Maternal & Child Nursing
Unit 1, 2 & 3 Independent Practice Exam
Unofficial Study Resource — Not an Authenticated Course Exam or Verified Question Bank
Section 1: Brief Introduction
This independent practice exam reviews antepartum assessment, gestational dating, fetal
development, normal maternal adaptations, prenatal screening, high-risk pregnancy, family-
centered care, and ethical/legal nursing principles. The questions are newly written for study
and do not replace your course materials, clinical supervision, or current facility protocols.
Section 2: The Complete Exam
Instructions: Choose the single best answer. Rationales are provided in italic font.
ANTEPARTUM • FETAL DEVELOPMENT • PHYSIOLOGY • PRENATAL TESTING • HIGH-RISK CARE
• ETHICS
1. A client's last menstrual period began on October 10. Using the standard 280-day
estimate for a regular 28-day cycle, what is the estimated due date (EDD)?
A. July 17 of the following year.
B. July 10 of the following year.
C. June 17 of the following year.
D. August 17 of the following year.
Rationale: Using Naegele's rule, subtract 3 months from the first day of the LMP
(October 10 - 3 months = July 10) and add 7 days (July 17). This provides an estimated
due date based on a standard 28-day cycle. [R1]
2. A pregnant patient is unsure of her last menstrual period. Which approach generally
provides the most accurate pregnancy dating?
A. Fundal height measured once in the third trimester.
B. The date fetal movement is first perceived (quickening).
C. A late-pregnancy ultrasound alone, regardless of prior data.
D. First-trimester ultrasound using crown-rump length.
Rationale: First-trimester ultrasound using crown-rump length is the most accurate
method for establishing or confirming gestational age, with an accuracy of +/- 5-7 days.
Once established, the EDD should not be changed routinely without a sound clinical
reason. [R1]
,3. A patient asks why prenatal care is recommended early in pregnancy. Which response by
the nurse is best?
A. Prenatal care is useful only after fetal movement begins.
B. Early care is primarily to determine the mode of birth.
C. Routine prenatal care can replace urgent evaluation of new warning symptoms.
D. Early care helps assess health and psychosocial needs, establish dating, review
medications, and plan screening and prevention.
Rationale: Early, comprehensive assessment supports accurate dating, risk identification,
screening choices, and individualized planning. It does not replace immediate
assessment when warning signs occur. [R2]
4. A pregnant patient asks how many weeks pregnant she is. Which convention is generally
used for gestational age?
A. Count from the presumed day of fertilization in every case.
B. Count from the first day fetal movement is felt.
C. Count from the first positive home pregnancy test.
D. Count from the first day of the last menstrual period, with confirmation or revision
based on the best obstetric estimate.
Rationale: Gestational age is conventionally dated from the first day of the LMP, about
two weeks before fertilization in a typical cycle. The documented best obstetric estimate
integrates reliable LMP and early ultrasound when indicated. [R1]
5. A client is 10 weeks pregnant and asks about folic acid. Which teaching is appropriate for
an average-risk pregnancy?
A. Folic acid is unnecessary after conception.
B. Avoid folate because it increases fetal growth.
C. Take 4 milligrams daily without discussing individual risk.
D. A prenatal vitamin should generally provide at least 400 micrograms of folic acid daily;
total daily folate needs in pregnancy are about 600 micrograms.
Rationale: Folate supports neural tube development; ACOG advises a daily prenatal
vitamin with at least 400 mcg folic acid and about 600 mcg total folate daily during
pregnancy. Higher-dose regimens are individualized for specific risk histories with
clinician guidance. [R3]
6. A nurse is calculating the expected date of birth for a client with a 28-day cycle who
reports her LMP started on January 20. Using Naegele's rule, what is the EDD?
A. October 27.
B. October 20.
C. November 27.
, D. September 27.
Rationale: Naegele's rule involves subtracting 3 months (January 20 - 3 months =
October 20) and adding 7 days, resulting in October 27 of the same year. [R1]
7. Which of the following is considered a positive (definitive) sign of pregnancy?
A. Amenorrhea.
B. Nausea and vomiting.
C. Fetal heart tones auscultated by a healthcare provider.
D. Breast tenderness.
Rationale: Positive signs of pregnancy are those that can be attributed only to the
presence of a fetus, such as fetal heart tones, visualization of the fetus via ultrasound,
and fetal movement felt by the examiner. Presumptive signs include amenorrhea,
nausea, and breast tenderness. [R1]
8. A client in her first trimester reports frequent urination. Which physiological change
explains this?
A. Increased glomerular filtration rate and pressure from the enlarging uterus on the
bladder.
