NUR 230 Maternal Nursing Exam WITH CORRECT ANSWERS PLUS
RATIONALES 2026/2027 VERSION
1. A client who is planning a pregnancy asks the nurse when folic acid supplementation
should begin. What is the best response?
A. After the first prenatal visit
B. After the first trimester
C. Before conception
D. During labor
Answer: C. Before conception
Rationale: Folic acid should ideally be started before conception and continued during
pregnancy to reduce the risk of neural tube defects.
2. Which finding is considered a positive sign of pregnancy?
A. Amenorrhea
B. Nausea and vomiting
C. Fetal heart activity detected by ultrasound
D. Breast tenderness
Answer: C. Fetal heart activity detected by ultrasound
Rationale: Positive signs are findings that can only be explained by pregnancy, such as fetal
heart activity, visualization of the fetus, or fetal movement palpated by an examiner.
3. Which finding is considered a presumptive sign of pregnancy?
A. Fetal heart tones
B. Amenorrhea
C. Ultrasound visualization of the fetus
D. Fetal movement palpated by the examiner
Answer: B. Amenorrhea
Rationale: Presumptive signs are subjective or reported changes that may suggest pregnancy but
can have other causes.
,4. A pregnant client asks why the nurse is measuring fundal height during prenatal visits.
What is the best response?
A. "It estimates fetal sex."
B. "It helps evaluate fetal growth and gestational progress."
C. "It determines your blood type."
D. "It measures your blood pressure."
Answer: B. "It helps evaluate fetal growth and gestational progress."
Rationale: Fundal height provides an indirect assessment of uterine and fetal growth during
pregnancy.
5. Which nutrient is particularly important during pregnancy because of increased
maternal blood volume and fetal red blood cell production?
A. Iron
B. Vitamin C
C. Sodium
D. Vitamin K
Answer: A. Iron
Rationale: Iron requirements increase during pregnancy because maternal blood volume
expands and iron is needed for fetal and placental development.
6. A pregnant client reports persistent vomiting and inability to keep fluids down. Which
condition should the nurse suspect?
A. Hyperemesis gravidarum
B. Placenta previa
C. Gestational hypertension
D. Abruptio placentae
Answer: A. Hyperemesis gravidarum
Rationale: Hyperemesis gravidarum involves severe nausea and vomiting that can lead to
dehydration, electrolyte abnormalities, and weight loss.
7. Which instruction is appropriate for a client experiencing typical morning sickness?
,A. Eat large meals three times daily
B. Eat small, frequent meals
C. Drink large amounts of fluid with meals
D. Skip breakfast every day
Answer: B. Eat small, frequent meals
Rationale: Small, frequent meals and avoiding an empty stomach can help reduce pregnancy-
related nausea.
8. Which vaccine is generally recommended during pregnancy to protect the newborn and
mother from influenza?
A. Live attenuated influenza vaccine
B. Inactivated influenza vaccine
C. MMR vaccine
D. Varicella vaccine
Answer: B. Inactivated influenza vaccine
Rationale: Inactivated influenza vaccination is recommended during pregnancy, while live
attenuated influenza vaccine is not.
9. Which immunization is generally contraindicated during pregnancy because it contains
a live attenuated virus?
A. Influenza injection
B. Tdap
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: MMR is a live vaccine and is generally avoided during pregnancy.
10. A pregnant client asks why Tdap vaccination is recommended during pregnancy. What
is the primary benefit?
A. It prevents all childhood infections
B. It helps provide passive protection to the newborn against pertussis
, C. It prevents gestational diabetes
D. It eliminates the need for childhood vaccines
Answer: B. It helps provide passive protection to the newborn against pertussis
Rationale: Maternal Tdap vaccination during pregnancy allows antibodies to cross the placenta
and provide protection to the infant during early life.
11. Which assessment finding during pregnancy requires immediate evaluation?
A. Mild fatigue
B. Increased urinary frequency early in pregnancy
C. Vaginal bleeding with abdominal pain
D. Mild breast tenderness
Answer: C. Vaginal bleeding with abdominal pain
Rationale: Vaginal bleeding accompanied by abdominal pain may indicate miscarriage, ectopic
pregnancy, placental complications, or another serious condition.
12. A pregnant client reports painless bright-red vaginal bleeding in the third trimester.
Which condition should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Hyperemesis gravidarum
Answer: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright-red vaginal bleeding during
the second half of pregnancy.
13. A client with suspected placenta previa has vaginal bleeding. Which action should the
nurse avoid?
