NSG 3500 Maternal Exam 1 with
questions and correct answers with
rationale and well highlighted
options updated 2026 rated A+
SECTION A: ANATOMY & PHYSIOLOGY OF PREGNANCY
1. Which hormone is primarily responsible for maintaining the uterine lining during the first
trimester of pregnancy?
A) Estrogen
B) Progesterone
C) Human Chorionic Gonadotropin (hCG)
D) Relaxin
Rationale: Progesterone is secreted by the corpus luteum in early pregnancy and later by the
placenta. It maintains the decidua (uterine lining), suppresses myometrial contractions, and supports
embryonic implantation.
2. The fertilized ovum typically implants in the uterus at which stage?
A) Zygote
B) Blastocyst
C) Morula
D) Embryo
Rationale: Implantation occurs when the embryo is at the blastocyst stage (approximately 6–10 days
after fertilization). The blastocyst's trophoblast cells invade the endometrium.
3. What is the function of Human Chorionic Gonadotropin (hCG)?
, A) Maintains the corpus luteum during early pregnancy
B) Stimulates milk production
C) Initiates labor
D) Causes cervical ripening
Rationale: hCG is secreted by the syncytiotrophoblast and signals the corpus luteum to continue
producing progesterone and estrogen until the placenta takes over around weeks 8–10.
4. Which hormone causes the relaxation of pelvic ligaments and joints during pregnancy?
A) Oxytocin
B) Estrogen
C) Relaxin
D) Progesterone
Rationale: Relaxin is produced by the corpus luteum and placenta. It relaxes the symphysis pubis and
sacroiliac joints to facilitate pelvic expansion during labor.
5. The normal length of a full-term pregnancy in weeks is:
A) 36 weeks
B) 38 weeks
C) 40 weeks
D) 42 weeks
Rationale: A full-term pregnancy is defined as 40 weeks (280 days) from the first day of the last
menstrual period (LMP), with a normal range of 37–42 weeks.
6. Nagele's Rule calculates the estimated date of delivery (EDD) by:
A) Adding 7 days to LMP and subtracting 3 months
, B) Adding 7 days to LMP, subtracting 3 months, and adding 1 year
C) Adding 9 months to LMP
D) Adding 14 days to LMP
Rationale: Naegele's Rule: EDD = LMP + 7 days − 3 months + 1 year. Based on a 28-day cycle with
ovulation on day 14.
7. Which of the following is a presumptive sign of pregnancy?
A) Positive pregnancy test
B) Fetal heart tones
C) Amenorrhea
D) Uterine enlargement
Rationale: Presumptive signs are subjective changes perceived by the woman (e.g., amenorrhea,
nausea, breast tenderness). Probable signs are detected by examiner, and positive signs confirm
pregnancy.
8. A positive sign of pregnancy is:**
A) Quickening
B) Amenorrhea
C) Visualization of fetus on ultrasound
D) Positive hCG test
Rationale: Positive (diagnostic) signs of pregnancy include fetal heartbeat on Doppler/ultrasound,
fetal movement felt by examiner, and visualization of the fetus.
9. During pregnancy, cardiac output increases by approximately:**
A) 10–15%
B) 20–25%
, C) 30–50%
D) 60–70%
Rationale: Cardiac output increases by 30–50% during pregnancy, peaking around 32 weeks. This is
due to increased stroke volume and heart rate.
10. Which physiologic change occurs in the respiratory system during pregnancy?
A) Decreased tidal volume
B) Increased residual volume
C) Elevated diaphragm with dyspnea
D) Decreased oxygen consumption
Rationale: The diaphragm elevates by approximately 4 cm due to the enlarging uterus, leading to
dyspnea. Tidal volume increases by 30–50%.
11. The placenta is fully functional by which gestational age?
A) 6 weeks
B) 8 weeks
C) 12 weeks
D) 20 weeks
Rationale: The placenta is fully established and functional by 12 weeks gestation. Before this, the
corpus luteum supports pregnancy.
