NU 661 Exam 2 V3 | NU 661 Primary Care
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 2) | Regis
1. A 24-year-old primigravida presents for her initial prenatal visit at 9 weeks gestation.
According to standard ACOG and Regis university clinical guidelines, which of the following
laboratory tests should be included in the routine initial prenatal screening panel? (Select all
that apply)
A. Complete Blood Count (CBC)
B. Blood Type and Rh factor
C. Syphilis screening (RPR or VDRL)
D. Hepatitis B Surface Antigen (HBsAg)
E. HIV screening
F. Oral Glucose Tolerance Test (OGTT)
Correct Answer: A, B, C, D, E
The initial prenatal laboratory assessment is designed to establish a baseline of maternal
health and identify potential complications early in pregnancy. Routine screening includes
a CBC to assess for anemia, blood typing for Rh status, and screening for infectious diseases
including Syphilis, HIV, and Hepatitis B. Screening for gestational diabetes with an OGTT
typically occurs later, between 24 and 28 weeks gestation, unless the patient is at high risk.
,2. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a patient whose last
menstrual period (LMP) began on June 10, 2023?
A. March 10, 2024
B. March 3, 2024
C. March 17, 2024
D. March 20, 2024
Correct Answer: C
Naegele’s rule is a standard method used to calculate the EDD by adding seven days to the
first day of the last menstrual period and then subtracting three months. For an LMP of
June 10, adding seven days brings the date to June 17, and subtracting three months results
in a date in March. Therefore, the calculated EDD is March 17 of the following year.
3. A patient at 20 weeks gestation is undergoing a physical examination. Where does the
nurse practitioner expect to palpate the fundus?
A. At the symphysis pubis
B. At the level of the umbilicus
C. Halfway between the symphysis pubis and the umbilicus
D. At the xiphoid process
Correct Answer: B
, At approximately 20 weeks gestation, the fundus of the uterus typically reaches the level
of the umbilicus in a singleton pregnancy. This landmark is commonly used to assess fetal
growth and correlate with gestational age. Prior to this, at 12 weeks, the fundus is at the
symphysis pubis, and at 16 weeks, it is midway between the symphysis and umbilicus.
4. Which of the following physiological cardiovascular changes is considered normal during
the second trimester of pregnancy?
A. Increase in systemic vascular resistance
B. Decrease in plasma volume
C. Decrease in heart rate
D. Decrease in diastolic blood pressure
Correct Answer: D
During the second trimester, systemic vascular resistance decreases due to the hormonal
effects of progesterone, leading to a typical nadir in blood pressure. Diastolic blood
pressure usually drops more significantly than systolic pressure during this period.
Conversely, cardiac output and plasma volume increase significantly to meet the metabolic
demands of the fetus and mother.
5. A pregnant woman with a pre-pregnancy Body Mass Index (BMI) of 22 kg/m² asks about
recommended weight gain. What is the total recommended weight gain for this patient?
A. 15 to 25 pounds
B. 25 to 35 pounds
, C. 28 to 40 pounds
D. 11 to 20 pounds
Correct Answer: B
The Institute of Medicine (IOM) provides guidelines for weight gain in pregnancy based on
pre-pregnancy BMI. For a woman with a normal BMI (18.5–24.9), the recommended total
weight gain is 25 to 35 pounds. Women who are underweight or overweight have different
targets to optimize maternal and neonatal outcomes.
6. A 28-year-old G2P1 patient at 26 weeks gestation has an Rh-negative blood type. Her
antibody screen is negative. When should she receive her routine dose of Rho(D) immune
globulin (RhoGAM)?
A. Immediately
B. At 28 weeks gestation
C. At 36 weeks gestation
D. Only after delivery
Correct Answer: B
Rho(D) immune globulin is routinely administered to Rh-negative, unsensitized women at
28 weeks gestation to prevent isoimmunization. This prophylactic dose covers the third
trimester when the risk of transplacental hemorrhage increases. A second dose is
administered within 72 hours postpartum if the neonate is confirmed to be Rh-positive.
