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NCLEX Maternity Practice Questions

Maternal-newborn nursing practice questions on antepartum, labor, postpartum, and newborn care — free with evidence-backed rationales.

PharmacologyMed-SurgFundamentalsPediatricsPsych
Question 1Multiple choiceMaternity

A client with severe preeclampsia is receiving magnesium sulfate. The nurse notes respirations of 10/min, absent reflexes, and decreased urine output. The nurse should prepare to administer:

  1. Protamine sulfate
  2. Calcium gluconate
  3. Naloxone
  4. Vitamin K
Show answer & rationale

Correct: Calcium gluconate

Why: Respirations of 10/min, absent deep-tendon reflexes, and oliguria are the classic triad of magnesium toxicity (therapeutic 4–7 mEq/L; toxicity brings loss of reflexes then respiratory depression). Stop the infusion, notify the provider, and give calcium gluconate or calcium chloride, which antagonizes magnesium at the neuromuscular junction. Memory aid: the 3 Rs disappear in magnesium toxicity — Reflexes, Respirations, Renal output.

📚 Basis: MgSO4 therapeutic 4–7 mEq/L; toxicity triad: loss of DTRs, respiratory depression, oliguria; antidote: calcium gluconate/chloride. · ACOG preeclampsia guidance

Question 2Multiple choiceMaternity

A woman planning pregnancy asks about preventing birth defects. What should the nurse teach about folic acid?

  1. Take 400 mcg of folic acid daily before conception and during the first trimester to prevent neural tube defects
  2. Folic acid prevents Down syndrome and should start in the third trimester
  3. Folic acid is only needed if blood tests show a deficiency
  4. Take folic acid only after the pregnancy is confirmed
Show answer & rationale

Correct: Take 400 mcg of folic acid daily before conception and during the first trimester to prevent neural tube defects

Why: (1) Principle: Periconceptional folic acid reduces neural tube defects (spina bifida, anencephaly) because the neural tube closes by week 4, often before pregnancy is known. (2) Correct: 400 mcg daily starting at least 1 month before conception through the first 12 weeks. (3) Wrong: folic acid does not prevent chromosomal conditions like Down syndrome; starting in the third trimester or after confirmation misses neural tube closure; waiting for deficiency testing is unsafe. (4) Memory aid: Folate first — 400 mcg before and early, for the neural tube.

📚 Basis: CDC: 400 mcg folic acid daily before conception and through the first trimester prevents neural tube defects; neural tube closes within the first 28 days. · CDC; ACOG

Question 3Multiple choiceMaternity

A new mother asks how long she should exclusively breastfeed her infant. What does the nurse teach?

  1. Exclusive breastfeeding for about the first 6 months
  2. Exclusive breastfeeding for the first 3 months only
  3. Breast milk and formula are equivalent, so either is fine from birth
  4. Exclusive breastfeeding for 12 months with no other foods
Show answer & rationale

Correct: Exclusive breastfeeding for about the first 6 months

Why: (1) Principle: Exclusive breastfeeding for ~6 months provides optimal nutrition and immune protection, with continued breastfeeding plus complementary foods to 12 months and beyond. (2) Correct: about 6 months exclusive. (3) Wrong: 3 months is too short per guidelines; formula is not equivalent to breast milk's immunologic benefits; after ~6 months infants need complementary foods for iron and nutrients. (4) Memory aid: Six months exclusive, then food plus breast — AAP/WHO's plan.

📚 Basis: AAP/WHO: exclusive breastfeeding for about 6 months, then complementary foods with continued breastfeeding to 12 months and beyond. · AAP; WHO

Question 4Multiple choiceMaternity

On postpartum day 3, a new mother cries easily and feels overwhelmed but is bonding well with her infant. The nurse recognizes these findings as consistent with:

  1. Postpartum blues.
  2. Postpartum depression.
  3. Postpartum psychosis.
  4. Adjustment disorder.
Show answer & rationale

Correct: Postpartum blues.

Why: (1) Clinical principle: postpartum blues involves mood lability, tearfulness, and anxiety beginning 2 to 5 days after birth, peaking around day 5, and resolving within about 2 weeks without impairing infant care. (2) The day-3 timing, mild tearfulness, and intact bonding fit postpartum blues exactly. (3) Postpartum depression persists beyond 2 weeks with impaired functioning and bonding; postpartum psychosis involves delusions or hallucinations and is a psychiatric emergency; blues is a transient physiologic response, not an adjustment disorder diagnosis. (4) Memory aid: blues is brief with bonding intact; depression is deep and disabling.

📚 Basis: Postpartum blues begins 2 to 5 days after birth and resolves within about 2 weeks. · ACOG

Question 5Select all that applyMaternity

A client at 34 weeks gestation with preeclampsia asks which symptoms require immediate reporting. Select all that apply.

  1. Severe, unrelenting headache
  2. Visual disturbances such as blurred vision or seeing spots
  3. Right upper quadrant or epigastric pain
  4. Sudden swelling of the face and hands
  5. Decreased urine output
  6. Increased appetite
Show answer & rationale

Correct: Severe, unrelenting headache; Visual disturbances such as blurred vision or seeing spots; Right upper quadrant or epigastric pain; Sudden swelling of the face and hands; Decreased urine output

Why: (1) Principle: preeclampsia (blood pressure 140/90 mmHg or higher after 20 weeks with proteinuria or severe features) can progress to eclampsia, HELLP syndrome, and organ damage; severe features are emergencies. (2) Correct: severe headache and visual changes signal cerebral involvement; right upper quadrant or epigastric pain signals liver capsule swelling (HELLP); sudden facial and hand edema plus oliguria signal worsening disease. (3) Wrong: increased appetite is not a warning sign of preeclampsia. (4) Memory aid: 'Pre-E warners: Head, Eyes, RUQ, Edema, Urine down.'

📚 Basis: Severe preeclampsia features include severe headache, visual changes, right upper quadrant pain, sudden edema, and oliguria; preeclampsia is defined by BP 140/90 mmHg or higher after 20 weeks. · ACOG Practice Bulletin: Gestational Hypertension and Preeclampsia, 2024

Question 6Multiple choiceMaternity

A client planning pregnancy asks about folic acid. What does the nurse recommend?

  1. 400 mcg daily, starting at least 1 month before conception
  2. 800 mg daily starting in the third trimester
  3. 1 g daily only after a positive pregnancy test
  4. Folic acid is not needed with a balanced diet
Show answer & rationale

Correct: 400 mcg daily, starting at least 1 month before conception

Why: (1) Principle: folic acid prevents neural tube defects (spina bifida, anencephaly), and the neural tube closes by day 28 of gestation — before most pregnancies are detected. (2) Correct: the CDC recommends 400 mcg daily for all people capable of pregnancy, starting at least one month before conception. (3) Wrong: 800 mg is a thousand-fold overdose (micrograms, not milligrams); starting in the third trimester or only after a positive test is too late; diet alone is unreliable for reaching protective levels. (4) Memory aid: 'Folate before fate — 400 mcg before conception.'

📚 Basis: CDC recommends 400 mcg of folic acid daily starting at least one month before conception to prevent neural tube defects. · CDC Folic Acid Recommendations; ACOG

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PharmacologyMed-SurgFundamentalsPediatricsPsych

NCLEX Drill offers practice questions for study purposes only — not medical advice, and not a substitute for professional judgment or official study materials. Question bank grows daily; last updated 2026-10-09.