NSG 3500 MATERNAL EXAM 1 | Actual Test
Questions and Verified Correct Detailed Q&A
Study Guide
Section 1: Questions 1–50
1. A nurse is reviewing reproductive physiology with a student. Which statement by the
student accurately describes a primary function of the male reproductive system?
A. "It produces estrogen and progesterone."
B. "It produces sperm and introduces them into the female body."
C. "Its primary role is to regulate the menstrual cycle."
D. "It nurtures and protects a developing fetus."
Rationale: The primary biological functions of the male reproductive system are the
production of spermatozoa and their delivery into the female reproductive tract.
Estrogen/progesterone production and menstrual cycle regulation are female functions,
and nurturing a fetus occurs in the female uterus .
2. A nurse is teaching a class about male hormones. Which hormone should the nurse
identify as the primary male sex hormone?
A. Estrogen
B. Progesterone
C. Follicle-stimulating hormone
D. Androgens
Rationale: Androgens, primarily testosterone, are the class of hormones responsible for
the development and maintenance of male secondary sexual characteristics and
reproductive function .
3. During a health assessment, a client asks when menarche typically occurs. Which
response by the nurse is accurate?
A. "It is the first ovulation cycle."
B. "It is the cessation of menstrual periods."
C. "It is the first menstrual period."
D. "It is the final stage of menopause."
Rationale: Menarche is defined as the onset of the first menstrual period, marking the
beginning of a female's reproductive years. The cessation of menses is menopause .
4. A nurse is counseling a couple who is trying to conceive. The woman states she
tracks her basal body temperature. The nurse should explain that a rise in basal body
temperature is most indicative of which event?
A. Onset of menses
B. Implantation
C. Ovulation
, D. Peak estrogen production
Rationale: Basal body temperature typically dips slightly just before ovulation and then
rises by about 0.5–1.0°F immediately after ovulation due to the thermogenic effect of
progesterone released from the corpus luteum .
5. A nurse is reviewing a client's chart during the proliferative phase of the menstrual
cycle. Which finding should the nurse anticipate regarding the endometrial lining?
A. It is highly vascular and secretory.
B. It is being shed through menstruation.
C. It is thick, at approximately 10–12 mm.
D. It is thin, at approximately 1–2 mm.
Rationale: During the proliferative phase, estrogen stimulates the endometrium to
rebuild and thicken. Immediately following menstruation, the lining is thin
(approximately 1–2 mm) and progressively thickens .
6. The perinatal nurse explains to a new nurse that a female fetus has developed
ovaries by which gestational age?
A. 8 weeks
B. 10 weeks
C. 12 weeks
D. 16 weeks
Rationale: The ovaries develop in the female fetus by approximately 10 weeks of
gestation .
7. The perinatal nurse explains to an adolescent that ova are produced and estrogen is
secreted at which phase of life?
A. Puberty
B. Birth
C. The climacteric
D. Pregnancy
Rationale: Ova are produced and estrogen is secreted during puberty, marking the
onset of reproductive capability .
8. Which hormone is responsible for regulating oogenesis?
A. Estrogen
B. Follicle-stimulating hormone (FSH)
C. Gonadotropin-releasing hormone (GnRH)
D. Progesterone
Rationale: FSH stimulates the growth and maturation of ovarian follicles, regulating
oogenesis .
9. A nurse is conducting prenatal classes. The nurse explains the incision made to
enlarge the perineal opening for a vaginal birth. What is this incision called?
A. Colposcopy
B. Episiotomy
C. Ligation
D. Septal myotomy
, Rationale: An episiotomy is a surgical incision made in the perineum to enlarge the
vaginal opening for delivery .
10. A pregnant woman has been advised that she has a platypelloid pelvis type. What
action by the prenatal nurse is best?
A. Advise the woman that she may need a cesarean delivery.
B. Reassure the woman that a trial of labor will still be allowed.
C. Tell the woman that this pelvic type is most favorable for birth.
D. Recommend immediate induction of labor.
Rationale: A platypelloid pelvis is flattened and narrow, which may prevent the fetus
from descending through the birth canal, often necessitating cesarean delivery .
11. A woman presents to the OB unit in active labor. She has had no prenatal care and
tells the nurse that the baby's father has gonorrhea. She has not been treated. For
what complication is the newborn at most risk?
A. Pneumonia
B. Skin lesions
C. Blindness
D. Intellectual disability
Rationale: Untreated maternal gonorrhea can be transmitted to the newborn during
vaginal delivery, causing ophthalmia neonatorum, which can lead to blindness if not
treated promptly with erythromycin ointment .
12. A woman presents to the perinatal clinic with abdominal pain. She has missed one
period and, following a transvaginal ultrasound, pregnancy is confirmed. However,
implantation has occurred in the right fallopian tube. The ectopic mass is 3 cm and
has not ruptured. The nurse prepares the patient for which therapy?
A. Laparoscopic salpingostomy
B. Methotrexate
C. Partial salpingectomy
D. Salpingectomy by laparotomy
Rationale: Methotrexate is the treatment of choice for unruptured ectopic pregnancy
with a mass less than 3.5 cm. It is a folic acid antagonist that destroys the rapidly
dividing trophoblastic tissue .
13. The prenatal clinic nurse assesses a woman at 15 weeks gestation. The patient's
blood pressure, measured twice at intervals 1 hour apart with a cuff that fits
appropriately, is 146/96 mm Hg. The nurse understands the patient has which
condition?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Transient hypertension
Rationale: Chronic hypertension is defined as elevated blood pressure (≥140/90 mm
Hg) before 20 weeks gestation. Gestational hypertension occurs after 20 weeks without
proteinuria .
, 14. A woman in her second trimester of pregnancy presents to the perinatal clinic with
complaints of scant vaginal bleeding, abdominal pain, and shoulder pain. What
action should the nurse perform first?
A. Assess her for a history of preterm labor
B. Obtain a blood sample for β-hCG test
C. Prepare the woman for a pelvic exam
D. Request an order for methotrexate
Rationale: Scant vaginal bleeding, abdominal pain, and shoulder pain in the second
trimester suggest a possible ectopic pregnancy or other acute condition. Obtaining a β-
hCG is a priority diagnostic step before further intervention .
15. A nurse is assessing a woman in the perinatal clinic with diagnosed cervical
insufficiency. The woman is in her 18th week of a viable pregnancy. Which action by
the nurse is most appropriate?
A. Assist with obtaining informed consent for a cerclage.
B. Prepare the client for immediate delivery.
C. Administer methotrexate as prescribed.
D. Schedule a follow-up appointment in 4 weeks.
Rationale: Cervical insufficiency in a viable pregnancy is managed with cerclage
placement to reinforce the cervix and prevent preterm birth. Informed consent is
required before the procedure .
16. A pregnant client at 34 weeks' gestation reports a sudden gush of clear fluid from
the vagina. Which assessment finding best confirms rupture of membranes?
A. Fern test showing ferning pattern under microscopy
B. Nitrazine paper turning yellow
C. Presence of leukocytes on wet mount
D. Fundal height increase of 2 cm
Rationale: The fern test detects amniotic fluid crystallization due to sodium chloride
and proteins, producing a fern-like pattern; it is a reliable confirmation of rupture of
membranes. Nitrazine turns blue with alkaline amniotic fluid, not yellow .
17. A laboring client receiving oxytocin has a contraction lasting 95 seconds with a fetal
heart rate showing late decelerations. What is the nurse's priority action?
A. Increase oxytocin rate to strengthen contractions
B. Discontinue oxytocin and administer oxygen
C. Position client supine and monitor closely
D. Document findings and reassess in 30 minutes
Rationale: Late decelerations with prolonged contractions indicate uteroplacental
insufficiency; stopping oxytocin and giving oxygen improves fetal oxygenation.
Increasing oxytocin worsens the condition .
18. A nurse is reviewing the electronic fetal monitor tracing and notes a pattern of
variable decelerations. Which intervention should the nurse implement first?
A. Administer a tocolytic agent
B. Change the client's position
C. Increase intravenous fluid rate
Questions and Verified Correct Detailed Q&A
Study Guide
Section 1: Questions 1–50
1. A nurse is reviewing reproductive physiology with a student. Which statement by the
student accurately describes a primary function of the male reproductive system?
A. "It produces estrogen and progesterone."
B. "It produces sperm and introduces them into the female body."
C. "Its primary role is to regulate the menstrual cycle."
D. "It nurtures and protects a developing fetus."
Rationale: The primary biological functions of the male reproductive system are the
production of spermatozoa and their delivery into the female reproductive tract.
Estrogen/progesterone production and menstrual cycle regulation are female functions,
and nurturing a fetus occurs in the female uterus .
2. A nurse is teaching a class about male hormones. Which hormone should the nurse
identify as the primary male sex hormone?
A. Estrogen
B. Progesterone
C. Follicle-stimulating hormone
D. Androgens
Rationale: Androgens, primarily testosterone, are the class of hormones responsible for
the development and maintenance of male secondary sexual characteristics and
reproductive function .
3. During a health assessment, a client asks when menarche typically occurs. Which
response by the nurse is accurate?
A. "It is the first ovulation cycle."
B. "It is the cessation of menstrual periods."
C. "It is the first menstrual period."
D. "It is the final stage of menopause."
Rationale: Menarche is defined as the onset of the first menstrual period, marking the
beginning of a female's reproductive years. The cessation of menses is menopause .
4. A nurse is counseling a couple who is trying to conceive. The woman states she
tracks her basal body temperature. The nurse should explain that a rise in basal body
temperature is most indicative of which event?
A. Onset of menses
B. Implantation
C. Ovulation
, D. Peak estrogen production
Rationale: Basal body temperature typically dips slightly just before ovulation and then
rises by about 0.5–1.0°F immediately after ovulation due to the thermogenic effect of
progesterone released from the corpus luteum .
5. A nurse is reviewing a client's chart during the proliferative phase of the menstrual
cycle. Which finding should the nurse anticipate regarding the endometrial lining?
A. It is highly vascular and secretory.
B. It is being shed through menstruation.
C. It is thick, at approximately 10–12 mm.
D. It is thin, at approximately 1–2 mm.
Rationale: During the proliferative phase, estrogen stimulates the endometrium to
rebuild and thicken. Immediately following menstruation, the lining is thin
(approximately 1–2 mm) and progressively thickens .
6. The perinatal nurse explains to a new nurse that a female fetus has developed
ovaries by which gestational age?
A. 8 weeks
B. 10 weeks
C. 12 weeks
D. 16 weeks
Rationale: The ovaries develop in the female fetus by approximately 10 weeks of
gestation .
7. The perinatal nurse explains to an adolescent that ova are produced and estrogen is
secreted at which phase of life?
A. Puberty
B. Birth
C. The climacteric
D. Pregnancy
Rationale: Ova are produced and estrogen is secreted during puberty, marking the
onset of reproductive capability .
8. Which hormone is responsible for regulating oogenesis?
A. Estrogen
B. Follicle-stimulating hormone (FSH)
C. Gonadotropin-releasing hormone (GnRH)
D. Progesterone
Rationale: FSH stimulates the growth and maturation of ovarian follicles, regulating
oogenesis .
9. A nurse is conducting prenatal classes. The nurse explains the incision made to
enlarge the perineal opening for a vaginal birth. What is this incision called?
A. Colposcopy
B. Episiotomy
C. Ligation
D. Septal myotomy
, Rationale: An episiotomy is a surgical incision made in the perineum to enlarge the
vaginal opening for delivery .
10. A pregnant woman has been advised that she has a platypelloid pelvis type. What
action by the prenatal nurse is best?
A. Advise the woman that she may need a cesarean delivery.
B. Reassure the woman that a trial of labor will still be allowed.
C. Tell the woman that this pelvic type is most favorable for birth.
D. Recommend immediate induction of labor.
Rationale: A platypelloid pelvis is flattened and narrow, which may prevent the fetus
from descending through the birth canal, often necessitating cesarean delivery .
