NU 661 Final Exam V3 | NU 661 Primary
Care of Childbearing Woman | Actual Q&A
with Rationale (NU661 Final Exam) | Regis
1. A 26-year-old G1P0 presents for her initial prenatal visit. Her last menstrual period began
on May 10th. Using Naegele’s Rule, what is her estimated date of delivery (EDD)?
A. February 10th
B. February 17th
C. February 3rd
D. May 17th
Correct Answer: B
Naegele’s Rule is calculated by subtracting three months and adding seven days to the first
day of the last menstrual period. For a May 10th LMP, subtracting three months brings the
date to February 10th, and adding seven days results in February 17th. This method
assumes a standard 28-day menstrual cycle and remains the clinical standard for initial
dating.
2. Which of the following findings are clinical indicators of preeclampsia with severe
features? (Select All That Apply)
A. Platelet count < 100,000/microliter
B. Serum creatinine > 1.1 mg/dL
,C. Right upper quadrant or epigastric pain
D. 1+ proteinuria on dipstick
E. New-onset cerebral or visual disturbances
F. Blood pressure of 145/95 mmHg
Correct Answer: A, B, C, E
Preeclampsia with severe features is defined by specific multisystem involvement beyond
standard hypertension. Key markers include a platelet count below 100,000, renal
insufficiency evidenced by elevated creatinine, and neurological symptoms like persistent
headache or scotoma. Severe RUQ pain indicates hepatic involvement or subcapsular
hematoma, requiring urgent intervention.
3. During a prenatal visit at 28 weeks, a patient’s fundal height is measured at 32 cm. What is
the most appropriate next step in management?
A. Recheck the fundal height in two weeks
B. Order an ultrasound for growth and amniotic fluid index
C. Schedule an immediate Cesarean section
D. Diagnose the patient with gestational diabetes
Correct Answer: B
A fundal height measurement that is 3 cm or more larger than the gestational age requires
further investigation for polyhydramnios or macrosomia. Ultrasound is the gold standard
,to assess fetal growth and fluid volume to determine the etiology of the discrepancy.
Accurate assessment of fundal height relies on measuring from the symphysis pubis to the
top of the uterine fundus.
4. A patient at 36 weeks gestation tests positive for Group B Streptococcus (GBS). What is the
standard of care for this patient?
A. Treat with oral penicillin immediately for 10 days
B. Perform an elective Cesarean section at 39 weeks
C. Repeat the GBS culture in one week
D. Administer intravenous penicillin G during active labor
Correct Answer: D
Intrapartum antibiotic prophylaxis is indicated for GBS-positive women to prevent early-
onset neonatal sepsis. Penicillin G is the preferred agent and should be initiated once labor
begins or membranes rupture. Treating GBS during the prenatal period with oral
antibiotics is ineffective as the bacteria often recolonizes the vaginal tract before delivery.
5. At what gestational age should a nurse practitioner routinely screen a low-risk pregnant
woman for gestational diabetes mellitus (GDM)?
A. 12–14 weeks gestation
B. 16–20 weeks gestation
C. 32–34 weeks gestation
, D. 24–28 weeks gestation
Correct Answer: D
Routine screening for GDM occurs between 24 and 28 weeks because insulin resistance
typically increases during the late second trimester. This timing allows for adequate
identification and management to reduce risks such as macrosomia and shoulder dystocia.
Women with high risk factors may be screened earlier, but the standard universal screen
remains in the 24-28 week window.
6. Which of the following medications is considered a Category X teratogen and should be
strictly avoided during pregnancy?
A. Isotretinoin
B. Amoxicillin
C. Labetalol
D. Levothyroxine
Correct Answer: A
Isotretinoin is associated with severe craniofacial, cardiac, and central nervous system
malformations in the developing fetus. It is part of the iPLEDGE program to ensure no
female patient becomes pregnant while using the medication. Other medications like
amoxicillin and levothyroxine are considered safe for use during pregnancy under
appropriate supervision.
