NR 327 MAIN EXAM SCRIPT 2025 QUESTIONS WITH
SOLUTIONS GUARANTEE A+
✔✔Expected weight gain in pregnancy - ✔✔4.4lbs in first trimester
1 lb/week after 13 weeks
✔✔Expected weight gain for patient with a normal BMI - ✔✔25-35lbs (11.5-16kg)
✔✔Expected weight gain for patient who is underweight - ✔✔27.5-40lbs (12.5-18kg)
✔✔Expected weight gain for a patient who is overweight - ✔✔15-25lbs (7-11.5kg)
✔✔Expected weight gain for a patient who is obese - ✔✔15lbs (7kg)
✔✔Things done at every prenatal visit - ✔✔Vital signs (know baseline)
Weight
Urine sample (risk for UTI)
Fundal height
Leopolds maneuvers
FHR (fetal activity)
✔✔Leopold's maneuver - ✔✔Determines fetal position
✔✔BP risk for pre-eclampsia - ✔✔140/90
✔✔Fundal height - ✔✔Measured between 18-32 weeks
Measured in centimeters
Symphysis pubis to top of uterus fundus
Purpose: approximates gestational age
-Correlated with GA: 18 wks = 18cm (may be +/- 2)
✔✔When to call MD - ✔✔Swelling
Decreased fetal movement
Pain with urination
Fluid leaking
Headache (sign of elevated BP)
S/s of infection
Vaginal bleeding
Backache (poss labor)
Labor s/s
✔✔Fetal kick counts - ✔✔Recommended 10kicks/hour
✔✔Nitrazine paper test - ✔✔Inserted into cervix
,-If turns blue than +amniotic fluid
✔✔False labor - ✔✔Contractions are irregular, mild, and relieved by rest
No cervical change
✔✔Labor - ✔✔Contractions are strong and not relieved by rest
Cervical change/dilation
✔✔Abruptio placenta - ✔✔Premature separation of placenta from uterine wall
-Will cause bleeding
✔✔Hemoglobin in pregnancy - ✔✔1st trimester: 11
2nd trimester: 10.5
3rd trimester: 11
✔✔Negative Rh Factor - ✔✔Needs rhogam
-Check baby's blood type, if negative ok, if positive mother will need another round of
rhogam
✔✔RPR - ✔✔Rapid plasma regimen
-Checked in 1st trimester on all PG patients
-Checked in 3rd trimester for HR patients (hx of STD, noncompliance, many sexual
partners etc)
-Normal = non-reactive
✔✔GBS - ✔✔Checked around 36 weeks
-If positive, start on antibiotics
-If no cultures available, will check blood culture of baby
✔✔Hepatitis B - ✔✔Normal = negative
-All babies receive hep B vaccine, if mother has +test, baby will also receive
immunoglobulin at hospital and 2nd hep B vaccine with pediatrician
✔✔Immunoglobulin - ✔✔IgG
-Provides passive immunity (temporary)
✔✔Live vaccines - ✔✔Not given during pregnancy
Patient's should avoid pregnancy for 30-90 days after Rubella vaccine
✔✔Rubella - ✔✔Normal = immune/positive
-Vaccine must be given pre-pregnancy and PP
✔✔5ps of labor - ✔✔Passage
Powers
Psyche
, Passenger
Position
✔✔Macrosomic - ✔✔LGA
>8lbs or 4000grams
✔✔Passage - ✔✔Maternal pelvis
✔✔Gynecoid pelvis - ✔✔Pelvis can accommodate average sized baby
✔✔Cephalopelvic disproportion (CPD) - ✔✔Head > pelvis
Cannot engage/cannot delivery vaginally
Problem: slows labor progress and inhibit fetal descent
✔✔Molding - ✔✔Allows the fetal head to reshape and fit thru the pelvis
-Shape normalizes after 48 hours
✔✔Passengers - ✔✔Baby
Placenta
Membranes
✔✔Passenger-fetal lie - ✔✔Relationship of the fetal spine to the maternal spine
-Longitudinal
-Transverse
✔✔Longitudinal lie - ✔✔Breech/vertex
✔✔Fetal attitude - ✔✔Relationship of the fetal body parts to one another
Flexion/extension of head
-Vertex
-Brow
-Sinciput
-Face
✔✔Vertex - ✔✔Full flexion
-Ideal position
✔✔Sinciput - ✔✔Moderate flexion (military attitude)
✔✔Brow - ✔✔Partial extension
