NSG 3500 – Nursing Practice: Maternal Health
Section I: Antepartum Nursing Care (1–35)
1. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule for a client
whose last menstrual period began on April 10. What is the EDD?
A. January 10
B. January 17
C. January 24
D. January 31
Correct Answer: B
Rationale: Naegele's rule: subtract 3 months (April → January) and add 7 days (10 + 7 = 17).
EDD = January 17.
2. A nurse is teaching a client at 10 weeks' gestation about fetal development. Which statement
indicates understanding?
A. "The baby's heart begins beating around 8 weeks."
B. "The baby's major organs are formed by 8 weeks."
C. "The baby's sex can be determined at 10 weeks."
D. "The baby starts moving at 10 weeks."
Correct Answer: B
Rationale: Organogenesis occurs during the embryonic period (weeks 3–8), and major
organs are formed by 8 weeks.
3. A nurse is assessing a client at 12 weeks' gestation. Which finding should be reported to the
provider?
A. Nausea and vomiting
B. Urinary frequency
C. Vaginal bleeding
D. Breast tenderness
Correct Answer: C
Rationale: Vaginal bleeding at any time during pregnancy is abnormal and may indicate
miscarriage, ectopic pregnancy, or other complications.
,4. A nurse is teaching a client about folic acid supplementation. The nurse should explain that
folic acid prevents which condition?
A. Gestational diabetes
B. Neural tube defects
C. Preeclampsia
D. Preterm labor
Correct Answer: B
Rationale: Folic acid (400–800 mcg/day) prevents neural tube defects such as spina bifida.
5. A nurse is assessing a client at 20 weeks' gestation. The client asks when she should feel fetal
movement. The nurse should respond that quickening typically occurs at:
A. 8–10 weeks
B. 12–14 weeks
C. 16–20 weeks
D. 24–28 weeks
Correct Answer: C
Rationale: Quickening (first fetal movement felt by the mother) typically occurs between 16
and 20 weeks.
6. A nurse is reviewing laboratory results for a client at 28 weeks' gestation. Which finding
should be reported?
A. Hemoglobin 11.5 g/dL
B. Glucose 200 mg/dL on 1-hour GTT
C. Platelet count 200,000/mm³
D. WBC 10,000/mm³
Correct Answer: B
Rationale: A 1-hour glucose tolerance test ≥140 mg/dL is abnormal and requires a 3-hour
GTT to rule out gestational diabetes.
7. A nurse is measuring fundal height on a client at 24 weeks' gestation. The nurse should
expect the fundus to be at which level?
A. At the symphysis pubis
B. At the umbilicus
,C. 2 cm above the umbilicus
D. At the xiphoid process
Correct Answer: C
Rationale: At 20–22 weeks, the fundus is at the umbilicus. At 24 weeks, it is approximately
2 cm above.
8. A nurse is teaching a client about the alpha-fetoprotein (AFP) test. The nurse should explain
that this test screens for:
A. Gestational diabetes
B. Neural tube defects
C. Group B streptococcus
D. Rh incompatibility
Correct Answer: B
Rationale: AFP screens for neural tube defects (elevated AFP) and Down syndrome (low
AFP), performed between 15 and 22 weeks.
9. A nurse is assessing a client at 36 weeks' gestation. Which finding indicates a potential
complication?
A. Braxton Hicks contractions
B. Blood pressure 150/95 mm Hg
C. Mild ankle edema
D. Cervical dilation of 1 cm
Correct Answer: B
Rationale: Blood pressure ≥140/90 mm Hg after 20 weeks may indicate gestational
hypertension or preeclampsia.
10. A nurse is teaching a pregnant client about danger signs. Which should the nurse include?
A. Mild fatigue
B. Occasional heartburn
C. Severe headache with visual changes
D. Braxton Hicks contractions
, Correct Answer: C
Rationale: Severe headache with visual changes may indicate preeclampsia and requires
immediate medical attention.
11. A nurse is assessing a client at 10 weeks' gestation with hyperemesis gravidarum. Which
finding is most concerning?
A. Nausea
B. Vomiting
C. Weight loss of 5% of prepregnancy weight
D. Increased salivation
Correct Answer: C
Rationale: Weight loss >5% of prepregnancy weight with dehydration and electrolyte
imbalances indicates severe hyperemesis gravidarum.
12. A nurse is performing a pelvic examination on a client at 8 weeks' gestation. Which finding
is a probable sign of pregnancy?
A. Amenorrhea
B. Nausea
C. Chadwick's sign
D. Breast tenderness
Correct Answer: C
Rationale: Chadwick's sign (bluish discoloration of the cervix) is a probable sign.
Amenorrhea, nausea, and breast tenderness are presumptive.
13. A nurse is teaching a client about nutrition during pregnancy. The nurse should recommend
an increase of how many calories per day during the second trimester?
A. 100 calories
B. 340 calories
C. 500 calories
D. 800 calories
Correct Answer: B
Rationale: The recommended caloric increase is 340 calories/day during the second
trimester and 452 calories/day during the third.
