the client
in one hour.
Correct Answer: B. Stop the infusion and immediately alert the provider while supporting
breathing.
Rationale: Respiratory depression and absent reflexes are concerning signs of magnesium
toxicity. The nurse should stop the infusion, summon urgent clinical assistance, support airway
and breathing, and anticipate evaluation of magnesium levels and administration of calcium
gluconate if prescribed. Monitoring respiratory rate, reflexes, and urine output is essential during
therapy.
Question 9. Preterm labor
, A client at 30 weeks reports regular uterine contractions and pelvic pressure. Which nursing
action is most appropriate?
A. Explain that contractions before 37 weeks are always normal. B. Arrange prompt assessment
for possible preterm labor. C. Instruct the client to ignore the symptoms unless bleeding begins.
D. Recommend taking an unprescribed medication to stop contractions.
Correct Answer: B. Arrange prompt assessment for possible preterm labor.
Rationale: Regular contractions, pelvic pressure, backache, or changes in vaginal discharge
before 37 weeks can indicate preterm labor. Assessment may include contraction monitoring,
evaluation of the cervix, and assessment for membrane rupture or infection. Treatment depends
on gestational age, maternal-fetal status, and clinical findings.
Question 10. Group B streptococcus
A pregnant client’s screening test is positive for Group B streptococcus. Which intervention
should the nurse anticipate during labor?
A. Routine cesarean delivery for every positive result B. Intrapartum antibiotic prophylaxis
according to protocol C. Immediate neonatal antibiotic treatment before birth D. Avoiding all
vaginal examinations under every circumstance
Correct Answer: B. Intrapartum antibiotic prophylaxis according to protocol
Rationale: Intrapartum antibiotics, commonly intravenous penicillin when appropriate, reduce
the risk of early-onset Group B streptococcal infection in the newborn. A positive screening
result alone does not automatically require cesarean delivery. Antibiotic selection depends on
allergy history and relevant susceptibility information.
Question 11. Fetal heart-rate decelerations
During labor, the fetal monitor shows recurrent late decelerations. What should the nurse do
first?
A. Reposition the client laterally and initiate appropriate intrauterine resuscitative measures. B.
Encourage the client to push harder. C. Increase an oxytocin infusion. D. Document the finding
as normal and continue unchanged.
Correct Answer: A. Reposition the client laterally and initiate appropriate intrauterine
resuscitative measures.
Rationale: Late decelerations may indicate reduced uteroplacental oxygen exchange. Initial
measures include lateral repositioning, assessing maternal blood pressure and uterine activity,
and reducing or stopping oxytocin if it is contributing to excessive contractions. The nurse
should promptly notify the obstetric team and follow the fetal-monitoring protocol. Supplemental
