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Maternal and Newborn Nursing

Prenatal Care and Risk Assessment Practice Questions

20 free Prenatal Care and Risk Assessment practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.

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Question 1 of 20 Medium

A client presents for her first prenatal visit at 10 weeks gestation. Using Naegele's rule, what is the estimated date of delivery (EDD) if the client's last menstrual period (LMP) began on June 10?

  1. A March 3
  2. B March 17
  3. C March 10
  4. D April 17

Correct answer: March 17

To calculate Naegele's rule, subtract 3 months from the first day of the LMP and add 7 days and 1 year. June 10 minus 3 months is March 10, plus 7 days equals March 17.

Question 2 of 20 Medium

During a prenatal assessment, the nurse notes the client has a bluish-purple discoloration of the cervix and vaginal mucosa. How should the nurse document this finding?

  1. A Goodell's sign
  2. B Hegar's sign
  3. C Chadwick's sign
  4. D Ballottement sign

Correct answer: Chadwick's sign

Chadwick's sign is a probable sign of pregnancy characterized by a bluish color of the cervix and vagina due to increased vascularity. Goodell's sign refers to cervical softening, and Hegar's sign is the softening of the lower uterine segment.

Question 3 of 20 Medium

A pregnant client at 16 weeks gestation asks the nurse when she will begin to feel the baby move. What is the most appropriate response by the nurse?

  1. A 'You should have felt movement by 12 weeks.'
  2. B 'Most women feel fetal movement between 18 and 20 weeks.'
  3. C 'Fetal movement is usually not felt until the third trimester.'
  4. D 'Movement is only detectable by ultrasound at this stage.'

Correct answer: 'Most women feel fetal movement between 18 and 20 weeks.'

Quickening, the first perception of fetal movement, typically occurs between 18 and 20 weeks in primigravidas and as early as 16 weeks in multigravidas. At 16 weeks, it is normal not to have felt movement yet.

Question 4 of 20 Medium

A nurse is providing nutritional counseling to a pregnant client with a pre-pregnancy Body Mass Index (BMI) of 22.5. What is the recommended total weight gain for this client?

  1. A 11 to 20 lbs
  2. B 15 to 25 lbs
  3. C 25 to 35 lbs
  4. D 28 to 40 lbs

Correct answer: 25 to 35 lbs

For a client with a normal pre-pregnancy BMI (18.5–24.9), the recommended weight gain is 25 to 35 pounds. This supports adequate fetal growth while minimizing maternal postpartum weight retention.

Question 5 of 20 Medium

A client at 28 weeks gestation is scheduled for a 1-hour oral glucose tolerance test (OGTT). What instruction should the nurse provide?

  1. A 'You must fast for 12 hours before the test.'
  2. B 'The test is positive if your blood glucose is above 100 mg/dL.'
  3. C 'You'll drink a glucose solution; blood is drawn in 1 hour.'
  4. D 'This test definitively diagnoses gestational diabetes.'

Correct answer: 'You'll drink a glucose solution; blood is drawn in 1 hour.'

The 1-hour OGTT is a screening test that does not require fasting. A result of 130–140 mg/dL or higher is considered positive and requires a follow-up 3-hour glucose tolerance test for a definitive diagnosis.

Question 6 of 20 Medium

The nurse is reviewing the lab results of a client at 36 weeks gestation. Which result should be reported to the healthcare provider immediately?

  1. A Hemoglobin 11.2 g/dL
  2. B White blood cell count 12,000/mm3
  3. C Platelet count 85,000/mm3
  4. D Blood urea nitrogen (BUN) 12 mg/dL

Correct answer: Platelet count 85,000/mm3

A platelet count below 100,000/mm3 (thrombocytopenia) may indicate HELLP syndrome or preeclampsia and requires immediate intervention. A hemoglobin of 11.2 is common due to physiological anemia of pregnancy.

