NUR 230 OB/Peds Exam 1 Questions And
Answers With 100% Correct Answers 2026/2027
Updates
Question 1.
A pregnant client at 10 weeks gestation asks the nurse when she should expect to feel
fetal movement. The nurse correctly responds that quickening is typically felt
between:
A. 8–12 weeks gestation.
B. 16–20 weeks gestation.
C. 24–28 weeks gestation.
D. 32–36 weeks gestation.
Correct Answer: B
Rationale: Quickening, or the first perception of fetal movement, typically occurs between
16 and 20 weeks of gestation in a primigravida. Multigravidas may perceive movement
slightly earlier (14–18 weeks) due to prior experience. Before 16 weeks, perceived
movement is usually gastrointestinal motility rather than true fetal movement.
Question 2.
The nurse is assessing a pregnant client at 28 weeks gestation. Using McDonald's
rule, the nurse measures the fundal height. At 28 weeks, the expected fundal height
measurement is approximately:
A. 20 cm.
B. 24 cm.
C. 28 cm.
D. 32 cm.
Correct Answer: C
Rationale: McDonald's rule states that from approximately 20 weeks gestation onward, the
fundal height in centimeters should roughly equal the gestational age in weeks (±2 cm).
Therefore, at 28 weeks gestation, the fundal height should measure approximately 28 cm.
This is a quick screening tool for fetal growth assessment.
,Question 3.
A client at 32 weeks gestation presents to the clinic with complaints of sudden onset
of vaginal bleeding. The bleeding is bright red, and the client denies pain. On
assessment, the fetal heart rate is 140 bpm and regular. The nurse suspects which
complication?
A. Placental abruption.
B. Placenta previa.
C. Preterm labor.
D. Cervical insufficiency.
Correct Answer: B
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester. The bleeding occurs when the placenta implants over or near the
internal cervical os. In contrast, placental abruption typically presents with painful bleeding
(often dark red) and uterine tenderness. The absence of pain and the bright red color
strongly suggest placenta previa.
Question 4.
A pregnant client with gestational diabetes is being taught about dietary
management. The nurse emphasizes that the client should consume carbohydrates
that are:
A. Simple sugars to provide quick energy.
B. Complex carbohydrates distributed throughout the day.
C. Eliminated entirely to prevent hyperglycemia.
D. Consumed only at breakfast when insulin resistance is lowest.
Correct Answer: B
Rationale: Complex carbohydrates should be distributed evenly throughout the day in
gestational diabetes to maintain stable blood glucose levels. Simple sugars cause rapid
spikes in blood glucose. Carbohydrates should not be eliminated as they are essential for
fetal brain development. Insulin resistance is actually highest in the morning (dawn
phenomenon), making breakfast the most challenging meal for glucose control.
, Question 5.
During a prenatal visit, a client at 24 weeks gestation reports swelling in her ankles
and hands. The nurse notes +1 pitting edema in both lower extremities. The nurse's
priority action is to:
A. Immediately contact the provider for preeclampsia evaluation.
B. Assess the client's blood pressure and check for proteinuria.
C. Advise the client to increase sodium intake to mobilize fluids.
D. Prescribe diuretics to reduce the edema.
Correct Answer: B
Rationale: Physiologic edema is common in pregnancy due to increased blood volume and
venous stasis. However, edema combined with hypertension and proteinuria indicates
preeclampsia. The nurse must assess blood pressure and check for proteinuria before
determining if the edema is physiologic or pathologic. Increasing sodium would worsen
edema, and diuretics are contraindicated in pregnancy as they reduce plasma volume and
can compromise placental perfusion.
Question 6.
The nurse is caring for a client in active labor. The client is 7 cm dilated, 100%
effaced, and the fetus is at 0 station. The client reports intense rectal pressure and an
urge to push. The nurse's best response is to:
A. Encourage the client to push with each contraction.
B. Instruct the client to use pant-blow breathing to avoid pushing.
C. Prepare for immediate delivery in the current position.
D. Administer an epidural bolus immediately.
Correct Answer: B
Rationale: At 7 cm dilation, the cervix is not fully dilated (10 cm). Pushing before complete
dilation can cause cervical edema, laceration, and impede progress. The nurse should
instruct the client to use pant-blow or hee-hee-hoo breathing to resist the urge to push until
full dilation is achieved. This is a critical intervention to prevent cervical trauma and
prolonged labor.
