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NCLEX Maternity and OB Practice Questions

Maternal-newborn questions test a lot of normal values and a few true emergencies. Knowing which findings are expected keeps you from over-reacting to normal changes.

These questions cover fetal monitoring, preeclampsia, postpartum hemorrhage and newborn assessment.

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What the NCLEX tests in maternity and ob

5 maternity and ob practice questions with rationales

Answer each one before opening the rationale. Every option is explained, including the wrong ones.

Question 1 · Multiple choice
The nurse sees late decelerations on the fetal monitor. What is the first action?
  1. Document and continue to observe
  2. Turn the client to her side
  3. Prepare for immediate delivery
  4. Increase the oxytocin infusion
Show answer and rationale

Answer: B

A. Late decelerations signal uteroplacental insufficiency and need action.

B. Correct. Side-lying improves placental perfusion; then stop oxytocin, give fluids and oxygen as ordered and notify the provider.

C. Delivery may be needed if the pattern persists, but repositioning comes first.

D. Oxytocin should be stopped, not increased.

Question 2 · Select all that apply
A client with preeclampsia is receiving magnesium sulfate. Which findings suggest toxicity? Select all that apply.
  1. Respiratory rate of 10/min
  2. Absent deep tendon reflexes
  3. Urine output of 20 mL/hr
  4. Blood pressure of 150/96
  5. Decreased level of consciousness
Show answer and rationale

Answer: A, B, C, E

A. Correct. Respiratory depression is a toxicity sign.

B. Correct. Loss of reflexes is an early toxicity sign.

C. Correct. Low output lets magnesium accumulate.

D. Elevated BP is the preeclampsia itself, not magnesium toxicity.

E. Correct. CNS depression signals toxicity.

Question 3 · Multiple choice
Twelve hours after birth, the fundus is boggy and displaced to the right. What should the nurse do first?
  1. Massage the fundus
  2. Help the client empty her bladder
  3. Notify the provider
  4. Give oxytocin
Show answer and rationale

Answer: A

A. Correct. A boggy fundus is the immediate risk; massage it until firm, then address the likely full bladder.

B. A full bladder displaces the uterus, but firming a boggy fundus comes first.

C. Notify if massage does not work or bleeding is heavy.

D. Oxytocin requires an order and follows massage.

Question 4 · Multiple choice
Which newborn finding at one hour of age should the nurse report?
  1. Acrocyanosis
  2. Respiratory rate of 72/min with grunting
  3. Heart rate of 140/min
  4. Milia on the nose
Show answer and rationale

Answer: B

A. Bluish hands and feet are normal in the first day.

B. Correct. Above 60 breaths/min with grunting indicates respiratory distress.

C. Normal newborn heart rate is about 110 to 160.

D. Milia are normal.

Question 5 · Select all that apply
Which are expected physiologic changes of pregnancy? Select all that apply.
  1. Increased blood volume
  2. Mild dependent edema late in pregnancy
  3. Sudden severe headache with visual changes
  4. Linea nigra
  5. Increased heart rate
Show answer and rationale

Answer: A, B, D, E

A. Correct. Blood volume rises about 40 to 50%.

B. Correct. Mild lower-leg swelling is common.

C. Severe headache with visual changes suggests preeclampsia.

D. Correct. Pigmentation change is normal.

E. Correct. Heart rate rises 10 to 15 beats/min.

How to study maternity and ob for the NCLEX

  1. VEAL CHOP pairs fetal heart patterns with causes: late decelerations mean placental insufficiency.
  2. For magnesium sulfate, check reflexes, respirations and urine output, and keep calcium gluconate available.
  3. Postpartum: fundus first, then bladder.

Frequently asked questions

How much maternity is on the NCLEX?

Maternal-newborn content is spread across categories rather than one section, but it appears regularly, especially safety, fetal monitoring and postpartum care.

What maternity topics should I focus on?

Fetal monitoring, preeclampsia, postpartum hemorrhage, labor stages and newborn assessment.

Can I generate OB questions from my class notes?

Yes. Upload your OB notes to NurseQuizAI and practise on questions built from them.

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