NUR 231 Exam 1 Actual Exam V2 | NUR 231 Childbearing & Child
Caring Family (NUR231 Exam 1) | Galen College of Nursing
1. A nurse is performing an assessment on a client who is at 12 weeks of gestation. Which of
the following findings is considered a positive sign of pregnancy?
A. Positive serum pregnancy test
B. Fetal heart tones heard via Doppler
C. Chadwick’s sign
D. Quickening reported by the client
Answer: B
Rationale: Positive signs of pregnancy are those that are directly attributed to the fetus,
such as hearing fetal heart tones, visualizing the fetus via ultrasound, or palpating fetal
movement by an examiner. A positive serum pregnancy test and Chadwick’s sign are
probable signs, while quickening is a presumptive sign. This assessment is critical for
confirming a viable intrauterine pregnancy during the first trimester.
2. Using Naegele’s rule, calculate the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on November 15.
A. February 22
B. August 8
C. August 15
D. August 22
Answer: D
Rationale: Naegele’s rule involves subtracting 3 months from the first day of the LMP and
adding 7 days and 1 year. For an LMP of November 15, subtracting 3 months leads to
August, and adding 7 days results in August 22. This calculation is a fundamental skill in
prenatal care to establish a timeline for gestational milestones.
3. A nurse is teaching a pregnant client about the physiological changes in the cardiovascular
system. Which statement should the nurse include?
A. Red blood cell production decreases to prevent clotting.
B. The heart rate typically decreases by 10 to 15 beats per minute.
C. Blood volume increases by approximately 40% to 50%.
D. Blood pressure significantly increases in the second trimester.
,Answer: C
Rationale: During pregnancy, total blood volume increases by 40% to 50% to provide
adequate perfusion to the placenta and compensate for blood loss during delivery. Heart
rate actually increases, and blood pressure usually stays stable or slightly decreases in the
second trimester. This physiological hypervolemia is a normal adaptation that prevents
maternal shock during the birthing process.
4. A client at 28 weeks gestation reports feeling dizzy and faint when lying on her back. Which
action should the nurse recommend?
A. Take a warm shower to promote peripheral vasodilation.
B. Increase fluid intake to boost blood pressure.
C. Perform deep breathing exercises while supine.
D. Lie on the left side to relieve pressure on the vena cava.
Answer: D
Rationale: The client is experiencing supine hypotensive syndrome, caused by the heavy
uterus compressing the inferior vena cava when lying flat. Shifting to a side-lying position,
particularly the left side, improves venous return to the heart and increases cardiac output.
This intervention is a vital safety measure to ensure both maternal and fetal oxygenation.
5. A nurse is reviewing the GTPAL of a client who is currently pregnant, has a 5-year-old child
born at 39 weeks, and had a miscarriage at 10 weeks. How should the nurse document this?
A. G2 T1 P0 A1 L1
B. G3 T1 P0 A1 L1
C. G3 T0 P1 A1 L1
D. G2 T1 P1 A0 L1
Answer: B
Rationale: G (Gravidity) is 3 (current pregnancy, 5-year-old, and miscarriage). T (Term) is
1 (the 39-week birth). P (Preterm) is 0. A (Abortion/Miscarriage) is 1 (the 10-week loss). L
(Living) is 1. Accurate GTPAL documentation is essential for assessing obstetrical history
and potential risk factors in the current pregnancy.
6. What is the primary function of the amniotic fluid during fetal development?
A. Provides direct nutrient exchange between mother and fetus.
B. Maintains constant body temperature and allows movement.
C. Acts as the primary site for fetal gas exchange.
D. Produces red blood cells for the fetal circulatory system.
, Answer: B
Rationale: Amniotic fluid serves multiple purposes, including temperature regulation,
protection from trauma, and allowing for symmetrical fetal growth and movement. It is not
the site of gas or nutrient exchange; those are functions of the placenta. Monitoring
amniotic fluid volume is a key component of assessing fetal well-being.
7. A client in her first trimester is concerned about morning sickness. Which nutritional
intervention should the nurse suggest?
A. Drink large amounts of water with every meal.
B. Eat dry crackers or toast before rising in the morning.
C. Consume three large, high-protein meals daily.
D. Avoid ginger-based products as they irritate the stomach.
Answer: B
Rationale: Eating small, frequent meals and dry carbohydrates like crackers before getting
out of bed helps stabilize blood sugar and reduce nausea. Drinking fluids between meals
rather than with them can also prevent gastric distention. Ginger is actually often
recommended as a natural remedy for nausea in pregnancy.
8. Which fetal structure is responsible for shunting blood from the right atrium directly to the
left atrium, bypassing the lungs?
A. Ductus venosus
B. Ductus arteriosus
C. Foramen ovale
D. Umbilical vein
Answer: C
Rationale: The foramen ovale is an anatomical opening between the right and left atria in
the fetal heart that allows oxygenated blood to bypass the non-functional fetal lungs. The
ductus arteriosus shunts blood from the pulmonary artery to the aorta. Understanding fetal
circulation is vital for recognizing normal neonatal transitions after birth.
9. A nurse is educating a client about folic acid intake. What is the recommended daily dose
to prevent neural tube defects?
