◌ Free NCLEX practice · 2026
NCLEX Maternity & Newborn Practice Questions
Practice maternal-newborn assessment, complications, safety and health promotion. The goal is not to memorize a letter pattern. Read the stem, identify the clinical problem, decide what matters most for safety, and compare every option against that priority.
These questions are original Free NCLEX Prep educational items, not official NCSBN questions. Use each rationale to review why the best option fits and why the alternatives are less appropriate. For stronger learning, answer before opening the explanation, then write one short takeaway from any item you miss.
8 examples
with rationales
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Do not chase perfect scores. Chase better reasoning.Every reviewed mistake can become a safer decision on the next question.
Question 1 · moderate · Health Promotion and Maintenance
Which cluster is most concerning in a client at 34 weeks?
- Mild dependent edema after a long day
- Severe headache, visual spots, and right-upper-quadrant pain
- Fetal movement consistent with baseline
- Request for a childbirth class flyer
Show answer & rationale
Best answer: B — Severe headache, visual spots, and right-upper-quadrant painHA + scotomata + RUQ pain are preeclampsia/HELLP danger signs.
Question 2 · moderate · Pharmacological and Parenteral Therapies
A client on magnesium sulfate for preeclampsia has RR 9/min, absent reflexes, and slurred speech. What is the priority action?
- Increase the magnesium to prevent seizure
- Stop the infusion and prepare calcium gluconate per protocol while supporting ventilation
- Give an extra opioid for comfort
- Ambulate in the hall
Show answer & rationale
Best answer: B — Stop the infusion and prepare calcium gluconate per protocol while supporting ventilationRespiratory depression and lost reflexes are magnesium toxicity. Calcium gluconate is the antidote.
Question 3 · moderate · Physiological Adaptation
A fundus is boggy and the pad is saturated in 15 minutes. First action?
- Massage the fundus and call for help while assessing bladder and bleeding
- Document and wait for the next hourly round
- Start discharge teaching
- Place the client in high-lithotomy and leave
Show answer & rationale
Best answer: A — Massage the fundus and call for help while assessing bladder and bleedingTone is the most common PPH cause. Fundal massage is immediate, plus help, bladder, and quantification of blood.
Question 4 · moderate · Health Promotion and Maintenance
Continuous fetal monitoring shows repetitive late decelerations. Which action is indicated first among the following?
- Increase oxytocin to speed delivery
- Stop oxytocin, reposition, oxygen per protocol, fluid bolus as ordered, and notify the provider
- Document only
- Give a full meal
Show answer & rationale
Best answer: B — Stop oxytocin, reposition, oxygen per protocol, fluid bolus as ordered, and notify the providerLates suggest uteroplacental insufficiency. Intrauterine resuscitation starts by stopping the tachysystole driver (oxytocin).
Question 5 · moderate · Physiological Adaptation
A cord is visible at the introitus after rupture of membranes. What should the nurse do?
- Push the cord back into the uterus and start ambulation
- Relieve pressure on the cord (knee-chest or Trendelenburg and lift the presenting part) and call for help
- Clamp and cut the cord immediately at the bedside alone
- Give oral fluids and wait
Show answer & rationale
Best answer: B — Relieve pressure on the cord (knee-chest or Trendelenburg and lift the presenting part) and call for helpDo not shove the cord inside. Lift the presenting part off the cord and get an operative delivery pathway.
Question 6 · moderate · Physiological Adaptation
A jittery newborn of a mother with diabetes is most likely to need which first check?
- Serum or point-of-care glucose per protocol
- Hearing screen only
- Circumcision consent
- Phototherapy intensity
Show answer & rationale
Best answer: A — Serum or point-of-care glucose per protocolIDM newborns are at high risk for hypoglycemia. Jitteriness is a cue to check and treat glucose.
Question 7 · moderate · Physiological Adaptation
During delivery the head is born but the shoulder will not deliver. Which action is correct?
- Apply fundal pressure
- McRoberts maneuver and suprapubic pressure as directed
- Pull harder on the head
- Leave the room to find a textbook
Show answer & rationale
Best answer: B — McRoberts maneuver and suprapubic pressure as directedMcRoberts plus suprapubic (not fundal) pressure are first-line nursing/assist actions.
Question 8 · moderate · Physiological Adaptation
A client at 36 weeks has a rigid, board-like abdomen, dark bleeding, and severe pain. This pattern is most consistent with?
- Placenta previa
- Placental abruption
- Normal Braxton-Hicks
- Round-ligament stretch only
Show answer & rationale
Best answer: B — Placental abruptionPainful dark bleeding and a rigid uterus suggest abruption. Previa is typically painless bright bleeding.
How to use this practice well
Start with one pass without notes. On review, separate a knowledge gap from a decision-making gap. If you did not know a fact, review that concept. If you knew the facts but chose the wrong action, identify the cue or priority rule you overlooked. This keeps practice focused on clinical reasoning instead of raw question volume.
Build a repeatable NCLEX routine
Mix focused practice with broader daily sets. Focused pages help repair a specific weakness; mixed sets test whether you can recognize the problem when the category is not announced. As your exam approaches, add timed work and longer sessions, but keep rationale review central. Accuracy, reasoning and consistency matter more than rushing through a large bank.