RNSG 1517 A Maternity ATI/NCLEX Preparation |
High-Yield Practice Questions & Rationales Complete
Questions with Correct Answers and Detailed
Rationales - Latest Update 2026
Question 1
A nurse is reviewing the prenatal record of a client who is currently 32
weeks pregnant. The client has a 3-year-old child born at 39 weeks, a 5-
year-old child born at 37 weeks, and a history of a spontaneous
abortion at 10 weeks gestation. What is the client's GTPAL score?
A. G4 T2 P0 A1 L2
B. G3 T2 P0 A1 L2
C. G4 T1 P1 A1 L2
D. G4 T2 P1 A0 L2
Correct Answer: A. G4 T2 P0 A1 L2
Detailed Rationale: GTPAL stands for Gravidity (total pregnancies = 4),
Term births (>= 37 weeks = 2), Preterm births (20-36 weeks = 0),
Abortions/miscarriages (< 20 weeks = 1), and Living children (= 2).
Question 2
Which normal cardiovascular adaptation occurs during the second
trimester of pregnancy?
A. Increased systemic vascular resistance
,B. Increased blood pressure due to vasoconstriction
C. Decreased pulse rate by 20 beats/min
D. Increased cardiac output and plasma volume expansion
Correct Answer: D. Increased cardiac output and plasma volume
expansion
Detailed Rationale: During pregnancy, cardiac output increases by 30%
to 50%, and plasma volume increases significantly (40-50%) to meet
metabolic demands, while systemic vascular resistance and blood
pressure typically decrease during the second trimester.
Question 3
A prenatal client at 10 weeks gestation has laboratory results indicating
a non-immune rubella titer. What is the appropriate nursing action?
A. Administer the subcutaneous rubella vaccine immediately during the
first trimester.
B. Inform the client that the vaccine will be administered in the
immediate postpartum period.
C. Instruct the client to avoid all children for the remainder of the
pregnancy.
D. Administer immune globulin immediately to prevent congenital
anomalies.
Correct Answer: B. Inform the client that the vaccine will be
administered in the immediate postpartum period.
Detailed Rationale: The rubella vaccine is a live-attenuated virus and is
contraindicated during pregnancy due to the risk of teratogenic effects
,on the fetus. Non-immune clients should receive the vaccine
postpartum before discharge.
Question 4
A nurse is providing pre-procedure instructions to a client at 16 weeks
gestation scheduled for an amniocentesis. Which instruction should the
nurse include?
A. "You must maintain a completely full bladder throughout the
procedure."
B. "You should empty your bladder completely just before the
procedure begins."
C. "You must fast from all foods and fluids for 24 hours prior."
D. "You will need to remain on bed rest in the hospital for 48 hours
post-procedure."
Correct Answer: B. "You should empty your bladder completely just
before the procedure begins."
Detailed Rationale: In early pregnancy (15-20 weeks), an empty bladder
reduces the risk of accidental bladder puncture during amniocentesis.
In late pregnancy, a full bladder may be needed to elevate the uterus.
Question 5
A nurse is evaluating a non-stress test (NST) for a client at 34 weeks
gestation. Which finding indicates a reactive NST?
A. No accelerations during a 20-minute continuous recording
B. At least two fetal heart rate accelerations of 15 beats/min above
baseline lasting at least 15 seconds within a 20-minute window
, C. Variable decelerations occurring with 30% of fetal movements
D. Baseline fetal heart rate of 100 beats/min with absent variability
Correct Answer: B. At least two fetal heart rate accelerations of 15
beats/min above baseline lasting at least 15 seconds within a 20-minute
window
Detailed Rationale: A reactive NST requires at least two qualifying
accelerations (15 bpm above baseline for 15 seconds) within 20
minutes, indicating an intact fetal autonomic nervous system and
adequate oxygenation.
Question 6
Which five parameters are evaluated during a biophysical profile (BPP)
ultrasound assessment?
A. Maternal blood pressure, heart rate, temperature, weight, urine
output
B. Fetal breathing movements, gross body movements, fetal tone,
amniotic fluid volume, and non-stress test (NST)
C. Fetal heart rate baseline, variability, accelerations, decelerations, and
contractions
D. Placental maturity, umbilical cord length, cervical dilation,
effacement, and station
Correct Answer: B. Fetal breathing movements, gross body movements,
fetal tone, amniotic fluid volume, and non-stress test (NST)
High-Yield Practice Questions & Rationales Complete
Questions with Correct Answers and Detailed
Rationales - Latest Update 2026
Question 1
A nurse is reviewing the prenatal record of a client who is currently 32
weeks pregnant. The client has a 3-year-old child born at 39 weeks, a 5-
year-old child born at 37 weeks, and a history of a spontaneous
abortion at 10 weeks gestation. What is the client's GTPAL score?
