Maternal-Newborn Nursing 2026/2027 | ACTUAL-Style Nursing
Practice Questions & Answers, Maternity and Obstetric Nursing
Exam Prep, Prenatal Care, High-Risk Pregnancy, Labor and
Delivery, Postpartum Complications, Newborn Assessment, and
Detailed Rationales
Question 1: A nurse is reviewing the physiology of lactation with a
postpartum client. Which hormone is primarily responsible for the milk
ejection reflex during breastfeeding?
A. Prolactin
B. Oxytocin
C. Estrogen
D. Progesterone
CORRECT ANSWER: B. Oxytocin
Rationale: Oxytocin is released from the posterior pituitary gland and
stimulates the myoepithelial cells surrounding the alveoli to contract,
causing milk to be ejected from the breast (let-down reflex). Prolactin is
responsible for milk production, while estrogen and progesterone support
pregnancy and are not the primary hormones for milk ejection.
Question 2: A pregnant client at 28 weeks gestation asks the nurse
when she should expect to feel fetal movement consistently. Which
response by the nurse is most accurate?
A. "You should feel movement by 12 weeks."
B. "Most women feel consistent movement between 18 and 22 weeks."
C. "Fetal movement is not felt until the third trimester."
D. "You will only feel movement when the baby is awake."
CORRECT ANSWER: B. "Most women feel consistent movement
between 18 and 22 weeks."
Rationale: Quickening, the first perception of fetal movement, typically
occurs between 18 and 22 weeks in primigravidas and slightly earlier in
multigravidas. By 28 weeks, movement should be well established. Feeling
movement at 12 weeks is too early, and third-trimester-only perception is
incorrect.
Question 3: A nurse is assessing a newborn immediately after birth.
Which finding should the nurse report as a sign of respiratory distress?
,A. Respiratory rate of 40 breaths per minute
B. Nasal flaring and intercostal retractions
C. Acrocyanosis of the hands and feet
D. Periodic breathing with pauses of 5 seconds
CORRECT ANSWER: B. Nasal flaring and intercostal retractions
Rationale: Nasal flaring and intercostal retractions are classic signs of
respiratory distress in a newborn, indicating increased work of breathing. A
respiratory rate of 40 is normal (30–60), acrocyanosis is a normal finding in
the first hours, and periodic breathing with brief pauses is common and
usually benign.
Question 4: A postpartum client who is breastfeeding asks the nurse
how to prevent engorgement. Which instruction should the nurse
include?
A. "Limit fluid intake to 1 liter per day."
B. "Feed the baby on demand and ensure proper latch."
C. "Apply warm compresses before feeding and cold after."
D. "Pump both breasts completely after each feeding."
CORRECT ANSWER: B. "Feed the baby on demand and ensure proper
latch."
Rationale: Frequent, effective breastfeeding on demand with a proper latch
is the best prevention for engorgement. Limiting fluids is not
recommended. Warm compresses before feeding can help with let-down,
and cold compresses after may reduce swelling, but these are treatments
rather than primary prevention. Pumping after feeding can worsen
engorgement by stimulating oversupply.
Question 5: A nurse is caring for a client in the first stage of labor. The
client's cervix is dilated to 4 cm and effaced 80%. The client reports
severe back pain. Which position should the nurse suggest to alleviate
back pain?
A. Supine with legs elevated
B. Lateral recumbent position
C. Hands-and-knees position
D. Lithotomy position
CORRECT ANSWER: C. Hands-and-knees position
,Rationale: The hands-and-knees position helps relieve back pain by
reducing pressure on the sacrum and allowing the fetus to rotate from an
occiput posterior position. Supine and lithotomy positions increase
pressure on the back. Lateral recumbent may be comfortable but is less
effective for back labor.
Question 6: A newborn is born at 38 weeks gestation with a birth weight
of 2,400 grams. The nurse should classify this newborn as:
A. Appropriate for gestational age (AGA)
B. Small for gestational age (SGA)
C. Large for gestational age (LGA)
D. Macrosomic
CORRECT ANSWER: B. Small for gestational age (SGA)
Rationale: A newborn at 38 weeks with a birth weight below 2,500 grams is
classified as small for gestational age (SGA). AGA is between the 10th and
90th percentiles. LGA and macrosomia refer to larger birth weights,
typically above 4,000 grams.
