NURS 317 Maternal Adaptation During
Pregnancy (NCLEX Questions and Review) with
Correct Answers Plus Rationale | New Update
2026/27 | Graded A+
The nurse is assessing a pregnant client at her 20-week visit. Which breast
assessment should the nurse anticipate documenting?
A) Slack, soft breast tissue
B) Deeply fissured nipples
C) Enlarged lymph nodes
D) Darkened breast areolae
Correct Answer: D) Darkened breast areolae
Rationale: During pregnancy, hormonal changes (increased estrogen,
progesterone, and melanocyte-stimulating hormone) cause hyperpigmentation of
the areolae and nipples. This is a normal and expected finding. Slack, soft breast
tissue would not be typical; breasts often become fuller and more nodular.
Enlarged lymph nodes could indicate infection or malignancy and should be
evaluated. Deeply fissured nipples are not an expected normal change.
A pregnant woman tells the nurse she often has allergic responses to drugs. She is
concerned that she will be allergic to her fetus or her body will reject the
pregnancy. The nurse's reply would be based on which statement?
,A) Immunologic activity is decreased during pregnancy.
B) The level of aldosterone during pregnancy reduces production of IgG
antibodies.
C) The decreased corticosteroid activity during pregnancy ensures this will not
happen.
D) The kidneys release a hormone during pregnancy to prevent this from
happening.
Correct Answer: A) Immunologic activity is decreased during pregnancy.
Rationale: It is a physiologic mystery why a woman's body does not reject the
fetus as foreign tissue. However, a substance secreted by the placenta is thought
to decrease the usual maternal immunologic response, effectively suppressing it
to prevent rejection. This is why pregnant women may experience fewer
autoimmune flare-ups and also why they are more susceptible to certain
infections.
A new mother asks the postpartum nurse if her baby is getting enough
nourishment from breast-feeding within the first 24 hours following birth. The
nurse would provide her what information?
A) The mother needs to supplement breast-feedings with formula until her milk
comes in.
B) Breast milk comes in within 12 hours after delivery and nourishment should not
be a problem.
C) Most infants need minimal nourishment for the first 24 hours, so the mother
should not be concerned.
,D) Colostrum, which is the first milk produced, is rich in calories and protein that
nourishes the infant well.
Correct Answer: D) Colostrum, which is the first milk produced, is rich in calories
and protein that nourishes the infant well.
Rationale: Colostrum is the first milk produced, present before and immediately
after delivery. It is thick, yellowish, and rich in protein, calories, and
immunoglobulins (especially IgA). It provides adequate nutrition for the newborn
during the first 2-3 days of life until the mother's mature milk "comes in." Formula
supplementation is generally not recommended and can interfere with
breastfeeding establishment.
Amanda's menstrual period is two weeks late. She has been feeling tired and has
had bouts of nausea in the morning. What classification of pregnancy symptoms is
Amanda experiencing?
A) Positive
B) Presumptive
C) Probable
D) No classification
Correct Answer: B) Presumptive
Rationale: Presumptive signs of pregnancy are subjective changes reported by the
woman that are suggestive of pregnancy but could also be caused by other
factors. The classic presumptive signs include amenorrhea (missed period),
, nausea and vomiting (morning sickness), fatigue, and breast tenderness. They are
not definitive proof of pregnancy.
A woman in a prenatal clinic tells the nurse that her pregnancy was unplanned
and unwanted. At what point in pregnancy does the average woman change her
mind about an unwanted pregnancy?
A) Around the third month
B) When quickening occurs
C) After lightening happens
D) After the seventh month
Correct Answer: B) When quickening occurs
Rationale: Quickening is the mother's first perception of fetal movement, usually
felt between 16 and 20 weeks of gestation. This tangible, physical experience of
the baby moving inside her can be a profound turning point. It often transforms
the pregnancy from an abstract concept into a real, emotional connection, causing
many women to accept and bond with the pregnancy.
What is Quickening?
Correct Answer: Fetal movements felt by the mother
Rationale: Quickening is the sensation of the baby moving, felt by the pregnant
woman. It is a significant milestone in pregnancy.
