NUR 2513
MATERNAL CHILD NURSING
EXAM 1 TESTBANK
Latest 2026/2027 Course Content
Comprehensive Obstetric and Pediatric Nursing Application
Rasmussen College NUR 2513 Curriculum Aligned
100 Questions with Verified Answers and A+ Graded Rationales
NCLEX-RN Maternal-Newborn Nursing Competencies
Sections: Antepartum | Intrapartum | Postpartum | Newborn | Clinical Scenarios
,SECTION 1: ANTEPARTUM NURSING
Prenatal Care, Fetal Development, Maternal Adaptations, and Risk Factors (Questions 1-30)
Q1. A pregnant client at 4 weeks gestation asks the nurse when the fetal heart begins to beat. Which response
by the nurse is accurate?
A. The fetal heart begins beating at approximately 6 weeks gestation
B. The fetal heart begins beating at approximately 4 weeks gestation [CORRECT]
C. The fetal heart begins beating at approximately 8 weeks gestation
D. The fetal heart begins beating at approximately 10 weeks gestation
Correct Answer: B
Rationale: The fetal heart begins to beat at approximately 4 weeks gestation, which is a critical milestone in early fetal
development detectable by transvaginal ultrasound. The 6-week and 8-week marks represent when the heartbeat becomes
more reliably detectable and audible, respectively, but initiation occurs earlier. Understanding this timeline is essential for
Rasmussen NUR 2513 nurses when counseling patients about early pregnancy milestones and interpreting ultrasound
findings.
Q2. A nurse is performing a prenatal assessment on a client at 20 weeks gestation. Where should the nurse
expect to palpate the fundal height?
A. At the level of the symphysis pubis
B. At the level of the umbilicus [CORRECT]
C. Midway between the symphysis pubis and the umbilicus
D. Just above the umbilicus
Correct Answer: B
Rationale: At 20 weeks gestation, the fundal height is expected to be at the level of the umbilicus, which is a standard
clinical landmark used to estimate gestational age during prenatal care. At 12 weeks the fundus is at the symphysis pubis,
and at 16 weeks it is midway between the symphysis and umbilicus. This assessment is a fundamental skill in NUR 2513
maternal-child nursing for monitoring fetal growth and detecting potential complications such as intrauterine growth
restriction or macrosomia.
Q3. A prenatal nurse observes a blue-purple discoloration of the cervix, vagina, and vulva during a pelvic
examination of a client at 8 weeks gestation. The nurse documents this finding as which of the following?
A. Goodell's sign
B. Hegar's sign
C. Chadwick's sign [CORRECT]
D. Montgomery's tubercles
Correct Answer: C
Rationale: Chadwick's sign is the blue-purple discoloration of the cervix, vagina, and vulva caused by increased
vascularity and blood flow to the pelvic organs during pregnancy, typically visible at 6-8 weeks. Goodell's sign refers to
softening of the cervix, Hegar's sign refers to softening of the lower uterine segment, and Montgomery's tubercles are
enlarged sebaceous glands on the areolae. Differentiating these signs is a core competency for NUR 2513 students
performing prenatal assessments.
Q4. A nurse is assessing a pregnant client at 6 weeks gestation and notes softening of the cervix upon bimanual
examination. This finding is documented as:
A. Chadwick's sign
B. Goodell's sign [CORRECT]
C. Hegar's sign
D. Braxton Hicks contractions
2
,Correct Answer: B
Rationale: Goodell's sign is the softening of the cervix that occurs at approximately 6 weeks gestation due to increased
vascularity and hormonal effects of progesterone. Hegar's sign involves softening of the lower uterine segment rather than
the cervix, Chadwick's sign involves color change, and Braxton Hicks contractions are painless uterine contractions that
occur later in pregnancy. Accurate identification of these presumptive signs of pregnancy is essential for NUR 2513
clinical reasoning and documentation.
