NUR 2513 MATERNAL-CHILD
NURSING: EXAMINATION 2
COMPREHENSIVE STUDY GUIDE – 100
PRACTICE QUESTIONS WITH VERIFIED
ANSWER RATIONALES
Section 1: Antepartum Nursing Care (Questions 1-15)
Question 1
A client at 12 weeks gestation reports nausea and vomiting that is worse in the
morning. Which intervention should the nurse recommend first?
A) Eat a large breakfast immediately upon waking
B) Eat dry crackers or toast before getting out of bed
C) Drink large amounts of fluid with meals
D) Avoid eating between meals
Correct Answer: B
Rationale: Eating dry crackers or toast before getting out of bed helps stabilize
blood glucose and reduce nausea by preventing an empty stomach. Large meals and
drinking fluids with meals can worsen symptoms. Small, frequent meals are preferred
over avoiding snacks .
Question 2
A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule. The
client's last menstrual period (LMP) was January 15. What is the EDD?
A) October 8
B) October 15
C) October 22
D) October 29
Correct Answer: C
Rationale: Naegele's rule: Add 7 days to the first day of LMP (January 15 + 7 =
,January 22), then subtract 3 months (January 22 - 3 months = October 22). This
assumes a 28-day cycle. Only about 5% of women deliver on their exact EDD .
Question 3
A client at 16 weeks gestation reports a sudden gush of fluid from the vagina. Which
is the priority nursing action?
A) Check the fluid for presence of meconium
B) Assess the client's vital signs
C) Perform a sterile speculum exam to confirm rupture of membranes
D) Prepare the client for immediate delivery
Correct Answer: C
Rationale: When membranes may have ruptured, the priority is to confirm rupture
through sterile speculum exam assessing for fluid pooling, ferning, and nitrazine
paper testing. Premature rupture of membranes requires monitoring for infection
and may necessitate induction depending on gestational age .
Question 4
A primigravida at 32 weeks gestation has a fundal height of 28 cm. What is the
priority nursing action?
A) Prepare for immediate cesarean section
B) Notify the healthcare provider and prepare for further evaluation
C) Reassure the patient that measurements can vary
D) Instruct the patient to increase caloric intake
Correct Answer: B
Rationale: Between 20-34 weeks, fundal height should approximate gestational age
(±2-3 cm). A 4 cm discrepancy suggests possible intrauterine growth restriction,
oligohydramnios, or incorrect dating. The provider should be notified for further
evaluation such as ultrasound .
Question 5
A patient at 10 weeks gestation reports moderate to severe nausea and vomiting
,throughout the day and has lost 4 pounds in 3 weeks. These findings are most
consistent with:
A) Morning sickness
B) Hyperemesis gravidarum
C) Gastroenteritis
D) Food poisoning
Correct Answer: B
Rationale: Hyperemesis gravidarum is a severe form of nausea and vomiting in
pregnancy distinct from common morning sickness. It can lead to dehydration,
electrolyte imbalances, and weight loss requiring medical intervention .
Question 6
The nurse is teaching a patient at 12 weeks gestation with a pre-pregnancy BMI of 23
kg/m² about recommended weight gain. What is the recommended total weight
gain?
A) 11-20 pounds (5-9 kg)
B) 15-25 pounds (7-11.5 kg)
C) 25-35 pounds (11.5-16 kg)
D) 28-40 pounds (12.5-18 kg)
Correct Answer: C
Rationale: For normal weight women (BMI 18.5-24.9), the Institute of Medicine
recommends total weight gain of 25-35 pounds (11.5-16 kg) during pregnancy .
Question 7
A client at 32 weeks gestation presents with a fundal height that has only increased 2
cm over 4 weeks. What does this finding suggest?
A) Normal fetal growth
B) Inadequate interval growth requiring evaluation
C) Multiple gestation
D) Polyhydramnios
Correct Answer: B
Rationale: Fundal height should increase approximately 1 cm per week. An increase
, of only 2 cm over 4 weeks is less than expected and may indicate intrauterine growth
restriction or other complications requiring further evaluation .
Question 8
A nurse is teaching a pregnant client about warning signs during the third trimester.
Which statement indicates the need for further teaching?
A) "If I have headaches and blurred vision, I should call the clinic."
B) "Swelling in my hands and face could be a sign of a serious problem."
C) "If my baby is not moving much, I should try to rest and drink cold water."
D) "Leaking fluid or bleeding from my vagina is something I need to report right
away."
Correct Answer: C
Rationale: Decreased fetal movement is a potential sign of fetal distress. While
drinking cold water or lying on the left side may be tried, persistent decreased
movement should always be evaluated by a healthcare provider. This statement
indicates a need for further teaching .
Question 9
A client at 28 weeks gestation is Rh-negative and has not received RhoGAM. When
should RhoGAM be administered?
A) Only after delivery
B) At 28 weeks and within 72 hours after delivery
C) Only if the baby is Rh-negative
D) At 20 weeks only
Correct Answer: B
Rationale: RhoGAM is given at 28 weeks gestation for antenatal prophylaxis and
within 72 hours after delivery if the newborn is Rh-positive. Administration only after
delivery misses the critical antenatal prophylaxis .
