Galen College NUR 230 Exam 1 (pdf) | 2026/2027 | Maternal-Child
Q&A | NCLEX
1. A 32-year-old patient at 10 weeks gestation asks the nurse about the
changes occurring in her body. The nurse explains that the hormone
responsible for stimulating milk production is:
A) Estrogen
B) Progesterone
C) Prolactin
D) Oxytocin
Correct Answer: Prolactin
Rationale: Prolactin is the hormone responsible for milk production
(lactogenesis). Estrogen and progesterone are involved in breast
development during pregnancy, and oxytocin is responsible for the let-down
reflex (milk ejection).
2. A pregnant patient reports that she has been experiencing nausea and
vomiting, especially in the morning. Which of the following recommendations
is most appropriate?
A) Eat a large meal before getting out of bed
B) Eat small, frequent meals throughout the day
C) Avoid all fluids to prevent vomiting
D) Increase intake of spicy foods
Correct Answer: Eat small, frequent meals throughout the day
Rationale: Morning sickness is common in the first trimester. Eating small,
frequent meals throughout the day can help manage nausea. Dry crackers
before getting out of bed can also be helpful.
,3. The nurse is teaching a patient about the signs of pregnancy. Which of the
following is a presumptive sign of pregnancy?
A) Positive pregnancy test
B) Fetal heart tones
C) Amenorrhea
D) Ultrasound visualization of the fetus
Correct Answer: Amenorrhea
Rationale: Presumptive signs of pregnancy are subjective and include
amenorrhea (absence of menstruation), fatigue, breast tenderness, and
urinary frequency. Positive pregnancy tests and fetal heart tones are
probable signs, and ultrasound visualization is a positive sign.
4. The nurse is assessing a patient's fundal height at 28 weeks gestation.
The nurse expects the fundal height to be approximately:
A) 24 cm
B) 26 cm
C) 28 cm
D) 30 cm
Correct Answer: 28 cm
Rationale: Fundal height in centimeters is approximately equal to the
gestational age in weeks between 20 and 34 weeks. At 28 weeks, the fundal
height should be approximately 28 cm.
,5. A patient at 32 weeks gestation reports that she has not felt fetal
movement for the past 12 hours. What is the nurse's priority action?
A) Reassure the patient that this is normal
B) Instruct the patient to count fetal movements and report back
C) Have the patient lie on her side, drink something sugary, and count
movements
D) Send the patient to the emergency room immediately
Correct Answer: Have the patient lie on her side, drink something sugary,
and count movements
Rationale: Decreased fetal movement is a concern. The patient should lie on
her side, drink something sugary, and count fetal movements. She should
feel 6-10 movements per hour. If movements are still decreased, she should
contact her provider.
6. A pregnant patient has a blood pressure of 150/92 mmHg and proteinuria.
The nurse should suspect:
A) Gestational diabetes
B) Preeclampsia
C) Hyperemesis gravidarum
D) Anemia
Correct Answer: Preeclampsia
Rationale: Preeclampsia is characterized by hypertension (≥140/90 mmHg)
and proteinuria after 20 weeks of gestation. Gestational diabetes is
diagnosed by abnormal glucose tolerance testing.
, 7. The nurse is providing education to a patient with gestational diabetes.
Which of the following is a potential fetal complication?
A) Macrosomia
B) Microsomia
C) Intrauterine growth restriction
D) Preterm labor
Correct Answer: Macrosomia
Rationale: Gestational diabetes increases the risk of fetal macrosomia (large
for gestational age) due to excess glucose crossing the placenta. This can
lead to shoulder dystocia and birth injuries.
8. A patient in labor is having contractions that are regular and increasing in
intensity. The cervix is 4 cm dilated and 80% effaced. The patient is in which
stage of labor?
A) Latent phase of the first stage
B) Active phase of the first stage
C) Transition phase of the first stage
D) Second stage of labor
Correct Answer: Active phase of the first stage
Rationale: The active phase of the first stage is characterized by cervical
dilation from 4 to 8 cm with rapid effacement. The latent phase is 0-3 cm,
and transition is 8-10 cm.
