RNSG 1517 A Maternity Nursing Master Practice
Exam | Comprehensive Questions & Detailed
Answers 2026/2027
Question 1
A nurse is assessing a pregnant client at 10 weeks gestation and notes
softening of the lower uterine segment (isthmus). What is this clinical
finding called?
A. Goodell's sign
B. Chadwick's sign
C. Hegar's sign
D. Ballottement
Correct Answer: C. Hegar's sign
Detailed Rationale: Hegar's sign is the softening of the isthmus of the
uterus observed during a bimanual examination around 6 to 12 weeks
of pregnancy, serving as a probable sign of pregnancy. Goodell's sign is
softening of the cervix, and Chadwick's sign is bluish discoloration of the
vagina and cervix.
Question 2
A nurse is reviewing the laboratory results of an Rh-negative pregnant
client at 28 weeks gestation whose indirect Coombs test is negative.
What is the correct nursing interpretation and action?
A. The client is sensitized; administer RhoGAM immediately.
,B. The client is not sensitized; administer prophylactic RhoGAM.
C. The client has developed antibodies; prepare for exchange
transfusion.
D. No action is required until delivery.
Correct Answer: B. The client is not sensitized; administer prophylactic
RhoGAM.
Detailed Rationale: A negative indirect Coombs test indicates that the
mother has not formed antibodies against Rh-positive blood (she is
unsensitized). Routine prophylactic RhoGAM is administered at 28
weeks gestation to prevent maternal sensitization.
Question 3
A nurse is providing dietary counseling to a client in her first trimester
of pregnancy regarding the prevention of neural tube defects. Which
supplement should the nurse emphasize?
A. Iron
B. Folic acid (folate)
C. Calcium
D. Vitamin D
Correct Answer: B. Folic acid (folate)
Detailed Rationale: Daily supplementation of folic acid before
conception and throughout early pregnancy significantly reduces the
risk of fetal neural tube defects, such as spina bifida and anencephaly.
Question 4
,A client with a pre-pregnancy Body Mass Index (BMI) of 22 (normal
weight) asks how much total weight she should expect to gain during
her pregnancy. What is the recommended weight gain range?
A. 11 to 20 pounds
B. 15 to 25 pounds
C. 25 to 35 pounds
D. 28 to 40 pounds
Correct Answer: C. 25 to 35 pounds
Detailed Rationale: For women with a normal pre-pregnancy BMI
(18.5–24.9), the Institute of Medicine (IOM) recommends a total weight
gain of 25 to 35 pounds. Underweight women should gain more, and
overweight or obese women should gain less.
Question 5
A pregnant client at 30 weeks gestation reports feeling dizzy,
lightheaded, and nauseated while lying flat on her back on the
examination table. What physiological mechanism explains this finding?
A. Sudden drop in blood glucose levels
B. Compression of the aorta and inferior vena cava by the gravid uterus
C. Acute maternal hyperventilation
D. Rapid expansion of maternal plasma volume
Correct Answer: B. Compression of the aorta and inferior vena cava by
the gravid uterus
, Detailed Rationale: Supine hypotension syndrome (vena caval
syndrome) occurs when the heavy gravid uterus compresses the inferior
vena cava and aorta when the mother lies flat, reducing venous return
and cardiac output, leading to dizziness and hypotension. Turning the
client to a side-lying position resolves this.
Question 6
A nurse is explaining the 1-hour oral glucose tolerance test (OGTT) to a
client at 26 weeks gestation. Which blood glucose threshold value
indicates a positive screen requiring a diagnostic 3-hour oral glucose
tolerance test?
A. Greater than or equal to 130–140 mg/dL
B. Greater than 200 mg/dL
C. Less than 90 mg/dL
D. Exactly 100 mg/dL
Correct Answer: A. Greater than or equal to 130–140 mg/dL
Detailed Rationale: Universal screening for gestational diabetes is
performed at 24-28 weeks using a 50-g 1-hour glucose load test. A
blood glucose level of 130 to 140 mg/dL or higher is considered positive
and requires a diagnostic 3-hour OGTT.
Question 7
A primary healthcare provider performs an amniocentesis at 36 weeks
gestation to evaluate fetal lung maturity. Which lecithin-to-
sphingomyelin (L/S) ratio indicates fetal lung maturity?
