Maternal and Child Health Nursing Pillitteri 8th Ed. Test Bank Actual Exam 2026/2027
– Complete 120 NCLEX-Style Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
SECTION A: Maternal-Newborn Nursing — Antepartum Care (Q1–Q15)
Q1: A client's last menstrual period (LMP) began July 10. Using Nägele's rule, the nurse
calculates the estimated date of delivery (EDD) as:
A. October 17
B. April 10
C. April 17 [CORRECT]
D. April 24
Correct Answer: C
Rationale: Nägele's rule subtracts 3 months and adds 7 days to the first day of the LMP
(July 10 → April 17). October 17 adds rather than subtracts months, April 10 omits the 7
days, and April 24 adds 14 days.
Q2: Which finding is a positive (diagnostic) sign of pregnancy?
A. Chadwick's sign
B. Visualization of the fetus on ultrasound [CORRECT]
C. Nausea and vomiting
D. Positive urine pregnancy test
Correct Answer: B
Rationale: Only fetal visualization by ultrasound, auscultation of fetal heart tones, and
fetal movement felt by the examiner are positive signs. Chadwick's sign is probable,
while nausea and urine testing are presumptive/probable indicators.
Q3: A client is currently pregnant. She delivered one son at 39 weeks, twins at 34 weeks
(both living), and has had two spontaneous abortions. Using GTPAL, her status is:
A. G4, T1, P1, A2, L2 [CORRECT]
B. G4, T1, P1, A2, L1
C. G5, T2, P1, A2, L3
D. G4, T2, P1, A1, L2
Correct Answer: A
,Rationale: She is pregnant now (G4), has 1 term birth, 1 preterm birth (the twins count
as one pregnancy), 2 abortions, and 2 living children (both twins). Options B and D
miscount living children or term births; C counts the current pregnancy twice.
Q4: At a prenatal visit, the nurse notes the fundal height is at the level of the umbilicus.
This finding most closely corresponds to a gestational age of about:
A. 12 weeks
B. 16 weeks
C. 24 weeks
D. 20 weeks [CORRECT]
Correct Answer: D
Rationale: The fundus reaches the umbilicus at approximately 20–22 weeks' gestation
and grows roughly 1 cm per week thereafter. By 12 and 16 weeks it is still below the
umbilicus, and by 24 weeks it is above it.
Q5: A client who is 8 weeks pregnant calls the clinic reporting bright red vaginal spotting
and mild lower abdominal cramping. The best nursing response is to:
A. Reassure her this is normal implantation bleeding
B. Tell her to increase fluids and rest without further evaluation
C. Instruct her to notify her provider immediately for evaluation of possible spontaneous
abortion [CORRECT]
D. Advise her to return in 4 weeks for routine care
Correct Answer: C
Rationale: Bright red bleeding with cramping in the first trimester may signal
spontaneous abortion or ectopic pregnancy and requires immediate provider
notification. Implantation bleeding occurs earlier, is scant, and lacks cramping.
Q6: A primigravida can expect to first perceive fetal movement (quickening) at
approximately:
A. 18–20 weeks [CORRECT]
B. 8–10 weeks
C. 24–26 weeks
D. 12–14 weeks
Correct Answer: A
Rationale: Primigravidas typically feel quickening at 18–20 weeks; multigravidas may
feel it earlier (as early as 16 weeks). Feeling movement at 8–12 weeks is not possible at
maternal perception level.
Q7: To reduce the risk of neural tube defects, the nurse teaches a client planning
pregnancy to take which supplement daily?
,A. Calcium 1000 mg
B. Folic acid 400 mcg [CORRECT]
C. Vitamin C 500 mg
D. Iron 65 mg
Correct Answer: B
Rationale: Folic acid 400 mcg daily, ideally begun before conception, reduces neural
tube defect risk. Calcium, vitamin C, and iron support other aspects of pregnancy but do
not prevent neural tube defects.
Q8: The nurse teaches a client at 30 weeks' gestation fetal movement counting. Which
instruction is correct?
A. Count movements only after breakfast each day
B. The baby must move every 10 minutes continuously throughout the day
C. Decreased fetal movement near term is always normal
D. Report if fewer than 10 movements are felt within 2 hours after lying on the side
following a meal [CORRECT]
Correct Answer: D
Rationale: The standard is at least 10 fetal movements within 2 hours; fewer requires
immediate provider notification. Decreased movement near term is never assumed to
be normal without evaluation.
Q9: An unsensitized Rh-negative client at 28 weeks' gestation should receive:
A. An indirect Coombs test every 2 weeks
B. Rho(D) immune globulin only after birth
C. Rho(D) immune globulin (RhoGAM) at 28 weeks [CORRECT]
D. No prophylaxis unless bleeding occurs
Correct Answer: C
Rationale: RhoGAM is routinely given at 28 weeks (and within 72 hours of birth if the
newborn is Rh-positive) to prevent anti-Rh antibody sensitization. Waiting until after
birth leaves the antepartum window unprotected.
