G ALE N C O LLE G E O F NURS I NG
E X A M 2 · P RAC TI C E REVI EW
NUR 231 Maternal Nursing
Actual-Style Questions,
Answers & Rationales
A complete 70-question multiple-choice practice exam covering
antepartum, intrapartum, postpartum, and newborn care, with the
correct answer and a detailed rationale provided for every item.
Course NUR 231 — Maternal Nursing
Total Questions 70
Format Multiple Choice (A–D)
Answer Key Inline, with Rationales
Coverage Full Course Breadth
2 0 2 6 E D I TI ON · GUARANTEE-PASS STU DY SE RI E S
,NUR 231 Exam 2 - Maternal Nursing Practice Review with Rationales
NUR 231 Exam 2 - Maternal Nursing
70 Questions | Correct Answers and Detailed Rationales Included | 2026 Edition
Choose the single best response for each item. The correct answer and a detailed rationale follow each
question, so review carefully before moving on. These items cover the full breadth of maternal nursing
content: antepartum care, labor and birth, the postpartum period, and newborn care.
1. A nurse is calculating the estimated date of birth (EDB) for a client whose
last menstrual period (LMP) began on February 10. Using Naegele's rule,
which date should the nurse identify as the estimated date of birth?
A. November 14
B. November 10
C. November 17
D. December 3
Correct Answer: C
Rationale: Naegele's rule is calculated by subtracting 3 months from the first day of the LMP, adding 7
days, and adjusting the year as needed. February 10 minus 3 months equals November 10, and adding 7
days gives November 17. The other options result from adding or subtracting the months and days in the
wrong order, so they should be eliminated.
2. A client who is currently pregnant has a history of one full-term vaginal birth,
one set of twins delivered at 35 weeks of gestation (both twins living), and one
spontaneous miscarriage at 10 weeks. How should the nurse document this client
using the GTPAL system?
A. G3 T1 P1 A1 L3
B. G4 T1 P1 A1 L3
C. G4 T1 P2 A1 L3
D. G4 T2 P1 A1 L4
Correct Answer: B
Rationale: GTPAL stands for gravida, term births, preterm births, abortions, and living children.
Gravida counts the current pregnancy, making this client a G4. The twins at 35 weeks count as one
preterm birth event (P1), not two, and the living children total three (the term child plus both twins). This
makes the correct documentation G4 T1 P1 A1 L3.
Galen College of Nursing | 2026 Edition 1
,NUR 231 Exam 2 - Maternal Nursing Practice Review with Rationales
3. During a prenatal visit, the nurse is reviewing assessment findings that
confirm a client's pregnancy. Which of the following is considered a positive
(diagnostic) sign of pregnancy?
A. Chadwick's sign of the cervix
B. A positive result on a urine human chorionic gonadotropin (hCG) test
C. Softening of the lower uterine segment (Hegar's sign)
D. Fetal heart tones detected by Doppler at 11 weeks of gestation
Correct Answer: D
Rationale: Positive signs of pregnancy are attributable only to the presence of a fetus and include
visualization of the fetus by ultrasound, auscultation of fetal heart tones, and fetal movement felt by an
examiner. Chadwick's sign and Hegar's sign are probable signs, and an elevated hCG level is also
classified as a probable sign because other conditions can elevate it. Only positive signs objectively
confirm the pregnancy.
4. A primigravida client at 15 weeks of gestation asks the nurse when she will
first begin to feel her baby move. Which response by the nurse is accurate?
A. Between 8 and 10 weeks of gestation
B. Between 12 and 14 weeks of gestation
C. Between 18 and 20 weeks of gestation
D. Between 24 and 26 weeks of gestation
Correct Answer: C
Rationale: Quickening, the first perception of fetal movement, is typically felt by a primigravida
between 18 and 20 weeks of gestation. Multiparas often recognize movement earlier, at approximately 16
to 18 weeks, because they are familiar with the sensation. Movement cannot be felt at 8 to 14 weeks
because the fetus is too small, and waiting until 24 to 26 weeks would unnecessarily alarm the client.
Galen College of Nursing | 2026 Edition 2
, NUR 231 Exam 2 - Maternal Nursing Practice Review with Rationales
5. A client at 28 weeks of gestation has a hemoglobin of 11.0 g/dL and a
hematocrit of 33%. The nurse interprets these findings as which of the
following?
A. Iron-deficiency anemia requiring parenteral iron therapy
B. A laboratory error requiring repeat testing
C. Pernicious anemia requiring vitamin B12 supplementation
D. Physiologic anemia caused by hemodilution of pregnancy
Correct Answer: D
Rationale: During pregnancy, plasma volume increases by 40% to 50% while the red blood cell mass
increases only by about 20% to 30%, producing dilutional (physiologic) anemia. A hemoglobin of 11.0
g/dL and hematocrit of 33% fall within the expected limits for the third trimester. Supplementation or
further workup is generally reserved for values below these thresholds, so the client should be reassured
that this is an expected adaptation.
6. A pregnant client at 8 weeks of gestation is found to be nonimmune to rubella.
Which action should the nurse anticipate?
A. Administering the rubella vaccine now, at 8 weeks of gestation
B. Administering rubella immune globulin during the third trimester
C. Recommending termination of the pregnancy because of infection risk
D. Administering the rubella vaccine in the postpartum period before
discharge
Correct Answer: D
Rationale: The rubella vaccine is a live attenuated vaccine and is contraindicated during pregnancy
because of theoretical teratogenic risk. It is administered in the immediate postpartum period before
discharge, and the client must avoid becoming pregnant for 4 weeks after vaccination. Rubella immune
globulin is not routinely given to pregnant clients, and termination is not indicated.
