NUR 2633/NUR2633 Exam 1 V2 | Maternal Child
Health Nursing Q&A with Rationale | Rasmussen
University
1. A nurse is calculating the GTPAL for a client who is currently at 20 weeks gestation. The
client has one child born at 39 weeks, twins born at 34 weeks, and had one miscarriage at 10
weeks. Which of the following is the correct GTPAL?
A. G3, T1, P2, A1, L2
B. G4, T2, P1, A1, L3
C. G4, T1, P1, A1, L3
D. G4, T1, P2, A1, L3
Correct Answer: C
Explanation: The client is currently pregnant, which makes G=4. The child born at 39
weeks is one term birth (T=1), and the twins born at 34 weeks count as one preterm birth
event (P=1). The miscarriage at 10 weeks is one abortion (A=1), and since the term child
and both twins are alive, the living count is three (L=3).
2. Using Naegele’s Rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on October 15th?
A. July 8th
B. August 15th
,C. January 22nd
D. July 22nd
Correct Answer: D
Explanation: Naegele’s Rule is calculated by taking the first day of the LMP, subtracting
three months, and adding seven days. For an LMP of October 15, subtracting three months
takes us to July, and adding seven days to the 15th results in the 22nd. This calculation
provides an approximate due date based on a 28-day menstrual cycle.
3. A nurse is monitoring a client in labor and observes late decelerations on the fetal heart
rate monitor. Which of the following should be the nurse’s first action?
A. Increase the rate of the oxytocin infusion
B. Reposition the client to a side-lying position
C. Perform a vaginal examination to check for cord prolapse
D. Administer oxygen via nasal cannula at 2L/min
Correct Answer: B
Explanation: Late decelerations are indicative of uteroplacental insufficiency, which can
compromise fetal oxygenation. Repositioning the client to a lateral (side-lying) position is
the priority intervention to improve blood flow to the placenta. Other immediate actions
include discontinuing oxytocin, increasing IV fluids, and administering oxygen via a non-
rebreather mask at 8-10L/min.
, 4. A client at 34 weeks gestation is receiving magnesium sulfate for the treatment of
preeclampsia. Which finding should the nurse report to the provider immediately?
A. Urinary output of 20 mL/hr
B. Deep tendon reflexes of 2+
C. Respiratory rate of 14 breaths per minute
D. Fetal heart rate of 140 beats per minute
Correct Answer: A
Explanation: Magnesium sulfate is excreted by the kidneys, so adequate urine output is
essential to prevent toxicity. A urinary output of less than 30 mL/hr is a significant finding
that may indicate renal compromise and an increased risk of magnesium accumulation. The
nurse must monitor for signs of toxicity such as absent deep tendon reflexes, respiratory
depression, and decreased urine output.
5. A nurse is assessing a newborn 1 minute after birth. The newborn has a heart rate of
110/min, a weak cry, some flexion of the extremities, a grimace when suctioned, and a
completely pink body. What is the APGAR score?
A. 7
B. 6
C. 8
D. 9
Health Nursing Q&A with Rationale | Rasmussen
University
1. A nurse is calculating the GTPAL for a client who is currently at 20 weeks gestation. The
client has one child born at 39 weeks, twins born at 34 weeks, and had one miscarriage at 10
weeks. Which of the following is the correct GTPAL?
A. G3, T1, P2, A1, L2
B. G4, T2, P1, A1, L3
C. G4, T1, P1, A1, L3
D. G4, T1, P2, A1, L3
Correct Answer: C
Explanation: The client is currently pregnant, which makes G=4. The child born at 39
weeks is one term birth (T=1), and the twins born at 34 weeks count as one preterm birth
event (P=1). The miscarriage at 10 weeks is one abortion (A=1), and since the term child
and both twins are alive, the living count is three (L=3).
2. Using Naegele’s Rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on October 15th?
A. July 8th
B. August 15th
,C. January 22nd
D. July 22nd
Correct Answer: D
Explanation: Naegele’s Rule is calculated by taking the first day of the LMP, subtracting
three months, and adding seven days. For an LMP of October 15, subtracting three months
takes us to July, and adding seven days to the 15th results in the 22nd. This calculation
provides an approximate due date based on a 28-day menstrual cycle.
3. A nurse is monitoring a client in labor and observes late decelerations on the fetal heart
rate monitor. Which of the following should be the nurse’s first action?
A. Increase the rate of the oxytocin infusion
B. Reposition the client to a side-lying position
C. Perform a vaginal examination to check for cord prolapse
D. Administer oxygen via nasal cannula at 2L/min
Correct Answer: B
Explanation: Late decelerations are indicative of uteroplacental insufficiency, which can
compromise fetal oxygenation. Repositioning the client to a lateral (side-lying) position is
the priority intervention to improve blood flow to the placenta. Other immediate actions
include discontinuing oxytocin, increasing IV fluids, and administering oxygen via a non-
rebreather mask at 8-10L/min.
, 4. A client at 34 weeks gestation is receiving magnesium sulfate for the treatment of
preeclampsia. Which finding should the nurse report to the provider immediately?
A. Urinary output of 20 mL/hr
B. Deep tendon reflexes of 2+
C. Respiratory rate of 14 breaths per minute
D. Fetal heart rate of 140 beats per minute
Correct Answer: A
Explanation: Magnesium sulfate is excreted by the kidneys, so adequate urine output is
essential to prevent toxicity. A urinary output of less than 30 mL/hr is a significant finding
that may indicate renal compromise and an increased risk of magnesium accumulation. The
nurse must monitor for signs of toxicity such as absent deep tendon reflexes, respiratory
depression, and decreased urine output.
5. A nurse is assessing a newborn 1 minute after birth. The newborn has a heart rate of
110/min, a weak cry, some flexion of the extremities, a grimace when suctioned, and a
completely pink body. What is the APGAR score?
A. 7
B. 6
C. 8
D. 9
