Maternity Nursing NCLEX questions range from the time prior to conception until the first few weeks after delivery. While it is understood that the nurse cares for both the mother and the fetus at the three stages of the perinatal period with the neonate/infant, it is important that the nurse remembers that for most of this time period, the health of the mother should also be given due importance and attention.
The NCLEX-RN test plan, specifically areas testing safe and effective care management and physiological integrity, ensures that the nurse knows how to prioritize the expectant mother’s needs.
This practice test covers topics during pregnancy, labor, and delivery and includes questions related to monitoring for signs and symptoms of pregnancy, prenatal care regimen including medications, complications of pregnancy, preparation during standard diagnostic examinations, and facilitating maternal-infant bonding immediately after delivery. Try answering the questions below, following a one-minute time pressure per item, to simulate the examination. Answer key and rationale are also provided to help in understanding the concepts better.
Maternity Nursing NCLEX Questions
1. When assessing a client at 12 weeks of gestation, the nurse recommends that she and her husband attend childbirth preparation classes. When is the best time for the couple to participate in these classes?
A. At 16 weeks of gestation
B. At 20 weeks of gestation
C. At 24 weeks of gestation
D. At 30 weeks of gestation
2. A client at 30 weeks of gestation is on bed rest at home because of increased blood pressure. The home health nurse has taught her how to take her blood pressure and gave her parameters to judge a significant increase in blood pressure. When the client calls the clinic complaining of indigestion, which instruction should the nurse provide?
A. Lie on your left side and call 911 for emergency assistance.
B. Take an antacid and call back if the pain has not subsided.
C. Take your blood pressure now and if it is seriously elevated, go to the hospital.
D. See your health care provider to obtain a prescription for a histamine blocking agent.
3. Which finding(s) is (are) of most concern to the nurse when caring for a woman in the first trimester of pregnancy? (Select all that apply.)
A. Cramping with bright red spotting
B. Extreme tenderness of the breast
C. Lack of the tenderness of the breast
D. Increased amounts of discharge
E. Increased right-side flank pain
4. In developing a teaching plan for expectant parents, the nurse decides to include information about when the parents can expect the infant’s fontanels to close. Which statement is accurate regarding the timing of an infant’s fontanels’ closure should be included in this teaching plan?
A. The anterior fontanel closes at 2 to 4 months and the posterior fontanel by the end of the first week.
B. The anterior fontanel closes at 5 to 7 months and the posterior fontanel by the end of the second week.
C. The anterior fontanel closes at 8 to 11 months and the posterior fontanel by the end of the first month.
D. The anterior fontanel closes at 12 to 18 months and the posterior fontanel by the end of the second month.
5. The nurse is teaching a prenatal client about chorionic villus sampling (CVS). The nurse correctly teaches the client that risks related to CVS include which of the following? Select all that apply.
A. Intrauterine infection
B. Rupture of membranes
C. Maternal hypertension
D. Spontaneous abortion
6. A prenatal client at 35 weeks gestation is scheduled for an amniocentesis to determine fetal lung maturity. The nurse expects the lecithin/sphingomyelin (L/S) ratio to be:
7. A pregnant client is concerned about a blow to the abdomen if she continues to play basketball during her pregnancy. The nurse’s response is based upon her knowledge of which of the following facts concerning amniotic fluid?
A. The total amount of amniotic fluid during pregnancy is 300 mL.
B. Amniotic fluid functions as a cushion to protect against mechanical injury.
C. The fetus does not contribute to the production of amniotic fluid.
D. Amniotic fluid is slightly acidic.
8. A client states that she had a spontaneous abortion 12 months ago. The client asks if her hormones may have contributed to the loss of the pregnancy. The nurse’s response is based upon her knowledge of which of the following facts?
