NUR 129 – MATERNAL-NEWBORN
NURSING | COMPLETE STUDY GUIDE
Comprehensive -Question Examination with
Answers and Rationales
Question 1
A nurse is caring for a client at 12 weeks gestation. Which physiological change
would the nurse expect to assess?
• A. Decreased heart rate
• B. Increased blood pressure
• C. Increased maternal blood volume
• D. Decreased cardiac output
Answer: C. Increased maternal blood volume
Rationale: Maternal blood volume increases by approximately 40–50% during
pregnancy, peaking at 32–34 weeks gestation. This increase supports fetal
oxygenation and nutrient delivery. Heart rate increases (not decreases), blood
pressure slightly decreases in the second trimester, and cardiac output increases
(not decreases).
Question 2
The nurse is assessing a pregnant client at 16 weeks gestation. Which finding
should be reported to the healthcare provider?
• A. Quickening
• B. Striae gravidarum
• C. Epistaxis
• D. Persistent vomiting with weight loss
Answer: D. Persistent vomiting with weight loss
,Rationale: Persistent vomiting with weight loss may indicate hyperemesis
gravidarum, a severe form of nausea and vomiting during pregnancy that can lead
to dehydration, electrolyte imbalances, and nutritional deficiencies. This requires
medical evaluation and intervention.
Question 3
A primigravida at 8 weeks gestation asks the nurse if she can continue to have
intercourse during pregnancy. The nurse's best response is:
• A. "Sexual intercourse is contraindicated throughout pregnancy."
• B. "Intercourse is safe as long as you do not have vaginal bleeding, ruptured
membranes, or preterm labor."
• C. "You should avoid intercourse until after the first trimester."
• D. "Intercourse is only safe during the second trimester."
Answer: B. "Intercourse is safe as long as you do not have vaginal bleeding,
ruptured membranes, or preterm labor."
Rationale: Sexual intercourse is safe during pregnancy unless contraindicated by
conditions such as vaginal bleeding, ruptured membranes, placenta previa, or
history of preterm labor. Couples should be educated on positions that are
comfortable and safe.
Question 4
The nurse is calculating the estimated date of birth (EDB) using Naegele's rule for
a client whose last menstrual period (LMP) was May 10, 2025. What is the
estimated date of birth?
• A. February 17, 2026
• B. February 10, 2026
• C. March 10, 2026
• D. March 17, 2026
Answer: A. February 17, 2026
,Rationale: Naegele's rule: Add 7 days to the first day of the LMP and subtract 3
months. May 10 + 7 days = May 17; May 17 – 3 months = February 17.
Alternatively, add 9 months and 7 days: May 10 → February 10 + 7 days =
February 17, 2026.
Question 5
A nurse is assessing a client at 24 weeks gestation. The fundal height is measured
at 20 cm. What is the most appropriate action?
• A. Document the measurement as normal
• B. Reassess the client in 4 weeks
• C. Notify the healthcare provider of the measurement
• D. Instruct the client to increase food intake
Answer: C. Notify the healthcare provider of the measurement
Rationale: Fundal height in centimeters should correlate with weeks of gestation
(±2 cm). At 24 weeks, the fundal height should be 22–26 cm. A measurement of
20 cm indicates the uterus is smaller than expected, which may suggest intrauterine
growth restriction (IUGR), oligohydramnios, or inaccurate dates.
Question 6
A pregnant client at 28 weeks gestation has a positive glucose screening test. What
is the next step in management?
• A. Begin insulin therapy immediately
• B. Schedule a 3-hour oral glucose tolerance test (OGTT)
• C. Recommend a low-carbohydrate diet
• D. Repeat the 1-hour glucose screening in 2 weeks
Answer: B. Schedule a 3-hour oral glucose tolerance test (OGTT)
Rationale: A positive 1-hour glucose challenge test (GCT) (≥130–140 mg/dL,
depending on facility protocol) indicates the need for a diagnostic 3-hour OGTT to
confirm gestational diabetes mellitus (GDM). Insulin therapy is not initiated until a
, diagnosis is confirmed and glycemic control is inadequate with lifestyle
modifications.
Question 7
Which of the following is considered a presumptive sign of pregnancy?
• A. Positive pregnancy test
• B. Fetal heart tones
• C. Quickening
• D. Chadwick's sign
Answer: C. Quickening
Rationale: Quickening (fetal movement felt by the mother) is a presumptive sign
of pregnancy, as it can be subjective and mimicked by other conditions. Positive
pregnancy test is a probable sign; fetal heart tones are a positive (definitive) sign;
Chadwick's sign (bluish discoloration of the cervix) is a probable sign.
Question 8
A nurse is educating a client about prenatal nutrition. Which statement indicates
the client understands teaching?
• A. "I need to double my calorie intake during pregnancy."
• B. "I should consume about 300 extra calories per day during the second and
third trimesters."
• C. "Calorie intake doesn't change during pregnancy."
• D. "I only need extra calories during the third trimester."
Answer: B. "I should consume about 300 extra calories per day during the
second and third trimesters."
Rationale: Caloric needs increase by about 300–350 calories per day during the
second and third trimesters. A complete doubling of calorie intake is unnecessary
and unhealthy. The first trimester typically requires no extra calories.