12. Which of the following best describes the function of the amniotic fluid?**
A) Provides nutrients to the fetus
B) Protects the fetus from trauma and maintains temperature
C) Supplies oxygen to the fetus
D) Produces hormones for pregnancy
questions and correct answers with
rationale and well highlighted
options updated 2026 rated A+
SECTION A: ANATOMY & PHYSIOLOGY OF PREGNANCY
1. Which hormone is primarily responsible for maintaining the uterine lining during the first
trimester of pregnancy?
A) Estrogen
B) Progesterone
C) Human Chorionic Gonadotropin (hCG)
D) Relaxin
Rationale: Progesterone is secreted by the corpus luteum in early pregnancy and later by the
placenta. It maintains the decidua (uterine lining), suppresses myometrial contractions, and supports
embryonic implantation.
2. The fertilized ovum typically implants in the uterus at which stage?
A) Zygote
B) Blastocyst
C) Morula
D) Embryo
Rationale: Implantation occurs when the embryo is at the blastocyst stage (approximately 6–10 days
after fertilization). The blastocyst's trophoblast cells invade the endometrium.
3. What is the function of Human Chorionic Gonadotropin (hCG)?
, A) Maintains the corpus luteum during early pregnancy
B) Stimulates milk production
C) Initiates labor
D) Causes cervical ripening
Rationale: hCG is secreted by the syncytiotrophoblast and signals the corpus luteum to continue
producing progesterone and estrogen until the placenta takes over around weeks 8–10.
4. Which hormone causes the relaxation of pelvic ligaments and joints during pregnancy?
A) Oxytocin
B) Estrogen
C) Relaxin
D) Progesterone
Rationale: Relaxin is produced by the corpus luteum and placenta. It relaxes the symphysis pubis and
sacroiliac joints to facilitate pelvic expansion during labor.
5. The normal length of a full-term pregnancy in weeks is:
A) 36 weeks
B) 38 weeks
C) 40 weeks
D) 42 weeks
Rationale: A full-term pregnancy is defined as 40 weeks (280 days) from the first day of the last
menstrual period (LMP), with a normal range of 37–42 weeks.
6. Nagele's Rule calculates the estimated date of delivery (EDD) by:
A) Adding 7 days to LMP and subtracting 3 months
, B) Adding 7 days to LMP, subtracting 3 months, and adding 1 year
C) Adding 9 months to LMP
D) Adding 14 days to LMP
Rationale: Naegele's Rule: EDD = LMP + 7 days − 3 months + 1 year. Based on a 28-day cycle with
ovulation on day 14.
7. Which of the following is a presumptive sign of pregnancy?
A) Positive pregnancy test
B) Fetal heart tones
C) Amenorrhea
D) Uterine enlargement
Rationale: Presumptive signs are subjective changes perceived by the woman (e.g., amenorrhea,
nausea, breast tenderness). Probable signs are detected by examiner, and positive signs confirm
pregnancy.
8. A positive sign of pregnancy is:**
A) Quickening
B) Amenorrhea
C) Visualization of fetus on ultrasound
D) Positive hCG test
Rationale: Positive (diagnostic) signs of pregnancy include fetal heartbeat on Doppler/ultrasound,
fetal movement felt by examiner, and visualization of the fetus.
9. During pregnancy, cardiac output increases by approximately:**
A) 10–15%
B) 20–25%
, C) 30–50%
D) 60–70%
Rationale: Cardiac output increases by 30–50% during pregnancy, peaking around 32 weeks. This is
due to increased stroke volume and heart rate.
10. Which physiologic change occurs in the respiratory system during pregnancy?
A) Decreased tidal volume
B) Increased residual volume
C) Elevated diaphragm with dyspnea
D) Decreased oxygen consumption
Rationale: The diaphragm elevates by approximately 4 cm due to the enlarging uterus, leading to
dyspnea. Tidal volume increases by 30–50%.
11. The placenta is fully functional by which gestational age?
A) 6 weeks
B) 8 weeks
C) 12 weeks
D) 20 weeks
Rationale: The placenta is fully established and functional by 12 weeks gestation. Before this, the
corpus luteum supports pregnancy.
12. Which of the following best describes the function of the amniotic fluid?**
A) Provides nutrients to the fetus
B) Protects the fetus from trauma and maintains temperature
C) Supplies oxygen to the fetus
D) Produces hormones for pregnancy
