How to Actually Use Saunders Comprehensive Review for the NCLEX-RN (Obstetrics Section)
The 6th edition of Saunders Comprehensive Review for the NCLEX-RN is not the same thing as the textbook most people actually want. If you are looking for Obstetrics Normal And Problem Pregnancies 6th Edition by Mary Lou Saunders and Kathleen Rice Simpson, that is a different book entirely. It is a foundational nursing text, not a test-prep review. Students mix them up constantly in the pharmacy aisle and at the library reshelving desk. That book covers maternal-newborn nursing across the continuum. The 6th edition was published around 2017 by Elsevier. It has sections on normal pregnancy, high-risk conditions, labor and delivery, postpartum care, and newborn transition. The clinical case studies are embedded throughout, and the evidence-based practice boxes are scattered in each chapter. It is dense. It assumes you already know basic anatomy and pharmacology from earlier courses. It does not walk you through IV drug calculations or the detailed mechanism of magnesium sulfate toxicity from scratch. I used this text as a primary reference when I was coordinating a maternal-fetal monitoring rotation at a community hospital. We had students who could recite the stages of labor but could not interpret aCategory II tracing without panicking. The book has a section on electronic fetal monitoring that is more detailed than most review guides, but it still requires some instructor guidance. The figures on uterine activity monitoring are accurate. The section on preeclampsia management reflects the ACOG guidelines from around 2013 to 2017. That part has aged reasonably well, though some of the medication dosing references should be cross-checked against current institutional protocols.
One edge case I ran into involves gestational diabetes screening. The 6th edition discusses the two-step Carpenter-Coustan method and the one-step IADPSG criteria. A resident once insisted that the book was outdated because our hospital used the one-step approach, but the text actually covers both and even compares outcomes. I told the resident to read pages 548 through 561 carefully instead of arguing. The real problem was that she had only read the summary tables, not the discussion sections. The full narrative explains why the choice between methods matters clinically, not just statistically. Skipping to the bullet points in that book is a common mistake that wastes everyone's time.
How to Obtain a Legal Copy
The 6th edition is under copyright. There is no legal free PDF available. If someone offers you one, it is pirated. I have seen students get flagged for it, and it is not worth the risk to your academic record. Here are the practical options:
Get the Full Details
- Purchase the hardcover or eBook from Elsevier's website or major retailers.
- Borrow it from your nursing school library. Reservations can take one to three weeks depending on demand.
- Check if your program has a required copy in the course pack. Many programs now use the 7th edition, so the 6th may still be in circulation at the library.
- Look for a used copy on Chegg, Amazon Marketplace, or AbeBooks. A used hardcover in decent condition typically runs between 60 and 120 dollars, sometimes less if the previous owner highlighted heavily.
The eBook version is available through Elsevier's VitalSource or RedShelf platforms. It includes the embedded multimedia content, which matters for the fetal monitoring videos. Those videos do not appear in the print version. If you buy the hardcover and only read the print pages, you are missing about twelve minutes of procedural demonstrations that instructors often reference during skills lab. The strength of this edition is its breadth. It covers conditions that other texts skip, like multiple gestation complications and the nuances of precipitous labor. The chapter on postpartum hemorrhage is thorough, with clear algorithms for uterine atony versus retained placenta. The pharmacology tables are useful for quick reference during clinical rotations. The weakness is that it is not a step-by-step procedural manual. It will tell you the classification of hypertensive disorders in pregnancy, but it will not walk you through the exact nursing interventions during a seizure event in real time. For that, you need the ACLS and PALS materials alongside it, plus whatever simulation labs your program provides.
Another limitation: the 6th edition predates several important updates. The WHO recommendations on intrapartum care changed after this publication. Some of the vaginal delivery positioning content reflects traditional supine and lithotomy positions more than the current evidence favoring lateral or upright positions. Cross-reference with the latest ACOG Practice Bulletins if you are studying for certification or preparing for clinicals at a hospital that has updated its protocols.
Practical Tips for Getting Through It
Read the chapter summaries first, then go back and hit the detailed sections. The book is structured so the summaries contain the high-yield facts, but the narratives contain the clinical reasoning. If you only read the summaries, you will know what preeclampsia is but not when to escalate care beyond what the textbook states. Use the case studies actively. Do not just read the scenario and flip to the answer. Write down your nursing priorities before looking at the provided rationale. This takes about three extra minutes per case, but it forces you to apply the content instead of passively recognizing it. If you are using this for exam prep rather than a course requirement, pair it with a question bank. The book itself does not have enough practice questions to replace dedicated NCLEX-style or certification question practice. The review questions at the end of each chapter are useful, but they are limited in number and do not always reflect the current item format used by the NCLEX or the RNC-OB exam.
The book runs approximately 1,100 pages. A realistic reading schedule for a nursing student taking this as a required text is about three to four weeks if you are reading two chapters per week alongside clinical rotations. Trying to power through it in a single weekend will leave you with surface-level familiarity at best. The content requires spacing and repetition to stick, especially the pharmacology and pathophysiology sections. ISBN for reference: 978-0-323-35621-8 for the hardcover. The eBook ISBN differs. Make sure you are matching the correct edition to your syllabus, because the 7th edition exists now and some professors have already switched to it. The differences between editions are not trivial, particularly in the gestational diabetes and postpartum depression chapters.
