Question 1

A 7 month pregnant woman is admitted with complaints of painless vaginal bleeding over several hours. The nurse should prepare the client for an immediate?

Accepted Answer

Answer reason: Painless third-trimester vaginal bleeding suggests placenta previa. Diagnosis and placental location are assessed by abdominal ultrasound; pelvic exam is contraindicated, and NST or X-ray do not address immediate diagnosis.

Question 2

A pregnant client asks the nurse about the scheduled blood test for alpha-fetoprotein (AFP). The nurse's BEST explanation is?

Accepted Answer

Answer reason: Maternal serum AFP screening helps identify risk for fetal neural tube defects; elevated AFP suggests defects such as spina bifida. Thus the best explanation is that possible neurological defects may be identified.

Question 3

What is the average weight gain during pregnancy?

Accepted Answer

Answer reason: For a singleton pregnancy with normal pre-pregnancy BMI, recommended total gain is about 11.5–16 kg; the typical average approximates 12 kg, making 12 kg the best choice.

Question 4

What is the correct position for a nurse to place a client during monitoring of uterine fundal height?

Accepted Answer

Answer reason: Fundal height is measured with the client lying supine (often with a slight head elevation and an empty bladder) to allow consistent, accurate measurement from the symphysis pubis to the uterine fundus. Other positions are not standard for this assessment.

Question 5

What is the term for the first fetal movement felt by the mother?

Accepted Answer

Answer reason: Quickening is the first fetal movement perceived by the mother. Engagement is descent of the presenting part into the pelvic inlet; ballottement is a rebounding of the fetus on palpation; lightening is fetal descent late in pregnancy.

Question 6

What is the appropriate nursing action following a positive pregnancy test?

Accepted Answer

Answer reason: A positive urine hCG result should be confirmed—repeat the test or obtain a serum hCG—before proceeding with counseling or care.

Question 7

What is the name of the first phase of lochia?

Accepted Answer

Answer reason: The first postpartum lochia stage is lochia rubra, a red, blood-tinged discharge occurring in the first 1–3 days after birth.

Question 8

A nurse is caring for a postpartum patient. Which nursing action best supports uterine involution during the fourth stage of labor?

Accepted Answer

Answer reason: Fundal massage stimulates uterine contraction, which promotes uterine involution and prevents postpartum hemorrhage.

Question 9

Post-delivery, the woman is soaking a pad every 15 minutes. What's your priority action?

Accepted Answer

Answer reason: Soaking a pad every 15 minutes indicates possible postpartum hemorrhage, most commonly due to uterine atony. The immediate priority is to massage the fundus to stimulate uterine contraction and reduce bleeding. After initiating massage, the nurse would call for help, increase IV fluids/oxytocin as ordered, and quantify blood loss, but these should not delay the first action. Weighing pads and notifying the provider are important, but initial hemorrhage control takes precedence.

Question 10

Copper-T is a type of?

Accepted Answer

Answer reason: The Copper-T is a T-shaped intrauterine contraceptive device that releases copper ions within the uterus. Copper is spermicidal and creates an intrauterine environment that impairs sperm motility and fertilization. It is not an oral hormone pill, an injectable contraceptive, or a barrier method like a condom.

Question 11

The postnatal period lasts for?

Accepted Answer

Answer reason: The postnatal (puerperium) period is defined as the time from delivery until maternal reproductive organs and physiology return near the prepregnant state, which occurs by about 6 weeks (approximately 42 days). Uterine involution is largely complete by this time, lochia has typically resolved, and most systemic changes of pregnancy have normalized. Hence, 6 weeks is the standard duration used for postpartum follow-up.

Question 12

Which of the following is NOT a common early sign of pregnancy?

Accepted Answer

Answer reason: Common early pregnancy signs include amenorrhea, breast tenderness, and nausea/vomiting due to rising hCG and estrogen levels. Appetite often decreases in the first trimester because of nausea and food aversions. Increased appetite more typically occurs later in pregnancy as caloric needs rise. Therefore, increased appetite is not a common early sign.

Question 13

Lochia that is reddish in color is called?

Accepted Answer

Answer reason: Postpartum lochia progresses from rubra to serosa to alba. Lochia rubra is bright to dark red due to blood and decidual tissue and occurs in the first few days after birth. Lochia serosa is pink-brown and follows rubra, and lochia alba is whitish-yellow in later stages. Therefore, reddish lochia is termed lochia rubra.

Question 14

Postnatal checkup should be done within?

Accepted Answer

Answer reason: Routine postpartum follow‑up for the mother is traditionally scheduled at about 6 weeks after delivery to evaluate uterine involution, healing, mood, breastfeeding, and contraception. Earlier contacts in the first 24–72 hours are part of immediate postnatal monitoring, not the standard comprehensive checkup. Therefore, the recommended checkup timeframe among the options is 6 weeks.

Question 15

The gestational age for late preterm is?

Accepted Answer

Answer reason: Late preterm infants are those born from 34 0/7 through 36 6/7 weeks’ gestation. Earlier ranges such as 20–24 and 28–32 weeks correspond to extremely and very preterm, respectively. Gestation of 37–40 weeks is considered term. Therefore, the best match is 34–37 weeks.

Question 16

Type of Abnormal presentation on a term pregnancy ______?

Accepted Answer

Answer reason: At term, the normal presentation is cephalic (head-first). A breech presentation, in which the buttocks or feet present first, is abnormal and associated with higher risks such as cord prolapse and head entrapment, often necessitating cesarean delivery. Transverse and oblique describe abnormal fetal lies rather than presentations. Therefore, among the listed options, breech is the abnormal presentation.

Question 17

Fetal presentation is confirmed at?

Accepted Answer

Answer reason: Fetal presentation varies earlier in pregnancy and typically becomes fixed by the late third trimester as the fetus engages in the pelvis. By about 32–36 weeks, most fetuses assume and maintain a cephalic presentation, allowing reliable confirmation via Leopold maneuvers and/or ultrasound. Earlier gestations are too variable, and while presentation can still rarely change near term, assessment at 36 weeks is standard for clinical planning.

Question 18

The most common presentation during labour is?

Accepted Answer

Answer reason: Cephalic (vertex) presentation is by far the most common at term, occurring in roughly 95–97% of labors. The fetal head is the largest and heaviest part, naturally positioning toward the pelvis. Breech occurs in about 3–4%, while face and shoulder presentations are rare. Thus, cephalic is the expected and most frequent presentation for vaginal delivery.

Question 19

The instrument used to determine the foetal heart beat is called?

Accepted Answer

Answer reason: The traditional instrument for assessing fetal heart tones in obstetrics is the Pinard’s fetoscope, a horn-shaped acoustic fetoscope used from about 18–20 weeks’ gestation. It transmits fetal heart sounds to the examiner’s ear without electronics, unlike handheld Dopplers. Among the options, the closest eponym provided corresponds to Pinard’s fetoscope. Therefore, the correct choice is Piner's fetoscope.

Question 20

Labor is divided into how many stages?

Accepted Answer

Answer reason: Labor is classically divided into four stages. The first stage is cervical effacement and dilation to 10 cm (latent and active phases). The second stage is from full dilation to delivery of the fetus, the third stage is delivery of the placenta, and the fourth stage is the immediate postpartum recovery period with uterine contraction and hemostasis.

Question 21

The safest position for mother during labour is?

Accepted Answer

Answer reason: The left lateral position reduces aortocaval compression by the gravid uterus, improving venous return and maternal blood pressure. This enhances uteroplacental perfusion and fetal oxygenation, making it safest during labour. Supine and lithotomy positions can worsen hypotension and decrease uterine blood flow, and prone is inappropriate in pregnancy.

Question 22

First movement felt by mother is?

Accepted Answer

Answer reason: The first fetal movement perceived by the mother is termed quickening. It typically occurs around 18–20 weeks in primigravidas and can be felt earlier in multiparas. Sneezing, bleeding, and pain are not normal markers of initial fetal movement and may indicate unrelated or pathologic conditions.

Question 23

Fundal height measurement is started from?

Accepted Answer

Answer reason: Tape measurement of symphysis–fundal height becomes reliable once the uterus reaches the level of the umbilicus at about 20 weeks’ gestation. From 20–36 weeks, fundal height in centimeters approximates gestational age, aiding screening for growth abnormalities. Before 20 weeks the uterus is largely within the pelvis, making measurement inaccurate.

Question 24

The normal blood loss in vaginal delivery is?

Accepted Answer

Answer reason: Average expected blood loss at a vaginal delivery is up to about 500 mL. Amounts ≥500 mL meet the definition of postpartum hemorrhage, while typical losses under this threshold are considered normal. Values of 200–300 mL are lower than the usual average, and 800 mL indicates excessive bleeding.