A. 100 to 200 mcg
B. 400 to 800 mcg
C. 2 to 4 mg
D. 10 mg
Caring Family (NUR231 Exam 1) | Galen College of Nursing
1. A nurse is performing an assessment on a client who is at 12 weeks of gestation. Which of
the following findings is considered a positive sign of pregnancy?
A. Positive serum pregnancy test
B. Fetal heart tones heard via Doppler
C. Chadwick’s sign
D. Quickening reported by the client
Answer: B
Rationale: Positive signs of pregnancy are those that are directly attributed to the fetus,
such as hearing fetal heart tones, visualizing the fetus via ultrasound, or palpating fetal
movement by an examiner. A positive serum pregnancy test and Chadwick’s sign are
probable signs, while quickening is a presumptive sign. This assessment is critical for
confirming a viable intrauterine pregnancy during the first trimester.
2. Using Naegele’s rule, calculate the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on November 15.
A. February 22
B. August 8
C. August 15
D. August 22
Answer: D
Rationale: Naegele’s rule involves subtracting 3 months from the first day of the LMP and
adding 7 days and 1 year. For an LMP of November 15, subtracting 3 months leads to
August, and adding 7 days results in August 22. This calculation is a fundamental skill in
prenatal care to establish a timeline for gestational milestones.
3. A nurse is teaching a pregnant client about the physiological changes in the cardiovascular
system. Which statement should the nurse include?
A. Red blood cell production decreases to prevent clotting.
B. The heart rate typically decreases by 10 to 15 beats per minute.
C. Blood volume increases by approximately 40% to 50%.
D. Blood pressure significantly increases in the second trimester.
,Answer: C
Rationale: During pregnancy, total blood volume increases by 40% to 50% to provide
adequate perfusion to the placenta and compensate for blood loss during delivery. Heart
rate actually increases, and blood pressure usually stays stable or slightly decreases in the
second trimester. This physiological hypervolemia is a normal adaptation that prevents
maternal shock during the birthing process.
4. A client at 28 weeks gestation reports feeling dizzy and faint when lying on her back. Which
action should the nurse recommend?
A. Take a warm shower to promote peripheral vasodilation.
B. Increase fluid intake to boost blood pressure.
C. Perform deep breathing exercises while supine.
D. Lie on the left side to relieve pressure on the vena cava.
Answer: D
Rationale: The client is experiencing supine hypotensive syndrome, caused by the heavy
uterus compressing the inferior vena cava when lying flat. Shifting to a side-lying position,
particularly the left side, improves venous return to the heart and increases cardiac output.
This intervention is a vital safety measure to ensure both maternal and fetal oxygenation.
5. A nurse is reviewing the GTPAL of a client who is currently pregnant, has a 5-year-old child
born at 39 weeks, and had a miscarriage at 10 weeks. How should the nurse document this?
A. G2 T1 P0 A1 L1
B. G3 T1 P0 A1 L1
C. G3 T0 P1 A1 L1
D. G2 T1 P1 A0 L1
Answer: B
Rationale: G (Gravidity) is 3 (current pregnancy, 5-year-old, and miscarriage). T (Term) is
1 (the 39-week birth). P (Preterm) is 0. A (Abortion/Miscarriage) is 1 (the 10-week loss). L
(Living) is 1. Accurate GTPAL documentation is essential for assessing obstetrical history
and potential risk factors in the current pregnancy.
6. What is the primary function of the amniotic fluid during fetal development?
A. Provides direct nutrient exchange between mother and fetus.
B. Maintains constant body temperature and allows movement.
C. Acts as the primary site for fetal gas exchange.
D. Produces red blood cells for the fetal circulatory system.
, Answer: B
Rationale: Amniotic fluid serves multiple purposes, including temperature regulation,
protection from trauma, and allowing for symmetrical fetal growth and movement. It is not
the site of gas or nutrient exchange; those are functions of the placenta. Monitoring
amniotic fluid volume is a key component of assessing fetal well-being.
7. A client in her first trimester is concerned about morning sickness. Which nutritional
intervention should the nurse suggest?
A. Drink large amounts of water with every meal.
B. Eat dry crackers or toast before rising in the morning.
C. Consume three large, high-protein meals daily.
D. Avoid ginger-based products as they irritate the stomach.
Answer: B
Rationale: Eating small, frequent meals and dry carbohydrates like crackers before getting
out of bed helps stabilize blood sugar and reduce nausea. Drinking fluids between meals
rather than with them can also prevent gastric distention. Ginger is actually often
recommended as a natural remedy for nausea in pregnancy.
8. Which fetal structure is responsible for shunting blood from the right atrium directly to the
left atrium, bypassing the lungs?
A. Ductus venosus
B. Ductus arteriosus
C. Foramen ovale
D. Umbilical vein
Answer: C
Rationale: The foramen ovale is an anatomical opening between the right and left atria in
the fetal heart that allows oxygenated blood to bypass the non-functional fetal lungs. The
ductus arteriosus shunts blood from the pulmonary artery to the aorta. Understanding fetal
circulation is vital for recognizing normal neonatal transitions after birth.
9. A nurse is educating a client about folic acid intake. What is the recommended daily dose
to prevent neural tube defects?
A. 100 to 200 mcg
B. 400 to 800 mcg
C. 2 to 4 mg
D. 10 mg
