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Maternal & Newborn Nursing Practice Test

These 25 questions test your knowledge of antepartum, intrapartum, and postpartum care — including high-risk pregnancy complications, fetal monitoring, labour progression, newborn assessment, and recognising emergencies that require immediate nursing action.

~8%
Covers antepartum through postpartum of the NCLEX-RN exam
25 questions ~15 minutes Instant scoring No signup needed

Maternal & Newborn Nursing Quiz

Test your maternal and newborn nursing knowledge with NCLEX-style questions on labour, postpartum care, and newborn assessment.

20 questions | 90 minutes | 70% to pass

Question 1: A 28-year-old woman at 8 weeks gestation presents to the ED with sharp right lower quadrant pain, vaginal spotting, and a positive pregnancy test. Her BP is 88/54 and HR is 118. The nurse's PRIORITY action is:

  1. Reassure the patient that implantation bleeding is normal in early pregnancy
  2. Prepare the patient for emergency surgery — this presentation is consistent with a ruptured ectopic pregnancy
  3. Perform a bedside urine pregnancy test to confirm results
  4. Administer misoprostol as ordered and discharge

Answer: B — Sharp unilateral pain + vaginal bleeding + positive pregnancy test + hemodynamic instability = ruptured ectopic pregnancy until proven otherwise. This is a surgical emergency. Notify the provider immediately and prepare for OR. Delay causes hemorrhagic shock and death.

Question 2: A patient at 32 weeks gestation reports sudden, painless, bright red vaginal bleeding. She denies contractions. The nurse's FIRST action should be:

  1. Perform a vaginal exam to assess cervical dilation
  2. Place the patient on bed rest, apply continuous fetal monitoring, and notify the provider — suspect placenta previa
  3. Encourage oral hydration and reassess in 1 hour
  4. Administer Pitocin to prepare for delivery

Answer: B — Painless bright red bleeding in the third trimester is placenta previa until proven otherwise. NEVER perform a vaginal exam — it can cause catastrophic hemorrhage. Apply fetal monitor, establish IV access, and notify the provider immediately.

Question 3: A nurse is caring for a patient at 36 weeks gestation who suddenly develops severe abdominal pain described as 'board-like rigidity,' dark vaginal bleeding, and fetal bradycardia. The nurse should suspect:

  1. Placenta previa
  2. Preterm labor
  3. Abruptio placentae
  4. Round ligament pain

Answer: C — Abruptio placentae (placental abruption) presents with sudden severe abdominal pain, a rigid/tender uterus, dark vaginal bleeding, and fetal distress. Unlike placenta previa, pain IS present. This is a life-threatening emergency requiring immediate delivery.

Question 4: A patient at 28 weeks is diagnosed with gestational hypertension. Her BP is 158/104 and she reports a severe headache and visual disturbances. The nurse recognizes these findings as signs of:

  1. Normal pregnancy-related discomfort
  2. Preeclampsia with severe features requiring immediate magnesium sulfate and antihypertensive therapy
  3. Mild preeclampsia that can be managed at home with bed rest
  4. Eclampsia — the nurse should administer diazepam

Answer: B — BP ≥160/110 + severe headache + visual changes = preeclampsia with severe features. Priority: IV magnesium sulfate (seizure prophylaxis), antihypertensives (labetalol or hydralazine), continuous fetal monitoring, and delivery planning. Eclampsia requires the same plus airway management.

Question 5: A patient with preeclampsia is receiving magnesium sulfate. The nurse assesses: respirations 10/min, absent deep tendon reflexes, and urine output 20 mL/hr. The nurse's PRIORITY action is:

  1. Increase the magnesium drip rate — the patient needs more seizure prophylaxis
  2. Stop the magnesium infusion immediately and prepare to administer calcium gluconate
  3. Document findings as expected side effects of magnesium
  4. Administer Pitocin to expedite delivery

Answer: B — These are signs of magnesium toxicity: RR <12, loss of DTRs, and oliguria. The antidote is calcium gluconate 1g IV. Stop the infusion FIRST. Normal therapeutic range for mag is 4–7 mEq/L. DTRs are the earliest sign of toxicity.

