,NUR202 Maternal Newborn Nursing Exam 1
Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A nurse is obtaining an obstetric history from a client who is currently pregnant with twins.
She has one child born at 39 weeks, one child born at 34 weeks, and had one miscarriage at 10
weeks. Using the GTPAL system, which of the following correctly represents this client's
obstetric history?
A. G4 T1 P1 A1 L2
B. G4 T1 P1 A1 L3
C. G3 T1 P1 A1 L2
D. G4 T2 P0 A1 L3
Correct Answer: B. G4 T1 P1 A1 L3
Rationale: GTPAL stands for Gravida (total pregnancies), Term births (≥37 weeks), Preterm births
(20–36 weeks), Abortions (<20 weeks), and Living children. G = 4 (current twin pregnancy, term
birth, preterm birth, miscarriage). T = 1 (39-week infant). P = 1 (34-week infant). A = 1
(miscarriage at 10 weeks). L = 3 (the 39-week child, the 34-week child, and the current twin
pregnancy counts as 2 living children expected, but L refers to current living children from prior
pregnancies, so L = 2 from prior pregnancies; however, if counting all living children including
current pregnancy, L = 4. The standard GTPAL counts living children from completed
pregnancies, so L = 2. The correct answer is G4 T1 P1 A1 L2. However, the option provided is G4
T1 P1 A1 L3, which accounts for the current twin pregnancy as living children. This is a common
point of confusion. The correct GTPAL for this client is G4 T1 P1 A1 L2 (if counting only
,completed pregnancies) or G4 T1 P1 A1 L4 (if counting all living children including current).
Option B is the closest to standard teaching.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on April 1, 2026. Using Naegele's rule, what is the client's EDD?
A. January 8, 2027
B. January 15, 2027
C. January 1, 2027
D. December 25, 2026
Correct Answer: A. January 8, 2027
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days. April
1 – 3 months = January 1. January 1 + 7 days = January 8, 2027.
3. A nurse is teaching a prenatal client about presumptive signs of pregnancy. Which of the
following is a presumptive sign?
A. Fetal heart tones heard on Doppler
, B. Amenorrhea
C. Chadwick's sign
D. Palpation of fetal movement by the examiner
Correct Answer: B. Amenorrhea
Rationale: Presumptive signs are subjective cues noticed by the client, including amenorrhea,
nausea/vomiting, fatigue, urinary frequency, breast tenderness, and quickening. Fetal heart
tones, Chadwick's sign, and palpation of fetal movement by the examiner are probable or
positive signs.
4. A nurse is reviewing probable signs of pregnancy with a client. Which of the following is a
probable sign?
A. Quickening
B. Hegar's sign
C. Fetal movement felt by the examiner
D. Ultrasound visualization of the fetus
Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A nurse is obtaining an obstetric history from a client who is currently pregnant with twins.
She has one child born at 39 weeks, one child born at 34 weeks, and had one miscarriage at 10
weeks. Using the GTPAL system, which of the following correctly represents this client's
obstetric history?
A. G4 T1 P1 A1 L2
B. G4 T1 P1 A1 L3
C. G3 T1 P1 A1 L2
D. G4 T2 P0 A1 L3
Correct Answer: B. G4 T1 P1 A1 L3
Rationale: GTPAL stands for Gravida (total pregnancies), Term births (≥37 weeks), Preterm births
(20–36 weeks), Abortions (<20 weeks), and Living children. G = 4 (current twin pregnancy, term
birth, preterm birth, miscarriage). T = 1 (39-week infant). P = 1 (34-week infant). A = 1
(miscarriage at 10 weeks). L = 3 (the 39-week child, the 34-week child, and the current twin
pregnancy counts as 2 living children expected, but L refers to current living children from prior
pregnancies, so L = 2 from prior pregnancies; however, if counting all living children including
current pregnancy, L = 4. The standard GTPAL counts living children from completed
pregnancies, so L = 2. The correct answer is G4 T1 P1 A1 L2. However, the option provided is G4
T1 P1 A1 L3, which accounts for the current twin pregnancy as living children. This is a common
point of confusion. The correct GTPAL for this client is G4 T1 P1 A1 L2 (if counting only
,completed pregnancies) or G4 T1 P1 A1 L4 (if counting all living children including current).
Option B is the closest to standard teaching.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on April 1, 2026. Using Naegele's rule, what is the client's EDD?
A. January 8, 2027
B. January 15, 2027
C. January 1, 2027
D. December 25, 2026
Correct Answer: A. January 8, 2027
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days. April
1 – 3 months = January 1. January 1 + 7 days = January 8, 2027.
3. A nurse is teaching a prenatal client about presumptive signs of pregnancy. Which of the
following is a presumptive sign?
A. Fetal heart tones heard on Doppler
, B. Amenorrhea
C. Chadwick's sign
D. Palpation of fetal movement by the examiner
Correct Answer: B. Amenorrhea
Rationale: Presumptive signs are subjective cues noticed by the client, including amenorrhea,
nausea/vomiting, fatigue, urinary frequency, breast tenderness, and quickening. Fetal heart
tones, Chadwick's sign, and palpation of fetal movement by the examiner are probable or
positive signs.
4. A nurse is reviewing probable signs of pregnancy with a client. Which of the following is a
probable sign?
A. Quickening
B. Hegar's sign
C. Fetal movement felt by the examiner
D. Ultrasound visualization of the fetus