Q5. During a prenatal visit, a nurse observes enlarged sebaceous glands on the areolae of a pregnant client's
breasts. The nurse correctly identifies these as:
A. Chadwick's sign
B. Goodell's sign
C. Hegar's sign
D. Montgomery's tubercles [CORRECT]
Correct Answer: D
Rationale: Montgomery's tubercles are enlarged sebaceous glands on the areolae that become prominent during pregnancy
due to hormonal stimulation, and they serve to lubricate and protect the nipples during breastfeeding. Chadwick's sign,
Goodell's sign, and Hegar's sign are all related to cervical and uterine changes, not breast changes. Recognition of
Montgomery's tubercles is part of the comprehensive breast assessment taught in the Rasmussen NUR 2513 maternal
adaptation curriculum.
Q6. A nurse is educating a pregnant client about cardiovascular adaptations during pregnancy. Which
statement by the nurse is correct?
A. Blood volume increases by 20-30% during pregnancy
B. Cardiac output decreases by 10-15% during pregnancy
C. Blood volume increases by 40-50% during pregnancy [CORRECT]
D. Cardiac output remains unchanged throughout pregnancy
Correct Answer: C
Rationale: Blood volume increases by 40-50% during pregnancy to meet the increased metabolic demands of the mother
and fetus, and to provide a reserve for blood loss at delivery. Cardiac output also increases by 30-50%, not decreases.
These cardiovascular adaptations are among the most significant physiological changes in pregnancy and are a key focus
of the Rasmussen NUR 2513 antepartum nursing curriculum. Understanding these changes helps nurses identify abnormal
findings such as those seen in preeclampsia or cardiac decompensation.
Q7. A pregnant client at 28 weeks gestation reports increased shortness of breath. The nurse explains that
during pregnancy, oxygen consumption increases by approximately what percentage?
A. 5%
B. 10%
C. 15% [CORRECT]
D. 25%
Correct Answer: C
Rationale: Oxygen consumption increases by approximately 15% during pregnancy to meet the metabolic demands of the
growing fetus and placenta. The tidal volume also increases while the respiratory rate remains relatively unchanged,
allowing for improved gas exchange. This physiological adaptation is a critical concept in the NUR 2513 curriculum
because it helps nurses distinguish between normal dyspnea of pregnancy and pathological respiratory conditions that
require further evaluation and intervention.
Q8. A nurse is providing dietary counseling to a pregnant client who reports frequent constipation and
heartburn. The nurse explains that these symptoms are primarily caused by which hormone?
A. Estrogen
B. Progesterone [CORRECT]
3
, C. Human chorionic gonadotropin (hCG)
D. Relaxin
Correct Answer: B
Rationale: Progesterone slows gastrointestinal motility during pregnancy, leading to increased transit time, which results in
constipation and increased risk of heartburn due to esophageal sphincter relaxation. While estrogen, hCG, and relaxin all
play roles in pregnancy, progesterone is the primary hormone responsible for GI changes. This knowledge is essential for
NUR 2513 nurses when providing anticipatory guidance and recommending dietary modifications, fiber intake, and
hydration to manage these common pregnancy complaints.
Q9. A nurse is reviewing first trimester screening results for a pregnant client. Which screening tests are
typically performed during the first trimester?
A. Glucose tolerance test and Group B Streptococcus screening
B. hCG, PAPP-A, and nuchal translucency screening at 11-13 weeks [CORRECT]
C. Maternal serum alpha-fetoprotein and amniocentesis
D. Non-stress test and biophysical profile
Correct Answer: B
Rationale: First trimester screening includes hCG (human chorionic gonadotropin), PAPP-A (pregnancy-associated plasma
protein A), and nuchal translucency ultrasound measurement performed between 11-13 weeks gestation to assess risk for
chromosomal abnormalities. The glucose tolerance test is performed at 24-28 weeks, GBS screening at 35-37 weeks, and
NST/BPP are third-trimester tests. Understanding the timing and purpose of each prenatal screening is a core competency
in the Rasmussen NUR 2513 prenatal care module.
