If you want to pass the Next Generation NCLEX on the first try but are struggling with the maternity section, then this episode is a must-watch for you!
Maternity nursing can be a difficult subject, but not anymore after you listen to this episode.
In it, I’ll be sharing with you 10 Next Generation NCLEX maternity questions and answers you can use to practice for the NGN.
Plus, as a bonus, I also share with you a few FREE flashcards you can use to study.
Are you ready to ace the NCLEX?
Then tune in now!
Hydatidiform Mole Flashcard
Hydatidiform mole is a degenerative anomaly of the chorionic villi, which is an abnormal pregnancy. It’s a rare complication of pregnancy. Curettage is performed to completely remove all molar tissue. A non-viable fertilized egg implants in the uterus, so if there is an embryo, it will not survive. The tumor must be removed.
Now let’s apply what you just learned to the following question:
Question #1: The 25-year-old patient was just informed that she is diagnosed with a hydatidiform mole. Which of the following statements demonstrates the nurse’s understanding of hydatidiform mole?
- Hydatidiform mole is a common complication of pregnancy
- The embryo will not survive
- Hydatidiform mole is a benign tumor that does not need to be removed
- The embryo has a 75% probable chance of surviving
Answer: The embryo will not survive.
Rationale: Hydatidiform mole is a rare complication of a non-viable pregnancy. There is rarely a fetus, but if there is, then there is rarely a heartbeat. There is no probable chance of the embryo surviving. Hydatidiform is usually a benign tumor, but it can turn cancerous so it needs to be removed.
GTPAL Flashcard
Gravida is the number of times the patient got pregnant. T is term births, which is the number of times a baby has been born 37+ weeks of gestation. P is preterm births, which is the number of times a baby has been born between 20 and 37 weeks of gestation. A is abortion, which is pregnancy losses before 20 weeks. L is living children, which is the number of children that are living.
Let’s apply what you just learned to the following question:
Question #2: A 28-year-old female patient is currently 10-weeks pregnant with no living children. Five years ago she had 2 miscarriages at 10 and 12-weeks gestation. What is her GTPAL?
- G=3, T=0, P=2, A=0, L=0
- G=3, T=0, P=0, A=2, L=0
- G=1, T=0, P=2, A=0, L=0
- G=1, T=0, P=0, A=2, L=0
Answer: G=3, T=0, P=0, A=2, L=0.
Rationale: G is gravida, which is the number of times she was pregnant. We can narrow the choices down to A and B because she was pregnant three times. T stands for term, which is the number of times a baby has been born at 37-weeks gestation. None of her pregnancy made it to term so the total should be at 0. All four choices already have T and L at 0. L is the number of children that are living. So to select A or B, you have to determine if her two miscarriages are considered P or A. P is the number of times a baby has been born between 20 and 37 weeks of pregnancy. A is pregnancy losses prior to 20 weeks. We know she had 2 miscarriages at 10 and 12 weeks so we can conclude that the correct answer is b.
Nonstress Test Flashcard
When performing a nonstress test, we want to see two or more fetal heart rate accelerations that exceed the baseline by 15 beats/minute or more and last longer than 15 seconds within a 20-minute period.
This nonstress test monitors the fetal heart rate and does not place stress on the fetus as the test is being performed. We want two or more fetal heart rate accelerations, which is a reactive nonstress test.
Let’s apply what you just learned to the following question:
Question #3: A 32-year-old pregnant patient just had a nonstress test completed. The nurse noted that the results are three fetal heart rate accelerations of at least 15 beats/min that lasted 15 seconds with fetal movement during a 20-minute period. What would the results be documented as?
- Nonreactive stress test
- Reactive stress test
- Nonreactive nonstress test
- Reactive nonstress test
Answer: Reactive nonstress test.
