NCLEX Maternity Practice Questions For Aspiring Nurses - 2023 Update
If you're starting the rewarding journey of becoming a nurse, one significant milestone awaits you - the National Council Licensure Examination (NCLEX). As you set your sights on conquering this essential exam, it's crucial to equip yourself with the right tools and knowledge to succeed.
In this blog, we are thrilled to present you with maternity NCEX questions from Smart’n’s maternal child nursing care test bank, designed specifically to help you excel in the maternity and women's health aspect of the exam. As we understand how vital this field is in providing holistic care to patients of all ages, we've curated a comprehensive set of questions and explanations to enhance your understanding and boost your confidence.
Smart'n is an NCLEX study tool that offers over 2500 NCLEX practice questions, organized by subject and customized to suit your requirements. It also monitors your advancement and presents a comprehensive summary of your performance, aiding you in recognizing your strengths and areas that need improvement.
What is a maternity nurse?
A maternity nurse, also known as a perinatal nurse or obstetric nurse, is a specialized registered nurse who provides care to women during pregnancy, childbirth, and the postpartum period. Their role is focused on supporting expectant mothers and their families throughout the entire childbirth process, ensuring a safe and healthy experience for both the mother and the baby.
Maternity nurses play a crucial role in various settings, including hospitals, birthing centers, clinics, and home-based care. Their responsibilities may include:
1- Prenatal care
Assisting with prenatal check-ups, monitoring the mother's health, and providing education on pregnancy, nutrition, and childbirth preparation.
2- Labor and delivery
Supporting women during labor, monitoring vital signs, administering medications if needed, and providing emotional support.
3- Postpartum care
Caring for the mother and newborn after childbirth, monitoring their recovery, and offering guidance on breastfeeding, newborn care, and postpartum health.
4- Neonatal care
Maternity nurses may also be involved in caring for premature or sick infants in neonatal intensive care units (NICUs).
5- Education and counseling
Offering information on birth control, family planning, and infant care to new parents.
Maternity NCLEX questions
Here are some maternity NCLEX questions from Smart’n’s maternity test bank.
Question One
A nurse is assessing a pregnant client for possible preeclampsia. Which symptom would be indicative of this diagnosis?
Edema in the feet
Active fetal movement
Proteinuria
Seizures
A. Incorrect Answer
Edema in the feet
Rationale: Dependent edema is normal in pregnancy, but in a preeclamptic client there would be a sudden increase and usually in hands and face.
B. Incorrect Answer
Active fetal movement
Rationale: This would be a normal finding in pregnancy. If anything, we would expect decreased fetal movement in preeclampsia.
C. Correct Answer
Proteinuria
Rationale: A client must have protein in her urine to be diagnosed as preeclamptic.
D. Incorrect Answer
Seizures
Rationale: This would indicate progression to eclampsia if the client was already preeclamptic, but seizures alone would not indicate preeclampsia.
Question Two
Which symptom reported by a pregnant client would be most concerning to the nurse?
Swelling in one leg
Lower back pain
Lightheaded when standing
Frequent urination
A. Correct answer
Swelling in one leg
Rationale: This would be the most concerning. We would be worried about a blood clot/DVT because of the increase in coagulopathies in pregnancy.
B. Incorrect Answer
Lower back pain
Rationale: This is normal in pregnancy. If accompanied by other symptoms of UTI it might be more of a concern.
C. Incorrect Answer
Lightheaded when standing
Rationale: This can be normal because of the weight of the growing uterus.
D. Incorrect Answer
Frequent urination
Rationale: This can happen because of low blood pressure, especially when standing too fast. If it was happening very frequently or accompanied a fall or the client hit their head, it would be more concerning. However, because it is a normal finding in pregnancy, it is not as concerning as the signs of a blood clot.
Question Three
The nurse receives report for a client at 36 weeks gestation who is being transferred to the unit for labor induction from a rural health care facility with an intrauterine fetal demise of unknown duration. Which intervention is most important when receiving care of the client?
Apply tocodynamometer and evaluate current contraction pattern
Ask the client about the family's desire for speaking with a chaplain
Draw coagulation tests, fibrinogen, and complete blood count with platelets
Initiate oxytocin prescription to begin induction of labor
A. Incorrect Answer
Apply tocodynamometer and evaluate current contraction pattern
Rationale: The nurse applies a tocodynamometer ("toco") to monitor for contractions that may begin prior to oxytocin administration, but this is not a priority over laboratory assessment for DIC.
