👶 Introduction
Maternity nursing is a vital area of the NCLEX-RN exam that tests your understanding of pregnancy, labor, delivery, postpartum care, and newborn health. Success in this section requires not only memorization but also critical thinking and empathy in handling maternal and fetal concerns.
This 100-question NCLEX Maternity Nursing Practice Test will help you review essential nursing concepts related to obstetrics, maternal complications, and neonatal nursing. Each question includes a detailed rationale to help you understand the reasoning behind correct answers — improving both your confidence and accuracy on exam day.
🍼 NCLEX Maternity Nursing Practice Test — Part 1 (Questions 1–25)
1. The nurse is caring for a woman in active labor. Which finding indicates the transition phase?
A. Contractions every 10 minutes, lasting 30 seconds
B. Cervical dilation of 4 cm
C. Cervical dilation of 8 cm with strong contractions
D. Client is calm and cooperative
✅ Correct Answer: C
💡 Rationale: The transition phase occurs when the cervix is 8–10 cm dilated, contractions are strong, and the client may feel irritable, tired, or restless.
2. A mother asks when she will start feeling fetal movements. The nurse should respond:
A. Around 8 weeks
B. Around 16–20 weeks
C. Around 28 weeks
D. Around 36 weeks
✅ Correct Answer: B
💡 Rationale: Fetal movement, or “quickening,” is typically felt between 16 and 20 weeks of gestation, depending on parity and maternal awareness.
3. The most reliable indicator of true labor is:
A. Regular contractions increasing in intensity
B. Back pain
C. Rupture of membranes
D. Fetal descent
✅ Correct Answer: A
💡 Rationale: True labor is characterized by regular contractions that progressively increase in intensity and result in cervical dilation and effacement.
4. A postpartum woman is experiencing uterine atony. The nurse should first:
A. Call the physician
B. Massage the fundus firmly
C. Administer antibiotics
D. Start oxygen therapy
✅ Correct Answer: B
💡 Rationale: Uterine atony is the most common cause of postpartum hemorrhage. Immediate fundal massage promotes uterine contraction and reduces bleeding.
5. The nurse identifies which sign as an early indicator of preeclampsia?
A. Proteinuria
B. Severe headache
C. Elevated blood pressure after 20 weeks
D. Blurred vision
✅ Correct Answer: C
💡 Rationale: Preeclampsia typically presents after 20 weeks with elevated BP; proteinuria and symptoms like headache appear later.
6. A patient in labor is receiving oxytocin. The nurse must stop the infusion if:
A. Contractions occur every 3 minutes
B. Contractions last longer than 90 seconds
C. The client feels pressure to push
D. The fetal heart rate is 150 bpm
✅ Correct Answer: B
💡 Rationale: Oxytocin should be discontinued if contractions last >90 seconds or occur more frequently than every 2 minutes due to risk of uterine rupture or fetal distress.
7. A nurse is assessing a newborn 1 hour after birth. Which finding requires immediate intervention?
A. Respiratory rate of 48 breaths per minute
B. Heart rate of 140 bpm
C. Nasal flaring and grunting
D. Pink color with acrocyanosis
✅ Correct Answer: C
💡 Rationale: Nasal flaring, grunting, or retractions are signs of respiratory distress and must be addressed immediately.
8. The nurse should teach a pregnant woman that folic acid helps prevent:
A. Spina bifida
B. Down syndrome
C. Cleft palate
D. Premature labor
✅ Correct Answer: A
💡 Rationale: Folic acid prevents neural tube defects such as spina bifida and anencephaly; supplementation should start before conception.
9. Which fetal heart rate pattern requires the most immediate attention?
A. Early decelerations
B. Late decelerations
C. Accelerations
D. Variable decelerations
✅ Correct Answer: B
💡 Rationale: Late decelerations indicate uteroplacental insufficiency — a sign of fetal hypoxia requiring urgent intervention.
10. A nurse caring for a woman in the second stage of labor should:
A. Keep the woman NPO
B. Encourage frequent position changes
C. Prepare for episiotomy
D. Encourage bearing down with contractions
✅ Correct Answer: D
💡 Rationale: During the second stage, the client pushes with contractions to facilitate fetal descent and delivery.
11. A patient at 38 weeks gestation complains of sudden sharp abdominal pain and no fetal movement. The nurse suspects:
A. Placenta previa
B. Placental abruption
C. Preterm labor
D. False labor
✅ Correct Answer: B
💡 Rationale: Abruptio placentae presents with sudden pain, uterine tenderness, and decreased or absent fetal movement.
