NR 465 Exam 1: Maternal Newborn Nursing V2 Updated
and Latest Questions and Correct Answers- Regis
University
1. A nurse is calculating the estimated date of birth (EDB) for a client whose last menstrual
period began on May 4. Using Naegele’s rule, which date should the nurse identify?
A. January 27
B. February 11
C. February 4
D. February 18
Correct Answer: B
Explanation: Naegele’s rule is the standard method for calculating the estimated date of birth. To use
this rule, you subtract three months from the first day of the last menstrual period. Then, you add seven
days and one year to that date. For a May 4 start date, subtracting three months leads to February.
Adding seven days to May 4 results in February 11. Option B is incorrect because the day calculation is
wrong. Option C fails to add the required seven days. Option D adds too many days to the calculation.
Accurate dating is essential for timing prenatal screenings and interventions. Nurses must verify the
regularity of the client’s menstrual cycle for accuracy. This calculation provides the baseline for
monitoring fetal growth throughout pregnancy.
2. A client is pregnant for the fourth time, has one living child born at term, had one
miscarriage at 10 weeks, and one birth at 35 weeks. What is her GTPAL?
A. G4 T1 P1 A1 L2
B. G4 T1 P1 A1 L1
C. G3 T1 P1 A1 L1
D. G4 T2 P0 A1 L1
Correct Answer: B
Explanation: The GTPAL system provides a detailed obstetric history for pregnant clients. Gravida (G)
represents the total number of pregnancies including the current one. Term (T) indicates births at 37
weeks or later. Preterm (P) indicates births between 20 and 37 weeks. Abortion (A) refers to losses
before 20 weeks of gestation. Living (L) counts the number of children currently alive. In this scenario,
she is G4 because she has had four pregnancies. Term is 1 for her one term birth. Preterm is 1 for the 35-
week birth. Abortion is 1 for the 10-week miscarriage. Living is 1 because only one child is mentioned as
living. Understanding this history helps identify risks for the current pregnancy.
,3. Which of the following is considered a positive sign of pregnancy?
A. Amenorrhea
B. Goodell’s sign
C. Positive pregnancy test
D. Fetal heart tones heard by Doppler
Correct Answer: D
Explanation: Positive signs of pregnancy are those that can only be attributed to a fetus. Hearing fetal
heart tones is a definitive diagnostic finding. Amenorrhea is a presumptive sign because it can be caused
by stress. A positive pregnancy test is a probable sign because certain tumors can raise hCG levels.
Goodell’s sign is the softening of the cervix and is a probable sign. Presumptive signs are subjective
feelings reported by the patient. Probable signs are objective findings observed by a healthcare provider.
Only positive signs provide 100% confirmation of a developing fetus. Visualizing the fetus via ultrasound
is another example of a positive sign. Nurses must distinguish these categories to provide accurate
patient education.
4. A nurse is assessing a client at 34 weeks gestation who has severe preeclampsia. Which
finding is the priority to report?
A. 1+ pitting edema in lower extremities
B. Urine output of 20 mL/hr
C. Blood pressure of 142/92 mmHg
D. Deep tendon reflexes of 2+
Correct Answer: B
Explanation: Severe preeclampsia can lead to multi-organ failure and decreased renal perfusion. Urine
output less than 30 mL/hr indicates potential renal compromise. Edema is common in pregnancy and is
not the highest priority. A blood pressure of 142/92 is elevated but common in preeclamptic patients.
Normal deep tendon reflexes (2+) are a reassuring finding in this context. Decreased urine output can
lead to Magnesium toxicity if the patient is on a drip. The nurse must monitor kidney function to prevent
further systemic damage. Reporting low output allows for immediate adjustment of the plan of care.
Preeclampsia requires constant vigilance for signs of worsening condition. Maintaining adequate
perfusion is the primary goal of nursing management.
, 5. A client is receiving Magnesium Sulfate for seizure prophylaxis. Which medication should
the nurse have available at the bedside?
A. Naloxone
B. Calcium Gluconate
C. Terbutaline
D. Oxytocin
Correct Answer: B
Explanation: Magnesium Sulfate is the primary medication used to prevent seizures in preeclampsia.
Calcium gluconate is the specific antidote for magnesium toxicity. Naloxone is used to reverse opioid-
induced respiratory depression. Terbutaline is a tocolytic used to stop preterm labor contractions.
Oxytocin is used to induce labor or treat postpartum hemorrhage. Signs of magnesium toxicity include
loss of DTRs and respiratory depression. The nurse must assess the patient hourly for signs of overdose.
Having the antidote ready is a critical safety standard. Magnesium levels are often monitored via blood
draws in high-risk units. Providing a safe environment includes monitoring for these adverse drug
effects.
6. What is the primary purpose of administering Vitamin K (Phytonadione) to a newborn?
A. To prevent vitamin K deficiency bleeding
B. To enhance the immune system
C. To prevent ophthalmia neonatorum
D. To treat neonatal jaundice
Correct Answer: A
Explanation: Newborns are born with low levels of Vitamin K due to a sterile gut. Vitamin K is essential
for the synthesis of clotting factors. Without it, the infant is at risk for Vitamin K Deficiency Bleeding.
Ophthalmia neonatorum is prevented by erythromycin ointment, not Vitamin K. The immune system is
not the primary target of this specific injection. Jaundice is related to bilirubin processing, which Vitamin
K does not treat. The injection is typically given in the vastus lateralis muscle. Most facilities require this
within the first hour after birth. Parental refusal requires extensive education regarding the risk of brain
bleeds. This is a standard prophylactic treatment in neonatal care units.
and Latest Questions and Correct Answers- Regis
University
1. A nurse is calculating the estimated date of birth (EDB) for a client whose last menstrual
period began on May 4. Using Naegele’s rule, which date should the nurse identify?
