RNSG 1517 A Maternity Exam 1, 2 & Final Review
| Complete Question Bank with Detailed
Rationales
Question 1
A nurse is reviewing presumptive, probable, and positive signs of
pregnancy with a prenatal client. Which of the following findings is
considered a positive sign of pregnancy?
A. Amenorrhea and breast tenderness
B. Goodell's sign and Chadwick's sign
C. Visualization of the fetus via ultrasound and auscultation of fetal
heart tones
D. Positive home pregnancy urine test
Correct Answer: C
Detailed Rationale: Positive signs of pregnancy are objective signs that
can be attributed only to the presence of a fetus, such as visualization
on ultrasound, fetal heart tones auscultated by a health care provider,
and fetal movement felt by the examiner. Amenorrhea and breast
tenderness are presumptive signs, while Goodell's and Chadwick's signs
are probable signs.
Question 2
,A pregnant client states that her last menstrual period began on
October 10. Using Nagele's rule, what is the estimated date of birth
(EDB)?
A. July 17
B. July 3
C. June 17
D. August 17
Correct Answer: A
Detailed Rationale: Nagele's rule calculates the estimated date of birth
by taking the first day of the last menstrual period, subtracting 3
months, adding 7 days, and adjusting the year if necessary. October 10
minus 3 months is July 10, plus 7 days equals July 17.
Question 3
A nurse is explaining physiological anemia of pregnancy to a client at 28
weeks of gestation. What is the primary physiological mechanism
responsible for this finding?
A. Decreased dietary iron intake leading to impaired red blood cell
production
B. Greater increase in plasma volume relative to the increase in red
blood cell mass, resulting in hemodilution
C. Increased destruction of red blood cells by the placenta
D. Suppression of bone marrow activity caused by elevated estrogen
levels
Correct Answer: B
,Detailed Rationale: During pregnancy, plasma volume increases by
approximately 40% to 50%, while red blood cell mass increases by only
20% to 30%. This disproportionate rise causes hemodilution, commonly
referred to as physiological anemia of pregnancy.
Question 4
A nurse is providing dietary counseling to a client in her first trimester
of pregnancy. Which vitamin supplement is essential to recommend to
reduce the incidence of neural tube defects?
A. Vitamin A
B. Folic acid (Vitamin B9)
C. Vitamin C
D. Vitamin D
Correct Answer: B
Detailed Rationale: Adequate intake of folic acid (folate) before
conception and during early pregnancy is vital for preventing neural
tube defects such as spina bifida and anencephaly.
Question 5
A client at 34 weeks of gestation presents to the labor and triage unit
reporting a severe continuous headache, blurred vision, and right upper
quadrant abdominal pain. Blood pressure is 160/110 mm Hg and 3+
proteinuria is noted. What condition do these findings indicate?
A. Gestational diabetes mellitus
B. Chronic hypertension without complications
C. Preeclampsia with severe features
, D. Normal physiological discomforts of late pregnancy
Correct Answer: C
Detailed Rationale: Severe features of preeclampsia include blood
pressure of 160/110 mm Hg or higher, significant proteinuria, persistent
central nervous system symptoms (headache, visual changes), and
hepatic capsule distention (right upper quadrant or epigastric pain).
Question 6
A laboring client in the active stage of labor reports intense pelvic
pressure and a strong, uncontrollable urge to push. The nurse performs
a sterile vaginal exam and finds the cervix is fully dilated (10 cm) and
100% effaced. How should the nurse classify this phase of labor?
A. Latent phase of the first stage of labor
B. Active phase of the first stage of labor
C. Transition phase (or second stage onset)
D. Third stage of labor
Correct Answer: C
Detailed Rationale: Full cervical dilation (10 cm) marks the end of the
first stage of labor and the transition into the second stage of labor,
where pushing typically occurs due to intense pelvic and rectal
pressure.
