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Quizzes > Health & Medicine > Human Anatomy & Medicine

Maternity NCLEX Quiz: Test Your Knowledge Now!

Challenge Yourself with NCLEX RN Maternity & Pregnancy Questions

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for maternity NCLEX knowledge quiz on dark blue background

Ready to challenge your maternity NCLEX expertise? Our free "Can You Ace Maternity NCLEX Questions?" quiz is designed to help nursing students and practicing RNs sharpen their skills and reinforce critical concepts in maternal-child care. You'll tackle carefully crafted pregnancy NCLEX questions and nclex rn maternity questions that mirror real exam scenarios, so you can identify strengths, uncover knowledge gaps, and build confidence. Dive into maternity NCLEX questions now or explore an obstetrics nursing quiz to expand your practice. Start testing your skills and boost your readiness today!

In the GTPAL system, what does the 'P' represent?
Pregnancies
Preterm births
Para (number of births ?20 weeks)
Postdates
In GTPAL, 'P' stands for Para and refers to the number of births at or beyond 20 weeks' gestation. This distinguishes deliveries from pregnancies that ended before viability. The system helps track obstetrical history accurately. ACOG: GTPAL Definitions
What is the recommended total weight gain for a pregnant woman with a normal pre-pregnancy BMI?
15 - 25 pounds
11 - 20 pounds
35 - 45 pounds
25 - 35 pounds
For women with a normal BMI (18.5 - 24.9), the Institute of Medicine recommends gaining 25 - 35 pounds during pregnancy. This supports fetal growth while minimizing maternal complications. Under- or over-gaining can increase risks. NICHD: Pregnancy Weight Gain
At approximately what week of gestation is the fundal height expected to be at the level of the umbilicus?
20 weeks
28 weeks
16 weeks
24 weeks
Fundal height generally corresponds in centimeters to weeks of gestation after 20 weeks, so at 20 weeks the fundus is at the umbilicus. Deviations may signal growth or amniotic fluid issues. Routine measurement helps monitor fetal development. ACOG: Fundal Height
During pregnancy, 'quickening' refers to the first fetal movements felt by the mother. When does this typically occur?
8 - 10 weeks
18 - 20 weeks
24 - 26 weeks
12 - 14 weeks
Quickening usually occurs between 18 and 20 weeks in primigravidas and slightly earlier in multiparas. It indicates fetal activity and neurological development. Absence of movement later may warrant further evaluation. ACOG: Fetal Movement FAQ
A daily supplement of folic acid is recommended before conception and during early pregnancy primarily to prevent which anomaly?
Cardiac septal defects
Neural tube defects
Cleft palate
Clubfoot
Supplemental folic acid before conception and during early pregnancy has been shown to reduce the risk of neural tube defects like spina bifida. The neural tube closes by 28 days post-conception. Current guidelines recommend 400 - 800 mcg daily. CDC: Folic Acid](https://www.cdc.gov/ncbddd/folicacid/index.html)
Which hormone is primarily responsible for maintaining the corpus luteum in early pregnancy?
Prolactin
Human chorionic gonadotropin (hCG)
Progesterone
Estrogen
Human chorionic gonadotropin (hCG), produced by the trophoblast, stimulates the corpus luteum to produce progesterone during the first trimester. This maintains the endometrial lining until the placenta develops. Serum hCG levels are also used in pregnancy testing. ACOG: hCG Physiology
What is the normal range for a fetal heart rate (FHR) in term pregnancy?
90 - 120 bpm
110 - 160 bpm
70 - 90 bpm
160 - 200 bpm
A normal fetal heart rate ranges from 110 to 160 beats per minute at term. Rates outside this range may indicate fetal distress and require further assessment. Continuous monitoring is common during labor. ACOG: Fetal Heart Monitoring
Leopold's maneuvers are performed during labor to assess what?
Placental location
Fetal lie, presentation, and position
Maternal contraction strength
Cervical dilation
Leopold's maneuvers are four abdominal palpations used to determine fetal lie, presentation, and position. They assist in planning labor management and delivery approach. Proper technique increases accuracy. Medscape: Leopold's Maneuvers
When should a non-pregnant woman receive the MMR vaccine if her rubella immunity is negative during prenatal screening?