A. January 27
B. February 11
C. February 4
D. February 18
Correct Answer: B
Explanation: Naegele’s rule is the standard method for calculating the estimated date of birth. To use
this rule, you subtract three months from the first day of the last menstrual period. Then, you add seven
days and one year to that date. For a May 4 start date, subtracting three months leads to February.
Adding seven days to May 4 results in February 11. Option B is incorrect because the day calculation is
wrong. Option C fails to add the required seven days. Option D adds too many days to the calculation.
Accurate dating is essential for timing prenatal screenings and interventions. Nurses must verify the
regularity of the client’s menstrual cycle for accuracy. This calculation provides the baseline for
monitoring fetal growth throughout pregnancy.
2. A client is pregnant for the fourth time, has one living child born at term, had one
miscarriage at 10 weeks, and one birth at 35 weeks. What is her GTPAL?
A. G4 T1 P1 A1 L2
B. G4 T1 P1 A1 L1
C. G3 T1 P1 A1 L1
D. G4 T2 P0 A1 L1
Correct Answer: B
Explanation: The GTPAL system provides a detailed obstetric history for pregnant clients. Gravida (G)
represents the total number of pregnancies including the current one. Term (T) indicates births at 37
weeks or later. Preterm (P) indicates births between 20 and 37 weeks. Abortion (A) refers to losses
before 20 weeks of gestation. Living (L) counts the number of children currently alive. In this scenario,
she is G4 because she has had four pregnancies. Term is 1 for her one term birth. Preterm is 1 for the 35-
week birth. Abortion is 1 for the 10-week miscarriage. Living is 1 because only one child is mentioned as
living. Understanding this history helps identify risks for the current pregnancy.
,3. Which of the following is considered a positive sign of pregnancy?
A. Amenorrhea
B. Goodell’s sign
C. Positive pregnancy test
D. Fetal heart tones heard by Doppler
Correct Answer: D
Explanation: Positive signs of pregnancy are those that can only be attributed to a fetus. Hearing fetal
heart tones is a definitive diagnostic finding. Amenorrhea is a presumptive sign because it can be caused
by stress. A positive pregnancy test is a probable sign because certain tumors can raise hCG levels.
Goodell’s sign is the softening of the cervix and is a probable sign. Presumptive signs are subjective
feelings reported by the patient. Probable signs are objective findings observed by a healthcare provider.
Only positive signs provide 100% confirmation of a developing fetus. Visualizing the fetus via ultrasound
is another example of a positive sign. Nurses must distinguish these categories to provide accurate
patient education.
4. A nurse is assessing a client at 34 weeks gestation who has severe preeclampsia. Which
finding is the priority to report?
A. 1+ pitting edema in lower extremities
B. Urine output of 20 mL/hr
C. Blood pressure of 142/92 mmHg
D. Deep tendon reflexes of 2+
Correct Answer: B
Explanation: Severe preeclampsia can lead to multi-organ failure and decreased renal perfusion. Urine
output less than 30 mL/hr indicates potential renal compromise. Edema is common in pregnancy and is
not the highest priority. A blood pressure of 142/92 is elevated but common in preeclamptic patients.
Normal deep tendon reflexes (2+) are a reassuring finding in this context. Decreased urine output can
lead to Magnesium toxicity if the patient is on a drip. The nurse must monitor kidney function to prevent
further systemic damage. Reporting low output allows for immediate adjustment of the plan of care.
Preeclampsia requires constant vigilance for signs of worsening condition. Maintaining adequate
perfusion is the primary goal of nursing management.
, 5. A client is receiving Magnesium Sulfate for seizure prophylaxis. Which medication should
the nurse have available at the bedside?
A. Naloxone
B. Calcium Gluconate
C. Terbutaline
D. Oxytocin
Correct Answer: B
Explanation: Magnesium Sulfate is the primary medication used to prevent seizures in preeclampsia.
Calcium gluconate is the specific antidote for magnesium toxicity. Naloxone is used to reverse opioid-
induced respiratory depression. Terbutaline is a tocolytic used to stop preterm labor contractions.
Oxytocin is used to induce labor or treat postpartum hemorrhage. Signs of magnesium toxicity include
loss of DTRs and respiratory depression. The nurse must assess the patient hourly for signs of overdose.
Having the antidote ready is a critical safety standard. Magnesium levels are often monitored via blood
draws in high-risk units. Providing a safe environment includes monitoring for these adverse drug
effects.
6. What is the primary purpose of administering Vitamin K (Phytonadione) to a newborn?
A. To prevent vitamin K deficiency bleeding
B. To enhance the immune system
C. To prevent ophthalmia neonatorum
D. To treat neonatal jaundice
Correct Answer: A
Explanation: Newborns are born with low levels of Vitamin K due to a sterile gut. Vitamin K is essential
for the synthesis of clotting factors. Without it, the infant is at risk for Vitamin K Deficiency Bleeding.
Ophthalmia neonatorum is prevented by erythromycin ointment, not Vitamin K. The immune system is
not the primary target of this specific injection. Jaundice is related to bilirubin processing, which Vitamin
K does not treat. The injection is typically given in the vastus lateralis muscle. Most facilities require this
within the first hour after birth. Parental refusal requires extensive education regarding the risk of brain
bleeds. This is a standard prophylactic treatment in neonatal care units.
