NSG 432 EXAM 2: NURSING CARE OF THE CHILDBEARING FAMILY
EXAM NEWEST 2026/2027 ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
WITH RATIONALES|ALREADY GRADED A+||
BRAND NEW VERSION!!
SECTION 1: ANTEPARTUM NURSING CARE (Questions 1-50)
NORMAL PHYSIOLOGICAL CHANGES IN PREGNANCY
1. A primigravida at 10 weeks gestation reports frequent urination. Which
response by the nurse is most appropriate?
A) "This is abnormal and requires further evaluation"
B) "This is normal due to hormonal changes and uterine pressure"
C) "You should decrease your fluid intake"
D) "This indicates a urinary tract infection"
Answer: B
Rationale: Frequent urination in the first trimester is a normal physiological
response to increased glomerular filtration rate and pressure of the enlarging
uterus on the bladder. Increased hCG and progesterone contribute to this
symptom. According to ACOG (2025), this is a common discomfort that typically
resolves in the second trimester.
2. A client at 36 weeks gestation reports heartburn after meals. Which instruction
should the nurse provide?
A) "Lie down immediately after eating"
B) "Eat small, frequent meals throughout the day"
C) "Increase intake of spicy foods"
D) "Drink large amounts of fluid with meals"
Answer: B
Rationale: Heartburn is caused by progesterone-induced relaxation of the cardiac
sphincter and delayed gastric emptying. Small, frequent meals prevent gastric
distention and reduce reflux. The client should remain upright after meals, as
supported by the American College of Gastroenterology (2025).
3. A pregnant client asks why her skin is darker on her face and abdomen. The
nurse explains this is due to:
A) Increased estrogen and melanocyte-stimulating hormone
B) Decreased progesterone levels
1
,C) Increased fetal circulation
D) Decreased adrenal gland activity
Answer: A
Rationale: Chloasma (mask of pregnancy) and linea nigra result from increased
estrogen, progesterone, and melanocyte-stimulating hormone (MSH) from the
anterior pituitary, which increases melanin production.
4. A client at 28 weeks gestation reports ankle edema. Which nursing action is
most appropriate?
A) Assess for pitting edema and blood pressure
B) Recommend strict bed rest
C) Administer a diuretic
D) Restrict fluid intake to 1L per day
Answer: A
Rationale: Dependent edema is common due to venous stasis from the gravid
uterus compressing the vena cava. However, the nurse must assess for pitting
edema and hypertension to rule out preeclampsia. Diuretics are contraindicated
in normal pregnancy.
5. During a prenatal visit at 32 weeks, the client's fundal height measures 34 cm.
The nurse should:
A) Document this as a normal finding
B) Prepare for immediate induction
C) Notify the provider of potential macrosomia
D) Schedule a growth ultrasound
Answer: A
Rationale: Fundal height in centimeters correlates with weeks of gestation ± 2 cm
between 20-36 weeks. A measurement of 34 cm at 32 weeks is within normal
limits.
6. The nurse is assessing a client at 20 weeks gestation. Which cardiovascular
change would the nurse expect?
A) Decreased cardiac output
B) Increased heart rate by 10-15 bpm
C) Decreased blood volume
D) Increased peripheral vascular resistance
Answer: B
2
,Rationale: Heart rate increases by 10-15 bpm starting in the first trimester and
persists through pregnancy. Cardiac output increases by 30-50%, and blood
volume increases by 40-50% by 32-34 weeks.
7. A client at 12 weeks gestation asks about the "blood test" for Down syndrome.
The nurse explains that first-trimester screening includes:
A) Nuchal translucency ultrasound and maternal serum beta-hCG and PAPP-A
B) Quad screen for AFP, hCG, estriol, and inhibin A
C) Amniocentesis for chromosomal analysis
D) Cell-free DNA testing only
Answer: A
Rationale: First-trimester screening (11-14 weeks) combines nuchal translucency
ultrasound with maternal serum beta-hCG and pregnancy-associated plasma
protein A (PAPP-A). Quad screen is performed at 15-20 weeks.
8. The nurse is teaching a class on warning signs during pregnancy. Which
symptom requires immediate provider notification?
