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SECTION 1: Antepartum Care & Assessment
(Questions 1–12)
Q1: A pregnant client at 12 weeks gestation asks the nurse when she should expect
to feel fetal movement. Which response is most accurate?
A. "You should feel movement by 8 weeks gestation."
B. "Most first-time mothers feel movement between 18 and 20 weeks gestation."
[CORRECT]
C. "Fetal movement is not felt until the third trimester."
D. "You will feel movement by 14 weeks at the latest."
Correct Answer: B
Rationale: Correct because quickening, the first perception of fetal movement,
typically occurs between 18–20 weeks for nulliparous women and 16–18 weeks for
multiparous women.
Q2: Which laboratory value is expected to increase during pregnancy due to
hemodilution?
A. Hemoglobin
B. Hematocrit
C. Plasma volume [CORRECT]
D. Red blood cell count
Correct Answer: C
Rationale: Correct because plasma volume increases by 40–50% during pregnancy,
exceeding the 20–30% increase in red blood cell mass, resulting in physiologic
anemia of pregnancy.
,Q3: A pregnant client at 28 weeks gestation reports swelling in her ankles at the end
of the day. Which assessment finding would indicate that the edema is physiologic
rather than pathologic?
A. Edema that is present upon waking and does not resolve with rest
B. Edema that is 2+ or greater and accompanied by headache
C. Edema that resolves with rest and elevation and is not accompanied by
hypertension or proteinuria [CORRECT]
D. Edema that is generalized and includes the face and hands
Correct Answer: C
Rationale: Correct because physiologic edema in pregnancy is dependent, bilateral,
and resolves with rest and elevation; pathologic edema associated with
preeclampsia involves the face and hands and does not resolve.
Q4: Which prenatal screening test is routinely offered between 15 and 22 weeks
gestation to assess for neural tube defects and chromosomal abnormalities?
A. Chorionic villus sampling
B. Nuchal translucency ultrasound
C. Maternal serum alpha-fetoprotein (MSAFP) screening [CORRECT]
D. Amniocentesis
Correct Answer: C
Rationale: Correct because MSAFP screening is a non-invasive blood test performed
between 15–22 weeks to detect elevated AFP levels associated with neural tube
defects and low levels associated with Down syndrome.
Q5: A pregnant client at 32 weeks gestation reports decreased fetal movement.
Which nursing intervention is the priority?
A. Reassure the client that decreased movement is normal at this gestational age.
B. Instruct the client to perform daily kick counts and report fewer than 10
movements in 2 hours. [CORRECT]
C. Schedule a non-stress test for the following week.
D. Advise the client to drink a glass of cold water and call only if no movement is felt
within 24 hours.
Correct Answer: B
Rationale: Correct because kick counts are a simple, effective method of fetal
surveillance; fewer than 10 movements in 2 hours warrants immediate evaluation
with a non-stress test or biophysical profile.
Q6: Which fundal height measurement at 24 weeks gestation is considered within
normal limits?
, A. 16 cm
B. 20 cm
C. 24 cm [CORRECT]
D. 30 cm
Correct Answer: C
Rationale: Correct because fundal height in centimeters approximately corresponds
to weeks of gestation between 20–36 weeks; 24 cm at 24 weeks is consistent with
normal fetal growth.
Q7: A pregnant client is Rh-negative and the father is Rh-positive. At what gestational
age should the nurse anticipate administration of Rho(D) immune globulin
(RhoGAM)?
A. 12 weeks and again at delivery
B. 28 weeks and within 72 hours after delivery if the infant is Rh-positive [CORRECT]
C. 20 weeks and again at 36 weeks
D. Only after delivery if the infant is Rh-positive
Correct Answer: B
Rationale: Correct because RhoGAM is administered at 28 weeks gestation as
antepartum prophylaxis and postpartum within 72 hours if the infant is Rh-positive to
prevent Rh sensitization.
Q8: Which dietary recommendation is most appropriate for a pregnant client to
support fetal neural tube development?
A. Increase calcium intake to 1,500 mg daily.
B. Take 400–800 mcg of folic acid daily. [CORRECT]
C. Limit protein intake to 40 g daily.
D. Avoid all sources of iron supplementation.
Correct Answer: B
Rationale: Correct because adequate folic acid intake before conception and during
early pregnancy reduces the risk of neural tube defects by supporting proper neural
tube closure.
Q9: A pregnant client at 36 weeks gestation reports regular, painful contractions
every 5 minutes. Vaginal examination reveals the cervix is 3 cm dilated, 80% effaced,
and the presenting part is at 0 station. Which stage of labor is this client in?
A. Prelabor
B. Latent phase of the first stage of labor [CORRECT]
C. Active phase of the first stage of labor
D. Second stage of labor