Question 25

Breast milk should be expressed if?

Accepted Answer

Answer reason: Breast milk expression is indicated when direct breastfeeding is not possible, such as when the mother is temporarily absent or when the infant cannot effectively latch/suck. Expression also helps maintain milk supply and prevents engorgement while ensuring the infant can still receive breast milk via alternative feeding methods. If the mother is taking medication, milk expression may be used to maintain supply during temporary interruption or to provide stored milk as advised, depending on medication safety. Therefore, the best answer encompassing these situations is that breast milk should be expressed in all of these scenarios.

Question 26

Retained placenta is diagnosed when not delivered after?

Accepted Answer

Answer reason: A retained placenta is commonly diagnosed when the placenta has not been expelled within 30 minutes after delivery of the baby (third stage of labor). Prolonged third-stage labor increases the risk of postpartum hemorrhage due to uterine atony and ongoing bleeding from the placental implantation site. Therefore, 30 minutes is the best threshold among the options for diagnosing retained placenta and prompting evaluation/management.

Question 27

Important nutritional advice during ANC is?

Accepted Answer

Answer reason: During antenatal care (ANC), nutrition counseling commonly emphasizes iron-rich foods to prevent or treat maternal anemia, adequate protein intake to support fetal growth and maternal tissue expansion, and folate-rich foods to reduce the risk of neural tube defects. These recommendations are complementary rather than mutually exclusive and are standard components of prenatal dietary guidance. Therefore, the best answer is that all listed nutritional advice is important.

Question 28

The normal fetal heart rate during labour is?

Accepted Answer

Answer reason: A normal baseline fetal heart rate in labor is typically 110–160 bpm, so the best matching option is 120–160 bpm. Rates below this range suggest fetal bradycardia and may indicate hypoxia or cord compression depending on the context. Rates above this range suggest fetal tachycardia, which can be associated with maternal fever/infection, dehydration, or fetal distress. Therefore, 120–160 bpm represents the expected normal range during labor monitoring.

Question 29

The first sign of preterm labour is usually?

Accepted Answer

Answer reason: Preterm labor typically first presents with regular uterine contractions that may be perceived as lower abdominal cramping or pain, often accompanied by pelvic pressure and/or backache. These contractions can lead to progressive cervical change, which distinguishes true labor from isolated discomfort. Headache, fever, and vaginal itching are not typical early indicators of preterm labor and suggest other conditions (e.g., preeclampsia, infection, or vulvovaginitis). Therefore, abdominal pain with contractions is the best answer.

Question 30

Which assessment data can be determined by examining the fetal heart rate strip from the electronic fetal monitor?

Accepted Answer

Answer reason: Electronic fetal monitoring (EFM) reflects fetal well-being, primarily by assessing fetal oxygenation through baseline rate, variability, accelerations, and decelerations. Decreased variability and recurrent late decelerations can indicate uteroplacental insufficiency and fetal hypoxia. EFM does not determine fetal gender or fetal position directly, and labor progress is assessed through cervical change and contraction pattern rather than the fetal heart rate strip alone.

Question 31

Quickening is usually felt by the mother at?

Accepted Answer

Answer reason: Quickening is the first maternal perception of fetal movement and is typically felt around 16–20 weeks’ gestation. It may be perceived slightly earlier in multiparous clients (often closer to 16–18 weeks) and later in primigravidas (closer to 18–20 weeks). Earlier options are generally too early for consistent maternal perception, while 24–28 weeks is later than expected for first recognition in most pregnancies.

Question 32

At 20 weeks of gestation, fundal height is at?

Accepted Answer

Answer reason: By approximately 20 weeks’ gestation, the uterine fundus typically reaches the level of the umbilicus. Earlier in pregnancy, the fundus is at/just above the symphysis pubis (~12 weeks) and halfway to the umbilicus (~16 weeks). Later, it approaches the xiphoid process around 36 weeks before descending slightly near term. Therefore, the best answer is the umbilicus.

Question 33

What is the recommended number of antenatal visits according to WHO?

Accepted Answer

Answer reason: WHO’s 2016 antenatal care model recommends a minimum of 8 contacts (often referred to as visits/contacts) during pregnancy to improve maternal and perinatal outcomes. This replaces the older focused ANC model that recommended 4 visits. More frequent scheduled contacts allow earlier detection and management of complications, provision of preventive interventions, and improved patient education and support. Therefore, 8 is the best answer.

