NUR 1020 exam with correct answers
and rationale graded A+ updated
2026 new!!
Section 1: Antepartum Care (Questions 1–25)
1. Using Naegele’s rule, a client whose last menstrual period (LMP) began on April 10 has an
estimated due date (EDD) of:
A. January 17
B. January 10
C. July 17
D. July 10
Answer: A
Rationale: Naegele’s rule: add 7 days to the LMP, subtract 3 months, and add 1 year (April 10 → April
17 → January 17).
2. The recommended daily folic acid intake for a low-risk woman of childbearing age is:
A. 0.1 mg
B. 0.4 mg
C. 4 mg
D. 10 mg
Answer: B
Rationale: 0.4 mg (400 mcg) daily is recommended to reduce the risk of neural tube defects; 4 mg is
reserved for high-risk histories.
3. Physiologic anemia of pregnancy is primarily caused by:
A. Decreased red blood cell production
,B. Plasma volume expansion exceeding the increase in red blood cells
C. Chronic iron deficiency
D. Folate deficiency
Answer: B
Rationale: Plasma volume increases up to 50%, while red cell mass increases only ~25%, causing a
dilutional drop in hematocrit.
4. A client at 32 weeks calls the clinic reporting sudden, painless vaginal bleeding. The nurse
suspects:
A. Placental abruption
B. Placenta previa
C. Cervical insufficiency
D. Round ligament pain
Answer: B
Rationale: Sudden, painless late-pregnancy bleeding is classic for placenta previa; abruption is
typically painful.
5. A client at 30 weeks reports a sudden gush of clear fluid. Nitrazine paper turns blue-black and
ferning is seen on microscopy. The nurse recognizes this as:
A. Urinary incontinence
B. Normal leukorrhea
C. Premature rupture of membranes (PROM)
D. Bacterial vaginosis
Answer: C
Rationale: A positive nitrazine test (alkaline pH) and ferning pattern are diagnostic of ruptured
membranes.
6. The most definitive method to confirm an intrauterine pregnancy at 6 weeks is:
A. Urine hCG testing
B. Serum quantitative hCG
,C. Transvaginal ultrasound showing a gestational sac
D. Doppler detection of fetal heart tones
Answer: C
Rationale: Ultrasound visualization of an intrauterine gestational sac confirms pregnancy location
and viability; hCG only confirms conception.
7. At 24 weeks gestation, the expected fundal height measurement is approximately:
A. 20 cm
B. 24 cm
C. 28 cm
D. 32 cm
Answer: B
Rationale: From approximately 20–32 weeks, fundal height in centimeters roughly equals gestational
age in weeks.
8. Which vaccine is contraindicated during pregnancy?
A. Tdap
B. Inactivated influenza
C. Hepatitis B
D. MMR
Answer: D
Rationale: MMR is a live attenuated vaccine and is contraindicated in pregnancy due to theoretical
fetal risk.
9. For a low-risk pregnancy, prenatal visits are scheduled every 4 weeks until:
A. 20 weeks
B. 28 weeks
C. 32 weeks
D. 36 weeks
, Answer: B
Rationale: Standard schedule: every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, then
weekly.
10. A pregnant client complains of heartburn. The nurse should recommend:
A. Eating three large meals daily
B. Drinking large amounts of fluid with meals
C. Small, frequent meals and avoiding lying down after eating
D. Sodium bicarbonate tablets as needed
Answer: C
Rationale: Small meals and upright positioning reduce gastric reflux; sodium bicarbonate is not
recommended due to electrolyte effects.
11. A client at 36 weeks reports severe headache, visual spots, and right upper quadrant pain. These
symptoms suggest:
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Normal third-trimester discomforts
Answer: B
Rationale: Headache, visual changes, and RUQ pain are hallmark symptoms of worsening
preeclampsia.
12. The quad marker screen is used to assess for all of the following EXCEPT:
A. Down syndrome
B. Trisomy 18
C. Neural tube defects
D. Cystic fibrosis
Answer: D
and rationale graded A+ updated
2026 new!!
