Maternal and Newborn Nursing Questions for the Prometric Exam 2026: 20 MCQs with Answers on Antenatal Care, Labour, Postpartum, Newborn Assessment and Obstetric Emergencies

Maternal and newborn nursing is 8 to 10% of the registered nurse paper, about 12 to 15 questions, and it is the domain that trips up nurses who have worked years in surgical or ICU units. The questions are predictable: normal ranges in pregnancy, what each stage of labour looks like, the priority action in an obstetric emergency, and what is normal and abnormal in a newborn. This set covers what recurs. Midwives sit a deeper paper (midwife sample questions).

Antenatal care

Question 1

A woman at 30 weeks reports headache, visual disturbance and swelling of the hands and face. Her blood pressure is 160/105 mmHg with 3+ proteinuria. The nurse's priority is:

1. Reassure and advise rest at home
2. Recognise severe pre-eclampsia, notify the doctor immediately, keep the woman in a quiet environment with seizure precautions, prepare for antihypertensives and magnesium sulfate, and monitor blood pressure, reflexes, urine output and the fetus
3. Give paracetamol only
4. Encourage walking

Answer: B. Headache and visual symptoms are warning signs of impending eclampsia. Calcium gluconate is kept available as the antidote to magnesium toxicity.

Question 2

Which finding at 36 weeks should the nurse report immediately?

1. Mild ankle swelling in the evening
2. Reduced fetal movements, vaginal bleeding, leaking fluid or regular painful contractions
3. Braxton Hicks contractions that stop with rest
4. Backache after standing

Answer: B. Reduced fetal movements are assessed with a CTG the same day; bleeding may indicate placenta praevia or abruption.

Question 3

A woman at 26 weeks has an oral glucose tolerance test result diagnostic of gestational diabetes. The nurse's teaching includes:

1. Stop eating all carbohydrates
2. Blood glucose self-monitoring, a dietitian-led meal plan with consistent carbohydrate, regular activity, and that metformin or insulin may be needed if targets are not met, with growth scans and postpartum screening for type 2 diabetes
3. No changes are needed
4. Oral sulfonylureas as first line

Answer: B. Gestational diabetes increases macrosomia, shoulder dystocia and neonatal hypoglycaemia; it is very common in Gulf populations.

Question 4

An RhD-negative woman is 28 weeks pregnant with an RhD-positive partner and no antibodies. The nurse expects to give:

1. Nothing until delivery
2. Routine antenatal anti-D immunoglobulin, with further doses after any sensitising event and within 72 hours of delivery if the baby is RhD positive
3. Iron injections
4. Rubella vaccine

Answer: B. Anti-D prevents sensitisation that would harm future pregnancies; live vaccines such as rubella are given postpartum, not in pregnancy.

Labour and delivery

Question 5

A woman in labour is 8 cm dilated with contractions every two to three minutes lasting 60 seconds, feeling an urge to push, irritable and nauseated. She is in:

1. The latent phase of the first stage
2. Transition, the end of the active first stage, before full dilatation
3. The third stage
4. The fourth stage

Answer: B. Pushing before full dilatation risks cervical oedema; the nurse coaches breathing until the cervix is fully dilated. The second stage runs from full dilatation to birth; the third stage is delivery of the placenta.

Question 6

During a contraction, the fetal heart rate slows gradually, reaching its lowest point after the peak of the contraction and returning to baseline after the contraction ends. This pattern is:

1. Early decelerations from head compression, benign
2. Late decelerations from uteroplacental insufficiency, requiring repositioning, stopping oxytocin, intravenous fluids, oxygen per protocol and immediate notification of the provider
3. Variable decelerations
4. Normal accelerations

Answer: B. Early decelerations mirror the contraction; late decelerations lag behind it; variable decelerations are abrupt and suggest cord compression.

