MCN 374 All Exam Files 2024 BUNDLE
Section 1: Antepartum Care and Fetal Development (Q1–Q30)
1. A client at 10 weeks' gestation asks when she should expect to feel fetal
movement for the first time. The nurse correctly responds that quickening is
typically felt at:
A. 8–10 weeks
B. 12–14 weeks
C. 16–20 weeks
D. 22–24 weeks
Answer: C
Rationale: Quickening, the first perception of fetal movement, is typically felt
between 16 and 20 weeks' gestation, though it may be earlier in multigravida
clients.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose
last menstrual period began on June 5. Using Naegele's rule, what is the EDD?
A. March 5
B. March 12
C. March 19
D. March 26
Answer: B
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP (June
→ March), add 7 days (5 + 7 = 12). EDD is March 12.
3. Which physiologic change in pregnancy increases the risk for supine
hypotensive syndrome?
A. Increased cardiac output
B. Compression of the inferior vena cava by the gravid uterus
C. Decreased blood volume
D. Increased peripheral vascular resistance
Answer: B
Rationale: Supine hypotensive syndrome results from compression of the inferior
vena cava by the enlarged uterus, reducing venous return and cardiac output.
,4. A pregnant client at 32 weeks' gestation reports heartburn. Which instruction
is most appropriate?
A. "Lie down immediately after eating."
B. "Eat three large meals daily."
C. "Avoid spicy foods and eat small, frequent meals."
D. "Drink large amounts of fluid with meals."
Answer: C
Rationale: Progesterone decreases lower esophageal sphincter tone, causing
reflux. Small, frequent meals and avoiding trigger foods reduce symptoms.
5. A nurse is assessing a pregnant client for signs of preeclampsia. Which finding
is most concerning?
A. Blood pressure 118/76 mm Hg
B. 1+ proteinuria
C. Blood pressure 150/96 mm Hg and headache
D. Mild ankle edema
Answer: C
Rationale: Hypertension with headache suggests preeclampsia with severe
features, requiring immediate evaluation.
6. A client at 36 weeks' gestation with placenta previa presents with painless
vaginal bleeding. Which action is contraindicated?
A. Assessing fetal heart rate
B. Performing a vaginal exam
C. Monitoring maternal vital signs
D. Preparing for possible cesarean delivery
Answer: B
Rationale: Vaginal exam is contraindicated with placenta previa because it can
cause severe hemorrhage.
7. Which laboratory test is used to screen for neural tube defects?
A. Maternal serum alpha-fetoprotein (MSAFP)
B. Hemoglobin A1c
C. Urine culture
D. Thyroid-stimulating hormone
,Answer: A
Rationale: MSAFP is a screening test for neural tube defects and chromosomal
abnormalities, performed between 15 and 20 weeks.
8. A client at 28 weeks' gestation is Rh-negative with a negative antibody
screen. When should RhoGAM be administered?
A. At 12 weeks
B. At 28 weeks and within 72 hours postpartum if the infant is Rh-positive
C. Only after delivery
D. At 36 weeks
Answer: B
Rationale: RhoGAM is given at 28 weeks and within 72 hours after delivery if the
newborn is Rh-positive.
9. A nurse is teaching a pregnant client about folic acid. Which statement
indicates correct understanding?
A. "Folic acid prevents gestational diabetes."
B. "Folic acid helps prevent neural tube defects."
C. "Folic acid is only needed in the third trimester."
D. "Folic acid prevents preterm labor."
Answer: B
Rationale: Folic acid is essential for preventing neural tube defects and should be
taken before conception and throughout pregnancy.
10. A client at 34 weeks' gestation reports decreased fetal movement. What is
the priority nursing action?
A. Perform a non-stress test
B. Encourage oral fluids
C. Notify the provider
D. Document the finding
Answer: A
Rationale: Decreased fetal movement requires immediate assessment of fetal
well-being, beginning with a non-stress test.
11. Which finding on a non-stress test is considered reactive?
A. Two accelerations of 15 bpm lasting 15 seconds in 20 minutes
, B. No accelerations in 20 minutes
C. One acceleration of 10 bpm
D. Variable decelerations
Answer: A
Rationale: A reactive NST demonstrates two or more FHR accelerations of at least
15 bpm lasting at least 15 seconds in a 20-minute period.
12. A client at 12 weeks' gestation is scheduled for chorionic villus sampling
(CVS). What is the primary advantage of CVS over amniocentesis?
A. Lower risk of miscarriage
B. Earlier results
C. Can detect neural tube defects
D. No risk of limb defects
Answer: B
Rationale: CVS can be performed earlier (10–12 weeks) than amniocentesis (15–
20 weeks), providing earlier results.
13. A nurse is assessing a pregnant client with hyperemesis gravidarum. Which
finding requires immediate intervention?
A. Nausea with vomiting once daily
B. Potassium 2.9 mEq/L
C. Weight loss of 1 kg
D. Mild dehydration
Answer: B
Rationale: Hypokalemia (potassium <3.0 mEq/L) can cause cardiac dysrhythmias
and requires immediate intervention.
14. Which pelvic type is most favorable for vaginal delivery?
A. Android
B. Anthropoid
C. Gynecoid
D. Platypelloid
Answer: C
Rationale: The gynecoid pelvis has a rounded, oval inlet and straight side walls,
making it most favorable for vaginal birth.
