NR327/NR 327 Exam 1 V3 | Maternal Child
Nursing Q&A with Rationale | Chamberlain
University
1. A nurse is calculating a client’s estimated date of delivery (EDD) using Naegele’s rule. The
client’s last menstrual period (LMP) began on June 10th. Which of the following is the correct
EDD?
A. March 17th
B. March 3rd
C. March 7th
D. April 17th
Correct Answer: A
Rationale: Naegele’s rule is calculated by subtracting three months and adding seven days
and one year to the first day of the last menstrual period. Subtracting three months from
June leads to March, and adding seven days to the 10th results in the 17th. This method
assumes a standard 28-day cycle and is the primary tool used in clinical practice to
estimate the delivery date.
2. A nurse is assessing a pregnant client who is at 30 weeks of gestation. Which of the
following findings should the nurse report to the provider as a potential sign of preeclampsia?
A. Dependent edema of the ankles
,B. Increased vaginal discharge
C. Periodic shortness of breath
D. Epigastric pain
Correct Answer: D
Rationale: Epigastric pain is a significant finding that can indicate hepatic involvement or
subcapsular hemorrhage in severe preeclampsia. While dependent edema is common in
pregnancy, epigastric pain, severe headaches, and visual disturbances are considered
‘warning signs’ that require immediate evaluation. The nurse must prioritize this finding to
prevent progression to eclampsia or HELLP syndrome.
3. A woman who is 12 weeks pregnant tells the nurse that she is concerned about her
increased vaginal discharge. How should the nurse respond?
A. This is a sign of infection and requires a prescription for antibiotics.
B. This is called leukorrhea and is a normal finding due to increased estrogen.
C. You should use douches daily to maintain hygiene during pregnancy.
D. This is likely a sign that your membranes have ruptured prematurely.
Correct Answer: B
Rationale: Leukorrhea is a thin, white, or slightly gray mucoid discharge that occurs in
response to cervical stimulation by estrogen and progesterone. It is considered a normal
physiological change of pregnancy unless it is accompanied by itching or a foul odor. The
,nurse should reassure the client and advise against douching, as it can disrupt the normal
vaginal flora.
4. A client presents to the clinic for her first prenatal visit. She has a history of one
miscarriage at 10 weeks, one child born at 38 weeks, and is currently pregnant. What is her
GTPAL?
A. G3 T1 P1 A1 L2
B. G2 T1 P1 A0 L1
C. G3 T1 P0 A1 L1
D. G2 T0 P0 A1 L1
Correct Answer: C
Rationale: G stands for Gravida (3: current, miscarriage, and term birth); T for Term (1:
birth at 38 weeks); P for Preterm (0: no births between 20-37 weeks); A for Abortion (1:
miscarriage at 10 weeks); and L for Living (1: the child from the term birth). Understanding
the GTPAL system is essential for accurately documenting an obstetrical history.
Miscarriages before 20 weeks are counted as abortions, while births after 20 weeks
contribute to the T or P categories.
5. During a routine second-trimester visit, a client asks why her blood pressure is lower than
it was before she got pregnant. What is the nurse’s best explanation?
A. The heart is beating slower during the second trimester.
B. Lowered blood pressure is a sign of dehydration and requires IV fluids.
, C. The blood volume has decreased, leading to lower pressure.
D. There is a decrease in peripheral vascular resistance due to progesterone.
Correct Answer: D
Rationale: Blood pressure typically decreases slightly during the second trimester due to
the vasodilatory effects of progesterone and increased capillary bed surface area.
Peripheral vascular resistance drops to accommodate the increased blood volume required
for fetal growth. This is a normal physiological adaptation and usually returns to pre-
pregnancy levels by the third trimester.
6. A nurse is performing a fundal height measurement on a client who is at 24 weeks of
gestation. Where should the nurse expect to find the fundus?
A. At the level of the symphysis pubis
B. At the level of the umbilicus
C. Halfway between the symphysis pubis and the umbilicus
D. Approximately 4 cm above the umbilicus
Correct Answer: D
Rationale: Between 18 and 32 weeks of gestation, the fundal height in centimeters usually
matches the week of gestation plus or minus 2 cm. At 20 weeks, the fundus is typically at
the umbilicus, so at 24 weeks, it should be approximately 4 cm above the umbilicus. This
measurement is used as a screening tool to assess for appropriate fetal growth or amniotic
fluid abnormalities.
