NR-327 – Maternal-Child Nursing
Comprehensive Study Guide, Pregnancy Care,
Labor and Delivery, Newborn Care, Pediatric
Nursing, and Practice Review
Q1. A nurse is calculating the estimated date of delivery (EDD) for a patient whose
last menstrual period (LMP) was January 15, 2025. Using Naegele's rule, what is
the EDD?
A) October 22, 2025
B) October 8, 2025
C) November 22, 2025
D) October 29, 2025
Answer: A — October 22, 2025
Rationale: Naegele's rule: Subtract 3 months from the LMP and add 7 days + 1
year (if applicable). January 15 – 3 months = October 15; October 15 + 7 days =
October 22, 2025. This rule assumes a 28-day cycle and is used to estimate the
EDD, which is approximately 40 weeks (280 days) from the LMP.
Q2. A nurse is assessing a patient at 12 weeks gestation. Which finding is
considered a presumptive sign of pregnancy?
A) Positive pregnancy test
B) Amenorrhea (missed menstrual period)
C) Goodell's sign
D) Fetal heart tones audible on Doppler
Answer: B — Amenorrhea (missed menstrual period)
Rationale: Presumptive signs of pregnancy are subjective and can be caused by
other conditions (e.g., amenorrhea, nausea and vomiting, breast changes,
fatigue). Probable signs are objective and detected by the examiner (e.g., positive
pregnancy test, Goodell's sign, Hegar's sign, Chadwick's sign). Positive signs are
,definitive (e.g., fetal heart tones, fetal movement felt by examiner, visualization of
fetus on ultrasound).
Q3. A patient at 16 weeks gestation asks the nurse about prenatal vitamins. Which
nutrient is most important for preventing neural tube defects?
A) Iron
B) Calcium
C) Folic acid
D) Vitamin D
Answer: C — Folic acid
Rationale: Folic acid is essential for neural tube development in the fetus. The
neural tube closes by 28 days of gestation, often before a woman knows she is
pregnant. Folic acid supplementation (400–800 mcg/day) before and during early
pregnancy reduces the risk of neural tube defects, including spina
bifida and anencephaly. The recommended daily allowance for pregnant women
is 600 mcg/day.
Q4. A nurse is performing a prenatal assessment on a patient at 36 weeks
gestation. The patient reports decreased fetal movement. What is the priority
nursing action?
A) Document the finding and discharge the patient
B) Perform a non-stress test (NST) or biophysical profile (BPP)
C) Tell the patient to eat a meal and count movements
D) Schedule a follow-up appointment in 1 week
Answer: B — Perform a non-stress test (NST) or biophysical profile (BPP)
Rationale: Decreased fetal movement is a concerning finding that may
indicate fetal distress or compromise. The nurse should immediately notify the
provider and prepare for a non-stress test (NST) or biophysical profile (BPP) to
assess fetal well-being. A normal NST is reactive (at least two accelerations of ≥
15 bpm lasting ≥ 15 seconds in 20 minutes). A BPP evaluates fetal breathing,
movement, tone, amniotic fluid volume, and NST results.
,Q5. A patient at 28 weeks gestation reports heartburn. Which recommendation
should the nurse provide?
A) Eat large, heavy meals before bed
B) Eat small, frequent meals and avoid lying flat after eating
C) Drink carbonated beverages with meals
D) Avoid all fluids between meals
Answer: B — Eat small, frequent meals and avoid lying flat after eating
Rationale: Heartburn (pyrosis) is common in pregnancy due to relaxation of the
lower esophageal sphincter (progesterone effect) and delayed gastric
emptying (progesterone and physical displacement of the stomach). The nurse
should recommend small, frequent meals, avoiding lying flat after eating,
and avoiding spicy, fatty, or acidic foods. Antacids may be used with caution and
under the provider's guidance.
Q6. A nurse is assessing a patient at 10 weeks gestation. Which of the following is
a probable sign of pregnancy?
