At her 2-week postpartum visit, a patient who is exclusively breastfeeding and has no other medical conditions asks to begin hormonal contraception today. Which method is appropriate to start now?

Combined estrogen–progestin pill

Which reflex finding in a 2-day-old term newborn should the nurse document as expected?

Toes fan and the great toe dorsiflexes when the sole is stroked

Ankle clonus that persists for more than 10 beats with dorsiflexion

Moro response with movement of the left arm only

A patient discharged 5 days after an uncomplicated birth calls to report a headache that has not improved with acetaminophen. Her home BP reading is 158/102 mm Hg. What should the nurse instruct?

Come to the hospital now for evaluation

Rest, since headaches are common after an epidural

Take ibuprofen and recheck the BP in 4 hours

A term newborn is born through thick meconium-stained fluid and is limp with no respiratory effort. According to current NRP guidance, what should the team do first?

Perform the initial steps at the warmer, then start PPV if apnea persists

Suction the mouth and nose on the perineum before the shoulders deliver

Intubate and suction the trachea before any stimulation

A patient at 26 weeks had a Roux-en-Y gastric bypass 3 years ago. Which approach to gestational diabetes screening should the nurse anticipate?

Fasting and postprandial capillary glucose monitoring for about a week

A 1-hour 50-g glucose challenge test at the next visit

A 3-hour 100-g oral glucose tolerance test after an overnight fast

A patient chooses a levonorgestrel IUD placed within 10 minutes after placental delivery. Which teaching point is accurate?

Expulsion is likelier than with later insertion; check the strings

The IUD will need to be removed if she decides to breastfeed her baby

The IUD will not prevent pregnancy until after her 6-week visit

A newborn has a large blue-gray, flat area over the lower back and buttocks. Which action is most appropriate?

Document its size, location, and color to prevent confusion with bruising

Request coagulation studies to evaluate for a bleeding disorder

Report it to child protective services because it may represent bruising

A postpartum patient receiving magnesium sulfate at 2 g/hour has had urine output of 18 mL/hour for the past 2 hours, and her creatinine has risen from 0.6 to 1.2 mg/dL. Reflexes are 2+. What is the most appropriate action?

Notify the provider and anticipate a magnesium level and rate reduction

Increase the infusion to 3 g/hour because the risk of seizures is rising

Give a 2-L crystalloid bolus to restore urine output

A 34-week newborn has grunting, nasal flaring, and retractions that worsen over the first 4 hours, with a rising oxygen requirement. The chest x-ray shows a diffuse ground-glass pattern with air bronchograms and low lung volumes. Which condition is most likely?

Transient tachypnea of the newborn

Persistent pulmonary hypertension

Maternal Newborn Nursing

Free Maternal Newborn Nursing Practice Questions

10 sample questions for the Maternal Newborn Nursing, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Pregnancy and Birth Risk Factors, Maternal Postpartum Care, Newborn Assessment and Management, Postpartum Complications, Newborn Complications.

