NRSG 112 Exam 1 V1 | NRSG 112 Maternal-Child
Nursing | Actual Q&A with Rationale (NRSG112
Exam 1) | Ivy Tech
1. A nurse is assessing a client who reports their last menstrual period began on May 10th.
Using Naegele’s rule, which of the following is the estimated date of birth?
A. February 13th
B. January 17th
C. February 3rd
D. February 17th
E. March 17th
Correct Answer: D
Explanation: To calculate the estimated date of birth using Naegele’s rule, the nurse
should subtract 3 months from the first day of the last menstrual period and add 7 days
and 1 year. For a client whose LMP started May 10th, subtracting 3 months results in
February, and adding 7 days to the 10th results in the 17th. This method assumes a
standard 28-day cycle and is the primary tool for clinical dating in maternal nursing.
2. Which of the following physiological changes is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive serum pregnancy test
,C. Goodell’s sign
D. Visualization of the fetus by ultrasound
Correct Answer: D
Explanation: Positive signs of pregnancy are those that can be attributed only to the
presence of a fetus, such as fetal heart tones, visualization by ultrasound, or palpation of
fetal movement by an examiner. Presumptive signs are subjective feelings like nausea or
amenorrhea, while probable signs are objective findings like a positive HCG test or Hegar’s
sign. Understanding these distinctions is critical for the nurse to accurately confirm
pregnancy and educate the client.
3. A client is pregnant for the fourth time. She has one living child born at 38 weeks, one child
born at 35 weeks, and had one miscarriage at 10 weeks. How should the nurse record her
GTPAL?
A. G4, T2, P1, A1, L2
B. G3, T1, P1, A1, L2
C. G4, T1, P1, A1, L2
D. G4, T1, P2, A0, L2
Correct Answer: C
Explanation: G stands for Gravida (total pregnancies), T for Term (37+ weeks), P for
Preterm (20-36.6 weeks), A for Abortions/Miscarriages (before 20 weeks), and L for Living
children. This client is currently pregnant (G4), has one term birth (T1), one preterm birth
,(P1), one miscarriage (A1), and two living children (L2). Accurate GTPAL documentation is
essential for identifying risks related to obstetric history during the intake assessment.
4. During a routine prenatal visit at 20 weeks gestation, where should the nurse expect to
palpate the fundus?
A. Symphysis pubis
B. Halfway between the symphysis pubis and the umbilicus
C. At the xiphoid process
D. At the level of the umbilicus
Correct Answer: D
Explanation: At approximately 20 weeks of gestation, the fundus is typically located at the
level of the umbilicus. Before this, at 12 weeks, it is just above the symphysis pubis, and it
reaches the xiphoid process at 36 weeks. Fundal height measurements are a standard
screening tool to assess for appropriate fetal growth and amniotic fluid volume.
5. A nurse is teaching a pregnant client about the importance of folic acid. Which statement
by the client indicates an understanding of why this supplement is needed?
A. It helps prevent gestational diabetes.
B. It prevents maternal anemia only.
C. It helps with the absorption of iron.
D. It prevents neural tube defects in the baby.
, Correct Answer: D
Explanation: Folic acid is crucial during the early stages of pregnancy to ensure the proper
closure of the neural tube, which eventually becomes the brain and spinal cord. Inadequate
intake of folate is strongly linked to defects such as spina bifida and anencephaly. The
recommended daily intake for most pregnant women is 400 to 800 mcg to mitigate these
risks effectively.
6. A nurse is reviewing a client’s lab results and notes a hemoglobin level of 10.5 g/dL. Which
of the following is the most likely cause during the second trimester?
A. Active internal bleeding
B. Iron deficiency anemia only
C. Red blood cell destruction
D. Physiological anemia of pregnancy
Correct Answer: D
Explanation: Physiological anemia of pregnancy occurs because the plasma volume
increases more rapidly (40-50%) than the red blood cell mass (20-30%). This
hemodilution results in a lower hemoglobin and hematocrit reading despite an overall
increase in oxygen-carrying capacity. Nurses must distinguish between this normal
physiological adaptation and true iron deficiency anemia requiring treatment.