B. Decreased renal plasma flow.
C. Compression of the vena cava.
D. Increased production of antidiuretic hormone.
Rationale: During the first trimester, the enlarging uterus presses on the bladder, and
increased renal blood flow and glomerular filtration rate lead to increased urine
production. This often resolves in the second trimester as the uterus rises out of the
pelvis. [R2]
9. A pregnant client asks when she should expect to feel fetal movement for the first time.
The nurse should instruct her that quickening typically occurs at:
A. 8 to 10 weeks.
B. 16 to 20 weeks.
C. 24 to 28 weeks.
D. 28 to 32 weeks.
Rationale: Quickening, the first perception of fetal movement, typically occurs between
16 and 20 weeks of gestation in primigravida clients, and slightly earlier in multigravida
clients. [R1]
10. Which laboratory test is routinely performed at the first prenatal visit to determine
immunity status?
A. Glucose tolerance test.
B. Rubella titer.
, C. Group B Streptococcus culture.
D. Amniocentesis.
Rationale: A rubella titer is drawn at the initial prenatal visit to determine if the client is
immune to rubella. If non-immune, the client should be counseled to avoid exposure and
receive the vaccine postpartum. [R3]
11. A nurse is teaching a pregnant client about maternal physiological adaptations. Which
cardiovascular change is expected?
A. Decreased blood volume.
B. Decreased heart rate.
C. Increased blood volume by 40% to 50%.
D. Increased blood pressure.
Rationale: Maternal blood volume increases by approximately 40% to 50% during
pregnancy to meet the metabolic demands of the uteroplacental unit and to prepare for
blood loss during birth. [R2]
12. A client at 32 weeks gestation reports shortness of breath. Which anatomical change
explains this?
A. Decreased oxygen consumption.
B. Elevation of the diaphragm by the enlarging uterus.
C. Decreased tidal volume.
D. Compression of the bronchioles.
Rationale: As the uterus enlarges, it pushes the diaphragm upward, reducing lung
capacity and causing shortness of breath. This is a normal physiological adaptation. [R2]
13. A pregnant client complains of heartburn. Which physiological change is the primary
cause?
A. Increased gastric motility.
B. Decreased gastric emptying time and relaxation of the lower esophageal sphincter.
C. Increased stomach acid production.
D. Compression of the stomach by the liver.
Rationale: Progesterone causes relaxation of the lower esophageal sphincter and
decreases gastric motility, leading to reflux and heartburn. Additionally, the enlarging
uterus displaces the stomach upward. [R2]
14. A client in her second trimester reports nasal stuffiness and occasional nosebleeds. The
nurse should explain that this is likely due to:
A. Increased estrogen levels causing vascular congestion of the nasal mucosa.
B. Decreased progesterone levels.
C. A Vitamin K deficiency.
Unit 1, 2 & 3 Independent Practice Exam
Unofficial Study Resource — Not an Authenticated Course Exam or Verified Question Bank
Section 1: Brief Introduction
This independent practice exam reviews antepartum assessment, gestational dating, fetal
development, normal maternal adaptations, prenatal screening, high-risk pregnancy, family-
centered care, and ethical/legal nursing principles. The questions are newly written for study
and do not replace your course materials, clinical supervision, or current facility protocols.
Section 2: The Complete Exam
Instructions: Choose the single best answer. Rationales are provided in italic font.
ANTEPARTUM • FETAL DEVELOPMENT • PHYSIOLOGY • PRENATAL TESTING • HIGH-RISK CARE
• ETHICS
1. A client's last menstrual period began on October 10. Using the standard 280-day
estimate for a regular 28-day cycle, what is the estimated due date (EDD)?
A. July 17 of the following year.
B. July 10 of the following year.
C. June 17 of the following year.
D. August 17 of the following year.
Rationale: Using Naegele's rule, subtract 3 months from the first day of the LMP
(October 10 - 3 months = July 10) and add 7 days (July 17). This provides an estimated
due date based on a standard 28-day cycle. [R1]
2. A pregnant patient is unsure of her last menstrual period. Which approach generally
provides the most accurate pregnancy dating?
A. Fundal height measured once in the third trimester.
B. The date fetal movement is first perceived (quickening).
C. A late-pregnancy ultrasound alone, regardless of prior data.
D. First-trimester ultrasound using crown-rump length.
Rationale: First-trimester ultrasound using crown-rump length is the most accurate
method for establishing or confirming gestational age, with an accuracy of +/- 5-7 days.
Once established, the EDD should not be changed routinely without a sound clinical
reason. [R1]
,3. A patient asks why prenatal care is recommended early in pregnancy. Which response by
the nurse is best?
A. Prenatal care is useful only after fetal movement begins.
B. Early care is primarily to determine the mode of birth.
C. Routine prenatal care can replace urgent evaluation of new warning symptoms.
D. Early care helps assess health and psychosocial needs, establish dating, review
medications, and plan screening and prevention.
Rationale: Early, comprehensive assessment supports accurate dating, risk identification,
screening choices, and individualized planning. It does not replace immediate
assessment when warning signs occur. [R2]
4. A pregnant patient asks how many weeks pregnant she is. Which convention is generally
used for gestational age?
