Galen NSG 4380 Exam 2 | Perioperative Nursing (2026) Actual
Q&A PDF
1. During the menstrual cycle, a surge in which hormone triggers ovulation?
A) Estrogen
B) Progesterone
C) Luteinizing hormone (LH)
D) Follicle-stimulating hormone (FSH)
Correct Answer: Luteinizing hormone (LH)
Rationale: A mid-cycle surge of luteinizing hormone (LH) from the anterior pituitary triggers
ovulation approximately 24-36 hours later. Estrogen stimulates the LH surge, progesterone
dominates the luteal phase, and FSH promotes follicular growth.
2. A nurse is teaching a couple about conception. Which statement indicates correct
understanding of fertilization?
A) "Fertilization usually occurs in the uterus."
B) "Fertilization typically occurs in the ampulla of the fallopian tube."
C) "Sperm can fertilize an egg up to 5 days after ovulation."
D) "The fertilized egg implants immediately after fertilization."
Correct Answer: "Fertilization typically occurs in the ampulla of the fallopian tube."
Rationale: Fertilization usually occurs in the ampulla (outer third) of the fallopian tube.
Implantation in the uterus occurs 6-10 days later. Sperm viability is about 48-72 hours, and the
ovum is viable for about 24 hours.
,3. A nurse is providing preconception counseling. Which supplement is most important to
prevent neural tube defects?
A) Iron
B) Calcium
C) Folic acid
D) Vitamin D
Correct Answer: Folic acid
Rationale: Folic acid (400-800 mcg daily) before conception and during early pregnancy
significantly reduces the risk of neural tube defects such as spina bifida. Iron prevents anemia,
calcium supports bone health, and vitamin D aids calcium absorption.
4. A patient at 8 weeks gestation reports frequent urination. The nurse explains this is most
likely due to:
A) Urinary tract infection
B) Increased glomerular filtration rate and uterine pressure on the bladder
C) Decreased fluid intake
D) Progesterone relaxation of the ureters
Correct Answer: Increased glomerular filtration rate and uterine pressure on the bladder
Rationale: Increased glomerular filtration rate (GFR) during early pregnancy increases urine
production, and the enlarging uterus puts pressure on the bladder, causing frequency.
Progesterone relaxes ureters but does not directly cause frequency.
,5. The nurse is calculating a patient's estimated due date using Naegele's rule. The patient's last
menstrual period began on May 10. What is the estimated due date?
A) February 3
B) February 17
C) March 3
D) March 17
Correct Answer: February 17
Rationale: Naegele's rule: subtract 3 months from the first day of the last menstrual period
(LMP) and add 7 days. May 10 → subtract 3 months = February 10 → add 7 days = February 17.
6. A patient at 12 weeks gestation asks about the risk of miscarriage. The nurse understands
that most spontaneous abortions occur during which period?
A) First trimester
B) Second trimester
C) Third trimester
D) Postpartum period
Correct Answer: First trimester
Rationale: Approximately 80% of spontaneous abortions (miscarriages) occur during the first
trimester, most before 12 weeks, often due to chromosomal abnormalities.
7. A nurse is assessing a patient at 16 weeks gestation. Which finding would be considered an
expected cardiovascular change of pregnancy?
A) Decreased heart rate
B) Decreased cardiac output
, C) Increased blood pressure
D) Increased heart rate and cardiac output
Correct Answer: Increased heart rate and cardiac output
Rationale: Cardiac output increases by 30-50% during pregnancy, heart rate increases by 10-15
bpm, and blood pressure slightly decreases in the second trimester due to peripheral
vasodilation.
8. A patient at 20 weeks gestation reports feeling "fluttering" movements. The nurse documents
this as:
A) Ballottement
B) Quickening
C) Lightening
D) Braxton Hicks contractions
Correct Answer: Quickening
Rationale: Quickening is the mother's first perception of fetal movement, typically felt between
16-20 weeks. Ballottement is a rebound feeling of the fetus during exam, lightening is fetal
descent into the pelvis, and Braxton Hicks are irregular uterine contractions.
9. The nurse is assessing fetal heart rate at 12 weeks gestation. Which method is most
appropriate?
