,NUR 231 Final Exam | Childbearing & Child Caring Families
(2026) Q&A | Galen College
1. A nurse is calculating a client's GTPAL. The client is currently pregnant, had a twin
birth at 38 weeks, and a spontaneous abortion at 10 weeks. What is the correct
GTPAL?
A) G2, T1, P0, A1, L2
B) G3, T1, P0, A1, L2
C) G3, T2, P0, A1, L2
D) G2, T2, P0, A1, L1
Correct Answer: G3, T1, P0, A1, L2
Rationale: Gravida (G) is 3: the current pregnancy, the twin pregnancy, and the
abortion. Term (T) is 1: the twins born at 38 weeks count as one term birth event.
Preterm (P) is 0. Abortion (A) is 1: the miscarriage at 10 weeks. Living (L) is 2: the
twins. This nota tion captures the complete obstetric history.
2. A client's last menstrual period began on May 10, 2025. Using Naegele's rule, what
is the estimated date of delivery?
A) February 3, 2026
B) February 17, 2026
C) February 24, 2026
D) March 3, 2026
Correct Answer: February 17, 2026
Rationale: Naegele's rule subtracts 3 months from the first day of the last
menstrual period and adds 7 days. May 10 minus 3 months is February 10, plus 7
days is February 17, 2026. The year is advanced when the calculation crosses into
the next calendar year.
,3. During which gestational week does the embryonic period begin, marking the
period of greatest vulnerability to teratogens?
A) Week 2
B) Week 3
C) Week 5
D) Week 8
Correct Answer: Week 3
Rationale: The embryonic period begins at week 3 and continues through week 8.
This is when major organ systems are forming, making the fetus most vulnerable to
teratogens. Exposure during this time can cause major structural anomalies.
4. A client asks the nurse when the fetal heartbeat can first be detected by Doppler
ultrasound. What is the most accurate response?
A) 6 - 8 weeks
B) 10- 12 weeks
C) 14- 16 weeks
D) 18- 20 weeks
Correct Answer: 10- 12 weeks
Rationale: Fetal heart tones can typically be detected by Doppler ultrasound
between 10 and 12 weeks of gestation. Transvaginal ultrasound may detect cardiac
activity as early as 6 weeks, but Doppler is not reliable until later.
5. A nurse is explaining the function of the placenta to a client. Which statement by
the client indicates understanding?
A) "The placenta filters maternal blood to remove toxins."
B) "The placenta allows for the exchange of oxygen and nutrients without mixing
maternal and fetal blood."
C) "The placenta produces all the hormones needed for pregnancy."
D) "The placenta stores fetal waste until delivery."
, Correct Answer: "The placenta allows for the exchange of oxygen and nutrients
without mixing maternal and fetal blood."
Rationale: The placenta facilitates the exchange of oxygen, nutrients, and waste
products between the mother and fetus without mixing their blood. This separation
is essential for fetal health and maternal - fetal compatibility.
6. A client at 34 weeks of gestation has a prescription for magnesium sulfate. Which
finding should the nurse identify as a manifestation of magnesium toxicity?
A) Hyperreflexia
B) Respiratory rate of 10/min
C) Increased urinary output
D) Blood pressure of 150/90 mm Hg
Correct Answer: Respiratory rate of 10/min
Rationale: Magnesium toxicity causes central nervous system depression, leading
to decreased respiratory rate (below 12/min), loss of deep tendon reflexes, and
decreased urinary output. A respiratory rate of 10/min is a critical sign requiring
immediate intervention .
7. A client in the first stage of labor has a fetal heart rate tracing showing late
decelerations. Which action should the nurse take first?
A) Assist the client into a side - lying position
B) Increase the IV fluid rate
C) Perform a vaginal exam
D) Administer oxygen via nonrebreather mask
Correct Answer: Assist the client into a side - lying position
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority
action is to position the client on her side to improve blood flow to the placenta. This
is the first step in the intrauterine resuscitation protocol, often remembered as the
LION appr oach.