A. Count from the presumed day of fertilization in every case.
B. Count from the first day fetal movement is felt.
C. Count from the first positive home pregnancy test.
D. Count from the first day of the last menstrual period, with confirmation or revision
based on the best obstetric estimate.
Rationale: Gestational age is conventionally dated from the first day of the LMP, about
two weeks before fertilization in a typical cycle. The documented best obstetric estimate
integrates reliable LMP and early ultrasound when indicated. [R1]
5. A client is 10 weeks pregnant and asks about folic acid. Which teaching is appropriate for
an average-risk pregnancy?
A. Folic acid is unnecessary after conception.
B. Avoid folate because it increases fetal growth.
C. Take 4 milligrams daily without discussing individual risk.
D. A prenatal vitamin should generally provide at least 400 micrograms of folic acid daily;
total daily folate needs in pregnancy are about 600 micrograms.
Rationale: Folate supports neural tube development; ACOG advises a daily prenatal
vitamin with at least 400 mcg folic acid and about 600 mcg total folate daily during
pregnancy. Higher-dose regimens are individualized for specific risk histories with
clinician guidance. [R3]
6. A nurse is calculating the expected date of birth for a client with a 28-day cycle who
reports her LMP started on January 20. Using Naegele's rule, what is the EDD?
A. October 27.
B. October 20.
C. November 27.
, D. September 27.
Rationale: Naegele's rule involves subtracting 3 months (January 20 - 3 months =
October 20) and adding 7 days, resulting in October 27 of the same year. [R1]
7. Which of the following is considered a positive (definitive) sign of pregnancy?
A. Amenorrhea.
B. Nausea and vomiting.
C. Fetal heart tones auscultated by a healthcare provider.
D. Breast tenderness.
Rationale: Positive signs of pregnancy are those that can be attributed only to the
presence of a fetus, such as fetal heart tones, visualization of the fetus via ultrasound,
and fetal movement felt by the examiner. Presumptive signs include amenorrhea,
nausea, and breast tenderness. [R1]
8. A client in her first trimester reports frequent urination. Which physiological change
explains this?
A. Increased glomerular filtration rate and pressure from the enlarging uterus on the
bladder.
B. Decreased renal plasma flow.
C. Compression of the vena cava.
D. Increased production of antidiuretic hormone.
Rationale: During the first trimester, the enlarging uterus presses on the bladder, and
increased renal blood flow and glomerular filtration rate lead to increased urine
production. This often resolves in the second trimester as the uterus rises out of the
pelvis. [R2]
9. A pregnant client asks when she should expect to feel fetal movement for the first time.
The nurse should instruct her that quickening typically occurs at:
A. 8 to 10 weeks.
B. 16 to 20 weeks.
C. 24 to 28 weeks.
D. 28 to 32 weeks.
Rationale: Quickening, the first perception of fetal movement, typically occurs between
16 and 20 weeks of gestation in primigravida clients, and slightly earlier in multigravida
clients. [R1]
10. Which laboratory test is routinely performed at the first prenatal visit to determine
immunity status?
A. Glucose tolerance test.
B. Rubella titer.
, C. Group B Streptococcus culture.
D. Amniocentesis.
Rationale: A rubella titer is drawn at the initial prenatal visit to determine if the client is
immune to rubella. If non-immune, the client should be counseled to avoid exposure and
receive the vaccine postpartum. [R3]
11. A nurse is teaching a pregnant client about maternal physiological adaptations. Which
cardiovascular change is expected?
A. Decreased blood volume.
B. Decreased heart rate.
C. Increased blood volume by 40% to 50%.
D. Increased blood pressure.
Rationale: Maternal blood volume increases by approximately 40% to 50% during
pregnancy to meet the metabolic demands of the uteroplacental unit and to prepare for
blood loss during birth. [R2]
12. A client at 32 weeks gestation reports shortness of breath. Which anatomical change
explains this?
A. Decreased oxygen consumption.
B. Elevation of the diaphragm by the enlarging uterus.
C. Decreased tidal volume.
D. Compression of the bronchioles.
Rationale: As the uterus enlarges, it pushes the diaphragm upward, reducing lung
capacity and causing shortness of breath. This is a normal physiological adaptation. [R2]
13. A pregnant client complains of heartburn. Which physiological change is the primary
cause?
A. Increased gastric motility.
B. Decreased gastric emptying time and relaxation of the lower esophageal sphincter.
C. Increased stomach acid production.
D. Compression of the stomach by the liver.
Rationale: Progesterone causes relaxation of the lower esophageal sphincter and
decreases gastric motility, leading to reflux and heartburn. Additionally, the enlarging
uterus displaces the stomach upward. [R2]
14. A client in her second trimester reports nasal stuffiness and occasional nosebleeds. The
nurse should explain that this is likely due to:
A. Increased estrogen levels causing vascular congestion of the nasal mucosa.
B. Decreased progesterone levels.
C. A Vitamin K deficiency.