A) Nausea in the morning
B) Braxton Hicks contractions
C) Vaginal bleeding
D) Heartburn after meals
Answer: C
Rationale: Vaginal bleeding can indicate placenta previa, abruptio placentae, or
miscarriage. It requires immediate evaluation. The other options are normal
discomforts of pregnancy.
9. A client at 8 weeks gestation has a hemoglobin of 10.8 g/dL. The nurse should:
A) Notify the provider immediately
B) Document as normal for pregnancy
C) Prepare for blood transfusion
D) Assess for iron deficiency anemia
Answer: B
Rationale: Normal hemoglobin in pregnancy is 10.5-12.5 g/dL due to physiological
hemodilution from increased plasma volume. This value is within expected range
for the first trimester.
10. The nurse auscultates the fetal heart rate at 150 bpm. Which action is correct?
3
, A) Notify the provider immediately
B) Document this as a normal finding
C) Reassess in 15 minutes
D) Prepare for fetal monitoring
Answer: B
Rationale: Normal FHR is 110-160 bpm. 150 bpm is within normal range. The
nurse should document the finding.
11. A client at 16 weeks gestation reports her first fetal movement. The nurse
documents this as:
A) Ballottement
B) Quickening
C) Chadwick's sign
D) Goodell's sign
Answer: B
Rationale: Quickening is the first perception of fetal movement, typically felt
between 16-20 weeks in primigravidas and earlier in multigravidas.
12. The nurse is assessing for cervical changes in a client at 6 weeks gestation.
Which sign is an expected finding?
A) Ballottement
B) Chadwick's sign
C) Naegele's rule
D) McDonald's sign
Answer: B
Rationale: Chadwick's sign (bluish-purple discoloration of the cervix, vagina, and
vulva) is an early sign of pregnancy due to increased vascularity, appearing at 6-8
weeks.
13. A client asks the nurse about the purpose of the hormone relaxin during
pregnancy. The nurse explains it:
A) Stimulates milk production
B) Relaxes pelvic ligaments for delivery
C) Prevents preterm labor
D) Increases blood glucose levels
Answer: B
Rationale: Relaxin, produced by the corpus luteum and placenta, relaxes pelvic
ligaments and the cervix, facilitating fetal passage during delivery.
4
EXAM NEWEST 2026/2027 ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
WITH RATIONALES|ALREADY GRADED A+||
BRAND NEW VERSION!!
SECTION 1: ANTEPARTUM NURSING CARE (Questions 1-50)
NORMAL PHYSIOLOGICAL CHANGES IN PREGNANCY
1. A primigravida at 10 weeks gestation reports frequent urination. Which
response by the nurse is most appropriate?
A) "This is abnormal and requires further evaluation"
B) "This is normal due to hormonal changes and uterine pressure"
C) "You should decrease your fluid intake"
D) "This indicates a urinary tract infection"
Answer: B
Rationale: Frequent urination in the first trimester is a normal physiological
response to increased glomerular filtration rate and pressure of the enlarging
uterus on the bladder. Increased hCG and progesterone contribute to this
symptom. According to ACOG (2025), this is a common discomfort that typically
resolves in the second trimester.
2. A client at 36 weeks gestation reports heartburn after meals. Which instruction
should the nurse provide?
A) "Lie down immediately after eating"
B) "Eat small, frequent meals throughout the day"
C) "Increase intake of spicy foods"
D) "Drink large amounts of fluid with meals"
Answer: B
Rationale: Heartburn is caused by progesterone-induced relaxation of the cardiac
sphincter and delayed gastric emptying. Small, frequent meals prevent gastric
distention and reduce reflux. The client should remain upright after meals, as
supported by the American College of Gastroenterology (2025).
3. A pregnant client asks why her skin is darker on her face and abdomen. The
nurse explains this is due to:
A) Increased estrogen and melanocyte-stimulating hormone
B) Decreased progesterone levels
1
,C) Increased fetal circulation
D) Decreased adrenal gland activity
Answer: A
Rationale: Chloasma (mask of pregnancy) and linea nigra result from increased
estrogen, progesterone, and melanocyte-stimulating hormone (MSH) from the
anterior pituitary, which increases melanin production.
4. A client at 28 weeks gestation reports ankle edema. Which nursing action is
most appropriate?
A) Assess for pitting edema and blood pressure
B) Recommend strict bed rest
C) Administer a diuretic
D) Restrict fluid intake to 1L per day
Answer: A
Rationale: Dependent edema is common due to venous stasis from the gravid
uterus compressing the vena cava. However, the nurse must assess for pitting
edema and hypertension to rule out preeclampsia. Diuretics are contraindicated
in normal pregnancy.
5. During a prenatal visit at 32 weeks, the client's fundal height measures 34 cm.
The nurse should:
A) Document this as a normal finding
B) Prepare for immediate induction
C) Notify the provider of potential macrosomia
D) Schedule a growth ultrasound
Answer: A
Rationale: Fundal height in centimeters correlates with weeks of gestation ± 2 cm
between 20-36 weeks. A measurement of 34 cm at 32 weeks is within normal
limits.
6. The nurse is assessing a client at 20 weeks gestation. Which cardiovascular
change would the nurse expect?
A) Decreased cardiac output
B) Increased heart rate by 10-15 bpm
C) Decreased blood volume
D) Increased peripheral vascular resistance
Answer: B
2
,Rationale: Heart rate increases by 10-15 bpm starting in the first trimester and
persists through pregnancy. Cardiac output increases by 30-50%, and blood
volume increases by 40-50% by 32-34 weeks.
7. A client at 12 weeks gestation asks about the "blood test" for Down syndrome.
The nurse explains that first-trimester screening includes:
A) Nuchal translucency ultrasound and maternal serum beta-hCG and PAPP-A
B) Quad screen for AFP, hCG, estriol, and inhibin A
C) Amniocentesis for chromosomal analysis
D) Cell-free DNA testing only
Answer: A
Rationale: First-trimester screening (11-14 weeks) combines nuchal translucency
ultrasound with maternal serum beta-hCG and pregnancy-associated plasma
protein A (PAPP-A). Quad screen is performed at 15-20 weeks.
8. The nurse is teaching a class on warning signs during pregnancy. Which
symptom requires immediate provider notification?
A) Nausea in the morning
B) Braxton Hicks contractions
C) Vaginal bleeding
D) Heartburn after meals
Answer: C
Rationale: Vaginal bleeding can indicate placenta previa, abruptio placentae, or
miscarriage. It requires immediate evaluation. The other options are normal
discomforts of pregnancy.
9. A client at 8 weeks gestation has a hemoglobin of 10.8 g/dL. The nurse should:
A) Notify the provider immediately
B) Document as normal for pregnancy
C) Prepare for blood transfusion
D) Assess for iron deficiency anemia
Answer: B
Rationale: Normal hemoglobin in pregnancy is 10.5-12.5 g/dL due to physiological
hemodilution from increased plasma volume. This value is within expected range
for the first trimester.
10. The nurse auscultates the fetal heart rate at 150 bpm. Which action is correct?
3
, A) Notify the provider immediately
B) Document this as a normal finding
C) Reassess in 15 minutes
D) Prepare for fetal monitoring
Answer: B
Rationale: Normal FHR is 110-160 bpm. 150 bpm is within normal range. The
nurse should document the finding.
11. A client at 16 weeks gestation reports her first fetal movement. The nurse
documents this as:
A) Ballottement
B) Quickening
C) Chadwick's sign
D) Goodell's sign
Answer: B
Rationale: Quickening is the first perception of fetal movement, typically felt
between 16-20 weeks in primigravidas and earlier in multigravidas.
12. The nurse is assessing for cervical changes in a client at 6 weeks gestation.
Which sign is an expected finding?
A) Ballottement
B) Chadwick's sign
C) Naegele's rule
D) McDonald's sign
Answer: B
Rationale: Chadwick's sign (bluish-purple discoloration of the cervix, vagina, and
vulva) is an early sign of pregnancy due to increased vascularity, appearing at 6-8
weeks.
13. A client asks the nurse about the purpose of the hormone relaxin during
pregnancy. The nurse explains it:
A) Stimulates milk production
B) Relaxes pelvic ligaments for delivery
C) Prevents preterm labor
D) Increases blood glucose levels
Answer: B
Rationale: Relaxin, produced by the corpus luteum and placenta, relaxes pelvic
ligaments and the cervix, facilitating fetal passage during delivery.
4