Question 7
A nurse is monitoring the external fetal heart rate monitor and notes
early decelerations that mirror the shape of uterine contractions, with
| Complete Question Bank with Detailed
Rationales
Question 1
A nurse is reviewing presumptive, probable, and positive signs of
pregnancy with a prenatal client. Which of the following findings is
considered a positive sign of pregnancy?
A. Amenorrhea and breast tenderness
B. Goodell's sign and Chadwick's sign
C. Visualization of the fetus via ultrasound and auscultation of fetal
heart tones
D. Positive home pregnancy urine test
Correct Answer: C
Detailed Rationale: Positive signs of pregnancy are objective signs that
can be attributed only to the presence of a fetus, such as visualization
on ultrasound, fetal heart tones auscultated by a health care provider,
and fetal movement felt by the examiner. Amenorrhea and breast
tenderness are presumptive signs, while Goodell's and Chadwick's signs
are probable signs.
Question 2
,A pregnant client states that her last menstrual period began on
October 10. Using Nagele's rule, what is the estimated date of birth
(EDB)?
A. July 17
B. July 3
C. June 17
D. August 17
Correct Answer: A
Detailed Rationale: Nagele's rule calculates the estimated date of birth
by taking the first day of the last menstrual period, subtracting 3
months, adding 7 days, and adjusting the year if necessary. October 10
minus 3 months is July 10, plus 7 days equals July 17.
Question 3
A nurse is explaining physiological anemia of pregnancy to a client at 28
weeks of gestation. What is the primary physiological mechanism
responsible for this finding?
A. Decreased dietary iron intake leading to impaired red blood cell
production
B. Greater increase in plasma volume relative to the increase in red
blood cell mass, resulting in hemodilution
C. Increased destruction of red blood cells by the placenta
D. Suppression of bone marrow activity caused by elevated estrogen
levels
Correct Answer: B
,Detailed Rationale: During pregnancy, plasma volume increases by
approximately 40% to 50%, while red blood cell mass increases by only
20% to 30%. This disproportionate rise causes hemodilution, commonly
referred to as physiological anemia of pregnancy.
Question 4
A nurse is providing dietary counseling to a client in her first trimester
of pregnancy. Which vitamin supplement is essential to recommend to
reduce the incidence of neural tube defects?
A. Vitamin A
B. Folic acid (Vitamin B9)
C. Vitamin C
D. Vitamin D
Correct Answer: B
Detailed Rationale: Adequate intake of folic acid (folate) before
conception and during early pregnancy is vital for preventing neural
tube defects such as spina bifida and anencephaly.
Question 5
A client at 34 weeks of gestation presents to the labor and triage unit
reporting a severe continuous headache, blurred vision, and right upper
quadrant abdominal pain. Blood pressure is 160/110 mm Hg and 3+
proteinuria is noted. What condition do these findings indicate?
A. Gestational diabetes mellitus
B. Chronic hypertension without complications
C. Preeclampsia with severe features
, D. Normal physiological discomforts of late pregnancy
Correct Answer: C
Detailed Rationale: Severe features of preeclampsia include blood
pressure of 160/110 mm Hg or higher, significant proteinuria, persistent
central nervous system symptoms (headache, visual changes), and
hepatic capsule distention (right upper quadrant or epigastric pain).
Question 6
A laboring client in the active stage of labor reports intense pelvic
pressure and a strong, uncontrollable urge to push. The nurse performs
a sterile vaginal exam and finds the cervix is fully dilated (10 cm) and
100% effaced. How should the nurse classify this phase of labor?
A. Latent phase of the first stage of labor
B. Active phase of the first stage of labor
C. Transition phase (or second stage onset)
D. Third stage of labor
Correct Answer: C
Detailed Rationale: Full cervical dilation (10 cm) marks the end of the
first stage of labor and the transition into the second stage of labor,
where pushing typically occurs due to intense pelvic and rectal
pressure.
Question 7
A nurse is monitoring the external fetal heart rate monitor and notes
early decelerations that mirror the shape of uterine contractions, with
