Actual PN Maternal Newborn 2026 |
•
Proctored Exam with NGN Questions,
Answers, Comprehensive Review and Level 3
Exam Preparation
• 1. A nurse is caring for a client who is at 38 weeks of gestation and reports
a sudden gush of fluid from the vagina. Which of the following actions
should the nurse take first?
o A. Prepare the client for an immediate delivery.
o B. Perform a sterile vaginal examination.
o C. Assess the fetal heart rate.
o D. Check the client's temperature.
o Correct Answer: C. Assess the fetal heart rate.
o Rationale: The priority nursing action following a spontaneous
rupture of membranes (SROM) is to assess the fetal heart rate (FHR)
to check for a prolapsed umbilical cord, which is a medical
emergency. A sterile vaginal exam (B) would be performed next to
check for cord prolapse, but the immediate priority is to assess the
fetus's well-being. Preparing for delivery (A) and checking the
temperature (D) are important but not the first priority.
• 2. A nurse is teaching a client who is at 10 weeks of gestation about
nutrition. Which of the following statements by the client indicates an
understanding of the teaching?
o A. "I should increase my intake of folic acid to 400 micrograms daily."
o B. "I will need to double my calorie intake during the first trimester."
o C. "I should limit my caffeine intake to no more than 500 mg per day."
o D. "I will take a calcium supplement to help with the baby's bone
development."
, o Correct Answer: A. "I should increase my intake of folic acid to
400 micrograms daily."
o Rationale: Folic acid is crucial for preventing neural tube defects,
and 400 mcg daily is the recommended intake for clients of
childbearing age. Calorie intake does not need to be doubled during
the first trimester (B); it only increases by about 340 calories in the
second and 450 in the third. Caffeine should be limited to 200-300
mg per day (C). While calcium is important, the statement about folic
acid is the most specific and correct nutritional teaching point for
early pregnancy (D).
• 3. A nurse is assessing a newborn immediately following birth. Which of
the following findings should the nurse report to the provider?
o A. Heart rate of 130/min.
o B. Respiratory rate of 50/min.
o C. Grunting with respirations.
o D. Acrocyanosis of the hands and feet.
o Correct Answer: C. Grunting with respirations.
o Rationale: Grunting is a sign of respiratory distress in a newborn
and must be reported. A heart rate of 130/min (A), a respiratory rate
of 50/min (B), and acrocyanosis (D) are all normal findings in a
newborn immediately after birth.
• 4. A client in the active phase of the first stage of labor is experiencing
contractions every 2 to 3 minutes. Which of the following findings should
the nurse report to the provider?
o A. Fetal heart rate baseline of 140/min.
o B. Maternal temperature of 37.5° C (99.5° F).
o C. Fetal heart rate decelerations that occur with contractions.
, o D. Contraction duration of 60 seconds.
o Correct Answer: C. Fetal heart rate decelerations that occur with
contractions.
o Rationale: Decelerations that occur with contractions can be a
sign of uteroplacental insufficiency or umbilical cord compression and
must be investigated. A baseline FHR of 140/min (A), a temperature
of 37.5°C (B), and contractions lasting 60 seconds (D) are all within
normal limits.
• 5. A postpartum client is 12 hours post-vaginal delivery and reports
saturating a perineal pad every hour. Which of the following actions
should the nurse take first?
o A. Notify the provider.
o B. Massage the client's fundus.
o C. Administer a prescribed analgesic.
o D. Teach the client to perform Kegel exercises.
o Correct Answer: B. Massage the client's fundus.
o Rationale: Saturating a pad every hour is a sign of postpartum
hemorrhage, most commonly caused by a boggy uterus (uterine
atony). The first action is to massage the fundus to stimulate
contraction. If this is ineffective, the nurse should then notify the
provider (A). Analgesics (C) and Kegel exercises (D) are not relevant to
the immediate management of hemorrhage.
• 6. A nurse is providing discharge teaching to a client who is breastfeeding.
Which of the following instructions should the nurse include to prevent
engorgement?
o A. "Supplement with formula if the baby seems hungry."
o B. "Pump your breasts after each feeding."
, o C. "Feed the baby on demand, at least 8 to 12 times in 24 hours."
o D. "Apply warm compresses to your breasts between feedings."
o Correct Answer: C. "Feed the baby on demand, at least 8 to 12
times in 24 hours."
o Rationale: Frequent and effective milk removal is the best way to
prevent engorgement. Supplementing with formula (A) can decrease
supply and lead to engorgement. Pumping after feeding (B) can lead
to oversupply. Warm compresses between feedings (D) can increase
blood flow and worsen engorgement; cold compresses are
recommended between feedings to reduce swelling.
• 7. A nurse is caring for a client who is at 36 weeks of gestation and has a
prescription for a nonstress test (NST). Which of the following statements
should the nurse include in the teaching?
o A. "This test will tell us if you are in labor."
o B. "You will need to have a full bladder for this test."
o C. "The test will monitor how your baby's heart rate responds to
movement."
o D. "We will be giving you medication to start your contractions."
o Correct Answer: C. "The test will monitor how your baby's heart
rate responds to movement."
o Rationale: An NST evaluates fetal well-being by monitoring the
fetal heart rate in response to fetal movement. A full bladder (B) is
required for an ultrasound, not an NST. An NST does not indicate
labor (A) or induce contractions (D) (that is a contraction stress test).
• 8. A newborn is 1 hour old. The nurse notes the newborn has a respiratory
rate of 70/min, is grunting, and has nasal flaring. Which of the following
actions should the nurse take?
