NUR 327 Final Semester Paper Exam Guide 2026

NUR 327 NUR 327 Final Semester Paper Exam Guide 2026 What are positive signs of pregnancy? Fetal movement, audio, and visualization What are probable signs of pregnancy? Hegar's and Goodell's signs, pregnancy test What are presumptive signs of pregnancy? Amenorrhea, nausea, and vomiting What are the different ways to refer to a women's due date? EDC: estimated date of confinement EDD: estimated due date EDB: estimated date of birth How do you utilize Nagele's rule to estimate a women's due date? The nurse would assess the client's last menstrual period by subtracting 3 months and adding 7 days to the stated LMP date. *Example: LMP = 11/21 (November is the 11th month), so 11-3 months = 8 (I.e., due date is August). Now take the first day of the LMP and subtract 7 days (21 + 7 = 28th day). 8/28 is the EDD. Gravida The number of times a woman has been pregnant Primigravida One pregnancy Nulligravida No pregnancies Multigravida Multigravida Primipara One birth NUR 327 NUR 327 Nullipara No births Multipara Multiple births What is GTPAL? G: # of pregnancies T: # of term births ( 38 weeks) P: # of preterm births (viability to 37 weeks) A: # of abortions or miscarriages ( viability) L: # of living children When is a fetus considered to be at term? 37 weeks When is a fetus considered preterm? 37 weeks When is a fetus considered viable? At 22 weeks How do the Chinese Confucian view pregnancy? Pregnancy is viewed as a happiness in the body. Labor is seen as a painful step, although short, to motherhood. Modesty and self-control are important, so women try to remain stoic throughout the childbearing experience, asking very few questions. How do Mormon individuals view pregnancy? Pregnancy creates a connection with eternity. The religion empowers members to create families. Pregnancy and childbirth are viewed as times of personal and family growth How do Muslims view pregnancy? Menstruation is a woman's issue, surrounded by tradition. Female topics are not to be discussed with men. When menstruating, a woman is considered unclean and cannot touch the Koran. Planning for the baby or even holding baby showers are considered defiance of God's will. At birth, before anyone but the physician holds the baby, the Muslim father (eldest male member) whispers a prayer of Allah into the baby's ear as protection from evil NUR 327 NUR 327 How do Orthodox Jews view pregnancy? The lineage is passed through the mother. During the prenatal period, neither baby preparations nor baby showers are allowed. A menstruating woman cannot be touched from the first day of her period until 7 days after the flow ceases and she has completed her ritual bath. Husbands may not be exposed to vaginal blood. The woman is considered ritually impure after her water breaks, so the father is unlikely to be in the delivery room; he will be praying in the waiting area How do Roman Catholics (Christians) view pregnancy? A child is viewed as a gift of the marriage; parents may bring a religious object or symbol with them to the birth The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell the patient that she can expect to feel the fetus move at which time? a. Between 10 and 12 weeks gestation b. Between 16 and 20 weeks gestation c. Between 21 and 23 weeks gestation d. Between 24 and 26 weeks gestation Answer: A; between 10 and 12 weeks gestation. A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to: a. Place the mother in the supine position b. Document the findings and continue to monitor the fetal patterns c. Administer oxygen via face mask d. Increase the rate of pitocin IV infusion Answer: C Rationale: Late decelerations are due to uteroplacental insufficiency as the result of decreased blood flow and oxygen to the fetus during the uterine contractions. This causes hypoxemia; therefore oxygen is necessary. The supine position is avoided because it decreases uterine blood flow to the fetus. The client should be turned to her side to displace pressure of the gravid uterus on the inferior vena cava. An intravenous pitocin infusion is discontinued when a late deceleration is noted. NUR 327 NUR 327 The nurse is caring for a primigravida at about 2 months and 1 week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says: a. "Nausea and vomiting can be decreased if I eat a few crackers before arising" b. "If I start to leak colostrum, I should cleanse my nipples with soap and water" c. "If I have vaginal discharge, I should wear nylon underwear" d. "Leg cramps can be alleviated if I put an ice pack on the area" Answer: A Which hormone helps to stabilize the uterus during pregnancy and reduce the likelihood of contractions, sometimes given as a medication to reduce the risk of preterm labor? a. Estrogen b. hcg c. Progesterone d. Oxytocin Answer: C; progesterone True or False: The MSAFP test is a diagnostic test to determine the presence of Down Syndrome