NURSING | COMPLETE STUDY GUIDE
Comprehensive -Question Examination with
Answers and Rationales
Question 1
A nurse is caring for a client at 12 weeks gestation. Which physiological change
would the nurse expect to assess?
• A. Decreased heart rate
• B. Increased blood pressure
• C. Increased maternal blood volume
• D. Decreased cardiac output
Answer: C. Increased maternal blood volume
Rationale: Maternal blood volume increases by approximately 40–50% during
pregnancy, peaking at 32–34 weeks gestation. This increase supports fetal
oxygenation and nutrient delivery. Heart rate increases (not decreases), blood
pressure slightly decreases in the second trimester, and cardiac output increases
(not decreases).
Question 2
The nurse is assessing a pregnant client at 16 weeks gestation. Which finding
should be reported to the healthcare provider?
• A. Quickening
• B. Striae gravidarum
• C. Epistaxis
• D. Persistent vomiting with weight loss
Answer: D. Persistent vomiting with weight loss
,Rationale: Persistent vomiting with weight loss may indicate hyperemesis
gravidarum, a severe form of nausea and vomiting during pregnancy that can lead
to dehydration, electrolyte imbalances, and nutritional deficiencies. This requires
medical evaluation and intervention.
Question 3
A primigravida at 8 weeks gestation asks the nurse if she can continue to have
intercourse during pregnancy. The nurse's best response is:
• A. "Sexual intercourse is contraindicated throughout pregnancy."
• B. "Intercourse is safe as long as you do not have vaginal bleeding, ruptured
membranes, or preterm labor."
• C. "You should avoid intercourse until after the first trimester."
• D. "Intercourse is only safe during the second trimester."
Answer: B. "Intercourse is safe as long as you do not have vaginal bleeding,
ruptured membranes, or preterm labor."
Rationale: Sexual intercourse is safe during pregnancy unless contraindicated by
conditions such as vaginal bleeding, ruptured membranes, placenta previa, or
history of preterm labor. Couples should be educated on positions that are
comfortable and safe.
Question 4
The nurse is calculating the estimated date of birth (EDB) using Naegele's rule for
a client whose last menstrual period (LMP) was May 10, 2025. What is the
estimated date of birth?
• A. February 17, 2026
• B. February 10, 2026
• C. March 10, 2026
• D. March 17, 2026
Answer: A. February 17, 2026
,Rationale: Naegele's rule: Add 7 days to the first day of the LMP and subtract 3
months. May 10 + 7 days = May 17; May 17 – 3 months = February 17.
Alternatively, add 9 months and 7 days: May 10 → February 10 + 7 days =
February 17, 2026.
Question 5
A nurse is assessing a client at 24 weeks gestation. The fundal height is measured
at 20 cm. What is the most appropriate action?
• A. Document the measurement as normal
• B. Reassess the client in 4 weeks
• C. Notify the healthcare provider of the measurement
• D. Instruct the client to increase food intake
Answer: C. Notify the healthcare provider of the measurement
Rationale: Fundal height in centimeters should correlate with weeks of gestation
(±2 cm). At 24 weeks, the fundal height should be 22–26 cm. A measurement of
20 cm indicates the uterus is smaller than expected, which may suggest intrauterine
growth restriction (IUGR), oligohydramnios, or inaccurate dates.
Question 6
A pregnant client at 28 weeks gestation has a positive glucose screening test. What
is the next step in management?
• A. Begin insulin therapy immediately
• B. Schedule a 3-hour oral glucose tolerance test (OGTT)
• C. Recommend a low-carbohydrate diet
• D. Repeat the 1-hour glucose screening in 2 weeks
Answer: B. Schedule a 3-hour oral glucose tolerance test (OGTT)
Rationale: A positive 1-hour glucose challenge test (GCT) (≥130–140 mg/dL,
depending on facility protocol) indicates the need for a diagnostic 3-hour OGTT to
confirm gestational diabetes mellitus (GDM). Insulin therapy is not initiated until a
, diagnosis is confirmed and glycemic control is inadequate with lifestyle
modifications.
Question 7
Which of the following is considered a presumptive sign of pregnancy?
• A. Positive pregnancy test
• B. Fetal heart tones
• C. Quickening
• D. Chadwick's sign
Answer: C. Quickening
Rationale: Quickening (fetal movement felt by the mother) is a presumptive sign
of pregnancy, as it can be subjective and mimicked by other conditions. Positive
pregnancy test is a probable sign; fetal heart tones are a positive (definitive) sign;
Chadwick's sign (bluish discoloration of the cervix) is a probable sign.
Question 8
A nurse is educating a client about prenatal nutrition. Which statement indicates
the client understands teaching?
• A. "I need to double my calorie intake during pregnancy."
• B. "I should consume about 300 extra calories per day during the second and
third trimesters."
• C. "Calorie intake doesn't change during pregnancy."
• D. "I only need extra calories during the third trimester."
Answer: B. "I should consume about 300 extra calories per day during the
second and third trimesters."
Rationale: Caloric needs increase by about 300–350 calories per day during the
second and third trimesters. A complete doubling of calorie intake is unnecessary
and unhealthy. The first trimester typically requires no extra calories.