Answers With 100% Correct Answers 2026/2027
Updates
Question 1.
A pregnant client at 10 weeks gestation asks the nurse when she should expect to feel
fetal movement. The nurse correctly responds that quickening is typically felt
between:
A. 8–12 weeks gestation.
B. 16–20 weeks gestation.
C. 24–28 weeks gestation.
D. 32–36 weeks gestation.
Correct Answer: B
Rationale: Quickening, or the first perception of fetal movement, typically occurs between
16 and 20 weeks of gestation in a primigravida. Multigravidas may perceive movement
slightly earlier (14–18 weeks) due to prior experience. Before 16 weeks, perceived
movement is usually gastrointestinal motility rather than true fetal movement.
Question 2.
The nurse is assessing a pregnant client at 28 weeks gestation. Using McDonald's
rule, the nurse measures the fundal height. At 28 weeks, the expected fundal height
measurement is approximately:
A. 20 cm.
B. 24 cm.
C. 28 cm.
D. 32 cm.
Correct Answer: C
Rationale: McDonald's rule states that from approximately 20 weeks gestation onward, the
fundal height in centimeters should roughly equal the gestational age in weeks (±2 cm).
Therefore, at 28 weeks gestation, the fundal height should measure approximately 28 cm.
This is a quick screening tool for fetal growth assessment.
,Question 3.
A client at 32 weeks gestation presents to the clinic with complaints of sudden onset
of vaginal bleeding. The bleeding is bright red, and the client denies pain. On
assessment, the fetal heart rate is 140 bpm and regular. The nurse suspects which
complication?
A. Placental abruption.
B. Placenta previa.
C. Preterm labor.
D. Cervical insufficiency.
Correct Answer: B
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester. The bleeding occurs when the placenta implants over or near the
internal cervical os. In contrast, placental abruption typically presents with painful bleeding
(often dark red) and uterine tenderness. The absence of pain and the bright red color
strongly suggest placenta previa.
Question 4.
A pregnant client with gestational diabetes is being taught about dietary
management. The nurse emphasizes that the client should consume carbohydrates
that are:
A. Simple sugars to provide quick energy.
B. Complex carbohydrates distributed throughout the day.
C. Eliminated entirely to prevent hyperglycemia.
D. Consumed only at breakfast when insulin resistance is lowest.
Correct Answer: B
Rationale: Complex carbohydrates should be distributed evenly throughout the day in
gestational diabetes to maintain stable blood glucose levels. Simple sugars cause rapid
spikes in blood glucose. Carbohydrates should not be eliminated as they are essential for
fetal brain development. Insulin resistance is actually highest in the morning (dawn
phenomenon), making breakfast the most challenging meal for glucose control.
, Question 5.
During a prenatal visit, a client at 24 weeks gestation reports swelling in her ankles
and hands. The nurse notes +1 pitting edema in both lower extremities. The nurse's
priority action is to:
A. Immediately contact the provider for preeclampsia evaluation.
B. Assess the client's blood pressure and check for proteinuria.
C. Advise the client to increase sodium intake to mobilize fluids.
D. Prescribe diuretics to reduce the edema.
Correct Answer: B
Rationale: Physiologic edema is common in pregnancy due to increased blood volume and
venous stasis. However, edema combined with hypertension and proteinuria indicates
preeclampsia. The nurse must assess blood pressure and check for proteinuria before
determining if the edema is physiologic or pathologic. Increasing sodium would worsen
edema, and diuretics are contraindicated in pregnancy as they reduce plasma volume and
can compromise placental perfusion.
Question 6.
The nurse is caring for a client in active labor. The client is 7 cm dilated, 100%
effaced, and the fetus is at 0 station. The client reports intense rectal pressure and an
urge to push. The nurse's best response is to:
A. Encourage the client to push with each contraction.
B. Instruct the client to use pant-blow breathing to avoid pushing.
C. Prepare for immediate delivery in the current position.
D. Administer an epidural bolus immediately.
Correct Answer: B
Rationale: At 7 cm dilation, the cervix is not fully dilated (10 cm). Pushing before complete
dilation can cause cervical edema, laceration, and impede progress. The nurse should
instruct the client to use pant-blow or hee-hee-hoo breathing to resist the urge to push until
full dilation is achieved. This is a critical intervention to prevent cervical trauma and
prolonged labor.
