OB/NB SU Exam 4 | Complete Questions with Correct
Answers and Detailed Rationales - Latest Update 2026
SECTION 1: ANTEPARTUM ASSESSMENT
1. A nurse is assessing a client at 12 weeks gestation.
Which finding is consistent with normal pregnancy at this stage?
A) Fundus palpable at the umbilicus
B) Fundus palpable just above the symphysis pubis
C) Quickening reported by the client
D) Braxton Hicks contractions noted
Answer: B) Fundus palpable just above the symphysis pubis
Rationale: At 12 weeks, the fundus is palpable just above the symphysis pubis.
The fundus reaches the umbilicus at 20 weeks. Quickening is typically felt at 16–
20 weeks. Braxton Hicks contractions occur in the second and third trimesters.
2. A client at 8 weeks gestation reports nausea and vomiting, especially in the
morning. The nurse should recommend:
,A) Avoid fluids with meals
B) Drink fluids between meals
C) Eat a heavy meal before bedtime
D) Skip breakfast
Answer: B) Drink fluids between meals
Rationale: To manage nausea and vomiting in early pregnancy, clients should
drink fluids between meals rather than with meals to avoid gastric distension.
Eating small, frequent meals and avoiding fatty/spicy foods is also recommended.
3. Chadwick's sign in pregnancy refers to:
A) Softening of the cervix
B) Bluish-purple discoloration of the vaginal mucosa and cervix
C) Palpable uterine contractions
D) Fetal movement felt by the examiner
Answer: B) Bluish-purple discoloration of the vaginal mucosa and cervix
Rationale: Chadwick's sign is the bluish-purple coloration of the vaginal mucosa
and cervix due to increased vascularity. It is a probable sign of pregnancy.
Goodell's sign is softening of the cervix. Hegar's sign is softening of the lower
uterine segment.
,4. A client at 16 weeks gestation asks if she should be feeling fetal movement. The
nurse should respond:
A) "Most women feel movement by 12 weeks."
B) "You should feel movement by now; we should assess the fetus."
C) "Primigravidas often feel movement at 18–20 weeks."
D) "You won't feel movement until the third trimester."
Answer: C) "Primigravidas often feel movement at 18–20 weeks."
Rationale: Quickening (first fetal movement) is typically felt by primigravidas at
18–20 weeks and by multigravidas at 16–18 weeks. Reassuring the client with this
information is appropriate.
5. Preconception counseling should include folic acid supplementation at what
dose?
A) 0.2 mg/day
B) 0.4 mg/day
C) 0.8 mg/day
D) 4.0 mg/day
Answer: B) 0.4 mg/day
Rationale: The CDC recommends 400 mcg (0.4 mg) of folic acid daily for all
women of childbearing age to reduce the risk of neural tube defects. Higher doses
(4.0 mg) are recommended for women with a history of neural tube defects.
6. Nagele's rule is used to:
A) Determine fetal position
B) Estimate the expected date of delivery
, C) Calculate weight gain during pregnancy
D) Assess fetal heart rate
Answer: B) Estimate the expected date of delivery
Rationale: Nagele's rule calculates the estimated date of delivery (EDD) by
subtracting 3 months from the first day of the last menstrual period (LMP), adding
7 days, and adding 1 year.
7. A client asks about weight gain during pregnancy. The nurse should recommend
weight gain of how many pounds for a woman with a normal pre-pregnancy BMI?
A) 11–20 pounds
B) 15–25 pounds
C) 25–35 pounds
D) 28–40 pounds
Answer: C) 25–35 pounds
Rationale: For women with a normal pre-pregnancy BMI (18.5–24.9), the
recommended total weight gain during pregnancy is 25–35 pounds (11.5–16 kg).
Underweight women should gain 28–40 pounds, while overweight women should
gain 15–25 pounds.
8. During a prenatal visit at 24 weeks' gestation, where should the nurse expect to
palpate the uterine fundus?
A) At the xiphoid process
B) At the level of the umbilicus
C) Approximately 2 cm above the umbilicus
D) Just above the symphysis pubis
Answer: C) Approximately 2 cm above the umbilicus
Rationale: At 24 weeks, the uterine fundus is typically about 2 cm above the
umbilicus. It reaches the umbilicus at approximately 20 weeks and the xiphoid
process near 36 weeks.