12. The nurse teaches a pregnant woman about the purpose of the nonstress test (NST):
A. To determine fetal lung maturity
B. To assess fetal movement and heart rate pattern
C. To detect neural tube defects
D. To identify gestational diabetes
✅ Correct Answer: B
💡 Rationale: The NST evaluates fetal heart rate response to movement — an indicator of fetal well-being.
13. A postpartum woman reports burning during urination. The nurse suspects:
A. UTI
B. Lochia rubra
C. Vaginal dryness
D. Perineal healing
✅ Correct Answer: A
💡 Rationale: Dysuria and frequency postpartum often indicate urinary tract infection caused by catheterization or perineal trauma.
14. A newborn’s Apgar score is 8 at 1 minute and 9 at 5 minutes. The nurse should:
A. Call the physician immediately
B. Provide routine newborn care
C. Begin resuscitation
D. Give supplemental oxygen
✅ Correct Answer: B
💡 Rationale: Scores of 7–10 are considered normal; no special interventions are required.
15. A nurse identifies that a woman in the fourth stage of labor is at greatest risk for:
A. Infection
B. Hemorrhage
C. Hypertension
D. Eclampsia
✅ Correct Answer: B
💡 Rationale: The first 1–4 hours after delivery (fourth stage) is the period of greatest risk for postpartum hemorrhage due to uterine atony.
16. The nurse should instruct a woman with gestational diabetes to:
A. Decrease carbohydrate intake drastically
B. Monitor blood glucose frequently
C. Avoid physical activity
D. Reduce protein consumption
✅ Correct Answer: B
💡 Rationale: Blood glucose monitoring helps prevent maternal hyperglycemia and fetal macrosomia.
17. A nurse notes the umbilical cord is wrapped around the baby’s neck. The nurse should first:
A. Cut the cord immediately
B. Slip the cord over the head gently
C. Apply pressure to the cord
D. Call for emergency C-section
✅ Correct Answer: B
💡 Rationale: The priority is to gently loosen the cord over the baby’s head before delivery of the shoulders.
18. Which of the following is a sign of placental separation?
A. Sudden gush of blood
B. Decrease in fundal height
C. Contraction pain
D. Pale skin
✅ Correct Answer: A
💡 Rationale: A sudden gush of blood and lengthening of the umbilical cord indicate placental separation.
19. The nurse identifies which position is best for relieving supine hypotension?
A. Supine
B. Semi-Fowler’s
C. Left lateral
D. Prone
✅ Correct Answer: C
💡 Rationale: The left lateral position prevents uterine compression of the vena cava, improving venous return.
20. When teaching a postpartum mother about breastfeeding, the nurse should emphasize:
A. Keep the baby on a strict schedule
B. Feed every 4–6 hours
C. Feed on demand, 8–12 times daily
D. Limit each feeding to 5 minutes
✅ Correct Answer: C
💡 Rationale: Frequent feeding establishes milk supply and prevents engorgement; newborns typically feed every 2–3 hours.
21. Which newborn finding should be reported immediately?
A. Jaundice within first 24 hours
B. Acrocyanosis
C. Overlapping cranial sutures
D. Vernix caseosa
✅ Correct Answer: A
💡 Rationale: Early jaundice may indicate hemolysis or infection and requires immediate evaluation.
22. A postpartum woman’s fundus is boggy and deviated to the right. The nurse should:
A. Massage the fundus
B. Assist her to urinate
C. Notify the physician
D. Administer oxytocin
✅ Correct Answer: B
💡 Rationale: A distended bladder can displace the uterus to the right and prevent contraction; help the mother void first.
23. Which vitamin deficiency causes neural tube defects?
A. Vitamin D
B. Vitamin C
C. Folic acid
D. Vitamin K
✅ Correct Answer: C
💡 Rationale: Folic acid deficiency during early pregnancy causes neural tube defects; supplementation is essential.
24. During pregnancy, the nurse advises avoiding which food to prevent listeriosis?
A. Fresh fruits
B. Pasteurized milk
C. Soft cheese
D. Well-cooked eggs
✅ Correct Answer: C
💡 Rationale: Soft cheeses and deli meats can carry Listeria monocytogenes, which may cause miscarriage or stillbirth.
25. A nurse should teach a pregnant woman with morning sickness to:
A. Eat large meals twice daily
B. Drink fluids with meals
C. Eat small, frequent meals
D. Skip breakfast
✅ Correct Answer: C
💡 Rationale: Small, frequent meals prevent gastric emptiness and reduce nausea during early pregnancy.
