WGU D447 Women and Children's Health
OA – Western Governors University –
2026/2027 Academic Year – 100 Questions
and Answers Covering Four Core Domains
Antepartum Care
Question 1
A client is being seen for her first prenatal visit at 10 weeks' gestation. The nurse
should anticipate which finding?
A) Fetal heart tones via fetoscope
B) Fetal movement felt by the mother
C) Fundal height at the umbilicus
D) Fetal heart tones via Doppler
Correct Answer: D
Rationale: At 10 weeks, fetal heart tones can be detected by Doppler ultrasound.
Fetoscope detection is possible at 18–20 weeks. Quickening (fetal movement) occurs
at 16–20 weeks. Fundal height at the umbilicus is expected at 20 weeks.
Question 2
The nurse is teaching a client about the changes in the urinary system during
pregnancy. Which statement is accurate?
A) The glomerular filtration rate decreases
B) Frequent urination is common due to pressure on the bladder
C) Urinary output typically decreases in the third trimester
D) Kidney function is not affected by pregnancy
Correct Answer: B
Rationale: Frequent urination is a common symptom of pregnancy, especially in the
first and third trimesters, due to the pressure of the enlarging uterus on the bladder.
The glomerular filtration rate actually increases during pregnancy, and urinary output
typically increases.
Question 3
The nurse is discussing the changes in the gastrointestinal system during pregnancy.
Which finding should the nurse include?
A) Decreased gastric motility is common
B) Heartburn is caused by relaxation of the gastroesophageal sphincter
C) Gallstones are less common during pregnancy
D) Constipation is rare in pregnancy
,Correct Answer: B
Rationale: Heartburn during pregnancy is caused by relaxation of the
gastroesophageal sphincter due to progesterone. Gastric motility decreases, which
can lead to constipation. Gallstones are actually more common during pregnancy.
Question 4
The nurse is assessing a client at 20 weeks' gestation. The fundal height should be
approximately at which location?
A) Symphysis pubis
B) Xiphoid process
C) Level of the umbilicus
D) Midway between symphysis and umbilicus
Correct Answer: C
Rationale: At 20 weeks' gestation, the fundal height is expected to be at the level of
the umbilicus. Fundal height in centimeters typically corresponds to weeks of
gestation (e.g., 20 cm at 20 weeks).
Question 5
The nurse is teaching a client about the changes in the skin during pregnancy. The
nurse should explain that striae gravidarum are:
A) A darkening of skin on the face
B) Stretch marks on the abdomen and breasts
C) A vascular lesion of the skin
D) An increase in skin pigmentation
Correct Answer: B
Rationale: Striae gravidarum are stretch marks that commonly appear on the
abdomen, breasts, and thighs during pregnancy. Melasma (darkening of skin on the
face) is different. Spider angiomas are vascular lesions that may also occur.
Question 6
The nurse is teaching a client about the changes in the reproductive system during
pregnancy. The nurse should explain that the cervix:
A) Remains firm throughout pregnancy
B) Becomes softer (Goodell sign)
C) Shortens in the first trimester
D) Does not change during pregnancy
Correct Answer: B
Rationale: Goodell's sign refers to softening of the cervix that occurs during
pregnancy due to increased vascularity and edema. This is a normal physiological
adaptation.
,Question 7
The nurse is teaching a client about the changes in the musculoskeletal system
during pregnancy. The nurse should include that:
A) Lordosis occurs due to changes in the center of gravity
B) Joints become more stable
C) Muscle strength increases
D) Relaxin decreases joint mobility
Correct Answer: A
Rationale: Lordosis (inward curvature of the lower spine) occurs during pregnancy to
compensate for the shift in the center of gravity as the abdomen enlarges. Relaxin
causes increased joint mobility and softening of pelvic ligaments.
Question 8
The nurse is teaching a client about the changes in the endocrine system during
pregnancy. The nurse should explain that the placenta produces:
A) Estrogen only
B) Progesterone only
C) Human chorionic gonadotropin (hCG)
D) All of the above
Correct Answer: D
Rationale: The placenta produces multiple hormones, including estrogen,
progesterone, and human chorionic gonadotropin (hCG). hCG is the hormone
detected by pregnancy tests and is essential for maintaining early pregnancy.