A. G4 T2 P0 A1 L2
B. G3 T2 P0 A1 L2
C. G4 T1 P1 A1 L2
D. G4 T2 P1 A0 L2
Correct Answer: A. G4 T2 P0 A1 L2
Detailed Rationale: GTPAL stands for Gravidity (total pregnancies = 4),
Term births (>= 37 weeks = 2), Preterm births (20-36 weeks = 0),
Abortions/miscarriages (< 20 weeks = 1), and Living children (= 2).
Question 2
Which normal cardiovascular adaptation occurs during the second
trimester of pregnancy?
A. Increased systemic vascular resistance
,B. Increased blood pressure due to vasoconstriction
C. Decreased pulse rate by 20 beats/min
D. Increased cardiac output and plasma volume expansion
Correct Answer: D. Increased cardiac output and plasma volume
expansion
Detailed Rationale: During pregnancy, cardiac output increases by 30%
to 50%, and plasma volume increases significantly (40-50%) to meet
metabolic demands, while systemic vascular resistance and blood
pressure typically decrease during the second trimester.
Question 3
A prenatal client at 10 weeks gestation has laboratory results indicating
a non-immune rubella titer. What is the appropriate nursing action?
A. Administer the subcutaneous rubella vaccine immediately during the
first trimester.
B. Inform the client that the vaccine will be administered in the
immediate postpartum period.
C. Instruct the client to avoid all children for the remainder of the
pregnancy.
D. Administer immune globulin immediately to prevent congenital
anomalies.
Correct Answer: B. Inform the client that the vaccine will be
administered in the immediate postpartum period.
Detailed Rationale: The rubella vaccine is a live-attenuated virus and is
contraindicated during pregnancy due to the risk of teratogenic effects
,on the fetus. Non-immune clients should receive the vaccine
postpartum before discharge.
Question 4
A nurse is providing pre-procedure instructions to a client at 16 weeks
gestation scheduled for an amniocentesis. Which instruction should the
nurse include?
A. "You must maintain a completely full bladder throughout the
procedure."
B. "You should empty your bladder completely just before the
procedure begins."
C. "You must fast from all foods and fluids for 24 hours prior."
D. "You will need to remain on bed rest in the hospital for 48 hours
post-procedure."
Correct Answer: B. "You should empty your bladder completely just
before the procedure begins."
Detailed Rationale: In early pregnancy (15-20 weeks), an empty bladder
reduces the risk of accidental bladder puncture during amniocentesis.
In late pregnancy, a full bladder may be needed to elevate the uterus.
Question 5
A nurse is evaluating a non-stress test (NST) for a client at 34 weeks
gestation. Which finding indicates a reactive NST?
A. No accelerations during a 20-minute continuous recording
B. At least two fetal heart rate accelerations of 15 beats/min above
baseline lasting at least 15 seconds within a 20-minute window
, C. Variable decelerations occurring with 30% of fetal movements
D. Baseline fetal heart rate of 100 beats/min with absent variability
Correct Answer: B. At least two fetal heart rate accelerations of 15
beats/min above baseline lasting at least 15 seconds within a 20-minute
window
Detailed Rationale: A reactive NST requires at least two qualifying
accelerations (15 bpm above baseline for 15 seconds) within 20
minutes, indicating an intact fetal autonomic nervous system and
adequate oxygenation.
Question 6
Which five parameters are evaluated during a biophysical profile (BPP)
ultrasound assessment?
A. Maternal blood pressure, heart rate, temperature, weight, urine
output
B. Fetal breathing movements, gross body movements, fetal tone,
amniotic fluid volume, and non-stress test (NST)
C. Fetal heart rate baseline, variability, accelerations, decelerations, and
contractions
D. Placental maturity, umbilical cord length, cervical dilation,
effacement, and station
Correct Answer: B. Fetal breathing movements, gross body movements,
fetal tone, amniotic fluid volume, and non-stress test (NST)
