Page 1 of 53
MATERNAL & NEWBORN NURSING – 2026 EXAM STUDY
GUIDE QUESTIONS WITH EDTAILED RATIONALES
Maternal-Newborn Nursing / Obstetric and Neonatal Nursing Practice
Exam coverage:
✓ Section 1, Questions 1-25: Antepartum Assessment &
Complications: Covers prenatal care, preeclampsia, placenta
previa, and emergency interventions.
✓ Section 2, Questions 26-50: Intrapartum & Postpartum
Nursing: Focuses on labor management, PPH, infections,
breastfeeding, and postpartum care.
✓ Section 3, Questions 51-75: Newborn Assessment:
Emphasizes APGAR, physical exam, reflexes, common
variations, and feeding.
✓ Section 4, Questions 76-100: Pharmacology & High-Risk
Care: Covers tocolytics, magnesium sulfate, NICU care, NAS,
and NCLEX-style prioritization.
Section 1: Question 1-25: Antepartum Assessment &
Pregnancy Complications
1. A pregnant client at 28 weeks reports painless bright-red
vaginal bleeding. Which condition should the nurse
suspect?
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A. Abruptio placentae
B. Preterm labor
C. Placenta previa
D. Ectopic pregnancy
CORRECT ANSWER: C
RATIONALE: Painless bright-red bleeding in the second or third
trimester is classically associated with placenta previa. The
bleeding occurs because the placenta partially or completely
covers the cervical os. A vaginal examination should be avoided
until the placenta location is confirmed to prevent severe
hemorrhage .
2. A client at 34 weeks gestation presents with severe
headache, visual disturbances, and right upper-quadrant
pain. What is the priority nursing action?
A. Encourage ambulation and rest
B. Offer a high-sodium meal
C. Assess for severe preeclampsia and notify the provider
promptly
D. Delay assessment until the next scheduled visit
CORRECT ANSWER: C
RATIONALE: Severe headache, visual changes, and
epigastric/right upper-quadrant pain are concerning for severe
features of preeclampsia. These symptoms indicate potential
hepatic involvement and cerebral edema. The provider must be
notified immediately for further evaluation .
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3. A client receiving magnesium sulfate for severe
preeclampsia has a respiratory rate of 9/min and absent
deep-tendon reflexes. What should the nurse do first?
A. Increase the infusion rate
B. Encourage oral fluids
C. Stop the magnesium infusion and prepare for emergency
management
D. Ambulate the client
CORRECT ANSWER: C
RATIONALE: Respiratory depression (fewer than 12
breaths/min) and absent deep-tendon reflexes are signs of
magnesium toxicity. The nurse should immediately stop the
infusion, notify the provider, and prepare to administer calcium
gluconate as the antidote .
4. Which medication is the antidote for significant
magnesium sulfate toxicity?
A. Naloxone
B. Vitamin K
C. Protamine sulfate
D. Calcium gluconate
CORRECT ANSWER: D
RATIONALE: Calcium gluconate is the antidote for magnesium
sulfate toxicity. It reverses the effects of excessive magnesium
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by competing for receptor sites. It should be readily available at
the bedside for any patient receiving IV magnesium sulfate .
5. A client with preeclampsia is on magnesium sulfate. The
nurse should report which urinary output to the provider?
A. 35 mL/hr
B. 40 mL/hr
C. 25 mL/hr
D. 50 mL/hr
CORRECT ANSWER: C
RATIONALE: Urinary output below 30 mL/hr is a sign of
magnesium toxicity and should be reported immediately.
Magnesium is excreted renally, so adequate urine output is
essential to prevent drug accumulation and toxicity .
6. A patient presents 1-week postpartum with her right
breast engorged, hot, red, and painful. She reports a fever of
101°F. Which organism is most likely responsible?
A. Aerobic Streptococcus
B. Anaerobic Streptococcus
C. E. coli
D. Staphylococcus aureus
CORRECT ANSWER: D
RATIONALE: Staphylococcus aureus is the most common
organism causing mastitis. This infection typically occurs in
breastfeeding women due to cracked nipples or engorgement.