Question 6: A patient at 24 weeks gestation has a fasting blood glucose of 105 mg/dL and a 1-hour glucose challenge test of 185 mg/dL. The nurse anticipates which diagnosis and primary teaching point?

  1. Type 1 diabetes — the patient will need lifelong insulin
  2. Gestational diabetes — teach carbohydrate monitoring, blood glucose self-testing, exercise, and the risk of macrosomia
  3. Prediabetes — no intervention needed until after delivery
  4. Normal findings — glucose rises in pregnancy and requires no intervention

Answer: B — A 1-hour GCT >140 mg/dL triggers a 3-hour GTT for diagnosis. GDM increases risk of macrosomia, birth trauma, neonatal hypoglycemia, and future Type 2 DM. Management: diet, glucose monitoring, and insulin if needed. GDM typically resolves postpartum.

Question 7: A primigravida at 39 weeks has been in labor for 14 hours. Her cervix has not changed from 6 cm over the last 3 hours and contractions are irregular. The nurse recognizes this as:

  1. Normal latent phase labor
  2. Active phase arrest (dystocia) — notify the provider and anticipate augmentation or cesarean
  3. Second stage prolongation
  4. Transition phase

Answer: B — Failure to progress (active phase arrest) is defined as no cervical change for ≥4 hours with adequate contractions, or ≥6 hours with inadequate contractions. Oxytocin augmentation or cesarean birth may be required. The provider must be notified.

Question 8: A nurse is monitoring fetal heart rate and notes the FHR drops from 145 to 90 bpm beginning at the peak of contractions and returns to baseline after the contraction ends. The nurse interprets this as:

  1. Early decelerations — normal, caused by fetal head compression
  2. Late decelerations — caused by uteroplacental insufficiency, requires immediate intervention
  3. Variable decelerations — caused by cord compression
  4. Accelerations — a reassuring sign of fetal well-being

Answer: B — Late decelerations mirror contractions but begin AFTER the peak and recover AFTER the contraction ends. This indicates uteroplacental insufficiency and fetal hypoxia. Priority: reposition (left lateral), O2 by mask, stop Pitocin, IV bolus, notify provider.

Question 9: A nurse notes a sudden, prolonged fetal heart rate deceleration to 60 bpm on the monitor. Upon vaginal exam, the nurse feels a pulsating loop of umbilical cord in the vagina. The nurse's IMMEDIATE action is:

  1. Prepare for a routine vaginal delivery
  2. Push the cord back into the uterus
  3. Place the patient in Trendelenburg or knee-chest position and manually elevate the presenting part off the cord — call for emergency cesarean
  4. Apply fundal pressure to expedite delivery

Answer: C — Cord prolapse is a obstetric emergency. The priority is to relieve cord compression by manually elevating the fetal presenting part off the cord while calling for emergency cesarean. Never push the cord back. Knee-chest or Trendelenburg uses gravity to assist.

Question 10: A patient delivers vaginally after 18 hours of labor. One hour postpartum the nurse assesses the fundus and finds it is firm, at the umbilicus, and deviated to the right. Lochia is rubra. The nurse's BEST action is:

  1. Document findings as normal postpartum assessment
  2. Massage the fundus vigorously
  3. Assist the patient to void — a full bladder displaces the uterus and increases hemorrhage risk
  4. Notify the provider of uterine atony

Answer: C — A fundus deviated to the right almost always indicates a full bladder pushing the uterus aside. The priority is to have the patient void or insert a urinary catheter. If the uterus remains displaced after voiding, notify the provider.

Question 11: A postpartum patient who delivered 2 hours ago is soaking one perineal pad every 15 minutes. Her fundus is boggy and displaced. Vital signs: BP 88/56, HR 122. The nurse recognizes this as:

  1. Normal lochia rubra
  2. Postpartum hemorrhage — perform fundal massage, administer oxytocin, notify the provider, and establish large-bore IV access
  3. Late postpartum hemorrhage — reassess in one hour
  4. Uterine inversion — prepare for manual reduction

Answer: B — Soaking >1 pad/hour + boggy uterus + hemodynamic instability = postpartum hemorrhage (PPH). Most common cause is uterine atony. Priority: uterine massage, oxytocin (or other uterotonics), IV fluid resuscitation, blood typing, and provider notification.