Question 7: A nurse is teaching a pregnant client about nutritional
needs. Which nutrient should the nurse emphasize as critical for
preventing neural tube defects?
A. Iron
B. Calcium
C. Folic acid
D. Vitamin D
CORRECT ANSWER: C. Folic acid
Rationale: Folic acid is essential for preventing neural tube defects such as
spina bifida and anencephaly. It is recommended that women of
childbearing age consume 400 mcg daily, increasing to 600 mcg during
pregnancy. Iron, calcium, and vitamin D are important but not specifically
for neural tube defect prevention.
Question 8: A postpartum client is diagnosed with endometritis. Which
finding should the nurse expect?
A. Decreased white blood cell count
B. Foul-smelling lochia and fever
, C. Painless vaginal bleeding
D. Bradycardia and hypertension
CORRECT ANSWER: B. Foul-smelling lochia and fever
Rationale: Endometritis is a postpartum infection of the uterine lining,
characterized by fever, chills, foul-smelling lochia, and uterine tenderness.
White blood cell count is typically elevated. Painless bleeding and
bradycardia are not typical findings.
Question 9: A nurse is performing a newborn assessment. Which reflex
is elicited by stroking the sole of the newborn's foot from the heel to
the toes?
A. Moro reflex
B. Babinski reflex
C. Rooting reflex
D. Palmar grasp reflex
CORRECT ANSWER: B. Babinski reflex
Rationale: The Babinski reflex is elicited by stroking the sole of the foot from
heel to toes, causing dorsiflexion of the great toe and fanning of the other
toes. The Moro reflex is a startle response, rooting is elicited by stroking the
cheek, and palmar grasp is elicited by placing a finger in the newborn's
palm.
Question 10: A client at 36 weeks gestation presents with bright red
vaginal bleeding and a rigid, tender abdomen. Which condition should
the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical insufficiency
CORRECT ANSWER: B. Abruptio placentae
Rationale: Abruptio placentae presents with painful, bright red vaginal
bleeding, a rigid and tender abdomen, and often uterine hypertonicity.
Placenta previa typically presents with painless bright red bleeding. Uterine
rupture is rare and associated with severe fetal distress and loss of station.
Cervical insufficiency presents with painless dilation without bleeding.
Practice Questions & Answers, Maternity and Obstetric Nursing
Exam Prep, Prenatal Care, High-Risk Pregnancy, Labor and
Delivery, Postpartum Complications, Newborn Assessment, and
Detailed Rationales
Question 1: A nurse is reviewing the physiology of lactation with a
postpartum client. Which hormone is primarily responsible for the milk
ejection reflex during breastfeeding?
A. Prolactin
B. Oxytocin
C. Estrogen
D. Progesterone
CORRECT ANSWER: B. Oxytocin
Rationale: Oxytocin is released from the posterior pituitary gland and
stimulates the myoepithelial cells surrounding the alveoli to contract,
causing milk to be ejected from the breast (let-down reflex). Prolactin is
responsible for milk production, while estrogen and progesterone support
pregnancy and are not the primary hormones for milk ejection.
Question 2: A pregnant client at 28 weeks gestation asks the nurse
when she should expect to feel fetal movement consistently. Which
response by the nurse is most accurate?
A. "You should feel movement by 12 weeks."
B. "Most women feel consistent movement between 18 and 22 weeks."
C. "Fetal movement is not felt until the third trimester."
D. "You will only feel movement when the baby is awake."
CORRECT ANSWER: B. "Most women feel consistent movement
between 18 and 22 weeks."
Rationale: Quickening, the first perception of fetal movement, typically
occurs between 18 and 22 weeks in primigravidas and slightly earlier in
multigravidas. By 28 weeks, movement should be well established. Feeling
movement at 12 weeks is too early, and third-trimester-only perception is
incorrect.
Question 3: A nurse is assessing a newborn immediately after birth.
Which finding should the nurse report as a sign of respiratory distress?
,A. Respiratory rate of 40 breaths per minute
B. Nasal flaring and intercostal retractions
C. Acrocyanosis of the hands and feet
D. Periodic breathing with pauses of 5 seconds
CORRECT ANSWER: B. Nasal flaring and intercostal retractions
Rationale: Nasal flaring and intercostal retractions are classic signs of
respiratory distress in a newborn, indicating increased work of breathing. A
respiratory rate of 40 is normal (30–60), acrocyanosis is a normal finding in
the first hours, and periodic breathing with brief pauses is common and
usually benign.