9. The nurse is assessing a patient's contractions. The patient reports that
her contractions are "in my back and then wrap around to the front." This is a
classic description of:
Q&A | NCLEX
1. A 32-year-old patient at 10 weeks gestation asks the nurse about the
changes occurring in her body. The nurse explains that the hormone
responsible for stimulating milk production is:
A) Estrogen
B) Progesterone
C) Prolactin
D) Oxytocin
Correct Answer: Prolactin
Rationale: Prolactin is the hormone responsible for milk production
(lactogenesis). Estrogen and progesterone are involved in breast
development during pregnancy, and oxytocin is responsible for the let-down
reflex (milk ejection).
2. A pregnant patient reports that she has been experiencing nausea and
vomiting, especially in the morning. Which of the following recommendations
is most appropriate?
A) Eat a large meal before getting out of bed
B) Eat small, frequent meals throughout the day
C) Avoid all fluids to prevent vomiting
D) Increase intake of spicy foods
Correct Answer: Eat small, frequent meals throughout the day
Rationale: Morning sickness is common in the first trimester. Eating small,
frequent meals throughout the day can help manage nausea. Dry crackers
before getting out of bed can also be helpful.
,3. The nurse is teaching a patient about the signs of pregnancy. Which of the
following is a presumptive sign of pregnancy?
A) Positive pregnancy test
B) Fetal heart tones
C) Amenorrhea
D) Ultrasound visualization of the fetus
Correct Answer: Amenorrhea
Rationale: Presumptive signs of pregnancy are subjective and include
amenorrhea (absence of menstruation), fatigue, breast tenderness, and
urinary frequency. Positive pregnancy tests and fetal heart tones are
probable signs, and ultrasound visualization is a positive sign.
4. The nurse is assessing a patient's fundal height at 28 weeks gestation.
The nurse expects the fundal height to be approximately:
A) 24 cm
B) 26 cm
C) 28 cm
D) 30 cm
Correct Answer: 28 cm
Rationale: Fundal height in centimeters is approximately equal to the
gestational age in weeks between 20 and 34 weeks. At 28 weeks, the fundal
height should be approximately 28 cm.
,5. A patient at 32 weeks gestation reports that she has not felt fetal
movement for the past 12 hours. What is the nurse's priority action?
A) Reassure the patient that this is normal
B) Instruct the patient to count fetal movements and report back
C) Have the patient lie on her side, drink something sugary, and count
movements
D) Send the patient to the emergency room immediately
Correct Answer: Have the patient lie on her side, drink something sugary,
and count movements
Rationale: Decreased fetal movement is a concern. The patient should lie on
her side, drink something sugary, and count fetal movements. She should
feel 6-10 movements per hour. If movements are still decreased, she should
contact her provider.
6. A pregnant patient has a blood pressure of 150/92 mmHg and proteinuria.
The nurse should suspect:
A) Gestational diabetes
B) Preeclampsia
C) Hyperemesis gravidarum
D) Anemia
Correct Answer: Preeclampsia
Rationale: Preeclampsia is characterized by hypertension (≥140/90 mmHg)
and proteinuria after 20 weeks of gestation. Gestational diabetes is
diagnosed by abnormal glucose tolerance testing.
, 7. The nurse is providing education to a patient with gestational diabetes.
Which of the following is a potential fetal complication?
A) Macrosomia
B) Microsomia
C) Intrauterine growth restriction
D) Preterm labor
Correct Answer: Macrosomia
Rationale: Gestational diabetes increases the risk of fetal macrosomia (large
for gestational age) due to excess glucose crossing the placenta. This can
lead to shoulder dystocia and birth injuries.
8. A patient in labor is having contractions that are regular and increasing in
intensity. The cervix is 4 cm dilated and 80% effaced. The patient is in which
stage of labor?
A) Latent phase of the first stage
B) Active phase of the first stage
C) Transition phase of the first stage
D) Second stage of labor
Correct Answer: Active phase of the first stage
Rationale: The active phase of the first stage is characterized by cervical
dilation from 4 to 8 cm with rapid effacement. The latent phase is 0-3 cm,
and transition is 8-10 cm.
9. The nurse is assessing a patient's contractions. The patient reports that
her contractions are "in my back and then wrap around to the front." This is a
classic description of:
