VATI PN Maternal Newborn Practice Exam (120
Questions)
1. A client's last menstrual period began on January 10. Using Naegele's rule,
what is the estimated date of delivery?
A. October 17
B. October 3
C. September 24
D. November 10
Correct Answer: A. October 17
Rationale: Naegele's rule subtracts 3 months from the first day of the LMP and adds
7 days, giving October 17 of the same year.
2. A client is pregnant for the fourth time. She had one term birth, one preterm
birth and one abortion, and has two living children. How is this recorded using
GTPAL?
A. 4-2-1-0-2
B. 4-1-1-1-2
C. 4-1-1-2-1
D. 3-1-1-1-2
Correct Answer: B. 4-1-1-1-2
Rationale: Gravida is 4 including the current pregnancy. Term 1, preterm 1, abortions
1 and living children 2.
3. Which finding is a probable sign of pregnancy?
A. Fetal movement felt by the examiner
B. Visualization of the fetus on ultrasound
C. Chadwick's sign
D. Fetal heart tones by Doppler
Correct Answer: C. Chadwick's sign
Rationale: Chadwick's sign is bluish discoloration of the cervix and vagina. Fetal
heart tones, fetal movement felt by the examiner and ultrasound visualization are
positive signs.
,4. Which supplement is recommended before conception and in early
pregnancy to reduce the risk of neural tube defects?
A. Vitamin C
B. Calcium carbonate
C. Vitamin K
D. Folic acid
Correct Answer: D. Folic acid
Rationale: Folic acid, at least 400 mcg daily, reduces neural tube defects such as
spina bifida.
5. Which symptom should a pregnant client report immediately?
A. Severe headache with blurred vision
B. Occasional backache
C. Mild nausea in the morning
D. Increased vaginal mucus
Correct Answer: A. Severe headache with blurred vision
Rationale: Severe headache with visual changes can indicate severe preeclampsia
and requires urgent evaluation.
6. Which finding indicates preeclampsia?
A. Blood pressure of 120/80 with glucosuria
B. Blood pressure of 150/96 mm Hg with proteinuria after 20 weeks
C. Blood pressure of 100/60 with headache
D. Blood pressure of 110/70 mm Hg with ankle edema
Correct Answer: B. Blood pressure of 150/96 mm Hg with proteinuria after 20
weeks
Rationale: Preeclampsia is new hypertension of 140/90 or higher after 20 weeks with
proteinuria or other signs of organ involvement.
,7. A client with severe preeclampsia is receiving magnesium sulfate. Which
finding requires the nurse to stop the infusion?
A. Blood pressure of 150/90 mm Hg
B. Deep tendon reflexes of 2+
C. Respiratory rate of 10 breaths per minute
D. Urine output of 40 mL/hr
Correct Answer: C. Respiratory rate of 10 breaths per minute
Rationale: A respiratory rate under 12 suggests toxicity. Reflexes should be present
and urine output at least 30 mL/hr. Calcium gluconate is the antidote.
8. A pregnant client has a seizure. What is the nurse's priority action?
A. Give oral fluids
B. Insert a padded tongue blade
C. Restrain the client
D. Maintain the airway and turn the client to the side
Correct Answer: D. Maintain the airway and turn the client to the side
Rationale: Protecting the airway and preventing injury come first. Magnesium sulfate
is then given as prescribed.
9. Which laboratory findings are associated with HELLP syndrome?
A. Hemolysis, elevated liver enzymes and low platelets
B. Low hemoglobin only
C. Elevated glucose and low calcium
D. High platelets and low liver enzymes
Correct Answer: A. Hemolysis, elevated liver enzymes and low platelets
Rationale: HELLP is a severe variant of preeclampsia. It stands for hemolysis,
elevated liver enzymes and low platelet count.
, 10. Which finding is most consistent with hyperemesis gravidarum?
A. Vomiting once weekly
B. Persistent vomiting with weight loss and ketonuria
C. Nausea relieved by crackers
D. Occasional morning nausea only
Correct Answer: B. Persistent vomiting with weight loss and ketonuria
Rationale: Hyperemesis causes dehydration, electrolyte imbalance and weight loss
of more than 5 percent of body weight.
11. When is screening for gestational diabetes usually performed?
A. After delivery only
B. At 8 weeks
C. Between 24 and 28 weeks of gestation
D. At 36 weeks only
Correct Answer: C. Between 24 and 28 weeks of gestation
Rationale: Placental hormones raise insulin resistance in the second trimester, so
the glucose challenge is done at 24 to 28 weeks.
12. Which finding is expected with placenta previa?
A. Absent fetal movement with cramping
B. Rigid board-like abdomen
C. Painful dark red bleeding
D. Painless bright red vaginal bleeding
Correct Answer: D. Painless bright red vaginal bleeding
Rationale: Previa causes painless bright red bleeding in the third trimester. Vaginal
examinations are avoided until previa is ruled out.