•
Proctored Exam with NGN Questions,
Answers, Comprehensive Review and Level 3
Exam Preparation
• 1. A nurse is caring for a client who is at 38 weeks of gestation and reports
a sudden gush of fluid from the vagina. Which of the following actions
should the nurse take first?
o A. Prepare the client for an immediate delivery.
o B. Perform a sterile vaginal examination.
o C. Assess the fetal heart rate.
o D. Check the client's temperature.
o Correct Answer: C. Assess the fetal heart rate.
o Rationale: The priority nursing action following a spontaneous
rupture of membranes (SROM) is to assess the fetal heart rate (FHR)
to check for a prolapsed umbilical cord, which is a medical
emergency. A sterile vaginal exam (B) would be performed next to
check for cord prolapse, but the immediate priority is to assess the
fetus's well-being. Preparing for delivery (A) and checking the
temperature (D) are important but not the first priority.
• 2. A nurse is teaching a client who is at 10 weeks of gestation about
nutrition. Which of the following statements by the client indicates an
understanding of the teaching?
o A. "I should increase my intake of folic acid to 400 micrograms daily."
o B. "I will need to double my calorie intake during the first trimester."
o C. "I should limit my caffeine intake to no more than 500 mg per day."
o D. "I will take a calcium supplement to help with the baby's bone
development."
, o Correct Answer: A. "I should increase my intake of folic acid to
400 micrograms daily."
o Rationale: Folic acid is crucial for preventing neural tube defects,
and 400 mcg daily is the recommended intake for clients of
childbearing age. Calorie intake does not need to be doubled during
the first trimester (B); it only increases by about 340 calories in the
second and 450 in the third. Caffeine should be limited to 200-300
mg per day (C). While calcium is important, the statement about folic
acid is the most specific and correct nutritional teaching point for
early pregnancy (D).
• 3. A nurse is assessing a newborn immediately following birth. Which of
the following findings should the nurse report to the provider?
o A. Heart rate of 130/min.
o B. Respiratory rate of 50/min.
o C. Grunting with respirations.
o D. Acrocyanosis of the hands and feet.
o Correct Answer: C. Grunting with respirations.
o Rationale: Grunting is a sign of respiratory distress in a newborn
and must be reported. A heart rate of 130/min (A), a respiratory rate
of 50/min (B), and acrocyanosis (D) are all normal findings in a
newborn immediately after birth.
• 4. A client in the active phase of the first stage of labor is experiencing
contractions every 2 to 3 minutes. Which of the following findings should
the nurse report to the provider?
o A. Fetal heart rate baseline of 140/min.
o B. Maternal temperature of 37.5° C (99.5° F).
o C. Fetal heart rate decelerations that occur with contractions.
, o D. Contraction duration of 60 seconds.
o Correct Answer: C. Fetal heart rate decelerations that occur with
contractions.
o Rationale: Decelerations that occur with contractions can be a
sign of uteroplacental insufficiency or umbilical cord compression and
must be investigated. A baseline FHR of 140/min (A), a temperature
of 37.5°C (B), and contractions lasting 60 seconds (D) are all within
normal limits.
• 5. A postpartum client is 12 hours post-vaginal delivery and reports
saturating a perineal pad every hour. Which of the following actions
should the nurse take first?
o A. Notify the provider.
o B. Massage the client's fundus.
o C. Administer a prescribed analgesic.
o D. Teach the client to perform Kegel exercises.
o Correct Answer: B. Massage the client's fundus.
o Rationale: Saturating a pad every hour is a sign of postpartum
hemorrhage, most commonly caused by a boggy uterus (uterine
atony). The first action is to massage the fundus to stimulate
contraction. If this is ineffective, the nurse should then notify the
provider (A). Analgesics (C) and Kegel exercises (D) are not relevant to
the immediate management of hemorrhage.
• 6. A nurse is providing discharge teaching to a client who is breastfeeding.
Which of the following instructions should the nurse include to prevent
engorgement?
o A. "Supplement with formula if the baby seems hungry."
o B. "Pump your breasts after each feeding."
, o C. "Feed the baby on demand, at least 8 to 12 times in 24 hours."
o D. "Apply warm compresses to your breasts between feedings."
o Correct Answer: C. "Feed the baby on demand, at least 8 to 12
times in 24 hours."
o Rationale: Frequent and effective milk removal is the best way to
prevent engorgement. Supplementing with formula (A) can decrease
supply and lead to engorgement. Pumping after feeding (B) can lead
to oversupply. Warm compresses between feedings (D) can increase
blood flow and worsen engorgement; cold compresses are
recommended between feedings to reduce swelling.
• 7. A nurse is caring for a client who is at 36 weeks of gestation and has a
prescription for a nonstress test (NST). Which of the following statements
should the nurse include in the teaching?
o A. "This test will tell us if you are in labor."
o B. "You will need to have a full bladder for this test."
o C. "The test will monitor how your baby's heart rate responds to
movement."
o D. "We will be giving you medication to start your contractions."
o Correct Answer: C. "The test will monitor how your baby's heart
rate responds to movement."
o Rationale: An NST evaluates fetal well-being by monitoring the
fetal heart rate in response to fetal movement. A full bladder (B) is
required for an ultrasound, not an NST. An NST does not indicate
labor (A) or induce contractions (D) (that is a contraction stress test).
• 8. A newborn is 1 hour old. The nurse notes the newborn has a respiratory
rate of 70/min, is grunting, and has nasal flaring. Which of the following
actions should the nurse take?