A) Amenorrhea
B) Breast tenderness
C) Chadwick's sign (bluish-purple discoloration of the cervix and vaginal
mucosa)
D) Fetal heart tones
Answer: C — Chadwick's sign (bluish-purple discoloration of the cervix and
vaginal mucosa)
Rationale: Chadwick's sign is a probable sign of pregnancy caused by increased
vascularity and blood flow to the pelvic organs. It appears as a bluish-purple
discoloration of the cervix and vaginal mucosa. Other probable signs
include Goodell's sign (softening of the cervix), Hegar's sign (softening of the
uterine isthmus), and a positive pregnancy test. Presumptive signs include
amenorrhea and breast tenderness. Positive signs include fetal heart tones and fetal
movement palpated by the examiner.
, Q7. A patient at 32 weeks gestation is diagnosed with gestational diabetes. Which
complication is the patient at greatest risk for?
A) Post-term delivery
B) Macrosomia (large for gestational age)
C) Oligohydramnios
D) Placenta previa
Answer: B — Macrosomia (large for gestational age)
Rationale: Gestational diabetes is associated with fetal hyperinsulinemia due to
maternal hyperglycemia crossing the placenta. This results in macrosomia (birth
weight > 4,000 g or > 4,500 g), which increases the risk of shoulder
dystocia, birth trauma, and cesarean delivery. Other complications include
polyhydramnios, preeclampsia, and neonatal hypoglycemia. Gestational diabetes is
managed with dietary modification, exercise, and insulin if needed.
Q8. A nurse is teaching a patient about the signs of preterm labor. Which sign
should the patient report immediately?
A) Mild backache
B) Braxton-Hicks contractions
C) Regular uterine contractions (4 or more in 20 minutes) with or without
cervical change
D) Increased fetal movement
Answer: C — Regular uterine contractions (4 or more in 20 minutes) with or
without cervical change
Rationale: Preterm labor is defined as regular uterine contractions
causing cervical change between 20 and 37 weeks gestation. Signs to report
include regular contractions (4 in 20 minutes or 8 in 60 minutes), low back
pain, pelvic pressure, vaginal bleeding, or change in vaginal discharge.
Braxton-Hicks contractions are irregular and do not cause cervical change. Patients
should be educated to seek immediate care if these signs occur.
Q9. A patient at 20 weeks gestation is diagnosed with a urinary tract infection
(UTI). Which antibiotic is considered safe during pregnancy?
Comprehensive Study Guide, Pregnancy Care,
Labor and Delivery, Newborn Care, Pediatric
Nursing, and Practice Review
Q1. A nurse is calculating the estimated date of delivery (EDD) for a patient whose
last menstrual period (LMP) was January 15, 2025. Using Naegele's rule, what is
the EDD?
A) October 22, 2025
B) October 8, 2025
C) November 22, 2025
D) October 29, 2025
Answer: A — October 22, 2025
Rationale: Naegele's rule: Subtract 3 months from the LMP and add 7 days + 1
year (if applicable). January 15 – 3 months = October 15; October 15 + 7 days =
October 22, 2025. This rule assumes a 28-day cycle and is used to estimate the
EDD, which is approximately 40 weeks (280 days) from the LMP.
Q2. A nurse is assessing a patient at 12 weeks gestation. Which finding is
considered a presumptive sign of pregnancy?
A) Positive pregnancy test
B) Amenorrhea (missed menstrual period)
C) Goodell's sign
D) Fetal heart tones audible on Doppler
Answer: B — Amenorrhea (missed menstrual period)
Rationale: Presumptive signs of pregnancy are subjective and can be caused by
other conditions (e.g., amenorrhea, nausea and vomiting, breast changes,
fatigue). Probable signs are objective and detected by the examiner (e.g., positive
pregnancy test, Goodell's sign, Hegar's sign, Chadwick's sign). Positive signs are
,definitive (e.g., fetal heart tones, fetal movement felt by examiner, visualization of
fetus on ultrasound).
Q3. A patient at 16 weeks gestation asks the nurse about prenatal vitamins. Which
nutrient is most important for preventing neural tube defects?
A) Iron
B) Calcium
C) Folic acid
D) Vitamin D
Answer: C — Folic acid
Rationale: Folic acid is essential for neural tube development in the fetus. The
neural tube closes by 28 days of gestation, often before a woman knows she is
pregnant. Folic acid supplementation (400–800 mcg/day) before and during early
pregnancy reduces the risk of neural tube defects, including spina
bifida and anencephaly. The recommended daily allowance for pregnant women
is 600 mcg/day.
