NUR 230 MATERNAL EXAM
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. A nurse is reviewing signs of pregnancy with a client. Which of the following should the
nurse identify as a probable sign of pregnancy?
A. Fetal heart tones heard by Doppler
B. Quickening
C. Amenorrhea
D. Chadwick’s sign
Answer: D
Conceptual Explanation: Probable signs of pregnancy are objective findings observed by
the examiner, such as Chadwick’s sign (bluish discoloration of the cervix). Fetal heart tones
are a positive sign. Amenorrhea and quickening are presumptive signs.
2. Using Naegele’s Rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on March 15th?
A. December 15th
,B. January 22nd
C. December 8th
D. December 22nd
Answer: D
Conceptual Explanation: Naegele’s Rule: Subtract 3 months from the first day of the LMP
and add 7 days and 1 year. March 15 - 3 months = December 15; + 7 days = December 22.
3. A client at 16 weeks gestation is scheduled for an alpha-fetoprotein (AFP) screening. The
nurse explains that this test screens for which of the following?
A. Gestational diabetes
B. Fetal lung maturity
C. Neural tube defects
D. Group B Streptococcus
Answer: C
Conceptual Explanation: Alpha-fetoprotein is a screening tool for neural tube defects
(high levels) and chromosomal disorders like Down syndrome (low levels).
4. A nurse is monitoring a client in the second stage of labor. The nurse notes the fetal heart
rate (FHR) begins to slow after the peak of a contraction and returns to baseline after the
contraction ends. Which action is the priority?
A. Increase the oxytocin infusion rate
, B. Document this as a normal finding
C. Perform a vaginal exam to check for cord prolapse
D. Turn the client to a side-lying position
Answer: D
Conceptual Explanation: The description indicates late decelerations, which suggest
uteroplacental insufficiency. The first action is to improve perfusion, typically by
repositioning the client to the side.
5. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding should the nurse report immediately?
A. Respiratory rate of 10 breaths/min
B. Deep tendon reflexes of 2+
C. Urinary output of 40 mL/hr
D. Fetal heart rate of 140 bpm
Answer: A
Conceptual Explanation: Magnesium sulfate toxicity causes central nervous system
depression. A respiratory rate below 12 breaths/min is a sign of toxicity and requires
immediate intervention with calcium gluconate.
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. A nurse is reviewing signs of pregnancy with a client. Which of the following should the
nurse identify as a probable sign of pregnancy?
A. Fetal heart tones heard by Doppler
B. Quickening
C. Amenorrhea
D. Chadwick’s sign
Answer: D
Conceptual Explanation: Probable signs of pregnancy are objective findings observed by
the examiner, such as Chadwick’s sign (bluish discoloration of the cervix). Fetal heart tones
are a positive sign. Amenorrhea and quickening are presumptive signs.
2. Using Naegele’s Rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on March 15th?
A. December 15th
,B. January 22nd
C. December 8th
D. December 22nd
Answer: D
Conceptual Explanation: Naegele’s Rule: Subtract 3 months from the first day of the LMP
and add 7 days and 1 year. March 15 - 3 months = December 15; + 7 days = December 22.
3. A client at 16 weeks gestation is scheduled for an alpha-fetoprotein (AFP) screening. The
nurse explains that this test screens for which of the following?
A. Gestational diabetes
B. Fetal lung maturity
C. Neural tube defects
D. Group B Streptococcus
Answer: C
Conceptual Explanation: Alpha-fetoprotein is a screening tool for neural tube defects
(high levels) and chromosomal disorders like Down syndrome (low levels).
4. A nurse is monitoring a client in the second stage of labor. The nurse notes the fetal heart
rate (FHR) begins to slow after the peak of a contraction and returns to baseline after the
contraction ends. Which action is the priority?
A. Increase the oxytocin infusion rate
, B. Document this as a normal finding
C. Perform a vaginal exam to check for cord prolapse
D. Turn the client to a side-lying position
Answer: D
Conceptual Explanation: The description indicates late decelerations, which suggest
uteroplacental insufficiency. The first action is to improve perfusion, typically by
repositioning the client to the side.
5. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding should the nurse report immediately?
A. Respiratory rate of 10 breaths/min
B. Deep tendon reflexes of 2+
C. Urinary output of 40 mL/hr
D. Fetal heart rate of 140 bpm
Answer: A
Conceptual Explanation: Magnesium sulfate toxicity causes central nervous system
depression. A respiratory rate below 12 breaths/min is a sign of toxicity and requires
immediate intervention with calcium gluconate.
