MATERNAL–NEWBORN SPECIALTY REVIEW • CURRENT STUDY EDITION
MATERNAL NEWBORN NURSING
2026//2027
COMPLETE EXAM STUDY GUIDE
WITH NGN QUESTIONS
Comprehensive ATI & NCLEX-RN® Preparation with Verified Answers & Detailed Clinical Rationales | NGN Case
Scenarios Included
300 5×6 7 9
ORIGINAL QUESTIONS UNFOLDING CASES DOMAIN SECTIONS ITEM FORMATS
OVERVIEW
This editable Word guide contains 300 independently written questions arranged in seven maternal–newborn domains. It combines
traditional questions, five six-item unfolding cases, stand-alone NGN formats, four original fetal-monitoring graphics, calculation work, bold-green
answer keys, clinical rationales, response analysis, Client Needs alignment, and CJMM mapping.
✓ Domain organization — Antepartum, intrapartum, postpartum, newborn, pharmacology, pregnancy complications, and
ethical/legal/cultural/health-equity content.
✓ Emergency readiness — Preeclampsia/eclampsia, hemorrhage, cord prolapse, fetal intolerance, sepsis, ectopic rupture, shoulder dystocia, and
newborn deterioration.
✓ Medication mastery — Magnesium sulfate, oxytocin, terbutaline, betamethasone, naloxone, antihypertensives, uterotonics, prophylaxis, and
step-by-step calculations.
✓ Safety teaching — Newborn identification/security, safe sleep, feeding, jaundice, car seats, warning signs, language access, consent, and
respectful care.
300-QUESTION DOMAIN BLUEPRINT
Domain Questions Share of guide
Antepartum Nursing 50 16.7%
Intrapartum Nursing 60 20.0%
Postpartum Nursing 45 15.0%
Newborn Nursing 55 18.3%
Maternal–Newborn Pharmacology 35 11.7%
Complications of Pregnancy 40 13.3%
Ethical, Legal, Cultural & Health Equity 15 5.0%
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, MATERNAL–NEWBORN NURSING • COMPLETE EXAM STUDY GUIDE • 2026/2027
PLAN • PRACTICE • REMEDIATE
HOW TO USE THIS GUIDE
Transparent study mode for 2026/2027 maternal–newborn review.
CONTENTS
Part Domain Core emphasis Questions
1 Antepartum Nursing Pregnancy foundations & surveillance 1–50
2 Intrapartum Nursing Labor, birth & fetal monitoring 51–110
3 Postpartum Nursing Recovery, complications & family adaptation 111–155
4 Newborn Nursing Transition, safety, feeding & screening 156–210
5 Maternal–Newborn Pharmacology Safe medication administration & calculations 211–245
6 Complications of Pregnancy High-risk pregnancy & emergency response 246–285
7 Ethical, Legal, Cultural & Health Equity Autonomy, culture, law & equitable care 286–300
FORMAT LEGEND
• Traditional multiple choice — choose the single safest/best response.
• Extended multiple response — select all that apply; use the plus/minus practice rule.
• Matrix/grid — choose one classification for each row.
• Bowtie — choose two actions, one condition, and two parameters.
• Cloze/drop-down — choose one option for each blank.
• Highlight — select lettered phrases that would be highlighted in an electronic record.
• Ordered response — number all steps in the safest sequence.
• Calculation/fill-in — enter the numeric response with unit; compare your work with the displayed dimensional analysis.
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, MATERNAL–NEWBORN NURSING • COMPLETE EXAM STUDY GUIDE • 2026/2027
PART 1 OF 7 • 50 QUESTIONS
ANTEPARTUM NURSING
Pregnancy foundations & surveillance
SECTION DIRECTIONS Questions 1–50. Answer before reading the green panel. Choices are shuffled with a fixed seed so the correct option is
not tied to one letter.
SIX-ITEM UNFOLDING NGN CASE
UNFOLDING CASE 1 — PREECLAMPSIA WITH SEVERE
FEATURES
Antepartum • 33 weeks' gestation • six NCJMM steps
INITIAL CLIENT EXHIBIT
• A 26-year-old G1P0 client at 33 weeks 2 days presents with a persistent headache and flashing lights. Blood pressure is 168/112 mm Hg, repeated
at 166/110 mm Hg 18 minutes later; heart rate 92/min; respiratory rate 18/min; SpO₂ 98%.