A. Implantation occurs when progesterone levels are low.
B. hCG reaches a maximum level at 4 weeks gestation.
C. Progesterone decreases the contractility of the uterus.
D. Progesterone is only produced by the corpus luteum during pregnancy.
9. At 17 weeks pregnant, a mother asks the nurse questions about the development of her baby. The mother states that it may be too early to visualize anybody of the structures via ultrasound. The nurse’s best response in relation to fetal development at 17 weeks is:
A. Myelination of the spinal cord has occurred.
B. Differentiation of the hard and soft palate can be seen.
C. The earlobes are soft with little cartilage.
D. Hard tissue (enamel) for teeth has developed.
10. The nurse encourages the mother of a healthy newborn to put the newborn to the breast immediately after birth for which reason?
A. To aid in maturing the newborn’s sucking reflex
B. To encourage the development of maternal antibodies
C. To facilitate maternal-infant bonding
D. To enhance the clearing of the newborn’s respiratory passages
11. Just after delivery, a newborn’s axillary temperature is 94 degrees F. What action would be most appropriate?
A. Assess the newborn’s gestational age.
B. Rewarm the newborn gradually.
C. Observe the newborn every hour.
D. Notify the physician if the temperature goes lower.
12. A client at 28 weeks gestation is admitted to the labor and birth unit. Which test would most likely be used to assess the client’s comprehensive fetal status?
A. Ultrasound for physical structure
B. Nonstress test (NST)
C. Biophysical profile (BPP)
13. The nurse is preparing a prenatal client for a transvaginal ultrasound. What nursing action should the nurse include in the preparations? Select all that apply.
A. Advise the client to empty her bladder.
B. Encourage the client to drink 1.5 quarts of fluid.
C. Apply transmission gel over the client’s abdomen.
D. Place client in a lithotomy position.
14. A pregnant client asks why ultrasound is used so frequently during pregnancy. The nurse’s response is based on her knowledge that the advantages of ultrasound include which of the following? Select all that apply.
A. “It is non-invasive and painless.”
B. “It can be used to estimate gestational age.”
C. “Results are immediate.”
D. “The ultrasound is the only test to determine gender.”
15. A nurse is teaching a group of student nurses about amniotic fluid. Which of the following statements by the student nurse reflects an understanding of the fetus’s contribution to the quality of amniotic fluid? Select all that apply.
A. “The fetus contributes to the volume of amniotic fluid by excreting urine.”
B. “Approximately 400 mL of amniotic fluid flows out of the fetal lungs each day.”
C. “The fetus swallows about 600 mL of the fluid in 24 hours.”
D. “A fetus can move freely and develop normally, even if there is no amniotic fluid.”
16. A nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the Fallopian tube for 3 days, the nurse responds that the reason for this is that it:
A. Promotes the fertilized ovum’s chances of survival.
B. Promotes the fertilized ovum’s exposure to estrogen & progesterone.
C. Promotes the fertilized ovum’s normal implantation in the top portion of the uterus.
D. Promotes the fertilized ovum’s exposure to LH and FSH.
17. The nurse is taking an initial history of a prenatal client. Which of the following, if detected by the nurse practitioner, would indicate a positive, or diagnostic sign of pregnancy?
A. Positive pregnancy test
B. Goodell’s sign
C. Uterine enlargement and amenorrhea
D. Fetal heartbeat with a Doppler at 11 weeks gestation
18. After removing the epidural, the patient develops a severe headache when she sits up in bed. The physician has instructed the patient that she will need a blood patch. Which best describes this procedure?
A. Removing blood from a vein in the patient and injecting it into the epidural space in the back
B. Placement of a large bandage over the site of the epidural insertion.
C. Replacement of the epidural catheter into the same space for long-term control
D. Placement of a nerve block in the spinal column at the location of the affected
19. On the first day following delivery, the physician ordered a hemoglobin level for the patient; the result was 9.9 g/dL. The physician did not list any other orders in the patient’s chart since that time. Which response of the nurse is most appropriate?
A. Call the physician and ask if he wants a blood transfusion for the patient
B. Ask the physician about the hemoglobin level when he comes in for rounds
C. Contact the laboratory and ask them to repeat the test
D. Continue to monitor the patient and document the result
20. Which of the following patients would be at high risk of developing preeclampsia? Select all that apply.
A. A patient who is pregnant with her 3rd child
B. A patient who is married
C. A patient who is 40 yrs old
D. A patient who is overweight
E. A patient who is pregnant with twins
21. A patient who is 37 weeks pregnant has collapsed in the hallway of the hospital. A nurse responds and notes that the patient does not have a heart rate; which intervention must be modified to respond to this situation because of this patient’s pregnancy?
