UR 202/ NUR202 Exam 1 –
N
Maternal-Newborn Nursing Review ACTUAL
EXAM 2026/2027 | Maternal-Newborn
Nursing Review | Verified Q&A | Pass
Guaranteed - A+ Graded
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PART A – MULTIPLE CHOICE (Q1‑60)
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* *Q1 (Reproductive anatomy – menstrual cycle):** A 24-year-old patient asks the nurse to
explain when ovulation occurs during her 28-day menstrual cycle. The nurse correctly states
that ovulation typically occurs:
A. On day 5 of the cycle
B. On day 14 of the cycle
C. On day 21 of the cycle
D. On day 28 of the cycle
**[CORRECT]** B
*Rationale: Ovulation typically occurs on day 14 of a 28-day cycle, triggered by the LH surge
that occurs approximately 24-36 hours prior. The follicular phase (days 1-14) is characterized by
rising estrogen levels that trigger positive feedback on the anterior pituitary, causing the LH
surge. Option A is incorrect because day 5 is during menstruation; option C is during the luteal
phase when progesterone is dominant; option D is when menstruation would begin if no
pregnancy occurred. Clinical pearl: Teach patients that ovulation occurs approximately 14 days
before the next expected period, regardless of cycle length.*
* *Q2 (Reproductive anatomy – hormones):** Which hormone is primarily responsible for
maintaining the endometrium during the luteal phase of the menstrual cycle?
A. Follicle-stimulating hormone (FSH)
B. Luteinizing hormone (LH)
C. Estrogen
D. Progesterone
**[CORRECT]** D
*Rationale: Progesterone, produced by the corpus luteum after ovulation, is the dominant
hormone of the luteal phase and maintains the thickened endometrium for potential
implantation. FSH (option A) stimulates follicular development in the follicular phase; LH (option
, ) triggers ovulation and supports the corpus luteum; estrogen (option C) is dominant in the
B
follicular phase and promotes endometrial proliferation but does not maintain it. Clinical pearl: If
fertilization does not occur, the corpus luteum degenerates, progesterone levels drop, and
menstruation begins.*
* *Q3 (Fertilization and implantation):** Fertilization of the ovum most commonly occurs in which
anatomical location?
A. The ovary
B. The ampulla of the fallopian tube
C. The uterine fundus
D. The endocervical canal
**[CORRECT]** B
*Rationale: Fertilization most commonly occurs in the ampulla (outer third) of the fallopian tube,
where the ovum is swept by fimbriae after ovulation. The ovary (option A) releases the ovum but
is not the site of fertilization; the uterine fundus (option C) is where implantation occurs 6-10
days after fertilization; the endocervical canal (option D) is where sperm must pass through but
fertilization does not occur there. Clinical pearl: Ectopic pregnancy most commonly occurs in the
ampulla of the fallopian tube because this is the typical fertilization site.*
* *Q4 (Placental development):** The decidua basalis is best described as:
A. The portion of the decidua that covers the blastocyst
B. The portion of the decidua that lies between the blastocyst and the myometrium
C. The portion of the decidua that lines the remainder of the uterus
D. The fetal portion of the placenta
**[CORRECT]** B
*Rationale: The decidua basalis is the maternal portion of the placenta that lies between the
blastocyst and the myometrium; it forms the maternal contribution to placental circulation. The
decidua capsularis (option A) covers the blastocyst; the decidua parietalis (option C) lines the
remainder of the uterus; the chorionic villi (option D) form the fetal portion of the placenta.
Clinical pearl: The decidua basalis and chorionic villi together form the functional placenta, with
maternal and fetal blood coming into close proximity but never mixing.*
* *Q5 (Preconception health – folic acid):** A nurse is counseling a 28-year-old woman who is
planning pregnancy. The nurse correctly recommends that she begin taking folic acid at what
dose and for what primary purpose?
A. 200 mcg daily to prevent anemia
B. 400-800 mcg daily to prevent neural tube defects
C. 1000 mcg daily to prevent preterm labor
D. 5 mg daily to prevent gestational diabetes
**[CORRECT]** B
*Rationale: ACOG and CDC recommend 400-800 mcg of folic acid daily for all women of
childbearing age, beginning at least one month before conception, to reduce the risk of neural
tube defects (spina bifida and anencephaly). Option A is an insufficient dose for neural tube
defect prevention; option C is not a recognized indication for folic acid; option D is an excessive
, ose and not indicated for gestational diabetes prevention. Clinical pearl: Women with a prior
d
pregnancy affected by a neural tube defect should take 4 mg (4000 mcg) daily under physician
guidance.*
* *Q6 (Preconception health – rubella immunity):** A 30-year-old woman planning pregnancy
has a rubella titer of <8 IU/mL (non-immune). What is the most appropriate nursing action?