Question 7 of 20 Medium

Which immunization is contraindicated for a pregnant client during a prenatal visit?

  1. A Inactivated influenza vaccine
  2. B Tetanus, diphtheria, and acellular pertussis (Tdap)
  3. C Measles, mumps, and rubella (MMR)
  4. D Recombinant Hepatitis B

Correct answer: Measles, mumps, and rubella (MMR)

Live virus vaccines, such as MMR and Varicella, are contraindicated during pregnancy due to the theoretical risk of transmission to the fetus. Inactivated vaccines like the flu shot and Tdap are safe and recommended.

Question 8 of 20 Medium

A client in her second trimester complains of dizziness and feeling faint when lying on her back. Which action should the nurse recommend?

  1. A Increase daily oral fluid intake by at least 1 liter.
  2. B Lie on the left side with a pillow under the hip.
  3. C Wear compression stockings during the day.
  4. D Take an iron supplement with orange juice.

Correct answer: Lie on the left side with a pillow under the hip.

Supine hypotensive syndrome occurs when the heavy uterus compresses the inferior vena cava, reducing cardiac output. Turning to a lateral position (preferably the left side) relieves the pressure and improves blood flow.

Question 9 of 20 Medium

A nurse is performing a Leopold maneuver on a client at 38 weeks gestation. What is the primary purpose of this procedure?

  1. A To measure fundal height in centimeters for gestational dating.
  2. B To assess for the presence of a fluid wave.
  3. C To identify the location of the placenta.
  4. D To determine the fetal position, presentation, and lie.

Correct answer: To determine the fetal position, presentation, and lie.

Leopold maneuvers consist of four specific palpations used to determine fetal presentation and position. This information helps the nurse identify the best location to auscultate the fetal heart rate.

Question 10 of 20 Medium

A 24-year-old client is G3, P1. How should the nurse interpret this obstetric history?

  1. A Three pregnancies, one birth after 20 weeks.
  2. B Three pregnancies, one living child.
  3. C Two total pregnancies, one birth after 20 weeks.
  4. D One pregnancy, three births after 20 weeks.

Correct answer: Three pregnancies, one birth after 20 weeks.

Gravida (G) refers to the total number of pregnancies regardless of duration; Para (P) refers to the number of pregnancies that reached 20 weeks gestation. This client has been pregnant three times and had one pregnancy reach viability.

Question 11 of 20 Medium

A pregnant client at 32 weeks gestation reports a sudden gush of clear fluid from the vagina. What is the nurse's priority action?

  1. A Test the fluid with Nitrazine paper.
  2. B Perform a vaginal exam.
  3. C Advise the client to monitor for contractions at home.
  4. D Schedule a follow-up ultrasound for the next day.

Correct answer: Test the fluid with Nitrazine paper.

The gush of fluid suggests premature rupture of membranes (PROM). Nitrazine paper or a ferning test is used to confirm the presence of amniotic fluid (amniotic fluid is alkaline and turns the paper blue).

Question 12 of 20 Medium

Which discomfort of pregnancy is most commonly associated with the first trimester?

  1. A Leg cramps
  2. B Shortness of breath
  3. C Lower back pain
  4. D Urinary frequency

Correct answer: Urinary frequency

Urinary frequency occurs in the first trimester as the enlarging uterus exerts pressure on the bladder. It usually subsides in the second trimester as the uterus rises into the abdomen, and returns in the third trimester as the fetus descends.

Question 13 of 20 Medium

A nurse is providing teaching to a pregnant client with pica. Which laboratory value should the nurse prioritize for review?

  1. A Hemoglobin and hematocrit
  2. B Serum albumin
  3. C Liver enzymes
  4. D Serum creatinine and BUN levels

Correct answer: Hemoglobin and hematocrit

Pica, the consumption of non-food substances, is strongly associated with iron-deficiency anemia. The nurse should assess hemoglobin and hematocrit levels to determine if the client is anemic.