Question 12: A nurse is assessing a postpartum patient on day 3 using the BUBBLE-HE mnemonic. The patient reports breast engorgement and a temperature of 38.6°C (101.5°F). Which assessment finding requires the nurse to notify the provider?

  1. Lochia rubra transitioning to lochia serosa
  2. Fundus 3 fingerbreadths below the umbilicus
  3. A tender, warm, red, wedge-shaped area on the right breast with flu-like symptoms
  4. Mild perineal discomfort at the episiotomy site

Answer: C — This presentation — unilateral breast tenderness, warmth, redness, fever, and flu-like symptoms — is mastitis, typically caused by Staphylococcus aureus. Treatment: antibiotics (dicloxacillin), continued breastfeeding or pumping, warm compresses. If untreated, can progress to abscess.

Question 13: A postpartum patient on day 5 calls the clinic crying, stating she feels overwhelmed, cannot stop crying, and feels like a 'bad mother.' She denies thoughts of harming herself or her baby. The nurse should:

  1. Tell the patient this is normal 'baby blues' and it will resolve by day 10
  2. Screen the patient using the Edinburgh Postnatal Depression Scale and schedule a same-day or next-day provider visit
  3. Advise the patient to get more sleep and call back in two weeks
  4. Refer the patient directly to inpatient psychiatric hospitalization

Answer: B — Baby blues (days 1–5) vs. postpartum depression (PPD, persists >2 weeks) must be distinguished. Day 5 crying with feelings of inadequacy warrants formal screening and prompt follow-up. The Edinburgh scale is the validated screening tool. Untreated PPD has serious consequences for mother and infant.

Question 14: A nurse assesses a newborn at 1 minute of life. Findings: HR 96, weak cry, some flexion, grimace to stimulation, blue hands and feet. What is the APGAR score and the appropriate response?

  1. APGAR 10 — no intervention needed
  2. APGAR 6 — provide stimulation, dry the infant, and administer blow-by oxygen
  3. APGAR 4 — begin positive pressure ventilation immediately
  4. APGAR 2 — initiate full neonatal resuscitation

Answer: C — HR <100 = 1, weak cry = 1, some flexion = 1, grimace = 1, acrocyanosis = 1 → APGAR 5. An APGAR of 4–6 requires stimulation and supplemental O2. APGAR <4 requires positive pressure ventilation. Reassess at 5 minutes.

Question 15: A newborn's APGAR score is 3 at 5 minutes. The nurse's PRIORITY action is:

  1. Reassess at 10 minutes and document
  2. Begin positive pressure ventilation and call the neonatal resuscitation team
  3. Administer epinephrine immediately
  4. Place the infant skin-to-skin with the mother to improve score

Answer: B — APGAR <4 at 5 minutes indicates severe neonatal depression. Begin PPV with 100% O2, call for neonatal resuscitation support, and prepare for possible intubation. Epinephrine is only given if HR <60 after 30 seconds of effective PPV.

Question 16: A nurse is assessing a 24-hour-old newborn. The infant has a bilirubin of 14 mg/dL and appears jaundiced. The mother is breastfeeding. The nurse's BEST action is:

  1. Reassure the mother that jaundice is always normal in newborns
  2. Assess the age of onset, level, and progression of jaundice — initiate phototherapy per order and encourage frequent breastfeeding
  3. Stop breastfeeding immediately to treat the jaundice
  4. Administer a blood transfusion to reduce bilirubin

Answer: B — Jaundice within 24 hours is pathological and requires immediate evaluation. Physiologic jaundice appears after 24 hours. Phototherapy is the primary treatment. Frequent feeding promotes bilirubin excretion. Bilirubin >25 mg/dL risks kernicterus (brain damage).