Nursing Q&A with Rationale | Chamberlain
University
1. A nurse is calculating a client’s estimated date of delivery (EDD) using Naegele’s rule. The
client’s last menstrual period (LMP) began on June 10th. Which of the following is the correct
EDD?
A. March 17th
B. March 3rd
C. March 7th
D. April 17th
Correct Answer: A
Rationale: Naegele’s rule is calculated by subtracting three months and adding seven days
and one year to the first day of the last menstrual period. Subtracting three months from
June leads to March, and adding seven days to the 10th results in the 17th. This method
assumes a standard 28-day cycle and is the primary tool used in clinical practice to
estimate the delivery date.
2. A nurse is assessing a pregnant client who is at 30 weeks of gestation. Which of the
following findings should the nurse report to the provider as a potential sign of preeclampsia?
A. Dependent edema of the ankles
,B. Increased vaginal discharge
C. Periodic shortness of breath
D. Epigastric pain
Correct Answer: D
Rationale: Epigastric pain is a significant finding that can indicate hepatic involvement or
subcapsular hemorrhage in severe preeclampsia. While dependent edema is common in
pregnancy, epigastric pain, severe headaches, and visual disturbances are considered
‘warning signs’ that require immediate evaluation. The nurse must prioritize this finding to
prevent progression to eclampsia or HELLP syndrome.
3. A woman who is 12 weeks pregnant tells the nurse that she is concerned about her
increased vaginal discharge. How should the nurse respond?
A. This is a sign of infection and requires a prescription for antibiotics.
B. This is called leukorrhea and is a normal finding due to increased estrogen.
C. You should use douches daily to maintain hygiene during pregnancy.
D. This is likely a sign that your membranes have ruptured prematurely.
Correct Answer: B
Rationale: Leukorrhea is a thin, white, or slightly gray mucoid discharge that occurs in
response to cervical stimulation by estrogen and progesterone. It is considered a normal
physiological change of pregnancy unless it is accompanied by itching or a foul odor. The
,nurse should reassure the client and advise against douching, as it can disrupt the normal
vaginal flora.
4. A client presents to the clinic for her first prenatal visit. She has a history of one
miscarriage at 10 weeks, one child born at 38 weeks, and is currently pregnant. What is her
GTPAL?
A. G3 T1 P1 A1 L2
B. G2 T1 P1 A0 L1
C. G3 T1 P0 A1 L1
D. G2 T0 P0 A1 L1
Correct Answer: C
Rationale: G stands for Gravida (3: current, miscarriage, and term birth); T for Term (1:
birth at 38 weeks); P for Preterm (0: no births between 20-37 weeks); A for Abortion (1:
miscarriage at 10 weeks); and L for Living (1: the child from the term birth). Understanding
the GTPAL system is essential for accurately documenting an obstetrical history.
Miscarriages before 20 weeks are counted as abortions, while births after 20 weeks
contribute to the T or P categories.
5. During a routine second-trimester visit, a client asks why her blood pressure is lower than
it was before she got pregnant. What is the nurse’s best explanation?
A. The heart is beating slower during the second trimester.
B. Lowered blood pressure is a sign of dehydration and requires IV fluids.
, C. The blood volume has decreased, leading to lower pressure.
D. There is a decrease in peripheral vascular resistance due to progesterone.
Correct Answer: D
Rationale: Blood pressure typically decreases slightly during the second trimester due to
the vasodilatory effects of progesterone and increased capillary bed surface area.
Peripheral vascular resistance drops to accommodate the increased blood volume required
for fetal growth. This is a normal physiological adaptation and usually returns to pre-
pregnancy levels by the third trimester.
6. A nurse is performing a fundal height measurement on a client who is at 24 weeks of
gestation. Where should the nurse expect to find the fundus?
A. At the level of the symphysis pubis
B. At the level of the umbilicus
C. Halfway between the symphysis pubis and the umbilicus
D. Approximately 4 cm above the umbilicus
Correct Answer: D
Rationale: Between 18 and 32 weeks of gestation, the fundal height in centimeters usually
matches the week of gestation plus or minus 2 cm. At 20 weeks, the fundus is typically at
the umbilicus, so at 24 weeks, it should be approximately 4 cm above the umbilicus. This
measurement is used as a screening tool to assess for appropriate fetal growth or amniotic
fluid abnormalities.
