G A L E N C O L L E G E O F N U R S I N G · A S S O C I AT E D E G R E E N U R S I N G P R O G R A M
NUR 254 Exam 1
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Maternal-Newborn Nursing — Childbearing & Child Caring
Families
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Maternal-Newborn Nursing 2
NUR 254 · Galen College of Nursing Page 1
,NUR 254 EXAM 1 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Maternal-Newborn Nursing — Childbearing & Child Caring
Families
1 The nurse is reviewing a client's medical record and notes the abbreviation GTPAL.
What does the "T" in GTPAL represent?
A Total pregnancies
B Term births
C Trimester at delivery
D Time since last pregnancy
Correct Answer: B In the GTPAL system, "T" stands for Term births — the number of
pregnancies that reached 37 weeks or greater. GTPAL stands for Gravida, Pre-term, Term,
Abortion, Living.
A — Total pregnancies is represented by "G" (Gravida), not "T."
C — Trimester at delivery is not a component of the GTPAL system.
D — Time since last pregnancy is not part of the GTPAL abbreviation.
Tested Concept: GTPAL acronym
Source Concept: GPTAL — Gravida, Pre-term, term, abortion, living
,2 A nurse is assessing a pregnant client who reports breast tenderness, fatigue, and
amenorrhea. The nurse should document these findings as which type of signs of
pregnancy?
A Presumptive signs
B Probable signs
C Positive signs
D Diagnostic signs
Correct Answer: A Presumptive signs of pregnancy are subjective and include breast
tenderness, amenorrhea, and fatigue. These are experienced by the client but are not
definitive for pregnancy.
B — Probable signs include objective findings such as positive pregnancy test, Hegar's sign,
and Chadwick's sign.
C — Positive signs definitively confirm pregnancy, such as fetal heartbeat, visualization, and
palpating movement.
D — Diagnostic signs is not a standard classification for signs of pregnancy.
Tested Concept: Presumptive signs of pregnancy
Source Concept: Signs of pregnancy: Presumptive (Subjective) — breast tenderness, amenorrhea,
fatigue
, 3 A client who is 8 weeks pregnant asks the nurse to explain the difference between
"probable" and "positive" signs of pregnancy. Which response by the nurse is
correct?
A "Probable signs are subjective, and positive signs are objective."
B "Probable signs are experienced by the client, while positive signs are measured by
the provider."
C "Probable signs may indicate pregnancy but are not definitive, while positive signs
confirm pregnancy."
D "Probable signs occur in the first trimester, while positive signs occur in the third
trimester."
Correct Answer: C Probable signs (such as positive pregnancy test, Hegar's sign,
Chadwick's sign) suggest pregnancy but may have other causes. Positive signs (fetal
heartbeat, visualization, movement) definitively confirm pregnancy.
A — This reverses the correct understanding; presumptive signs are subjective, while
probable signs are objective but not definitive.
B — Probable signs are objective findings by the provider, not subjective experiences.
D — Timing is not the distinguishing factor; both types of signs can occur at various points.
Tested Concept: Probable vs. positive signs of pregnancy
Source Concept: Signs of pregnancy: Probable — pregnancy test, hegar, ballotments, goodell sign,
Chadwick. Signs of pregnancy: Positive — heart beat, visualization, palpating movement
NUR 254 Exam 1
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Maternal-Newborn Nursing — Childbearing & Child Caring
Families
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Maternal-Newborn Nursing 2
NUR 254 · Galen College of Nursing Page 1
,NUR 254 EXAM 1 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Maternal-Newborn Nursing — Childbearing & Child Caring
Families
1 The nurse is reviewing a client's medical record and notes the abbreviation GTPAL.
What does the "T" in GTPAL represent?
A Total pregnancies
B Term births
C Trimester at delivery
D Time since last pregnancy
Correct Answer: B In the GTPAL system, "T" stands for Term births — the number of
pregnancies that reached 37 weeks or greater. GTPAL stands for Gravida, Pre-term, Term,
Abortion, Living.
A — Total pregnancies is represented by "G" (Gravida), not "T."
C — Trimester at delivery is not a component of the GTPAL system.
D — Time since last pregnancy is not part of the GTPAL abbreviation.
Tested Concept: GTPAL acronym
Source Concept: GPTAL — Gravida, Pre-term, term, abortion, living
,2 A nurse is assessing a pregnant client who reports breast tenderness, fatigue, and
amenorrhea. The nurse should document these findings as which type of signs of
pregnancy?
A Presumptive signs
B Probable signs
C Positive signs
D Diagnostic signs
Correct Answer: A Presumptive signs of pregnancy are subjective and include breast
tenderness, amenorrhea, and fatigue. These are experienced by the client but are not
definitive for pregnancy.
B — Probable signs include objective findings such as positive pregnancy test, Hegar's sign,
and Chadwick's sign.
C — Positive signs definitively confirm pregnancy, such as fetal heartbeat, visualization, and
palpating movement.
D — Diagnostic signs is not a standard classification for signs of pregnancy.
Tested Concept: Presumptive signs of pregnancy
Source Concept: Signs of pregnancy: Presumptive (Subjective) — breast tenderness, amenorrhea,
fatigue
, 3 A client who is 8 weeks pregnant asks the nurse to explain the difference between
"probable" and "positive" signs of pregnancy. Which response by the nurse is
correct?
A "Probable signs are subjective, and positive signs are objective."
B "Probable signs are experienced by the client, while positive signs are measured by
the provider."
C "Probable signs may indicate pregnancy but are not definitive, while positive signs
confirm pregnancy."
D "Probable signs occur in the first trimester, while positive signs occur in the third
trimester."
Correct Answer: C Probable signs (such as positive pregnancy test, Hegar's sign,
Chadwick's sign) suggest pregnancy but may have other causes. Positive signs (fetal
heartbeat, visualization, movement) definitively confirm pregnancy.
A — This reverses the correct understanding; presumptive signs are subjective, while
probable signs are objective but not definitive.
B — Probable signs are objective findings by the provider, not subjective experiences.
D — Timing is not the distinguishing factor; both types of signs can occur at various points.
Tested Concept: Probable vs. positive signs of pregnancy
Source Concept: Signs of pregnancy: Probable — pregnancy test, hegar, ballotments, goodell sign,
Chadwick. Signs of pregnancy: Positive — heart beat, visualization, palpating movement