Q10: A client at 12 weeks' gestation asks when the baby's heartbeat can first be heard
with a Doppler. The nurse replies:
A. "Not until about 20 weeks, using a fetoscope."
B. "It can usually be heard now, between 10 and 12 weeks." [CORRECT]
C. "Heart tones are only detected by ultrasound imaging."
D. "Fetal heart tones are audible after 16 weeks."
Correct Answer: B
, Rationale: Fetal heart tones are typically audible by Doppler at 10–12 weeks; a
fetoscope requires 18–20 weeks. Tones are detectable by Doppler, not only by
ultrasound imaging.
Q11: A pregnant client has an indoor cat. Which instruction about toxoplasmosis is
most appropriate?
A. "Ask someone else to change the cat litter, and wear gloves if gardening." [CORRECT]
B. "You only need to worry if the cat appears ill."
C. "Antibiotics for the cat will eliminate your risk."
D. "Toxoplasmosis poses no risk after the first trimester."
Correct Answer: A
Rationale: Toxoplasma oocysts in cat feces and soil can cause serious fetal infection,
so litter duty and gardening should be delegated or done with gloves. Cats may appear
healthy while shedding oocysts, and infection is dangerous throughout pregnancy.
Q12: Following a 16-week genetic amniocentesis, the priority nursing action is to:
A. Encourage the client to resume vigorous exercise immediately
B. Expect the amniotic fluid to be dark green
C. Instruct the client to keep her bladder full for 24 hours
D. Monitor fetal heart rate and fetal movement, and administer Rho(D) immune globulin
if she is Rh negative [CORRECT]
Correct Answer: D
Rationale: Post-amniocentesis care focuses on monitoring FHR and fetal activity for
distress and giving RhoGAM to Rh-negative clients. Normal fluid is clear/pale straw, and
strenuous activity should be avoided.
Q13: A client at 26 weeks' gestation reports regularly eating ice and laundry starch
(pica). The nurse recognizes this may indicate:
A. A benign habit requiring no follow-up
B. Excessive calcium intake
C. Iron-deficiency anemia, warranting provider notification [CORRECT]
D. A prediction that the newborn will crave sweets
Correct Answer: C
Rationale: Pica is associated with iron-deficiency anemia and requires assessment of
hemoglobin/hematocrit and provider notification. Dismissing it or attributing it to
folklore risks missing maternal-fetal compromise.
Q14: For a pregnant client with a normal pre-pregnancy BMI, total recommended weight
gain is:
A. 11–20 lb
– Complete 120 NCLEX-Style Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
SECTION A: Maternal-Newborn Nursing — Antepartum Care (Q1–Q15)
Q1: A client's last menstrual period (LMP) began July 10. Using Nägele's rule, the nurse
calculates the estimated date of delivery (EDD) as:
A. October 17
B. April 10
C. April 17 [CORRECT]
D. April 24
Correct Answer: C
Rationale: Nägele's rule subtracts 3 months and adds 7 days to the first day of the LMP
(July 10 → April 17). October 17 adds rather than subtracts months, April 10 omits the 7
days, and April 24 adds 14 days.
Q2: Which finding is a positive (diagnostic) sign of pregnancy?
A. Chadwick's sign
B. Visualization of the fetus on ultrasound [CORRECT]
C. Nausea and vomiting
D. Positive urine pregnancy test
Correct Answer: B
Rationale: Only fetal visualization by ultrasound, auscultation of fetal heart tones, and
fetal movement felt by the examiner are positive signs. Chadwick's sign is probable,
while nausea and urine testing are presumptive/probable indicators.
Q3: A client is currently pregnant. She delivered one son at 39 weeks, twins at 34 weeks
(both living), and has had two spontaneous abortions. Using GTPAL, her status is:
A. G4, T1, P1, A2, L2 [CORRECT]
B. G4, T1, P1, A2, L1
C. G5, T2, P1, A2, L3
D. G4, T2, P1, A1, L2
Correct Answer: A
,Rationale: She is pregnant now (G4), has 1 term birth, 1 preterm birth (the twins count
as one pregnancy), 2 abortions, and 2 living children (both twins). Options B and D
miscount living children or term births; C counts the current pregnancy twice.
Q4: At a prenatal visit, the nurse notes the fundal height is at the level of the umbilicus.
This finding most closely corresponds to a gestational age of about:
A. 12 weeks
B. 16 weeks
C. 24 weeks
D. 20 weeks [CORRECT]
Correct Answer: D
Rationale: The fundus reaches the umbilicus at approximately 20–22 weeks' gestation
and grows roughly 1 cm per week thereafter. By 12 and 16 weeks it is still below the
umbilicus, and by 24 weeks it is above it.