At the first prenatal visit
During the second trimester
Immediately postpartum
At 28 weeks gestation
The live-attenuated MMR vaccine is contraindicated during pregnancy but recommended immediately postpartum for women lacking rubella immunity. This prevents congenital rubella in future pregnancies. Women should avoid pregnancy for one month after vaccination. CDC: MMR Vaccine
A reactive non-stress test (NST) is defined as at least two fetal heart rate accelerations of 15 bpm above baseline lasting 15 seconds within what timeframe?
5 minutes
30 minutes
10 minutes
20 minutes
A reactive NST shows two or more accelerations of ?15 bpm for ?15 seconds within 20 minutes; usually clinicians allow up to 40 minutes. It indicates adequate fetal oxygenation and autonomic function. Nonreactive tests require further evaluation. ACOG: Fetal Assessment
When is the first prenatal care visit typically scheduled?
8 - 12 weeks gestation
24 - 28 weeks gestation
16 - 20 weeks gestation
4 - 6 weeks gestation
Initial prenatal visits are best scheduled between 8 and 12 weeks of gestation to confirm pregnancy, assess maternal risk factors, and establish baseline labs. Early care improves outcomes. High-risk patients may be seen earlier. ACOG: Prenatal Care Guidelines
Which ultrasound measurement is most accurate for dating a pregnancy in the first trimester?
Crown-rump length
Femur length
Abdominal circumference
Biparietal diameter
Crown - rump length measured between 7 and 13 weeks is the most accurate sonographic method for estimating gestational age, with ±5 - 7 days accuracy. Later measurements are less precise. Early dating improves management. ACOG: Obstetric Ultrasound
Which supplement is considered first-line for alleviating mild morning sickness in early pregnancy?
Folic acid
Iron
Vitamin C
Vitamin B6 (pyridoxine)
Vitamin B6 (pyridoxine) is recommended as initial therapy for nausea and vomiting of pregnancy. It can be combined with doxylamine if needed. It is safe and effective. ACOG: Morning Sickness
Lochia rubra, the initial postpartum vaginal discharge, typically lasts how many days?
1 - 3 days
4 - 6 days
7 - 10 days
10 - 14 days
Lochia rubra, characterized by bright red discharge, usually persists for 1 - 3 days postpartum before transitioning to serosa and alba. Duration beyond this may suggest retained products. Monitoring helps detect complications. ACOG: Postpartum Care
A 5-minute Apgar score of 8 - 10 in a newborn indicates what?
Moderate depression
Severe distress
Requires resuscitation
Good adaptation
An Apgar score of 8 - 10 at 5 minutes suggests the newborn is adapting well with minimal or no need for intervention. Scores 4 - 7 indicate moderate depression; 0 - 3 severe depression. It guides immediate care. ACOG: Newborn Assessment
Colostrum differs from mature breast milk primarily because it is:
Higher in fat content
Rich in antibodies and proteins
Higher in lactose
Thinner and lower in protein
Colostrum is the early milk produced in the first days postpartum, rich in immunoglobulins and proteins that protect the neonate. It is lower in fat and lactose than mature milk. It supports the infant's immune system. WHO: Breastfeeding
Which of the following defines preeclampsia?
Gestational hypertension with no proteinuria
Any hypertension plus seizures
BP ?140/90 before 20 weeks
BP ?140/90 after 20 weeks with proteinuria
Preeclampsia is new-onset hypertension (?140/90) after 20 weeks plus proteinuria ?300 mg/24 h or signs of end-organ dysfunction. It can progress to eclampsia or HELLP syndrome. Early detection prevents complications. ACOG: Hypertension in Pregnancy
A patient on magnesium sulfate for preeclampsia exhibits absent deep tendon reflexes. What is the most appropriate action?
Administer furosemide
Give a bolus of magnesium
Stop the magnesium infusion and assess respiratory status
Increase the infusion rate
Absent deep tendon reflexes indicate magnesium toxicity. The infusion should be stopped and respiratory and cardiac status assessed. Calcium gluconate is the antidote if severe. Monitoring prevents life-threatening complications. ACOG: Magnesium Sulfate Use
When should Rho(D) immune globulin be administered to an Rh-negative mother?
Only if amniocentesis is performed
After any spontaneous abortion only
At 12 weeks gestation