A. Administer the rubella vaccine and advise her she may conceive immediately
B. Advise her to avoid pregnancy for 1 month after receiving the MMR vaccine
C. Reassure her that rubella immunity is not necessary during pregnancy
D. Recommend the varicella vaccine instead
**[CORRECT]** B
*Rationale: CDC guidelines recommend that women who are non-immune to rubella receive the
MMR vaccine and avoid pregnancy for 28 days (1 month) afterward because the rubella
component is a live attenuated virus with theoretical teratogenic risk. Option A is incorrect
because conception should be delayed; option C is incorrect because rubella during pregnancy
can cause congenital rubella syndrome; option D is incorrect because varicella immunity is a
separate issue. Clinical pearl: Document rubella immunity status in all women of childbearing
age, as rubella infection in the first trimester carries up to 90% risk of congenital defects.*
* *Q7 (Preconception health – teratogens):** Which of the following medications is a known
teratogen that should be discontinued before pregnancy?
A. Acetaminophen
B. Isotretinoin
C. Folic acid
D. Prenatal vitamins
**[CORRECT]** B
*Rationale: Isotretinoin (Accutane), a vitamin A derivative used for acne, is a Category X
teratogen associated with severe birth defects including craniofacial abnormalities, CNS
defects, and cardiovascular malformations; it must be discontinued at least one month before
conception. Acetaminophen (option A) is generally considered safe in pregnancy; folic acid
(option C) and prenatal vitamins (option D) are recommended before and during pregnancy.
Clinical pearl: The iPLEDGE program requires two negative pregnancy tests before isotretinoin
prescription and monthly testing during therapy.*
* *Q8 (Preconception health – genetic screening):** Which of the following is included in
standard preconception/prenatal genetic carrier screening according to ACOG 2026 guidelines?
A. Huntington disease
B. Cystic fibrosis, spinal muscular atrophy, and hemoglobinopathies
C. Down syndrome
D. Duchenne muscular dystrophy
**[CORRECT]** B
*Rationale: ACOG recommends offering carrier screening for cystic fibrosis (CF), spinal
muscular atrophy (SMA), and hemoglobinopathies (thalassemia, sickle cell) to all women of
childbearing age, regardless of ethnicity. Huntington disease (option A) is an autosomal
, ominant condition, not typically screened in asymptomatic individuals; Down syndrome (option
d
C) is not a carrier-screened condition but rather screened during pregnancy; Duchenne
muscular dystrophy (option D) is X-linked and not part of universal screening. Clinical pearl:
Expanded carrier screening panels now test for 100+ conditions and should be offered to all
patients considering pregnancy.*
* *Q9 (Prenatal care – initial visit):** During the initial prenatal visit, which laboratory test is NOT
routinely performed?
A. Complete blood count (CBC)
B. Blood type and Rh factor
C. Thyroid-stimulating hormone (TSH)
D. Urinalysis and urine culture
**[CORRECT]** C
*Rationale: TSH is not routinely performed on all pregnant women unless they have risk factors
for thyroid disease; routine initial labs include CBC, blood type/Rh, antibody screen, rubella titer,
syphilis screening, HIV, hepatitis B, urinalysis, and urine culture. The CBC (option A) screens for
anemia and infection; blood type/Rh (option B) identifies at-risk Rh-negative mothers; urinalysis
(option D) screens for proteinuria, glucosuria, and bacteriuria. Clinical pearl: Universal TSH
screening is not recommended by ACOG, but targeted screening is indicated for women with
symptoms, goiter, or history of thyroid disease.*
* *Q10 (Prenatal care – visit schedule):** A patient is 30 weeks pregnant with an uncomplicated
pregnancy. According to ACOG guidelines, how frequently should she have prenatal visits?
A. Every 4 weeks
B. Every 2 weeks
C. Every week
D. Every 3 weeks
**[CORRECT]** B
*Rationale: ACOG recommends prenatal visits every 4 weeks until 28 weeks gestation, then
every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until delivery. At 30 weeks, the
patient falls in the 28-36 week range requiring biweekly visits. Every 4 weeks (option A) is for
the first and second trimesters; every week (option C) begins at 36 weeks; every 3 weeks
(option D) is not a standard schedule. Clinical pearl: High-risk pregnancies may require more
frequent visits regardless of gestational age.*
* *Q11 (Prenatal assessment – fundal height):** At 32 weeks gestation, the nurse measures the
fundal height at 30 cm. What is the most appropriate nursing action?
A. Immediately notify the provider of intrauterine growth restriction
B. Document the finding as within normal limits
C. Prepare the patient for an emergency ultrasound
D. Recheck the measurement with a different tape measure
**[CORRECT]** B
*Rationale: Fundal height in centimeters should equal gestational age in weeks +/-2 cm after 20
weeks gestation; 30 cm at 32 weeks (2 cm less than expected) falls within the normal range.