Question 10
A nurse is reviewing a fetal heart rate tracing and notes an acceleration of 20 bpm
lasting 20 seconds. This pattern indicates:
NURSING: EXAMINATION 2
COMPREHENSIVE STUDY GUIDE – 100
PRACTICE QUESTIONS WITH VERIFIED
ANSWER RATIONALES
Section 1: Antepartum Nursing Care (Questions 1-15)
Question 1
A client at 12 weeks gestation reports nausea and vomiting that is worse in the
morning. Which intervention should the nurse recommend first?
A) Eat a large breakfast immediately upon waking
B) Eat dry crackers or toast before getting out of bed
C) Drink large amounts of fluid with meals
D) Avoid eating between meals
Correct Answer: B
Rationale: Eating dry crackers or toast before getting out of bed helps stabilize
blood glucose and reduce nausea by preventing an empty stomach. Large meals and
drinking fluids with meals can worsen symptoms. Small, frequent meals are preferred
over avoiding snacks .
Question 2
A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule. The
client's last menstrual period (LMP) was January 15. What is the EDD?
A) October 8
B) October 15
C) October 22
D) October 29
Correct Answer: C
Rationale: Naegele's rule: Add 7 days to the first day of LMP (January 15 + 7 =
,January 22), then subtract 3 months (January 22 - 3 months = October 22). This
assumes a 28-day cycle. Only about 5% of women deliver on their exact EDD .
Question 3
A client at 16 weeks gestation reports a sudden gush of fluid from the vagina. Which
is the priority nursing action?
A) Check the fluid for presence of meconium
B) Assess the client's vital signs
C) Perform a sterile speculum exam to confirm rupture of membranes
D) Prepare the client for immediate delivery
Correct Answer: C
Rationale: When membranes may have ruptured, the priority is to confirm rupture
through sterile speculum exam assessing for fluid pooling, ferning, and nitrazine
paper testing. Premature rupture of membranes requires monitoring for infection
and may necessitate induction depending on gestational age .
Question 4
A primigravida at 32 weeks gestation has a fundal height of 28 cm. What is the
priority nursing action?
A) Prepare for immediate cesarean section
B) Notify the healthcare provider and prepare for further evaluation
C) Reassure the patient that measurements can vary
D) Instruct the patient to increase caloric intake
Correct Answer: B
Rationale: Between 20-34 weeks, fundal height should approximate gestational age
(±2-3 cm). A 4 cm discrepancy suggests possible intrauterine growth restriction,
oligohydramnios, or incorrect dating. The provider should be notified for further
evaluation such as ultrasound .
Question 5
A patient at 10 weeks gestation reports moderate to severe nausea and vomiting
,throughout the day and has lost 4 pounds in 3 weeks. These findings are most
consistent with:
A) Morning sickness
B) Hyperemesis gravidarum
C) Gastroenteritis
D) Food poisoning
Correct Answer: B
Rationale: Hyperemesis gravidarum is a severe form of nausea and vomiting in
pregnancy distinct from common morning sickness. It can lead to dehydration,
electrolyte imbalances, and weight loss requiring medical intervention .
Question 6
The nurse is teaching a patient at 12 weeks gestation with a pre-pregnancy BMI of 23
kg/m² about recommended weight gain. What is the recommended total weight
gain?
A) 11-20 pounds (5-9 kg)
B) 15-25 pounds (7-11.5 kg)
C) 25-35 pounds (11.5-16 kg)
D) 28-40 pounds (12.5-18 kg)
Correct Answer: C
Rationale: For normal weight women (BMI 18.5-24.9), the Institute of Medicine
recommends total weight gain of 25-35 pounds (11.5-16 kg) during pregnancy .
Question 7
A client at 32 weeks gestation presents with a fundal height that has only increased 2
cm over 4 weeks. What does this finding suggest?
A) Normal fetal growth
B) Inadequate interval growth requiring evaluation
C) Multiple gestation
D) Polyhydramnios
Correct Answer: B
Rationale: Fundal height should increase approximately 1 cm per week. An increase
, of only 2 cm over 4 weeks is less than expected and may indicate intrauterine growth
restriction or other complications requiring further evaluation .
Question 8
A nurse is teaching a pregnant client about warning signs during the third trimester.
Which statement indicates the need for further teaching?
A) "If I have headaches and blurred vision, I should call the clinic."
B) "Swelling in my hands and face could be a sign of a serious problem."
C) "If my baby is not moving much, I should try to rest and drink cold water."
D) "Leaking fluid or bleeding from my vagina is something I need to report right
away."
Correct Answer: C
Rationale: Decreased fetal movement is a potential sign of fetal distress. While
drinking cold water or lying on the left side may be tried, persistent decreased
movement should always be evaluated by a healthcare provider. This statement
indicates a need for further teaching .
Question 9
A client at 28 weeks gestation is Rh-negative and has not received RhoGAM. When
should RhoGAM be administered?
A) Only after delivery
B) At 28 weeks and within 72 hours after delivery
C) Only if the baby is Rh-negative
D) At 20 weeks only
Correct Answer: B
Rationale: RhoGAM is given at 28 weeks gestation for antenatal prophylaxis and
within 72 hours after delivery if the newborn is Rh-positive. Administration only after
delivery misses the critical antenatal prophylaxis .
Question 10
A nurse is reviewing a fetal heart rate tracing and notes an acceleration of 20 bpm
lasting 20 seconds. This pattern indicates:
