GALEN COLLEGE OF NURSING | NUR 230: MATERNAL-NEWBORN NURSING
GALEN COLLEGE OF NURSING
NUR 230: Maternal-Newborn Nursing — Exam 1 Practice Examination (Fall 2026)
Student Name: ___________________________ Date: ________________________
Course/Section: NUR 230 Fall 2026 Total Questions: 50 Multiple Choice
Question 1. A client presents to the antepartum clinic for her first prenatal visit. She states that the first
day of her last normal menstrual period (LMP) was October 10. Using Naegele’s rule, what is her
expected date of delivery (EDD)?
(A) July 10 of the following year
(B) July 17 of the following year
(C) July 3 of the following year
(D) June 17 of the following year
✔ Correct Answer: Option B
Rationale: Naegele’s rule is calculated by taking the first day of the patient's last menstrual period (LMP),
subtracting 3 months, adding 7 days, and adjusting the year accordingly. For an LMP of October 10: October
minus 3 months is July, and 10 days plus 7 days is 17. Thus, the EDD is July 17.
Question 2. A nurse is obtaining an obstetric history from a pregnant client. She is currently pregnant.
She previously delivered a healthy single infant at 38 weeks gestation, delivered twin infants at 32 weeks
gestation (both living), and had a spontaneous abortion at 10 weeks gestation. Using the GTPAL system,
how should the nurse document her obstetric history?
(A) G4 T2 P1 A1 L3
(B) G3 T1 P2 A1 L3
(C) G4 T1 P1 A1 L3
(D) G5 T1 P1 A1 L2
✔ Correct Answer: Option C
Rationale: GTPAL notation breakdown: G (Gravida) = total # of pregnancies including current = 4 (current + 38
wk delivery + twin delivery + abortion). T (Term) = deliveries at 37-42 weeks = 1 (38 wk delivery). P (Preterm) =
deliveries between 20-36 weeks = 1 (twin delivery counts as ONE delivery event >= 20 wks). A (Abortion) =
deliveries/losses before 20 weeks = 1. L (Living) = number of living children = 3 (1 term + 2 twin children).
Result: G4 T1 P1 A1 L3.
Fall 2026 Exam 1 Paper — Strictly Source-Grounded — Page 1
, GALEN COLLEGE OF NURSING | NUR 230: MATERNAL-NEWBORN NURSING
Question 3. Which of the following assessment findings is classified as a POSITIVE sign of pregnancy?
(A) Positive blood pregnancy test for human chorionic gonadotropin (hCG)
(B) Bluish discoloration of the cervix and vaginal mucosa (Chadwick's sign)
(C) Auscultation of fetal heart tones by a Doppler ultrasound device
(D) Client report of amenorrhea, breast soreness, and morning nausea
✔ Correct Answer: Option C
Rationale: Positive signs of pregnancy are objective indicators attributed ONLY to the presence of the fetus
('SEE, FEEL, HEAR'): visualizing fetus on ultrasound, auscultating fetal heart tones (Doppler at 12 weeks), and
feeling fetal movement by the examiner. Positive pregnancy tests, Chadwick's sign, Hegar's sign, and Goodell's
sign are PROBABLE signs. Amenorrhea, nausea, breast tenderness, and fatigue are PRESUMPTIVE signs.
Question 4. During a routine prenatal visit at 20 weeks gestation, the nurse measures the client's fundal
height. Where does the nurse expect to locate the uterine fundus?
(A) At the level of the umbilicus (belly button)
(B) Slightly above the symphysis pubis
(C) Halfway between the symphysis pubis and the umbilicus
(D) At the level of the xiphoid process
✔ Correct Answer: Option A
Rationale: At 20 weeks gestation, the uterine fundus reaches the level of the umbilicus (belly button),
measuring approximately 20 cm (+/- 2 cm). At 12 weeks, the fundus is palpable just above the symphysis pubis,
and after 12 weeks growth proceeds at approximately 1 cm per week.
Question 5. A nurse is teaching a group of nursing students about maternal physiological adaptation to
pregnancy. Which statement regarding cardiovascular changes is accurate?
(A) Maternal cardiac output decreases by 20% to divert blood supply to the placenta.
(B) Maternal blood volume remains unchanged throughout all three trimesters.
(C) Maternal heart rate decreases by 10 to 15 beats per minute during the third trimester.
(D) Maternal blood volume increases by 40% to 50%, resulting in physiological anemia.
✔ Correct Answer: Option D
Rationale: During pregnancy, total blood volume increases by 40% to 50%. Because plasma volume expands
more rapidly than red blood cell mass, hemodilution occurs, leading to physiological anemia (normal Hgb > 11
g/dL, Hct > 33%). Cardiac output increases by 30% to 50% and maternal heart rate increases by 10 to 15 bpm.
