,NUR 231 Exam 1 | Concepts of Nursing: Childbearing & Child
Caring Families (2026) Q&A | Galen College
1. A nurse is teaching a prenatal class about the hormones of pregnancy. Which
hormone is responsible for stimulating milk production?
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Correct Answer: Prolactin
Rationale: Prolactin is the hormone produced by the anterior pituitary gland that
stimulates milk production (lactogenesis) in the breasts. Oxytocin is responsible for
milk ejection (let - down reflex) and uterine contractions. Estrogen and progesterone
support the pr egnancy but do not directly stimulate milk production. Understanding
hormonal roles is essential for breastfeeding education.
2. A client at 32 weeks' gestation reports irregular, painless uterine contractions
that subside with walking. Which term best describes these contractions?
A) Preterm labor
B) Braxton Hicks contractions
C) True labor
D) Cervical effacement
Correct Answer: Braxton Hicks contractions
Rationale: Braxton Hicks contractions are irregular, painless, and often subside with
activity or position changes. They are a probable sign of pregnancy and do not cause
cervical dilation. Preterm labor contractions are regular and progressive. True labor
contracti ons increase in intensity and frequency. Cervical effacement refers to
thinning of the cervix.
,3. Which finding is considered a positive sign of pregnancy?
A) Amenorrhea
B) Positive urine pregnancy test
C) Fetal heart tones heard by Doppler
D) Goodell's sign
Correct Answer: Fetal heart tones heard by Doppler
Rationale: Positive signs of pregnancy are objective findings that can only be
attributed to the presence of a fetus. These include fetal heart sounds, visualization
of the fetus by ultrasound, and palpation of fetal movement by a clinician.
Amenorrhea is presumptiv e, and a positive pregnancy test and Goodell's sign are
probable signs.
4. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule
for a client whose last menstrual period began on June 10. What is the correct EDD?
A) March 3
B) March 17
C) April 10
D) April 17
Correct Answer: March 17
Rationale: Naegele's rule involves subtracting three months from the first day of the
last menstrual period and adding seven days. June 10 minus three months is March
10, plus seven days is March 17. This calculation assumes a 28 - day cycle with
ovulation on day 14.
5. A client is pregnant for the fourth time. She has one living child born at 39 weeks,
one miscarriage at 12 weeks, and twins born at 34 weeks. What is her GTPAL?
A) G4, T1, P2, A1, L3
B) G3, T2, P1, A0, L3
C) G4, T2, P2, A1, L2
, D) G4, T1, P1, A1, L3
Correct Answer: G4, T1, P1, A1, L3
Rationale: Gravida (G) is 4 (current pregnancy plus three past pregnancies). Term
(T) is 1 (the 39 - week birth). Preterm (P) is 1 (the twins born at 34 weeks count as
one preterm event). Abortion (A) is 1 (the miscarriage). Living (L) is 3 (the 39 - week
child plus the twins). This notation captures the complete obstetric history.
6. Which physiological adaptation normally occurs during an uncomplicated
pregnancy?
A) Decreased cardiac output
B) Increased respiratory rate
C) Increased blood volume
D) Decreased heart rate
Correct Answer: Increased blood volume
Rationale: Blood volume increases by approximately 40% during pregnancy to meet
the metabolic demands of the fetus and prepare for blood loss during delivery.
Cardiac output increases, heart rate may increase slightly, and respiratory rate
typically remains unchange d or increases slightly. Physiologic anemia may occur
due to hemodilution.
7. A pregnant client complains of dizziness and faintness when lying on her back.
What is the nurse's best response?
A) Elevate your feet to increase blood flow to the head.
B) Increase your fluid intake as you are likely dehydrated.
C) Turn onto your left side to relieve pressure on the vena cava.
D) Take deep breaths to improve oxygenation.
Correct Answer: Turn onto your left side to relieve pressure on the vena cava.
Caring Families (2026) Q&A | Galen College
1. A nurse is teaching a prenatal class about the hormones of pregnancy. Which
hormone is responsible for stimulating milk production?
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Correct Answer: Prolactin
Rationale: Prolactin is the hormone produced by the anterior pituitary gland that
stimulates milk production (lactogenesis) in the breasts. Oxytocin is responsible for
milk ejection (let - down reflex) and uterine contractions. Estrogen and progesterone
support the pr egnancy but do not directly stimulate milk production. Understanding
hormonal roles is essential for breastfeeding education.
2. A client at 32 weeks' gestation reports irregular, painless uterine contractions
that subside with walking. Which term best describes these contractions?
A) Preterm labor
B) Braxton Hicks contractions
C) True labor
D) Cervical effacement
Correct Answer: Braxton Hicks contractions
Rationale: Braxton Hicks contractions are irregular, painless, and often subside with
activity or position changes. They are a probable sign of pregnancy and do not cause
cervical dilation. Preterm labor contractions are regular and progressive. True labor
contracti ons increase in intensity and frequency. Cervical effacement refers to
thinning of the cervix.
,3. Which finding is considered a positive sign of pregnancy?
A) Amenorrhea
B) Positive urine pregnancy test
C) Fetal heart tones heard by Doppler
D) Goodell's sign
Correct Answer: Fetal heart tones heard by Doppler
Rationale: Positive signs of pregnancy are objective findings that can only be
attributed to the presence of a fetus. These include fetal heart sounds, visualization
of the fetus by ultrasound, and palpation of fetal movement by a clinician.
Amenorrhea is presumptiv e, and a positive pregnancy test and Goodell's sign are
probable signs.
4. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule
for a client whose last menstrual period began on June 10. What is the correct EDD?
A) March 3
B) March 17
C) April 10
D) April 17
Correct Answer: March 17
Rationale: Naegele's rule involves subtracting three months from the first day of the
last menstrual period and adding seven days. June 10 minus three months is March
10, plus seven days is March 17. This calculation assumes a 28 - day cycle with
ovulation on day 14.
5. A client is pregnant for the fourth time. She has one living child born at 39 weeks,
one miscarriage at 12 weeks, and twins born at 34 weeks. What is her GTPAL?
A) G4, T1, P2, A1, L3
B) G3, T2, P1, A0, L3
C) G4, T2, P2, A1, L2
, D) G4, T1, P1, A1, L3
Correct Answer: G4, T1, P1, A1, L3
Rationale: Gravida (G) is 4 (current pregnancy plus three past pregnancies). Term
(T) is 1 (the 39 - week birth). Preterm (P) is 1 (the twins born at 34 weeks count as
one preterm event). Abortion (A) is 1 (the miscarriage). Living (L) is 3 (the 39 - week
child plus the twins). This notation captures the complete obstetric history.
6. Which physiological adaptation normally occurs during an uncomplicated
pregnancy?
A) Decreased cardiac output
B) Increased respiratory rate
C) Increased blood volume
D) Decreased heart rate
Correct Answer: Increased blood volume
Rationale: Blood volume increases by approximately 40% during pregnancy to meet
the metabolic demands of the fetus and prepare for blood loss during delivery.
Cardiac output increases, heart rate may increase slightly, and respiratory rate
typically remains unchange d or increases slightly. Physiologic anemia may occur
due to hemodilution.
7. A pregnant client complains of dizziness and faintness when lying on her back.
What is the nurse's best response?
A) Elevate your feet to increase blood flow to the head.
B) Increase your fluid intake as you are likely dehydrated.
C) Turn onto your left side to relieve pressure on the vena cava.
D) Take deep breaths to improve oxygenation.
Correct Answer: Turn onto your left side to relieve pressure on the vena cava.
