NLE NP II Review: Maternal Care, Newborn, Growth and Development

NLE NP II Review: Maternal Care, Newborn, Growth and Development

Nursing Practice II is the second test on Day 1 of the NLE (11:30 a.m.–1:30 p.m., 2 hours). The current PRC program titles it in two parts: Care of Mother, Adolescent (Well Clients), At Risk or With Problems and Human Growth and Development. Pediatric illnesses by body system can also show up in NP III and NP IV, so the child-health section below is worth covering either way.

PRC doesn't publish an item breakdown by topic. This post goes with the NLE guide.

Antepartum care

Drill list:

Pregnancy physiology:

• Signs: presumptive (subjective), probable (objective), positive (definitive)
• Hormonal changes: hCG, estrogen, progesterone, hPL
• Cardiovascular changes: increased blood volume (40-50%), increased cardiac output, physiological anemia
• Other systems: respiratory, renal, GI changes
• GTPAL system for parity (gravida, term, preterm, abortion, living)

Prenatal care:

• Visit schedule: the classic textbook pattern (monthly to 28 weeks, every 2 weeks to 36, then weekly)
• Naegele's rule: LMP - 3 months + 7 days + 1 year
• Routine labs: blood type, Rh, CBC, urinalysis, GBS at 35-37 weeks, 1-hour glucose at 24-28 weeks
• Prenatal vitamins: folic acid (400-800 mcg), iron
• Diet, exercise, danger signs

Common complications:

• Hyperemesis gravidarum
• Gestational diabetes
• Preeclampsia: classic triad (hypertension, proteinuria, edema), severe features, magnesium sulfate (toxicity: respiratory depression, decreased reflexes — antidote calcium gluconate)
• Eclampsia: seizure prevention, magnesium
• Placenta previa: painless bright red bleeding, no vaginal exam
• Placental abruption: painful dark red bleeding, rigid abdomen
• Ectopic pregnancy: methotrexate vs surgical
• Spontaneous abortion: types (threatened, inevitable, incomplete, complete, missed)
• HELLP syndrome
• Rh incompatibility: RhoGAM at 28 weeks and within 72 hours postpartum

Intrapartum care

Drill list:

Labor stages:

• Stage 1 (latent + active + transition): cervical dilation 0-10 cm
• Stage 2: full dilation to delivery
• Stage 3: delivery to placental expulsion
• Stage 4: first 1-4 hours postpartum

Fetal monitoring:

• Fetal heart rate baseline: 110-160
• Variability: absent, minimal, moderate, marked
• Accelerations vs decelerations:

- Early decelerations: head compression, benign - Late decelerations: utero-placental insufficiency, concerning, position change + O2 + IV bolus - Variable decelerations: cord compression, position change first

Pain management:

• Non-pharmacological: positioning, breathing, hydrotherapy, doula support
• Pharmacological: opioids (concerns at delivery), epidural (contraindications, complications)

Complications:

• Preterm labor: tocolytics (magnesium, indomethacin, nifedipine), corticosteroids for fetal lung maturity
• Premature rupture of membranes
• Cord prolapse: emergency, knee-chest position, lift presenting part off cord, no cord manipulation
• Shoulder dystocia: McRoberts maneuver
• Postpartum hemorrhage: causes (4 Ts — tone, trauma, tissue, thrombin)
• Uterine rupture
• Amniotic fluid embolism

Postpartum care

Drill list:

Maternal recovery:

• Fundal assessment: should be midline, firm, descending 1 fingerbreadth/day
• Lochia: rubra (1-3 days), serosa (4-10 days), alba (10+ days). Foul-smelling = infection
• BUBBLE-HE assessment: Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/Edema, Homan's, Emotional
• Postpartum complications: hemorrhage, infection (endometritis), DVT, thromboembolism, depression vs blues vs psychosis

Breastfeeding:

• Anatomy of let-down reflex
• Engorgement management
• Mastitis: continue breastfeeding, antibiotics, warm compresses
• Common medications safety in breastfeeding

Newborn care

Drill list:

Immediate post-delivery:

• APGAR score (HR, respiratory effort, muscle tone, reflex, color) at 1 and 5 minutes
• Vitamin K injection (prevents hemorrhagic disease)
• Erythromycin eye prophylaxis
• Hepatitis B first dose
• Cord care
• Essential Intrapartum and Newborn Care (EINC, "Unang Yakap"): immediate drying, skin-to-skin contact, properly timed cord clamping, and breastfeeding started within the first hour

Newborn assessment:

• Vital signs ranges (HR 120-160, RR 30-60, T 36.5-37.5)
• Reflexes: moro, rooting, sucking, palmar grasp, plantar grasp, Babinski (positive in newborn), tonic neck, stepping
• Common variations: vernix, lanugo, milia, mongolian spots, stork bites, erythema toxicum
• Concerning findings: cyanosis, jaundice within 24h (pathological), poor feeding, lethargy

Common newborn conditions:

• Physiological vs pathological jaundice (bilirubin nomogram)
• Hypoglycemia (especially in IDM, SGA, LGA)
• Respiratory distress syndrome (premature infants)
• Meconium aspiration
• TORCH infections
• Congenital anomalies: cleft lip/palate, congenital heart defects, neural tube defects
• Phenylketonuria (PKU) screening

Pediatrics

Growth and development by age:

Erikson's stages applied:

• Trust vs Mistrust (0-1y)
• Autonomy vs Shame and Doubt (1-3y)
• Initiative vs Guilt (3-6y)
• Industry vs Inferiority (6-12y)
• Identity vs Role Confusion (12-18y)

Common pediatric conditions:

• Otitis media
• Bronchiolitis (RSV)
• Croup vs epiglottitis
• Asthma
• GERD in infants
• Pyloric stenosis (projectile vomiting, olive-shaped mass)
• Intussusception (red currant jelly stool)
• Hirschsprung's disease
• Sickle cell crisis
• Leukemia
• Cystic fibrosis
• Type 1 diabetes onset

Immunization (DOH Expanded Program on Immunization): know the current DOH schedule. Its core is BCG and hepatitis B at birth; pentavalent vaccine, OPV and PCV at 6, 10 and 14 weeks; IPV; and a measles-containing vaccine at 9 and 12 months. Also know cold-chain basics and common contraindications.

Pediatric emergencies

• Respiratory distress: signs (retractions, nasal flaring, grunting, accessory muscle use), management
• Dehydration: assessment (capillary refill, mucous membranes, fontanelle, urine output)
• Seizures: febrile seizure (most common), status epilepticus
• Burns: rule of nines (modified for children), fluid resuscitation
• Foreign body airway obstruction by age

Family planning

Drill list:

• Natural methods: calendar, BBT, cervical mucus, symptothermal
• Barrier methods: condoms, diaphragm, cervical cap
• Hormonal: combined OCPs, POPs, patches, ring, depot, implant
• IUD: copper (10y), levonorgestrel
• Permanent: vasectomy, tubal ligation
• Emergency contraception
• Contraindications: combined OCPs in HTN, smokers over 35, history of DVT/stroke
• The Responsible Parenthood and Reproductive Health Act (RA 10354)

A 4-week plan

Review with Super Tutor

Super Tutor's NLE reviewer covers reproductive health and family planning, antepartum/intrapartum/postpartum care, high-risk pregnancy, newborn and neonatal nursing, and pediatric nursing, each in 11 study formats with practice quizzes at three difficulty levels. There's an AI tutor for any question, plus full mock exams from a bank of 4,300+ NLE-style questions. Start free — 5-day trial, no card.

What to read next

The NLE guide anchors the full review. Other topic reviews: med-surg (NP III and GI from NP IV) and psychiatric nursing (NP V). The 60% floor rule explainer is essential context.