Q4. A nurse is performing a prenatal assessment on a patient at 36 weeks
gestation. The patient reports decreased fetal movement. What is the priority
nursing action?
A) Document the finding and discharge the patient
B) Perform a non-stress test (NST) or biophysical profile (BPP)
C) Tell the patient to eat a meal and count movements
D) Schedule a follow-up appointment in 1 week
Answer: B — Perform a non-stress test (NST) or biophysical profile (BPP)
Rationale: Decreased fetal movement is a concerning finding that may
indicate fetal distress or compromise. The nurse should immediately notify the
provider and prepare for a non-stress test (NST) or biophysical profile (BPP) to
assess fetal well-being. A normal NST is reactive (at least two accelerations of ≥
15 bpm lasting ≥ 15 seconds in 20 minutes). A BPP evaluates fetal breathing,
movement, tone, amniotic fluid volume, and NST results.
,Q5. A patient at 28 weeks gestation reports heartburn. Which recommendation
should the nurse provide?
A) Eat large, heavy meals before bed
B) Eat small, frequent meals and avoid lying flat after eating
C) Drink carbonated beverages with meals
D) Avoid all fluids between meals
Answer: B — Eat small, frequent meals and avoid lying flat after eating
Rationale: Heartburn (pyrosis) is common in pregnancy due to relaxation of the
lower esophageal sphincter (progesterone effect) and delayed gastric
emptying (progesterone and physical displacement of the stomach). The nurse
should recommend small, frequent meals, avoiding lying flat after eating,
and avoiding spicy, fatty, or acidic foods. Antacids may be used with caution and
under the provider's guidance.
Q6. A nurse is assessing a patient at 10 weeks gestation. Which of the following is
a probable sign of pregnancy?
A) Amenorrhea
B) Breast tenderness
C) Chadwick's sign (bluish-purple discoloration of the cervix and vaginal
mucosa)
D) Fetal heart tones
Answer: C — Chadwick's sign (bluish-purple discoloration of the cervix and
vaginal mucosa)
Rationale: Chadwick's sign is a probable sign of pregnancy caused by increased
vascularity and blood flow to the pelvic organs. It appears as a bluish-purple
discoloration of the cervix and vaginal mucosa. Other probable signs
include Goodell's sign (softening of the cervix), Hegar's sign (softening of the
uterine isthmus), and a positive pregnancy test. Presumptive signs include
amenorrhea and breast tenderness. Positive signs include fetal heart tones and fetal
movement palpated by the examiner.
, Q7. A patient at 32 weeks gestation is diagnosed with gestational diabetes. Which
complication is the patient at greatest risk for?
A) Post-term delivery
B) Macrosomia (large for gestational age)
C) Oligohydramnios
D) Placenta previa
Answer: B — Macrosomia (large for gestational age)
Rationale: Gestational diabetes is associated with fetal hyperinsulinemia due to
maternal hyperglycemia crossing the placenta. This results in macrosomia (birth
weight > 4,000 g or > 4,500 g), which increases the risk of shoulder
dystocia, birth trauma, and cesarean delivery. Other complications include
polyhydramnios, preeclampsia, and neonatal hypoglycemia. Gestational diabetes is
managed with dietary modification, exercise, and insulin if needed.
Q8. A nurse is teaching a patient about the signs of preterm labor. Which sign
should the patient report immediately?
A) Mild backache
B) Braxton-Hicks contractions
C) Regular uterine contractions (4 or more in 20 minutes) with or without
cervical change
D) Increased fetal movement
Answer: C — Regular uterine contractions (4 or more in 20 minutes) with or
without cervical change
Rationale: Preterm labor is defined as regular uterine contractions
causing cervical change between 20 and 37 weeks gestation. Signs to report
include regular contractions (4 in 20 minutes or 8 in 60 minutes), low back
pain, pelvic pressure, vaginal bleeding, or change in vaginal discharge.
Braxton-Hicks contractions are irregular and do not cause cervical change. Patients
should be educated to seek immediate care if these signs occur.
Q9. A patient at 20 weeks gestation is diagnosed with a urinary tract infection
(UTI). Which antibiotic is considered safe during pregnancy?