Rationale: We can narrow down the answers to c and d because a nonstress test was completed. We will remove the choices that state “stress test”. If you forget about the flashcard, you can look at the question and note that the first sentence states that a nonstress test was completed. Now we need to determine if it is reactive or nonreactive. Three fetal heart rate accelerations of at least 15 beats/min that lasted 15 seconds with fetal movement during a 20-minute period sounds like the fetus is reacting to the nonstress test. You can then conclude that the correct answer is 4.
Contraindicated Antibiotics During Pregnancy Flashcard
What kind of cat should not be dealing with a pregnant patient? An MCAT! I did not make this mnemonic up, but I absolutely love sharing them with you.
The antibiotics that should be avoided when pregnant are Metronidazole, Chloramphenicol, Aminoglycoside, and Tetracycline (aka MCAT).
Let’s apply what you just learned to the following question:
Question #4: The nurse is about to administer an antibiotic to a 25-year-old pregnant patient. Which of the following antibiotics is safe to take during pregnancy?
- Azithromycin
- Chloromycetin
- Doxycycline
- Tobramycin
Answer: Azithromycin.
Rationale: Azithromycin is one of the antibiotics that are safe to take during pregnancy from the macrolide family. If you did not know this, you’d have to complete the process of elimination as it wasn’t one of the medications listed on the flashcard that is contraindicated.
Chloromycetin is from the chloramphenicol family. Note that they both start with Chlor-. Doxycycline is from the tetracycline family so it is contraindicated. Note that they both end in -cycline. Tobramycin is from the aminoglycoside family so it is contraindicated. I can’t really help you here, but you just need to remember -mycin ending usually indicates that the medication is from the aminoglycoside family.
Placenta Previa Flashcard
To manage placenta previa, bed rest is advised and an ultrasound is performed every two to three weeks for fetal surveillance. Marginal placenta previa is when the placenta implantation occurs in the margin of the cervical os. This means that the placenta is touching the cervix, but not covering it. It does not cover the os. Low-lying placenta previa is when the placenta implantation occurs in the lower uterine segment and does not reach the cervical os.
Let’s apply what you just learned to the following question:
Question #5: The nurse is providing care for a 31-year-old female pregnant patient. The placenta implantation is noted to be in the lower uterine segment. Which of the following should be performed for the patient?
- Amniocentesis
- Nonstress test
- Ultrasound every two weeks and bed rest
- CT scan
Answer: Ultrasound every two weeks and bed rest.
Rationale: First, note that this is a low-lying placenta previa, when the placenta implantation is noted to be in the lower uterine segment. The placenta should attach at the top or the side of the uterus. If the placenta attaches in the lower part of the uterus, close to or over the cervical opening, then this is an abnormal finding called placenta previa.
After noting that this is a low-lying placenta previa, the nurse should know what management would be done for the patient. Amniocentesis is done for genetic testing and for fetal assessment. It would not be performed for placenta previa. Nonstress test is done to monitor fetal heart rate accelerations, which is irrelevant to monitoring the condition of placenta previa. CT scan would not be completed for placenta previa.
Bed rest is recommended for the patient and an ultrasound is completed to diagnose and monitor a patient with placenta previa so the correct answer is 3.
First of Leopold’s Maneuvers Flashcards
To determine the fetal position and presentation, the nurse performs Leopold’s Maneuvers by palpating the maternal abdomen. Take a look at the flashcard above, First of Leopold’s Maneuvers.
Fundal grip is also known as the first of Leopold’s Maneuvers. This is performed by placing both hands over the abdomen with the fingers placed around the fundus. The size, consistency, shape, and mobility is noted upon assessment.
Let’s apply what you just learned to the following question:
Question #6: The nurse is providing care for a pregnant patient and is about to perform Leopold’s Maneuvers. Which of the four Leopold’s Maneuvers is used to determine the size, consistency, shape, and mobility of the fetus to identify the form?
- First maneuver
- Second maneuver
- Third maneuver
- Fourth maneuver
Answer: First maneuver.
