D447 Women’s & Children’s Health Comprehensive Assessment 2026 UPDATE
1. A nurse is calculating the GTPAL for a client who is currently 20 weeks pregnant, has a 4-
year-old born at 39 weeks, a 2-year-old born at 34 weeks, and had one miscarriage at 10
weeks. What is the correct GTPAL?
A. G3, T2, P0, A1, L2
B. G4, T1, P1, A1, L2
C. G4, T2, P1, A0, L2
D. G3, T1, P1, A1, L2
Answer: B
Rationale: G (gravida) is 4 (current, plus 3 previous). T (term) is 1 (39-weeker). P
(preterm) is 1 (34-weeker). A (abortion/miscarriage) is 1 (10-weeker). L (living) is 2.
2. Which fetal heart rate pattern is most indicative of uteroplacental insufficiency?
A. Early decelerations
B. Accelerations
C. Variable decelerations
D. Late decelerations
Answer: D
,Rationale: Late decelerations are caused by uteroplacental insufficiency and are
considered a non-reassuring sign requiring intervention.
3. A nurse is caring for a client in the transition phase of labor. Which clinical manifestation
should the nurse expect?
A. Dilation of 0 to 3 cm and talkative behavior
B. Dilation of 4 to 7 cm and serious expression
C. Dilation of 8 to 10 cm and urge to push
D. Dilation of 1 to 2 cm and mild contractions
Answer: C
Rationale: Transition is the final part of the first stage of labor, characterized by 8-10 cm
dilation, intense contractions, and often a feeling of loss of control or the urge to push.
4. A client at 32 weeks gestation is diagnosed with preeclampsia. Which of the following
findings should the nurse report to the provider immediately?
A. 1+ pedal edema
B. Right upper quadrant pain
C. Urinary output of 50 mL/hr
D. Blood pressure of 138/88 mmHg
Answer: B
, Rationale: Right upper quadrant (epigastric) pain can indicate liver involvement (HELLP
syndrome) and is a sign of worsening preeclampsia.
5. What is the primary purpose of administering Magnesium Sulfate to a client with
preeclampsia?
A. To lower blood pressure
B. To prevent seizures
C. To increase urine output
D. To strengthen uterine contractions
Answer: B
Rationale: While Magnesium Sulfate has a mild vasodilatory effect, its primary clinical
purpose in preeclampsia is seizure prophylaxis (preventing eclampsia).
6. A newborn has a heart rate of 110, a weak cry, some flexion of extremities, grimace when
stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 5
B. 6
C. 7
D. 8
Answer: B
1. A nurse is calculating the GTPAL for a client who is currently 20 weeks pregnant, has a 4-
year-old born at 39 weeks, a 2-year-old born at 34 weeks, and had one miscarriage at 10
weeks. What is the correct GTPAL?
A. G3, T2, P0, A1, L2
B. G4, T1, P1, A1, L2
C. G4, T2, P1, A0, L2
D. G3, T1, P1, A1, L2
Answer: B
Rationale: G (gravida) is 4 (current, plus 3 previous). T (term) is 1 (39-weeker). P
(preterm) is 1 (34-weeker). A (abortion/miscarriage) is 1 (10-weeker). L (living) is 2.
2. Which fetal heart rate pattern is most indicative of uteroplacental insufficiency?
A. Early decelerations
B. Accelerations
C. Variable decelerations
D. Late decelerations
Answer: D
,Rationale: Late decelerations are caused by uteroplacental insufficiency and are
considered a non-reassuring sign requiring intervention.
3. A nurse is caring for a client in the transition phase of labor. Which clinical manifestation
should the nurse expect?
A. Dilation of 0 to 3 cm and talkative behavior
B. Dilation of 4 to 7 cm and serious expression
C. Dilation of 8 to 10 cm and urge to push
D. Dilation of 1 to 2 cm and mild contractions
Answer: C
Rationale: Transition is the final part of the first stage of labor, characterized by 8-10 cm
dilation, intense contractions, and often a feeling of loss of control or the urge to push.
4. A client at 32 weeks gestation is diagnosed with preeclampsia. Which of the following
findings should the nurse report to the provider immediately?
A. 1+ pedal edema
B. Right upper quadrant pain
C. Urinary output of 50 mL/hr
D. Blood pressure of 138/88 mmHg
Answer: B
, Rationale: Right upper quadrant (epigastric) pain can indicate liver involvement (HELLP
syndrome) and is a sign of worsening preeclampsia.
5. What is the primary purpose of administering Magnesium Sulfate to a client with
preeclampsia?
A. To lower blood pressure
B. To prevent seizures
C. To increase urine output
D. To strengthen uterine contractions
Answer: B
Rationale: While Magnesium Sulfate has a mild vasodilatory effect, its primary clinical
purpose in preeclampsia is seizure prophylaxis (preventing eclampsia).
6. A newborn has a heart rate of 110, a weak cry, some flexion of extremities, grimace when
stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 5
B. 6
C. 7
D. 8
Answer: B