Fall 2026 Exam 1 Paper — Strictly Source-Grounded — Page 2
, GALEN COLLEGE OF NURSING | NUR 230: MATERNAL-NEWBORN NURSING
Question 6. A client at 32 weeks gestation complains of feeling lightheaded, dizzy, nauseated, and
clammy while lying supine on the examination table. What is the immediate priority action by the
nurse?
(A) Turn the client onto her left side.
(B) Administer supplemental oxygen via non-rebreather mask at 10 L/min.
(C) Increase the IV fluid infusion rate rapidly.
(D) Place the client in Trendelenburg position.
✔ Correct Answer: Option A
Rationale: The client is experiencing supine hypotensive syndrome (vena cava syndrome) caused by the heavy
gravid uterus compressing the inferior vena cava when lying flat on her back. The priority intervention is
positioning the woman on her side (preferably left side) to relieve pressure on the vena cava and restore
venous return, blood pressure, and placental perfusion.
Question 7. At what gestational age is routine prenatal screening for Group B Streptococcus (GBS)
performed, and what is the required management if the test result is positive?
(A) Screened at 24-28 weeks; oral ampicillin given for 14 days
(B) Screened at 35-37 weeks; IV penicillin administered every 4 hours during labor
(C) Screened at 12-16 weeks; immediate administration of RhoGAM IM
(D) Screened at 36 weeks; prophylactic C-section scheduled at 38 weeks
✔ Correct Answer: Option B
Rationale: Group B Streptococcus (GBS) screening is conducted between 35 and 37 weeks gestation via a
vaginal/rectal swab (valid for 5 weeks). If the client tests positive, she must be treated intrapartum with IV
Penicillin (PCN) every 4 hours from the onset of labor until delivery to prevent neonatal GBS infection.
Question 8. A nurse is providing dietary teaching to a pregnant client prescribed an oral iron supplement
for anemia. Which instruction should the nurse include?
(A) Take the iron supplement with milk to prevent gastric distress.
(B) Take the iron supplement with an antacid to promote absorption.
(C) Expect stools to become bright red and report this immediately.
(D) Take the supplement on an empty stomach with orange juice (Vitamin C).
✔ Correct Answer: Option D
Rationale: Iron supplements are best absorbed when taken on an empty stomach with Vitamin C (such as
orange juice), which enhances absorption. Clients should be forewarned that iron causes dark green or black
stools, constipation, and nausea. Milk and calcium inhibit iron absorption.
Fall 2026 Exam 1 Paper — Strictly Source-Grounded — Page 3
GALEN COLLEGE OF NURSING
NUR 230: Maternal-Newborn Nursing — Exam 1 Practice Examination (Fall 2026)
Student Name: ___________________________ Date: ________________________
Course/Section: NUR 230 Fall 2026 Total Questions: 50 Multiple Choice
Question 1. A client presents to the antepartum clinic for her first prenatal visit. She states that the first
day of her last normal menstrual period (LMP) was October 10. Using Naegele’s rule, what is her
expected date of delivery (EDD)?
(A) July 10 of the following year
(B) July 17 of the following year
(C) July 3 of the following year
(D) June 17 of the following year
✔ Correct Answer: Option B
Rationale: Naegele’s rule is calculated by taking the first day of the patient's last menstrual period (LMP),
subtracting 3 months, adding 7 days, and adjusting the year accordingly. For an LMP of October 10: October
minus 3 months is July, and 10 days plus 7 days is 17. Thus, the EDD is July 17.
Question 2. A nurse is obtaining an obstetric history from a pregnant client. She is currently pregnant.
She previously delivered a healthy single infant at 38 weeks gestation, delivered twin infants at 32 weeks
gestation (both living), and had a spontaneous abortion at 10 weeks gestation. Using the GTPAL system,
how should the nurse document her obstetric history?
(A) G4 T2 P1 A1 L3
(B) G3 T1 P2 A1 L3
(C) G4 T1 P1 A1 L3
(D) G5 T1 P1 A1 L2
✔ Correct Answer: Option C
Rationale: GTPAL notation breakdown: G (Gravida) = total # of pregnancies including current = 4 (current + 38
wk delivery + twin delivery + abortion). T (Term) = deliveries at 37-42 weeks = 1 (38 wk delivery). P (Preterm) =
deliveries between 20-36 weeks = 1 (twin delivery counts as ONE delivery event >= 20 wks). A (Abortion) =
deliveries/losses before 20 weeks = 1. L (Living) = number of living children = 3 (1 term + 2 twin children).
Result: G4 T1 P1 A1 L3.
Fall 2026 Exam 1 Paper — Strictly Source-Grounded — Page 1
, GALEN COLLEGE OF NURSING | NUR 230: MATERNAL-NEWBORN NURSING
Question 3. Which of the following assessment findings is classified as a POSITIVE sign of pregnancy?