At 28 weeks gestation and within 72 hours postpartum if baby is Rh-positive
Rho(D) immune globulin is given at 28 weeks to prevent isoimmunization and within 72 hours postpartum if the newborn is Rh-positive. It's also indicated after procedures or trauma. It prevents hemolytic disease in subsequent pregnancies. ACOG: Rh Alloimmunization
Which vaccine is safe and recommended during any trimester of pregnancy?
Varicella
Inactivated influenza
Live attenuated influenza
MMR
The inactivated influenza vaccine is safe in any trimester and recommended to protect both mother and fetus. Live vaccines like MMR and varicella are contraindicated. Immunization reduces maternal morbidity. CDC: Vaccines in Pregnancy
A GBS-positive mother in labor should receive which antibiotic for prophylaxis?
Vancomycin
Ampicillin
Ceftriaxone
Clindamycin
Intravenous penicillin or ampicillin is first-line for GBS prophylaxis during labor. It reduces neonatal sepsis risk. Alternatives are used for penicillin-allergic patients without anaphylaxis. CDC: GBS Guidelines
A biophysical profile (BPP) score of 8 - 10 in the third trimester indicates:
Equivocal status requiring further testing
Normal fetal status
Severe fetal compromise
Immediate delivery
A BPP score of 8 - 10 indicates good fetal oxygenation and CNS function, suggesting no immediate intervention. Scores of 4 - 6 are equivocal; ?4 indicates compromise and possible delivery. It combines NST and ultrasound findings. ACOG: BPP
Oligohydramnios is diagnosed when the amniotic fluid index (AFI) falls below:
10 cm
12 cm
5 cm
8 cm
An AFI of less than 5 cm is diagnostic for oligohydramnios, which can be associated with fetal renal anomalies or placental insufficiency. Monitoring and possible intervention prevent complications. ACOG: Amniotic Fluid Disorders
Which medication is commonly used as a tocolytic to suppress preterm labor?
Nifedipine
Betamethasone
Magnesium sulfate
Methyldopa
Nifedipine, a calcium-channel blocker, is frequently used off-label as a tocolytic to delay preterm labor. It relaxes uterine smooth muscle. Other agents include indomethacin and terbutaline. ACOG: Preterm Labor
Screening for gestational diabetes mellitus is recommended between which gestational weeks?
30 - 32 weeks
24 - 28 weeks
36 - 38 weeks
16 - 18 weeks
Universal screening with a glucose challenge test is recommended at 24 - 28 weeks. Earlier screening is done for high-risk women. Proper management reduces perinatal morbidity. ACOG: Gestational Diabetes
Which type of insulin is considered safe and commonly used to manage gestational diabetes?
Glargine
Glyburide
NPH insulin
Metformin
Intermediate-acting NPH insulin is commonly used for gestational diabetes management due to its safety profile. Rapid-acting and short-acting insulins are also used. Oral agents are second-line. ACOG: Diabetes Management
Betamethasone administration in preterm labor primarily accelerates which fetal development?
Lung maturity
Muscle mass
Neurological development
Gastrointestinal maturity
Antenatal corticosteroids like betamethasone accelerate fetal lung surfactant production, reducing neonatal respiratory distress syndrome. It's recommended between 24 and 34 weeks if preterm birth is likely. Dosing is two doses 24 hours apart. ACOG: Corticosteroids
What is the first-line management for postpartum hemorrhage due to uterine atony?
Methylergonovine IM
Bakri balloon insertion
IV oxytocin and uterine massage
Hysterectomy
Initial management of uterine atony includes uterine massage and IV oxytocin to stimulate contractions and reduce bleeding. If ineffective, additional uterotonics or surgical interventions follow. Prompt action prevents shock. ACOG: PPH Management
Which screening tool is used to assess postpartum depression?
Papanicolaou test
Hamilton Anxiety Rating Scale
Edinburgh Postnatal Depression Scale
Beck Depression Inventory
The Edinburgh Postnatal Depression Scale is a validated 10-item questionnaire used worldwide to screen for postpartum depression. Scores ?13 suggest depression and warrant evaluation. Early detection improves outcomes. NIH: EPDS
Painless, bright red vaginal bleeding in the second trimester is most indicative of:
Placenta previa
Uterine rupture
Vasa previa
Abruptio placentae