Question 17: A nurse assesses a newborn 2 hours after delivery and notes: respiratory rate 74/min, grunting, nasal flaring, and subcostal retractions. The nurse should:

  1. Document findings as normal newborn breathing
  2. Place the infant prone to improve lung expansion
  3. Notify the provider immediately — these are signs of respiratory distress syndrome (RDS) requiring CPAP or oxygen support
  4. Continue to monitor and reassess in 4 hours

Answer: C — Normal newborn RR is 30–60/min. RR >60 + grunting + flaring + retractions = respiratory distress. Common in preterm infants (surfactant deficiency). Requires immediate intervention: O2, possible CPAP, and surfactant therapy. Notify provider and NICU team.

Question 18: A nurse administers vitamin K (phytonadione) to a newborn within 1 hour of birth. A parent asks why this is necessary. The nurse's BEST response is:

  1. It prevents jaundice from developing in the first week of life
  2. Newborns are born without the gut bacteria needed to produce vitamin K, so this injection prevents serious bleeding disorders
  3. It boosts the newborn's immune system against infections
  4. It is required by law and does not have a specific medical reason

Answer: B — Newborns have sterile guts and cannot produce vitamin K, which is essential for clotting factors II, VII, IX, and X. Without it, newborns are at risk for vitamin K deficiency bleeding (VKDB), including intracranial hemorrhage. IM vitamin K is the standard of care at birth.

Question 19: A newborn's blood glucose is 38 mg/dL at 30 minutes of life. The infant appears jittery and has a weak cry. The nurse's PRIORITY action is:

  1. Reassess glucose in 4 hours — this is a normal newborn value
  2. Initiate early breastfeeding or provide D10W oral gel immediately and notify the provider
  3. Administer IV D50 as for adult hypoglycemia
  4. Document findings and continue routine newborn care

Answer: B — Normal newborn glucose is 40–60 mg/dL. A level of 38 with symptoms (jitteriness, weak cry) = neonatal hypoglycemia. Initial treatment: early breastfeeding or dextrose gel. IV dextrose is reserved for symptomatic infants who cannot feed. Untreated hypoglycemia causes seizures and brain injury.

Question 20: A patient at 34 weeks with variable fetal heart rate decelerations is found to have decreased amniotic fluid on ultrasound. The nurse anticipates which fetal monitoring pattern as MOST likely associated with cord compression?

  1. Late decelerations with a sinusoidal pattern
  2. Early decelerations that mirror contractions
  3. Abrupt drops in FHR unrelated to contraction timing that recover quickly — variable decelerations
  4. Absent baseline variability with no decelerations

Answer: C — Variable decelerations are abrupt FHR drops that vary in timing, duration, and depth — they are caused by umbilical cord compression. Oligohydramnios (decreased amniotic fluid) reduces cushioning of the cord, making variables more frequent. Repositioning is the first nursing intervention.

What your score means

85% or above — Strong maternal and newborn knowledge

You can recognise pregnancy complications, manage labour emergencies, and assess newborns at an exam-ready level. Review any missed questions and move on.

70–84% — Close. Sharpen your complication recognition.

Most students in this range confuse similar-presenting conditions — placenta previa vs. abruptio placentae, preeclampsia vs. eclampsia — or miss the correct nursing priority in labour emergencies. Use the urgency bands below to drill those distinctions.

Below 70% — Work through all four cheat sheet sections.

Maternal and newborn questions reward pattern recognition. Work through the complication bands, APGAR visual, postpartum assessment strip, and newborn scan below. Then retake before your exam.

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What’s covered in Maternal & Newborn

This category spans the full perinatal continuum — from first trimester complications through postpartum discharge. Questions are scenario-based: you’re given a clinical finding during labour, or a set of postpartum vitals, and must identify what’s happening and what to do first.

Antepartum Complications

Ectopic pregnancy, gestational hypertension, preeclampsia, placenta previa, abruptio placentae, gestational diabetes.

~8 questions

Intrapartum & Fetal Monitoring

Stages of labour, fetal heart rate patterns (early/late/variable decelerations), dystocia, cord prolapse, emergency interventions.

~7 questions

Postpartum Assessment

BUBBLE-HE assessment, uterine involution, lochia progression, postpartum haemorrhage, mastitis, postpartum depression.