👉 NCLEX Fundamentals of Nursing Practice Questions
🍼 NCLEX Maternity Nursing Practice Test — Part 2 (Questions 26–50)
26. A nurse is caring for a newborn of a diabetic mother. Which finding requires immediate intervention?
A. Jitteriness
B. Pink skin tone
C. Blood glucose of 55 mg/dL
D. Mild acrocyanosis
✅ Correct Answer: A
💡 Rationale: Jitteriness can indicate hypoglycemia in infants of diabetic mothers. Prompt glucose testing and feeding are required.
27. A primigravida at 10 weeks reports morning nausea. Which advice is most helpful?
A. Skip breakfast until nausea subsides
B. Eat dry crackers before getting out of bed
C. Drink coffee to settle the stomach
D. Eat spicy food in small amounts
✅ Correct Answer: B
💡 Rationale: Dry crackers before rising help absorb stomach acid and ease morning nausea.
28. Which test confirms pregnancy?
A. Abdominal ultrasound
B. Positive urine hCG test
C. Fetal heart rate detected by Doppler
D. Abdominal enlargement
✅ Correct Answer: B
💡 Rationale: Human chorionic gonadotropin (hCG) in urine or blood confirms pregnancy.
29. Which sign indicates probable pregnancy?
A. Fetal movement felt by mother
B. Positive pregnancy test
C. Fetal heartbeat by Doppler
D. Ultrasound visualization of fetus
✅ Correct Answer: B
💡 Rationale: Probable signs are objective indicators like positive pregnancy tests, while fetal movement and heartbeat are positive signs.
30. Which finding during postpartum assessment requires immediate action?
A. Firm midline fundus
B. Saturating one pad per hour
C. Fundus boggy and high
D. Lochia rubra for 2 days
✅ Correct Answer: C
💡 Rationale: A boggy, elevated fundus indicates uterine atony — the leading cause of postpartum hemorrhage.
31. When should Rho(D) immune globulin (RhoGAM) be administered?
A. Within 72 hours after delivery of an Rh-positive baby to an Rh-negative mother
B. During the first trimester
C. Only after miscarriage
D. Before every prenatal visit
✅ Correct Answer: A
💡 Rationale: RhoGAM prevents Rh isoimmunization and must be given within 72 hours postpartum if the infant is Rh positive.
32. Which of the following newborn reflexes should be present at birth?
A. Babinski reflex
B. Parachute reflex
C. Stepping reflex
D. Moro reflex
✅ Correct Answer: D
💡 Rationale: The Moro (startle) reflex appears at birth and disappears by 4 months; absence suggests neurological impairment.
33. The nurse notes a positive Chadwick’s sign. This indicates:
A. Bluish discoloration of the cervix
B. Softening of the uterus
C. Absence of menses
D. Breast tenderness
✅ Correct Answer: A
💡 Rationale: Chadwick’s sign — bluish discoloration of the cervix and vaginal mucosa — is an early probable sign of pregnancy.
34. Which activity should be avoided during the third trimester?
A. Light stretching
B. Prolonged standing
C. Side-lying rest
D. Walking 20 minutes daily
✅ Correct Answer: B
💡 Rationale: Prolonged standing in late pregnancy increases venous stasis and risk of preterm contractions.
35. The best position for the laboring client with a prolapsed umbilical cord is:
A. Supine
B. Trendelenburg
C. Lithotomy
D. High-Fowler’s
✅ Correct Answer: B
💡 Rationale: Trendelenburg or knee-chest positions use gravity to relieve cord compression until delivery.
36. Which assessment indicates effective breastfeeding?
A. Mother reports nipple pain
B. Infant sleeps for 5 hours straight
C. Audible swallowing is heard during feeds
D. Baby loses 15% of body weight
✅ Correct Answer: C
💡 Rationale: Audible swallowing shows proper latch and milk transfer; weight loss >10% is abnormal.
37. A nurse teaching about contraception after delivery should emphasize:
A. Ovulation cannot occur while breastfeeding
B. Use of contraception even during lactation
C. Pregnancy cannot occur before first menses
D. Oral contraceptives are safe immediately postpartum
✅ Correct Answer: B
💡 Rationale: Ovulation can occur before the first menstrual period; contraception is advised even while breastfeeding.
38. The nurse should monitor a client receiving magnesium sulfate for:
A. Hypertension
B. Deep tendon reflexes
C. Increased urine output
D. Tachycardia
✅ Correct Answer: B
💡 Rationale: Magnesium sulfate toxicity causes loss of reflexes, respiratory depression, and decreased urine output.
39. A nurse assesses a postpartum client’s perineum using REEDA. What does “E” stand for?
A. Edema
B. Erythema
C. Episiotomy
D. Elasticity
✅ Correct Answer: B
💡 Rationale: REEDA: Redness, Edema, Ecchymosis, Discharge, Approximation — a tool for perineal healing assessment.