Question 1 · Pregnancy and Birth Risk Factors
A patient gave birth today to a healthy term newborn. Her history includes twins born at 35 weeks who are both living and a spontaneous loss at 8 weeks. How should the nurse record her obstetric history using GTPAL?
- A.G3 T1 P2 A1 L3
- B.G4 T1 P1 A1 L3
- C.G3 T1 P1 A1 L3
Show answer and explanation
Answer: C. G3 T1 P1 A1 L3
She has been pregnant three times; today's birth is one term birth, the twin birth counts as one preterm birth because a multifetal gestation is a single pregnancy, there is one abortion, and three children are living. Recording two preterm births counts the twins as separate pregnancies, and listing four gravidas makes the same error in the gravida count.
Question 2 · Maternal Postpartum Care
At her 2-week postpartum visit, a patient who is exclusively breastfeeding and has no other medical conditions asks to begin hormonal contraception today. Which method is appropriate to start now?
- A.Combined estrogen–progestin pill
- B.Progestin-only pill
- C.Combined hormonal vaginal ring
Show answer and explanation
Answer: B. Progestin-only pill
Under the CDC Medical Eligibility Criteria, combined hormonal methods are unacceptable before 21 days postpartum because estrogen adds to the high postpartum VTE risk, and they are generally not advised while breastfeeding during the first month. Progestin-only methods carry no estrogen-related clotting risk and can be started at any time postpartum.
Question 3 · Newborn Assessment and Management
Which reflex finding in a 2-day-old term newborn should the nurse document as expected?
- A.Toes fan and the great toe dorsiflexes when the sole is stroked
- B.Ankle clonus that persists for more than 10 beats with dorsiflexion
- C.Moro response with movement of the left arm only
Show answer and explanation
Answer: A. Toes fan and the great toe dorsiflexes when the sole is stroked
A positive Babinski response is normal in newborns and persists until about 1 year of age. An asymmetric Moro suggests brachial plexus injury, clavicle fracture, or a neurologic deficit, and sustained clonus beyond a few beats is abnormal and needs evaluation.
Question 4 · Postpartum Complications
A patient discharged 5 days after an uncomplicated birth calls to report a headache that has not improved with acetaminophen. Her home BP reading is 158/102 mm Hg. What should the nurse instruct?
- A.Rest, since headaches are common after an epidural
- B.Come to the hospital now for evaluation
- C.Take ibuprofen and recheck the BP in 4 hours
Show answer and explanation
Answer: B. Come to the hospital now for evaluation
Preeclampsia can begin after birth, most often within the first week, even in patients who were normotensive during pregnancy. A persistent headache with BP 158/102 mm Hg requires same-day in-person evaluation for postpartum preeclampsia and possible magnesium sulfate. Waiting or attributing the headache to anesthesia delays treatment of a condition linked to eclampsia and stroke.
Question 5 · Newborn Complications
A term newborn is born through thick meconium-stained fluid and is limp with no respiratory effort. According to current NRP guidance, what should the team do first?
- A.Perform the initial steps at the warmer, then start PPV if apnea persists
- B.Suction the mouth and nose on the perineum before the shoulders deliver
- C.Intubate and suction the trachea before any stimulation
Show answer and explanation
Answer: A. Perform the initial steps at the warmer, then start PPV if apnea persists
Current NRP guidance no longer recommends routine intubation for tracheal suctioning of nonvigorous meconium-exposed newborns; the team performs the initial steps and begins PPV within the first minute if the baby is apneic or the heart rate is below 100/min. Delaying ventilation for tracheal suctioning postpones the most effective intervention, and intrapartum suctioning on the perineum does not prevent meconium aspiration.
Question 6 · Pregnancy and Birth Risk Factors
A patient at 26 weeks had a Roux-en-Y gastric bypass 3 years ago. Which approach to gestational diabetes screening should the nurse anticipate?
- A.A 1-hour 50-g glucose challenge test at the next visit
- B.Fasting and postprandial capillary glucose monitoring for about a week
- C.A 3-hour 100-g oral glucose tolerance test after an overnight fast
Show answer and explanation
Answer: B. Fasting and postprandial capillary glucose monitoring for about a week
After gastric bypass, a concentrated oral glucose load can trigger dumping syndrome with rapid hyperglycemia followed by hypoglycemia, so home capillary glucose monitoring is the preferred alternative. Both the 50-g challenge and the 100-g tolerance test rely on an oral glucose load and are avoided.
Question 7 · Maternal Postpartum Care
A patient chooses a levonorgestrel IUD placed within 10 minutes after placental delivery. Which teaching point is accurate?
- A.The IUD will need to be removed if she decides to breastfeed her baby
- B.Expulsion is likelier than with later insertion; check the strings
- C.The IUD will not prevent pregnancy until after her 6-week visit
Show answer and explanation
Answer: B. Expulsion is likelier than with later insertion; check the strings
Postplacental IUD insertion is safe and convenient but has a higher expulsion rate than interval insertion, so patients are taught to check for the strings and report expulsion. Levonorgestrel IUDs are compatible with breastfeeding, and immediate insertion provides contraception well before a 6-week visit.
Question 8 · Newborn Assessment and Management
A newborn has a large blue-gray, flat area over the lower back and buttocks. Which action is most appropriate?
- A.Request coagulation studies to evaluate for a bleeding disorder
- B.Report it to child protective services because it may represent bruising
- C.Document its size, location, and color to prevent confusion with bruising
Show answer and explanation
Answer: C. Document its size, location, and color to prevent confusion with bruising
Congenital dermal melanocytosis is a benign pigmentation that fades over years; careful documentation prevents later misinterpretation as abuse. A report is not warranted for a congenital finding, and a uniform flat lesion present at birth does not suggest a bleeding disorder.
Question 9 · Postpartum Complications
A postpartum patient receiving magnesium sulfate at 2 g/hour has had urine output of 18 mL/hour for the past 2 hours, and her creatinine has risen from 0.6 to 1.2 mg/dL. Reflexes are 2+. What is the most appropriate action?
- A.Notify the provider and anticipate a magnesium level and rate reduction
- B.Increase the infusion to 3 g/hour because the risk of seizures is rising
- C.Give a 2-L crystalloid bolus to restore urine output
Show answer and explanation
Answer: A. Notify the provider and anticipate a magnesium level and rate reduction
Magnesium is cleared by the kidneys, so oliguria and rising creatinine cause accumulation and toxicity before clinical signs appear. The provider is notified, a serum level is drawn, and the infusion is reduced or held. Large fluid boluses risk pulmonary edema in preeclampsia, and increasing the dose worsens accumulation.
Question 10 · Newborn Complications
A 34-week newborn has grunting, nasal flaring, and retractions that worsen over the first 4 hours, with a rising oxygen requirement. The chest x-ray shows a diffuse ground-glass pattern with air bronchograms and low lung volumes. Which condition is most likely?
- A.Transient tachypnea of the newborn
- B.Respiratory distress syndrome
- C.Persistent pulmonary hypertension
Show answer and explanation
Answer: B. Respiratory distress syndrome
Progressive distress in a preterm infant with a ground-glass, low-volume x-ray and air bronchograms reflects surfactant deficiency and alveolar collapse. Transient tachypnea shows fluid in the fissures with normal or increased volumes and improves, and pulmonary hypertension causes labile hypoxemia, often with clear lung fields.

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