NR 602 Final Exams / Midterm Exams (Latest 2024
/ 2025) Package
Section 1: Antepartum and Prenatal Care Management (Q1–Q25)
1. During a client's first prenatal visit, she reports amenorrhea, nausea, and breast
tenderness. The nurse documents these findings as which category of pregnancy signs?
A. Positive signs
B. Probable signs
C. Presumptive signs
D. Diagnostic signs
Answer: C
Rationale: Presumptive signs are subjective symptoms reported by the client, such as
amenorrhea, nausea, breast changes, and fatigue. They suggest but do not confirm pregnancy,
as they can be caused by other conditions.
2. A nurse palpates the uterine fundus at the level of the umbilicus. The nurse estimates the
gestational age to be approximately:
A. 12 weeks
B. 16 weeks
C. 20 weeks
D. 24 weeks
Answer: C
Rationale: A fundal height at the level of the umbilicus is a classic landmark for 20 weeks'
gestation. At 12 weeks, the fundus is at the symphysis pubis.
3. A client's last menstrual period began on May 10. Using Naegele's rule, what is the
estimated date of delivery?
A. February 3
B. February 17
C. February 20
D. February 24
Answer: B
Rationale: Naegele's rule: Add 7 days (May 17), subtract 3 months (February 17).
4. Which process describes programmed cell death that is orderly and does not provoke
inflammation?
A. Necrosis
B. Apoptosis
,C. Gangrenous necrosis
D. Coagulative necrosis
Answer: B
Rationale: Apoptosis is genetically regulated cell death that removes damaged cells without
significant inflammatory response.
5. What is the primary mechanism of hypoxic cell injury?
A. Immediate DNA fragmentation
B. Reduced ATP production causing sodium-potassium pump failure
C. Exclusive free radical injury
D. Increased oxidative phosphorylation
Answer: B
Rationale: Hypoxia impairs oxidative phosphorylation, depleting ATP; ion pump failure causes
sodium and water influx and cellular swelling.
6. Which type of necrosis is typically seen in the brain after ischemic injury?
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis
Answer: C
Rationale: Ischemic injury in the brain produces liquefactive necrosis due to high lipid content
and enzymatic digestion.
7. Which cellular adaptation involves an increase in cell size without an increase in cell
number?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Answer: B
Rationale: Hypertrophy is an increase in cell size in response to increased demand, without cell
division.
8. A 28-year-old G1P0 presents at 10 weeks gestation. According to ACOG guidelines, how
frequently should a low-risk primigravid patient be seen during the third trimester?
A. Every 2 weeks
B. Every week
C. Every 4 weeks
D. Every 3 weeks
,Answer: B
Rationale: ACOG recommends weekly visits from 36 weeks until delivery for low-risk
pregnancies.
9. Which hormone is primarily responsible for stimulating the growth of the ovarian follicle
during the follicular phase?
A. Estrogen
B. Follicle-stimulating hormone (FSH)
C. Gonadotropin-releasing hormone (GnRH)
D. Luteinizing hormone (LH)
Answer: B
Rationale: FSH directly targets the ovaries to stimulate follicular growth and maturation.
10. A surge in which hormone is the direct trigger for ovulation?
A. Estrogen
B. FSH
C. GnRH
D. LH
Answer: D
Rationale: A surge in luteinizing hormone (LH) triggers ovulation approximately 36 hours after
the surge begins.
11. A client inquires about the most effective reversible contraceptive method. The nurse
should recommend a method from which tier?
A. Tier 1
B. Tier 2
C. Tier 3
D. Tier 4
Answer: A
Rationale: Tier 1 contraceptives (IUDs, implants) have the lowest failure rates (<1%) and are the
most effective reversible methods.
12. During a pelvic assessment, the nurse notes the inlet is oval and the side walls are
straight. This is most consistent with which pelvic type?
A. Android
B. Anthropoid
C. Gynecoid
D. Platypelloid
Answer: C
Rationale: The gynecoid pelvis has a rounded, oval inlet and straight side walls and is the most
favorable for vaginal birth.
, 13. A pregnant patient at 10 weeks' gestation asks why folic acid supplementation is
recommended early in pregnancy. What is the primary benefit?
A. Prevents gestational diabetes
B. Prevents neural tube defects
C. Prevents preeclampsia
D. Prevents preterm labor
Answer: B
Rationale: Folic acid is essential for preventing neural tube defects and should be taken before
conception and throughout pregnancy.
14. A 32-year-old woman at 34 weeks' gestation reports sudden, painless vaginal bleeding.
On exam, the uterus is soft and non-tender. What is the most likely diagnosis?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Vasa previa
Answer: A
Rationale: Painless, bright red vaginal bleeding in the third trimester with a soft, non-tender
uterus is characteristic of placenta previa.
15. A patient at 30 weeks' gestation has a fundal height measuring 25 cm. What is the most
appropriate action?
A. Reassure the patient that this is normal
B. Order a growth ultrasound
C. Schedule a non-stress test
D. Perform a cervical exam
Answer: B
Rationale: Fundal height should correlate with gestational age. A measurement 5 cm less than
expected warrants ultrasound evaluation for fetal growth restriction.
16. A pregnant patient reports decreased fetal movement for 12 hours. What is the priority
nursing action?
A. Perform a non-stress test
B. Encourage oral fluids
C. Notify the provider
D. Document the finding
Answer: A
Rationale: Decreased fetal movement requires immediate assessment of fetal well-being,
beginning with a non-stress test.
