NSG 432 EXAMINATION 2
Nursing Care of the Childbearing Family
Comprehensive Review Examination
Total Questions: 100
Cognitive Distribution: 30% Recall | 50% Application | 20% Analysis
,Q1: A nurse is teaching a group of adolescents about female reproductive anatomy. Which structure is
responsible for producing the egg cells (ova) and the hormones estrogen and progesterone?
A. The vagina, which serves as the birth canal
B. The uterus, where fetal development occurs
C. The ovaries, located on each side of the uterus [CORRECT]
D. The fallopian tubes, which transport eggs
Correct Answer: C
Rationale: Correct because the ovaries are the primary female reproductive organs (gonads) responsible for both gamete
production (oogenesis) and hormone secretion (estrogen and progesterone). The ovaries contain follicles that house developing
ova and endocrine cells that produce sex steroids essential for the menstrual cycle and pregnancy.
Q2: During which phase of the menstrual cycle does ovulation typically occur?
A. Menstrual phase (days 1-5)
B. Follicular phase (days 6-13)
C. Mid-cycle around day 14 in a 28-day cycle [CORRECT]
D. Luteal phase (days 15-28)
Correct Answer: C
Rationale: Correct because ovulation occurs approximately midway through the menstrual cycle, typically around day 14 in a
standard 28-day cycle. This event is triggered by the luteinizing hormone (LH) surge from the anterior pituitary, which causes
the dominant follicle to release a mature oocyte into the peritoneal cavity near the fimbriated end of the fallopian tube.
Q3: A couple is trying to conceive. The nurse explains that fertilization normally occurs in which
anatomical location?
A. The uterine cavity
B. The ampulla of the fallopian tube [CORRECT]
C. The ovarian follicle
D. The cervix
Correct Answer: B
Rationale: Correct because fertilization typically occurs in the ampulla, which is the widest portion of the fallopian tube. After
ovulation, the oocyte is swept into the tube by ciliary action, where it may encounter sperm that have migrated through the
cervix and uterus. The ampulla provides the optimal environment for sperm-egg interaction and the beginning of embryonic
development.
Q4: At 12 weeks gestation, a pregnant woman asks what developments her fetus has undergone. The
nurse should include which information?
A. The fetus can now open its eyes and has developed eyelashes
B. Sex determination is possible via ultrasound; fingernails are present [CORRECT]
C. Lung surfactant production begins and rapid brain growth occurs
D. The fetus assumes a vertex position and gains most of its weight
Correct Answer: B
Rationale: Correct because at 12 weeks (end of first trimester), external genitalia are differentiated enough to determine sex via
ultrasound, and fingernails have begun forming. This marks the transition to the fetal period when organogenesis is largely
complete and growth and refinement of structures becomes the primary focus. Eyelashes appear later (around 20 weeks),
surfactant production begins at approximately 24 weeks, and vertex positioning typically occurs in the third trimester.
Q5: Which hormone produced by the placenta is used as the basis for many pregnancy tests because it
appears in maternal blood and urine shortly after implantation?
A. Human placental lactogen (hPL)
B. Estriol
, C. Progesterone
D. Human chorionic gonadotropin (hCG) [CORRECT]
Correct Answer: D
Rationale: Correct because hCG is a glycoprotein hormone produced by syncytiotrophoblast cells of the developing placenta
following implantation. It can be detected in maternal serum as early as 7-11 days after conception and forms the basis for both
urine and serum pregnancy tests. hCG maintains the corpus luteum during early pregnancy, ensuring continued progesterone
production until the placenta assumes this function.
Q6: A nurse assesses a pregnant client at 34 weeks and notes oligohydramnios (decreased amniotic fluid).
The nurse understands that amniotic fluid performs all of the following functions EXCEPT:
A. Protecting the fetus from trauma and infection
B. Allowing fetal movement and musculoskeletal development
C. Maintaining constant fetal temperature
D. Providing nutritional calories for fetal growth [CORRECT]
Correct Answer: D
Rationale: Correct because while amniotic fluid serves critical protective, developmental, and thermoregulatory functions, it
does not provide significant caloric nutrition to the fetus. The fetus receives all nutrients via the placental circulation. Amniotic
fluid does allow the fetus to swallow and practice gastrointestinal function, but its primary roles are cushioning, temperature
maintenance (stable at 37 degrees C), lung development through breathing movements, and preventing umbilical cord
compression.
