Maternity Practice Questions to Skyrocket Your Learning

 Are you preparing for the NCLEX exam and looking for some help with the topic of maternity? You will likely need to answer at least a few questions about caring for pregnant clients and newborns. The amount of information about maternity and newborn care is extensive, so make a plan, and give yourself enough time to study. You will want to know what normal pregnancy, labor and delivery, and newborn care look like. You will also want to know the most common complications for each stage. Always consider the health of both the mother and baby when answering questions about pregnancy.

If you are feeling overwhelmed by the topic of maternity and newborn care, keep reading! Below is a study checklist and some practice questions to help you get started. Start by working through the study checklist. Then, come back to test your knowledge with the practice questions.

The blog covers:

1. NCLEX Study Checklist for Maternity and Newborn

2. Pregnancy Questions

3. Labor and Delivery Questions

4. Newborn Questions

5. Post-partum Questions

6. Answers

1. NCLEX Study Checklist for Maternity and Newborn

1. Know what information is pertinent for prenatal check-ups, including pregnancy history, sexually transmitted diseases, drug use, current medications, weight, protein in the urine, and blood pressure.
2. Know the basics of electronic fetal monitoring, including accelerations, decelerations, variability, and what each means.
3. Know the most common pregnancy complications, such as hyperemesis, placenta previa, gestational hypertension, vaginal bleeding, intrauterine growth restriction, oligohydramnios, polyhydramnios, urinary tract infections, premature rupture of membranes, preterm labor, gestational diabetes, and cholestasis.
4. Know the stages of labor, including latent, first stage, transition, second stage, and third stage.
5. Know APGAR and newborn vital signs.
6. Know the basics of breastfeeding.
7. Study the most common medications for pregnancy, labor, and delivery, including oxytocin, terbutaline, and magnesium. Remember that most medications will affect both mom and baby during pregnancy and breastfeeding.
8. Know the possible complications for labor and delivery, such as prolapsed cord, placental abruption, shoulder dystocia, and fetal distress.
9. Know about possible post-partum complications, including hemorrhage, mastitis, and post-partum depression.
10. Study the most common newborn conditions, including jaundice, low birth weight, hypoglycemia, drug withdrawal, and fetal alcohol syndrome.

Are you ready for some practice questions? Scroll to the bottom for the answers and rationales. Happy studying and good luck!

2. Pregnancy Questions

Question 1

A nurse is taking a client's health history during her first prenatal check-up. The client has had a miscarriage and has delivered two babies, one of which was preterm. Which is the correct abbreviation for this client?

A. G4 T1 P1 A1 L2
B. G3 T2 P1 A2 L1
C. G4, T2, P0, A1, L2
D. G2, T1, P1, A1, L2

Question 2

A nurse is providing patient teaching for a newly pregnant client. Which of the following is not an important part of education for early pregnancy?

A. The stages of labor.
B. The importance of taking prenatal vitamins daily.
C. The need to avoid drinking alcohol.
D. The early fetal developmental stages.

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Question 3

While assessing a patient who is currently 16 weeks pregnant, the nurse notes the patient's blood pressure is 154/96. This is indicative of which of the following:

A. The patient is developing preeclampsia.
B. This is a normal development in pregnancy during the second trimester.
C. The patient likely had chronic hypertension preceding the pregnancy.
D. The patient is likely anemic.

Question 4

A nurse is providing education for a patient with newly discovered placenta previa. The instructions should include all the following except:

A. The importance of taking an iron supplement daily.

B. The importance of not having sex.

C. The need to report any spotting or bleeding.

D. The need for a pap smear.

Question 5

While reading a patient's chart, the nurse notes that the patient was diagnosed with oligohydramnios. The nurse knows:

A. The patient has a low level of amniotic fluid.

B. The patient has a high level of amniotic fluid.

C. The patient's baby is measuring small.

D. The patient's baby is measuring large.

3. Labor and Delivery Questions

Question 6

While triaging a patient in labor, the nurse learns the patient's previous delivery was precipitous. The nurse knows:

A. The patient is likely to labor quickly.

B. The patient is expected to need a cesarean section.

C. The baby will need extra help to breathe after delivery.

D. The baby will likely be large for gestational age.

Question 7

While observing the fetal heart rate monitor, the nurse notes the baby's heart rate dropping from 150 bpm to 110 bpm just before every contraction. The nurse should:

A. Ask the mother to rest on her side and begin the administration of oxygen.

B. Note that the baby has early decelerations and labor is progressing.

C. Notify the physician that the baby is in distress.

D. Administer terbutaline to stop the contractions.

Question 8

The nurse is administering oxytocin to induce labor in a patient. The nurse notes the patient is contracting 5 times in 10 minutes, and the fetal heart rate has dropped after each contraction. The nurse should:

A. Notify the physician that the patient will be ready to deliver soon.

B. Increase the administration rate of oxytocin.

C. Stop the Pitocin and begin oxygen administration.

D. Check the patient's cervical dilation.

Question 9

A laboring patient is contracting every 1.5-2 minutes, and each contraction lasts for 60-90 seconds. The patient reports the contractions are very painful. Her cervix is dilated to 7 cm. This patient is in what stage of labor:

A. Latent stage

B. 1st stage

C. 2nd stage

D. 3rd stage

Question 10

Normal estimated blood loss for a vaginal delivery is:

A. 1000 ml

B. 2000 ml

C. 500 ml

D. 100 ml

4. Newborn Questions

Question 11

The nurse is assessing the APGAR of a newborn. At 1 minute after birth, the baby has blue-tinted hands and feet, a vigorous cry, and a heart rate of 124 bpm while breathing regularly and being active with good tone. The nurse would note the APGAR as:

A. 5

B. 7

C. 2

D. 9

Question 12

The nurse is caring for a newborn 4 hours after delivery and notes the baby is shaking slightly and has pale blue hands and feet. The nurse should first:

A. Wrap the infant in warm blankets.

B. Encourage the mother to hold the baby skin-to-skin.

C. Check the infant's glucose level and temperature.

D. Give the infant a bottle of formula.

Question 13

Umbilical cord care instructions should include:

A. Wash with soap and water and apply antibacterial cream daily.

B. Allow the cord to air dry as much as possible.

C. Keep cord covered when not washing it.

D. Notify the doctor immediately if any blood is seen around the cord.

5. Post-partum Questions

Question 14

A breastfeeding mother with mastitis should:

A. Increase fluid intake and continue nursing.

B. Stop nursing until the infection resolves.

C. Use cabbage leaves to reduce engorgement.

D. Try to stay as active as possible.

Question 15

A 3-week post-partum mother calls the clinic to report she continues to have yellow, mucus-like discharge. The nurse should:

A. Ask the patient to come in to check for an infection.

B. Tell the patient this is normal and will likely stop in a few weeks.

C. Tell the patient to rest as much as possible for a few days.

D. Ask the patient if she had any stitches following delivery.

6. Answers

1. A: G = gravidity, T = term deliveries, P = preterm deliveries, A = abortions or miscarriages, L = live births. The patient described is G4 T1 P1 A1 L2.

2. A: Learning the stages of labor will be more relevant later in the pregnancy. The other options are more appropriate for early pregnancy.

3. C: Gestational hypertension develops after 20 weeks of pregnancy. Hypertension before 20 weeks is typically a chronic condition that proceeded gestation.

4. D: Placenta previa is a condition in which the placenta covers the cervix. The patient needs to be placed on complete pelvic rest, which means nothing in the vagina. A pap smear would risk irritating the cervix and causing bleeding.

5. A: Oligohydramnios is a condition of low amniotic fluid. The amniotic fluid is measured using ultrasound. An amniotic fluid index (AFI) of less than 8 is considered oligohydramnios. Polyhydramnios is too much amniotic fluid or an AFI greater than 18.

