NU 170 Exam 1 | NU 170 Maternal-Child Nursing |
Questions and Answers with Rationales
2026/2027 Update
1. Which physiological adaptation during pregnancy is responsible for the
characteristic nasal stuffiness and epistaxis experienced by many expectant
mothers?
A) Increased systemic vascular resistance and vasoconstriction
B) Estrogen-induced edema and vascular congestion of the nasal mucosa
C) Decreased overall platelet count and clotting factor production
D) Hyperventilation leading to drying of upper respiratory passages
Correct Answer: B
Rationale: Elevated estrogen levels during pregnancy cause increased vascularity,
hyperemia, and edema of the mucous membranes of the nasopharynx, frequently
leading to nasal stuffiness, epistaxis, and mild voice changes.
2. A pregnant patient at 28 weeks gestation reports feeling dizzy and
lightheaded when lying flat on her back. The nurse explains that this occurs due
to:
A) Compression of the abdominal aorta and inferior vena cava by the gravid
uterus
B) Acute maternal hypoglycemia resulting from fetal nutrient demands
C) Sudden drop in progesterone causing peripheral vasodilation
D) Normal gestational anemia reducing oxygen delivery to the brain
Correct Answer: A
Rationale: Supine hypotensive syndrome occurs when the heavy gravid uterus
compresses the inferior vena cava and descending aorta when the woman lies
,flat, decreasing venous return to the heart and causing maternal hypotension and
dizziness.
3. Which presumptive sign of pregnancy is reported by the client rather than
observed objectively by the healthcare provider?
A) Positive urine pregnancy test
B) Goodell sign
C) Amenorrhea
D) Braxton Hicks contractions
Correct Answer: C
Rationale: Presumptive signs are subjective changes reported by the woman
herself, such as amenorrhea, fatigue, nausea, and breast tenderness. Probable
signs are observed by the examiner, and positive signs confirm the fetus.
4. Which finding is classified as a positive (diagnostic) sign of pregnancy?
A) Quickening felt by the mother at 18 weeks
B) Ultrasound visualization of fetal cardiac activity and skeletal structure
C) Positive home immunoassay urine pregnancy test
D) Softening of the lower uterine segment known as Hegar sign
Correct Answer: B
Rationale: Positive signs of pregnancy can be attributed only to the presence of a
fetus, including visualization via ultrasound, fetal heart tones heard by a Doppler,
and palpation of fetal movement by an examiner.
5. What is the recommended daily folic acid supplementation for a woman of
childbearing age with no history of neural tube defects to prevent fetal
anomalies?
A) 0.1 milligrams
B) 0.4 milligrams
C) 2.0 milligrams
,D) 5.0 milligrams
Correct Answer: B
Rationale: The Centers for Disease Control and Prevention and the U.S. Public
Health Service recommend that all women capable of becoming pregnant
consume 0.4 mg (400 mcg) of folic acid daily to significantly reduce the risk of
neural tube defects.
6. Using Naegele rule, calculate the estimated date of birth (EDB) for a client
whose last menstrual period (LMP) began on May 10th.
A) February 17th of the following year
B) February 10th of the following year
C) March 17th of the following year
D) January 17th of the following year
Correct Answer: A
Rationale: Naegele rule involves taking the first day of the LMP (May 10th),
subtracting 3 calendar months (moving back to February 10th), and adding 7 days,
resulting in February 17th.
7. A pregnant woman at 16 weeks gestation asks when she can safely expect to
first perceive fetal movements (quickening). The nurse responds that quickening
typically occurs between:
A) 8 and 10 weeks
B) 12 and 14 weeks
C) 16 and 20 weeks
D) 24 and 26 weeks
Correct Answer: C
Rationale: Multiparous women often perceive quickening around 16 to 18 weeks,
whereas nulliparous women typically notice fetal movements around 18 to 20
weeks gestation.
, 8. Which maternal laboratory value indicates a need for iron supplementation
during pregnancy?
A) Hemoglobin of 13.5 g/dL and Hematocrit of 40 percent
B) Hemoglobin of 10.5 g/dL and Hematocrit of 32 percent
C) White blood cell count of 11,000 /mm3
D) Platelet count of 250,000 /mm3
Correct Answer: B
Rationale: During pregnancy, physiologic hemodilution occurs as plasma volume
increases faster than red blood cell mass. However, a hemoglobin below 11.0
g/dL or hematocrit below 33 percent in the first or third trimester indicates iron-
deficiency anemia, requiring supplementation.
9. Which pelvic shape is considered most favorable for a normal vaginal
delivery?
A) Android pelvis
B) Anthropoid pelvis
C) Gynecoid pelvis
D) Platypelloid pelvis
Correct Answer: C
Rationale: The gynecoid pelvis is the classic female pelvic type, featuring a
rounded inlet and wide transverse diameter, making it the most favorable shape
for vaginal birth.
10. What is the primary purpose of administering Rho(D) immune globulin
(RhoGAM) to an Rh-negative mother at 28 weeks gestation and within 72 hours
postpartum?