~5 questions

Newborn Assessment

APGAR scoring, normal newborn vital signs and findings, hypoglycaemia, jaundice, respiratory distress, and newborn medications.

~5 questions

All NCLEX-RN practice topics

Scored well here? Keep the momentum going. Each topic has 25 focused questions with full rationales.

Safe & Effective Care
25 questions — 21–33%
Pharmacology & Parenteral
25 questions — 12–18%
Physiological Adaptation
25 questions — 11–17%
Reduction of Risk Potential
25 questions — 9–15%
Health Promotion & Maintenance
25 questions — 6–12%
Psychosocial Integrity
25 questions — 6–12%
Mental Health Nursing
25 questions
You are here
Maternal & Newborn
25 questions
Pediatric Nursing
25 questions
Lab Values & Diagnostics
25 questions
Full 85-Question Test
All categories · Exam conditions

How to master Maternal & Newborn

Know your bleeding emergencies by their key distinguishing feature

Placenta previa and abruptio placentae both cause bleeding but require different nursing responses. Previa: painless bright red bleeding, do NOT perform vaginal examination (can cause fatal haemorrhage), prepare for C-section. Abruption: sudden severe abdominal pain + dark/concealed bleeding + rigid uterus, fetal distress. The pain/no-pain distinction and the vaginal exam contraindication are the two most tested facts in this category.

Master fetal heart rate deceleration patterns

Early decelerations (mirror contractions, head compression) are normal and require no intervention. Late decelerations (after contraction peak, uteroplacental insufficiency) are always non-reassuring — reposition, O₂, stop oxytocin, notify provider. Variable decelerations (abrupt, cord compression, any timing) — reposition first, then assess. If late or variable decelerations persist: left lateral position, O₂ 8-10L by mask, IV fluid bolus, stop oxytocin, call provider.

Learn preeclampsia progression and magnesium sulfate nursing care

Preeclampsia becomes eclampsia when seizures occur. The warning signs (headache, visual disturbances, epigastric pain, hyperreflexia) are tested repeatedly. Magnesium sulfate is the treatment — know the therapeutic range (4–7 mEq/L), the toxicity signs (absent DTRs, respiratory depression, <12 breaths/min), and the antidote (calcium gluconate). Always assess DTRs before each dose of magnesium.

Practise APGAR scoring until it’s automatic

The APGAR is assessed at 1 and 5 minutes. Each of the 5 components (Appearance, Pulse, Grimace, Activity, Respiration) scores 0, 1, or 2. Scores 7–10 are normal. Scores 4–6 require stimulation. Scores 0–3 require immediate resuscitation. The most commonly tested mistake is confusing the scoring criteria for Appearance (skin colour) — a score of 2 requires completely pink, not just pink body with blue extremities (that’s 1).

Retake until you score 85%+ consistently

Maternal and newborn questions follow very predictable patterns once you know the key distinctions. Each wrong answer points to one specific concept — review that concept in the cheat sheets below, then retake. Most students see significant improvement after one targeted review session.

Quick Reference Cheat Sheets

Four visual formats covering pregnancy complications, APGAR scoring, postpartum assessment, and newborn findings — each designed to be scanned, not read.

