2026 Maternal Proctored 2026 PN

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Sample questions from 2026 Maternal Proctored 2026 PN

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a postpartum unit, a licensed practical nurse (LPN/LVN) receives handoff report on four clients. Which client should the nurse collect data on first?

   • A.A 22-year-old client who is 12 hours postpartum with a saturated perineal pad in 15 minutes
   • B.A 34-year-old client who is 48 hours post-cesarean birth with hypoactive bowel sounds
   • C.A 19-year-old primipara who is 8 hours postpartum and has not yet voided
   • D.A 28-year-old client who is 24 hours postpartum reporting perineal soreness rating 4 out of 10

   Rationale: Saturating a perineal pad in 15 minutes or less indicates excessive blood loss and active postpartum hemorrhage, requiring immediate data collection, fundal massage, and emergency notification of the registered nurse and provider. Perineal soreness of 4 out of 10 is an expected finding 24 hours postpartum manageable with ice packs or ordered oral analgesics. Hypoactive bowel sounds are common 48 hours after cesarean delivery due to surgical manipulation and anesthesia. A client who has not voided 8 hours postpartum requires monitoring and bladder intervention, but hemorrhage poses the most immediate life-threatening physiological risk. The practical nurse must prioritize unstable circulatory compromise over routine recovery issues.

2. 2.While working in an antepartum clinic, the licensed practical nurse (LPN/LVN) is assisting the registered nurse (RN) with client care. Which task is appropriate to assign to the assistive personnel (AP)?

   • A.Determine if a client's uterine contractions are regular by manual palpation
   • B.Obtain the weight and blood pressure of a client at 28 weeks of gestation
   • C.Assess the severity of peripheral edema in a client diagnosed with gestational hypertension
   • D.Instruct a client at 36 weeks of gestation on how to perform daily fetal kick counts

   Rationale: Obtaining routine vital signs and physical measurements such as weight falls squarely within the scope of practice for assistive personnel (AP) caring for stable clients. Client teaching regarding fetal kick counts is a nursing responsibility requiring professional judgment, though an LPN/LVN may reinforce teaching once provided by the RN. Assessing edema severity and evaluating uterine contractions via palpation are assessment and clinical judgment activities that cannot be delegated to assistive personnel. The practical nurse must recognize tasks that involve standard measurement versus clinical evaluation.

3. 3.Refer to the client's chart. Which findings require immediate reporting to the supervising registered nurse? Select all that apply.

   • A.Client report of severe epigastric pain
   • B.Platelet count of 78000/mm3
   • C.Blood pressure change between 0730 and 0930
   • D.Baseline heart rate of 82 beats/min at 0730
   • E.Presence of 3+ patellar deep tendon reflexes and clonus
   • F.Trace pedal edema documented at 0730

   Rationale: A rapid rise in blood pressure to 164/104 mm Hg along with 3+ hyperreflexia with clonus, severe epigastric pain (suggesting hepatic capsular distention), and thrombocytopenia (platelets 78,000/mm3) indicate severe preeclampsia with features of HELLP syndrome, requiring immediate intervention to prevent eclamptic seizures or liver rupture. A baseline heart rate of 82 beats/min is a normal maternal cardiovascular finding. Trace pedal edema is a common, benign finding in late pregnancy and does not alone signify acute danger. The practical nurse must promptly recognize and escalate neurological, hepatic, and hematologic warning signs of severe preeclampsia.

4. 4.In the newborn nursery, the licensed practical nurse (LPN/LVN) is reviewing client assignments. Which infant should the nurse identify as having a finding that warrants immediate intervention and escalation to the registered nurse?

   • A.A 12-hour-old newborn with acrocyanosis of the hands and feet
   • B.A 24-hour-old breastfed newborn who has passed one dark green meconium stool
   • C.A 2-hour-old newborn with a blood glucose reading of 52 mg/dL
   • D.A 6-hour-old term newborn with a respiratory rate of 74 breaths/min and intercostal retractions

   Answer and rationale are in the full material.

5. 5.A client at 39 weeks of gestation in the labor and delivery triage area states, 'My water broke an hour ago and I feel something slipping down between my legs.' On visual inspection, the licensed practical nurse (LPN/LVN) observes a loop of umbilical cord protruding from the introitus. Which action should the nurse take first?

   • A.Prepare the client for immediate spontaneous vaginal birth
   • B.Attempt to gently push the umbilical cord back inside the cervical canal
   • C.Call for immediate help and assist the client into a knee-chest or modified Trendelenburg position
   • D.Administer oxygen at 2 L/min via nasal cannula

   Answer and rationale are in the full material.