NUR 230 Exam 1 – OB/Peds (2026) -Galen
70 Multiple-Choice Questions with Answers &
Rationales
1. The nurse is preparing to teach a client about the cardiovascular changes that
occur during pregnancy. Which of the following decreases or remains unchanged?
a. Heart rate
b. Blood pressure
c. Cardiac output
d. Blood volume
Correct Answer B
Rationale During pregnancy, blood volume increases by 40–50%, cardiac output
increases by 30–50%, and heart rate increases by 10–15 bpm. Blood pressure
typically decreases in the first and second trimesters due to peripheral
vasodilation and returns to pre-pregnancy levels in the third trimester.
2. The nurse has provided dietary teaching for a pregnant client who has iron-
deficiency anemia. Which of the following meal options selected by the client
indicates that teaching has been effective?
a. Grilled steak, creamed spinach, and an apple
b. Baked chicken breast and macaroni salad
c. Oatmeal, whole-wheat toast, and jelly
d. Grilled cheese sandwich and tomato soup
Correct AnswerA
Rationale Iron-rich foods include red meat (steak) and dark leafy greens (spinach).
Vitamin C–rich foods (apple) enhance iron absorption. The other options are low
in bioavailable iron.
,3. The nurse is caring for a pregnant client. The first day of the last menstrual
period (LMP) was October 11. Using Naegele's rule, the nurse calculates the
estimated date of delivery (EDD) as:
a. June 4
b. July 4
c. July 18
d. June 18
Correct AnswerC
Rationale Naegele's rule: subtract 3 months from the LMP and add 7 days (and 1
year if needed). October 11 minus 3 months = July 11; plus 7 days = July 18.
4. The nurse is caring for a pregnant client who is recently diagnosed with pica.
Which of the following hemoglobin (Hgb) levels should the nurse expect to find in
the client's chart?
a. 14 g/dL
b. 13 g/dL
c. 12 g/dL
d. 10 g/dL
Correct AnswerD
Rationale Pica (craving nonfood items such as ice, clay, or starch) is often
associated with iron-deficiency anemia. A normal Hgb in pregnancy is ≥11 g/dL; 10
g/dL indicates anemia and supports the pica diagnosis.
5. The nurse is caring for a client who is at 38 weeks gestation and in a supine
position for a pelvic examination. The client reports feeling dizzy and nauseated,
and upon assessment her skin feels cool and clammy. Which of the following
actions should the nurse take first?
a. Turn the client on her side
b. Elevate the client's legs 20 degrees above her hips
, c. Take the client's blood pressure (BP)
d. Assess the client's respiratory rate (RR)
Correct AnswerA
Rationale The client is experiencing supine hypotensive syndrome (vena cava
syndrome) caused by compression of the inferior vena cava by the gravid uterus.
The first and most important intervention is to turn the client to her left side to
relieve uterine compression and restore venous return.
6. The nurse is caring for a client who is a primigravida in her third trimester and is
experiencing shortness of breath when walking upstairs. Which of the following
statements by the nurse is most appropriate?
a. "You will feel much better once the baby is born."
b. "This can be uncomfortable; try taking breaks and use good posture."
c. "If you lie on your left side, it will relieve your shortness of breath."
d. "You should immediately report this difficulty breathing to your primary health
care provider."
Correct AnswerB
Rationale Mild dyspnea in the third trimester is common due to the upward
displacement of the diaphragm by the enlarging uterus. Teaching the client to
take breaks, maintain good posture, and avoid overexertion is appropriate.
Immediate reporting is only necessary if dyspnea is severe, occurs at rest, or is
accompanied by other symptoms.
7. The charge nurse is discussing probable signs of pregnancy with a newly hired
nurse. Which findings are probable signs of pregnancy?
Amenorrhea
Braxton Hicks contractions
Breast tenderness
Positive pregnancy test
Visualizing the fetus
70 Multiple-Choice Questions with Answers &
Rationales
1. The nurse is preparing to teach a client about the cardiovascular changes that
occur during pregnancy. Which of the following decreases or remains unchanged?
a. Heart rate
b. Blood pressure
c. Cardiac output
d. Blood volume
Correct Answer B
Rationale During pregnancy, blood volume increases by 40–50%, cardiac output
increases by 30–50%, and heart rate increases by 10–15 bpm. Blood pressure
typically decreases in the first and second trimesters due to peripheral
vasodilation and returns to pre-pregnancy levels in the third trimester.
2. The nurse has provided dietary teaching for a pregnant client who has iron-
deficiency anemia. Which of the following meal options selected by the client
indicates that teaching has been effective?
a. Grilled steak, creamed spinach, and an apple
b. Baked chicken breast and macaroni salad
c. Oatmeal, whole-wheat toast, and jelly
d. Grilled cheese sandwich and tomato soup
Correct AnswerA
Rationale Iron-rich foods include red meat (steak) and dark leafy greens (spinach).
Vitamin C–rich foods (apple) enhance iron absorption. The other options are low
in bioavailable iron.
,3. The nurse is caring for a pregnant client. The first day of the last menstrual
period (LMP) was October 11. Using Naegele's rule, the nurse calculates the
estimated date of delivery (EDD) as:
a. June 4
b. July 4
c. July 18
d. June 18
Correct AnswerC
Rationale Naegele's rule: subtract 3 months from the LMP and add 7 days (and 1
year if needed). October 11 minus 3 months = July 11; plus 7 days = July 18.
4. The nurse is caring for a pregnant client who is recently diagnosed with pica.
Which of the following hemoglobin (Hgb) levels should the nurse expect to find in
the client's chart?
a. 14 g/dL
b. 13 g/dL
c. 12 g/dL
d. 10 g/dL
Correct AnswerD
Rationale Pica (craving nonfood items such as ice, clay, or starch) is often
associated with iron-deficiency anemia. A normal Hgb in pregnancy is ≥11 g/dL; 10
g/dL indicates anemia and supports the pica diagnosis.
5. The nurse is caring for a client who is at 38 weeks gestation and in a supine
position for a pelvic examination. The client reports feeling dizzy and nauseated,
and upon assessment her skin feels cool and clammy. Which of the following
actions should the nurse take first?
a. Turn the client on her side
b. Elevate the client's legs 20 degrees above her hips
, c. Take the client's blood pressure (BP)
d. Assess the client's respiratory rate (RR)
Correct AnswerA
Rationale The client is experiencing supine hypotensive syndrome (vena cava
syndrome) caused by compression of the inferior vena cava by the gravid uterus.
The first and most important intervention is to turn the client to her left side to
relieve uterine compression and restore venous return.
6. The nurse is caring for a client who is a primigravida in her third trimester and is
experiencing shortness of breath when walking upstairs. Which of the following
statements by the nurse is most appropriate?
a. "You will feel much better once the baby is born."
b. "This can be uncomfortable; try taking breaks and use good posture."
c. "If you lie on your left side, it will relieve your shortness of breath."
d. "You should immediately report this difficulty breathing to your primary health
care provider."
Correct AnswerB
Rationale Mild dyspnea in the third trimester is common due to the upward
displacement of the diaphragm by the enlarging uterus. Teaching the client to
take breaks, maintain good posture, and avoid overexertion is appropriate.
Immediate reporting is only necessary if dyspnea is severe, occurs at rest, or is
accompanied by other symptoms.
7. The charge nurse is discussing probable signs of pregnancy with a newly hired
nurse. Which findings are probable signs of pregnancy?
Amenorrhea
Braxton Hicks contractions
Breast tenderness
Positive pregnancy test
Visualizing the fetus
