Maternity Nursing NGN Practice Exam
41 Questions with Rationales | Antepartum, High-Risk Pregnancy, Labour and Birth, Postpartum,
Newborn
Every question is written in NGN style with a full rationale in the green box. Cover the box, answer first, then
check your reasoning.
Part 1: Normal Pregnancy and Antepartum Care
Question 1
Which finding is considered a POSITIVE (objective) sign of pregnancy?
A. Amenorrhea
B. A positive home pregnancy (hCG) test
C. Fetal heartbeat heard by Doppler and fetus seen on ultrasound
D. Quickening reported by the mother
Answer: C
Why: Positive signs can only be caused by pregnancy: fetal heartbeat, fetal movement felt by the examiner, or
visualization of the fetus. hCG is a probable sign; amenorrhea and quickening are presumptive.
Question 2
A client reports the first day of her last menstrual period was July 10. Using Naegele's rule, what is
her estimated date of delivery?
A. April 3
B. April 10
C. April 17
D. May 17
Answer: C
Why: Naegele's rule: subtract 3 months and add 7 days. July 10 minus 3 months is April 10, plus 7 days is
April 17.
Question 3
A pregnant client has a 3-year-old born at 39 weeks, twins born at 35 weeks who are alive, and one
miscarriage at 10 weeks. What is her GTPAL?
A. G3 T1 P1 A0 L3
B. G4 T1 P1 A1 L3
C. G4 T2 P1 A1 L3
D. G3 T2 P0 A1 L2
Answer: B
Why: Gravida counts every pregnancy including the current one: 4. Term (37 weeks or more) is 1, Preterm is 1
(the twin pregnancy counts once), Abortions is 1 (the miscarriage), and Living children is 3.
For personal study use only — not for redistribution. Page 1
, Question 4
Which cardiovascular change is expected during a normal pregnancy?
A. Decreased total blood volume
B. Cardiac output increases by about 30 to 50 percent
C. Rising hematocrit throughout pregnancy
D. A decrease in resting heart rate
Answer: B
Why: Blood volume rises about 40 to 50 percent and cardiac output increases 30 to 50 percent. Because
plasma rises more than red cells, hematocrit drops (physiologic anemia of pregnancy), and heart rate
increases slightly.
Question 5
To best reduce the risk of neural tube defects, when should folic acid supplementation ideally
begin?
A. Only after a positive pregnancy test
B. Before conception and through early pregnancy
C. In the third trimester
D. During labour
Answer: B
Why: Neural tube closure happens very early, so folic acid (400 to 600 mcg) is most protective when started
before conception and continued through the first trimester.
Question 6
Which symptom reported during pregnancy should be treated as a danger sign and reported
immediately?
A. Mild ankle swelling at the end of the day
B. Occasional Braxton Hicks contractions
C. Vaginal bleeding
D. Urinary frequency in the first trimester
Answer: C
Why: Vaginal bleeding can signal serious complications such as placenta previa, abruption, or miscarriage and
must be evaluated. The others are common, expected findings.
Question 7
At what point in pregnancy is screening for gestational diabetes typically performed?
A. 6 to 8 weeks
B. 12 to 16 weeks
C. 24 to 28 weeks
D. 36 to 40 weeks
Answer: C
Why: Routine gestational diabetes screening (glucose tolerance testing) is done at 24 to 28 weeks, when
placental hormones most affect insulin resistance.
For personal study use only — not for redistribution. Page 2
41 Questions with Rationales | Antepartum, High-Risk Pregnancy, Labour and Birth, Postpartum,
Newborn
Every question is written in NGN style with a full rationale in the green box. Cover the box, answer first, then
check your reasoning.
Part 1: Normal Pregnancy and Antepartum Care
Question 1
Which finding is considered a POSITIVE (objective) sign of pregnancy?
A. Amenorrhea
B. A positive home pregnancy (hCG) test
C. Fetal heartbeat heard by Doppler and fetus seen on ultrasound
D. Quickening reported by the mother
Answer: C
Why: Positive signs can only be caused by pregnancy: fetal heartbeat, fetal movement felt by the examiner, or
visualization of the fetus. hCG is a probable sign; amenorrhea and quickening are presumptive.
Question 2
A client reports the first day of her last menstrual period was July 10. Using Naegele's rule, what is
her estimated date of delivery?
A. April 3
B. April 10
C. April 17
D. May 17
Answer: C
Why: Naegele's rule: subtract 3 months and add 7 days. July 10 minus 3 months is April 10, plus 7 days is
April 17.
Question 3
A pregnant client has a 3-year-old born at 39 weeks, twins born at 35 weeks who are alive, and one
miscarriage at 10 weeks. What is her GTPAL?
A. G3 T1 P1 A0 L3
B. G4 T1 P1 A1 L3
C. G4 T2 P1 A1 L3
D. G3 T2 P0 A1 L2
Answer: B
Why: Gravida counts every pregnancy including the current one: 4. Term (37 weeks or more) is 1, Preterm is 1
(the twin pregnancy counts once), Abortions is 1 (the miscarriage), and Living children is 3.
For personal study use only — not for redistribution. Page 1
, Question 4
Which cardiovascular change is expected during a normal pregnancy?
A. Decreased total blood volume
B. Cardiac output increases by about 30 to 50 percent
C. Rising hematocrit throughout pregnancy
D. A decrease in resting heart rate
Answer: B
Why: Blood volume rises about 40 to 50 percent and cardiac output increases 30 to 50 percent. Because
plasma rises more than red cells, hematocrit drops (physiologic anemia of pregnancy), and heart rate
increases slightly.
Question 5
To best reduce the risk of neural tube defects, when should folic acid supplementation ideally
begin?
A. Only after a positive pregnancy test
B. Before conception and through early pregnancy
C. In the third trimester
D. During labour
Answer: B
Why: Neural tube closure happens very early, so folic acid (400 to 600 mcg) is most protective when started
before conception and continued through the first trimester.
Question 6
Which symptom reported during pregnancy should be treated as a danger sign and reported
immediately?
A. Mild ankle swelling at the end of the day
B. Occasional Braxton Hicks contractions
C. Vaginal bleeding
D. Urinary frequency in the first trimester
Answer: C
Why: Vaginal bleeding can signal serious complications such as placenta previa, abruption, or miscarriage and
must be evaluated. The others are common, expected findings.
Question 7
At what point in pregnancy is screening for gestational diabetes typically performed?
A. 6 to 8 weeks
B. 12 to 16 weeks
C. 24 to 28 weeks
D. 36 to 40 weeks
Answer: C
Why: Routine gestational diabetes screening (glucose tolerance testing) is done at 24 to 28 weeks, when
placental hormones most affect insulin resistance.
For personal study use only — not for redistribution. Page 2