Question 34

Partograph is mainly used to monitor?

Accepted Answer

Answer reason: A partograph (partogram) is a labor monitoring tool used to track cervical dilatation and descent of the presenting part over time, alongside maternal and fetal parameters. Its primary purpose is to assess the progress of labor and identify abnormal or prolonged labor early so timely interventions can be initiated. It does not directly monitor fetal weight, placental separation, or postpartum bleeding.

Question 35

Which medication should the nurse expect to administer to a client who is experiencing preterm labor?

Accepted Answer

Answer reason: Preterm labor is treated with tocolytics to suppress uterine contractions and delay delivery long enough for interventions such as corticosteroids for fetal lung maturation. Nifedipine, a calcium channel blocker, is commonly used as a tocolytic to decrease uterine smooth muscle contractility. Oxytocin and misoprostol promote uterine contractions for labor induction/augmentation, which would worsen preterm labor. Methergine is used postpartum for uterine atony/hemorrhage and is not a treatment for preterm labor.

Question 36

Jane comes to the clinic for her prenatal appointment. She had twins at 36 weeks and a son at 38 weeks gestation. What is her GTPAL?

Accepted Answer

Answer reason: Gravida (G) is total number of pregnancies including the current one; she has had two prior pregnancies (twins and a singleton) and is currently pregnant, so G3. Term (T) is births at ≥37 weeks: the 38-week son makes T1. Preterm (P) is births from 20 to

Question 37

The first fetal movement (quickening) is usually felt at?

Accepted Answer

Answer reason: Quickening refers to the pregnant person’s first perception of fetal movement, which is typically felt in mid-second trimester. It is commonly perceived around 16–20 weeks’ gestation (often earlier in multiparous patients and later in primigravida). At 8–12 weeks, fetal movements may occur but are generally not strong enough to be felt by the mother. Therefore, 16–20 weeks is the best answer.

Question 38

First sign of pregnancy?

Accepted Answer

Answer reason: Among the listed choices, vomiting (often experienced as nausea and vomiting of pregnancy, or “morning sickness”) is a common early presumptive sign in the first trimester due to rising hCG and estrogen levels. Bleeding and pain are not normal early signs and can indicate complications (e.g., threatened miscarriage or ectopic pregnancy). “Labor” occurs at the end of pregnancy, not as an early sign. Therefore, vomiting is the best answer from the provided options.

Question 39

Which vaccine is routinely given during antenatal visits?

Accepted Answer

Answer reason: Tetanus toxoid (commonly administered as Td/Tdap per local guidelines) is routinely given in pregnancy to prevent maternal tetanus and, critically, neonatal tetanus through transplacental transfer of protective antibodies. It is a standard component of antenatal immunization programs, especially where risk of neonatal tetanus remains a concern. MMR is a live vaccine and is contraindicated during pregnancy, while rabies vaccine is given only for exposure risk. Hepatitis B may be given if the mother is at risk or non-immune, but it is not the routine antenatal vaccine in standard schedules.

Question 40

True labour pain is characterized by?

Accepted Answer

Answer reason: True labor is defined by regular contractions that lead to progressive cervical effacement and dilation. Unlike false labor (Braxton Hicks), true labor contractions tend to increase in frequency, duration, and intensity and are not relieved by rest. Pain in true labor often begins in the back and radiates to the abdomen, rather than being felt only in the abdomen.

Question 41

The third stage of labour involves?

Accepted Answer

Answer reason: The third stage of labor begins after the baby is delivered and ends with the delivery of the placenta. During this stage, uterine contractions continue to shear the placenta from the uterine wall and compress maternal blood vessels to reduce bleeding. Effacement of the cervix occurs in the first stage, and delivery of the baby is the second stage. Although membranes may pass, the defining event of the third stage is placental expulsion.

Question 42

Why is blood pressure checked in ANC?

Accepted Answer

Answer reason: Blood pressure monitoring during antenatal care is primarily done to screen for hypertensive disorders of pregnancy, especially preeclampsia. Preeclampsia is characterized by new-onset hypertension after 20 weeks’ gestation (often with proteinuria or end-organ dysfunction) and can rapidly progress to maternal and fetal complications. Anemia is screened by hemoglobin/hematocrit testing, infection by clinical signs/labs, and dehydration is assessed mainly via history, mucous membranes, and urine concentration rather than routine BP alone.