• Assessment shows brisk reflexes with 2 beats of ankle clonus and right-upper-quadrant tenderness. Urine protein/creatinine ratio is 0.5; platelets
92,000/mm³; AST 86 units/L; creatinine 1.2 mg/dL. Fetal baseline is 145/min with moderate variability and no decelerations.
• The client is in a quiet room with seizure precautions. Two IV sites are available. The obstetric and neonatal teams have been notified.
QUESTION 1 HIGHLIGHT ANTEPARTUM NURSING RECOGNIZE CUES
1. Select the four findings that most strongly indicate severe maternal end-organ involvement.
Static Word adaptation: select the lettered phrase(s) you would highlight.
A. ☐ BP 168/112 mm Hg
B. ☐ Persistent headache with flashing lights
C. ☐ Platelets 92,000/mm³
D. ☐ AST 86 units/L
E. ☐ SpO₂ 98%
F. ☐ Fetal baseline 145/min with moderate variability
CORRECT ANSWER A. BP 168/112 mm Hg; B. Persistent headache with flashing lights; C. Platelets 92,000/mm³; D. AST 86 units/L
CLINICAL RATIONALE Severe-range pressure, persistent neurologic symptoms, thrombocytopenia, and elevated liver enzymes identify preeclampsia
with severe features and risk for seizure, stroke, hepatic injury, and abruption.
DISTRACTOR / RESPONSE ANALYSIS A reassuring fetal baseline/variability and normal oxygen saturation are important but do not demonstrate severe
maternal end-organ involvement.
ALIGNMENT Antepartum Nursing • NCLEX Client Needs: Reduction of Risk Potential • CJMM: Recognize Cues
PRACTICE SCORING Practice plus/minus: +1 per keyed phrase, −1 per nonkey phrase, minimum 0. Maximum practice points: 4.
QUESTION 2 MATRIX / GRID ANTEPARTUM NURSING ANALYZE CUES
2. Classify each cue by the system it most directly reflects.
Finding / statement Hepatic involvement Neurologic irritability Renal involvement Hematologic involvement
Headache and visual flashing ☐ ☐ ☐ ☐
Platelets 92,000/mm³ ☐ ☐ ☐ ☐
AST 86 units/L with RUQ ☐ ☐ ☐ ☐
tenderness
Creatinine 1.2 mg/dL ☐ ☐ ☐ ☐
CORRECT ANSWER Headache and visual flashing: Neurologic irritability; Platelets 92,000/mm³: Hematologic involvement; AST 86
units/L with RUQ tenderness: Hepatic involvement; Creatinine 1.2 mg/dL: Renal involvement
CLINICAL RATIONALE The abnormalities show multisystem endothelial disease: cerebral irritation, platelet consumption, hepatic injury, and renal
dysfunction.
DISTRACTOR / RESPONSE ANALYSIS Treating every value as simply 'high blood pressure' misses the organ-specific risks that determine severity and
surveillance.
ALIGNMENT Antepartum Nursing • NCLEX Client Needs: Physiological Adaptation • CJMM: Analyze Cues
PRACTICE SCORING One point per accurately completed row; no negative points. Maximum practice points: 4.
QUESTION 3 CLOZE / DROP-DOWN ANTEPARTUM NURSING PRIORITIZE HYPOTHESES
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3. Complete the sentence: The priority condition is ___, and the most immediate maternal threat is ___.
Blank 1 — Condition: ☐ Preeclampsia with severe features | ☐ Normal third-trimester adaptation | ☐ Gestational hypertension without severe features
Blank 2 — Threat: ☐ Physiologic anemia | ☐ Seizure or stroke | ☐ Post-term pregnancy
CORRECT ANSWER Condition: Preeclampsia with severe features; Threat: Seizure or stroke
CLINICAL RATIONALE The client meets severe-feature criteria and has neurologic symptoms plus sustained severe pressure. Seizure and hemorrhagic
stroke are time-critical threats.
DISTRACTOR / RESPONSE ANALYSIS Gestational hypertension does not explain thrombocytopenia, liver injury, proteinuria, and neurologic symptoms; these
findings are not normal adaptation.
