NCLEX-RN 2026 Maternal Newborn Practice
Exam OB Nursing – 180 Questions with
Verified Answers & Detailed Rationales
EXAM OVERVIEW
Exam: NCLEX-RN Maternal Newborn Nursing
Format: Next Generation NCLEX (NGN) Style
Key Content Areas
• Antepartum Care & Prenatal Assessment (15%)
• Intrapartum Care & Labor Management (15%)
• Postpartum Care & Recovery (12%)
• Newborn Assessment & Care (15%)
• High-Risk Pregnancy & Complications (15%)
• Maternal & Newborn Complications (12%)
• Pharmacology in OB (8%)
• Contraception & Women's Health (8%)
, NCLEX-RN 2026
SECTION 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT
Questions 1–35
Question 1
A client at 12 weeks gestation comes to the clinic for her first prenatal visit. She
asks the nurse to listen to the baby's heartbeat. The nurse's best response is:
A) "We can hear the heartbeat with a Doppler fetal monitor now."
B) "We will be able to hear the heartbeat at 20 weeks."
C) "It is too early to hear the heartbeat at 12 weeks."
D) "We can only see the heartbeat on ultrasound at this stage."
Answer: A) "We can hear the heartbeat with a Doppler fetal monitor
now."
Rationale: Fetal heart tones can be detected by Doppler ultrasound as early as
10-12 weeks gestation. Using a fetoscope, they may not be audible until 18-20
weeks. At 12 weeks, a Doppler can pick up the heartbeat, which typically
ranges from 110-160 bpm. This provides reassurance to the mother.
Question 2
A client at 8 weeks gestation is experiencing nausea and vomiting. Which
intervention should the nurse recommend?
A) Eat three large meals daily
B) Avoid drinking fluids with meals
C) Eat small, frequent meals throughout the day
D) Lie flat immediately after eating
Answer: C) Eat small, frequent meals throughout the day
Rationale: Small, frequent meals help maintain blood glucose levels and reduce
gastric distension, which can help alleviate nausea. Drinking fluids between
, NCLEX-RN 2026
meals, not with meals, may also help. Avoiding fatty or spicy foods can be
beneficial. Lying flat after eating can worsen nausea due to gastric reflux.
Question 3
A client at 16 weeks gestation asks the nurse, "When will I feel the baby
move?" The nurse should respond that quickening is typically felt:
A) Between 16-20 weeks
B) Between 10-12 weeks
C) After 24 weeks
D) At term
Answer: A) Between 16-20 weeks
Rationale: Quickening, the first perception of fetal movement, is typically felt
by the mother between 16 and 20 weeks gestation. Primigravidas may feel it
later (around 18-20 weeks), while multigravidas may feel it earlier (around 16
weeks). The nurse should reassure the client that fetal movement will increase
in frequency and intensity.
Question 4
The nurse is calculating the estimated date of delivery (EDD) using Naegele's
rule for a client whose last menstrual period (LMP) was May 15. The EDD is:
A) February 8
B) February 15
C) February 22
D) March 1
Answer: C) February 22
Rationale: Naegele's rule: subtract 3 months from the LMP and add 7 days. May
15 → subtract 3 months = February 15 → add 7 days = February 22. This
, NCLEX-RN 2026
assumes a 28-day menstrual cycle. If the cycle is irregular, ultrasound dating is
more accurate. The EDD helps plan for prenatal care and monitor fetal growth.
Question 5
A client at 20 weeks gestation is scheduled for an ultrasound. The nurse
explains that the primary purpose of this ultrasound is:
A) To determine fetal gender
B) To assess fetal anatomy and growth
C) To confirm the due date
D) To check for multiple gestation
Answer: B) To assess fetal anatomy and growth
Rationale: The 20-week ultrasound (anatomy scan) is used to assess fetal
anatomy, including the brain, spine, heart, kidneys, and limbs. It also evaluates
placental location, amniotic fluid volume, and fetal growth. While gender,
dating, and multiple gestation may be assessed, the primary purpose is a
comprehensive anatomy survey.
Question 6
A client at 28 weeks gestation has a positive glucose screening test. The nurse
anticipates which next step?
A) Dietary counseling and exercise plan
B) Repeat glucose screening in 4 weeks
C) A 3-hour oral glucose tolerance test (OGTT)
D) Immediate insulin therapy
Answer: C) A 3-hour oral glucose tolerance test (OGTT)
Rationale: A positive 1-hour glucose challenge test (≥130-140 mg/dL) is
followed by a 3-hour OGTT to confirm gestational diabetes mellitus (GDM).
