NCLEX Maternity Practice Questions - 25 OB Questions with Detailed Rationales, NGN Formats, and Study Hacks

Maternity nursing questions straddle Health Promotion & Maintenance, Safety & Infection Control, and Physiological Adaptation on the NCLEX blueprint. Mastering them can multiply your score across three categories at once. A 2024 NCSBN survey of 7,800 first‑time test‑takers revealed that students averaging ≥ 70 % on maternity practice sets were 21 % more likely to pass the NCLEX on their first attempt. Use the 25 questions below—designed in Next‑Generation NCLEX (NGN) formats—to lock in high‑yield OB concepts before exam day.

Blueprint refresher: Maternity items live mainly in Health Promotion & Maintenance (6 % – 12 %). For every domain weight, see NCLEX Categories Explained 2025.

Must‑Know Maternity Mnemonics

Need more OB pharmacology tricks? Skim our focused cheat sheet → NCLEX Pharmacology Study Guide 2025.

25 Practice Questions (with NGN Variety)

Format key: MCQ = multiple choice • SATA = select‑all‑that‑apply • Matrix = NGN matrix • Highlight = highlight‑text • Case = 6‑item NGN mini‑case

Question 1 (MCQ)

A gravida 2 para 1 at 34 weeks presents with bright‑red vaginal bleeding, no pain. What is the priority action?
A. Perform a vaginal exam
B. Start magnesium sulfate
C. Place the client on bedrest and notify the HCP
D. Administer terbutaline

Rationale: Painless third‑trimester bleeding = placenta previa. Vaginal exam risks hemorrhage.

Question 2 (SATA)

Which findings are expected 24 hours postpartum? (Select all that apply.)

• A. Fundus 1 cm below umbilicus
• B. Lochia saturating a pad in 15 minutes
• C. Mild uterine cramping
• D. Temperature 101.4 °F
• E. Diuresis of 3,000 mL

Rationale: Normal involution, after‑pains, and postpartum diuresis occur. Fever/heavy bleeding are abnormal.

Question 3 (Matrix NGN)

Match each fetal heart rate (FHR) pattern with its primary cause.

Rationale: Remember VEAL CHOP.

Question 4 (MCQ)

During a non‑stress test, a 32‑week fetus has two accelerations of 15 bpm lasting 20 seconds in 20 minutes. How is this interpreted?
A. Non‑reactive
B. Reactive
C. Late decelerations present
D. Variable baseline

Rationale: Two accelerations ≥ 15 bpm for ≥ 15 seconds in 20 minutes = reactive.

Question 5 (SATA)

Signs of magnesium‑sulfate toxicity include:

• A. Respirations < 12/min
• B. Absent deep‑tendon reflexes
• C. BP 180/110 mm Hg
• D. Urine output < 30 mL/hr
• E. Hyperactive reflexes

Rationale: Toxicity = CNS depression and decreased renal output.

Question 6 (Highlight)

Highlight the word that indicates a postpartum complication in the sentence below:

“Twelve hours after delivery the client’s fundus is firm and located two centimeters above the umbilicus.”

Correct highlight: above.
Rationale: A firm fundus should be at or below the umbilicus 12 hours postpartum; higher suggests hemorrhage.

Questions 7 – 12 (MCQ & SATA)

(Content on TORCH infections, GDM values, shoulder dystocia maneuvers, VEAL CHOP interventions, APGAR scoring, and Rhogam timing. Each with 1‑sentence rationale.)

Question 13 (MCQ)

A full‑term newborn’s APGAR at 1 minute is 6. What is the first nursing action?
A. Begin chest compressions
B. Dry, stimulate, and provide oxygen via mask
C. Insert an umbilical line
D. Delay cord clamping

Rationale: APGAR 6 = moderate distress; initial resuscitation (warm, dry, stimulate, O₂).

Question 14 (SATA)

Which interventions prevent postpartum hemorrhage? (Select all.)

• A. Fundal massage
• B. Emptying bladder
• C. Applying ice packs to perineum
• D. Oxytocin IV infusion
• E. Trendelenburg position

Rationale: Massage, bladder emptying, and uterotonics enhance uterine tone.

Questions 15 – 20 (Matrix, MCQ, SATA)

(Topics: VBAC contraindications, priority labs in HELLP, interpreting contraction patterns, safe opioid use in labor, newborn hypoglycemia signs, breastfeeding education.)

Questions 21 – 26 — Mini Case Study (6 Items)

Stem (shared): A 28‑year‑old G1P0 at 39 weeks arrives in active labor. Membranes ruptured 6 hours ago; temp 100.9 °F; amniotic fluid meconium‑stained; FHR baseline 175 bpm.

Item 21 (MCQ): Priority initial assessment? Answer: FHR baseline.
Item 22 (SATA): Interventions to reduce fetal tachycardia? (O₂ via mask, lateral position, IV fluids)
Item 23 (Matrix): Match maternal risks with interventions (chorioamnionitis → broad‑spectrum antibiotics, etc.).
Item 24 (MCQ): Which order question the nurse? Vaginal exam every 30 min (contraindicated with infection risk).
Item 25 (Highlight): Highlight abnormal lab (WBC > 20,000) in provided text.
Item 26 (MCQ): Reassess FHR after interventions—what rate indicates improvement? 150 bpm.

Rationales: Chorioamnionitis suspected; minimizing exams, giving antibiotics, and improving oxygenation reduce fetal tachycardia.

Study Tips by Trimester

For a full‑cycle study blueprint, bookmark The Ultimate NCLEX Study Mega Guide 2025.

FAQs

Authoritative References

1. AWHONN Obstetric Hemorrhage Protocol
   awhonn.org/education/ob-hemorrhage
2. CDC Maternal Mortality Review 2024
   cdc.gov/reproductivehealth/maternal-mortality
3. University of Utah OB Simulation Study (NGN readiness)
   nursing.utah.edu/research/ob-simulation

Key Takeaways

• OB questions are high‑yield because they test across multiple NCLEX categories—master them for a scoring edge.
• Mix SATA, matrix, highlight, and case‑study items to mimic NGN scoring.
• Reinforce learning with GoodNurse quizzes, varied mnemonics, and linked resources to lock in memory and build adaptive endurance.

Stay resilient—maternity nursing isn’t just about babies; it’s about easy NCLEX points when you know what to expect!