Q7: A newborn is delivered with a normal umbilical cord. How many vessels should the nurse expect to
find in a healthy umbilical cord?
A. Two arteries and one vein [CORRECT]
B. Two veins and one artery
C. One artery and one vein
D. Two arteries and two veins
Correct Answer: A
Rationale: Correct because a normal umbilical cord contains two umbilical arteries carrying deoxygenated blood from the fetus
to the placenta, and one umbilical vein carrying oxygenated, nutrient-rich blood from the placenta to the fetus. This 2:1 ratio
(two arteries, one vein) is the expected finding. A single umbilical artery (two-vessel cord) is associated with increased risk of
congenital anomalies and requires further evaluation.
Q8: Which fetal structure allows blood to bypass the fetal liver by shunting oxygenated blood from the
umbilical vein directly to the inferior vena cava?
A. Foramen ovale
B. Ductus arteriosus
C. Ductus venosus [CORRECT]
D. Umbilical arteries
Correct Answer: C
Rationale: Correct because the ductus venosus is a vascular shunt that connects the umbilical vein to the inferior vena cava,
allowing oxygen-rich blood from the placenta to bypass the fetal liver. This ensures that the most highly oxygenated blood
reaches the fetal heart and brain. After birth, the ductus venosus constricts and becomes the ligamentum venosum.
Q9: A woman confirms she is pregnant and presents for her first prenatal visit at 8 weeks. Which
assessment is the HIGHEST priority during this initial appointment?
A. Establishing estimated date of delivery (EDD) using Naegele's rule
B. Obtaining comprehensive medical, obstetric, and family history [CORRECT]
C. Scheduling anatomy ultrasound for 18-20 weeks
D. Discussing childbirth education class options
Nursing Care of the Childbearing Family
Comprehensive Review Examination
Total Questions: 100
Cognitive Distribution: 30% Recall | 50% Application | 20% Analysis
,Q1: A nurse is teaching a group of adolescents about female reproductive anatomy. Which structure is
responsible for producing the egg cells (ova) and the hormones estrogen and progesterone?
A. The vagina, which serves as the birth canal
B. The uterus, where fetal development occurs
C. The ovaries, located on each side of the uterus [CORRECT]
D. The fallopian tubes, which transport eggs
Correct Answer: C
Rationale: Correct because the ovaries are the primary female reproductive organs (gonads) responsible for both gamete
production (oogenesis) and hormone secretion (estrogen and progesterone). The ovaries contain follicles that house developing
ova and endocrine cells that produce sex steroids essential for the menstrual cycle and pregnancy.
Q2: During which phase of the menstrual cycle does ovulation typically occur?
A. Menstrual phase (days 1-5)
B. Follicular phase (days 6-13)
C. Mid-cycle around day 14 in a 28-day cycle [CORRECT]
D. Luteal phase (days 15-28)
Correct Answer: C
Rationale: Correct because ovulation occurs approximately midway through the menstrual cycle, typically around day 14 in a
standard 28-day cycle. This event is triggered by the luteinizing hormone (LH) surge from the anterior pituitary, which causes
the dominant follicle to release a mature oocyte into the peritoneal cavity near the fimbriated end of the fallopian tube.
Q3: A couple is trying to conceive. The nurse explains that fertilization normally occurs in which
anatomical location?
A. The uterine cavity
B. The ampulla of the fallopian tube [CORRECT]
C. The ovarian follicle
D. The cervix
Correct Answer: B
Rationale: Correct because fertilization typically occurs in the ampulla, which is the widest portion of the fallopian tube. After
ovulation, the oocyte is swept into the tube by ciliary action, where it may encounter sperm that have migrated through the
cervix and uterus. The ampulla provides the optimal environment for sperm-egg interaction and the beginning of embryonic
development.