40. The nurse recognizes which sign as a normal physiological change in pregnancy?
A. Decreased blood volume
B. Increased cardiac output
C. Decreased urinary frequency
D. Reduced metabolic rate
✅ Correct Answer: B
💡 Rationale: Blood volume and cardiac output increase to meet maternal and fetal oxygen needs.
41. The nurse should instruct a client taking iron supplements to:
A. Take with milk
B. Take with orange juice
C. Take on an empty stomach
D. Avoid all fluids
✅ Correct Answer: B
💡 Rationale: Vitamin C enhances iron absorption; milk or caffeine inhibit it.
42. During labor, the nurse observes variable decelerations. The priority action is:
A. Increase oxytocin rate
B. Place mother in left lateral position
C. Start pushing
D. Continue monitoring
✅ Correct Answer: B
💡 Rationale: Variable decelerations indicate cord compression; repositioning relieves pressure and improves oxygenation.
43. A nurse notes yellow drainage from a C-section incision. The nurse should:
A. Document as normal
B. Apply warm compresses
C. Notify the physician immediately
D. Change dressing and reassess
✅ Correct Answer: C
💡 Rationale: Yellow drainage suggests infection; the provider should be notified for antibiotic therapy.
44. The nurse should suspect postpartum depression if:
A. The mother cries occasionally
B. The mother feels unable to bond with baby after 2 weeks
C. The mother sleeps well and eats normally
D. The mother expresses joy during feeds
✅ Correct Answer: B
💡 Rationale: Persistent sadness, guilt, or detachment beyond 2 weeks postpartum are key signs of depression.
45. Which nursing intervention is essential immediately after delivery of the placenta?
A. Administer oxytocin
B. Record Apgar score
C. Initiate breastfeeding
D. Allow rest
✅ Correct Answer: A
💡 Rationale: Oxytocin promotes uterine contraction, minimizing postpartum hemorrhage.
46. A nurse is assessing lochia. Which finding is abnormal 5 days postpartum?
A. Lochia rubra
B. Lochia serosa
C. Foul odor
D. Pinkish discharge
✅ Correct Answer: C
💡 Rationale: Foul odor indicates infection; lochia serosa (pink) is normal at this stage.
47. A nurse is teaching about signs of labor. Which is a true sign?
A. Lightening
B. Braxton Hicks contractions
C. Bloody show
D. Fetal movement
✅ Correct Answer: C
💡 Rationale: Bloody show (mucus mixed with blood) is a true sign indicating cervical dilation.
48. The nurse recognizes which behavior as a maternal adaptation to taking-in phase?
A. Mother wants to discuss labor experience
B. Mother focuses on infant’s needs
C. Mother begins independent infant care
D. Mother seeks social support
✅ Correct Answer: A
💡 Rationale: In the taking-in phase (first 1–2 days postpartum), the mother is focused on self and recounts her birth experience.
49. The nurse identifies a sign of potential postpartum infection when:
A. Temperature is 99°F (37.2°C)
B. Fundus is firm and midline
C. Lochia has foul odor
D. Breasts feel firm before feeding
✅ Correct Answer: C
💡 Rationale: Foul-smelling lochia indicates uterine infection (endometritis).
50. A nurse caring for a woman with hyperemesis gravidarum should expect which intervention?
A. Increase oral fluids
B. Provide high-fat meals
C. Administer IV fluids and antiemetics
D. Encourage lying flat after meals
✅ Correct Answer: C
💡 Rationale: Severe vomiting leads to dehydration and electrolyte imbalance; IV therapy restores balance and reduces nausea.
🩸 NCLEX Fluid & Electrolyte Questions
🧠 NCLEX Wound Care Practice Questions
NCLEX Maternity Nursing Practice Test (Questions 51–75)
51. The nurse is caring for a postpartum client who delivered 8 hours ago and reports severe perineal pain. Upon assessment, the nurse notes swelling and a bluish discoloration at the perineal site. What should the nurse suspect?
A. Uterine atony
B. Vaginal hematoma
C. Endometritis
D. Retained placental fragments
✅ Answer: B. Vaginal hematoma
Rationale: A bluish, swollen, painful perineum suggests a hematoma caused by bleeding beneath the tissue. The nurse should notify the healthcare provider promptly for possible drainage.
52. The nurse is providing discharge teaching for a woman who had a cesarean delivery. Which statement indicates the need for further teaching?
A. “I will avoid lifting anything heavier than my baby for two weeks.”
B. “I can drive again once I can comfortably wear a seatbelt.”
C. “I will keep the incision clean and dry.”
D. “I can resume sexual activity in one week.”
✅ Answer: D.