11. A woman presents to the OB unit in active labor. She has had no prenatal care and
tells the nurse that the baby's father has gonorrhea. She has not been treated. For
what complication is the newborn at most risk?
A. Pneumonia
B. Skin lesions
C. Blindness
D. Intellectual disability
Rationale: Untreated maternal gonorrhea can be transmitted to the newborn during
vaginal delivery, causing ophthalmia neonatorum, which can lead to blindness if not
treated promptly with erythromycin ointment .
12. A woman presents to the perinatal clinic with abdominal pain. She has missed one
period and, following a transvaginal ultrasound, pregnancy is confirmed. However,
implantation has occurred in the right fallopian tube. The ectopic mass is 3 cm and
has not ruptured. The nurse prepares the patient for which therapy?
A. Laparoscopic salpingostomy
B. Methotrexate
C. Partial salpingectomy
D. Salpingectomy by laparotomy
Rationale: Methotrexate is the treatment of choice for unruptured ectopic pregnancy
with a mass less than 3.5 cm. It is a folic acid antagonist that destroys the rapidly
dividing trophoblastic tissue .
13. The prenatal clinic nurse assesses a woman at 15 weeks gestation. The patient's
blood pressure, measured twice at intervals 1 hour apart with a cuff that fits
appropriately, is 146/96 mm Hg. The nurse understands the patient has which
condition?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Transient hypertension
Rationale: Chronic hypertension is defined as elevated blood pressure (≥140/90 mm
Hg) before 20 weeks gestation. Gestational hypertension occurs after 20 weeks without
proteinuria .
, 14. A woman in her second trimester of pregnancy presents to the perinatal clinic with
complaints of scant vaginal bleeding, abdominal pain, and shoulder pain. What
action should the nurse perform first?
A. Assess her for a history of preterm labor
B. Obtain a blood sample for β-hCG test
C. Prepare the woman for a pelvic exam
D. Request an order for methotrexate
Rationale: Scant vaginal bleeding, abdominal pain, and shoulder pain in the second
trimester suggest a possible ectopic pregnancy or other acute condition. Obtaining a β-
hCG is a priority diagnostic step before further intervention .
15. A nurse is assessing a woman in the perinatal clinic with diagnosed cervical
insufficiency. The woman is in her 18th week of a viable pregnancy. Which action by
the nurse is most appropriate?
A. Assist with obtaining informed consent for a cerclage.
B. Prepare the client for immediate delivery.
C. Administer methotrexate as prescribed.
D. Schedule a follow-up appointment in 4 weeks.
Rationale: Cervical insufficiency in a viable pregnancy is managed with cerclage
placement to reinforce the cervix and prevent preterm birth. Informed consent is
required before the procedure .
16. A pregnant client at 34 weeks' gestation reports a sudden gush of clear fluid from
the vagina. Which assessment finding best confirms rupture of membranes?
A. Fern test showing ferning pattern under microscopy
B. Nitrazine paper turning yellow
C. Presence of leukocytes on wet mount
D. Fundal height increase of 2 cm
Rationale: The fern test detects amniotic fluid crystallization due to sodium chloride
and proteins, producing a fern-like pattern; it is a reliable confirmation of rupture of
membranes. Nitrazine turns blue with alkaline amniotic fluid, not yellow .
17. A laboring client receiving oxytocin has a contraction lasting 95 seconds with a fetal
heart rate showing late decelerations. What is the nurse's priority action?
A. Increase oxytocin rate to strengthen contractions
B. Discontinue oxytocin and administer oxygen
C. Position client supine and monitor closely
D. Document findings and reassess in 30 minutes
Rationale: Late decelerations with prolonged contractions indicate uteroplacental
insufficiency; stopping oxytocin and giving oxygen improves fetal oxygenation.
Increasing oxytocin worsens the condition .
18. A nurse is reviewing the electronic fetal monitor tracing and notes a pattern of
variable decelerations. Which intervention should the nurse implement first?
A. Administer a tocolytic agent
B. Change the client's position
C. Increase intravenous fluid rate