Galen College of Nursing | 2026 Edition 3
E X A M 2 · P RAC TI C E REVI EW
NUR 231 Maternal Nursing
Actual-Style Questions,
Answers & Rationales
A complete 70-question multiple-choice practice exam covering
antepartum, intrapartum, postpartum, and newborn care, with the
correct answer and a detailed rationale provided for every item.
Course NUR 231 — Maternal Nursing
Total Questions 70
Format Multiple Choice (A–D)
Answer Key Inline, with Rationales
Coverage Full Course Breadth
2 0 2 6 E D I TI ON · GUARANTEE-PASS STU DY SE RI E S
,NUR 231 Exam 2 - Maternal Nursing Practice Review with Rationales
NUR 231 Exam 2 - Maternal Nursing
70 Questions | Correct Answers and Detailed Rationales Included | 2026 Edition
Choose the single best response for each item. The correct answer and a detailed rationale follow each
question, so review carefully before moving on. These items cover the full breadth of maternal nursing
content: antepartum care, labor and birth, the postpartum period, and newborn care.
1. A nurse is calculating the estimated date of birth (EDB) for a client whose
last menstrual period (LMP) began on February 10. Using Naegele's rule,
which date should the nurse identify as the estimated date of birth?
A. November 14
B. November 10
C. November 17
D. December 3
Correct Answer: C
Rationale: Naegele's rule is calculated by subtracting 3 months from the first day of the LMP, adding 7
days, and adjusting the year as needed. February 10 minus 3 months equals November 10, and adding 7
days gives November 17. The other options result from adding or subtracting the months and days in the
wrong order, so they should be eliminated.
2. A client who is currently pregnant has a history of one full-term vaginal birth,
one set of twins delivered at 35 weeks of gestation (both twins living), and one
spontaneous miscarriage at 10 weeks. How should the nurse document this client
using the GTPAL system?
A. G3 T1 P1 A1 L3
B. G4 T1 P1 A1 L3
C. G4 T1 P2 A1 L3
D. G4 T2 P1 A1 L4
Correct Answer: B
Rationale: GTPAL stands for gravida, term births, preterm births, abortions, and living children.
Gravida counts the current pregnancy, making this client a G4. The twins at 35 weeks count as one
preterm birth event (P1), not two, and the living children total three (the term child plus both twins). This
makes the correct documentation G4 T1 P1 A1 L3.
Galen College of Nursing | 2026 Edition 1
,NUR 231 Exam 2 - Maternal Nursing Practice Review with Rationales
3. During a prenatal visit, the nurse is reviewing assessment findings that
confirm a client's pregnancy. Which of the following is considered a positive
(diagnostic) sign of pregnancy?
A. Chadwick's sign of the cervix
B. A positive result on a urine human chorionic gonadotropin (hCG) test
C. Softening of the lower uterine segment (Hegar's sign)
D. Fetal heart tones detected by Doppler at 11 weeks of gestation
Correct Answer: D
Rationale: Positive signs of pregnancy are attributable only to the presence of a fetus and include
visualization of the fetus by ultrasound, auscultation of fetal heart tones, and fetal movement felt by an
examiner. Chadwick's sign and Hegar's sign are probable signs, and an elevated hCG level is also
classified as a probable sign because other conditions can elevate it. Only positive signs objectively
confirm the pregnancy.
4. A primigravida client at 15 weeks of gestation asks the nurse when she will
first begin to feel her baby move. Which response by the nurse is accurate?
A. Between 8 and 10 weeks of gestation
B. Between 12 and 14 weeks of gestation
C. Between 18 and 20 weeks of gestation
D. Between 24 and 26 weeks of gestation
Correct Answer: C
Rationale: Quickening, the first perception of fetal movement, is typically felt by a primigravida
between 18 and 20 weeks of gestation. Multiparas often recognize movement earlier, at approximately 16
to 18 weeks, because they are familiar with the sensation. Movement cannot be felt at 8 to 14 weeks
because the fetus is too small, and waiting until 24 to 26 weeks would unnecessarily alarm the client.
Galen College of Nursing | 2026 Edition 2
, NUR 231 Exam 2 - Maternal Nursing Practice Review with Rationales
5. A client at 28 weeks of gestation has a hemoglobin of 11.0 g/dL and a
hematocrit of 33%. The nurse interprets these findings as which of the
following?
A. Iron-deficiency anemia requiring parenteral iron therapy
B. A laboratory error requiring repeat testing
C. Pernicious anemia requiring vitamin B12 supplementation
D. Physiologic anemia caused by hemodilution of pregnancy
Correct Answer: D
Rationale: During pregnancy, plasma volume increases by 40% to 50% while the red blood cell mass
increases only by about 20% to 30%, producing dilutional (physiologic) anemia. A hemoglobin of 11.0
g/dL and hematocrit of 33% fall within the expected limits for the third trimester. Supplementation or
further workup is generally reserved for values below these thresholds, so the client should be reassured
that this is an expected adaptation.
6. A pregnant client at 8 weeks of gestation is found to be nonimmune to rubella.
Which action should the nurse anticipate?
A. Administering the rubella vaccine now, at 8 weeks of gestation
B. Administering rubella immune globulin during the third trimester
C. Recommending termination of the pregnancy because of infection risk
D. Administering the rubella vaccine in the postpartum period before
discharge
Correct Answer: D
Rationale: The rubella vaccine is a live attenuated vaccine and is contraindicated during pregnancy
because of theoretical teratogenic risk. It is administered in the immediate postpartum period before
discharge, and the client must avoid becoming pregnant for 4 weeks after vaccination. Rubella immune
globulin is not routinely given to pregnant clients, and termination is not indicated.
Galen College of Nursing | 2026 Edition 3