Question 4: A postpartum client who is breastfeeding asks the nurse
how to prevent engorgement. Which instruction should the nurse
include?
A. "Limit fluid intake to 1 liter per day."
B. "Feed the baby on demand and ensure proper latch."
C. "Apply warm compresses before feeding and cold after."
D. "Pump both breasts completely after each feeding."
CORRECT ANSWER: B. "Feed the baby on demand and ensure proper
latch."
Rationale: Frequent, effective breastfeeding on demand with a proper latch
is the best prevention for engorgement. Limiting fluids is not
recommended. Warm compresses before feeding can help with let-down,
and cold compresses after may reduce swelling, but these are treatments
rather than primary prevention. Pumping after feeding can worsen
engorgement by stimulating oversupply.
Question 5: A nurse is caring for a client in the first stage of labor. The
client's cervix is dilated to 4 cm and effaced 80%. The client reports
severe back pain. Which position should the nurse suggest to alleviate
back pain?
A. Supine with legs elevated
B. Lateral recumbent position
C. Hands-and-knees position
D. Lithotomy position
CORRECT ANSWER: C. Hands-and-knees position
,Rationale: The hands-and-knees position helps relieve back pain by
reducing pressure on the sacrum and allowing the fetus to rotate from an
occiput posterior position. Supine and lithotomy positions increase
pressure on the back. Lateral recumbent may be comfortable but is less
effective for back labor.
Question 6: A newborn is born at 38 weeks gestation with a birth weight
of 2,400 grams. The nurse should classify this newborn as:
A. Appropriate for gestational age (AGA)
B. Small for gestational age (SGA)
C. Large for gestational age (LGA)
D. Macrosomic
CORRECT ANSWER: B. Small for gestational age (SGA)
Rationale: A newborn at 38 weeks with a birth weight below 2,500 grams is
classified as small for gestational age (SGA). AGA is between the 10th and
90th percentiles. LGA and macrosomia refer to larger birth weights,
typically above 4,000 grams.
Question 7: A nurse is teaching a pregnant client about nutritional
needs. Which nutrient should the nurse emphasize as critical for
preventing neural tube defects?
A. Iron
B. Calcium
C. Folic acid
D. Vitamin D
CORRECT ANSWER: C. Folic acid
Rationale: Folic acid is essential for preventing neural tube defects such as
spina bifida and anencephaly. It is recommended that women of
childbearing age consume 400 mcg daily, increasing to 600 mcg during
pregnancy. Iron, calcium, and vitamin D are important but not specifically
for neural tube defect prevention.
Question 8: A postpartum client is diagnosed with endometritis. Which
finding should the nurse expect?
A. Decreased white blood cell count
B. Foul-smelling lochia and fever
, C. Painless vaginal bleeding
D. Bradycardia and hypertension
CORRECT ANSWER: B. Foul-smelling lochia and fever
Rationale: Endometritis is a postpartum infection of the uterine lining,
characterized by fever, chills, foul-smelling lochia, and uterine tenderness.
White blood cell count is typically elevated. Painless bleeding and
bradycardia are not typical findings.
Question 9: A nurse is performing a newborn assessment. Which reflex
is elicited by stroking the sole of the newborn's foot from the heel to
the toes?
A. Moro reflex
B. Babinski reflex
C. Rooting reflex
D. Palmar grasp reflex
CORRECT ANSWER: B. Babinski reflex
Rationale: The Babinski reflex is elicited by stroking the sole of the foot from
heel to toes, causing dorsiflexion of the great toe and fanning of the other
toes. The Moro reflex is a startle response, rooting is elicited by stroking the
cheek, and palmar grasp is elicited by placing a finger in the newborn's
palm.
Question 10: A client at 36 weeks gestation presents with bright red
vaginal bleeding and a rigid, tender abdomen. Which condition should
the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical insufficiency
CORRECT ANSWER: B. Abruptio placentae
Rationale: Abruptio placentae presents with painful, bright red vaginal
bleeding, a rigid and tender abdomen, and often uterine hypertonicity.
Placenta previa typically presents with painless bright red bleeding. Uterine
rupture is rare and associated with severe fetal distress and loss of station.
Cervical insufficiency presents with painless dilation without bleeding.