B. Incorrect Answer
Ask the client about the family's desire for speaking with a chaplain
Rationale: The nurse offers chaplain services and emotional support to clients and families experiencing pregnancy loss, but this is not the priority action.
C. Correct Answer
Draw coagulation tests, fibrinogen, and complete blood count with platelets
Rationale: Pregnant clients, especially those with placental abruption and intrauterine fetal demise, are at risk for disseminated intravascular coagulation (DIC). Thromboplastin from the retained dead fetus activates the clotting cascade, followed by consumption of clotting factors and platelets that leads quickly to life-threatening external and internal bleeding.
Signs of DIC include frank external bleeding (eg, venipuncture site bleeding), signs of internal bleeding (eg, petechiae, ecchymosis), and organ damage from blood clotting (eg, respiratory distress, renal failure). Baseline laboratory tests (eg, coagulation studies, platelets, fibrinogen) and physical assessment for signs of DIC are a priority for at-risk clients because clotting and bleeding are often sudden and life-threatening (Option 3).
D. Incorrect Answer
Initiate oxytocin prescription to begin induction of labor
Rationale : A hemodynamically stable client with fetal demise should have labor induced as quickly as possible to prevent DIC, but this does not take priority over initial laboratory assessment.
Question Four
A nurse is admitting a client at 42 weeks gestation to the labor and delivery unit for induction of labor. What is a predictor of a successful induction?
Bishop score of 10
Firm and posterior cervix
History of precipitous labor
Reactive nonstress test
A. Correct Answer
Bishop score of 10
Rationale: The Bishop score is a system for the assessment and rating of cervical favorability and readiness for induction of labor. The cervix is scored (0-3) on consistency, position, dilation, effacement, and station of the fetal presenting part. A higher Bishop score indicates an increased likelihood of successful induction that results in vaginal birth. For nulliparous women, a score ≥6-8 usually indicates that induction will be successful (Option 1).
B. Incorrect Answer
Firm and posterior cervix
Rationale: A cervix that is firm and posterior is associated with a low Bishop score, which reflects a low likelihood of successful labor induction.
C. Incorrect Answer
History of precipitous labor
Rationale: A history of precipitous labor (<3 hours from onset of contractions to birth) may indicate that the client will again experience precipitous labor once labor is established. However, such a history is not an independent predictor of successful induction.
D. Incorrect Answer
Reactive nonstress test
Rationale: A reactive nonstress test indicates that the fetus is well oxygenated and establishes fetal well-being. It does not provide information about the likely success or failure of labor induction.
Question Five
The nurse is performing an Apgar assessment on a newborn client at 1 minute of life. The newborn is completely blue, has a heart rate of 110/min, and is emitting a weak cry. Active movement and flexion of extremities are noted and the newborn grimaces when nares are suctioned. Which Apgar score should the nurse assign to this newborn?
Apgar score of 4
Apgar score of 5
Apgar score of 6
Apgar score of 8
A. Incorrect Answer
Apgar score of 4
Rationale: An Apgar score of 4 is too low for a newborn with these findings.
B. Incorrect Answer
Apgar score of 5
Rationale: An Apgar score of 5 is too low for a newborn with these findings.
C. Correct Answer
Apgar score of 6
Rationale: The Apgar score is an assessment tool used to describe how well a newborn is transitioning to extrauterine life. Apgar scoring is done at 1 and 5 minutes of life. Apgar scores do not predict future neurologic outcomes, nor should assigning Apgar scores delay the decision to initiate resuscitation.
An Apgar score of 6 at 1 minute of life is appropriate for a newborn with the following findings:
Completely blue (0 points for appearance/color of skin)
Heart rate >100/min (2 points for pulse)
Grimaces during stimuli (eg, nasal suction) (1 point for grimace/reaction)
Actively moves with good tone (ie, flexion of arms and legs) (2 points for activity/muscle tone)
Emits a weak cry (1 point for respiratory effort)
Apgar scoring is repeated every 5 minutes for up to 20 minutes if the 5-minute Apgar score is <7. Scores <7 indicate difficulty transitioning and may require further interventions (eg, oxygen, suctioning) in addition to typical supportive measures (eg, stimulating, drying, warming).