in a fetus False True or False: Insulin injections are considered teratogenic False True or False: The pregnant woman should avoid ibuprofen True A grandmother calls from the postpartum room requesting for the newborn to be brought back as soon as possible from the nursery. What should the nurse do? The grandmother does not call the shots; bringing the baby back from the nursery is up to the mother. Ask the mother if it is ok. A new parent asks "I'm unsure what to do, do you think I should have my son circumcised?" Provide the parents with educational tools for both sides of the argument The CNM is qualified to perform: a. Regional anesthesia. NUR 327 NUR 327 b. Cesarean deliveries. c. Vaginal deliveries. d. Internal version. Answer: C Rationale: The midwife is qualified to deliver infants vaginally in uncomplicated pregnancies. Regional anesthesia must be performed by a physician. Cesarean deliveries must be performed by a physician. An internal version must be performed by a physician. A nurse is caring for a client who is pregnant and states that their last menstrual period was April 1st. Which of the following is the client's estimated date of delivery? a. January 8 b. January 15 c. February 8 d. February 15 Answer: A (Subtract 3 months and add 7 days) A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following findings should the nurse expect? (SATA) a. Montgomery's glands b. Goodell's sign c. Ballottement d. Chadwick's sign e. Quickening Answer: B, C, D A and E are presumptive signs of pregnancy. A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make? a. "This is due to an increase in blood volume" NUR 327 NUR 327 b. "This is due to pressure from the uterus on the diaphragm" c. "This is due to the weight of the uterus on the vena cava" d. "This is due to increased cardiac output" Answer: C Rationale: Maternal hypotension occurs when the client is lying in the supine position and the weight of the gravid uterus places pressure on the vena cava, decreasing venous blood flow to the heart. An increase in blood volume and an increase in cardiac output results in cardiac hypertrophy. Pressure from the gravid uterus on the diaphragm might cause the client to experience SOB. A nurse in a clinic receives a phone call from a client who would like to be tested in the clinic to confirm a pregnancy. Which of the following information should the nurse provide to the client? a. "You should wait until 4 weeks after conception to be tested" b. "You should be off any medications for 24 hours prior to the test" c. "You should be NPO for at least 8 hours prior to the test" d. "You should collect the urine from the first morning void" Answer: D Rationale: Urine pregnancy tests should be done on a first-voided morning specimen to provide the most accurate results. A nurse is teaching a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include? (SATA) a. Avoid any lifting b. Perform Kegel exercises twice a day c. Perform the pelvic rock exercise every day d. Use proper body mechanics e. Avoid constrictive clothing Answer: C, D NUR 327 NUR 327 A nurse is caring for a client who is pregnant and reviewing manifestations of complications the client should promptly report to the provider. Which of the following complications should the nurse include? a. Vaginal bleeding b. Swelling of the ankles c. Heartburn after eating d. Lightheadedness when lying back Answer: A Rationale: vaginal bleeding indicates a potential complication of the placenta such as placenta previa. The remaining answers are common manifestations during pregnancy. A client who is at 7 weeks gestation is experiencing nausea and vomiting in the morning. Which of the following information should the nurse include? a. Eat crackers or plain toast before getting out of bed b. Awaken during the night to eat a snack c. Skip breakfast and eat lunch after nausea has subsided d. Eat a large evening meal Answer: A A nurse is teaching a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include? (SATA) a. Breast tenderness b. Urinary frequency c. Epistaxis d. Dysuria e. Epigastric pain Answer: A, B, C Dysuria and epigastric pain are complications that should be reported to the provider. Epigastric pain is a clinical finding of pregnancy-induced hypertension. A client who is at 8 weeks of gestation tells the nurse "I am not sure I am happy about being pregnant." Which of the following responses should the nurse make? a. "I will inform the provider that you are having these feelings" b. "It is normal to have these feelings during the first few months of pregnancy" NUR 327 NUR 327 c. "You should be happy that you are going to bring new life into the world" d. "I am going to make an appointment with the counselor for you to discuss these thoughts" Answer: B Feelings of ambivalence about pregnancy are normal during the first trimester. The remaining answers are all non-therapeutic responses. A nurse in a