A. Assessing fetal heart rate
B. Monitoring maternal vital signs
C. Performing a digital vaginal examination
D. Establishing IV access as ordered
RATIONALES 2026/2027 VERSION
1. A client who is planning a pregnancy asks the nurse when folic acid supplementation
should begin. What is the best response?
A. After the first prenatal visit
B. After the first trimester
C. Before conception
D. During labor
Answer: C. Before conception
Rationale: Folic acid should ideally be started before conception and continued during
pregnancy to reduce the risk of neural tube defects.
2. Which finding is considered a positive sign of pregnancy?
A. Amenorrhea
B. Nausea and vomiting
C. Fetal heart activity detected by ultrasound
D. Breast tenderness
Answer: C. Fetal heart activity detected by ultrasound
Rationale: Positive signs are findings that can only be explained by pregnancy, such as fetal
heart activity, visualization of the fetus, or fetal movement palpated by an examiner.
3. Which finding is considered a presumptive sign of pregnancy?
A. Fetal heart tones
B. Amenorrhea
C. Ultrasound visualization of the fetus
D. Fetal movement palpated by the examiner
Answer: B. Amenorrhea
Rationale: Presumptive signs are subjective or reported changes that may suggest pregnancy but
can have other causes.
,4. A pregnant client asks why the nurse is measuring fundal height during prenatal visits.
What is the best response?
A. "It estimates fetal sex."
B. "It helps evaluate fetal growth and gestational progress."
C. "It determines your blood type."
D. "It measures your blood pressure."
Answer: B. "It helps evaluate fetal growth and gestational progress."
Rationale: Fundal height provides an indirect assessment of uterine and fetal growth during
pregnancy.
5. Which nutrient is particularly important during pregnancy because of increased
maternal blood volume and fetal red blood cell production?
A. Iron
B. Vitamin C
C. Sodium
D. Vitamin K
Answer: A. Iron
Rationale: Iron requirements increase during pregnancy because maternal blood volume
expands and iron is needed for fetal and placental development.
6. A pregnant client reports persistent vomiting and inability to keep fluids down. Which
condition should the nurse suspect?
A. Hyperemesis gravidarum
B. Placenta previa
C. Gestational hypertension
D. Abruptio placentae
Answer: A. Hyperemesis gravidarum
Rationale: Hyperemesis gravidarum involves severe nausea and vomiting that can lead to
dehydration, electrolyte abnormalities, and weight loss.
7. Which instruction is appropriate for a client experiencing typical morning sickness?
,A. Eat large meals three times daily
B. Eat small, frequent meals
C. Drink large amounts of fluid with meals
D. Skip breakfast every day
Answer: B. Eat small, frequent meals
Rationale: Small, frequent meals and avoiding an empty stomach can help reduce pregnancy-
related nausea.
8. Which vaccine is generally recommended during pregnancy to protect the newborn and
mother from influenza?
A. Live attenuated influenza vaccine
B. Inactivated influenza vaccine
C. MMR vaccine
D. Varicella vaccine
Answer: B. Inactivated influenza vaccine
Rationale: Inactivated influenza vaccination is recommended during pregnancy, while live
attenuated influenza vaccine is not.
9. Which immunization is generally contraindicated during pregnancy because it contains
a live attenuated virus?
A. Influenza injection
B. Tdap
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: MMR is a live vaccine and is generally avoided during pregnancy.
10. A pregnant client asks why Tdap vaccination is recommended during pregnancy. What
is the primary benefit?
A. It prevents all childhood infections
B. It helps provide passive protection to the newborn against pertussis
, C. It prevents gestational diabetes
D. It eliminates the need for childhood vaccines
Answer: B. It helps provide passive protection to the newborn against pertussis
Rationale: Maternal Tdap vaccination during pregnancy allows antibodies to cross the placenta
and provide protection to the infant during early life.
11. Which assessment finding during pregnancy requires immediate evaluation?
A. Mild fatigue
B. Increased urinary frequency early in pregnancy
C. Vaginal bleeding with abdominal pain
D. Mild breast tenderness
Answer: C. Vaginal bleeding with abdominal pain
Rationale: Vaginal bleeding accompanied by abdominal pain may indicate miscarriage, ectopic
pregnancy, placental complications, or another serious condition.
12. A pregnant client reports painless bright-red vaginal bleeding in the third trimester.
Which condition should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Hyperemesis gravidarum
Answer: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright-red vaginal bleeding during
the second half of pregnancy.
13. A client with suspected placenta previa has vaginal bleeding. Which action should the
nurse avoid?
A. Assessing fetal heart rate
B. Monitoring maternal vital signs
C. Performing a digital vaginal examination
D. Establishing IV access as ordered