Question 7

Immediately after membranes rupture, the nurse should first:

1. Prepare the delivery pack
2. Assess the fetal heart rate and note the colour, amount and odour of the fluid, because cord prolapse and fetal distress can follow rupture
3. Give oral fluids
4. Encourage ambulation

Answer: B. Meconium-stained fluid and a non-reassuring heart rate are reported immediately; the time of rupture is documented for infection risk.

Question 8

Active management of the third stage of labour includes:

1. Fundal pressure before the placenta separates
2. Oxytocin 10 units intramuscularly after delivery of the baby, controlled cord traction with counter-traction once signs of separation appear, and fundal massage after the placenta delivers
3. Pulling on the cord immediately
4. Waiting two hours with no intervention

Answer: B. Prophylactic oxytocin is the single most effective measure against postpartum haemorrhage.

Postpartum care

Question 9

One hour after birth, the nurse finds the fundus soft and boggy, above the umbilicus and deviated to the right, with heavy lochia. The first action is:

1. Give a cup of tea
2. Massage the fundus until firm, assist the woman to empty her bladder (a full bladder displaces the uterus), assess bleeding, and notify the provider for uterotonics if the uterus does not stay contracted
3. Apply an abdominal binder
4. Encourage ambulation to the shower

Answer: B. Uterine atony is the commonest cause of early postpartum haemorrhage; a displaced fundus points to a full bladder.

Question 10

On day 3 postpartum, a woman has a temperature of 38.5 °C, foul-smelling lochia and uterine tenderness. The most likely diagnosis and action are:

1. Normal involution; no action
2. Endometritis; notify the provider, obtain cultures as ordered, administer intravenous antibiotics and monitor for sepsis
3. Breast engorgement; warm compresses
4. Urinary retention; catheterise

Answer: B. Postpartum sepsis remains a leading cause of maternal death globally; early antibiotics are life-saving.

Question 11

A breastfeeding mother on day 4 has painful, hard, warm, swollen breasts with no fever. The nurse advises:

1. Stop breastfeeding for two days
2. Frequent feeding or expressing to relieve engorgement, warm compresses before feeds and cold compresses after, a well-fitting bra and analgesia, checking the baby's latch
3. Antibiotics immediately
4. Bind the breasts tightly

Answer: B. Engorgement is treated by milk removal. A localised red, hot wedge with fever suggests mastitis, which needs antibiotics while breastfeeding continues.

Question 12

Which postpartum finding requires urgent assessment for venous thromboembolism?

1. Mild perineal discomfort
2. Unilateral calf pain and swelling, or sudden chest pain and breathlessness, especially after caesarean section
3. Afterpains during breastfeeding
4. Night sweats

Answer: B. The puerperium is a high-thrombosis period; low-molecular-weight heparin prophylaxis is given after caesarean and to high-risk women.

Newborn care

Question 13

At one minute a newborn has a heart rate of 110, a strong cry, active movement, a grimace on suction and blue hands and feet. The Apgar score is:

1. 6
2. 8
3. 10
4. 4

Answer: B. Heart rate 2, respiration 2, tone 2, reflex irritability 1, colour 1 (acrocyanosis) gives 8, a normal score needing routine care.

Question 14

Which newborn vital signs are within normal limits?

1. Heart rate 80, respiratory rate 20, temperature 36.0 °C
2. Heart rate 120 to 160, respiratory rate 30 to 60, axillary temperature 36.5 to 37.5 °C
3. Heart rate 200, respiratory rate 80
4. Heart rate 100, respiratory rate 10

Answer: B. Grunting, nasal flaring, retractions or a respiratory rate persistently above 60 indicate respiratory distress and are reported.

Question 15

A term newborn weighing 4.3 kg, born to a mother with gestational diabetes, is jittery two hours after birth. The nurse's priority is:

1. Wrap the baby warmly and recheck tomorrow
2. Check blood glucose immediately, feed the baby, and follow the hypoglycaemia protocol with repeat testing and escalation if glucose remains low
3. Give oral rehydration solution
4. Place under phototherapy

Answer: B. Macrosomic infants of diabetic mothers have hyperinsulinaemia and are at high risk of hypoglycaemia in the first hours.