Pregnancy Complications — Priority & Nursing Response
Colour = urgency level. Red bands require immediate intervention. Always know: what distinguishes it from similar conditions, and what the nurse does first.
🚨
STAT
Emergency
Conditions
Cord Prolapse Eclampsia Uterine Rupture Amniotic Fluid Embolism
Nursing Priority
Cord prolapse: Gloved hand into vagina to relieve cord compression, knee-chest or Trendelenburg position, O₂, call provider STAT — do NOT remove hand until C-section.
Eclampsia: Protect airway, pad side rails, O₂, call provider, give MgSO₄ or diazepam per order.
Uterine rupture: Sudden cessation of contractions + maternal shock + fetal distress — emergency C-section, IV access, blood products.
⚠️
Urgent
Notify Now
Conditions
Abruptio Placentae Placenta Previa Severe Preeclampsia Postpartum Haemorrhage
Key Distinctions & Priority
Previa: Painless bright red bleeding — no vaginal exam, bedrest, C-section likely.
Abruption: Painful, rigid uterus, dark/concealed bleeding, fetal distress.
Severe preeclampsia: BP ≥160/110 + headache + visual changes + epigastric pain — MgSO₄, antihypertensives, assess DTRs before each dose.
PPH: Boggy uterus first → fundal massage → oxytocin → call provider.
👁️
Monitor
Closely
Conditions
Mild Preeclampsia Gestational Diabetes Hyperemesis Gravidarum Late Decelerations
Nursing Priority
Mild preeclampsia: BP ≥140/90, proteinuria — bedrest, low-Na diet, daily weights, DTR assessment, no MgSO₄ yet.
GDM: Monitor BG, diet control, insulin if needed — fetal macrosomia risk.
Late decels: Left lateral position, O₂ 8–10 L/min mask, stop oxytocin, IV fluid bolus, notify provider.
📈
FHR
Patterns
Pattern Type
Early Decels Late Decels Variable Decels Accelerations
Pattern → Cause → Action
Early: Mirror contractions · Head compression · Normal — no action needed
Late: After contraction peak · Uteroplacental insufficiency · Reposition L lateral, O₂, stop oxytocin, notify
Variable: Abrupt/V-shaped · Cord compression · Reposition first; amnioinfusion if ordered
Accelerations: Rise ≥15 bpm × 15 sec · Reassuring — reactive NST
APGAR Score — Assessed at 1 & 5 Minutes
Sign (Letter)
0
Absent / None
1
Present / Weak
2
Good / Strong
A
Appearance (colour)
Blue/pale all over
Pink body, blue extremities
Completely pink all over
P
Pulse (heart rate)
Absent (no HR)
<100 bpm
≥100 bpm
G
Grimace (reflex)
No response to stimulation
Grimace only
Cry, cough, sneeze
A
Activity (muscle tone)
Limp / flaccid
Some flexion of extremities
Active movement, good tone
R
Respiration
Absent (not breathing)
Slow, irregular, weak cry
Regular, strong cry
0 – 3 Severely depressed
Immediate resuscitation
4 – 6 Moderately depressed
Stimulation & O₂ needed
7 – 10 Normal / Reassuring
Routine newborn care
Postpartum Assessment — BUBBLE-HE
Assessed at every postpartum check. Each letter = one body area. Know what’s normal and what requires immediate notification.
B
Breasts
Soft (day 1–2)
Engorged (day 3–4)
Colostrum → milk
Mastitis: warm, red, flu-like sx
U
Uterus
Firm at umbilicus
Descends 1 cm/day
Midline position
Boggy = PPH risk
Deviated = full bladder
B
Bladder
Void q2–4h
≥150 mL per void
No dysuria
Urinary retention → displaced uterus
B
Bowel
BM by day 2–3
Stool softeners
Assess haemorrhoids
No BM by day 3 → intervention
L
Lochia
Rubra: red (1–3 d)
Serosa: pink (4–10 d)
Alba: white (11–28 d)
Foul odour or return to rubra = report
E
Episiotomy / Incision
REEDA assessment
Edges approximated
Minimal swelling
Separation, pus, excessive pain = report
H
Homans’ / DVT
Assess for DVT
Calf pain/swelling
Ambulate early
Positive Homans’ → assess, notify
E
Emotions
Baby blues: days 1–5
Tearful, mood swings
Resolves by day 10
PPD: persists >2 wks, inability to care for infant
Newborn Assessment — Normal vs. Report Immediately
Most newborn findings that look alarming to new nurses are completely normal. Know which ones require intervention — and which ones to reassure the parents about.
Finding
✓ Normal
⚠ Report / Intervene
Heart Rate
110–160 bpm at rest; up to 180 bpm crying
<100 bpm at rest or >180 sustained → notify provider
Respiratory Rate
30–60 breaths/min; brief apnoeic pauses (<15 sec)
Apnoea >15 sec, grunting, nasal flaring, retractions → immediate assessment
Temperature
36.5–37.5°C (97.7–99.5°F); axillary preferred
<36.5°C = hypothermia (rewarm); >37.8°C = fever (sepsis workup)
Skin — Acrocyanosis
Blue hands/feet for first 24–48 hours — normal peripheral vasoconstriction
Central cyanosis (lips, trunk) = cardiac or respiratory emergency
Jaundice
Physiologic jaundice: appears day 2–3, peaks day 3–5, resolves by day 7–10
Jaundice within 24 hrs of birth = pathologic (Rh incompatibility) → phototherapy/exchange transfusion
Blood Glucose
≥45 mg/dL after first feed (screen at 30 min–1 hr in high-risk infants)
<45 mg/dL = hypoglycaemia → feed immediately; if <40 mg/dL or symptomatic → IV dextrose
Fontanelle
Anterior: diamond-shaped, soft, slightly sunken or flat; closes 12–18 months
Bulging (↑ICP) or severely sunken (dehydration) → report
Meconium / First Stool
Meconium passed within 24–48 hrs; transitions to yellow seedy stool by day 3–4
No meconium by 48 hrs → assess for imperforate anus or Hirschsprung’s disease
Newborn Medications
Vitamin K (IM): prevents haemorrhagic disease · Erythromycin eye ointment: prevents ophthalmia neonatorum
Parents may refuse — document refusal, educate on risks, no coercion
Full test
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Frequently asked questions