Rationale: The nurse performs the First maneuver to assess the size, consistency, shape, and mobility of the fetus. The second maneuver is performed to determine the location of the fetal back. The third maneuver is performed to determine what fetal part is above the inlet, and the fourth maneuver is performed to locate the fetus’ brow.
Rh Status Flashcard
If the mother is Rh negative and the fetus is Rh positive, then Rh immunoglobulin must be given to the mother. To remember this, think of a fetus always being a positive thing. The mother attacking the fetus would be a negative thing. If the baby’s blood mixes with the mother’s blood, the mother’s antibodies will attack the baby’s Rh-positive blood.
Let’s apply what you just learned to this question:
Question #7: The pregnant patient has Rh negative blood while the fetus has Rh positive blood. The nurse understands that which of the following statements is true?
- Rh immunoglobulin must be given to the fetus.
- Rh immunoglobulin must be given to the mother.
- Rh immunoglobulin must be given to both the fetus and the mother.
- Rh immunoglobulin must not be given either to the fetus or the mother.
Answer: Rh immunoglobulin must be given to the mother.
Rationale: If the mother is Rh negative and the fetus is Rh positive, then Rh immunoglobulin must be given to the mother. The Rh immunoglobulin would not be given to the fetus. If the mother is Rh positive, Rh immunoglobulin would not need to be given.
Variable Decelerations Flashcard
Variable decelerations means that there is a possible obstruction to the fetal blood flow, which is usually caused by cord compression. Variable decelerations are noted when the fetal heart rate decreases by 15 beats per minute or more, occurs for 15 seconds or greater, and the duration is less than two minutes. Usually, the nurse would adjust the mother’s position.
Let’s apply what you just learned to the following question:
Question #8: The nurse providing care for the pregnant patient should understand the different types of deceleration and the signs and symptoms to watch out for. Which of the following decelerations is caused by cord compression?
- Pressure deceleration
- Late deceleration
- Early deceleration
- Variable deceleration
Answer: Variable deceleration.
Rationale: Variable decelerations are caused by cord compression. Pressure deceleration is not a type of deceleration. Early deceleration is caused by head compression. Late deceleration is caused by placental insufficiency.
FHR Patterns Flashcard
Fetal Heart Rate Patterns can be noted by VEAL CHOP. Variable decelerations are caused by cord compression. Early deceleration is caused by head compression. It’s not alarming if acceleration is noted so that’s why it says OK no problem! Late deceleration is caused by placental insufficiency.
Let’s apply what you just learned to the following question:
Question #9: The nurse is providing care for a pregnant patient and notes late deceleration when assessing the fetal heart rate. Which of the following is the cause of late deceleration?
- It is a normal finding
- Cord compression
- Placental insufficiency
- Head compression
Answer: Placental insufficiency.
Rationale: If you can remember VEAL CHOP, you can attach the CHOP to the VEAL and recall the cause of each type of deceleration and acceleration. Variable decelerations are caused by cord compression. Early deceleration is caused by head compression. It’s not alarming if acceleration is noted so that’s why it says OK no problem! Late deceleration is caused by placental insufficiency.
Uterine Contractions Flashcard
Increment is the longest phase. Acme is the peak of the contraction. Decrement is the letting-down phase. Uterine contractions should be less than 90 seconds in duration when the patient is receiving oxytocin.
Let’s apply what you just learned to the question below:
Question #10: A nurse is providing education and teaching the nursing student how to measure contractions. Which of the following statements correctly demonstrates the nursing student’s understanding of uterine contractions?
- Decrement is the peak of the contraction.
- Increment is the fall of the contraction.
- Acme is the start of the contraction.
- Decrement is the fall of the contraction.
Answer: Decrement is the fall of the contraction.
Rationale: Contractions are measured by the duration, intensity, and frequency. The nursing student should know that increment is the longest phase, which is the beginning or rise of the contraction, acme is the peak of the contraction, and decrement is the letting-down phase, which is the fall of the contraction.
