ANSWERS) PLUS RATIONALES | 250 Q&A
Domain 1: Antepartum Care & Prenatal Assessment (Questions 1–80)
1. A nurse is calculating a due date using Nägele's rule for a client whose last menstrual period began
on May 10. Which date is correct?
A) February 3
B) February 17
C) March 3
D) March 17
Answer B: February 17
Rationale: Nägele's rule: subtract 3 months, add 7 days. May 10 → February 10 + 7 days = February 17.
2. Which finding is a positive sign of pregnancy?
A) Amenorrhea
B) Chadwick's sign
C) Fetal heartbeat on Doppler
D) Nausea
Answer C: Fetal heartbeat on Doppler
Rationale: Positive signs confirm pregnancy (fetal heart tones, ultrasound visualization, fetal movement felt
by examiner). Amenorrhea, Chadwick's sign, and nausea are probable/presumptive signs.
3. A nurse teaches a client about folic acid. Which statement indicates understanding?
A) "It prevents iron deficiency anemia."
B) "It reduces risk of neural tube defects."
C) "It is only needed in the third trimester."
D) "It is found mainly in dairy products."
Answer B: "It reduces risk of neural tube defects."
Rationale: Folic acid (400-800 mcg daily) in early pregnancy prevents neural tube defects like spina bifida.
,4. A nurse is providing teaching to a client who is at 8 weeks gestation about manifestations to report
to the provider. What information should the nurse include?
A) Nausea upon awakening
B) Blurred or double vision
C) Increase in white vaginal discharge
D) Leg cramps when sleeping
Answer B: Blurred or double vision
Rationale: Blurred or double vision can indicate preeclampsia or gestational hypertension and should be
reported immediately.
5. A nurse is teaching a client who is at 12 weeks gestation and has HIV. Which statement should the
nurse include?
A) "You will be in isolation after delivery."
B) "Abstain from sexual intercourse throughout pregnancy."
C) "Breastfeed your newborn to provide passive immunity."
D) "You should continue to take zidovudine throughout the pregnancy."
Answer D: "You should continue to take zidovudine throughout the pregnancy."
Rationale: Taking prescription antiviral medication every day decreases the risk of transmission of HIV to
the newborn.
6. A nurse is assessing a client at 11 weeks gestation who reports abdominal cramping. Which action
should the nurse take?
A) Schedule a routine follow-up appointment
B) Instruct the client to rest and drink fluids
C) Notify the provider immediately
D) Administer an anti-emetic
Answer C: Notify the provider immediately
Rationale: Abdominal cramping can indicate an ectopic pregnancy or manifestations of spontaneous
abortion. The nurse should request that the provider see this client first.
7. A nurse is teaching a client about signs of preterm labor. Which finding should the client report
immediately?
,A) Increased Braxton Hicks contractions
B) Low back pain that comes and goes
C) Menstrual-like cramping with diarrhea
D) Fetal movement >10 per hour
Answer C: Menstrual-like cramping with diarrhea
Rationale: Menstrual-like cramping with diarrhea can indicate preterm labor. Increased Braxton Hicks
contractions are normal.
8. A client at 38 weeks gestation asks the nurse how to tell if she is in true labor. Which statement
indicates understanding?
A) "True labor contractions are irregular and stop with activity."
B) "True labor contractions increase in frequency and intensity."
C) "True labor is felt only in the lower abdomen."
D) "True labor contractions are relieved by walking."
Answer B: "True labor contractions increase in frequency and intensity."
Rationale: True labor contractions become more frequent, regular, and intense over time, with progressive
cervical change.
9. Which laboratory finding is consistent with a diagnosis of gestational diabetes?
A) Fasting blood glucose 85 mg/dL
B) 1-hour glucose tolerance test >140 mg/dL
C) Hemoglobin A1c 4.5%
D) Random glucose 110 mg/dL
Answer B: 1-hour glucose tolerance test >140 mg/dL
Rationale: A 1-hour glucose tolerance test >140 mg/dL indicates the need for a 3-hour glucose tolerance
test; levels ≥180–200 mg/dL may be diagnostic.
10. A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate. Which
finding indicates magnesium toxicity?
A) Respiratory rate 18/min
B) Urinary output <30 mL/hr
C) Deep tendon reflexes 2+
D) Blood pressure 140/90 mmHg
, Answer B: Urinary output <30 mL/hr
Rationale: Magnesium toxicity is indicated by respiratory depression (<12/min), oliguria (<30 mL/hr), and
absent reflexes.
11. A nurse is teaching a client about the signs of preeclampsia. Which manifestation should the
client report immediately?
A) Mild ankle edema
B) Weight gain of 2 lbs in 1 week
C) Epigastric pain and headache
D) Occasional nausea
Answer C: Epigastric pain and headache
Rationale: Epigastric pain and headache are signs of severe preeclampsia and impending eclampsia; report
immediately.
12. A client at 36 weeks gestation is diagnosed with placenta previa. Which finding is most consistent
with this diagnosis?
A) Rigid, board-like abdomen
B) Painless, bright red vaginal bleeding
C) Severe abdominal pain with dark bleeding
D) Absent fetal heart tones
Answer B: Painless, bright red vaginal bleeding
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester.
13. A nurse is assessing a client with abruptio placentae. Which finding should the nurse expect?
A) Painless vaginal bleeding
B) Sudden, severe abdominal pain with dark bleeding
C) Normal uterine tone
D) Soft, non-tender abdomen
Answer B: Sudden, severe abdominal pain with dark bleeding
Rationale: Abruptio placentae presents with sudden, severe abdominal pain and dark, vaginal bleeding; a
rigid abdomen may also be present.