Rationale: Sexual activity should not be resumed until the healthcare provider confirms healing, usually after 4–6 weeks.
53. Which action should the nurse take first for a laboring woman showing signs of fetal bradycardia?
A. Reposition the mother
B. Start IV oxytocin
C. Encourage deep breathing
D. Document findings and continue monitoring
✅ Answer: A. Reposition the mother
Rationale: Fetal bradycardia often results from cord compression or maternal hypotension. Repositioning improves uteroplacental circulation.
54. A client at 38 weeks gestation reports severe itching on her palms and soles but no rash. What condition should the nurse suspect?
A. Preeclampsia
B. Intrahepatic cholestasis of pregnancy
C. Placental abruption
D. Gestational diabetes
✅ Answer: B. Intrahepatic cholestasis of pregnancy
Rationale: This liver condition leads to bile acid accumulation, causing intense itching. It increases fetal distress risk.
55. The nurse is assessing a newborn whose mother had diabetes. Which finding should the nurse expect?
A. Hypoglycemia
B. Hypothermia
C. Hyperbilirubinemia
D. Bradycardia
✅ Answer: A. Hypoglycemia
Rationale: Infants of diabetic mothers often have high insulin levels, leading to low blood sugar after birth.
56. Which newborn assessment finding requires immediate nursing intervention?
A. A pink body with bluish hands and feet
B. Heart rate of 90 bpm
C. Respiratory rate of 40 breaths/min
D. Flexed posture
✅ Answer: B. Heart rate of 90 bpm
Rationale: A newborn’s heart rate should be 110–160 bpm. A rate below 100 bpm is a sign of distress and needs urgent care.
57. The nurse teaches a client about signs of postpartum depression. Which statement shows understanding?
A. “It’s normal to feel sad and tired for a few hours after delivery.”
B. “If I feel hopeless and can’t bond with my baby, I should call my doctor.”
C. “Crying spells are always normal after childbirth.”
D. “Mood swings mean I have depression.”
✅ Answer: B.
Rationale: Persistent sadness, hopelessness, or lack of bonding indicates postpartum depression, requiring medical attention.
58. The nurse assists with a nonstress test. Which finding indicates fetal well-being?
A. Two accelerations of 15 bpm for 15 seconds in 20 minutes
B. A flat baseline with no accelerations
C. A deceleration after each contraction
D. A baseline heart rate of 170 bpm
✅ Answer: A.
Rationale: A reactive nonstress test (NST) shows two or more accelerations within 20 minutes, confirming adequate oxygenation.
59. A pregnant woman at 30 weeks complains of dizziness when lying flat. What is the most appropriate action?
A. Elevate the head of the bed
B. Turn her to her left side
C. Administer oxygen
D. Encourage slow deep breathing
✅ Answer: B.
Rationale: The supine position compresses the vena cava, reducing venous return. The left lateral position relieves pressure and restores circulation.
60. The nurse notes that a postpartum woman’s fundus is boggy and deviated to the right. What is the likely cause?
A. Retained placental fragments
B. Full bladder
C. Uterine atony
D. Endometritis
✅ Answer: B. Full bladder
Rationale: A distended bladder pushes the uterus to one side and prevents contraction. The nurse should assist with voiding.
61. Which of the following is an early sign of hypovolemic shock after delivery?
A. Low blood pressure
B. Rapid, weak pulse
C. Cyanosis
D. Loss of consciousness
✅ Answer: B. Rapid, weak pulse
Rationale: Tachycardia is an early compensatory sign of blood loss before blood pressure drops.
62. The nurse observes a mother bottle-feeding her newborn. Which behavior indicates a need for further teaching?
A. Holding the baby close during feeding
B. Propping the bottle while feeding
C. Burping the baby midway through feeding
D. Using room-temperature formula
✅ Answer: B.
Rationale: Bottle propping can cause choking and ear infections. Feeding should be done while holding the infant upright.
63. A nurse is monitoring a client in active labor. The contractions last 90 seconds and occur every 1 minute. What is the nurse’s priority action?
A. Reduce oxytocin infusion
B. Encourage ambulation
C. Increase IV fluids
D. Continue monitoring
✅ Answer: A.
Rationale: Contractions that are too long or too frequent may reduce oxygen to the fetus. The oxytocin infusion should be slowed or stopped.
64. The nurse teaches a woman about breast engorgement relief. Which statement shows understanding?
A. “I should apply cold compresses between feedings.”
B. “I will avoid breastfeeding until swelling subsides.”
C. “I should wear a tight bra to stop milk flow.”
D. “I’ll apply warm compresses before feeding.”
✅ Answer: D.
Rationale: Warm compresses promote milk flow and comfort. Cold compresses can be used after feeding to reduce swelling.