7. Which fetal heart rate pattern is associated with umbilical cord compression?
A. Early decelerations
Nursing | Actual Q&A with Rationale (NRSG112
Exam 1) | Ivy Tech
1. A nurse is assessing a client who reports their last menstrual period began on May 10th.
Using Naegele’s rule, which of the following is the estimated date of birth?
A. February 13th
B. January 17th
C. February 3rd
D. February 17th
E. March 17th
Correct Answer: D
Explanation: To calculate the estimated date of birth using Naegele’s rule, the nurse
should subtract 3 months from the first day of the last menstrual period and add 7 days
and 1 year. For a client whose LMP started May 10th, subtracting 3 months results in
February, and adding 7 days to the 10th results in the 17th. This method assumes a
standard 28-day cycle and is the primary tool for clinical dating in maternal nursing.
2. Which of the following physiological changes is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive serum pregnancy test
,C. Goodell’s sign
D. Visualization of the fetus by ultrasound
Correct Answer: D
Explanation: Positive signs of pregnancy are those that can be attributed only to the
presence of a fetus, such as fetal heart tones, visualization by ultrasound, or palpation of
fetal movement by an examiner. Presumptive signs are subjective feelings like nausea or
amenorrhea, while probable signs are objective findings like a positive HCG test or Hegar’s
sign. Understanding these distinctions is critical for the nurse to accurately confirm
pregnancy and educate the client.
3. A client is pregnant for the fourth time. She has one living child born at 38 weeks, one child
born at 35 weeks, and had one miscarriage at 10 weeks. How should the nurse record her
GTPAL?
A. G4, T2, P1, A1, L2
B. G3, T1, P1, A1, L2
C. G4, T1, P1, A1, L2
D. G4, T1, P2, A0, L2
Correct Answer: C
Explanation: G stands for Gravida (total pregnancies), T for Term (37+ weeks), P for
Preterm (20-36.6 weeks), A for Abortions/Miscarriages (before 20 weeks), and L for Living
children. This client is currently pregnant (G4), has one term birth (T1), one preterm birth
,(P1), one miscarriage (A1), and two living children (L2). Accurate GTPAL documentation is
essential for identifying risks related to obstetric history during the intake assessment.
4. During a routine prenatal visit at 20 weeks gestation, where should the nurse expect to
palpate the fundus?
A. Symphysis pubis
B. Halfway between the symphysis pubis and the umbilicus
C. At the xiphoid process
D. At the level of the umbilicus
Correct Answer: D
Explanation: At approximately 20 weeks of gestation, the fundus is typically located at the
level of the umbilicus. Before this, at 12 weeks, it is just above the symphysis pubis, and it
reaches the xiphoid process at 36 weeks. Fundal height measurements are a standard
screening tool to assess for appropriate fetal growth and amniotic fluid volume.
5. A nurse is teaching a pregnant client about the importance of folic acid. Which statement
by the client indicates an understanding of why this supplement is needed?
A. It helps prevent gestational diabetes.
B. It prevents maternal anemia only.
C. It helps with the absorption of iron.
D. It prevents neural tube defects in the baby.
, Correct Answer: D
Explanation: Folic acid is crucial during the early stages of pregnancy to ensure the proper
closure of the neural tube, which eventually becomes the brain and spinal cord. Inadequate
intake of folate is strongly linked to defects such as spina bifida and anencephaly. The
recommended daily intake for most pregnant women is 400 to 800 mcg to mitigate these
risks effectively.
6. A nurse is reviewing a client’s lab results and notes a hemoglobin level of 10.5 g/dL. Which
of the following is the most likely cause during the second trimester?
A. Active internal bleeding
B. Iron deficiency anemia only
C. Red blood cell destruction
D. Physiological anemia of pregnancy
Correct Answer: D
Explanation: Physiological anemia of pregnancy occurs because the plasma volume
increases more rapidly (40-50%) than the red blood cell mass (20-30%). This
hemodilution results in a lower hemoglobin and hematocrit reading despite an overall
increase in oxygen-carrying capacity. Nurses must distinguish between this normal
physiological adaptation and true iron deficiency anemia requiring treatment.
7. Which fetal heart rate pattern is associated with umbilical cord compression?
A. Early decelerations