A. the nurse must open the patient’s airway using the jaw thrust
B. the nurse must displace the uterus slightly before performing chest compressions
C. the nurse cannot use an AED on a pregnant patient
D. the nurse should provide compressions at a rate of 200/min on the pregnant patient
22. A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates:
A. the fetus is at risk for Down syndrome.
B. the woman is at high risk for developing preterm labor.
C. lung maturity.
D. meconium is present in the amniotic fluid.
23. A pregnant patient has a systolic blood pressure that exceeds 160 mm Hg. Which action should the nurse take for this patient?
A. Administer magnesium sulfate intravenously.
B. Obtain a prescription for antihypertensive medications.
C. Restrict intravenous and oral fluids to 125 mL/hr.
D. Monitor fetal heart rate (FHR) and uterine contractions (UCs).
24. A patient reports excessive vomiting in the first trimester of the pregnancy, which has resulted in nutritional deficiency and weight loss. The urinalysis report of the patient indicates ketonuria. Which disorder does the patient have?
B. Hyperthyroid disorder
C. Gestational hypertension
D. Hyperemesis gravidarum
25. A pregnant patient in the first trimester reports spotting of blood with the cervical os closed and mild uterine cramping. What does the nurse need to assess? Select all that apply.
A. Progesterone levels
B. Transvaginal ultrasounds
C. Human chorionic gonadotropin (hCG) measurement
D. Blood pressure
E. Kleihauer-Betke (KB) test reports
26. After being rehydrated in the emergency department, a 24-year-old primipara in her 18th week of pregnancy is at home and is to rest at home for the next two days and take in small but frequent fluids and food as possible. Discharge teaching at the hospital by the nurse has been effective if the patient makes which statement?
A. “I’m going to eat five to six small servings per day, which contain such foods and fluids as tea, crackers, or a few bites of baked potato.”
B. “A strip of bacon and a fried egg will taste good as long as I eat them slowly.”
C. “As long as I eat small amounts and allow enough time for digestion, I can eat almost anything, like barbequed chicken or spaghetti.”
D. “I’m going to stay only on clear fluids for the next 24 hours and then add dairy products like eggs and milk.”
27. At 37 weeks of gestation, a woman is admitted with a placental abruption after a motor vehicle accident. Which assessment data are most indicative of her condition worsening?
A. Pulse (P) 112, respiration (R) 32, blood pressure (BP) 108/60; fetal heart rate (FHR) 166—178
B. P 98, R 22, BP 110/74; FHR 150—162
C. P 88, R 20, BP 114/70; FHR 140—158
D. P 80, R 18, BP 120/78; FHR 138–150
28. A pregnant woman presents to the emergency department complaining of persistent nausea and vomiting. She was diagnosed with hyperemesis gravidarum. The nurse should include which information when teaching about diet for hyperemesis? Select all that apply.
A. Eat three larger meals a day.
B. Eat a high-protein snack at bedtime.
C. Ice cream may stay down better than other foods.
D. Avoid ginger tea or sweet drinks.
E. Eat what sounds good to you even if your meals are not well-balanced.
29. A pregnant patient with severe preeclampsia who is transported to a tertiary care center needs to be administered a magnesium sulfate injection for seizure activity. What actions does the nurse take when administering the drug? Select all that apply.
A. A 10-g dose is administered in the buttock.
B. A local anesthetic is added to the solution.
C. The Z-track technique is used to inject the drug.
D. The injection site is massaged after the injection.
E. The subcutaneous route is used to inject the drug.
30. A blunt abdominal trauma causes fetal hemorrhage in a pregnant patient. The nurse finds that the patient is Rh-negative. What action does the nurse take?
A. Initiate magnesium sulfate per protocol.
B. Administer oxytocin (pitocin).
C. Administer prescribed Rho (D) immunoglobulin.
D. Prepare the patient for magnetic resonance imaging (MRI).