65. A nurse is assessing a newborn’s reflexes. Which reflex disappears first after birth?
A. Moro
B. Rooting
C. Babinski
D. Stepping
✅ Answer: D. Stepping
Rationale: The stepping reflex disappears at about 2 months, while others persist longer.
66. The nurse notes that a pregnant client’s rubella titer is negative. When should the vaccine be given?
A. Immediately
B. In the second trimester
C. At delivery
D. After delivery
✅ Answer: D. After delivery
Rationale: The rubella vaccine is contraindicated in pregnancy due to its live virus content. It’s safe postpartum before discharge.
67. A laboring client suddenly develops sharp chest pain and dyspnea. The nurse suspects amniotic fluid embolism. What should be done first?
A. Administer oxygen
B. Start CPR
C. Notify the provider
D. Place in Trendelenburg position
✅ Answer: A. Administer oxygen
Rationale: Amniotic fluid embolism causes hypoxia. Oxygen administration is the top priority to support oxygenation.
68. The nurse observes a postpartum woman passing small clots during fundal massage. What should the nurse do?
A. Continue massaging the uterus
B. Stop the massage and notify the provider
C. Check the perineal pad and lochia
D. Document findings as normal
✅ Answer: C.
Rationale: Small clots are expected, but the nurse should check for uterine tone and ensure lochia remains normal.
69. Which nursing action prevents postpartum hemorrhage?
A. Monitoring vital signs hourly
B. Encouraging ambulation
C. Massaging a boggy uterus
D. Providing IV antibiotics
✅ Answer: C.
Rationale: A firm uterus prevents excessive bleeding. Massage helps contract the uterus if it becomes boggy.
70. A nurse teaches a pregnant woman about signs of preeclampsia. Which symptom requires immediate medical attention?
A. Mild swelling of feet
B. Headache and blurred vision
C. Nausea after eating
D. Occasional dizziness
✅ Answer: B.
Rationale: Headache, blurred vision, and facial swelling indicate preeclampsia, a serious hypertensive disorder.
71. A nurse is caring for a client who delivered a baby 24 hours ago. The fundus is firm but deviated to the right. What should the nurse do first?
A. Massage the fundus
B. Check for bladder distention
C. Notify the healthcare provider
D. Assess for retained placental fragments
✅ Answer: B. Check for bladder distention
💡 Rationale: A firm but deviated uterus indicates a full bladder pushing the uterus to one side. The nurse should assist the client to void, which helps the uterus return to midline and prevents postpartum hemorrhage.
72. A postpartum client reports severe perineal pain after a vaginal delivery with episiotomy. On assessment, the nurse notes a firm uterus and increasing perineal swelling. What should the nurse suspect?
A. Uterine atony
B. Hematoma formation
C. Infection
D. Retained placenta
✅ Answer: B. Hematoma formation
💡 Rationale: Severe perineal pain with swelling and a firm uterus suggests a hematoma, caused by vessel injury during delivery. The nurse should report this immediately for evaluation and possible surgical drainage.
73. A nurse is preparing to administer Rh immunoglobulin (Rho(D) immune globulin) to a postpartum client. Which condition must be met?
A. The mother is Rh positive
B. The newborn is Rh negative
C. The mother is Rh negative and baby is Rh positive
D. Both mother and baby are Rh negative
✅ Answer: C. The mother is Rh negative and baby is Rh positive
💡 Rationale: Rh immunoglobulin prevents sensitization in Rh-negative mothers exposed to Rh-positive fetal blood. It must be given within 72 hours after delivery to prevent Rh incompatibility in future pregnancies.
74. During labor, a client experiences variable decelerations in the fetal heart rate. What is the nurse’s priority action?
A. Administer oxygen
B. Change the client’s position
C. Prepare for cesarean birth
D. Increase oxytocin infusion
✅ Answer: B. Change the client’s position
💡 Rationale: Variable decelerations indicate cord compression. Repositioning the client (e.g., left lateral or knee-chest position) helps relieve cord pressure and restore oxygen flow to the fetus.
75. A nurse is caring for a client one hour after delivery who reports chills and shaking. Vital signs are stable. What is the appropriate nursing response?
A. Report this immediately
B. Administer antibiotics
C. Reassure the client and provide warm blankets
D. Encourage ambulation
✅ Answer: C. Reassure the client and provide warm blankets
💡 Rationale: Postpartum chills are a normal physiological response caused by fluid shifts and heat loss during delivery. The nurse should reassure the client and keep her warm unless other symptoms (fever, tachycardia) develop.