Question 16

Jaundice appearing in the first 24 hours of life is:

1. Physiological and expected
2. Always pathological until proven otherwise, requiring urgent bilirubin measurement and evaluation for haemolysis such as ABO or Rh incompatibility, with phototherapy according to the treatment chart
3. Caused by breastfeeding and harmless
4. Treated by sunlight exposure at home

Answer: B. Physiological jaundice appears after 24 hours and peaks at day 3 to 5. Kernicterus is the danger of untreated severe hyperbilirubinaemia.

Question 17

Immediately after birth, the measures to prevent hypothermia in a healthy term newborn include:

1. Bathing the baby within the first hour
2. Drying thoroughly, removing the wet towel, skin-to-skin contact with the mother, a hat, and delaying the first bath for at least 6 to 24 hours
3. Placing the baby under a fan
4. Keeping the baby in a cot away from the mother

Answer: B. Newborns lose heat rapidly by evaporation, conduction, convection and radiation; skin-to-skin also promotes breastfeeding.

Question 18

Which vaccines are given to a newborn at birth under most Gulf national schedules?

1. Measles and varicella
2. BCG and the first dose of hepatitis B vaccine, with hepatitis B immunoglobulin as well if the mother is HBsAg positive
3. Pneumococcal only
4. No vaccines until two months

Answer: B. Vitamin K is also given at birth to prevent haemorrhagic disease of the newborn.

Obstetric emergencies

Question 19

During a vaginal examination after membrane rupture, the nurse feels a pulsating loop of cord. The immediate actions are:

1. Push the cord back and continue
2. Call for help, keep the examining hand in place to lift the presenting part off the cord, position the woman knee-chest or in steep Trendelenburg, and prepare for emergency caesarean
3. Clamp and cut the cord
4. Encourage pushing

Answer: B. Cord prolapse compresses the cord and starves the fetus of oxygen; delivery is expedited.

Question 20

A woman with severe pre-eclampsia on a magnesium sulfate infusion has a respiratory rate of 10, absent patellar reflexes and a urine output of 20 mL/h. The nurse should:

1. Increase the infusion
2. Stop the infusion, call for help, give oxygen and prepare calcium gluconate 10% as the antidote, because these are signs of magnesium toxicity
3. Give a diuretic
4. Continue and reassess in an hour

Answer: B. Reflexes, respiratory rate and urine output are checked hourly during magnesium therapy; loss of reflexes precedes respiratory depression.

How to practise

• Learn the normal numbers for pregnancy, labour and the newborn; abnormal findings are tested against them.
• Memorise the emergencies as action sequences: PPH, cord prolapse, eclampsia, magnesium toxicity, neonatal hypoglycaemia.
• Know the fetal heart rate patterns and the intrauterine resuscitation steps.

Maternal and child chapters with explanations are in the Registered Nurse bank; related sets are the nursing sample questions, medical-surgical questions and pharmacology questions. The domain weighting is in the DHA nursing syllabus.

Frequently asked questions

How many maternal and newborn questions are in the Prometric nursing exam?

About 12 to 15 of 150, within the maternal and newborn domain, plus paediatric questions in a separate domain.

Which maternal topics come up most?

Pre-eclampsia and magnesium sulfate, fetal heart rate patterns, postpartum haemorrhage, and infection.

Which newborn topics come up most?

Apgar scoring, normal vital signs, hypoglycaemia in infants of diabetic mothers, jaundice and thermoregulation.

Do ICU or surgical nurses get these questions?

Yes. The registered nurse paper covers the whole blueprint regardless of your specialty.

Are these real exam questions?

No. They are original practice questions written to the published blueprint. Real exam content is confidential.