Question 14 of 20 Medium

A client at 12 weeks gestation reports severe, persistent vomiting and a weight loss of 5 lbs. Which condition does the nurse suspect?

  1. A Gestational hypertension
  2. B Morning sickness
  3. C Gestational trophoblastic disease
  4. D Hyperemesis gravidarum

Correct answer: Hyperemesis gravidarum

Hyperemesis gravidarum is characterized by excessive vomiting that leads to dehydration, electrolyte imbalances, and weight loss. It is much more severe than the typical 'morning sickness' of early pregnancy.

Question 15 of 20 Medium

The nurse is assessing a client's fundal height at 20 weeks gestation. Where does the nurse expect to palpate the fundus?

  1. A At the symphysis pubis
  2. B Halfway between the symphysis pubis and the umbilicus
  3. C At the xiphoid process
  4. D At the level of the umbilicus

Correct answer: At the level of the umbilicus

At 20 weeks gestation, the fundus is typically located at the level of the umbilicus. From 20 to 36 weeks, the fundal height in centimeters usually correlates with the weeks of gestation.

Question 16 of 20 Medium

A client is Rh-negative and at 28 weeks gestation. The indirect Coombs test is negative. What is the next nursing action?

  1. A Administer RhO(D) immune globulin as ordered.
  2. B No action is needed as the test is negative.
  3. C Prepare for an immediate amniocentesis.
  4. D Notify the provider that the client is sensitized.

Correct answer: Administer RhO(D) immune globulin as ordered.

A negative indirect Coombs test means the Rh-negative mother has not yet developed antibodies. RhO(D) immune globulin is administered at 28 weeks to prevent sensitization for the remainder of the pregnancy.

Question 17 of 20 Medium

Which of the following is a 'positive' sign of pregnancy?

  1. A Fetal heart tones heard by Doppler
  2. B Positive urine or serum pregnancy test
  3. C Amenorrhea
  4. D Uterine enlargement

Correct answer: Fetal heart tones heard by Doppler

Positive signs of pregnancy are objective findings that can only be attributed to a fetus: fetal heart tones, visualization of the fetus by ultrasound, and palpation of fetal movement by a trained clinician.

Question 18 of 20 Medium

A client at 35 weeks gestation reports a headache and blurry vision. Her blood pressure is 152/94 mmHg. Which additional finding would support a diagnosis of preeclampsia?

  1. A 1+ proteinuria
  2. B Glucosuria
  3. C Increased deep tendon reflexes (3+)
  4. D Peripheral edema

Correct answer: 1+ proteinuria

Preeclampsia is defined by hypertension (BP > 140/90) and the presence of proteinuria (1+ or more on dipstick) after 20 weeks gestation. Increased reflexes are a sign of worsening condition but proteinuria is a diagnostic criterion.

Question 19 of 20 Medium

The nurse is educating a client about Group B Streptococcus (GBS) screening. When is this test typically performed?

  1. A During the first prenatal visit
  2. B At 24 to 28 weeks gestation
  3. C Only if the client goes into preterm labor
  4. D At 35 to 37 weeks gestation

Correct answer: At 35 to 37 weeks gestation

GBS screening is performed via vaginal and rectal swabs between 35 and 37 weeks gestation. If positive, the client will receive intrapartum antibiotics to prevent transmission to the newborn during birth.

Question 20 of 20 Medium

A client asks the nurse why she needs to take folic acid during pregnancy. What is the best response?

  1. A It reduces the risk of neural tube defects in the baby.
  2. B It helps to prevent iron-deficiency anemia in the mother.
  3. C It ensures the baby develops strong bones.
  4. D It prevents gestational diabetes.

Correct answer: It reduces the risk of neural tube defects in the baby.

Adequate folic acid intake (400–800 mcg daily) before and during early pregnancy is essential to prevent neural tube defects, such as spina bifida and anencephaly.

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