prenatal clinic is providing education to a client who is at 8 weeks of gestation. The client states, "I don't like milk." Which of the following foods should the nurse recommend as a good source of calcium? a. Dark green leafy vegetables b. Deep red or orange vegetables c. White breads and rice d. Meat, poultry, and fish Answer: A Sources include kale, artichokes, turnip greens. B is a good source of vitamin A and C. A nurse in a prenatal clinic is caring for four clients. Which of the following clients' weight gain should the nurse report to the provider? a. 1.8 kg (4 lb) weight gain and is in the first trimester b. 3.6 kg (8 lb) weight gain and is In the first trimester c. 6.8 kg (15 lb) weight gain and is in the second trimester d. 11.3 kg (25 lb) weight gain and is in the third trimester Answer: B This weight gain exceeds the expected amount of 3-4 lb weight gain in the first trimester. A nurse in a clinic is teaching a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency? a. Iron deficiency anemia b. Poor bone formation c. Macrosomic fetus NUR 327 NUR 327 d. Neural tube defects Answer: D Food sources of folic acid include fresh green leafy vegetables, liver, peanuts, cereals, and whole-grain breads. A is caused by lack of iron-rich sources such as meat, chicken, and fish. B is a result of calcium deficiency. C is a result of maternal obesity. A nurse is reviewing a new prescription for iron supplements with a client who is at 8 weeks of gestation and has iron deficiency anemia. Which of the following beverages should the nurse instruct the client to take the iron supplements with? a. Ice water b. Low-fat or whole milk c. Tea or coffee d. Orange juice Answer: D Vitamin C aids in the absorption of iron. Only 200 mg/day of caffeine should be consumed due to the risk of spontaneous abortion. Milk interferes with iron absorption. Water does not promote the absorption of iron. A nurse is reviewing postpartum nutrition needs with a group of clients who have begun breastfeeding their newborns. Which of the following statements by a member of the group indicates an understanding of the teaching? a. "I am glad I can have my morning coffee" b. "I should take folic acid to increase my milk supply" c. "I will continue adding 330 calories per day to my diet" d. "I will continue my calcium supplements because I don't like milk" Answer: D Clients who are breastfeeding require an additional 450-500 calories. Folic acid does not increase milk production. Breastfeeding mothers should avoid caffeine intake because it affects iron absorption and infant weight gain. A nurse is reviewing findings of a client's biophysical profile. The nurse should expect which of the following variables to be included in this test? (SATA) NUR 327 NUR 327 a. Fetal weight b. Fetal breathing movement c. Fetal tone d. Fetal position e. Amniotic fluid volume Answer: B, C, E A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. The nurse should evaluate which of the following tests to assess fetal lung maturity? a. Alpha-fetoprotein (AFP) b. Lecithin/sphingomyelin (L/S) ratio c. Kleihauer-Betke test d. Indirect Coombs' test Answer: B L/S ratio is done as a part of an amniocentesis to determine fetal lung maturity. AFP is a test to assess for fetal neural tube defects or chromosome disorders. Kleihauer-Betke test is used to verify that fetal blood is present during a percutaneous umbilical cord sampling procedure. Indirect Coombs' test is used to detect Rh antibodies in the mother's blood A nurse is caring for a client who is pregnant and undergoing a non-stress test. Thee client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make? a. "It is used to stimulate uterine contractions" b. "It will decrease the incidence of uterine contractions" c. "It lulls the fetus to sleep" d. "It awakens a sleeping fetus" Answer: D This device is activated for 3 seconds on the maternal abdomen over the fetal head to awaken the fetus. A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching? NUR 327 NUR 327 a. "You will lay on your right side during the procedure" b. "You should not eat anything for 24 hours prior to the procedure" c. "You should empty your bladder prior to the procedure" d. "The test is done to determine gestational age" Answer: C Empty the bladder to avoid inadvertent puncture during the procedure. This procedure is done to Identify fetal genetic defects. The patient does not need to be NPO. The client will be in the supine position with a wedge placed under the right hip. A nurse is caring for a client who is pregnant and is to undergo a contraction stress test. Which of the following findings are indications for this procedure? (SATA) a. Decreased fetal movement b. Intrauterine growth restriction c. Postmaturity d. Placenta previa e. Amniotic fluid emboli Answer: A, B, C Placenta previa is a contraindication of a CST. Amniotic fluid emboli are a complication of an am NUR 327