(A) Positive blood pregnancy test for human chorionic gonadotropin (hCG)
(B) Bluish discoloration of the cervix and vaginal mucosa (Chadwick's sign)
(C) Auscultation of fetal heart tones by a Doppler ultrasound device
(D) Client report of amenorrhea, breast soreness, and morning nausea
✔ Correct Answer: Option C
Rationale: Positive signs of pregnancy are objective indicators attributed ONLY to the presence of the fetus
('SEE, FEEL, HEAR'): visualizing fetus on ultrasound, auscultating fetal heart tones (Doppler at 12 weeks), and
feeling fetal movement by the examiner. Positive pregnancy tests, Chadwick's sign, Hegar's sign, and Goodell's
sign are PROBABLE signs. Amenorrhea, nausea, breast tenderness, and fatigue are PRESUMPTIVE signs.
Question 4. During a routine prenatal visit at 20 weeks gestation, the nurse measures the client's fundal
height. Where does the nurse expect to locate the uterine fundus?
(A) At the level of the umbilicus (belly button)
(B) Slightly above the symphysis pubis
(C) Halfway between the symphysis pubis and the umbilicus
(D) At the level of the xiphoid process
✔ Correct Answer: Option A
Rationale: At 20 weeks gestation, the uterine fundus reaches the level of the umbilicus (belly button),
measuring approximately 20 cm (+/- 2 cm). At 12 weeks, the fundus is palpable just above the symphysis pubis,
and after 12 weeks growth proceeds at approximately 1 cm per week.
Question 5. A nurse is teaching a group of nursing students about maternal physiological adaptation to
pregnancy. Which statement regarding cardiovascular changes is accurate?
(A) Maternal cardiac output decreases by 20% to divert blood supply to the placenta.
(B) Maternal blood volume remains unchanged throughout all three trimesters.
(C) Maternal heart rate decreases by 10 to 15 beats per minute during the third trimester.
(D) Maternal blood volume increases by 40% to 50%, resulting in physiological anemia.
✔ Correct Answer: Option D
Rationale: During pregnancy, total blood volume increases by 40% to 50%. Because plasma volume expands
more rapidly than red blood cell mass, hemodilution occurs, leading to physiological anemia (normal Hgb > 11
g/dL, Hct > 33%). Cardiac output increases by 30% to 50% and maternal heart rate increases by 10 to 15 bpm.
Fall 2026 Exam 1 Paper — Strictly Source-Grounded — Page 2
, GALEN COLLEGE OF NURSING | NUR 230: MATERNAL-NEWBORN NURSING
Question 6. A client at 32 weeks gestation complains of feeling lightheaded, dizzy, nauseated, and
clammy while lying supine on the examination table. What is the immediate priority action by the
nurse?
(A) Turn the client onto her left side.
(B) Administer supplemental oxygen via non-rebreather mask at 10 L/min.
(C) Increase the IV fluid infusion rate rapidly.
(D) Place the client in Trendelenburg position.
✔ Correct Answer: Option A
Rationale: The client is experiencing supine hypotensive syndrome (vena cava syndrome) caused by the heavy
gravid uterus compressing the inferior vena cava when lying flat on her back. The priority intervention is
positioning the woman on her side (preferably left side) to relieve pressure on the vena cava and restore
venous return, blood pressure, and placental perfusion.
Question 7. At what gestational age is routine prenatal screening for Group B Streptococcus (GBS)
performed, and what is the required management if the test result is positive?
(A) Screened at 24-28 weeks; oral ampicillin given for 14 days
(B) Screened at 35-37 weeks; IV penicillin administered every 4 hours during labor
(C) Screened at 12-16 weeks; immediate administration of RhoGAM IM
(D) Screened at 36 weeks; prophylactic C-section scheduled at 38 weeks
✔ Correct Answer: Option B
Rationale: Group B Streptococcus (GBS) screening is conducted between 35 and 37 weeks gestation via a
vaginal/rectal swab (valid for 5 weeks). If the client tests positive, she must be treated intrapartum with IV
Penicillin (PCN) every 4 hours from the onset of labor until delivery to prevent neonatal GBS infection.
Question 8. A nurse is providing dietary teaching to a pregnant client prescribed an oral iron supplement
for anemia. Which instruction should the nurse include?
(A) Take the iron supplement with milk to prevent gastric distress.
(B) Take the iron supplement with an antacid to promote absorption.
(C) Expect stools to become bright red and report this immediately.
(D) Take the supplement on an empty stomach with orange juice (Vitamin C).
✔ Correct Answer: Option D
Rationale: Iron supplements are best absorbed when taken on an empty stomach with Vitamin C (such as
orange juice), which enhances absorption. Clients should be forewarned that iron causes dark green or black
stools, constipation, and nausea. Milk and calcium inhibit iron absorption.
Fall 2026 Exam 1 Paper — Strictly Source-Grounded — Page 3