N
Maternal-Newborn Nursing Review ACTUAL
EXAM 2026/2027 | Maternal-Newborn
Nursing Review | Verified Q&A | Pass
Guaranteed - A+ Graded
=======================================================================
=
========
PART A – MULTIPLE CHOICE (Q1‑60)
========================================================================
========
* *Q1 (Reproductive anatomy – menstrual cycle):** A 24-year-old patient asks the nurse to
explain when ovulation occurs during her 28-day menstrual cycle. The nurse correctly states
that ovulation typically occurs:
A. On day 5 of the cycle
B. On day 14 of the cycle
C. On day 21 of the cycle
D. On day 28 of the cycle
**[CORRECT]** B
*Rationale: Ovulation typically occurs on day 14 of a 28-day cycle, triggered by the LH surge
that occurs approximately 24-36 hours prior. The follicular phase (days 1-14) is characterized by
rising estrogen levels that trigger positive feedback on the anterior pituitary, causing the LH
surge. Option A is incorrect because day 5 is during menstruation; option C is during the luteal
phase when progesterone is dominant; option D is when menstruation would begin if no
pregnancy occurred. Clinical pearl: Teach patients that ovulation occurs approximately 14 days
before the next expected period, regardless of cycle length.*
* *Q2 (Reproductive anatomy – hormones):** Which hormone is primarily responsible for
maintaining the endometrium during the luteal phase of the menstrual cycle?
A. Follicle-stimulating hormone (FSH)
B. Luteinizing hormone (LH)
C. Estrogen
D. Progesterone
**[CORRECT]** D
*Rationale: Progesterone, produced by the corpus luteum after ovulation, is the dominant
hormone of the luteal phase and maintains the thickened endometrium for potential
implantation. FSH (option A) stimulates follicular development in the follicular phase; LH (option
, ) triggers ovulation and supports the corpus luteum; estrogen (option C) is dominant in the
B
follicular phase and promotes endometrial proliferation but does not maintain it. Clinical pearl: If
fertilization does not occur, the corpus luteum degenerates, progesterone levels drop, and
menstruation begins.*
* *Q3 (Fertilization and implantation):** Fertilization of the ovum most commonly occurs in which
anatomical location?
A. The ovary
B. The ampulla of the fallopian tube
C. The uterine fundus
D. The endocervical canal
**[CORRECT]** B
*Rationale: Fertilization most commonly occurs in the ampulla (outer third) of the fallopian tube,
where the ovum is swept by fimbriae after ovulation. The ovary (option A) releases the ovum but
is not the site of fertilization; the uterine fundus (option C) is where implantation occurs 6-10
days after fertilization; the endocervical canal (option D) is where sperm must pass through but
fertilization does not occur there. Clinical pearl: Ectopic pregnancy most commonly occurs in the
ampulla of the fallopian tube because this is the typical fertilization site.*
* *Q4 (Placental development):** The decidua basalis is best described as:
A. The portion of the decidua that covers the blastocyst
B. The portion of the decidua that lies between the blastocyst and the myometrium
C. The portion of the decidua that lines the remainder of the uterus
D. The fetal portion of the placenta
**[CORRECT]** B
*Rationale: The decidua basalis is the maternal portion of the placenta that lies between the
blastocyst and the myometrium; it forms the maternal contribution to placental circulation. The
decidua capsularis (option A) covers the blastocyst; the decidua parietalis (option C) lines the
remainder of the uterus; the chorionic villi (option D) form the fetal portion of the placenta.
Clinical pearl: The decidua basalis and chorionic villi together form the functional placenta, with
maternal and fetal blood coming into close proximity but never mixing.*
* *Q5 (Preconception health – folic acid):** A nurse is counseling a 28-year-old woman who is
planning pregnancy. The nurse correctly recommends that she begin taking folic acid at what
dose and for what primary purpose?
A. 200 mcg daily to prevent anemia
B. 400-800 mcg daily to prevent neural tube defects
C. 1000 mcg daily to prevent preterm labor
D. 5 mg daily to prevent gestational diabetes
**[CORRECT]** B
*Rationale: ACOG and CDC recommend 400-800 mcg of folic acid daily for all women of
childbearing age, beginning at least one month before conception, to reduce the risk of neural
tube defects (spina bifida and anencephaly). Option A is an insufficient dose for neural tube
defect prevention; option C is not a recognized indication for folic acid; option D is an excessive
, ose and not indicated for gestational diabetes prevention. Clinical pearl: Women with a prior
d
pregnancy affected by a neural tube defect should take 4 mg (4000 mcg) daily under physician
guidance.*
* *Q6 (Preconception health – rubella immunity):** A 30-year-old woman planning pregnancy
has a rubella titer of <8 IU/mL (non-immune). What is the most appropriate nursing action?