✔✔Face - ✔✔Poor flexion, complete extension
SOLUTIONS GUARANTEE A+
✔✔Expected weight gain in pregnancy - ✔✔4.4lbs in first trimester
1 lb/week after 13 weeks
✔✔Expected weight gain for patient with a normal BMI - ✔✔25-35lbs (11.5-16kg)
✔✔Expected weight gain for patient who is underweight - ✔✔27.5-40lbs (12.5-18kg)
✔✔Expected weight gain for a patient who is overweight - ✔✔15-25lbs (7-11.5kg)
✔✔Expected weight gain for a patient who is obese - ✔✔15lbs (7kg)
✔✔Things done at every prenatal visit - ✔✔Vital signs (know baseline)
Weight
Urine sample (risk for UTI)
Fundal height
Leopolds maneuvers
FHR (fetal activity)
✔✔Leopold's maneuver - ✔✔Determines fetal position
✔✔BP risk for pre-eclampsia - ✔✔140/90
✔✔Fundal height - ✔✔Measured between 18-32 weeks
Measured in centimeters
Symphysis pubis to top of uterus fundus
Purpose: approximates gestational age
-Correlated with GA: 18 wks = 18cm (may be +/- 2)
✔✔When to call MD - ✔✔Swelling
Decreased fetal movement
Pain with urination
Fluid leaking
Headache (sign of elevated BP)
S/s of infection
Vaginal bleeding
Backache (poss labor)
Labor s/s
✔✔Fetal kick counts - ✔✔Recommended 10kicks/hour
✔✔Nitrazine paper test - ✔✔Inserted into cervix
,-If turns blue than +amniotic fluid
✔✔False labor - ✔✔Contractions are irregular, mild, and relieved by rest
No cervical change
✔✔Labor - ✔✔Contractions are strong and not relieved by rest
Cervical change/dilation
✔✔Abruptio placenta - ✔✔Premature separation of placenta from uterine wall
-Will cause bleeding
✔✔Hemoglobin in pregnancy - ✔✔1st trimester: 11
2nd trimester: 10.5
3rd trimester: 11
✔✔Negative Rh Factor - ✔✔Needs rhogam
-Check baby's blood type, if negative ok, if positive mother will need another round of
rhogam
✔✔RPR - ✔✔Rapid plasma regimen
-Checked in 1st trimester on all PG patients
-Checked in 3rd trimester for HR patients (hx of STD, noncompliance, many sexual
partners etc)
-Normal = non-reactive
✔✔GBS - ✔✔Checked around 36 weeks
-If positive, start on antibiotics
-If no cultures available, will check blood culture of baby
✔✔Hepatitis B - ✔✔Normal = negative
-All babies receive hep B vaccine, if mother has +test, baby will also receive
immunoglobulin at hospital and 2nd hep B vaccine with pediatrician
✔✔Immunoglobulin - ✔✔IgG
-Provides passive immunity (temporary)
✔✔Live vaccines - ✔✔Not given during pregnancy
Patient's should avoid pregnancy for 30-90 days after Rubella vaccine
✔✔Rubella - ✔✔Normal = immune/positive
-Vaccine must be given pre-pregnancy and PP
✔✔5ps of labor - ✔✔Passage
Powers
Psyche
, Passenger
Position
✔✔Macrosomic - ✔✔LGA
>8lbs or 4000grams
✔✔Passage - ✔✔Maternal pelvis
✔✔Gynecoid pelvis - ✔✔Pelvis can accommodate average sized baby
✔✔Cephalopelvic disproportion (CPD) - ✔✔Head > pelvis
Cannot engage/cannot delivery vaginally
Problem: slows labor progress and inhibit fetal descent
✔✔Molding - ✔✔Allows the fetal head to reshape and fit thru the pelvis
-Shape normalizes after 48 hours
✔✔Passengers - ✔✔Baby
Placenta
Membranes
✔✔Passenger-fetal lie - ✔✔Relationship of the fetal spine to the maternal spine
-Longitudinal
-Transverse
✔✔Longitudinal lie - ✔✔Breech/vertex
✔✔Fetal attitude - ✔✔Relationship of the fetal body parts to one another
Flexion/extension of head
-Vertex
-Brow
-Sinciput
-Face
✔✔Vertex - ✔✔Full flexion
-Ideal position
✔✔Sinciput - ✔✔Moderate flexion (military attitude)
✔✔Brow - ✔✔Partial extension
✔✔Face - ✔✔Poor flexion, complete extension