(2026) Q&A | Galen College
1. A nurse is calculating a client's GTPAL. The client is currently pregnant, had a twin
birth at 38 weeks, and a spontaneous abortion at 10 weeks. What is the correct
GTPAL?
A) G2, T1, P0, A1, L2
B) G3, T1, P0, A1, L2
C) G3, T2, P0, A1, L2
D) G2, T2, P0, A1, L1
Correct Answer: G3, T1, P0, A1, L2
Rationale: Gravida (G) is 3: the current pregnancy, the twin pregnancy, and the
abortion. Term (T) is 1: the twins born at 38 weeks count as one term birth event.
Preterm (P) is 0. Abortion (A) is 1: the miscarriage at 10 weeks. Living (L) is 2: the
twins. This nota tion captures the complete obstetric history.
2. A client's last menstrual period began on May 10, 2025. Using Naegele's rule, what
is the estimated date of delivery?
A) February 3, 2026
B) February 17, 2026
C) February 24, 2026
D) March 3, 2026
Correct Answer: February 17, 2026
Rationale: Naegele's rule subtracts 3 months from the first day of the last
menstrual period and adds 7 days. May 10 minus 3 months is February 10, plus 7
days is February 17, 2026. The year is advanced when the calculation crosses into
the next calendar year.
,3. During which gestational week does the embryonic period begin, marking the
period of greatest vulnerability to teratogens?
A) Week 2
B) Week 3
C) Week 5
D) Week 8
Correct Answer: Week 3
Rationale: The embryonic period begins at week 3 and continues through week 8.
This is when major organ systems are forming, making the fetus most vulnerable to
teratogens. Exposure during this time can cause major structural anomalies.
4. A client asks the nurse when the fetal heartbeat can first be detected by Doppler
ultrasound. What is the most accurate response?
A) 6 - 8 weeks
B) 10- 12 weeks
C) 14- 16 weeks
D) 18- 20 weeks
Correct Answer: 10- 12 weeks
Rationale: Fetal heart tones can typically be detected by Doppler ultrasound
between 10 and 12 weeks of gestation. Transvaginal ultrasound may detect cardiac
activity as early as 6 weeks, but Doppler is not reliable until later.
5. A nurse is explaining the function of the placenta to a client. Which statement by
the client indicates understanding?
A) "The placenta filters maternal blood to remove toxins."
B) "The placenta allows for the exchange of oxygen and nutrients without mixing
maternal and fetal blood."
C) "The placenta produces all the hormones needed for pregnancy."
D) "The placenta stores fetal waste until delivery."
, Correct Answer: "The placenta allows for the exchange of oxygen and nutrients
without mixing maternal and fetal blood."
Rationale: The placenta facilitates the exchange of oxygen, nutrients, and waste
products between the mother and fetus without mixing their blood. This separation
is essential for fetal health and maternal - fetal compatibility.
6. A client at 34 weeks of gestation has a prescription for magnesium sulfate. Which
finding should the nurse identify as a manifestation of magnesium toxicity?
A) Hyperreflexia
B) Respiratory rate of 10/min
C) Increased urinary output
D) Blood pressure of 150/90 mm Hg
Correct Answer: Respiratory rate of 10/min
Rationale: Magnesium toxicity causes central nervous system depression, leading
to decreased respiratory rate (below 12/min), loss of deep tendon reflexes, and
decreased urinary output. A respiratory rate of 10/min is a critical sign requiring
immediate intervention .
7. A client in the first stage of labor has a fetal heart rate tracing showing late
decelerations. Which action should the nurse take first?
A) Assist the client into a side - lying position
B) Increase the IV fluid rate
C) Perform a vaginal exam
D) Administer oxygen via nonrebreather mask
Correct Answer: Assist the client into a side - lying position
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority
action is to position the client on her side to improve blood flow to the placenta. This
is the first step in the intrauterine resuscitation protocol, often remembered as the
LION appr oach.
