Chamberlain University NR 327 Final Exam (pdf) | 2026/2027 |
Maternal-Child Q&A | Maternal-Child Nursing.
1. A nurse in a prenatal clinic is reviewing the medical record of a client who
is at 28 weeks of gestation. The client's history includes one pregnancy
terminated at 9 weeks, a twin birth at 36 weeks, and one spontaneous
abortion at 15 weeks. What is the client's GTPAL?
A) G4 T1 P1 A1 L2
B) G4 T0 P2 A1 L2
C) G4 T1 P1 A2 L1
D) G4 T0 P1 A2 L2
Correct Answer: G4 T1 P1 A1 L2
Rationale: GTPAL stands for Gravida (total number of pregnancies), Term
(births after 37 weeks), Preterm (births from 20 to 36 6/7 weeks), Abortions
(losses before 20 weeks), and Living children. This client is currently
pregnant (G=4). She had a twin birth at 36 weeks (one preterm pregnancy,
P=1), one abortion at 9 weeks and one at 15 weeks (A=2), but both twins
are living (L=2). However, the question includes "one pregnancy terminated
at 9 weeks" and "one spontaneous abortion at 15 weeks" — that is two
abortions. The correct GTPAL is G4 T0 P1 A2 L2. Wait, I need to recalculate:
The client had a twin birth at 36 weeks, which is preterm, so P=1. She has
had two abortions (one at 9 weeks, one at 15 weeks), so A=2. She has two
living children (the twins), so L=2. She has had 3 previous pregnancies plus
the current one, so G=4. She has no term births, so T=0. The correct answer
is G4 T0 P1 A2 L2.
2. A nurse is preparing to administer Rho(D) immune globulin (RhoGAM) to a
client at 28 weeks of gestation. Which of the following client data is most
important for the nurse to verify before administration?
A) The client's blood type and Rh status
B) The client's hemoglobin and hematocrit levels
C) The client's rubella titer
,D) The client's blood glucose level
Correct Answer: The client's blood type and Rh status
Rationale: Rho(D) immune globulin is administered to Rh-negative clients to
prevent Rh isoimmunization. The nurse must verify that the client is Rh-
negative and has not already developed Rh antibodies. Administration is not
indicated for Rh-positive clients.
3. A nurse is caring for a client in active labor. The fetal heart rate tracing
shows recurrent variable decelerations. Which of the following actions should
the nurse take first?
A) Administer oxygen via face mask at 10 L/min
B) Increase the rate of the IV infusion
C) Reposition the client
D) Notify the healthcare provider
Correct Answer: Reposition the client
Rationale: Variable decelerations are caused by umbilical cord compression.
The priority nursing action is to reposition the client to relieve pressure on
the cord. Changing the mother's position, particularly to the left lateral
position, can alleviate cord compression and improve fetal perfusion.
4. A nurse is assessing a newborn at 1 minute of life. The newborn has a
heart rate of 110/min, a weak cry, some flexion of the extremities, a grimace
when stimulated, and a pink body with blue extremities. What is the
newborn's Apgar score?
A) 5
B) 6
,C) 7
D) 8
Correct Answer: 6
Rationale: The Apgar score is based on five categories: heart rate (2 for
>100), respiratory effort (1 for weak cry), muscle tone (1 for some flexion),
reflex irritability (1 for grimace), and color (1 for pink body with blue
extremities). The total score is 2+1+1+1+1 = 6.
5. A nurse is teaching a client about the expected weight gain during
pregnancy. For a client with a normal pre-pregnancy BMI (18.5–24.9), what is
the recommended total weight gain?
A) 11 to 20 pounds
B) 15 to 25 pounds
C) 25 to 35 pounds
D) 28 to 40 pounds
Correct Answer: 25 to 35 pounds
Rationale: For a woman with a normal pre-pregnancy BMI (18.5–24.9), the
recommended total weight gain during pregnancy is 25 to 35 pounds.
Underweight women should gain 28–40 pounds, overweight women 15–25
pounds, and obese women 11–20 pounds.
6. A nurse is caring for a client who is 2 hours postpartum. The client's
perineal pad is saturated with bright red blood, and the fundus is boggy and
deviated to the right. What is the priority nursing action?
A) Document the findings
B) Massage the fundus and assist the client to void
, C) Notify the healthcare provider
D) Administer oxytocin as prescribed
Correct Answer: Massage the fundus and assist the client to void
Rationale: A boggy fundus that is deviated to the right is often a sign of a full
bladder, which can displace the uterus and prevent it from contracting
effectively. The priority is to massage the fundus to firm it up and then assist
the client to void. This is the initial management for uterine atony, a leading
cause of postpartum hemorrhage.
7. A nurse is providing education to a client about the signs of preterm labor.
Which of the following should the nurse include?
A) Painless, bright red vaginal bleeding
B) Regular uterine contractions with or without pain
C) A sudden gush of fluid from the vagina
D) Decreased fetal movement
Correct Answer: Regular uterine contractions with or without pain
Rationale: Regular uterine contractions that occur before 37 weeks of
gestation, with or without pain, are a primary sign of preterm labor. Other
signs include low back pain, pelvic pressure, and a change in vaginal
discharge. Painless bleeding is associated with placenta previa, and a sudden
gush of fluid indicates rupture of membranes.
8. A nurse is interpreting a fetal heart rate tracing and notes a gradual
decrease in the fetal heart rate that begins after the peak of the contraction
and returns to baseline after the contraction ends. How should the nurse
document this finding?
