NCLEX Maternity Questions: Antepartum to Newborn
Nurseclex Editorial Team · Updated · 11 min read · Written around the NCSBN test plan
Short answer
NCLEX maternity questions test recognizing danger signs and choosing the first action through each stage: pregnancy, labor, postpartum and newborn. Know pre-eclampsia signs, fetal heart rate patterns, postpartum hemorrhage steps and newborn priorities such as airway, warmth and glucose.
Key takeaways
- Pre-eclampsia and magnesium safety are high yield.
- Know the causes of early, variable and late decelerations.
- A boggy fundus calls for fundal massage first.
- Newborn priorities are airway, warmth and assessment.
- Teach danger signs at every stage.
Antepartum
Prenatal care includes nutrition, folic acid, screening and teaching about danger signs such as bleeding, severe headache, visual changes and reduced fetal movement.
Hypertensive disorders and gestational diabetes are common topics. Know the signs and the monitoring each requires.
Placenta previa typically causes painless bleeding, and placental abruption often causes painful bleeding. Avoid vaginal examinations when previa is suspected.
Labor
Track the stages of labor, contraction patterns and the fetal heart rate.
Early decelerations are usually benign. Variable decelerations suggest cord compression. Late decelerations suggest uteroplacental insufficiency.
For worrying patterns, reposition the client, stop oxytocin, increase fluids and give oxygen according to protocol, and notify the provider.
Obstetric emergencies
With a prolapsed cord, relieve pressure on it by positioning and holding the presenting part off the cord, and call for help.
Watch for signs of shock with hemorrhage.
Magnesium toxicity shows as loss of reflexes, respiratory depression and low urine output.
Postpartum
The fundus should be firm and midline. If it is boggy, massage it. If it is displaced, have the client empty the bladder.
Monitor lochia, vital signs, pain and emotional wellbeing.
Screen for postpartum depression and teach warning signs.
Newborn
Priorities after birth are airway, warmth and Apgar scoring at 1 and 5 minutes.
Monitor glucose in at-risk infants, check for jaundice and support feeding.
Teach safe sleep: baby on their back, on a firm flat surface.
Practice questions
1. A client at 32 weeks has sudden painful vaginal bleeding and a rigid abdomen. What does the nurse suspect?
Answer and rationale
Correct: B. Painful bleeding with a rigid abdomen suggests placental abruption.
2. Late decelerations appear during an oxytocin infusion. What should the nurse do first?
Answer and rationale
Correct: B. Stopping oxytocin reduces uterine stimulation and improves placental perfusion.
3. A postpartum fundus is displaced to the right. What should the nurse do first?
Answer and rationale
Correct: B. A full bladder often displaces the uterus.
4. Which action prevents heat loss in a newborn?
Answer and rationale
Correct: B. Drying and skin-to-skin contact reduce evaporative and conductive heat loss.
Frequently asked questions
Is maternity heavily tested on the NCLEX?
It appears across several client-needs areas. Check the NCSBN test plan for details.
What is the priority for postpartum hemorrhage?
Fundal massage for a boggy uterus, then escalation if the uterus does not firm.
What causes variable decelerations?
Cord compression.
When are Apgar scores taken?
At 1 and 5 minutes after birth.
Where can I practice maternity questions?
See the Nurseclex maternity and newborn topic.
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Sources
All practice questions are original and are not actual exam items. NCLEX® is a registered trademark of NCSBN, which does not endorse this site.