6. A: Precipitous labor occurs when the process of labor takes less than 3 hours. A patient with a history of precipitous labor has a greater risk of experiencing it again. Therefore, the nurse should closely monitor the patient and baby and stay nearby.

7. B: Decelerations before contractions are considered early decelerations and are a sign of head compression and labor progressing. They are not considered ominous.

8. C: This patient is experiencing uterine hyperstimulation, and the baby is having late decelerations indicating distress. The nurse should stop the oxytocin immediately and administer oxygen to the patient.

9. C: This patient is in the second stage of labor. Contractions are 1.5-2 minutes apart and very strong.

10. C: Normal estimated blood loss for a vaginal delivery is 500ml and for a cesarean section is 1000 ml.

11. D: APGAR is assessed at 1 minute after birth and again at 5 minutes after birth. A perfect APGAR is 10. This baby lost one point for having blue hands and feet. Read more about APGAR scores here.

12. C: This infant is showing signs of hypoglycemia. The first action would be to check the glucose level and temperature. The other options might be appropriate after checking blood glucose.

13. B: The umbilical cord should be allowed to air dry as much as possible. The other solutions are unnecessary.

14. A: The mother should continue breastfeeding and drink more fluids. Antibiotics, rest, and massaging the breasts can help relieve mastitis.

15. B: Lochia, the discharge after delivery, will change from red/pink to yellow/white. Usually, lochia will stop 4-6 weeks after delivery.

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Sources:

Abramowski, A., & Hamdan, A. H. (2020). Neonatal Hypoglycemia. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537105/

Anderson-Bagga, F. M., & Sze, A. (2019, June 4). Placenta Previa. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539818/

Apgar Scores. (2015, September 25). HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Apgar-Scores.aspx

Braunthal, S., & Brateanu, A. (2019). Hypertension in pregnancy: Pathophysiology and treatment. SAGE Open Medicine, 7, 205031211984370. https://doi.org/10.1177/2050312119843700

Dr Colin Tidy. (2019, January 21). Gravidity and Parity Definitions (Implications in Risk Assessment). Patient.info. https://patient.info/doctor/gravidity-and-parity-definitions-and-their-implications-in-risk-assessment

Hamza, A., Herr, D., Solomayer, E., & Meyberg-Solomayer, G. (2013). Polyhydramnios: Causes, Diagnosis and Therapy. Geburtshilfe Und Frauenheilkunde, 73(12), 1241-1246. https://doi.org/10.1055/s-0033-1360163

Hutchison, J., Mahdy, H., & Hutchison, J. (2019, November 16). Stages of Labor. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544290/

Keilman, C., & Shanks, A. L. (2021). Oligohydramnios. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562326/

Postpartum Bleeding (Lochia): Is It Normal, What to Do, and More. (2018, July 23). Healthline. https://www.healthline.com/health/pregnancy/is-postpartum-bleeding-normal#aftera-vaginal-delivery

Precipitous Labor: When Labor is Fast and Furious. (2020, August 19). Healthline. https://www.healthline.com/health/pregnancy/precipitous-labor-when-labor-is-fast-and-furious

Simpson, K. R., & James, D. C. (2008). Effects of oxytocin-induced uterine hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. American Journal of Obstetrics and Gynecology, 199(1), 34.e1-34.e5. https://doi.org/10.1016/j.ajog.2007.12.015

Spencer, J. P. (2010). Management of Mastitis in Breastfeeding Women. American Family Physician, 78(6), 727-731. https://www.aafp.org/afp/2008/0915/p727.html

the Healthline Editorial Team. (2015, May 13). Fetal Heart Monitoring: What's Normal, What's Not? Healthline; Healthline Media. https://www.healthline.com/health/pregnancy/abnormal-fetal-heart-tracings#decelerations

About the Author: Christy Geaslen

Christy Geaslen is a registered nurse of eight years, a healthcare writer, and a mom of five. She loves researching and believes knowledge can change the world. This passion drives her to provide upbeat, informative, reader-friendly content that empowers others.