Q5: A client who is 8 weeks pregnant calls the clinic reporting bright red vaginal spotting
and mild lower abdominal cramping. The best nursing response is to:
A. Reassure her this is normal implantation bleeding
B. Tell her to increase fluids and rest without further evaluation
C. Instruct her to notify her provider immediately for evaluation of possible spontaneous
abortion [CORRECT]
D. Advise her to return in 4 weeks for routine care
Correct Answer: C
Rationale: Bright red bleeding with cramping in the first trimester may signal
spontaneous abortion or ectopic pregnancy and requires immediate provider
notification. Implantation bleeding occurs earlier, is scant, and lacks cramping.
Q6: A primigravida can expect to first perceive fetal movement (quickening) at
approximately:
A. 18–20 weeks [CORRECT]
B. 8–10 weeks
C. 24–26 weeks
D. 12–14 weeks
Correct Answer: A
Rationale: Primigravidas typically feel quickening at 18–20 weeks; multigravidas may
feel it earlier (as early as 16 weeks). Feeling movement at 8–12 weeks is not possible at
maternal perception level.
Q7: To reduce the risk of neural tube defects, the nurse teaches a client planning
pregnancy to take which supplement daily?
,A. Calcium 1000 mg
B. Folic acid 400 mcg [CORRECT]
C. Vitamin C 500 mg
D. Iron 65 mg
Correct Answer: B
Rationale: Folic acid 400 mcg daily, ideally begun before conception, reduces neural
tube defect risk. Calcium, vitamin C, and iron support other aspects of pregnancy but do
not prevent neural tube defects.
Q8: The nurse teaches a client at 30 weeks' gestation fetal movement counting. Which
instruction is correct?
A. Count movements only after breakfast each day
B. The baby must move every 10 minutes continuously throughout the day
C. Decreased fetal movement near term is always normal
D. Report if fewer than 10 movements are felt within 2 hours after lying on the side
following a meal [CORRECT]
Correct Answer: D
Rationale: The standard is at least 10 fetal movements within 2 hours; fewer requires
immediate provider notification. Decreased movement near term is never assumed to
be normal without evaluation.
Q9: An unsensitized Rh-negative client at 28 weeks' gestation should receive:
A. An indirect Coombs test every 2 weeks
B. Rho(D) immune globulin only after birth
C. Rho(D) immune globulin (RhoGAM) at 28 weeks [CORRECT]
D. No prophylaxis unless bleeding occurs
Correct Answer: C
Rationale: RhoGAM is routinely given at 28 weeks (and within 72 hours of birth if the
newborn is Rh-positive) to prevent anti-Rh antibody sensitization. Waiting until after
birth leaves the antepartum window unprotected.
Q10: A client at 12 weeks' gestation asks when the baby's heartbeat can first be heard
with a Doppler. The nurse replies:
A. "Not until about 20 weeks, using a fetoscope."
B. "It can usually be heard now, between 10 and 12 weeks." [CORRECT]
C. "Heart tones are only detected by ultrasound imaging."
D. "Fetal heart tones are audible after 16 weeks."
Correct Answer: B
, Rationale: Fetal heart tones are typically audible by Doppler at 10–12 weeks; a
fetoscope requires 18–20 weeks. Tones are detectable by Doppler, not only by
ultrasound imaging.
Q11: A pregnant client has an indoor cat. Which instruction about toxoplasmosis is
most appropriate?
A. "Ask someone else to change the cat litter, and wear gloves if gardening." [CORRECT]
B. "You only need to worry if the cat appears ill."
C. "Antibiotics for the cat will eliminate your risk."
D. "Toxoplasmosis poses no risk after the first trimester."
Correct Answer: A
Rationale: Toxoplasma oocysts in cat feces and soil can cause serious fetal infection,
so litter duty and gardening should be delegated or done with gloves. Cats may appear
healthy while shedding oocysts, and infection is dangerous throughout pregnancy.
Q12: Following a 16-week genetic amniocentesis, the priority nursing action is to:
A. Encourage the client to resume vigorous exercise immediately
B. Expect the amniotic fluid to be dark green
C. Instruct the client to keep her bladder full for 24 hours
D. Monitor fetal heart rate and fetal movement, and administer Rho(D) immune globulin
if she is Rh negative [CORRECT]
Correct Answer: D
Rationale: Post-amniocentesis care focuses on monitoring FHR and fetal activity for
distress and giving RhoGAM to Rh-negative clients. Normal fluid is clear/pale straw, and
strenuous activity should be avoided.
Q13: A client at 26 weeks' gestation reports regularly eating ice and laundry starch
(pica). The nurse recognizes this may indicate:
A. A benign habit requiring no follow-up
B. Excessive calcium intake
C. Iron-deficiency anemia, warranting provider notification [CORRECT]
D. A prediction that the newborn will crave sweets
Correct Answer: C
Rationale: Pica is associated with iron-deficiency anemia and requires assessment of
hemoglobin/hematocrit and provider notification. Dismissing it or attributing it to
folklore risks missing maternal-fetal compromise.
Q14: For a pregnant client with a normal pre-pregnancy BMI, total recommended weight
gain is:
A. 11–20 lb
