NUR 231 MATERNAL NURSING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is calculating the estimated date of delivery (EDD) using Naegele’s rule for a client
whose last menstrual period began on December 10. Which date should the nurse provide?
A. September 17
B. September 3
C. August 17
D. October 10
Answer: A
Conceptual Explanation: Naegele’s rule is calculated by subtracting 3 months from the
first day of the last menstrual period and adding 7 days and 1 year. December minus 3
months is September; 10 plus 7 days is 17.
2. A woman is pregnant for the fourth time. She has one child born at 39 weeks, twins born at
34 weeks, and had one miscarriage at 12 weeks. What is her GTPAL?
A. G4, T1, P2, A1, L3
B. G3, T1, P2, A1, L2
,C. G4, T1, P1, A1, L3
D. G4, T2, P1, A0, L3
Answer: C
Conceptual Explanation: G (Gravida) is 4 (current pregnancy included). T (Term) is 1 (the
39-week delivery). P (Preterm) is 1 (the twin delivery counts as one event). A (Abortion) is
1 (miscarriage). L (Living) is 3 (one from the first, two from the twins).
3. Which of the following is considered a positive sign of pregnancy?
A. Positive serum pregnancy test
B. Fetal heart tones heard by Doppler
C. Braxton Hicks contractions
D. Chadwick’s sign
Answer: B
Conceptual Explanation: Positive signs are objective and can only be attributed to a fetus:
fetal heart tones, visualization by ultrasound, or fetal movement felt by an examiner.
Pregnancy tests are ‘probable’ signs.
4. A client with preeclampsia is receiving Magnesium Sulfate. Which assessment finding
should the nurse report immediately?
A. Urinary output of 40 mL per hour
B. Deep tendon reflexes of 2+
, C. Respiratory rate of 10 breaths per minute
D. Feeling of warmth and flushing
Answer: C
Conceptual Explanation: Magnesium Sulfate toxicity causes central nervous system
depression, leading to respiratory depression (below 12), loss of DTRs, and decreased
urine output. 2+ reflexes and 40 mL/hr output are normal.
5. The nurse observes late decelerations on the fetal heart rate (FHR) monitor. What is the
priority nursing intervention?
A. Assist the client into a side-lying position
B. Perform a vaginal exam
C. Document the finding as normal
D. Increase the Oxytocin infusion rate
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. Priority
actions include repositioning the client to the side, administering oxygen, and stopping
Oxytocin.
6. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A. Abruptio placentae
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is calculating the estimated date of delivery (EDD) using Naegele’s rule for a client
whose last menstrual period began on December 10. Which date should the nurse provide?
A. September 17
B. September 3
C. August 17
D. October 10
Answer: A
Conceptual Explanation: Naegele’s rule is calculated by subtracting 3 months from the
first day of the last menstrual period and adding 7 days and 1 year. December minus 3
months is September; 10 plus 7 days is 17.
2. A woman is pregnant for the fourth time. She has one child born at 39 weeks, twins born at
34 weeks, and had one miscarriage at 12 weeks. What is her GTPAL?
A. G4, T1, P2, A1, L3
B. G3, T1, P2, A1, L2
,C. G4, T1, P1, A1, L3
D. G4, T2, P1, A0, L3
Answer: C
Conceptual Explanation: G (Gravida) is 4 (current pregnancy included). T (Term) is 1 (the
39-week delivery). P (Preterm) is 1 (the twin delivery counts as one event). A (Abortion) is
1 (miscarriage). L (Living) is 3 (one from the first, two from the twins).
3. Which of the following is considered a positive sign of pregnancy?
A. Positive serum pregnancy test
B. Fetal heart tones heard by Doppler
C. Braxton Hicks contractions
D. Chadwick’s sign
Answer: B
Conceptual Explanation: Positive signs are objective and can only be attributed to a fetus:
fetal heart tones, visualization by ultrasound, or fetal movement felt by an examiner.
Pregnancy tests are ‘probable’ signs.
4. A client with preeclampsia is receiving Magnesium Sulfate. Which assessment finding
should the nurse report immediately?
A. Urinary output of 40 mL per hour
B. Deep tendon reflexes of 2+
, C. Respiratory rate of 10 breaths per minute
D. Feeling of warmth and flushing
Answer: C
Conceptual Explanation: Magnesium Sulfate toxicity causes central nervous system
depression, leading to respiratory depression (below 12), loss of DTRs, and decreased
urine output. 2+ reflexes and 40 mL/hr output are normal.
5. The nurse observes late decelerations on the fetal heart rate (FHR) monitor. What is the
priority nursing intervention?
A. Assist the client into a side-lying position
B. Perform a vaginal exam
C. Document the finding as normal
D. Increase the Oxytocin infusion rate
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. Priority
actions include repositioning the client to the side, administering oxygen, and stopping
Oxytocin.
6. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A. Abruptio placentae
