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NCLEX-RN: Maternal and Newborn Nursing Essentials — quiz
20 multiple-choice questions covering Prenatal Signs, Naegele's Rule, GTPAL, Fundal Height, FHR Patterns. One answer each; you get a score at the end and the explanation for every question. No account needed.
Updated 2026-11-03. Keys 1–4 pick an answer, Enter moves on. Redo it any time, in order or shuffled.
The questions
Answers and explanations are shown after you finish.
- Prenatal Signs
A pregnant patient reports nausea, breast tenderness, and fatigue, but has not yet had a pelvic exam or ultrasound. How should the nurse classify these findings?
- Diagnostic signs of pregnancy
- Presumptive signs
- Probable signs
- Positive signs
- Prenatal Signs
Which finding definitively confirms pregnancy?
- Uterine enlargement noted on exam
- A positive urine hCG test
- Fetal heart tones auscultated by Doppler
- Chadwick's sign noted on exam
- Naegele's Rule
A patient's last menstrual period began September 8. Using Naegele's rule, what is her estimated due date?
- June 8
- June 15
- June 1
- May 15
- GTPAL
A woman is currently pregnant. Her history includes one set of twins delivered at 38 weeks (both living) and one miscarriage at 10 weeks. What is her GTPAL?
- G3 T2 P0 A1 L2
- G3 T1 P0 A1 L2
- G3 T1 P0 A1 L1
- G2 T1 P0 A1 L2
- Fundal Height
At 36 weeks, a nurse had palpated the fundus near the xiphoid process. At the next visit, the fundus is noted to have descended slightly even though the pregnancy continues. What does this most likely indicate?
- Postterm pregnancy requiring induction
- A measurement error by the examiner
- Oligohydramnios reducing uterine size
- Lightening, as the fetal head engages the pelvis
- FHR Patterns
During a contraction, the FHR gradually dips and returns to baseline, with the lowest point occurring exactly at the peak of the contraction. What is the appropriate nursing action?
- Administer oxygen via facemask
- Reposition the mother to her left side immediately
- Discontinue the oxytocin infusion
- No intervention needed; continue routine monitoring
- FHR Patterns
A laboring patient on an oxytocin infusion develops recurrent decelerations that begin after the contraction peaks and recover well after the contraction ends. What is the nurse's first action?
- Encourage the patient to begin pushing
- Prepare for immediate cesarean without further assessment
- Stop the oxytocin infusion
- Increase the oxytocin rate to speed up delivery
- FHR Patterns
An FHR tracing shows abrupt, V-shaped drops that are not consistently timed with contractions. What is the most likely cause?
- Uteroplacental insufficiency
- Fetal head compression
- Umbilical cord compression
- Maternal hypotension
- FHR Patterns
On vaginal exam, the nurse feels a pulsating loop of cord below the fetal presenting part. What is the priority nursing action?
- Administer oxytocin to speed up delivery
- Apply gentle traction on the cord to reposition it
- Place the mother in knee-chest or Trendelenburg position and keep a gloved hand in the vagina to relieve pressure on the cord
- Immediately rupture the membranes to confirm the finding
- Stages of Labor
A patient is 9 cm dilated, having intense contractions, feeling irritable, and reporting an urge to push. Which phase of labor is she in?
- Transition phase
- Latent phase
- Active phase
- Second stage of labor
- Preeclampsia & Mg Sulfate
Which finding indicates severe features of preeclampsia requiring urgent management?
- BP 142/92 with trace proteinuria
- Mild headache relieved by rest
- Epigastric pain with elevated liver enzymes
- Occasional ankle edema
- Preeclampsia & Mg Sulfate
A nurse is monitoring serum magnesium levels in a preeclamptic patient receiving a magnesium sulfate infusion. Which level falls within the therapeutic range?
- 5 mEq/L
- 12 mEq/L
- 9 mEq/L
- 2 mEq/L
- Preeclampsia & Mg Sulfate
A patient receiving magnesium sulfate has absent patellar reflexes and a respiratory rate of 9/min. What is the priority nursing action?
- Administer an additional magnesium sulfate bolus
- Continue the infusion and recheck reflexes in one hour
- Increase the infusion rate to prevent seizures
- Stop the infusion and prepare to administer calcium gluconate
- Postpartum Hemorrhage
A postpartum nurse notes a soft, boggy uterus with increased vaginal bleeding. What is the first nursing action?
- Perform fundal massage
- Notify the provider and wait for orders
- Insert a Foley catheter
- Administer antibiotics
- Postpartum Hemorrhage
On day 6 postpartum, a patient's lochia changes from pink-brown back to bright red with a foul odor. What should the nurse suspect?
- Possible retained placental tissue or infection
- Normal progression of lochia serosa
- Expected return to rubra before transitioning to alba
- Dehydration causing concentrated lochia
- Rh Incompatibility & RhoGAM
An Rh-negative mother delivers an Rh-positive infant. When should RhoGAM be administered after birth?
- Only if the mother plans future pregnancies
- Within 72 hours
- Within 7 days
- At the 6-week postpartum visit
- Newborn APGAR
A newborn's 5-minute APGAR score is 5. How should the nurse interpret this finding?
- Moderately depressed, needs some resuscitative support
- Normal, no further action needed
- The score predicts long-term neurological outcome
- Severely depressed, needs immediate resuscitation
- Newborn Reflexes
A nurse startles a newborn and observes that one arm does not abduct and extend like the other during the startle response. What should the nurse suspect?
- Possible brachial plexus injury or fracture
- A normal Moro reflex variation
- A sign of neonatal hypoglycemia
- An immature reflex that will resolve on its own
- Jaundice
A newborn develops visible jaundice at 18 hours of life. How should the nurse interpret this finding?
- Normal physiologic jaundice; monitor routinely
- Breastfeeding jaundice requiring only increased feeding
- An expected finding that will peak around day 3
- Pathologic jaundice requiring immediate workup
- Breastfeeding Teaching
Which observation indicates an effective breastfeeding latch?
- Clicking sounds with each suck
- Audible swallowing with the mouth covering most of the areola
- The mother leaning forward to bring the breast to the baby
- The infant's mouth covering only the nipple
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