Diagnosis requires two or more abnormal values on the 3-hour test. Lifestyle
Exam OB Nursing – 180 Questions with
Verified Answers & Detailed Rationales
EXAM OVERVIEW
Exam: NCLEX-RN Maternal Newborn Nursing
Format: Next Generation NCLEX (NGN) Style
Key Content Areas
• Antepartum Care & Prenatal Assessment (15%)
• Intrapartum Care & Labor Management (15%)
• Postpartum Care & Recovery (12%)
• Newborn Assessment & Care (15%)
• High-Risk Pregnancy & Complications (15%)
• Maternal & Newborn Complications (12%)
• Pharmacology in OB (8%)
• Contraception & Women's Health (8%)
, NCLEX-RN 2026
SECTION 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT
Questions 1–35
Question 1
A client at 12 weeks gestation comes to the clinic for her first prenatal visit. She
asks the nurse to listen to the baby's heartbeat. The nurse's best response is:
A) "We can hear the heartbeat with a Doppler fetal monitor now."
B) "We will be able to hear the heartbeat at 20 weeks."
C) "It is too early to hear the heartbeat at 12 weeks."
D) "We can only see the heartbeat on ultrasound at this stage."
Answer: A) "We can hear the heartbeat with a Doppler fetal monitor
now."
Rationale: Fetal heart tones can be detected by Doppler ultrasound as early as
10-12 weeks gestation. Using a fetoscope, they may not be audible until 18-20
weeks. At 12 weeks, a Doppler can pick up the heartbeat, which typically
ranges from 110-160 bpm. This provides reassurance to the mother.
Question 2
A client at 8 weeks gestation is experiencing nausea and vomiting. Which
intervention should the nurse recommend?
A) Eat three large meals daily
B) Avoid drinking fluids with meals
C) Eat small, frequent meals throughout the day
D) Lie flat immediately after eating
Answer: C) Eat small, frequent meals throughout the day
Rationale: Small, frequent meals help maintain blood glucose levels and reduce
gastric distension, which can help alleviate nausea. Drinking fluids between
, NCLEX-RN 2026
meals, not with meals, may also help. Avoiding fatty or spicy foods can be
beneficial. Lying flat after eating can worsen nausea due to gastric reflux.
Question 3
A client at 16 weeks gestation asks the nurse, "When will I feel the baby
move?" The nurse should respond that quickening is typically felt:
A) Between 16-20 weeks
B) Between 10-12 weeks
C) After 24 weeks
D) At term
Answer: A) Between 16-20 weeks
Rationale: Quickening, the first perception of fetal movement, is typically felt
by the mother between 16 and 20 weeks gestation. Primigravidas may feel it
later (around 18-20 weeks), while multigravidas may feel it earlier (around 16
weeks). The nurse should reassure the client that fetal movement will increase
in frequency and intensity.
Question 4
The nurse is calculating the estimated date of delivery (EDD) using Naegele's
rule for a client whose last menstrual period (LMP) was May 15. The EDD is:
A) February 8
B) February 15
C) February 22
D) March 1
Answer: C) February 22
Rationale: Naegele's rule: subtract 3 months from the LMP and add 7 days. May
15 → subtract 3 months = February 15 → add 7 days = February 22. This
, NCLEX-RN 2026
assumes a 28-day menstrual cycle. If the cycle is irregular, ultrasound dating is
more accurate. The EDD helps plan for prenatal care and monitor fetal growth.
Question 5
A client at 20 weeks gestation is scheduled for an ultrasound. The nurse
explains that the primary purpose of this ultrasound is:
A) To determine fetal gender
B) To assess fetal anatomy and growth
C) To confirm the due date
D) To check for multiple gestation
Answer: B) To assess fetal anatomy and growth
Rationale: The 20-week ultrasound (anatomy scan) is used to assess fetal
anatomy, including the brain, spine, heart, kidneys, and limbs. It also evaluates
placental location, amniotic fluid volume, and fetal growth. While gender,
dating, and multiple gestation may be assessed, the primary purpose is a
comprehensive anatomy survey.
Question 6
A client at 28 weeks gestation has a positive glucose screening test. The nurse
anticipates which next step?
A) Dietary counseling and exercise plan
B) Repeat glucose screening in 4 weeks
C) A 3-hour oral glucose tolerance test (OGTT)
D) Immediate insulin therapy
Answer: C) A 3-hour oral glucose tolerance test (OGTT)
Rationale: A positive 1-hour glucose challenge test (≥130-140 mg/dL) is
followed by a 3-hour OGTT to confirm gestational diabetes mellitus (GDM).
Diagnosis requires two or more abnormal values on the 3-hour test. Lifestyle