Section 1: Antepartum Care (Questions 1–25)
1. Using Naegele’s rule, a client whose last menstrual period (LMP) began on April 10 has an
estimated due date (EDD) of:
A. January 17
B. January 10
C. July 17
D. July 10
Answer: A
Rationale: Naegele’s rule: add 7 days to the LMP, subtract 3 months, and add 1 year (April 10 → April
17 → January 17).
2. The recommended daily folic acid intake for a low-risk woman of childbearing age is:
A. 0.1 mg
B. 0.4 mg
C. 4 mg
D. 10 mg
Answer: B
Rationale: 0.4 mg (400 mcg) daily is recommended to reduce the risk of neural tube defects; 4 mg is
reserved for high-risk histories.
3. Physiologic anemia of pregnancy is primarily caused by:
A. Decreased red blood cell production
,B. Plasma volume expansion exceeding the increase in red blood cells
C. Chronic iron deficiency
D. Folate deficiency
Answer: B
Rationale: Plasma volume increases up to 50%, while red cell mass increases only ~25%, causing a
dilutional drop in hematocrit.
4. A client at 32 weeks calls the clinic reporting sudden, painless vaginal bleeding. The nurse
suspects:
A. Placental abruption
B. Placenta previa
C. Cervical insufficiency
D. Round ligament pain
Answer: B
Rationale: Sudden, painless late-pregnancy bleeding is classic for placenta previa; abruption is
typically painful.
5. A client at 30 weeks reports a sudden gush of clear fluid. Nitrazine paper turns blue-black and
ferning is seen on microscopy. The nurse recognizes this as:
A. Urinary incontinence
B. Normal leukorrhea
C. Premature rupture of membranes (PROM)
D. Bacterial vaginosis
Answer: C
Rationale: A positive nitrazine test (alkaline pH) and ferning pattern are diagnostic of ruptured
membranes.
6. The most definitive method to confirm an intrauterine pregnancy at 6 weeks is:
A. Urine hCG testing
B. Serum quantitative hCG
,C. Transvaginal ultrasound showing a gestational sac
D. Doppler detection of fetal heart tones
Answer: C
Rationale: Ultrasound visualization of an intrauterine gestational sac confirms pregnancy location
and viability; hCG only confirms conception.
7. At 24 weeks gestation, the expected fundal height measurement is approximately:
A. 20 cm
B. 24 cm
C. 28 cm
D. 32 cm
Answer: B
Rationale: From approximately 20–32 weeks, fundal height in centimeters roughly equals gestational
age in weeks.
8. Which vaccine is contraindicated during pregnancy?
A. Tdap
B. Inactivated influenza
C. Hepatitis B
D. MMR
Answer: D
Rationale: MMR is a live attenuated vaccine and is contraindicated in pregnancy due to theoretical
fetal risk.
9. For a low-risk pregnancy, prenatal visits are scheduled every 4 weeks until:
A. 20 weeks
B. 28 weeks
C. 32 weeks
D. 36 weeks
, Answer: B
Rationale: Standard schedule: every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, then
weekly.
10. A pregnant client complains of heartburn. The nurse should recommend:
A. Eating three large meals daily
B. Drinking large amounts of fluid with meals
C. Small, frequent meals and avoiding lying down after eating
D. Sodium bicarbonate tablets as needed
Answer: C
Rationale: Small meals and upright positioning reduce gastric reflux; sodium bicarbonate is not
recommended due to electrolyte effects.
11. A client at 36 weeks reports severe headache, visual spots, and right upper quadrant pain. These
symptoms suggest:
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Normal third-trimester discomforts
Answer: B
Rationale: Headache, visual changes, and RUQ pain are hallmark symptoms of worsening
preeclampsia.
12. The quad marker screen is used to assess for all of the following EXCEPT:
A. Down syndrome
B. Trisomy 18
C. Neural tube defects
D. Cystic fibrosis
Answer: D
