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Essential Maternity Nursing Concepts for NCLEX

Apr 7, 2025

Maternity Nursing Review - NCLEX Questions and Answers

Fundal Height Measurement

  • Scenario: 24 weeks pregnant patient.
  • Normal Measurement: Fundal height after 20 weeks should be the number of weeks pregnant ± 2 cm.
    • Example: 24 weeks pregnant → 22 to 26 cm is normal.
  • Answer to Question: 26 cm (Option C).

APGAR Score Assessment

  • APGAR Components: Appearance, Pulse, Grimace, Activity, Respiration.
  • Scoring: Each category scored 0 to 2, max score is 10.
  • Scenario: 1-minute APGAR with specifics:
    • Heart rate: 140 bpm → Score 2
    • Strong cry → Score 2
    • Pink body, blue hands → Score 1
    • Flexion of limbs → Score 1
    • Newborn response (movement & cry) → Score 2
  • Total Score: 8 (Option D).

Fetal Heart Rate Decelerations

  • Types: Early, Variable, Late.
    • Early Deceleration: Due to head compression from uterine contractions (Answer: B).
    • Variable Deceleration: Due to umbilical cord compression.
    • Late Deceleration: Due to uteroplacental insufficiency.

Fetal Station

  • Definition: Baby's presenting part in pelvis.
  • Landmark: Ischial spine (not iliac spine).
  • Measurement: Above line - negative numbers; below line - positive numbers.
  • Scenario: +2 station → Baby is 2 cm below ischial spine (Answer: D).

Fundal Height Postpartum

  • Guideline: Decreases 1 cm per day postpartum.
  • Scenario: 2 days postpartum → Fundal height 2 cm below umbilicus (Answer: B).

Glucose Tolerance Test Interpretation

  • 3-Hour Test: Performed after failing 1-hour test.
  • Results: Fasting > 95 mg/dL, 1-hour > 180 mg/dL, 2-hour > 155 mg/dL, 3-hour > 140 mg/dL indicate gestational diabetes.
  • Scenario Result: 1 and 2-hour results abnormal; gestational diabetes.

Gravidity and Parity

  • Gravidity: Number of pregnancies.
  • Parity: Number of births after 20 weeks.
  • Scenario: First pregnancy with twins → Gravida 1, Para 1 (Answer: A).

Preeclampsia Management

  • Medication: Magnesium sulfate to prevent seizures.
  • Antidote: Calcium gluconate (Answer: D).

Naegele's Rule for Estimated Due Date

  • Formula: Last menstrual period - 3 months + 7 days + 1 year.
  • Scenario: LMP August 15, 2016 → EDD May 22, 2017.

Placental Abruption (Abruptio Placentae)

  • Symptoms: Dark red bleeding, hard abdomen, fetal distress, tender uterus.
  • Mnemonic: DETACHED.

Quickening

  • Definition: Feeling of fetal movement, termed 'quickening'.
  • Scenario: Described as fluttering, typical by 18 weeks (Answer: B).

Pregnancy Signs

  • Goodell's Sign: Softening of the cervix, probable sign of pregnancy.

Postpartum Uterus Assessment

  • Action: If uterus is soft and displaced, perform fundal massage and have the patient void.

True vs. False Labor

  • True Labor Characteristics: Regular contractions, changes in cervix, activity does not relieve pain.
  • Mnemonic for True Labor: TRUE (Timing, Radiating pain, Unable to relieve, Exam changes).

This summary includes essential concepts and clinical scenarios for understanding key maternity nursing topics, useful for NCLEX preparation.

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