Q10. A pregnant client's maternal serum alpha-fetoprotein (MSAFP) level is elevated. The nurse understands
that this finding may indicate which condition?
A. Down syndrome (trisomy 21)
B. Edwards syndrome (trisomy 18)
C. Neural tube defects such as spina bifida or anencephaly [CORRECT]
D. Gestational diabetes
Correct Answer: C
Rationale: Elevated MSAFP levels are associated with open neural tube defects such as spina bifida and anencephaly
because alpha-fetoprotein leaks from the fetal circulation into the amniotic fluid and maternal bloodstream through the
open defect. Decreased MSAFP is associated with Down syndrome and Edwards syndrome. This finding would be
confirmed by amniocentesis and targeted ultrasound. Understanding MSAFP interpretation is a critical prenatal screening
competency in the NUR 2513 curriculum for identifying fetal abnormalities and planning appropriate follow-up care.
Q11. A pregnant client at 25 weeks gestation has a 50g glucose challenge test result of 145 mg/dL. What is the
appropriate next step in management?
A. Diagnose the client with gestational diabetes and begin insulin therapy
B. Schedule a 100g 3-hour oral glucose tolerance test for further evaluation [CORRECT]
C. Repeat the 50g glucose challenge test in 2 weeks
D. Reassure the client that this is a normal result and no further testing is needed
Correct Answer: B
Rationale: A 50g glucose challenge test result of 145 mg/dL is above the threshold of 140 mg/dL and requires follow-up
with a 100g 3-hour oral glucose tolerance test (OGTT) for definitive diagnosis of gestational diabetes. The GCT is a
screening tool, not a diagnostic test, so insulin therapy would be premature. Repeating the GCT delays necessary
evaluation, and this result is not normal. This two-step screening approach is a standard of care in the Rasmussen NUR
2513 prenatal management curriculum for detecting and managing gestational diabetes.
Q12. A nurse is caring for a pregnant client at 36 weeks gestation whose Group B Streptococcus (GBS)
screening is positive. Which intervention is most appropriate?
4
MATERNAL CHILD NURSING
EXAM 1 TESTBANK
Latest 2026/2027 Course Content
Comprehensive Obstetric and Pediatric Nursing Application
Rasmussen College NUR 2513 Curriculum Aligned
100 Questions with Verified Answers and A+ Graded Rationales
NCLEX-RN Maternal-Newborn Nursing Competencies
Sections: Antepartum | Intrapartum | Postpartum | Newborn | Clinical Scenarios
,SECTION 1: ANTEPARTUM NURSING
Prenatal Care, Fetal Development, Maternal Adaptations, and Risk Factors (Questions 1-30)
Q1. A pregnant client at 4 weeks gestation asks the nurse when the fetal heart begins to beat. Which response
by the nurse is accurate?
A. The fetal heart begins beating at approximately 6 weeks gestation
B. The fetal heart begins beating at approximately 4 weeks gestation [CORRECT]
C. The fetal heart begins beating at approximately 8 weeks gestation
D. The fetal heart begins beating at approximately 10 weeks gestation
Correct Answer: B
Rationale: The fetal heart begins to beat at approximately 4 weeks gestation, which is a critical milestone in early fetal
development detectable by transvaginal ultrasound. The 6-week and 8-week marks represent when the heartbeat becomes
more reliably detectable and audible, respectively, but initiation occurs earlier. Understanding this timeline is essential for
Rasmussen NUR 2513 nurses when counseling patients about early pregnancy milestones and interpreting ultrasound
findings.
Q2. A nurse is performing a prenatal assessment on a client at 20 weeks gestation. Where should the nurse
expect to palpate the fundal height?
A. At the level of the symphysis pubis
B. At the level of the umbilicus [CORRECT]
C. Midway between the symphysis pubis and the umbilicus
D. Just above the umbilicus
Correct Answer: B
Rationale: At 20 weeks gestation, the fundal height is expected to be at the level of the umbilicus, which is a standard
clinical landmark used to estimate gestational age during prenatal care. At 12 weeks the fundus is at the symphysis pubis,
and at 16 weeks it is midway between the symphysis and umbilicus. This assessment is a fundamental skill in NUR 2513
maternal-child nursing for monitoring fetal growth and detecting potential complications such as intrauterine growth
restriction or macrosomia.
Q3. A prenatal nurse observes a blue-purple discoloration of the cervix, vagina, and vulva during a pelvic
examination of a client at 8 weeks gestation. The nurse documents this finding as which of the following?
A. Goodell's sign
B. Hegar's sign
C. Chadwick's sign [CORRECT]
D. Montgomery's tubercles
Correct Answer: C
Rationale: Chadwick's sign is the blue-purple discoloration of the cervix, vagina, and vulva caused by increased
vascularity and blood flow to the pelvic organs during pregnancy, typically visible at 6-8 weeks. Goodell's sign refers to
softening of the cervix, Hegar's sign refers to softening of the lower uterine segment, and Montgomery's tubercles are
enlarged sebaceous glands on the areolae. Differentiating these signs is a core competency for NUR 2513 students
performing prenatal assessments.
Q4. A nurse is assessing a pregnant client at 6 weeks gestation and notes softening of the cervix upon bimanual
examination. This finding is documented as:
A. Chadwick's sign
B. Goodell's sign [CORRECT]
C. Hegar's sign
D. Braxton Hicks contractions
2
,Correct Answer: B
Rationale: Goodell's sign is the softening of the cervix that occurs at approximately 6 weeks gestation due to increased
vascularity and hormonal effects of progesterone. Hegar's sign involves softening of the lower uterine segment rather than
the cervix, Chadwick's sign involves color change, and Braxton Hicks contractions are painless uterine contractions that
occur later in pregnancy. Accurate identification of these presumptive signs of pregnancy is essential for NUR 2513
clinical reasoning and documentation.
Q5. During a prenatal visit, a nurse observes enlarged sebaceous glands on the areolae of a pregnant client's
breasts. The nurse correctly identifies these as:
A. Chadwick's sign
B. Goodell's sign
C. Hegar's sign
D. Montgomery's tubercles [CORRECT]
Correct Answer: D
Rationale: Montgomery's tubercles are enlarged sebaceous glands on the areolae that become prominent during pregnancy
due to hormonal stimulation, and they serve to lubricate and protect the nipples during breastfeeding. Chadwick's sign,
Goodell's sign, and Hegar's sign are all related to cervical and uterine changes, not breast changes. Recognition of
Montgomery's tubercles is part of the comprehensive breast assessment taught in the Rasmussen NUR 2513 maternal
adaptation curriculum.
Q6. A nurse is educating a pregnant client about cardiovascular adaptations during pregnancy. Which
statement by the nurse is correct?
A. Blood volume increases by 20-30% during pregnancy
B. Cardiac output decreases by 10-15% during pregnancy
C. Blood volume increases by 40-50% during pregnancy [CORRECT]
D. Cardiac output remains unchanged throughout pregnancy
Correct Answer: C
Rationale: Blood volume increases by 40-50% during pregnancy to meet the increased metabolic demands of the mother
and fetus, and to provide a reserve for blood loss at delivery. Cardiac output also increases by 30-50%, not decreases.
These cardiovascular adaptations are among the most significant physiological changes in pregnancy and are a key focus
of the Rasmussen NUR 2513 antepartum nursing curriculum. Understanding these changes helps nurses identify abnormal
findings such as those seen in preeclampsia or cardiac decompensation.
Q7. A pregnant client at 28 weeks gestation reports increased shortness of breath. The nurse explains that
during pregnancy, oxygen consumption increases by approximately what percentage?
A. 5%
B. 10%
C. 15% [CORRECT]
D. 25%
Correct Answer: C
Rationale: Oxygen consumption increases by approximately 15% during pregnancy to meet the metabolic demands of the
growing fetus and placenta. The tidal volume also increases while the respiratory rate remains relatively unchanged,
allowing for improved gas exchange. This physiological adaptation is a critical concept in the NUR 2513 curriculum
because it helps nurses distinguish between normal dyspnea of pregnancy and pathological respiratory conditions that
require further evaluation and intervention.
Q8. A nurse is providing dietary counseling to a pregnant client who reports frequent constipation and
heartburn. The nurse explains that these symptoms are primarily caused by which hormone?
A. Estrogen
B. Progesterone [CORRECT]
3
, C. Human chorionic gonadotropin (hCG)
D. Relaxin
Correct Answer: B
Rationale: Progesterone slows gastrointestinal motility during pregnancy, leading to increased transit time, which results in
constipation and increased risk of heartburn due to esophageal sphincter relaxation. While estrogen, hCG, and relaxin all
play roles in pregnancy, progesterone is the primary hormone responsible for GI changes. This knowledge is essential for
NUR 2513 nurses when providing anticipatory guidance and recommending dietary modifications, fiber intake, and
hydration to manage these common pregnancy complaints.
Q9. A nurse is reviewing first trimester screening results for a pregnant client. Which screening tests are
typically performed during the first trimester?
A. Glucose tolerance test and Group B Streptococcus screening
B. hCG, PAPP-A, and nuchal translucency screening at 11-13 weeks [CORRECT]
C. Maternal serum alpha-fetoprotein and amniocentesis
D. Non-stress test and biophysical profile
Correct Answer: B
Rationale: First trimester screening includes hCG (human chorionic gonadotropin), PAPP-A (pregnancy-associated plasma
protein A), and nuchal translucency ultrasound measurement performed between 11-13 weeks gestation to assess risk for
chromosomal abnormalities. The glucose tolerance test is performed at 24-28 weeks, GBS screening at 35-37 weeks, and
NST/BPP are third-trimester tests. Understanding the timing and purpose of each prenatal screening is a core competency
in the Rasmussen NUR 2513 prenatal care module.
Q10. A pregnant client's maternal serum alpha-fetoprotein (MSAFP) level is elevated. The nurse understands
that this finding may indicate which condition?
A. Down syndrome (trisomy 21)
B. Edwards syndrome (trisomy 18)
C. Neural tube defects such as spina bifida or anencephaly [CORRECT]
D. Gestational diabetes
Correct Answer: C
Rationale: Elevated MSAFP levels are associated with open neural tube defects such as spina bifida and anencephaly
because alpha-fetoprotein leaks from the fetal circulation into the amniotic fluid and maternal bloodstream through the
open defect. Decreased MSAFP is associated with Down syndrome and Edwards syndrome. This finding would be
confirmed by amniocentesis and targeted ultrasound. Understanding MSAFP interpretation is a critical prenatal screening
competency in the NUR 2513 curriculum for identifying fetal abnormalities and planning appropriate follow-up care.
Q11. A pregnant client at 25 weeks gestation has a 50g glucose challenge test result of 145 mg/dL. What is the
appropriate next step in management?
A. Diagnose the client with gestational diabetes and begin insulin therapy
B. Schedule a 100g 3-hour oral glucose tolerance test for further evaluation [CORRECT]
C. Repeat the 50g glucose challenge test in 2 weeks
D. Reassure the client that this is a normal result and no further testing is needed
Correct Answer: B
Rationale: A 50g glucose challenge test result of 145 mg/dL is above the threshold of 140 mg/dL and requires follow-up
with a 100g 3-hour oral glucose tolerance test (OGTT) for definitive diagnosis of gestational diabetes. The GCT is a
screening tool, not a diagnostic test, so insulin therapy would be premature. Repeating the GCT delays necessary
evaluation, and this result is not normal. This two-step screening approach is a standard of care in the Rasmussen NUR
2513 prenatal management curriculum for detecting and managing gestational diabetes.
Q12. A nurse is caring for a pregnant client at 36 weeks gestation whose Group B Streptococcus (GBS)
screening is positive. Which intervention is most appropriate?
4