A. 1:1
Exam | Comprehensive Questions & Detailed
Answers 2026/2027
Question 1
A nurse is assessing a pregnant client at 10 weeks gestation and notes
softening of the lower uterine segment (isthmus). What is this clinical
finding called?
A. Goodell's sign
B. Chadwick's sign
C. Hegar's sign
D. Ballottement
Correct Answer: C. Hegar's sign
Detailed Rationale: Hegar's sign is the softening of the isthmus of the
uterus observed during a bimanual examination around 6 to 12 weeks
of pregnancy, serving as a probable sign of pregnancy. Goodell's sign is
softening of the cervix, and Chadwick's sign is bluish discoloration of the
vagina and cervix.
Question 2
A nurse is reviewing the laboratory results of an Rh-negative pregnant
client at 28 weeks gestation whose indirect Coombs test is negative.
What is the correct nursing interpretation and action?
A. The client is sensitized; administer RhoGAM immediately.
,B. The client is not sensitized; administer prophylactic RhoGAM.
C. The client has developed antibodies; prepare for exchange
transfusion.
D. No action is required until delivery.
Correct Answer: B. The client is not sensitized; administer prophylactic
RhoGAM.
Detailed Rationale: A negative indirect Coombs test indicates that the
mother has not formed antibodies against Rh-positive blood (she is
unsensitized). Routine prophylactic RhoGAM is administered at 28
weeks gestation to prevent maternal sensitization.
Question 3
A nurse is providing dietary counseling to a client in her first trimester
of pregnancy regarding the prevention of neural tube defects. Which
supplement should the nurse emphasize?
A. Iron
B. Folic acid (folate)
C. Calcium
D. Vitamin D
Correct Answer: B. Folic acid (folate)
Detailed Rationale: Daily supplementation of folic acid before
conception and throughout early pregnancy significantly reduces the
risk of fetal neural tube defects, such as spina bifida and anencephaly.
Question 4
,A client with a pre-pregnancy Body Mass Index (BMI) of 22 (normal
weight) asks how much total weight she should expect to gain during
her pregnancy. What is the recommended weight gain range?
A. 11 to 20 pounds
B. 15 to 25 pounds
C. 25 to 35 pounds
D. 28 to 40 pounds
Correct Answer: C. 25 to 35 pounds
Detailed Rationale: For women with a normal pre-pregnancy BMI
(18.5–24.9), the Institute of Medicine (IOM) recommends a total weight
gain of 25 to 35 pounds. Underweight women should gain more, and
overweight or obese women should gain less.
Question 5
A pregnant client at 30 weeks gestation reports feeling dizzy,
lightheaded, and nauseated while lying flat on her back on the
examination table. What physiological mechanism explains this finding?
A. Sudden drop in blood glucose levels
B. Compression of the aorta and inferior vena cava by the gravid uterus
C. Acute maternal hyperventilation
D. Rapid expansion of maternal plasma volume
Correct Answer: B. Compression of the aorta and inferior vena cava by
the gravid uterus
, Detailed Rationale: Supine hypotension syndrome (vena caval
syndrome) occurs when the heavy gravid uterus compresses the inferior
vena cava and aorta when the mother lies flat, reducing venous return
and cardiac output, leading to dizziness and hypotension. Turning the
client to a side-lying position resolves this.
Question 6
A nurse is explaining the 1-hour oral glucose tolerance test (OGTT) to a
client at 26 weeks gestation. Which blood glucose threshold value
indicates a positive screen requiring a diagnostic 3-hour oral glucose
tolerance test?
A. Greater than or equal to 130–140 mg/dL
B. Greater than 200 mg/dL
C. Less than 90 mg/dL
D. Exactly 100 mg/dL
Correct Answer: A. Greater than or equal to 130–140 mg/dL
Detailed Rationale: Universal screening for gestational diabetes is
performed at 24-28 weeks using a 50-g 1-hour glucose load test. A
blood glucose level of 130 to 140 mg/dL or higher is considered positive
and requires a diagnostic 3-hour OGTT.
Question 7
A primary healthcare provider performs an amniocentesis at 36 weeks
gestation to evaluate fetal lung maturity. Which lecithin-to-
sphingomyelin (L/S) ratio indicates fetal lung maturity?
A. 1:1