Care of Childbearing Woman | Actual Q&A
with Rationale (NU661 Final Exam) | Regis
1. A 26-year-old G1P0 presents for her initial prenatal visit. Her last menstrual period began
on May 10th. Using Naegele’s Rule, what is her estimated date of delivery (EDD)?
A. February 10th
B. February 17th
C. February 3rd
D. May 17th
Correct Answer: B
Naegele’s Rule is calculated by subtracting three months and adding seven days to the first
day of the last menstrual period. For a May 10th LMP, subtracting three months brings the
date to February 10th, and adding seven days results in February 17th. This method
assumes a standard 28-day menstrual cycle and remains the clinical standard for initial
dating.
2. Which of the following findings are clinical indicators of preeclampsia with severe
features? (Select All That Apply)
A. Platelet count < 100,000/microliter
B. Serum creatinine > 1.1 mg/dL
,C. Right upper quadrant or epigastric pain
D. 1+ proteinuria on dipstick
E. New-onset cerebral or visual disturbances
F. Blood pressure of 145/95 mmHg
Correct Answer: A, B, C, E
Preeclampsia with severe features is defined by specific multisystem involvement beyond
standard hypertension. Key markers include a platelet count below 100,000, renal
insufficiency evidenced by elevated creatinine, and neurological symptoms like persistent
headache or scotoma. Severe RUQ pain indicates hepatic involvement or subcapsular
hematoma, requiring urgent intervention.
3. During a prenatal visit at 28 weeks, a patient’s fundal height is measured at 32 cm. What is
the most appropriate next step in management?
A. Recheck the fundal height in two weeks
B. Order an ultrasound for growth and amniotic fluid index
C. Schedule an immediate Cesarean section
D. Diagnose the patient with gestational diabetes
Correct Answer: B
A fundal height measurement that is 3 cm or more larger than the gestational age requires
further investigation for polyhydramnios or macrosomia. Ultrasound is the gold standard
,to assess fetal growth and fluid volume to determine the etiology of the discrepancy.
Accurate assessment of fundal height relies on measuring from the symphysis pubis to the
top of the uterine fundus.
4. A patient at 36 weeks gestation tests positive for Group B Streptococcus (GBS). What is the
standard of care for this patient?
A. Treat with oral penicillin immediately for 10 days
B. Perform an elective Cesarean section at 39 weeks
C. Repeat the GBS culture in one week
D. Administer intravenous penicillin G during active labor
Correct Answer: D
Intrapartum antibiotic prophylaxis is indicated for GBS-positive women to prevent early-
onset neonatal sepsis. Penicillin G is the preferred agent and should be initiated once labor
begins or membranes rupture. Treating GBS during the prenatal period with oral
antibiotics is ineffective as the bacteria often recolonizes the vaginal tract before delivery.
5. At what gestational age should a nurse practitioner routinely screen a low-risk pregnant
woman for gestational diabetes mellitus (GDM)?
A. 12–14 weeks gestation
B. 16–20 weeks gestation
C. 32–34 weeks gestation
, D. 24–28 weeks gestation
Correct Answer: D
Routine screening for GDM occurs between 24 and 28 weeks because insulin resistance
typically increases during the late second trimester. This timing allows for adequate
identification and management to reduce risks such as macrosomia and shoulder dystocia.
Women with high risk factors may be screened earlier, but the standard universal screen
remains in the 24-28 week window.
6. Which of the following medications is considered a Category X teratogen and should be
strictly avoided during pregnancy?
A. Isotretinoin
B. Amoxicillin
C. Labetalol
D. Levothyroxine
Correct Answer: A
Isotretinoin is associated with severe craniofacial, cardiac, and central nervous system
malformations in the developing fetus. It is part of the iPLEDGE program to ensure no
female patient becomes pregnant while using the medication. Other medications like
amoxicillin and levothyroxine are considered safe for use during pregnancy under
appropriate supervision.
