NR602 WEEK 8 FINAL EXAM (2026/2027) / NR 602
PRIMARY CARE OF THE CHILDBEARING &
CHILDREARING FAMILY FINAL EXAM TEST BANK:
100 QUESTIONS & ANSWERS WITH RATIONALES |
CHAMBERLAIN UNIVERSITY | RATED A+
SECTION 1: PRENATAL CARE & OBSTETRICS
Question 1
A 28-year-old woman at 10 weeks gestation presents with nausea and vomiting
that has been worsening over the past week. She reports inability to keep any
food or fluids down for the past 3 days. She has lost 4 pounds since her last visit.
What is the most appropriate diagnosis?
A) Hyperemesis gravidarum
B) Gastroesophageal reflux disease (GERD)
C) Morning sickness
D) Gastroenteritis
Answer: A
Rationale: Hyperemesis gravidarum is characterized by severe nausea and
vomiting during pregnancy, leading to dehydration, electrolyte imbalances, and
weight loss (typically >5% of pre-pregnancy weight). Morning sickness is milder
and does not cause significant weight loss or dehydration. GERD and
gastroenteritis are less likely given the pregnancy context and duration of
symptoms.
Question 2
,A 34-year-old primigravida at 28 weeks gestation presents with a blood pressure
of 148/96 mmHg. Urinalysis reveals 2+ protein. She reports a headache and visual
changes. What is the most likely diagnosis?
A) Gestational hypertension
B) Preeclampsia
C) Eclampsia
D) Chronic hypertension
Answer: B
Rationale: Preeclampsia is diagnosed as new-onset hypertension (≥140/90 mmHg)
after 20 weeks gestation with proteinuria (≥300 mg/24 hours or 1+ on dipstick) or
signs of end-organ dysfunction (headache, visual changes). Gestational
hypertension lacks proteinuria. Eclampsia includes seizures. Chronic hypertension
predates pregnancy or occurs before 20 weeks.
Question 3
A 32-year-old G3P2 at 39 weeks gestation is in active labor. Which finding
indicates the need for immediate intervention?
A) Contractions every 3 minutes lasting 45 seconds
B) Late decelerations on fetal heart rate tracing
C) Cervical dilation from 5 cm to 7 cm over 2 hours
D) Maternal heart rate 100 beats per minute
Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal
hypoxia, requiring immediate intervention (position change, oxygen, IV fluids,
possible delivery). Contractions every 3 minutes, cervical dilation, and maternal
tachycardia can be normal or require monitoring but are not as immediately
concerning as late decelerations.
,Question 4
A patient at 12 weeks gestation is Rh-negative and has an Rh-positive partner.
When should RhoGAM be administered?
A) At 28 weeks gestation and within 72 hours of delivery
B) Only at delivery
C) At 20 weeks gestation
D) Only if fetal-maternal hemorrhage is detected
Answer: A
Rationale: RhoGAM (Rh immune globulin) is administered to Rh-negative women
at 28 weeks gestation and within 72 hours of delivery of an Rh-positive infant to
prevent Rh isoimmunization. It should also be given after miscarriage, abortion, or
invasive procedures. Administration at 20 weeks is not standard.
Question 5
A pregnant patient at 36 weeks gestation is positive for Group B Streptococcus
(GBS). Which intrapartum management is indicated?
A) Intravenous penicillin G every 4 hours until delivery
B) Oral ampicillin for 7 days
C) Vancomycin prophylaxis
D) No treatment is needed
Answer: A
Rationale: GBS-positive women should receive intrapartum antibiotic prophylaxis
with IV penicillin G every 4 hours until delivery to prevent neonatal GBS sepsis.
Oral antibiotics are not adequate for prevention. Vancomycin is reserved for
penicillin-allergic patients. Universal screening is performed at 35-37 weeks.
Question 6
, A 25-year-old G1P0 at 16 weeks gestation presents with severe nausea, vomiting,
and excessive thirst. Laboratory results show serum sodium 158 mEq/L and blood
glucose 450 mg/dL. What is the most likely diagnosis?
A) Hyperemesis gravidarum
B) Gestational diabetes with diabetic ketoacidosis
C) Preeclampsia with hypernatremia
D) Hyperthyroidism
Answer: B
Rationale: Gestational diabetes can present with hyperglycemia, osmotic
symptoms (polyuria, polydipsia), and may progress to DKA. Severe nausea and
vomiting may be triggered by DKA. Hyperemesis gravidarum does not cause
hyperglycemia. Preeclampsia does not cause hyperglycemia. Hyperthyroidism
presents with weight loss and tachycardia, not hyperglycemia.
Question 7
A pregnant patient at 20 weeks gestation is concerned about her weight gain. She
has gained 10 pounds since conception. What is the appropriate counseling?
A) She is underweight and needs to gain more
B) This is appropriate weight gain for this gestational age
C) She is overweight and needs to slow weight gain
D) She should be on a calorie-restricted diet
Answer: B
Rationale: Appropriate weight gain in pregnancy depends on pre-pregnancy BMI.
For normal BMI (18.5-24.9), recommended weight gain is 25-35 pounds total
(approximately 1 pound/week in second and third trimesters). At 20 weeks, 10
pounds is within normal range. Calorie restriction is never appropriate in
pregnancy.
PRIMARY CARE OF THE CHILDBEARING &
CHILDREARING FAMILY FINAL EXAM TEST BANK:
100 QUESTIONS & ANSWERS WITH RATIONALES |
CHAMBERLAIN UNIVERSITY | RATED A+
SECTION 1: PRENATAL CARE & OBSTETRICS
Question 1
A 28-year-old woman at 10 weeks gestation presents with nausea and vomiting
that has been worsening over the past week. She reports inability to keep any
food or fluids down for the past 3 days. She has lost 4 pounds since her last visit.
What is the most appropriate diagnosis?
A) Hyperemesis gravidarum
B) Gastroesophageal reflux disease (GERD)
C) Morning sickness
D) Gastroenteritis
Answer: A
Rationale: Hyperemesis gravidarum is characterized by severe nausea and
vomiting during pregnancy, leading to dehydration, electrolyte imbalances, and
weight loss (typically >5% of pre-pregnancy weight). Morning sickness is milder
and does not cause significant weight loss or dehydration. GERD and
gastroenteritis are less likely given the pregnancy context and duration of
symptoms.
Question 2
,A 34-year-old primigravida at 28 weeks gestation presents with a blood pressure
of 148/96 mmHg. Urinalysis reveals 2+ protein. She reports a headache and visual
changes. What is the most likely diagnosis?
A) Gestational hypertension
B) Preeclampsia
C) Eclampsia
D) Chronic hypertension
Answer: B
Rationale: Preeclampsia is diagnosed as new-onset hypertension (≥140/90 mmHg)
after 20 weeks gestation with proteinuria (≥300 mg/24 hours or 1+ on dipstick) or
signs of end-organ dysfunction (headache, visual changes). Gestational
hypertension lacks proteinuria. Eclampsia includes seizures. Chronic hypertension
predates pregnancy or occurs before 20 weeks.
Question 3
A 32-year-old G3P2 at 39 weeks gestation is in active labor. Which finding
indicates the need for immediate intervention?
A) Contractions every 3 minutes lasting 45 seconds
B) Late decelerations on fetal heart rate tracing
C) Cervical dilation from 5 cm to 7 cm over 2 hours
D) Maternal heart rate 100 beats per minute
Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal
hypoxia, requiring immediate intervention (position change, oxygen, IV fluids,
possible delivery). Contractions every 3 minutes, cervical dilation, and maternal
tachycardia can be normal or require monitoring but are not as immediately
concerning as late decelerations.
,Question 4
A patient at 12 weeks gestation is Rh-negative and has an Rh-positive partner.
When should RhoGAM be administered?
A) At 28 weeks gestation and within 72 hours of delivery
B) Only at delivery
C) At 20 weeks gestation
D) Only if fetal-maternal hemorrhage is detected
Answer: A
Rationale: RhoGAM (Rh immune globulin) is administered to Rh-negative women
at 28 weeks gestation and within 72 hours of delivery of an Rh-positive infant to
prevent Rh isoimmunization. It should also be given after miscarriage, abortion, or
invasive procedures. Administration at 20 weeks is not standard.
Question 5
A pregnant patient at 36 weeks gestation is positive for Group B Streptococcus
(GBS). Which intrapartum management is indicated?
A) Intravenous penicillin G every 4 hours until delivery
B) Oral ampicillin for 7 days
C) Vancomycin prophylaxis
D) No treatment is needed
Answer: A
Rationale: GBS-positive women should receive intrapartum antibiotic prophylaxis
with IV penicillin G every 4 hours until delivery to prevent neonatal GBS sepsis.
Oral antibiotics are not adequate for prevention. Vancomycin is reserved for
penicillin-allergic patients. Universal screening is performed at 35-37 weeks.
Question 6
, A 25-year-old G1P0 at 16 weeks gestation presents with severe nausea, vomiting,
and excessive thirst. Laboratory results show serum sodium 158 mEq/L and blood
glucose 450 mg/dL. What is the most likely diagnosis?
A) Hyperemesis gravidarum
B) Gestational diabetes with diabetic ketoacidosis
C) Preeclampsia with hypernatremia
D) Hyperthyroidism
Answer: B
Rationale: Gestational diabetes can present with hyperglycemia, osmotic
symptoms (polyuria, polydipsia), and may progress to DKA. Severe nausea and
vomiting may be triggered by DKA. Hyperemesis gravidarum does not cause
hyperglycemia. Preeclampsia does not cause hyperglycemia. Hyperthyroidism
presents with weight loss and tachycardia, not hyperglycemia.
Question 7
A pregnant patient at 20 weeks gestation is concerned about her weight gain. She
has gained 10 pounds since conception. What is the appropriate counseling?
A) She is underweight and needs to gain more
B) This is appropriate weight gain for this gestational age
C) She is overweight and needs to slow weight gain
D) She should be on a calorie-restricted diet
Answer: B
Rationale: Appropriate weight gain in pregnancy depends on pre-pregnancy BMI.
For normal BMI (18.5-24.9), recommended weight gain is 25-35 pounds total
(approximately 1 pound/week in second and third trimesters). At 20 weeks, 10
pounds is within normal range. Calorie restriction is never appropriate in
pregnancy.