MATERNAL & NEWBORN NURSING – 2026 EXAM STUDY
GUIDE QUESTIONS WITH EDTAILED RATIONALES
Maternal-Newborn Nursing / Obstetric and Neonatal Nursing Practice
Exam coverage:
✓ Section 1, Questions 1-25: Antepartum Assessment &
Complications: Covers prenatal care, preeclampsia, placenta
previa, and emergency interventions.
✓ Section 2, Questions 26-50: Intrapartum & Postpartum
Nursing: Focuses on labor management, PPH, infections,
breastfeeding, and postpartum care.
✓ Section 3, Questions 51-75: Newborn Assessment:
Emphasizes APGAR, physical exam, reflexes, common
variations, and feeding.
✓ Section 4, Questions 76-100: Pharmacology & High-Risk
Care: Covers tocolytics, magnesium sulfate, NICU care, NAS,
and NCLEX-style prioritization.
Section 1: Question 1-25: Antepartum Assessment &
Pregnancy Complications
1. A pregnant client at 28 weeks reports painless bright-red
vaginal bleeding. Which condition should the nurse
suspect?
, Page 2 of 53
A. Abruptio placentae
B. Preterm labor
C. Placenta previa
D. Ectopic pregnancy
CORRECT ANSWER: C
RATIONALE: Painless bright-red bleeding in the second or third
trimester is classically associated with placenta previa. The
bleeding occurs because the placenta partially or completely
covers the cervical os. A vaginal examination should be avoided
until the placenta location is confirmed to prevent severe
hemorrhage .
2. A client at 34 weeks gestation presents with severe
headache, visual disturbances, and right upper-quadrant
pain. What is the priority nursing action?
A. Encourage ambulation and rest
B. Offer a high-sodium meal
C. Assess for severe preeclampsia and notify the provider
promptly
D. Delay assessment until the next scheduled visit
CORRECT ANSWER: C
RATIONALE: Severe headache, visual changes, and
epigastric/right upper-quadrant pain are concerning for severe
features of preeclampsia. These symptoms indicate potential
hepatic involvement and cerebral edema. The provider must be
notified immediately for further evaluation .
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3. A client receiving magnesium sulfate for severe
preeclampsia has a respiratory rate of 9/min and absent
deep-tendon reflexes. What should the nurse do first?
A. Increase the infusion rate
B. Encourage oral fluids
C. Stop the magnesium infusion and prepare for emergency
management
D. Ambulate the client
CORRECT ANSWER: C
RATIONALE: Respiratory depression (fewer than 12
breaths/min) and absent deep-tendon reflexes are signs of
magnesium toxicity. The nurse should immediately stop the
infusion, notify the provider, and prepare to administer calcium
gluconate as the antidote .
4. Which medication is the antidote for significant
magnesium sulfate toxicity?
A. Naloxone
B. Vitamin K
C. Protamine sulfate
D. Calcium gluconate
CORRECT ANSWER: D
RATIONALE: Calcium gluconate is the antidote for magnesium
sulfate toxicity. It reverses the effects of excessive magnesium
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by competing for receptor sites. It should be readily available at
the bedside for any patient receiving IV magnesium sulfate .
5. A client with preeclampsia is on magnesium sulfate. The
nurse should report which urinary output to the provider?
A. 35 mL/hr
B. 40 mL/hr
C. 25 mL/hr
D. 50 mL/hr
CORRECT ANSWER: C
RATIONALE: Urinary output below 30 mL/hr is a sign of
magnesium toxicity and should be reported immediately.
Magnesium is excreted renally, so adequate urine output is
essential to prevent drug accumulation and toxicity .
6. A patient presents 1-week postpartum with her right
breast engorged, hot, red, and painful. She reports a fever of
101°F. Which organism is most likely responsible?
A. Aerobic Streptococcus
B. Anaerobic Streptococcus
C. E. coli
D. Staphylococcus aureus
CORRECT ANSWER: D
RATIONALE: Staphylococcus aureus is the most common
organism causing mastitis. This infection typically occurs in
breastfeeding women due to cracked nipples or engorgement.