D. Incorrect Answer
Apgar score of 8
Rationale: An Apgar score of 8 is too high for a newborn with these findings.
Question Six
A client comes to the clinic for a visit and gets an ultrasound in which a fetal heart rate is observed. Which of the following is this sign of pregnancy?
Possible
Probable
Positive
Presumptive
A. Incorrect Answer
Possible
Rationale: “Possible” is not a category of signs of pregnancy.
B. Incorrect Answer
Probable
Rationale: An example of a probable sign of pregnancy is a positive blood pregnancy test. It is something observable by the provider but is not a guarantee that the client is pregnant.
C. Correct Answer
Positive
Rationale: A fetal heart rate is a positive sign of pregnancy. This is a sign that indicates, without a doubt, that the client is pregnant.
D. Incorrect Answer
Presumptive
Rationale: A presumptive sign of pregnancy is something that the mother observes, such as a missed menstrual cycle or nipple changes.
Question Seven
A pregnant client receiving nifedipine as a tocolytic is having side effects from the medication. How should the nurse position the client to protect the fetus?
Place the client on the left side lying
Lay the client flat on her back
Place the client in trendelenburg
Sit the client up with pillows to keep her upright
A. Correct Answer
Place the client on the left side lying
Rationale: Nifedipine has a side effect of hypotension. Placing her on the left side lying will increase blood flow through the placenta to keep the fetus safe from maternal hypotension.
B. Incorrect Answer
Lay the client flat on her back
Rationale: A pregnant client should never be flat on her back because of supine hypotension which will only worsen the hypotension she is already experiencing.
C. Incorrect Answer
Place the client in trendelenburg
Rationale: Trendelenburg might help with any light headedness from hypotension but we need the client on the left side lying to increase blood flow through the placenta to the fetus.
D. Incorrect Answer
Sit the client up with pillows to keep her upright
Rationale": Nifedipine has a side effect of hypotension. Sitting the client upright won’t help correct this. Placing her on the left side lying will increase blood flow through the placenta to keep the fetus safe from the maternal hypotension.
Question Eight
When speaking to the parents of a newborn diagnosed with talipes equinovarus, the nurse knows which of the following topics should be discussed to ensure the best outcomes?
Applying creams to the affected leg
Compliance with braces and casts
Keeping the affected leg elevated
Assessing for signs of constipation
A. Incorrect Answer
Applying creams to the affected leg
Rationale: The most important factor in reaching optimal outcomes is compliance with braces and casts. If caregivers aren’t compliant the foot will gradually turn back in and down. Creams will not be used to treat clubfoot.
B. Correct Answer
Compliance with braces and casts
Rationale: Treatment for a club foot requires a series of casting where the foot is gradually turned to the correct position. Following this, the child must wear braces for some of the day to prevent the feet from returning to the malformed position. Compliance with the casts and braces is essential for helping the child reach optimal outcomes.
C. Incorrect Answer
Keeping the affected leg elevated
Rationale: The most important factor in reaching optimal outcomes is compliance with braces and casts. If caregivers aren’t compliant the foot will gradually turn back in and down.
D. Incorrect Answer
Assessing for signs of constipation
Rationale: The most important factor in reaching optimal outcomes is compliance with braces and casts. If caregivers aren’t compliant the foot will gradually turn back in and down. Constipation would not be expected with clubfoot treatment
Question Nine
A newly pregnant client that is HIV + is concerned about her baby contracting HIV. What is the best response by the nurse?
“Your baby will not get HIV because the baby’s circulation is different than yours”
“We will keep your CD4 count low to limit the spread of infection”
“Breastfeeding will really benefit the baby because he will receive your antibodies”
“Your baby will receive antiretrovirals after delivery to help decrease the risk of infection"
A. Incorrect Answer
“Your baby will not get HIV because the baby’s circulation is different than yours”
Rationale: There is closed fetal circulation but there is still a transmission risk across the placenta and at delivery.
B. Incorrect Answer
“We will keep your CD4 count low to limit the spread of infection”
Rationale: The CD4 count will monitored but we cannot make the count be low. Instead, medications are given and lab values are watched. Low CD4 counts do not mean that it won’t be transmitted.
C. Incorrect Answer
“Breastfeeding will really benefit the baby because he will receive your antibodies”
Rationale: Breastfeeding should not be encouraged as it increases the transmission risk.