Section I: Antepartum Nursing Care (1–35)
1. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule for a client
whose last menstrual period began on April 10. What is the EDD?
A. January 10
B. January 17
C. January 24
D. January 31
Correct Answer: B
Rationale: Naegele's rule: subtract 3 months (April → January) and add 7 days (10 + 7 = 17).
EDD = January 17.
2. A nurse is teaching a client at 10 weeks' gestation about fetal development. Which statement
indicates understanding?
A. "The baby's heart begins beating around 8 weeks."
B. "The baby's major organs are formed by 8 weeks."
C. "The baby's sex can be determined at 10 weeks."
D. "The baby starts moving at 10 weeks."
Correct Answer: B
Rationale: Organogenesis occurs during the embryonic period (weeks 3–8), and major
organs are formed by 8 weeks.
3. A nurse is assessing a client at 12 weeks' gestation. Which finding should be reported to the
provider?
A. Nausea and vomiting
B. Urinary frequency
C. Vaginal bleeding
D. Breast tenderness
Correct Answer: C
Rationale: Vaginal bleeding at any time during pregnancy is abnormal and may indicate
miscarriage, ectopic pregnancy, or other complications.
,4. A nurse is teaching a client about folic acid supplementation. The nurse should explain that
folic acid prevents which condition?
A. Gestational diabetes
B. Neural tube defects
C. Preeclampsia
D. Preterm labor
Correct Answer: B
Rationale: Folic acid (400–800 mcg/day) prevents neural tube defects such as spina bifida.
5. A nurse is assessing a client at 20 weeks' gestation. The client asks when she should feel fetal
movement. The nurse should respond that quickening typically occurs at:
A. 8–10 weeks
B. 12–14 weeks
C. 16–20 weeks
D. 24–28 weeks
Correct Answer: C
Rationale: Quickening (first fetal movement felt by the mother) typically occurs between 16
and 20 weeks.
6. A nurse is reviewing laboratory results for a client at 28 weeks' gestation. Which finding
should be reported?
A. Hemoglobin 11.5 g/dL
B. Glucose 200 mg/dL on 1-hour GTT
C. Platelet count 200,000/mm³
D. WBC 10,000/mm³
Correct Answer: B
Rationale: A 1-hour glucose tolerance test ≥140 mg/dL is abnormal and requires a 3-hour
GTT to rule out gestational diabetes.
7. A nurse is measuring fundal height on a client at 24 weeks' gestation. The nurse should
expect the fundus to be at which level?
A. At the symphysis pubis
B. At the umbilicus
,C. 2 cm above the umbilicus
D. At the xiphoid process
Correct Answer: C
Rationale: At 20–22 weeks, the fundus is at the umbilicus. At 24 weeks, it is approximately
2 cm above.
8. A nurse is teaching a client about the alpha-fetoprotein (AFP) test. The nurse should explain
that this test screens for:
A. Gestational diabetes
B. Neural tube defects
C. Group B streptococcus
D. Rh incompatibility
Correct Answer: B
Rationale: AFP screens for neural tube defects (elevated AFP) and Down syndrome (low
AFP), performed between 15 and 22 weeks.
9. A nurse is assessing a client at 36 weeks' gestation. Which finding indicates a potential
complication?
A. Braxton Hicks contractions
B. Blood pressure 150/95 mm Hg
C. Mild ankle edema
D. Cervical dilation of 1 cm
Correct Answer: B
Rationale: Blood pressure ≥140/90 mm Hg after 20 weeks may indicate gestational
hypertension or preeclampsia.
10. A nurse is teaching a pregnant client about danger signs. Which should the nurse include?
A. Mild fatigue
B. Occasional heartburn
C. Severe headache with visual changes
D. Braxton Hicks contractions
, Correct Answer: C
Rationale: Severe headache with visual changes may indicate preeclampsia and requires
immediate medical attention.
11. A nurse is assessing a client at 10 weeks' gestation with hyperemesis gravidarum. Which
finding is most concerning?
A. Nausea
B. Vomiting
C. Weight loss of 5% of prepregnancy weight
D. Increased salivation
Correct Answer: C
Rationale: Weight loss >5% of prepregnancy weight with dehydration and electrolyte
imbalances indicates severe hyperemesis gravidarum.
12. A nurse is performing a pelvic examination on a client at 8 weeks' gestation. Which finding
is a probable sign of pregnancy?
A. Amenorrhea
B. Nausea
C. Chadwick's sign
D. Breast tenderness
Correct Answer: C
Rationale: Chadwick's sign (bluish discoloration of the cervix) is a probable sign.
Amenorrhea, nausea, and breast tenderness are presumptive.
13. A nurse is teaching a client about nutrition during pregnancy. The nurse should recommend
an increase of how many calories per day during the second trimester?
A. 100 calories
B. 340 calories
C. 500 calories
D. 800 calories
Correct Answer: B
Rationale: The recommended caloric increase is 340 calories/day during the second
trimester and 452 calories/day during the third.