Questions)
1. A client's last menstrual period began on January 10. Using Naegele's rule,
what is the estimated date of delivery?
A. October 17
B. October 3
C. September 24
D. November 10
Correct Answer: A. October 17
Rationale: Naegele's rule subtracts 3 months from the first day of the LMP and adds
7 days, giving October 17 of the same year.
2. A client is pregnant for the fourth time. She had one term birth, one preterm
birth and one abortion, and has two living children. How is this recorded using
GTPAL?
A. 4-2-1-0-2
B. 4-1-1-1-2
C. 4-1-1-2-1
D. 3-1-1-1-2
Correct Answer: B. 4-1-1-1-2
Rationale: Gravida is 4 including the current pregnancy. Term 1, preterm 1, abortions
1 and living children 2.
3. Which finding is a probable sign of pregnancy?
A. Fetal movement felt by the examiner
B. Visualization of the fetus on ultrasound
C. Chadwick's sign
D. Fetal heart tones by Doppler
Correct Answer: C. Chadwick's sign
Rationale: Chadwick's sign is bluish discoloration of the cervix and vagina. Fetal
heart tones, fetal movement felt by the examiner and ultrasound visualization are
positive signs.
,4. Which supplement is recommended before conception and in early
pregnancy to reduce the risk of neural tube defects?
A. Vitamin C
B. Calcium carbonate
C. Vitamin K
D. Folic acid
Correct Answer: D. Folic acid
Rationale: Folic acid, at least 400 mcg daily, reduces neural tube defects such as
spina bifida.
5. Which symptom should a pregnant client report immediately?
A. Severe headache with blurred vision
B. Occasional backache
C. Mild nausea in the morning
D. Increased vaginal mucus
Correct Answer: A. Severe headache with blurred vision
Rationale: Severe headache with visual changes can indicate severe preeclampsia
and requires urgent evaluation.
6. Which finding indicates preeclampsia?
A. Blood pressure of 120/80 with glucosuria
B. Blood pressure of 150/96 mm Hg with proteinuria after 20 weeks
C. Blood pressure of 100/60 with headache
D. Blood pressure of 110/70 mm Hg with ankle edema
Correct Answer: B. Blood pressure of 150/96 mm Hg with proteinuria after 20
weeks
Rationale: Preeclampsia is new hypertension of 140/90 or higher after 20 weeks with
proteinuria or other signs of organ involvement.
,7. A client with severe preeclampsia is receiving magnesium sulfate. Which
finding requires the nurse to stop the infusion?
A. Blood pressure of 150/90 mm Hg
B. Deep tendon reflexes of 2+
C. Respiratory rate of 10 breaths per minute
D. Urine output of 40 mL/hr
Correct Answer: C. Respiratory rate of 10 breaths per minute
Rationale: A respiratory rate under 12 suggests toxicity. Reflexes should be present
and urine output at least 30 mL/hr. Calcium gluconate is the antidote.
8. A pregnant client has a seizure. What is the nurse's priority action?
A. Give oral fluids
B. Insert a padded tongue blade
C. Restrain the client
D. Maintain the airway and turn the client to the side
Correct Answer: D. Maintain the airway and turn the client to the side
Rationale: Protecting the airway and preventing injury come first. Magnesium sulfate
is then given as prescribed.
9. Which laboratory findings are associated with HELLP syndrome?
A. Hemolysis, elevated liver enzymes and low platelets
B. Low hemoglobin only
C. Elevated glucose and low calcium
D. High platelets and low liver enzymes
Correct Answer: A. Hemolysis, elevated liver enzymes and low platelets
Rationale: HELLP is a severe variant of preeclampsia. It stands for hemolysis,
elevated liver enzymes and low platelet count.
, 10. Which finding is most consistent with hyperemesis gravidarum?
A. Vomiting once weekly
B. Persistent vomiting with weight loss and ketonuria
C. Nausea relieved by crackers
D. Occasional morning nausea only
Correct Answer: B. Persistent vomiting with weight loss and ketonuria
Rationale: Hyperemesis causes dehydration, electrolyte imbalance and weight loss
of more than 5 percent of body weight.
11. When is screening for gestational diabetes usually performed?
A. After delivery only
B. At 8 weeks
C. Between 24 and 28 weeks of gestation
D. At 36 weeks only
Correct Answer: C. Between 24 and 28 weeks of gestation
Rationale: Placental hormones raise insulin resistance in the second trimester, so
the glucose challenge is done at 24 to 28 weeks.
12. Which finding is expected with placenta previa?
A. Absent fetal movement with cramping
B. Rigid board-like abdomen
C. Painful dark red bleeding
D. Painless bright red vaginal bleeding
Correct Answer: D. Painless bright red vaginal bleeding
Rationale: Previa causes painless bright red bleeding in the third trimester. Vaginal
examinations are avoided until previa is ruled out.