D. Correct Answer
“Your baby will receive antiretrovirals after delivery to help decrease the risk of infection"
Rationale: Antiretrovirals will be given prophylactically to help decrease the risk of infection.
Question Ten
The postpartum nurse is documenting client care at the unit's front desk. During that time, several clients request assistance from the nurse. Which client needs should the nurse address first?
The client reports that a suspicious visitor is walking up and down the hallway
The client reports that her newborn is uncontrollably crying and having difficulty breastfeeding
The client who had a cesarean birth 8 hours ago is requesting to ambulate for the first time
The client who is receiving IV antibiotics for postpartum endometritis reports that the IV pump is beeping
A. Correct Answer
The client reports that a suspicious visitor is walking up and down the hallway
Rationale: Newborns are a vulnerable client population, and nurses play an important role in establishing a culture of safety and preventing infant abduction. Security measures may include matching mother/newborn identification bracelets; newborn security sensors; locked perinatal units; specific uniforms for nursing staff; unit-specific badges; and hospitalwide, overhead emergency alerts (eg, code pink for the infant or child abduction).
Nurses should frequently educate parents about newborn safety and security procedures throughout the hospital admission and remain diligent and aware of any suspicious persons on the unit. The postpartum nurse must prioritize a quick response to any perceived or reported threat to newborn security to prevent infant abduction (Option 1).
B. Incorrect Answer
The client reports that her newborn is uncontrollably crying and having difficulty breastfeeding
Rationale: When feeding difficulties occur, hungry newborns can become frustrated and begin crying. Although distressing to parents, the nurse should address the client's needs after focusing on the security concern.
C. Incorrect Answer
The client who had a cesarean birth 8 hours ago is requesting to ambulate for the first time
Rationale: Ambulating after surgery helps to prevent deep venous thrombosis, and clients ambulating for the first time postoperatively should do so with a nurse. However, the nurse may postpone ambulation with the client until the infant abduction risk has been addressed.
D. Incorrect Answer
Client who is receiving IV antibiotics for postpartum endometritis reports that the IV pump is beeping
Rationale: The nurse should attend to medical device alarms promptly to ensure client safety; however, addressing a client's concern about a suspicious visitor is the priority.
The Importance of NCLEX maternity questions
Labor and delivery NCLEX questions hold significant importance for nursing students and aspiring nurses for several reasons:
1- Preparation for maternity nursing
NCLEX maternity questions help students prepare for caring for expectant mothers and newborns by testing their understanding of essential concepts.
2- Assessment of knowledge
These questions serve as a comprehensive assessment, identifying strengths and areas that need improvement.
3- NCLEX exam preparation
Practicing maternity questions familiarizes students with the exam format and level of difficulty.
4- Critical thinking and decision-making
Maternity questions challenge students' critical thinking abilities and decision-making skills.
5- Confidence building
Successfully answering these questions boosts students' confidence in handling maternity scenarios.
6- Improving test-taking skills
Practicing enhances time management and effective answering strategies.
7- Promoting safe patient care
Maternity questions reinforce knowledge for providing safe care to expectant mothers and newborns.
Conclusion
In conclusion, mastering NCLEX maternity practice questions is of utmost importance for aspiring nurses in 2023. The specialized knowledge and critical thinking skills acquired through these practice questions are essential for providing top-notch care to expectant mothers and newborns. By diligently preparing with up-to-date resources like the ones offered by Smart'n, aspiring nurses can boost their confidence, improve their chances of passing the NCLEX exam, and embark on a rewarding journey to excel in the field of maternity nursing. Remember, the path to becoming a skilled maternity nurse begins with dedicated practice and a commitment to lifelong learning. So, embrace the challenges, embrace the knowledge, and embrace the journey ahead!
FAQs
1- What are the topics for NCLEX maternity?
The topics covered in NCLEX maternity questions include various aspects of maternal and newborn health. Here are some key topics commonly included in NCLEX maternity questions:
1- Prenatal care
2- Labor and delivery
3- Postpartum care
4- Newborn care
5- Antepartum and postpartum complications
6- Intrapartum complications
7- Medications and interventions
8- Family planning and contraception
2- What is the maternal and child health nursing practice?
A maternal and child health nurse plays a vital role in safeguarding the rights of every family member, including the unborn child. This nursing field involves significant autonomy in performing various nursing tasks, as it often entails extensive teaching and counseling responsibilities.