Question 43

Postnatal exercises are mainly advised for?

Accepted Answer

Answer reason: Postnatal exercises (including pelvic floor and abdominal strengthening with gradual ambulation) are primarily recommended to promote uterine involution and restore muscle tone after childbirth. They help strengthen pelvic floor muscles, reduce the risk of urinary incontinence, and support recovery of abdominal and perineal tissues. They are not intended to increase blood pressure, delay menstruation, or promote weight gain.

Question 44

Which of the following is a danger sign in pregnancy?

Accepted Answer

Answer reason: Vaginal bleeding during pregnancy is a danger sign because it can indicate serious complications such as threatened miscarriage, ectopic pregnancy, placenta previa, or placental abruption, all of which require prompt evaluation. In contrast, morning sickness, mild fatigue, and leg cramps are common discomforts of pregnancy and are usually benign when mild and uncomplicated. Any bleeding warrants assessment of maternal hemodynamic status and fetal well-being and should be reported immediately.

Question 45

The nurse prepares to assist in the delivery of the placenta immediately following the delivery of a newborn infant. What is the correct action to deliver the placenta?

Accepted Answer

Answer reason: After signs of placental separation occur, the appropriate nursing action is to assist the mother to bear down during a uterine contraction to facilitate expulsion. Pulling on the cord or applying traction can precipitate uterine inversion or cord avulsion if the placenta is not fully separated. Manually separating the placenta with instruments is not a routine nursing action and is reserved for retained placenta under provider management. Therefore, instructing the mother to push during a contraction is the safest correct action.

Question 46

When should the first antenatal visit ideally occur?

Accepted Answer

Answer reason: The first antenatal (prenatal) visit is ideally scheduled in the first trimester, by about 12 weeks’ gestation, to confirm pregnancy dating and initiate early screening and risk assessment. This timing allows prompt initiation of folic acid and other health-promotion counseling, baseline labs (e.g., blood type/Rh, anemia, infections), and early identification of conditions such as hypertension or diabetes. Earlier attendance is beneficial, but among the provided options, 12 weeks best matches the standard “book by 12 weeks” recommendation for routine care planning.

Question 47

When should ANC check-up be started?

Accepted Answer

Answer reason: Antenatal care should begin as early as possible, ideally immediately after pregnancy is confirmed, to establish gestational dating and baseline maternal health status. Early ANC enables timely screening (e.g., anemia, infections), initiation of folic acid/iron supplementation as indicated, and identification of high-risk conditions requiring closer follow-up. Waiting until 12 or 28 weeks can miss opportunities for prevention and early intervention, and starting at delivery defeats the purpose of antenatal monitoring.

Question 48

The early stage of labor is called?

Accepted Answer

Answer reason: The first (early) stage of labor is the dilation stage, when regular uterine contractions lead to cervical effacement and dilation from 0 to 10 cm. This stage precedes the expulsion stage, which is the second stage when the baby is delivered. The placental stage is the third stage involving delivery of the placenta. Quickening refers to the mother first feeling fetal movement during pregnancy, not a labor stage.

Question 49

The main aim of Active Management of Third Stage of Labour (AMTSL) is to prevent?

Accepted Answer

Answer reason: Active management of the third stage of labor (AMTSL)—including prophylactic uterotonic (e.g., oxytocin), controlled cord traction, and uterine massage/assessment—primarily reduces the risk of uterine atony. Uterine atony is the leading cause of postpartum hemorrhage (PPH), so preventing excessive bleeding is the key goal. AMTSL does not specifically prevent eclampsia (a hypertensive disorder), sepsis (infection), or anemia (a consequence that may result from bleeding).

Question 50

When should folic acid supplementation be started?

Accepted Answer

Answer reason: Folic acid should be started before conception (or as soon as pregnancy is possible/recognized) because neural tube closure occurs very early, by about 4 weeks of gestation, often before a person knows they are pregnant. Adequate periconceptional folate reduces the risk of neural tube defects such as spina bifida and anencephaly. Starting only in the 2nd or 3rd trimester (or after delivery) is too late to provide this key preventive benefit.

Train with a large NCLEX question bank and jump into a full exam-style simulator

Ante-Intra-Postpartum Care NCLEX Practice Test

Continue Learning