What is the most important distinction between placenta previa and abruptio placentae?
The key differentiator is pain. Placenta previa presents with painless, bright red vaginal bleeding and is a contraindication to vaginal examination (which can trigger catastrophic haemorrhage). Abruptio placentae presents with sudden, severe abdominal pain, a rigid uterus, and bleeding that may be concealed. Both require immediate provider notification and preparation for emergency delivery, but the clinical presentation and nursing priorities differ significantly.
What are the signs of magnesium sulfate toxicity and what is the antidote?
Signs of MgSO₄ toxicity progress from loss of deep tendon reflexes (first sign, at >7 mEq/L) → respiratory depression (<12 breaths/min) → respiratory arrest → cardiac arrest. Always check DTRs before each dose — absent reflexes require holding the medication and notifying the provider. The antidote is calcium gluconate (not calcium chloride) — keep it at the bedside during MgSO₄ administration.
What is the priority action for cord prolapse?
Cord prolapse is a maternal-fetal emergency. The nurse’s first action is to place a sterile gloved hand into the vagina to manually relieve cord compression by elevating the presenting part off the cord — and keep that hand in place until an emergency C-section is performed. Position the patient in knee-chest or Trendelenburg, administer O₂, call for help, and do not remove the hand. Every second matters for fetal outcome.
When is jaundice in a newborn considered pathologic?
Jaundice is pathologic when it appears within the first 24 hours of life — this timing strongly suggests haemolytic disease (Rh or ABO incompatibility) and requires immediate evaluation and potentially phototherapy or exchange transfusion. Physiologic jaundice appears on day 2–3, peaks day 3–5, and resolves by day 7–10 in term infants. The 24-hour rule is the most tested fact about newborn jaundice on the NCLEX-RN.
What is the difference between postpartum blues and postpartum depression?
Postpartum blues (baby blues) is a normal, transient mood disturbance occurring in the first 1–5 days postpartum, characterised by tearfulness, mood swings, and anxiety. It resolves on its own within 10 days and requires supportive care, not pharmacological treatment. Postpartum depression is a clinical disorder that persists beyond 2 weeks, includes inability to care for the infant, thoughts of harming self or baby, and requires professional evaluation and treatment including therapy and possibly antidepressants.
Can I take this quiz more than once?
Yes, unlimited retakes with no signup required. For Maternal & Newborn, retake after reviewing the urgency band for whichever complication you missed. The clinical patterns are highly consistent — once you can distinguish presentations and nursing priorities, these questions become very predictable.

Get your free Maternal & Newborn cheat sheet

Complication urgency bands, APGAR scoring grid, BUBBLE-HE postpartum reference, and newborn normal vs. abnormal scan — all on one printable page.

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