/ 2025) Package
Section 1: Antepartum and Prenatal Care Management (Q1–Q25)
1. During a client's first prenatal visit, she reports amenorrhea, nausea, and breast
tenderness. The nurse documents these findings as which category of pregnancy signs?
A. Positive signs
B. Probable signs
C. Presumptive signs
D. Diagnostic signs
Answer: C
Rationale: Presumptive signs are subjective symptoms reported by the client, such as
amenorrhea, nausea, breast changes, and fatigue. They suggest but do not confirm pregnancy,
as they can be caused by other conditions.
2. A nurse palpates the uterine fundus at the level of the umbilicus. The nurse estimates the
gestational age to be approximately:
A. 12 weeks
B. 16 weeks
C. 20 weeks
D. 24 weeks
Answer: C
Rationale: A fundal height at the level of the umbilicus is a classic landmark for 20 weeks'
gestation. At 12 weeks, the fundus is at the symphysis pubis.
3. A client's last menstrual period began on May 10. Using Naegele's rule, what is the
estimated date of delivery?
A. February 3
B. February 17
C. February 20
D. February 24
Answer: B
Rationale: Naegele's rule: Add 7 days (May 17), subtract 3 months (February 17).
4. Which process describes programmed cell death that is orderly and does not provoke
inflammation?
A. Necrosis
B. Apoptosis
,C. Gangrenous necrosis
D. Coagulative necrosis
Answer: B
Rationale: Apoptosis is genetically regulated cell death that removes damaged cells without
significant inflammatory response.
5. What is the primary mechanism of hypoxic cell injury?
A. Immediate DNA fragmentation
B. Reduced ATP production causing sodium-potassium pump failure
C. Exclusive free radical injury
D. Increased oxidative phosphorylation
Answer: B
Rationale: Hypoxia impairs oxidative phosphorylation, depleting ATP; ion pump failure causes
sodium and water influx and cellular swelling.
6. Which type of necrosis is typically seen in the brain after ischemic injury?
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis
Answer: C
Rationale: Ischemic injury in the brain produces liquefactive necrosis due to high lipid content
and enzymatic digestion.
7. Which cellular adaptation involves an increase in cell size without an increase in cell
number?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Answer: B
Rationale: Hypertrophy is an increase in cell size in response to increased demand, without cell
division.
8. A 28-year-old G1P0 presents at 10 weeks gestation. According to ACOG guidelines, how
frequently should a low-risk primigravid patient be seen during the third trimester?
A. Every 2 weeks
B. Every week
C. Every 4 weeks
D. Every 3 weeks
,Answer: B
Rationale: ACOG recommends weekly visits from 36 weeks until delivery for low-risk
pregnancies.
9. Which hormone is primarily responsible for stimulating the growth of the ovarian follicle
during the follicular phase?
A. Estrogen
B. Follicle-stimulating hormone (FSH)
C. Gonadotropin-releasing hormone (GnRH)
D. Luteinizing hormone (LH)
Answer: B
Rationale: FSH directly targets the ovaries to stimulate follicular growth and maturation.
10. A surge in which hormone is the direct trigger for ovulation?
A. Estrogen
B. FSH
C. GnRH
D. LH
Answer: D
Rationale: A surge in luteinizing hormone (LH) triggers ovulation approximately 36 hours after
the surge begins.
11. A client inquires about the most effective reversible contraceptive method. The nurse
should recommend a method from which tier?
A. Tier 1
B. Tier 2
C. Tier 3
D. Tier 4
Answer: A
Rationale: Tier 1 contraceptives (IUDs, implants) have the lowest failure rates (<1%) and are the
most effective reversible methods.
12. During a pelvic assessment, the nurse notes the inlet is oval and the side walls are
straight. This is most consistent with which pelvic type?
A. Android
B. Anthropoid
C. Gynecoid
D. Platypelloid
Answer: C
Rationale: The gynecoid pelvis has a rounded, oval inlet and straight side walls and is the most
favorable for vaginal birth.
, 13. A pregnant patient at 10 weeks' gestation asks why folic acid supplementation is
recommended early in pregnancy. What is the primary benefit?
A. Prevents gestational diabetes
B. Prevents neural tube defects
C. Prevents preeclampsia
D. Prevents preterm labor
Answer: B
Rationale: Folic acid is essential for preventing neural tube defects and should be taken before
conception and throughout pregnancy.
14. A 32-year-old woman at 34 weeks' gestation reports sudden, painless vaginal bleeding.
On exam, the uterus is soft and non-tender. What is the most likely diagnosis?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Vasa previa
Answer: A
Rationale: Painless, bright red vaginal bleeding in the third trimester with a soft, non-tender
uterus is characteristic of placenta previa.
15. A patient at 30 weeks' gestation has a fundal height measuring 25 cm. What is the most
appropriate action?
A. Reassure the patient that this is normal
B. Order a growth ultrasound
C. Schedule a non-stress test
D. Perform a cervical exam
Answer: B
Rationale: Fundal height should correlate with gestational age. A measurement 5 cm less than
expected warrants ultrasound evaluation for fetal growth restriction.
16. A pregnant patient reports decreased fetal movement for 12 hours. What is the priority
nursing action?
A. Perform a non-stress test
B. Encourage oral fluids
C. Notify the provider
D. Document the finding
Answer: A
Rationale: Decreased fetal movement requires immediate assessment of fetal well-being,
beginning with a non-stress test.