Answers and Detailed Rationales - Latest Update 2026
SECTION 1: ANTEPARTUM ASSESSMENT
1. A nurse is assessing a client at 12 weeks gestation.
Which finding is consistent with normal pregnancy at this stage?
A) Fundus palpable at the umbilicus
B) Fundus palpable just above the symphysis pubis
C) Quickening reported by the client
D) Braxton Hicks contractions noted
Answer: B) Fundus palpable just above the symphysis pubis
Rationale: At 12 weeks, the fundus is palpable just above the symphysis pubis.
The fundus reaches the umbilicus at 20 weeks. Quickening is typically felt at 16–
20 weeks. Braxton Hicks contractions occur in the second and third trimesters.
2. A client at 8 weeks gestation reports nausea and vomiting, especially in the
morning. The nurse should recommend:
,A) Avoid fluids with meals
B) Drink fluids between meals
C) Eat a heavy meal before bedtime
D) Skip breakfast
Answer: B) Drink fluids between meals
Rationale: To manage nausea and vomiting in early pregnancy, clients should
drink fluids between meals rather than with meals to avoid gastric distension.
Eating small, frequent meals and avoiding fatty/spicy foods is also recommended.
3. Chadwick's sign in pregnancy refers to:
A) Softening of the cervix
B) Bluish-purple discoloration of the vaginal mucosa and cervix
C) Palpable uterine contractions
D) Fetal movement felt by the examiner
Answer: B) Bluish-purple discoloration of the vaginal mucosa and cervix
Rationale: Chadwick's sign is the bluish-purple coloration of the vaginal mucosa
and cervix due to increased vascularity. It is a probable sign of pregnancy.
Goodell's sign is softening of the cervix. Hegar's sign is softening of the lower
uterine segment.
,4. A client at 16 weeks gestation asks if she should be feeling fetal movement. The
nurse should respond:
A) "Most women feel movement by 12 weeks."
B) "You should feel movement by now; we should assess the fetus."
C) "Primigravidas often feel movement at 18–20 weeks."
D) "You won't feel movement until the third trimester."
Answer: C) "Primigravidas often feel movement at 18–20 weeks."
Rationale: Quickening (first fetal movement) is typically felt by primigravidas at
18–20 weeks and by multigravidas at 16–18 weeks. Reassuring the client with this
information is appropriate.
5. Preconception counseling should include folic acid supplementation at what
dose?
A) 0.2 mg/day
B) 0.4 mg/day
C) 0.8 mg/day
D) 4.0 mg/day
Answer: B) 0.4 mg/day
Rationale: The CDC recommends 400 mcg (0.4 mg) of folic acid daily for all
women of childbearing age to reduce the risk of neural tube defects. Higher doses
(4.0 mg) are recommended for women with a history of neural tube defects.
6. Nagele's rule is used to:
A) Determine fetal position
B) Estimate the expected date of delivery
, C) Calculate weight gain during pregnancy
D) Assess fetal heart rate
Answer: B) Estimate the expected date of delivery
Rationale: Nagele's rule calculates the estimated date of delivery (EDD) by
subtracting 3 months from the first day of the last menstrual period (LMP), adding
7 days, and adding 1 year.
7. A client asks about weight gain during pregnancy. The nurse should recommend
weight gain of how many pounds for a woman with a normal pre-pregnancy BMI?
A) 11–20 pounds
B) 15–25 pounds
C) 25–35 pounds
D) 28–40 pounds
Answer: C) 25–35 pounds
Rationale: For women with a normal pre-pregnancy BMI (18.5–24.9), the
recommended total weight gain during pregnancy is 25–35 pounds (11.5–16 kg).
Underweight women should gain 28–40 pounds, while overweight women should
gain 15–25 pounds.
8. During a prenatal visit at 24 weeks' gestation, where should the nurse expect to
palpate the uterine fundus?
A) At the xiphoid process
B) At the level of the umbilicus
C) Approximately 2 cm above the umbilicus
D) Just above the symphysis pubis
Answer: C) Approximately 2 cm above the umbilicus
Rationale: At 24 weeks, the uterine fundus is typically about 2 cm above the
umbilicus. It reaches the umbilicus at approximately 20 weeks and the xiphoid
process near 36 weeks.