⚕️ NCLEX Fundamentals of Nursing MCQs
🩺 NCLEX Maternity Nursing Practice Test (Questions 76–100)
76. The nurse is monitoring a client 1 hour after delivery. The fundus is firm at the midline, and there is steady vaginal bleeding. What should the nurse suspect?
A. Uterine atony
B. Vaginal or cervical laceration
C. Retained placenta
D. Bladder distention
✅ Answer: B. Vaginal or cervical laceration
Rationale: If the fundus is firm but bleeding continues, a laceration is the likely cause. The provider should be notified for repair.
77. A pregnant client reports painless, bright red vaginal bleeding at 32 weeks. What is the priority nursing action?
A. Perform a vaginal examination
B. Prepare for ultrasound
C. Encourage ambulation
D. Start oxytocin infusion
✅ Answer: B. Prepare for ultrasound
Rationale: Placenta previa causes painless bleeding. Vaginal exams are avoided until ultrasound confirms placental location.
78. Which instruction should be included in discharge teaching after a vaginal delivery with episiotomy?
A. “Take hot baths twice daily.”
B. “Use a peri-bottle after each void.”
C. “Avoid sitting for 2 weeks.”
D. “Clean the area with alcohol wipes.”
✅ Answer: B.
Rationale: A peri-bottle with warm water keeps the area clean and reduces infection risk after an episiotomy.
79. A nurse is caring for a client in labor who suddenly complains of intense back pain during contractions. The fetus is in the occiput posterior position. What intervention is best?
A. Encourage supine position
B. Apply firm pressure to the lower back
C. Start oxytocin
D. Encourage shallow breathing
✅ Answer: B.
Rationale: Firm counterpressure on the lower back helps relieve pain caused by fetal head pressing against the sacrum.
80. A nurse caring for a postpartum woman notices her temperature is 38.4°C (101.1°F) 24 hours after delivery. What is the most likely cause?
A. Urinary tract infection
B. Endometritis
C. Dehydration
D. Mastitis
✅ Answer: C. Dehydration
Rationale: A mild temperature rise within 24 hours after delivery is often due to dehydration from exertion during labor.
81. A nurse notes the umbilical cord is protruding from the vagina during labor. What should the nurse do first?
A. Push the cord back inside
B. Place the client in knee-chest position
C. Continue pushing
D. Apply a fetal monitor
✅ Answer: B.
Rationale: Prolapsed cord requires immediate knee-chest or Trendelenburg position to relieve pressure on the cord until delivery.
82. Which finding indicates a complication during magnesium sulfate therapy for preeclampsia?
A. Urine output 50 mL/hour
B. Respiratory rate 10/min
C. Deep tendon reflexes 2+
D. Warm flushing sensation
✅ Answer: B.
Rationale: A respiratory rate below 12 indicates magnesium toxicity, which requires stopping the infusion and giving calcium gluconate.
83. The nurse observes a postpartum client passing foul-smelling lochia. What should the nurse suspect?
A. Normal healing
B. Endometritis
C. Retained fragments
D. Cervical tear
✅ Answer: B. Endometritis
Rationale: Foul-smelling lochia indicates infection of the uterine lining (endometritis) and needs antibiotics.
84. A nurse is teaching a new mother about umbilical cord care. Which instruction is correct?
A. Clean with alcohol every 4 hours
B. Keep it moist with ointment
C. Fold the diaper below the cord
D. Cover with sterile gauze
✅ Answer: C.
Rationale: Keeping the cord dry and exposed to air promotes natural healing and prevents irritation.
85. Which nursing action helps prevent venous thromboembolism (VTE) after cesarean birth?
A. Limit movement
B. Apply compression stockings
C. Restrict fluids
D. Delay ambulation
✅ Answer: B.
Rationale: Sequential compression devices and early ambulation reduce post-cesarean clot risk.
86. The nurse teaches about iron supplementation during pregnancy. Which statement shows correct understanding?
A. “I’ll take iron with milk.”
B. “I’ll take it with orange juice.”
C. “I should take it before sleeping.”
D. “I’ll take it on an empty stomach with tea.”
✅ Answer: B.
Rationale: Vitamin C enhances iron absorption; milk and tea reduce it.
87. The nurse is assisting with the care of a newborn with jaundice. What is a priority nursing intervention?
A. Keep the newborn under phototherapy lights with eye protection
B. Decrease fluid intake
C. Cover the skin completely
D. Stop breastfeeding
✅ Answer: A.
Rationale: Phototherapy breaks down bilirubin. Eye protection prevents damage from strong light exposure.
88. A postpartum mother asks when she can start exercising again. What is the best response?
A. “You may begin light exercise after your 6-week checkup.”
B. “Start heavy workouts next week.”
C. “Exercise immediately to reduce swelling.”
D. “Avoid any movement for a month.”
✅ Answer: A.