A) To cure preexisting maternal Rh sensitization
B) To prevent the maternal immune system from forming antibodies against Rh-
positive fetal red blood cells
Questions and Answers with Rationales
2026/2027 Update
1. Which physiological adaptation during pregnancy is responsible for the
characteristic nasal stuffiness and epistaxis experienced by many expectant
mothers?
A) Increased systemic vascular resistance and vasoconstriction
B) Estrogen-induced edema and vascular congestion of the nasal mucosa
C) Decreased overall platelet count and clotting factor production
D) Hyperventilation leading to drying of upper respiratory passages
Correct Answer: B
Rationale: Elevated estrogen levels during pregnancy cause increased vascularity,
hyperemia, and edema of the mucous membranes of the nasopharynx, frequently
leading to nasal stuffiness, epistaxis, and mild voice changes.
2. A pregnant patient at 28 weeks gestation reports feeling dizzy and
lightheaded when lying flat on her back. The nurse explains that this occurs due
to:
A) Compression of the abdominal aorta and inferior vena cava by the gravid
uterus
B) Acute maternal hypoglycemia resulting from fetal nutrient demands
C) Sudden drop in progesterone causing peripheral vasodilation
D) Normal gestational anemia reducing oxygen delivery to the brain
Correct Answer: A
Rationale: Supine hypotensive syndrome occurs when the heavy gravid uterus
compresses the inferior vena cava and descending aorta when the woman lies
,flat, decreasing venous return to the heart and causing maternal hypotension and
dizziness.
3. Which presumptive sign of pregnancy is reported by the client rather than
observed objectively by the healthcare provider?
A) Positive urine pregnancy test
B) Goodell sign
C) Amenorrhea
D) Braxton Hicks contractions
Correct Answer: C
Rationale: Presumptive signs are subjective changes reported by the woman
herself, such as amenorrhea, fatigue, nausea, and breast tenderness. Probable
signs are observed by the examiner, and positive signs confirm the fetus.
4. Which finding is classified as a positive (diagnostic) sign of pregnancy?
A) Quickening felt by the mother at 18 weeks
B) Ultrasound visualization of fetal cardiac activity and skeletal structure
C) Positive home immunoassay urine pregnancy test
D) Softening of the lower uterine segment known as Hegar sign
Correct Answer: B
Rationale: Positive signs of pregnancy can be attributed only to the presence of a
fetus, including visualization via ultrasound, fetal heart tones heard by a Doppler,
and palpation of fetal movement by an examiner.
5. What is the recommended daily folic acid supplementation for a woman of
childbearing age with no history of neural tube defects to prevent fetal
anomalies?
A) 0.1 milligrams
B) 0.4 milligrams
C) 2.0 milligrams
,D) 5.0 milligrams
Correct Answer: B
Rationale: The Centers for Disease Control and Prevention and the U.S. Public
Health Service recommend that all women capable of becoming pregnant
consume 0.4 mg (400 mcg) of folic acid daily to significantly reduce the risk of
neural tube defects.
6. Using Naegele rule, calculate the estimated date of birth (EDB) for a client
whose last menstrual period (LMP) began on May 10th.
A) February 17th of the following year
B) February 10th of the following year
C) March 17th of the following year
D) January 17th of the following year
Correct Answer: A
Rationale: Naegele rule involves taking the first day of the LMP (May 10th),
subtracting 3 calendar months (moving back to February 10th), and adding 7 days,
resulting in February 17th.
7. A pregnant woman at 16 weeks gestation asks when she can safely expect to
first perceive fetal movements (quickening). The nurse responds that quickening
typically occurs between:
A) 8 and 10 weeks
B) 12 and 14 weeks
C) 16 and 20 weeks
D) 24 and 26 weeks
Correct Answer: C
Rationale: Multiparous women often perceive quickening around 16 to 18 weeks,
whereas nulliparous women typically notice fetal movements around 18 to 20
weeks gestation.
, 8. Which maternal laboratory value indicates a need for iron supplementation
during pregnancy?
A) Hemoglobin of 13.5 g/dL and Hematocrit of 40 percent
B) Hemoglobin of 10.5 g/dL and Hematocrit of 32 percent
C) White blood cell count of 11,000 /mm3
D) Platelet count of 250,000 /mm3
Correct Answer: B
Rationale: During pregnancy, physiologic hemodilution occurs as plasma volume
increases faster than red blood cell mass. However, a hemoglobin below 11.0
g/dL or hematocrit below 33 percent in the first or third trimester indicates iron-
deficiency anemia, requiring supplementation.
9. Which pelvic shape is considered most favorable for a normal vaginal
delivery?
A) Android pelvis
B) Anthropoid pelvis
C) Gynecoid pelvis
D) Platypelloid pelvis
Correct Answer: C
Rationale: The gynecoid pelvis is the classic female pelvic type, featuring a
rounded inlet and wide transverse diameter, making it the most favorable shape
for vaginal birth.
10. What is the primary purpose of administering Rho(D) immune globulin
(RhoGAM) to an Rh-negative mother at 28 weeks gestation and within 72 hours
postpartum?
A) To cure preexisting maternal Rh sensitization
B) To prevent the maternal immune system from forming antibodies against Rh-
positive fetal red blood cells
