NUR 231 MATERNAL NURSING
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A nurse is calculating a client’s expected date of delivery using Naegele’s rule. The client’s
last menstrual period began on May 10th. Which date should the nurse provide?
A. January 17th
B. February 3rd
C. February 10th
D. February 17th
Answer: D
Conceptual Explanation: Naegele’s rule is calculated by subtracting 3 months from the
first day of the last menstrual period and adding 7 days and 1 year. May 10 minus 3 months
is February 10, plus 7 days is February 17.
2. A client in labor is experiencing late decelerations on the fetal heart rate monitor. Which
action should the nurse take first?
A. Administer oxygen via nonrebreather mask
B. Reposition the client to a side-lying position
,C. Increase the rate of the IV fluid infusion
D. Notify the healthcare provider
Answer: B
Conceptual Explanation: While all options are valid interventions for late decelerations,
the first action should be to turn the client to a side-lying position to improve placental
perfusion.
3. Which of the following is a classic sign of Preeclampsia that the nurse should assess for?
A. Hyporeflexia
B. Polyuria
C. Hypotension
D. Proteinuria
Answer: D
Conceptual Explanation: Preeclampsia is characterized by hypertension and proteinuria
after 20 weeks of gestation. Hyperreflexia is often present, not hyporeflexia.
4. During the active phase of the first stage of labor, the nurse expects the cervix to be dilated
to which range?
A. 0 to 3 cm
B. Full dilation to delivery
C. 8 to 10 cm
, D. 4 to 7 cm
Answer: D
Conceptual Explanation: The first stage of labor has three phases: Latent (0-3cm), Active
(4-7cm), and Transition (8-10cm).
5. A nurse is assessing a postpartum client 2 hours after delivery and finds the fundus is boggy
and displaced to the right. What is the most likely cause?
A. Retained placental fragments
B. Uterine atony
C. Bladder distension
D. Cervical laceration
Answer: C
Conceptual Explanation: A distended bladder can displace the uterus upward and to the
side (usually the right), preventing the uterus from contracting effectively.
6. Which APGAR score component evaluates the newborn’s muscle tone?
A. Appearance
B. Pulse
C. Activity
D. Grimace
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A nurse is calculating a client’s expected date of delivery using Naegele’s rule. The client’s
last menstrual period began on May 10th. Which date should the nurse provide?
A. January 17th
B. February 3rd
C. February 10th
D. February 17th
Answer: D
Conceptual Explanation: Naegele’s rule is calculated by subtracting 3 months from the
first day of the last menstrual period and adding 7 days and 1 year. May 10 minus 3 months
is February 10, plus 7 days is February 17.
2. A client in labor is experiencing late decelerations on the fetal heart rate monitor. Which
action should the nurse take first?
A. Administer oxygen via nonrebreather mask
B. Reposition the client to a side-lying position
,C. Increase the rate of the IV fluid infusion
D. Notify the healthcare provider
Answer: B
Conceptual Explanation: While all options are valid interventions for late decelerations,
the first action should be to turn the client to a side-lying position to improve placental
perfusion.
3. Which of the following is a classic sign of Preeclampsia that the nurse should assess for?
A. Hyporeflexia
B. Polyuria
C. Hypotension
D. Proteinuria
Answer: D
Conceptual Explanation: Preeclampsia is characterized by hypertension and proteinuria
after 20 weeks of gestation. Hyperreflexia is often present, not hyporeflexia.
4. During the active phase of the first stage of labor, the nurse expects the cervix to be dilated
to which range?
A. 0 to 3 cm
B. Full dilation to delivery
C. 8 to 10 cm
, D. 4 to 7 cm
Answer: D
Conceptual Explanation: The first stage of labor has three phases: Latent (0-3cm), Active
(4-7cm), and Transition (8-10cm).
5. A nurse is assessing a postpartum client 2 hours after delivery and finds the fundus is boggy
and displaced to the right. What is the most likely cause?
A. Retained placental fragments
B. Uterine atony
C. Bladder distension
D. Cervical laceration
Answer: C
Conceptual Explanation: A distended bladder can displace the uterus upward and to the
side (usually the right), preventing the uterus from contracting effectively.
6. Which APGAR score component evaluates the newborn’s muscle tone?
A. Appearance
B. Pulse
C. Activity
D. Grimace
