Questions And Answers Latest Updates
Instructions: Read each question carefully. Select the best answer. Each question includes
the correct answer and an expert rationale.
Question 1.
A pregnant patient at 8 weeks gestation asks the nurse when she should expect to feel
fetal movement. The nurse correctly responds that quickening typically occurs
between:
A. 8–12 weeks gestation.
B. 14–18 weeks gestation.
C. 20–24 weeks gestation.
D. 28–32 weeks gestation.
[Correct Answer:]{.underline} B
[Rationale:]{.underline}
Quickening, or the mother's first perception of fetal movement, typically occurs between 14
and 18 weeks gestation in multiparous women and may occur slightly later (18–20 weeks)
in primigravida’s. Before 14 weeks, fetal movement is too subtle to be perceived. After 20
weeks, if movement has not been felt, further assessment is warranted.
Question 2.
A nurse is assessing a pregnant patient at 28 weeks gestation. Which finding would
require immediate follow-up and possible referral?
A. Fundal height measuring 28 cm.
B. Fetal heart rate of 140 beats per minute.
C. Blood pressure of 150/96 mmHg with 2+ proteinuria.
D. Weight gain of 2 pounds since the last visit 4 weeks ago.
[Correct Answer:]{.underline} C
[Rationale:]{.underline}
A blood pressure of 150/96 mmHg with proteinuria (2+) is diagnostic of preeclampsia, a
potentially life-threatening hypertensive disorder of pregnancy. This requires immediate
provider notification, further diagnostic workup, and possible hospitalization. Normal
,fundal height at 28 weeks is 26–30 cm; fetal heart rate of 140 bpm is normal; and a 2-pound
weight gain over 4 weeks in the third trimester is within expected parameters.
Question 3.
The nurse is teaching a pregnant patient about physiological changes during
pregnancy. The nurse correctly explains that the increase in blood volume during
pregnancy is primarily due to:
A. Increased erythrocyte production only.
B. Increased plasma volume and increased erythrocyte production.
C. Hemodilution caused by decreased erythrocyte production.
D. Decreased plasma volume with increased erythrocyte concentration.
[Correct Answer:]{.underline} B
[Rationale:]{.underline}
Maternal blood volume increases by 40–50% during pregnancy, peaking at 32–34 weeks
gestation. This increase is due to both increased plasma volume (up to 50% increase) and
increased erythrocyte production (up to 30% increase). The plasma volume increases more
than erythrocytes, causing physiologic anemia (hemodilution), but both components
increase absolutely.
Question 4.
A patient at 12 weeks gestation reports severe nausea and vomiting that has
persisted for 3 days, preventing her from keeping any food or fluids down. She
appears dehydrated with dry mucous membranes and decreased skin turgor. The
nurse recognizes these findings as consistent with:
A. Normal morning sickness.
B. Hyperemesis gravidarum.
C. Gastroenteritis.
D. Preeclampsia.
[Correct Answer:]{.underline} B
[Rationale:]{.underline}
Hyperemesis gravidarum is characterized by severe, persistent nausea and vomiting during
pregnancy that leads to dehydration, weight loss, electrolyte imbalances, and ketonuria.
Unlike typical "morning sickness," which is mild and self-limiting, hyperemesis gravidarum
requires medical intervention including IV fluids, antiemetics, and nutritional support. The
, presence of dehydration signs (dry mucous membranes, poor skin turgor) differentiates
this from normal pregnancy-related nausea.
Question 5.
During a prenatal visit, a patient asks the nurse why she needs to take a prenatal
vitamin with folic acid. The nurse's best response is:
A. "Folic acid prevents iron-deficiency anemia during pregnancy."
B. "Folic acid is essential for preventing neural tube defects in the developing fetus."
C. "Folic acid helps your body absorb calcium for fetal bone development."
D. "Folic acid reduces your risk of developing gestational diabetes."
[Correct Answer:]{.underline} B
[Rationale:]{.underline}
Folic acid supplementation (400–800 mcg daily) before conception and during early
pregnancy significantly reduces the risk of neural tube defects (NTDs) such as spina bifida
and anencephaly. The neural tube closes between 21 and 28 days after conception, often
before a woman knows she is pregnant, making early supplementation critical. Folic acid
does not prevent anemia (iron does), aid calcium absorption, or prevent gestational
diabetes.
Question 6.
A nurse is palpating the abdomen of a pregnant patient at 36 weeks gestation using
Leopold maneuvers. The nurse feels a firm, round, movable structure in the fundus
and a hard, smooth, ballotable structure above the symphysis pubis. These findings
indicate:
A. Cephalic presentation with the fetal head in the fundus.
B. Breech presentation with the fetal head in the fundus.
C. Cephalic presentation with the fetal buttocks in the fundus.
D. Breech presentation with the fetal buttocks in the fundus.
[Correct Answer:]{.underline} B
[Rationale:]{.underline}
Leopold maneuvers are used to determine fetal presentation and position. A firm, round,
movable structure in the fundus is consistent with the fetal head (which is rounder and
more mobile than the breech). A hard, smooth, ballotable structure above the symphysis
pubis indicates the breech (buttocks) is presenting at the pelvic inlet. Together, these