Rationale: Light activity is safe after medical clearance around 6 weeks postpartum.
89. Which finding indicates effective breastfeeding?
A. The baby sleeps more than 6 hours
B. The mother reports nipple pain
C. The baby has six or more wet diapers per day
D. The baby cries after every feeding
✅ Answer: C.
Rationale: Adequate urine output (≥6 wet diapers/day) shows proper hydration and feeding effectiveness.
90. The nurse is caring for a postpartum patient who reports passing large clots. What is the priority action?
A. Massage the fundus
B. Encourage fluid intake
C. Document findings
D. Notify the provider
✅ Answer: A.
Rationale: Large clots indicate pooling of blood due to uterine atony. Fundal massage helps contract the uterus and control bleeding.
91. Which finding in a newborn requires immediate attention?
A. Acrocyanosis
B. Respiratory rate 60/min
C. Nasal flaring
D. Flexed position
✅ Answer: C.
Rationale: Nasal flaring suggests respiratory distress and needs prompt evaluation.
92. A pregnant woman reports tingling around her mouth and fingers. Which condition should the nurse suspect?
A. Hypocalcemia
B. Hyperglycemia
C. Hypokalemia
D. Hyponatremia
✅ Answer: A. Hypocalcemia
Rationale: Low calcium levels cause tingling and muscle spasms, especially during pregnancy or lactation.
93. The nurse teaches a pregnant woman about warning signs of preterm labor. Which symptom should she report immediately?
A. Mild lower backache
B. Headache after rest
C. Blurred vision
D. Regular contractions before 37 weeks
✅ Answer: D.
Rationale: Regular contractions before 37 weeks may indicate preterm labor and require prompt medical care.
94. Which nursing measure promotes bonding after birth?
A. Keeping the newborn in the nursery
B. Allowing immediate skin-to-skin contact
C. Delaying breastfeeding
D. Limiting family contact
✅ Answer: B.
Rationale: Skin-to-skin contact enhances bonding and regulates the newborn’s temperature and heart rate.
95. A client with hyperemesis gravidarum is at risk for which complication?
A. Hypoglycemia
B. Metabolic alkalosis
C. Dehydration and electrolyte imbalance
D. Hypertension
✅ Answer: C.
Rationale: Excessive vomiting leads to fluid loss, weight loss, and electrolyte disturbances.
96. The nurse assesses a postpartum client with firm fundus and foul-smelling lochia. What should the nurse do?
A. Notify the provider
B. Document as normal
C. Encourage ambulation
D. Increase oral fluids
✅ Answer: A.
Rationale: Foul odor indicates infection and requires medical evaluation and antibiotic therapy.
97. Which statement about breastfeeding is accurate?
A. “I should give water between feedings.”
B. “I’ll nurse the baby every 2–3 hours.”
C. “I should limit feedings to 5 minutes per breast.”
D. “I’ll stop breastfeeding if I get a cold.”
✅ Answer: B.
Rationale: Feeding every 2–3 hours maintains milk production and ensures newborn nutrition.
98. The nurse teaches a pregnant client about folic acid. Why is it important?
A. It reduces morning sickness
B. It prevents neural tube defects
C. It promotes sleep
D. It increases blood pressure
✅ Answer: B.
Rationale: Folic acid prevents spina bifida and other neural tube defects during fetal development.
99. Which symptom suggests postpartum hemorrhage?
A. Firm uterus
B. Saturating a pad in 15 minutes
C. Scant lochia rubra
D. Faint lochia odor
✅ Answer: B.
Rationale: Soaking a pad in less than 15 minutes is a sign of excessive bleeding, requiring urgent care.
100. A postpartum woman is tearful, anxious, and overwhelmed 4 days after birth. What should the nurse do?
A. Reassure her this is normal baby blues
B. Recommend antidepressants immediately
C. Separate her from the baby temporarily
D. Notify the physician right away
✅ Answer: A.
Rationale: Postpartum blues are common and temporary, lasting up to 2 weeks. Support and rest help recovery.
🧠 Conclusion:
Preparing for the NCLEX Maternity Nursing questions helps you understand essential topics like labor stages, fetal monitoring, postpartum care, and newborn assessment. These 100 questions strengthen your clinical judgment and test readiness for real-world nursing practice.
For more NCLEX topic-based practice tests, check out:
👉 NCLEX Endocrine System Practice Questions
👉 NCLEX Respiratory System Questions
👉 NCLEX Mental Health Questions Free
Each quiz is designed with detailed rationales, exam-style difficulty, and up-to-date nursing concepts to help you achieve the highest score on your NCLEX.