A) Doppler ultrasound
B) Fetoscope
C) Electronic fetal monitor
D) Pinard stethoscope
Q&A PDF
1. During the menstrual cycle, a surge in which hormone triggers ovulation?
A) Estrogen
B) Progesterone
C) Luteinizing hormone (LH)
D) Follicle-stimulating hormone (FSH)
Correct Answer: Luteinizing hormone (LH)
Rationale: A mid-cycle surge of luteinizing hormone (LH) from the anterior pituitary triggers
ovulation approximately 24-36 hours later. Estrogen stimulates the LH surge, progesterone
dominates the luteal phase, and FSH promotes follicular growth.
2. A nurse is teaching a couple about conception. Which statement indicates correct
understanding of fertilization?
A) "Fertilization usually occurs in the uterus."
B) "Fertilization typically occurs in the ampulla of the fallopian tube."
C) "Sperm can fertilize an egg up to 5 days after ovulation."
D) "The fertilized egg implants immediately after fertilization."
Correct Answer: "Fertilization typically occurs in the ampulla of the fallopian tube."
Rationale: Fertilization usually occurs in the ampulla (outer third) of the fallopian tube.
Implantation in the uterus occurs 6-10 days later. Sperm viability is about 48-72 hours, and the
ovum is viable for about 24 hours.
,3. A nurse is providing preconception counseling. Which supplement is most important to
prevent neural tube defects?
A) Iron
B) Calcium
C) Folic acid
D) Vitamin D
Correct Answer: Folic acid
Rationale: Folic acid (400-800 mcg daily) before conception and during early pregnancy
significantly reduces the risk of neural tube defects such as spina bifida. Iron prevents anemia,
calcium supports bone health, and vitamin D aids calcium absorption.
4. A patient at 8 weeks gestation reports frequent urination. The nurse explains this is most
likely due to:
A) Urinary tract infection
B) Increased glomerular filtration rate and uterine pressure on the bladder
C) Decreased fluid intake
D) Progesterone relaxation of the ureters
Correct Answer: Increased glomerular filtration rate and uterine pressure on the bladder
Rationale: Increased glomerular filtration rate (GFR) during early pregnancy increases urine
production, and the enlarging uterus puts pressure on the bladder, causing frequency.
Progesterone relaxes ureters but does not directly cause frequency.
,5. The nurse is calculating a patient's estimated due date using Naegele's rule. The patient's last
menstrual period began on May 10. What is the estimated due date?
A) February 3
B) February 17
C) March 3
D) March 17
Correct Answer: February 17
Rationale: Naegele's rule: subtract 3 months from the first day of the last menstrual period
(LMP) and add 7 days. May 10 → subtract 3 months = February 10 → add 7 days = February 17.
6. A patient at 12 weeks gestation asks about the risk of miscarriage. The nurse understands
that most spontaneous abortions occur during which period?
A) First trimester
B) Second trimester
C) Third trimester
D) Postpartum period
Correct Answer: First trimester
Rationale: Approximately 80% of spontaneous abortions (miscarriages) occur during the first
trimester, most before 12 weeks, often due to chromosomal abnormalities.
7. A nurse is assessing a patient at 16 weeks gestation. Which finding would be considered an
expected cardiovascular change of pregnancy?
A) Decreased heart rate
B) Decreased cardiac output
, C) Increased blood pressure
D) Increased heart rate and cardiac output
Correct Answer: Increased heart rate and cardiac output
Rationale: Cardiac output increases by 30-50% during pregnancy, heart rate increases by 10-15
bpm, and blood pressure slightly decreases in the second trimester due to peripheral
vasodilation.
8. A patient at 20 weeks gestation reports feeling "fluttering" movements. The nurse documents
this as:
A) Ballottement
B) Quickening
C) Lightening
D) Braxton Hicks contractions
Correct Answer: Quickening
Rationale: Quickening is the mother's first perception of fetal movement, typically felt between
16-20 weeks. Ballottement is a rebound feeling of the fetus during exam, lightening is fetal
descent into the pelvis, and Braxton Hicks are irregular uterine contractions.
9. The nurse is assessing fetal heart rate at 12 weeks gestation. Which method is most
appropriate?
A) Doppler ultrasound
B) Fetoscope
C) Electronic fetal monitor
D) Pinard stethoscope