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 2) | Regis
1. A 24-year-old primigravida presents for her initial prenatal visit at 9 weeks gestation.
According to standard ACOG and Regis university clinical guidelines, which of the following
laboratory tests should be included in the routine initial prenatal screening panel? (Select all
that apply)
A. Complete Blood Count (CBC)
B. Blood Type and Rh factor
C. Syphilis screening (RPR or VDRL)
D. Hepatitis B Surface Antigen (HBsAg)
E. HIV screening
F. Oral Glucose Tolerance Test (OGTT)
Correct Answer: A, B, C, D, E
The initial prenatal laboratory assessment is designed to establish a baseline of maternal
health and identify potential complications early in pregnancy. Routine screening includes
a CBC to assess for anemia, blood typing for Rh status, and screening for infectious diseases
including Syphilis, HIV, and Hepatitis B. Screening for gestational diabetes with an OGTT
typically occurs later, between 24 and 28 weeks gestation, unless the patient is at high risk.
,2. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a patient whose last
menstrual period (LMP) began on June 10, 2023?
A. March 10, 2024
B. March 3, 2024
C. March 17, 2024
D. March 20, 2024
Correct Answer: C
Naegele’s rule is a standard method used to calculate the EDD by adding seven days to the
first day of the last menstrual period and then subtracting three months. For an LMP of
June 10, adding seven days brings the date to June 17, and subtracting three months results
in a date in March. Therefore, the calculated EDD is March 17 of the following year.
3. A patient at 20 weeks gestation is undergoing a physical examination. Where does the
nurse practitioner expect to palpate the fundus?
A. At the symphysis pubis
B. At the level of the umbilicus
C. Halfway between the symphysis pubis and the umbilicus
D. At the xiphoid process
Correct Answer: B
, At approximately 20 weeks gestation, the fundus of the uterus typically reaches the level
of the umbilicus in a singleton pregnancy. This landmark is commonly used to assess fetal
growth and correlate with gestational age. Prior to this, at 12 weeks, the fundus is at the
symphysis pubis, and at 16 weeks, it is midway between the symphysis and umbilicus.
4. Which of the following physiological cardiovascular changes is considered normal during
the second trimester of pregnancy?
A. Increase in systemic vascular resistance
B. Decrease in plasma volume
C. Decrease in heart rate
D. Decrease in diastolic blood pressure
Correct Answer: D
During the second trimester, systemic vascular resistance decreases due to the hormonal
effects of progesterone, leading to a typical nadir in blood pressure. Diastolic blood
pressure usually drops more significantly than systolic pressure during this period.
Conversely, cardiac output and plasma volume increase significantly to meet the metabolic
demands of the fetus and mother.
5. A pregnant woman with a pre-pregnancy Body Mass Index (BMI) of 22 kg/m² asks about
recommended weight gain. What is the total recommended weight gain for this patient?
A. 15 to 25 pounds
B. 25 to 35 pounds
, C. 28 to 40 pounds
D. 11 to 20 pounds
Correct Answer: B
The Institute of Medicine (IOM) provides guidelines for weight gain in pregnancy based on
pre-pregnancy BMI. For a woman with a normal BMI (18.5–24.9), the recommended total
weight gain is 25 to 35 pounds. Women who are underweight or overweight have different
targets to optimize maternal and neonatal outcomes.
6. A 28-year-old G2P1 patient at 26 weeks gestation has an Rh-negative blood type. Her
antibody screen is negative. When should she receive her routine dose of Rho(D) immune
globulin (RhoGAM)?
A. Immediately
B. At 28 weeks gestation
C. At 36 weeks gestation
D. Only after delivery
Correct Answer: B
Rho(D) immune globulin is routinely administered to Rh-negative, unsensitized women at
28 weeks gestation to prevent isoimmunization. This prophylactic dose covers the third
trimester when the risk of transplacental hemorrhage increases. A second dose is
administered within 72 hours postpartum if the neonate is confirmed to be Rh-positive.