Painless, bright red bleeding in mid-pregnancy is classic for placenta previa, where the placenta overlies or is near the cervical os. Diagnosis is confirmed by ultrasound. Vaginal exam is contraindicated. ACOG: Placenta Previa
A lecithin-sphingomyelin (L/S) ratio greater than 2.0 in amniotic fluid indicates:
Placental dysfunction
Fetal lung maturity
Oligohydramnios
Fetal anemia
An L/S ratio >2.0 typically indicates adequate fetal lung maturity and lower risk of respiratory distress syndrome. This test is performed after 32 weeks if early delivery is considered. It guides timing of delivery. ACOG: Fetal Lung Maturity
What is the first-line management for eclampsia during labor?
Immediate cesarean delivery
Oral nifedipine
IV labetalol only
Magnesium sulfate and rapid control of blood pressure
Eclampsia (seizures in preeclampsia) is managed with IV magnesium sulfate to stop seizures and IV antihypertensives (e.g., labetalol, hydralazine) to control BP. Delivery planning follows stabilization. Rapid treatment reduces maternal and fetal morbidity. ACOG: Eclampsia Management
A positive contraction stress test is indicated by:
Late decelerations in at least 50% of contractions
No decelerations with contractions
Early decelerations only
Variable decelerations only
A positive CST shows late decelerations with 50% or more contractions, indicating uteroplacental insufficiency. It suggests increased risk of fetal compromise. Management includes delivery planning. Medscape: CST Interpretation
Which laboratory finding is characteristic of HELLP syndrome?
Hypernatremia
Elevated hemoglobin
Low liver enzymes
Elevated LDH and low platelets
HELLP syndrome features hemolysis (?LDH), elevated liver enzymes (AST/ALT), and low platelets (<100,000). It's a severe variant of preeclampsia requiring prompt delivery. Maternal and fetal monitoring is critical. ACOG: HELLP Syndrome
Amniotic fluid embolism most often presents with which triad of symptoms?
Tachycardia, polyhydramnios, fever
Bradycardia, oliguria, hypercalcemia
Seizures, hyperglycemia, hypertension
Hypotension, DIC, respiratory distress
Amniotic fluid embolism presents suddenly with hypotension, respiratory distress, and disseminated intravascular coagulation (DIC). It's a catastrophic obstetric emergency with high maternal mortality. Immediate resuscitation and critical care are required. UpToDate: Amniotic Fluid Embolism
Which maneuver is used first to relieve shoulder dystocia during vaginal delivery?
McRoberts maneuver
Zavanelli maneuver
Wood's screw maneuver
Kristeller maneuver
The McRoberts maneuver (maternal legs flexed onto abdomen) is first-line for shoulder dystocia as it increases pelvic outlet. Additional methods include suprapubic pressure and rotational maneuvers. Knowledge of steps improves neonatal outcome. ACOG: Shoulder Dystocia
Which of the following is an absolute contraindication to a trial of labor after cesarean (TOLAC)?
Previous classical (vertical) uterine incision
Twins in vertex presentation
Age over 35
One prior low transverse cesarean scar
A prior classical (vertical) uterine incision poses high risk for uterine rupture and is an absolute contraindication to TOLAC. A low transverse scar is compatible with VBAC. Other factors are relative. ACOG: VBAC Guidelines
Which TORCH infection is most commonly prevented by advising pregnant women to avoid cat feces?
Herpes simplex
Toxoplasmosis
Cytomegalovirus
Rubella
Toxoplasmosis transmission can occur via oocysts in cat feces. Pregnant women should avoid handling cat litter to reduce congenital infection risk. Infection can cause severe fetal CNS and ocular damage. CDC: Toxoplasmosis
Peripartum cardiomyopathy typically presents in which timeframe?
One year postpartum
24 - 28 weeks gestation
First trimester
Last month of pregnancy to five months postpartum
Peripartum cardiomyopathy occurs from the last month of pregnancy up to five months postpartum and presents with signs of heart failure. Etiology is unclear, and management includes standard CHF therapy. Early recognition improves outcomes. AHA: Peripartum Cardiomyopathy
Newborn prophylaxis for an infant born to an HBsAg-positive mother includes:
HBIG and HBV vaccine within 12 hours
No prophylaxis needed
Oral antivirals immediately
Delayed vaccination at 2 months
Infants born to HBsAg-positive mothers should receive HBIG and the first dose of Hepatitis B vaccine within 12 hours to prevent perinatal transmission. Completion of vaccine series is critical. CDC: Hepatitis B Vaccine