Q4: At 12 weeks gestation, a pregnant woman asks what developments her fetus has undergone. The
nurse should include which information?
A. The fetus can now open its eyes and has developed eyelashes
B. Sex determination is possible via ultrasound; fingernails are present [CORRECT]
C. Lung surfactant production begins and rapid brain growth occurs
D. The fetus assumes a vertex position and gains most of its weight
Correct Answer: B
Rationale: Correct because at 12 weeks (end of first trimester), external genitalia are differentiated enough to determine sex via
ultrasound, and fingernails have begun forming. This marks the transition to the fetal period when organogenesis is largely
complete and growth and refinement of structures becomes the primary focus. Eyelashes appear later (around 20 weeks),
surfactant production begins at approximately 24 weeks, and vertex positioning typically occurs in the third trimester.
Q5: Which hormone produced by the placenta is used as the basis for many pregnancy tests because it
appears in maternal blood and urine shortly after implantation?
A. Human placental lactogen (hPL)
B. Estriol
, C. Progesterone
D. Human chorionic gonadotropin (hCG) [CORRECT]
Correct Answer: D
Rationale: Correct because hCG is a glycoprotein hormone produced by syncytiotrophoblast cells of the developing placenta
following implantation. It can be detected in maternal serum as early as 7-11 days after conception and forms the basis for both
urine and serum pregnancy tests. hCG maintains the corpus luteum during early pregnancy, ensuring continued progesterone
production until the placenta assumes this function.
Q6: A nurse assesses a pregnant client at 34 weeks and notes oligohydramnios (decreased amniotic fluid).
The nurse understands that amniotic fluid performs all of the following functions EXCEPT:
A. Protecting the fetus from trauma and infection
B. Allowing fetal movement and musculoskeletal development
C. Maintaining constant fetal temperature
D. Providing nutritional calories for fetal growth [CORRECT]
Correct Answer: D
Rationale: Correct because while amniotic fluid serves critical protective, developmental, and thermoregulatory functions, it
does not provide significant caloric nutrition to the fetus. The fetus receives all nutrients via the placental circulation. Amniotic
fluid does allow the fetus to swallow and practice gastrointestinal function, but its primary roles are cushioning, temperature
maintenance (stable at 37 degrees C), lung development through breathing movements, and preventing umbilical cord
compression.
Q7: A newborn is delivered with a normal umbilical cord. How many vessels should the nurse expect to
find in a healthy umbilical cord?
A. Two arteries and one vein [CORRECT]
B. Two veins and one artery
C. One artery and one vein
D. Two arteries and two veins
Correct Answer: A
Rationale: Correct because a normal umbilical cord contains two umbilical arteries carrying deoxygenated blood from the fetus
to the placenta, and one umbilical vein carrying oxygenated, nutrient-rich blood from the placenta to the fetus. This 2:1 ratio
(two arteries, one vein) is the expected finding. A single umbilical artery (two-vessel cord) is associated with increased risk of
congenital anomalies and requires further evaluation.
Q8: Which fetal structure allows blood to bypass the fetal liver by shunting oxygenated blood from the
umbilical vein directly to the inferior vena cava?
A. Foramen ovale
B. Ductus arteriosus
C. Ductus venosus [CORRECT]
D. Umbilical arteries
Correct Answer: C
Rationale: Correct because the ductus venosus is a vascular shunt that connects the umbilical vein to the inferior vena cava,
allowing oxygen-rich blood from the placenta to bypass the fetal liver. This ensures that the most highly oxygenated blood
reaches the fetal heart and brain. After birth, the ductus venosus constricts and becomes the ligamentum venosum.
Q9: A woman confirms she is pregnant and presents for her first prenatal visit at 8 weeks. Which
assessment is the HIGHEST priority during this initial appointment?
A. Establishing estimated date of delivery (EDD) using Naegele's rule
B. Obtaining comprehensive medical, obstetric, and family history [CORRECT]
C. Scheduling anatomy ultrasound for 18-20 weeks
D. Discussing childbirth education class options
