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Maternal and Newborn Nursing · OB Nursing NCLEX Practice Questions

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A client at 34 weeks' gestation has contractions every 5 minutes, pelvic pressure, and cervical change.

Which diagnosis is most consistent with these findings?

A. Normal quickening
B. False labor without cervical change
C. Post-term pregnancy
D. Preterm labor
E. Braxton Hicks contractions

Expert Explanatory Rationale

Correct Answer: D. Preterm labor

Regular contractions with cervical change before 37 weeks indicate preterm labor.

Question 2 of 15

Case excerpt

A client with suspected ectopic pregnancy reports unilateral pelvic pain and shoulder-tip pain and becomes dizzy.

Which complication is the priority concern?

A. Uncomplicated urinary frequency
B. Round-ligament stretching
C. Normal implantation discomfort
D. Mild constipation
E. Rupture with internal hemorrhage

Expert Explanatory Rationale

Correct Answer: E. Rupture with internal hemorrhage

Shoulder-tip pain and dizziness with pelvic pain may indicate intraperitoneal bleeding from a ruptured ectopic pregnancy.

Question 3 of 15

Case excerpt

A client at 36 weeks has a positive group B streptococcus screening result and is admitted in labor.

Which intervention should the nurse anticipate in this scenario: A client at 36 weeks has a positive group B streptococcus screening result and is admitted in?

A. Intrapartum IV antibiotic prophylaxis according to protocol
B. Giving the newborn oral antibiotics at home only
C. Avoiding all antibiotics
D. Delaying labor assessment
E. Administering Rh immune globulin regardless of blood type

Expert Explanatory Rationale

Correct Answer: A. Intrapartum IV antibiotic prophylaxis according to protocol

Intrapartum antibiotic prophylaxis reduces early-onset neonatal group B streptococcal disease for clients with a positive screen when indicated.

Question 4 of 15

Case excerpt

During labor, the fetal monitor shows abrupt decreases in heart rate that vary in timing and shape with contractions.

Which cause is most likely?

A. Fetal sleep cycle
B. Uteroplacental insufficiency
C. Umbilical cord compression
D. Maternal fever alone
E. Maternal hypoglycemia

Expert Explanatory Rationale

Correct Answer: C. Umbilical cord compression

Variable decelerations are commonly associated with umbilical cord compression.

Question 5 of 15

Case excerpt

A client at 41 weeks has a biophysical profile ordered.

Which components are typically assessed?

A. Placental location and maternal glucose only
B. Fetal sex and placental weight
C. Fetal breathing, movement, tone, amniotic fluid volume, and nonstress test
D. Cervical culture and hemoglobin only
E. Maternal lung sounds and bowel sounds

Expert Explanatory Rationale

Correct Answer: C. Fetal breathing, movement, tone, amniotic fluid volume, and nonstress test

The biophysical profile evaluates fetal well-being using ultrasound observations and often a nonstress test.

Question 6 of 15

Case excerpt

A client with suspected amniotic fluid embolism suddenly develops severe dyspnea, hypotension, and altered mental status during birth.

Which response is essential?

A. Activate emergency response and support oxygenation and circulation immediately
B. Assist the client to walk
C. Stop monitoring to reduce anxiety
D. Wait for a chest radiograph before calling for help
E. Encourage oral fluids

Expert Explanatory Rationale

Correct Answer: A. Activate emergency response and support oxygenation and circulation immediately

Amniotic fluid embolism is a life-threatening obstetric emergency requiring immediate multidisciplinary resuscitation.

Question 7 of 15

Case excerpt

A client at 7 weeks' gestation reports light spotting and mild cramping. The cervix is closed and ultrasound shows an intrauterine pregnancy.

Which term best describes this presentation?

A. Complete miscarriage
B. Threatened miscarriage
C. Inevitable miscarriage
D. Septic miscarriage
E. Ectopic pregnancy

Expert Explanatory Rationale

Correct Answer: B. Threatened miscarriage

Bleeding in early pregnancy with a closed cervix and ongoing intrauterine pregnancy is consistent with threatened miscarriage.

Question 8 of 15

Case excerpt

A client in labor has a temperature of 38.5°C (101.3°F), maternal tachycardia, and uterine tenderness.

Which condition should the nurse report as a concern?

A. Placenta previa
B. Intra-amniotic infection
C. Physiologic leukorrhea
D. Postpartum blues
E. Normal labor-related discomfort

Expert Explanatory Rationale

Correct Answer: B. Intra-amniotic infection

Maternal fever with tachycardia and uterine tenderness can indicate intra-amniotic infection and requires prompt evaluation.

Question 9 of 15

Case excerpt

A client at 29 weeks has a history of painless cervical dilation and a prior second-trimester loss.