Puerperal sepsis is most commonly caused by which organism?
Listeria monocytogenes
Group A Streptococcus
Staphylococcus epidermidis
Escherichia coli
Group A Streptococcus is a leading cause of severe puerperal sepsis and can progress rapidly. Early recognition and IV antibiotics reduce morbidity. Strict hygiene in childbirth settings is vital. WHO: Maternal Sepsis
Late decelerations on a fetal monitor are most indicative of:
Uteroplacental insufficiency
Umbilical cord compression
Normal variability
Fetal head compression
Late decelerations begin after contraction onset and indicate uteroplacental insufficiency and fetal hypoxia. They warrant intrauterine resuscitation and possible expedited delivery. Early detection is critical. ACOG: Fetal Monitoring
What is the immediate nursing intervention when a prolapsed umbilical cord is identified during labor?
Encourage pushing
Apply fundal pressure
Administer oxytocin
Push the presenting part off the cord and position mother prone or knee-chest
For cord prolapse, the nurse should push up the presenting fetal part to relieve pressure on the cord and place the mother in knee-chest or Trendelenburg position to improve blood flow. Immediate cesarean is often required. ACOG: Umbilical Cord Prolapse
Which step is essential in the management of uterine inversion?
Administration of oxytocin
Manual replacement of the uterus
Fundal massage
Immediate hysterectomy
Uterine inversion requires immediate manual replacement of the fundus through the vagina before administering uterotonics to prevent further inversion. Delay increases hemorrhage. Prompt correction is lifesaving. WHO: Uterine Inversion
High levels of hCG after evacuation of a molar pregnancy may indicate:
Choriocarcinoma
Placenta accreta
Ectopic pregnancy
Normal recovery
Persistently elevated or rising hCG after molar pregnancy evacuation suggests gestational trophoblastic neoplasia such as choriocarcinoma. Serial hCG monitoring is essential. Early oncology referral improves outcomes. Cancer.org: Gestational Trophoblastic Disease
Management of antiphospholipid syndrome in pregnancy most often includes:
Warfarin throughout pregnancy
Low-dose aspirin and heparin
High-dose steroids
No treatment unless thrombosis occurs
Antiphospholipid syndrome in pregnancy is managed with low-dose aspirin plus prophylactic heparin to reduce risk of miscarriage and thrombosis. Warfarin is teratogenic. Therapy improves live birth rates. ACOG: Autoimmune Disorders in Pregnancy
Intrahepatic cholestasis of pregnancy is confirmed by:
High ammonia levels
Low platelet count
Elevated serum bile acids
Elevated AST/ALT only
Intrahepatic cholestasis of pregnancy is diagnosed when maternal serum bile acids exceed 10 µmol/L, often accompanied by pruritus. It increases fetal risk and warrants early delivery. Ursodeoxycholic acid may relieve symptoms. ACOG: Liver Disease in Pregnancy
Acute fatty liver of pregnancy is best managed by:
High-dose corticosteroids
Emergent delivery and intensive supportive care
Conservative management and wait for spontaneous resolution
IV magnesium sulfate
Acute fatty liver of pregnancy is a life-threatening condition requiring prompt delivery once mother is stabilized, plus supportive care for hypoglycemia, coagulopathy, and hepatic failure. Delaying delivery increases maternal and fetal mortality. ACOG: Acute Fatty Liver of Pregnancy
'Mirror syndrome' in obstetrics refers to maternal symptoms that mirror:
Placental abruption signs
Maternal heart failure
Preeclampsia lab findings
Fetal hydrops (edema)
Mirror syndrome describes maternal edema and preeclampsia-like symptoms that reflect fetal hydrops. Treating the underlying cause or delivering the fetus often resolves maternal symptoms. Recognition is crucial. NIH: Mirror Syndrome
Fetal tachysystole due to oxytocin infusion is best managed by:
Discontinuing oxytocin and administering a tocolytic
Administering epidural analgesia
Increasing oxytocin rate
Immediate amniotomy
Excessive uterine activity (tachysystole) from oxytocin requires stopping the infusion and, if needed, giving a tocolytic (e.g., terbutaline) to restore uterine resting tone and improve fetal oxygenation. Monitoring follows. ACOG: Induction and Augmentation
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Study Outcomes