Question 9
The nurse is discussing the changes in the hematologic system during pregnancy.
The nurse should explain that blood volume:
A) Decreases by 10-15%
B) Remains unchanged
C) Increases by 40-50%
D) Increases by 20-30%
Correct Answer: C
Rationale: Blood volume increases by approximately 40-50% during pregnancy to
meet the demands of the growing fetus and placenta. This increase includes both
plasma volume and red blood cell mass.
Question 10
A client reports shortness of breath at 34 weeks' gestation. What is the nurse's best
response?
A) This is concerning and requires immediate evaluation
B) This is normal due to uterine pressure on the diaphragm
, C) You should lie flat to improve breathing
D) This is a sign of heart failure
Correct Answer: B
Rationale: Shortness of breath in the third trimester is often normal due to the
enlarging uterus pushing upward on the diaphragm, reducing lung capacity.
However, if accompanied by other concerning symptoms, further evaluation would
be warranted. The diaphragm elevates by approximately 4 cm during pregnancy.
Question 11
The nurse is teaching a client about fetal development. During the embryonic period
(weeks 3-8), which structures develop?
A) All major organs
B) Neural tube, heart, and limb buds
C) Lung surfactant
D) Fetal hair and nails
Correct Answer: B
Rationale: During the embryonic period (weeks 3-8), the neural tube, heart, and limb
buds develop. By 12 weeks, all major organs are formed. Surfactant production
begins at approximately 24-28 weeks.
Question 12
The nurse is teaching a client about fetal circulation. The structure that allows blood
to bypass the lungs is the:
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical vein
Correct Answer: C
Rationale: The ductus arteriosus connects the pulmonary artery to the aorta,
allowing blood to bypass the lungs during fetal development. The foramen ovale is
an opening between the atria that also allows blood to bypass the lungs. The ductus
venosus bypasses the liver.
Question 13
The nurse is teaching a client about fetal movement. Quickening is defined as:
A) The first sensation of fetal movement, felt at 16-20 weeks
B) A sudden fetal kick
C) Fetal hiccups
D) A contraction felt by the mother
Correct Answer: A
Rationale: Quickening is the first sensation of fetal movement perceived by the
OA – Western Governors University –
2026/2027 Academic Year – 100 Questions
and Answers Covering Four Core Domains
Antepartum Care
Question 1
A client is being seen for her first prenatal visit at 10 weeks' gestation. The nurse
should anticipate which finding?
A) Fetal heart tones via fetoscope
B) Fetal movement felt by the mother
C) Fundal height at the umbilicus
D) Fetal heart tones via Doppler
Correct Answer: D
Rationale: At 10 weeks, fetal heart tones can be detected by Doppler ultrasound.
Fetoscope detection is possible at 18–20 weeks. Quickening (fetal movement) occurs
at 16–20 weeks. Fundal height at the umbilicus is expected at 20 weeks.
Question 2
The nurse is teaching a client about the changes in the urinary system during
pregnancy. Which statement is accurate?
A) The glomerular filtration rate decreases
B) Frequent urination is common due to pressure on the bladder
C) Urinary output typically decreases in the third trimester
D) Kidney function is not affected by pregnancy
Correct Answer: B
Rationale: Frequent urination is a common symptom of pregnancy, especially in the
first and third trimesters, due to the pressure of the enlarging uterus on the bladder.
The glomerular filtration rate actually increases during pregnancy, and urinary output
typically increases.
Question 3
The nurse is discussing the changes in the gastrointestinal system during pregnancy.
Which finding should the nurse include?
A) Decreased gastric motility is common
B) Heartburn is caused by relaxation of the gastroesophageal sphincter
C) Gallstones are less common during pregnancy
D) Constipation is rare in pregnancy
,Correct Answer: B
Rationale: Heartburn during pregnancy is caused by relaxation of the
gastroesophageal sphincter due to progesterone. Gastric motility decreases, which
can lead to constipation. Gallstones are actually more common during pregnancy.
Question 4
The nurse is assessing a client at 20 weeks' gestation. The fundal height should be
approximately at which location?
A) Symphysis pubis
B) Xiphoid process
C) Level of the umbilicus
D) Midway between symphysis and umbilicus
Correct Answer: C
Rationale: At 20 weeks' gestation, the fundal height is expected to be at the level of
the umbilicus. Fundal height in centimeters typically corresponds to weeks of
gestation (e.g., 20 cm at 20 weeks).