A client has a prolapsed umbilical cord after membrane rupture. Which actions should the nurse take? (Select all that apply)

A. Use a gloved hand to lift the presenting part off the cord
B. Call for immediate obstetric assistance
C. Prepare for urgent birth
D. Attempt to push the cord back into the uterus
E. Position the client to reduce cord compression

Expert Explanatory Rationale

Correct Answer: A. Use a gloved hand to lift the presenting part off the cord; B. Call for immediate obstetric assistance; C. Prepare for urgent birth; E. Position the client to reduce cord compression

Cord prolapse requires immediate assistance, manual elevation of the presenting part, positioning to relieve compression, and preparation for urgent delivery.

Question 10 of 15

Case excerpt

A client in labor has a prolapsed umbilical cord visible at the vaginal opening after membrane rupture.

A client with suspected ectopic pregnancy reports unilateral pain and dizziness. Which findings require urgent escalation? (Select all that apply)

A. Mild nausea after a meal
B. Hypotension
C. Shoulder-tip pain
D. Increasing abdominal pain
E. Syncope or near-syncope

Expert Explanatory Rationale

Correct Answer: B. Hypotension; C. Shoulder-tip pain; D. Increasing abdominal pain; E. Syncope or near-syncope

Shoulder pain, syncope, hypotension, and worsening abdominal pain can indicate internal hemorrhage from a ruptured ectopic pregnancy.

Question 11 of 15

Case excerpt

A client at 24 weeks asks about the purpose of the anatomy ultrasound.

A laboring client has recurrent variable fetal heart rate decelerations. Which interventions may be appropriate? (Select all that apply)

A. Reposition the client
B. Evaluate for cord compression and notify the team
C. Increase oxytocin without reassessment
D. Continue fetal monitoring
E. Assess the contraction pattern

Expert Explanatory Rationale

Correct Answer: A. Reposition the client; B. Evaluate for cord compression and notify the team; D. Continue fetal monitoring; E. Assess the contraction pattern

Variable decelerations are commonly related to cord compression. Repositioning, assessment, communication, and continued monitoring are appropriate.

Question 12 of 15

Case excerpt

A client with gestational diabetes asks why glucose control matters during pregnancy.

A client at risk for preterm birth receives antenatal corticosteroids. Which statements about the treatment are accurate? (Select all that apply)

A. It can reduce complications of prematurity
B. It is used when preterm birth is considered likely within an appropriate time window
C. It guarantees that labor will stop
D. It replaces the need for neonatal assessment
E. It promotes fetal lung maturation

Expert Explanatory Rationale

Correct Answer: A. It can reduce complications of prematurity; B. It is used when preterm birth is considered likely within an appropriate time window; E. It promotes fetal lung maturation

Antenatal corticosteroids support fetal maturation and reduce complications when preterm birth is anticipated; they do not guarantee prevention of labor.

Question 13 of 15

Case excerpt

A client with a multifetal pregnancy asks why more frequent prenatal surveillance may be recommended.

A client with gestational diabetes is discussing newborn care after birth. Which risks should the nurse explain? (Select all that apply)

A. Neonatal hypoglycemia
B. Need for newborn glucose monitoring when indicated
C. Possible feeding support needs
D. Large-for-gestational-age growth
E. Guaranteed congenital heart disease

Expert Explanatory Rationale

Correct Answer: A. Neonatal hypoglycemia; B. Need for newborn glucose monitoring when indicated; C. Possible feeding support needs; D. Large-for-gestational-age growth

Maternal hyperglycemia can contribute to fetal overgrowth and neonatal hypoglycemia; newborn monitoring and feeding support may be needed.

Question 14 of 15

Case excerpt

Medication or fluid administration calculation in a maternal, newborn, or child-health setting.

An IV order is 750 mL over 6 hours during labor. What rate should the nurse program in mL/hr? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 125

750 mL ÷ 6 hours = 125 mL/hr.

Question 15 of 15

Case excerpt

The nurse is coordinating a time-sensitive maternal, newborn, or child-health response.

A prolapsed umbilical cord is identified during labor. Place the nursing actions in the safest order.

A. Recognize the cord prolapse and call for emergency assistance
B. Use a gloved hand to elevate the presenting part
C. Position the client to reduce cord compression
D. Prepare for emergency birth and continue fetal assessment
E. Document the event and care after stabilization

Expert Explanatory Rationale

Correct Answer: A. Recognize the cord prolapse and call for emergency assistance; B. Use a gloved hand to elevate the presenting part; C. Position the client to reduce cord compression; D. Prepare for emergency birth and continue fetal assessment; E. Document the event and care after stabilization

Immediate recognition and help are followed by relieving cord pressure, positioning, preparation for birth, and documentation after stabilization.

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