Section 1: Antepartum Care and Fetal Development (Q1–Q30)
1. A client at 10 weeks' gestation asks when she should expect to feel fetal
movement for the first time. The nurse correctly responds that quickening is
typically felt at:
A. 8–10 weeks
B. 12–14 weeks
C. 16–20 weeks
D. 22–24 weeks
Answer: C
Rationale: Quickening, the first perception of fetal movement, is typically felt
between 16 and 20 weeks' gestation, though it may be earlier in multigravida
clients.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose
last menstrual period began on June 5. Using Naegele's rule, what is the EDD?
A. March 5
B. March 12
C. March 19
D. March 26
Answer: B
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP (June
→ March), add 7 days (5 + 7 = 12). EDD is March 12.
3. Which physiologic change in pregnancy increases the risk for supine
hypotensive syndrome?
A. Increased cardiac output
B. Compression of the inferior vena cava by the gravid uterus
C. Decreased blood volume
D. Increased peripheral vascular resistance
Answer: B
Rationale: Supine hypotensive syndrome results from compression of the inferior
vena cava by the enlarged uterus, reducing venous return and cardiac output.
,4. A pregnant client at 32 weeks' gestation reports heartburn. Which instruction
is most appropriate?
A. "Lie down immediately after eating."
B. "Eat three large meals daily."
C. "Avoid spicy foods and eat small, frequent meals."
D. "Drink large amounts of fluid with meals."
Answer: C
Rationale: Progesterone decreases lower esophageal sphincter tone, causing
reflux. Small, frequent meals and avoiding trigger foods reduce symptoms.
5. A nurse is assessing a pregnant client for signs of preeclampsia. Which finding
is most concerning?
A. Blood pressure 118/76 mm Hg
B. 1+ proteinuria
C. Blood pressure 150/96 mm Hg and headache
D. Mild ankle edema
Answer: C
Rationale: Hypertension with headache suggests preeclampsia with severe
features, requiring immediate evaluation.
6. A client at 36 weeks' gestation with placenta previa presents with painless
vaginal bleeding. Which action is contraindicated?
A. Assessing fetal heart rate
B. Performing a vaginal exam
C. Monitoring maternal vital signs
D. Preparing for possible cesarean delivery
Answer: B
Rationale: Vaginal exam is contraindicated with placenta previa because it can
cause severe hemorrhage.
7. Which laboratory test is used to screen for neural tube defects?
A. Maternal serum alpha-fetoprotein (MSAFP)
B. Hemoglobin A1c
C. Urine culture
D. Thyroid-stimulating hormone
,Answer: A
Rationale: MSAFP is a screening test for neural tube defects and chromosomal
abnormalities, performed between 15 and 20 weeks.
8. A client at 28 weeks' gestation is Rh-negative with a negative antibody
screen. When should RhoGAM be administered?
A. At 12 weeks
B. At 28 weeks and within 72 hours postpartum if the infant is Rh-positive
C. Only after delivery
D. At 36 weeks
Answer: B
Rationale: RhoGAM is given at 28 weeks and within 72 hours after delivery if the
newborn is Rh-positive.
9. A nurse is teaching a pregnant client about folic acid. Which statement
indicates correct understanding?
A. "Folic acid prevents gestational diabetes."
B. "Folic acid helps prevent neural tube defects."
C. "Folic acid is only needed in the third trimester."
D. "Folic acid prevents preterm labor."
Answer: B
Rationale: Folic acid is essential for preventing neural tube defects and should be
taken before conception and throughout pregnancy.
10. A client at 34 weeks' gestation reports decreased fetal movement. What is
the priority nursing action?
A. Perform a non-stress test
B. Encourage oral fluids
C. Notify the provider
D. Document the finding
Answer: A
Rationale: Decreased fetal movement requires immediate assessment of fetal
well-being, beginning with a non-stress test.
11. Which finding on a non-stress test is considered reactive?
A. Two accelerations of 15 bpm lasting 15 seconds in 20 minutes
, B. No accelerations in 20 minutes
C. One acceleration of 10 bpm
D. Variable decelerations
Answer: A
Rationale: A reactive NST demonstrates two or more FHR accelerations of at least
15 bpm lasting at least 15 seconds in a 20-minute period.
12. A client at 12 weeks' gestation is scheduled for chorionic villus sampling
(CVS). What is the primary advantage of CVS over amniocentesis?
A. Lower risk of miscarriage
B. Earlier results
C. Can detect neural tube defects
D. No risk of limb defects
Answer: B
Rationale: CVS can be performed earlier (10–12 weeks) than amniocentesis (15–
20 weeks), providing earlier results.
13. A nurse is assessing a pregnant client with hyperemesis gravidarum. Which
finding requires immediate intervention?
A. Nausea with vomiting once daily
B. Potassium 2.9 mEq/L
C. Weight loss of 1 kg
D. Mild dehydration
Answer: B
Rationale: Hypokalemia (potassium <3.0 mEq/L) can cause cardiac dysrhythmias
and requires immediate intervention.
14. Which pelvic type is most favorable for vaginal delivery?
A. Android
B. Anthropoid
C. Gynecoid
D. Platypelloid
Answer: C
Rationale: The gynecoid pelvis has a rounded, oval inlet and straight side walls,
making it most favorable for vaginal birth.