Question 5
The nurse is teaching a client about the changes in the skin during pregnancy. The
nurse should explain that striae gravidarum are:
A) A darkening of skin on the face
B) Stretch marks on the abdomen and breasts
C) A vascular lesion of the skin
D) An increase in skin pigmentation
Correct Answer: B
Rationale: Striae gravidarum are stretch marks that commonly appear on the
abdomen, breasts, and thighs during pregnancy. Melasma (darkening of skin on the
face) is different. Spider angiomas are vascular lesions that may also occur.
Question 6
The nurse is teaching a client about the changes in the reproductive system during
pregnancy. The nurse should explain that the cervix:
A) Remains firm throughout pregnancy
B) Becomes softer (Goodell sign)
C) Shortens in the first trimester
D) Does not change during pregnancy
Correct Answer: B
Rationale: Goodell's sign refers to softening of the cervix that occurs during
pregnancy due to increased vascularity and edema. This is a normal physiological
adaptation.
,Question 7
The nurse is teaching a client about the changes in the musculoskeletal system
during pregnancy. The nurse should include that:
A) Lordosis occurs due to changes in the center of gravity
B) Joints become more stable
C) Muscle strength increases
D) Relaxin decreases joint mobility
Correct Answer: A
Rationale: Lordosis (inward curvature of the lower spine) occurs during pregnancy to
compensate for the shift in the center of gravity as the abdomen enlarges. Relaxin
causes increased joint mobility and softening of pelvic ligaments.
Question 8
The nurse is teaching a client about the changes in the endocrine system during
pregnancy. The nurse should explain that the placenta produces:
A) Estrogen only
B) Progesterone only
C) Human chorionic gonadotropin (hCG)
D) All of the above
Correct Answer: D
Rationale: The placenta produces multiple hormones, including estrogen,
progesterone, and human chorionic gonadotropin (hCG). hCG is the hormone
detected by pregnancy tests and is essential for maintaining early pregnancy.
Question 9
The nurse is discussing the changes in the hematologic system during pregnancy.
The nurse should explain that blood volume:
A) Decreases by 10-15%
B) Remains unchanged
C) Increases by 40-50%
D) Increases by 20-30%
Correct Answer: C
Rationale: Blood volume increases by approximately 40-50% during pregnancy to
meet the demands of the growing fetus and placenta. This increase includes both
plasma volume and red blood cell mass.
Question 10
A client reports shortness of breath at 34 weeks' gestation. What is the nurse's best
response?
A) This is concerning and requires immediate evaluation
B) This is normal due to uterine pressure on the diaphragm
, C) You should lie flat to improve breathing
D) This is a sign of heart failure
Correct Answer: B
Rationale: Shortness of breath in the third trimester is often normal due to the
enlarging uterus pushing upward on the diaphragm, reducing lung capacity.
However, if accompanied by other concerning symptoms, further evaluation would
be warranted. The diaphragm elevates by approximately 4 cm during pregnancy.
Question 11
The nurse is teaching a client about fetal development. During the embryonic period
(weeks 3-8), which structures develop?
A) All major organs
B) Neural tube, heart, and limb buds
C) Lung surfactant
D) Fetal hair and nails
Correct Answer: B
Rationale: During the embryonic period (weeks 3-8), the neural tube, heart, and limb
buds develop. By 12 weeks, all major organs are formed. Surfactant production
begins at approximately 24-28 weeks.
Question 12
The nurse is teaching a client about fetal circulation. The structure that allows blood
to bypass the lungs is the:
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical vein
Correct Answer: C
Rationale: The ductus arteriosus connects the pulmonary artery to the aorta,
allowing blood to bypass the lungs during fetal development. The foramen ovale is
an opening between the atria that also allows blood to bypass the lungs. The ductus
venosus bypasses the liver.
Question 13
The nurse is teaching a client about fetal movement. Quickening is defined as:
A) The first sensation of fetal movement, felt at 16-20 weeks
B) A sudden fetal kick
C) Fetal hiccups
D) A contraction felt by the mother
Correct Answer: A
Rationale: Quickening is the first sensation of fetal movement perceived by the