A. Administer the rubella vaccine and advise her she may conceive immediately
B. Advise her to avoid pregnancy for 1 month after receiving the MMR vaccine
C. Reassure her that rubella immunity is not necessary during pregnancy
D. Recommend the varicella vaccine instead
**[CORRECT]** B
*Rationale: CDC guidelines recommend that women who are non-immune to rubella receive the
MMR vaccine and avoid pregnancy for 28 days (1 month) afterward because the rubella
component is a live attenuated virus with theoretical teratogenic risk. Option A is incorrect
because conception should be delayed; option C is incorrect because rubella during pregnancy
can cause congenital rubella syndrome; option D is incorrect because varicella immunity is a
separate issue. Clinical pearl: Document rubella immunity status in all women of childbearing
age, as rubella infection in the first trimester carries up to 90% risk of congenital defects.*
* *Q7 (Preconception health – teratogens):** Which of the following medications is a known
teratogen that should be discontinued before pregnancy?
A. Acetaminophen
B. Isotretinoin
C. Folic acid
D. Prenatal vitamins
**[CORRECT]** B
*Rationale: Isotretinoin (Accutane), a vitamin A derivative used for acne, is a Category X
teratogen associated with severe birth defects including craniofacial abnormalities, CNS
defects, and cardiovascular malformations; it must be discontinued at least one month before
conception. Acetaminophen (option A) is generally considered safe in pregnancy; folic acid
(option C) and prenatal vitamins (option D) are recommended before and during pregnancy.
Clinical pearl: The iPLEDGE program requires two negative pregnancy tests before isotretinoin
prescription and monthly testing during therapy.*
* *Q8 (Preconception health – genetic screening):** Which of the following is included in
standard preconception/prenatal genetic carrier screening according to ACOG 2026 guidelines?
A. Huntington disease
B. Cystic fibrosis, spinal muscular atrophy, and hemoglobinopathies
C. Down syndrome
D. Duchenne muscular dystrophy
**[CORRECT]** B
*Rationale: ACOG recommends offering carrier screening for cystic fibrosis (CF), spinal
muscular atrophy (SMA), and hemoglobinopathies (thalassemia, sickle cell) to all women of
childbearing age, regardless of ethnicity. Huntington disease (option A) is an autosomal
, ominant condition, not typically screened in asymptomatic individuals; Down syndrome (option
d
C) is not a carrier-screened condition but rather screened during pregnancy; Duchenne
muscular dystrophy (option D) is X-linked and not part of universal screening. Clinical pearl:
Expanded carrier screening panels now test for 100+ conditions and should be offered to all
patients considering pregnancy.*
* *Q9 (Prenatal care – initial visit):** During the initial prenatal visit, which laboratory test is NOT
routinely performed?
A. Complete blood count (CBC)
B. Blood type and Rh factor
C. Thyroid-stimulating hormone (TSH)
D. Urinalysis and urine culture
**[CORRECT]** C
*Rationale: TSH is not routinely performed on all pregnant women unless they have risk factors
for thyroid disease; routine initial labs include CBC, blood type/Rh, antibody screen, rubella titer,
syphilis screening, HIV, hepatitis B, urinalysis, and urine culture. The CBC (option A) screens for
anemia and infection; blood type/Rh (option B) identifies at-risk Rh-negative mothers; urinalysis
(option D) screens for proteinuria, glucosuria, and bacteriuria. Clinical pearl: Universal TSH
screening is not recommended by ACOG, but targeted screening is indicated for women with
symptoms, goiter, or history of thyroid disease.*
* *Q10 (Prenatal care – visit schedule):** A patient is 30 weeks pregnant with an uncomplicated
pregnancy. According to ACOG guidelines, how frequently should she have prenatal visits?
A. Every 4 weeks
B. Every 2 weeks
C. Every week
D. Every 3 weeks
**[CORRECT]** B
*Rationale: ACOG recommends prenatal visits every 4 weeks until 28 weeks gestation, then
every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until delivery. At 30 weeks, the
patient falls in the 28-36 week range requiring biweekly visits. Every 4 weeks (option A) is for
the first and second trimesters; every week (option C) begins at 36 weeks; every 3 weeks
(option D) is not a standard schedule. Clinical pearl: High-risk pregnancies may require more
frequent visits regardless of gestational age.*
* *Q11 (Prenatal assessment – fundal height):** At 32 weeks gestation, the nurse measures the
fundal height at 30 cm. What is the most appropriate nursing action?
A. Immediately notify the provider of intrauterine growth restriction
B. Document the finding as within normal limits
C. Prepare the patient for an emergency ultrasound
D. Recheck the measurement with a different tape measure
**[CORRECT]** B
*Rationale: Fundal height in centimeters should equal gestational age in weeks +/-2 cm after 20
weeks gestation; 30 cm at 32 weeks (2 cm less than expected) falls within the normal range.