ALIGNMENT Antepartum Nursing • NCLEX Client Needs: Physiological Adaptation • CJMM: Prioritize Hypotheses
PRACTICE SCORING One point per correctly completed blank; no negative points. Maximum practice points: 2.
QUESTION 4 EXTENDED MULTIPLE RESPONSE ANTEPARTUM NURSING GENERATE SOLUTIONS
4. Which interventions belong in the immediate plan? Select all that apply.
A. ☐ Administer magnesium sulfate as prescribed
B. ☐ Trend urine output, reflexes, respirations, platelets, liver enzymes, and fetal status
C. ☐ Maintain seizure precautions and reduce stimulation
D. ☐ Prepare to treat persistent severe hypertension promptly
E. ☐ Delay treatment until proteinuria increases
F. ☐ Give unrestricted oral fluids
G. ☐ Encourage unassisted ambulation
CORRECT ANSWER C. Maintain seizure precautions and reduce stimulation; A. Administer magnesium sulfate as prescribed; D.
Prepare to treat persistent severe hypertension promptly; B. Trend urine output, reflexes, respirations, platelets, liver enzymes, and
fetal status
CLINICAL RATIONALE The plan prevents seizure/stroke, detects magnesium toxicity and disease progression, and supports maternal–fetal stabilization
while delivery timing is determined.
DISTRACTOR / RESPONSE ANALYSIS Unassisted ambulation increases seizure/fall risk. Treatment of severe features is not delayed for more protein, and fluid
administration is carefully managed because pulmonary edema can occur.
ALIGNMENT Antepartum Nursing • NCLEX Client Needs: Management of Care • CJMM: Generate Solutions
PRACTICE SCORING Practice plus/minus: +1 for each correct selection and −1 for each incorrect selection; minimum 0. Maximum practice points: 4.
UNFOLDING UPDATE BEFORE ITEM 5 Update: Magnesium sulfate and an urgent antihypertensive have been prescribed. One hour later, the
client reports less headache; BP is 148/94 mm Hg, respirations 16/min, patellar reflexes 2+, and urine output is 35 mL/hr.
QUESTION 5 BOWTIE ANTEPARTUM NURSING TAKE ACTION
5. Using the update, select the condition being treated, two actions, and two parameters requiring continued
surveillance.
ACTIONS — SELECT 2 CONDITION — SELECT 1 PARAMETERS — SELECT 2
☐ Continue prescribed magnesium with toxicity ☐ Normal labor transition ☐ Visual acuity only at discharge
checks ☐ Preeclampsia with severe features ☐ Respiratory rate/reflexes/urine output
☐ Discontinue all monitoring because headache ☐ Uncomplicated gestational edema ☐ Bowel sounds
improved
☐ Blood pressure and neurologic symptoms
☐ Continue BP treatment and escalation thresholds
☐ Encourage bright lights and frequent visitors
CORRECT ANSWER Condition: Preeclampsia with severe features; Actions: Continue prescribed magnesium with toxicity checks +
Continue BP treatment and escalation thresholds; Parameters: Respiratory rate/reflexes/urine output + Blood pressure and
neurologic symptoms
CLINICAL RATIONALE Improvement does not resolve severe preeclampsia. Magnesium safety and recurrent severe pressure/neurologic symptoms
require continuous reassessment.
DISTRACTOR / RESPONSE ANALYSIS Stopping surveillance after one improved measurement is unsafe; edema and labor transition do not explain the
laboratory and neurologic pattern.
ALIGNMENT Antepartum Nursing • NCLEX Client Needs: Pharmacological and Parenteral Therapies • CJMM: Take Action
PRACTICE SCORING Practice rationale scoring: the condition must be correct; then award one point for each complete action–condition or condition–parameter
pair. Maximum practice points: 4.
UNFOLDING UPDATE BEFORE ITEM 6 Update: Four hours later, evaluate each finding while magnesium therapy and close maternal–fetal
surveillance continue.
QUESTION 6 MATRIX / GRID ANTEPARTUM NURSING EVALUATE OUTCOMES
6. Classify each later finding as expected improvement or urgent deterioration.
Finding / statement Urgent deterioration Expected improvement
BP 142/90 mm Hg without headache ☐ ☐
Respirations 8/min with absent reflexes ☐ ☐
Urine output 45 mL/hr ☐ ☐
New constant abdominal pain with fetal bradycardia ☐ ☐
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