KAPLAN OBSTETRIC NURSING ASSESSMENT EXAM
2026/2027 | Complete 300-Question Q&A with Verified
Answers & Detailed Rationales – Maternal-Newborn
Nursing Test Bank | Graded A+ | Exams 1-3 Bundle
EXAM AT A GLANCE
Feature Detail
Format Multiple-choice and scenario-based
Antepartum, Intrapartum, Postpartum, Newborn, High-Risk,
Domains
Pharmacology
Aligned
Kaplan Integrated Exams (Forms A, B, C) & NCLEX-RN
With
Focus Clinical judgment, prioritization, safety, evidence-based practice
SECTION 1: ANTEPARTUM NURSING – PRENATAL CARE & ASSESSMENT
1. A client at 34 weeks gestation presents with painless, bright red vaginal
bleeding. Which action is the priority for the nurse?
A) Perform a sterile vaginal exam
B) Initiate an external fetal heart rate monitor
C) Prepare the client for immediate induction of labor
D) Administer a vaginal prostaglandin suppository
Answer: B) Initiate an external fetal heart rate monitor
Rationale: Painless bright red bleeding at 34 weeks is indicative of placenta previa. A
sterile vaginal exam is strictly contraindicated as it can cause hemorrhage. Continuous
fetal monitoring is essential to assess fetal well-being.
,2. The nurse teaches a prenatal client about warning signs of pregnancy. Teaching
is successful if the client states she should contact the provider for:
A) Swelling of the hands and face
B) Breast tenderness
C) Frequent urination
D) Mild backache
Answer: A) Swelling of the hands and face
Rationale: Swelling of the hands and face may indicate preeclampsia and should be
reported. Breast tenderness, frequent urination, and mild backache are normal
pregnancy discomforts.
3. A client at 24 weeks gestation is scheduled for a glucose tolerance test. The
nurse instructs the client to:
A) Fast for 8-12 hours before the test
B) Eat a heavy meal before the test
C) Avoid carbohydrates for 24 hours
D) Drink the glucose solution in 5 minutes
Answer: A) Fast for 8-12 hours before the test
Rationale: For the 3-hour glucose tolerance test, the client must fast for 8-12 hours
before the test. The 1-hour glucose challenge test does not require fasting.
4. A client at 20 weeks' gestation reports feeling fetal movement for the first time.
The nurse documents this as:
A) Quickening
B) Lightening
C) Engagement
D) Effacement
Answer: A) Quickening
Rationale: Quickening is the maternal perception of fetal movement, typically felt
between 18 and 20 weeks in primigravidas and earlier in multigravidas.
,5. The nurse instructs a client about folic acid supplementation. Which statement
indicates successful teaching?
A) "Folic acid prevents preterm labor"
B) "Folic acid reduces the risk of neural tube defects"
C) "Folic acid treats gestational diabetes"
D) "Folic acid prevents hypertension"
Answer: B) "Folic acid reduces the risk of neural tube defects"
Rationale: Folic acid (400-800 mcg/day) significantly reduces neural tube defects like
spina bifida and anencephaly. It should be taken before conception and during the first
trimester.
6. A client at 28 weeks gestation is diagnosed with gestational diabetes. The nurse
understands that this condition is caused by:
A) Maternal obesity only
B) Decreased insulin production
C) Increased insulin resistance from placental hormones
D) Decreased maternal glucose levels
Answer: C) Increased insulin resistance from placental hormones
Rationale: Gestational diabetes is caused by increased insulin resistance due to placental
hormones (human placental lactogen, estrogen, progesterone). The pancreas tries to
compensate, but if it cannot, hyperglycemia results.
7. A client asks about the purpose of a screening ultrasound at 20-24 weeks. Which
is the appropriate response?
A) "To determine the exact day you will go into labor"
B) "To evaluate fetal anatomy and check placental location"
C) "To confirm that the fetus has reached lung maturity"
D) "To assess for maternal gestational diabetes"
Answer: B) "To evaluate fetal anatomy and check placental location"
, Rationale: An ultrasound around 20–24 weeks is primarily performed as an anatomy
scan to evaluate fetal structural development and check the position of the placenta.
8. A pregnant client asks about weight gain recommendations. The nurse should
explain that total weight gain for a client with normal BMI should be:
A) 15-25 pounds
B) 25-35 pounds
C) 28-40 pounds
D) 11-20 pounds
Answer: B) 25-35 pounds
Rationale: For a woman with normal BMI (18.5-24.9), recommended weight gain is 25-35
pounds. First trimester: 2-4 pounds; second and third trimesters: approximately 1 pound
per week.
9. A client at 16 weeks gestation presents to the clinic. She has a history of two
previous spontaneous abortions at 10 weeks, one term delivery at 39 weeks, and
one preterm delivery at 34 weeks. Both children are living. Using the GTPAL
system, how should the nurse document her obstetric history?
A) G4 T1 P1 A2 L2
B) G5 T1 P1 A2 L2
C) G4 T1 P2 A2 L2
D) G5 T2 P2 A1 L2
Answer: A) G4 T1 P1 A2 L2
Rationale: Gravida (G) includes all pregnancies: 4. Term (T) = 1 (39 weeks). Preterm (P) =
1 (34 weeks). Abortions (A) = 2 (spontaneous abortions at 10 weeks). Living (L) = 2
children.
10. A client at 8 weeks gestation is experiencing mild vaginal bleeding and
cramping. Upon examination, the cervix is closed. Which type of abortion is the
client experiencing?
