NU 661 Exam 3 V2 | NU 661 Primary Care
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 3) | Regis
1. A 24-year-old patient presents for her first prenatal visit. During the physical examination,
the clinician notes a bluish-purple discoloration of the cervix and vaginal mucosa. Which of
the following signs should the clinician document in the medical record?
A. Goodell’s sign
B. Hegar’s sign
C. Braun von Fernwald sign
D. Chadwick’s sign
Correct Answer: D
Chadwick’s sign is characterized by the bluish-purple hue of the cervix and vaginal
mucosa due to increased vascularity and pelvic congestion. It is considered a probable sign
of pregnancy rather than a presumptive or positive sign. The clinician must distinguish this
from Goodell’s sign, which refers to the softening of the cervix.
2. A nurse practitioner is educating a group of expectant parents about the physiological
changes during the first trimester. Which of the following are classified as probable signs of
pregnancy? (Select All That Apply)
A. Positive serum pregnancy test
,B. Goodell’s sign
C. Amenorrhea
D. Hegar’s sign
E. Chadwick’s sign
F. Auscultation of fetal heart tones
Correct Answer: A, B, D, E
Probable signs of pregnancy are objective findings observed by the clinician but not
definitive evidence of a live fetus. These include Hegar’s sign, Goodell’s sign, Chadwick’s
sign, and positive laboratory tests for HCG. Amenorrhea is a presumptive sign, and fetal
heart tones are a positive sign of pregnancy.
3. Using Naegele’s Rule, calculate the estimated date of delivery (EDD) for a patient whose
last menstrual period (LMP) began on November 15, 2023.
A. August 15, 2024
B. September 22, 2024
C. August 25, 2024
D. August 22, 2024
Correct Answer: D
Naegele’s Rule involves subtracting three months from the first day of the LMP, adding
seven days, and adjusting the year if necessary. For an LMP of November 15, subtracting
, three months leads to August, and adding seven days to 15 results in August 22. This
method assumes a standard 28-day menstrual cycle and is the most common clinical
method for dating.
4. Which of the following interventions is the standard of care for a pregnant patient who is
Rh-negative at 28 weeks gestation?
A. Immediate delivery of the fetus
B. Administration of betamethasone
C. Amniocentesis for bilirubin levels
D. Administration of 300 mcg Rho(D) immune globulin
Correct Answer: D
Rho(D) immune globulin is administered to Rh-negative unsensitized patients at 28 weeks
to prevent isoimmunization. This prophylaxis protects the current pregnancy and future
pregnancies from hemolytic disease of the newborn. A second dose is usually required
postpartum if the infant is confirmed to be Rh-positive.
5. A patient at 36 weeks gestation tests positive for Group B Streptococcus (GBS) via vaginal-
rectal swab. What is the most appropriate management plan for this patient?
A. Intrapartum antibiotic prophylaxis once labor begins
B. Immediate induction of labor
C. Daily oral penicillin until delivery
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 3) | Regis
1. A 24-year-old patient presents for her first prenatal visit. During the physical examination,
the clinician notes a bluish-purple discoloration of the cervix and vaginal mucosa. Which of
the following signs should the clinician document in the medical record?
A. Goodell’s sign
B. Hegar’s sign
C. Braun von Fernwald sign
D. Chadwick’s sign
Correct Answer: D
Chadwick’s sign is characterized by the bluish-purple hue of the cervix and vaginal
mucosa due to increased vascularity and pelvic congestion. It is considered a probable sign
of pregnancy rather than a presumptive or positive sign. The clinician must distinguish this
from Goodell’s sign, which refers to the softening of the cervix.
2. A nurse practitioner is educating a group of expectant parents about the physiological
changes during the first trimester. Which of the following are classified as probable signs of
pregnancy? (Select All That Apply)
A. Positive serum pregnancy test
,B. Goodell’s sign
C. Amenorrhea
D. Hegar’s sign
E. Chadwick’s sign
F. Auscultation of fetal heart tones
Correct Answer: A, B, D, E
Probable signs of pregnancy are objective findings observed by the clinician but not
definitive evidence of a live fetus. These include Hegar’s sign, Goodell’s sign, Chadwick’s
sign, and positive laboratory tests for HCG. Amenorrhea is a presumptive sign, and fetal
heart tones are a positive sign of pregnancy.
3. Using Naegele’s Rule, calculate the estimated date of delivery (EDD) for a patient whose
last menstrual period (LMP) began on November 15, 2023.
A. August 15, 2024
B. September 22, 2024
C. August 25, 2024
D. August 22, 2024
Correct Answer: D
Naegele’s Rule involves subtracting three months from the first day of the LMP, adding
seven days, and adjusting the year if necessary. For an LMP of November 15, subtracting
, three months leads to August, and adding seven days to 15 results in August 22. This
method assumes a standard 28-day menstrual cycle and is the most common clinical
method for dating.
4. Which of the following interventions is the standard of care for a pregnant patient who is
Rh-negative at 28 weeks gestation?
A. Immediate delivery of the fetus
B. Administration of betamethasone
C. Amniocentesis for bilirubin levels
D. Administration of 300 mcg Rho(D) immune globulin
Correct Answer: D
Rho(D) immune globulin is administered to Rh-negative unsensitized patients at 28 weeks
to prevent isoimmunization. This prophylaxis protects the current pregnancy and future
pregnancies from hemolytic disease of the newborn. A second dose is usually required
postpartum if the infant is confirmed to be Rh-positive.
5. A patient at 36 weeks gestation tests positive for Group B Streptococcus (GBS) via vaginal-
rectal swab. What is the most appropriate management plan for this patient?
A. Intrapartum antibiotic prophylaxis once labor begins
B. Immediate induction of labor
C. Daily oral penicillin until delivery