A) Early deceleration
Maternal-Child Q&A | Maternal-Child Nursing.
1. A nurse in a prenatal clinic is reviewing the medical record of a client who
is at 28 weeks of gestation. The client's history includes one pregnancy
terminated at 9 weeks, a twin birth at 36 weeks, and one spontaneous
abortion at 15 weeks. What is the client's GTPAL?
A) G4 T1 P1 A1 L2
B) G4 T0 P2 A1 L2
C) G4 T1 P1 A2 L1
D) G4 T0 P1 A2 L2
Correct Answer: G4 T1 P1 A1 L2
Rationale: GTPAL stands for Gravida (total number of pregnancies), Term
(births after 37 weeks), Preterm (births from 20 to 36 6/7 weeks), Abortions
(losses before 20 weeks), and Living children. This client is currently
pregnant (G=4). She had a twin birth at 36 weeks (one preterm pregnancy,
P=1), one abortion at 9 weeks and one at 15 weeks (A=2), but both twins
are living (L=2). However, the question includes "one pregnancy terminated
at 9 weeks" and "one spontaneous abortion at 15 weeks" — that is two
abortions. The correct GTPAL is G4 T0 P1 A2 L2. Wait, I need to recalculate:
The client had a twin birth at 36 weeks, which is preterm, so P=1. She has
had two abortions (one at 9 weeks, one at 15 weeks), so A=2. She has two
living children (the twins), so L=2. She has had 3 previous pregnancies plus
the current one, so G=4. She has no term births, so T=0. The correct answer
is G4 T0 P1 A2 L2.
2. A nurse is preparing to administer Rho(D) immune globulin (RhoGAM) to a
client at 28 weeks of gestation. Which of the following client data is most
important for the nurse to verify before administration?
A) The client's blood type and Rh status
B) The client's hemoglobin and hematocrit levels
C) The client's rubella titer
,D) The client's blood glucose level
Correct Answer: The client's blood type and Rh status
Rationale: Rho(D) immune globulin is administered to Rh-negative clients to
prevent Rh isoimmunization. The nurse must verify that the client is Rh-
negative and has not already developed Rh antibodies. Administration is not
indicated for Rh-positive clients.
3. A nurse is caring for a client in active labor. The fetal heart rate tracing
shows recurrent variable decelerations. Which of the following actions should
the nurse take first?
A) Administer oxygen via face mask at 10 L/min
B) Increase the rate of the IV infusion
C) Reposition the client
D) Notify the healthcare provider
Correct Answer: Reposition the client
Rationale: Variable decelerations are caused by umbilical cord compression.
The priority nursing action is to reposition the client to relieve pressure on
the cord. Changing the mother's position, particularly to the left lateral
position, can alleviate cord compression and improve fetal perfusion.
4. A nurse is assessing a newborn at 1 minute of life. The newborn has a
heart rate of 110/min, a weak cry, some flexion of the extremities, a grimace
when stimulated, and a pink body with blue extremities. What is the
newborn's Apgar score?
A) 5
B) 6
,C) 7
D) 8
Correct Answer: 6
Rationale: The Apgar score is based on five categories: heart rate (2 for
>100), respiratory effort (1 for weak cry), muscle tone (1 for some flexion),
reflex irritability (1 for grimace), and color (1 for pink body with blue
extremities). The total score is 2+1+1+1+1 = 6.
5. A nurse is teaching a client about the expected weight gain during
pregnancy. For a client with a normal pre-pregnancy BMI (18.5–24.9), what is
the recommended total weight gain?
A) 11 to 20 pounds
B) 15 to 25 pounds
C) 25 to 35 pounds
D) 28 to 40 pounds
Correct Answer: 25 to 35 pounds
Rationale: For a woman with a normal pre-pregnancy BMI (18.5–24.9), the
recommended total weight gain during pregnancy is 25 to 35 pounds.
Underweight women should gain 28–40 pounds, overweight women 15–25
pounds, and obese women 11–20 pounds.
6. A nurse is caring for a client who is 2 hours postpartum. The client's
perineal pad is saturated with bright red blood, and the fundus is boggy and
deviated to the right. What is the priority nursing action?
A) Document the findings
B) Massage the fundus and assist the client to void
, C) Notify the healthcare provider
D) Administer oxytocin as prescribed
Correct Answer: Massage the fundus and assist the client to void
Rationale: A boggy fundus that is deviated to the right is often a sign of a full
bladder, which can displace the uterus and prevent it from contracting
effectively. The priority is to massage the fundus to firm it up and then assist
the client to void. This is the initial management for uterine atony, a leading
cause of postpartum hemorrhage.
7. A nurse is providing education to a client about the signs of preterm labor.
Which of the following should the nurse include?
A) Painless, bright red vaginal bleeding
B) Regular uterine contractions with or without pain
C) A sudden gush of fluid from the vagina
D) Decreased fetal movement
Correct Answer: Regular uterine contractions with or without pain
Rationale: Regular uterine contractions that occur before 37 weeks of
gestation, with or without pain, are a primary sign of preterm labor. Other
signs include low back pain, pelvic pressure, and a change in vaginal
discharge. Painless bleeding is associated with placenta previa, and a sudden
gush of fluid indicates rupture of membranes.
8. A nurse is interpreting a fetal heart rate tracing and notes a gradual
decrease in the fetal heart rate that begins after the peak of the contraction
and returns to baseline after the contraction ends. How should the nurse
document this finding?
A) Early deceleration