2026/2027 | Complete 300-Question Q&A with Verified
Answers & Detailed Rationales – Maternal-Newborn
Nursing Test Bank | Graded A+ | Exams 1-3 Bundle
EXAM AT A GLANCE
Feature Detail
Format Multiple-choice and scenario-based
Antepartum, Intrapartum, Postpartum, Newborn, High-Risk,
Domains
Pharmacology
Aligned
Kaplan Integrated Exams (Forms A, B, C) & NCLEX-RN
With
Focus Clinical judgment, prioritization, safety, evidence-based practice
SECTION 1: ANTEPARTUM NURSING – PRENATAL CARE & ASSESSMENT
1. A client at 34 weeks gestation presents with painless, bright red vaginal
bleeding. Which action is the priority for the nurse?
A) Perform a sterile vaginal exam
B) Initiate an external fetal heart rate monitor
C) Prepare the client for immediate induction of labor
D) Administer a vaginal prostaglandin suppository
Answer: B) Initiate an external fetal heart rate monitor
Rationale: Painless bright red bleeding at 34 weeks is indicative of placenta previa. A
sterile vaginal exam is strictly contraindicated as it can cause hemorrhage. Continuous
fetal monitoring is essential to assess fetal well-being.
,2. The nurse teaches a prenatal client about warning signs of pregnancy. Teaching
is successful if the client states she should contact the provider for:
A) Swelling of the hands and face
B) Breast tenderness
C) Frequent urination
D) Mild backache
Answer: A) Swelling of the hands and face
Rationale: Swelling of the hands and face may indicate preeclampsia and should be
reported. Breast tenderness, frequent urination, and mild backache are normal
pregnancy discomforts.
3. A client at 24 weeks gestation is scheduled for a glucose tolerance test. The
nurse instructs the client to:
A) Fast for 8-12 hours before the test
B) Eat a heavy meal before the test
C) Avoid carbohydrates for 24 hours
D) Drink the glucose solution in 5 minutes
Answer: A) Fast for 8-12 hours before the test
Rationale: For the 3-hour glucose tolerance test, the client must fast for 8-12 hours
before the test. The 1-hour glucose challenge test does not require fasting.
4. A client at 20 weeks' gestation reports feeling fetal movement for the first time.
The nurse documents this as:
A) Quickening
B) Lightening
C) Engagement
D) Effacement
Answer: A) Quickening
Rationale: Quickening is the maternal perception of fetal movement, typically felt
between 18 and 20 weeks in primigravidas and earlier in multigravidas.
,5. The nurse instructs a client about folic acid supplementation. Which statement
indicates successful teaching?
A) "Folic acid prevents preterm labor"
B) "Folic acid reduces the risk of neural tube defects"
C) "Folic acid treats gestational diabetes"
D) "Folic acid prevents hypertension"
Answer: B) "Folic acid reduces the risk of neural tube defects"
Rationale: Folic acid (400-800 mcg/day) significantly reduces neural tube defects like
spina bifida and anencephaly. It should be taken before conception and during the first
trimester.
6. A client at 28 weeks gestation is diagnosed with gestational diabetes. The nurse
understands that this condition is caused by:
A) Maternal obesity only
B) Decreased insulin production
C) Increased insulin resistance from placental hormones
D) Decreased maternal glucose levels
Answer: C) Increased insulin resistance from placental hormones
Rationale: Gestational diabetes is caused by increased insulin resistance due to placental
hormones (human placental lactogen, estrogen, progesterone). The pancreas tries to
compensate, but if it cannot, hyperglycemia results.
7. A client asks about the purpose of a screening ultrasound at 20-24 weeks. Which
is the appropriate response?
A) "To determine the exact day you will go into labor"
B) "To evaluate fetal anatomy and check placental location"
C) "To confirm that the fetus has reached lung maturity"
D) "To assess for maternal gestational diabetes"
Answer: B) "To evaluate fetal anatomy and check placental location"
, Rationale: An ultrasound around 20–24 weeks is primarily performed as an anatomy
scan to evaluate fetal structural development and check the position of the placenta.
8. A pregnant client asks about weight gain recommendations. The nurse should
explain that total weight gain for a client with normal BMI should be:
A) 15-25 pounds
B) 25-35 pounds
C) 28-40 pounds
D) 11-20 pounds
Answer: B) 25-35 pounds
Rationale: For a woman with normal BMI (18.5-24.9), recommended weight gain is 25-35
pounds. First trimester: 2-4 pounds; second and third trimesters: approximately 1 pound
per week.
9. A client at 16 weeks gestation presents to the clinic. She has a history of two
previous spontaneous abortions at 10 weeks, one term delivery at 39 weeks, and
one preterm delivery at 34 weeks. Both children are living. Using the GTPAL
system, how should the nurse document her obstetric history?
A) G4 T1 P1 A2 L2
B) G5 T1 P1 A2 L2
C) G4 T1 P2 A2 L2
D) G5 T2 P2 A1 L2
Answer: A) G4 T1 P1 A2 L2
Rationale: Gravida (G) includes all pregnancies: 4. Term (T) = 1 (39 weeks). Preterm (P) =
1 (34 weeks). Abortions (A) = 2 (spontaneous abortions at 10 weeks). Living (L) = 2
children.
10. A client at 8 weeks gestation is experiencing mild vaginal bleeding and
cramping. Upon examination, the cervix is closed. Which type of abortion is the
client experiencing?