  1. Understand maternal physiological adaptations -

    Explain key normal changes in cardiovascular, respiratory, and endocrine systems that are commonly tested in pregnancy NCLEX questions.

  2. Apply clinical decision-making to maternity scenarios -

    Use critical thinking skills to determine appropriate nursing interventions for common obstetric complications featured in maternity NCLEX questions.

  3. Identify proper assessments and interventions -

    Recognize priority assessment findings and evidence-based actions in response to NCLEX RN maternity questions.

  4. Interpret fetal monitoring and labor progress -

    Analyze patterns on electronic fetal monitoring and labor progression data, mirroring scenarios from maternity nursing practice questions.

  5. Evaluate patient education strategies -

    Develop effective prenatal and postpartum teaching plans that reinforce understanding and safety, as emphasized in the free scored quiz.

Cheat Sheet

  1. Cardiovascular and Hematologic Changes -

    During pregnancy, blood volume increases by 30% - 50% and cardiac output rises up to 40%, which can mask anemia (physiologic anemia). Remember the mnemonic "3-5-40" (30% - 50% volume ↑, 5 bpm HR ↑, 40% CO ↑) to quickly recall these shifts. These concepts are frequently tested in maternity nclex questions and maternity nursing practice questions.

  2. Stages of Labor and Cervical Station -

    The four stages of labor include latent, active, transition, and the third and fourth (delivery and recovery), with dilation progressing from 0 to 10 cm. Use the acronym "LET'S" (Latent, Expanding, Transition, Stage III, Stage IV) to anchor the phases and correlate with maternal and fetal assessments. Many pregnancy nclex questions and nclex rn maternity questions ask you to identify appropriate interventions at each stage.

  3. APGAR Scoring System -

    The APGAR score evaluates newborns at 1 and 5 minutes based on Appearance, Pulse, Grimace, Activity, and Respiration, each scored 0 - 2 for a maximum of 10. A score of 7 - 10 is reassuring, 4 - 6 indicates moderate distress, and 0 - 3 signifies severe distress; practice with sample calculations to build confidence for maternity nclex questions. This quick assessment is frequently featured in pregnancy nclex questions and NCLEX RN maternity questions alike.

  4. Fetal Heart Rate Patterns -

    Intermittent and continuous electronic fetal monitoring help identify early, variable, and late decelerations; early decels mirror contractions, variables show sharp drops, and lates indicate uteroplacental insufficiency. Use the mnemonic "VEAL CHOP" (Variable → Cord, Early → Head, Accel → Okay, Late → Placenta) to recall causes and interventions. Mastery of these patterns is critical for both maternity nclex questions and maternity nursing practice questions.

  5. Rh Incompatibility and Neonatal Management -

    Rh-negative mothers with Rh-positive fetuses receive rhesus (Rh) immunoglobulin (300 mcg covers up to 30 mL fetal blood) at 28 weeks and postpartum to prevent isoimmunization. Remember "28 and postpartum" as a simple rule-of-thumb when preparing for pregnancy nclex questions on immune prophylaxis. Being able to calculate dosages and recognize indirect Coombs positive results is a must for nclex rn maternity questions.

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