Pregnancy (NCLEX Questions and Review) with
Correct Answers Plus Rationale | New Update
2026/27 | Graded A+
The nurse is assessing a pregnant client at her 20-week visit. Which breast
assessment should the nurse anticipate documenting?
A) Slack, soft breast tissue
B) Deeply fissured nipples
C) Enlarged lymph nodes
D) Darkened breast areolae
Correct Answer: D) Darkened breast areolae
Rationale: During pregnancy, hormonal changes (increased estrogen,
progesterone, and melanocyte-stimulating hormone) cause hyperpigmentation of
the areolae and nipples. This is a normal and expected finding. Slack, soft breast
tissue would not be typical; breasts often become fuller and more nodular.
Enlarged lymph nodes could indicate infection or malignancy and should be
evaluated. Deeply fissured nipples are not an expected normal change.
A pregnant woman tells the nurse she often has allergic responses to drugs. She is
concerned that she will be allergic to her fetus or her body will reject the
pregnancy. The nurse's reply would be based on which statement?
,A) Immunologic activity is decreased during pregnancy.
B) The level of aldosterone during pregnancy reduces production of IgG
antibodies.
C) The decreased corticosteroid activity during pregnancy ensures this will not
happen.
D) The kidneys release a hormone during pregnancy to prevent this from
happening.
Correct Answer: A) Immunologic activity is decreased during pregnancy.
Rationale: It is a physiologic mystery why a woman's body does not reject the
fetus as foreign tissue. However, a substance secreted by the placenta is thought
to decrease the usual maternal immunologic response, effectively suppressing it
to prevent rejection. This is why pregnant women may experience fewer
autoimmune flare-ups and also why they are more susceptible to certain
infections.
A new mother asks the postpartum nurse if her baby is getting enough
nourishment from breast-feeding within the first 24 hours following birth. The
nurse would provide her what information?
A) The mother needs to supplement breast-feedings with formula until her milk
comes in.
B) Breast milk comes in within 12 hours after delivery and nourishment should not
be a problem.
C) Most infants need minimal nourishment for the first 24 hours, so the mother
should not be concerned.
,D) Colostrum, which is the first milk produced, is rich in calories and protein that
nourishes the infant well.
Correct Answer: D) Colostrum, which is the first milk produced, is rich in calories
and protein that nourishes the infant well.
Rationale: Colostrum is the first milk produced, present before and immediately
after delivery. It is thick, yellowish, and rich in protein, calories, and
immunoglobulins (especially IgA). It provides adequate nutrition for the newborn
during the first 2-3 days of life until the mother's mature milk "comes in." Formula
supplementation is generally not recommended and can interfere with
breastfeeding establishment.
Amanda's menstrual period is two weeks late. She has been feeling tired and has
had bouts of nausea in the morning. What classification of pregnancy symptoms is
Amanda experiencing?
A) Positive
B) Presumptive
C) Probable
D) No classification
Correct Answer: B) Presumptive
Rationale: Presumptive signs of pregnancy are subjective changes reported by the
woman that are suggestive of pregnancy but could also be caused by other
factors. The classic presumptive signs include amenorrhea (missed period),
, nausea and vomiting (morning sickness), fatigue, and breast tenderness. They are
not definitive proof of pregnancy.
A woman in a prenatal clinic tells the nurse that her pregnancy was unplanned
and unwanted. At what point in pregnancy does the average woman change her
mind about an unwanted pregnancy?
A) Around the third month
B) When quickening occurs
C) After lightening happens
D) After the seventh month
Correct Answer: B) When quickening occurs
Rationale: Quickening is the mother's first perception of fetal movement, usually
felt between 16 and 20 weeks of gestation. This tangible, physical experience of
the baby moving inside her can be a profound turning point. It often transforms
the pregnancy from an abstract concept into a real, emotional connection, causing
many women to accept and bond with the pregnancy.
What is Quickening?
Correct Answer: Fetal movements felt by the mother
Rationale: Quickening is the sensation of the baby moving, felt by the pregnant
woman. It is a significant milestone in pregnancy.
