NU 661 Exam 3 V3 | NU 661 Primary Care
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 3) | Regis
1. A 26-year-old primigravida at 28 weeks gestation presents for a routine prenatal visit. Her
glucose challenge test (GCT) result is 155 mg/dL. Which of the following is the most
appropriate next step in management?
A. Diagnose gestational diabetes mellitus and start insulin
B. Initiate a 1,800-calorie ADA diet and exercise plan
C. Repeat the 1-hour glucose challenge test in one week
D. Schedule a 3-hour glucose tolerance test (GTT)
Correct Answer: D
A glucose challenge test result above 140 mg/dL is considered abnormal and requires
further diagnostic testing. The 3-hour oral glucose tolerance test is the gold standard for
diagnosing gestational diabetes. Management depends on the results of the 3-hour test
rather than a single screening value.
2. A nurse practitioner is assessing a patient at 36 weeks gestation. Which of the following
findings would be considered most concerning and require immediate consultation?
A. Occasional Braxton Hicks contractions
B. New onset of facial and hand edema with a headache
,C. Increased vaginal discharge (leukorrhea)
D. Shortness of breath when lying supine
Correct Answer: B
Facial and hand edema coupled with a headache are classic warning signs of preeclampsia
in the third trimester. While dependent edema is common, facial swelling is more specific
to hypertensive disorders of pregnancy. This presentation necessitates immediate blood
pressure evaluation and urinalysis for protein.
3. During a prenatal visit at 35 weeks, the clinician performs Leopold maneuvers. The first
maneuver reveals a soft, irregular mass in the fundus. The second maneuver identifies a long,
smooth surface on the mother’s left side. Which fetal position does this indicate?
A. Right Occiput Anterior (ROA)
B. Left Occiput Anterior (LOA)
C. Breech presentation
D. Transverse lie
Correct Answer: B
The presence of a soft mass in the fundus suggests the breech (buttocks) is at the top,
meaning the fetus is in a cephalic presentation. Identifying the back on the mother’s left
side and the head (implied) downward points toward a Left Occiput position. This
maneuver helps clinicians determine fetal presentation and lie before labor onset.
, 4. Which of the following patients should receive Rho(D) immune globulin (RhoGAM) at 28
weeks gestation?
A. An Rh-positive mother with an Rh-negative partner
B. An Rh-negative mother with a negative antibody screen
C. An Rh-negative mother with a positive antibody screen
D. An Rh-positive mother with a positive antibody screen
Correct Answer: B
RhoGAM is administered to Rh-negative women who are not yet sensitized (negative
antibody screen) to prevent isoimmunization. If the mother is already sensitized, RhoGAM
is no longer effective. The standard prophylactic dose is given at 28 weeks and again within
72 hours of delivery if the neonate is Rh-positive.
5. A patient at 38 weeks gestation presents to the clinic with concerns about going into labor.
Which of the following signs or symptoms suggest that true labor is approaching or
occurring? (Select All That Apply)
A. Cervical effacement and dilation
B. Contractions that increase in frequency and intensity
C. Rupture of membranes
D. Contractions that stop with rest or hydration
E. Bloody show
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 3) | Regis
1. A 26-year-old primigravida at 28 weeks gestation presents for a routine prenatal visit. Her
glucose challenge test (GCT) result is 155 mg/dL. Which of the following is the most
appropriate next step in management?
A. Diagnose gestational diabetes mellitus and start insulin
B. Initiate a 1,800-calorie ADA diet and exercise plan
C. Repeat the 1-hour glucose challenge test in one week
D. Schedule a 3-hour glucose tolerance test (GTT)
Correct Answer: D
A glucose challenge test result above 140 mg/dL is considered abnormal and requires
further diagnostic testing. The 3-hour oral glucose tolerance test is the gold standard for
diagnosing gestational diabetes. Management depends on the results of the 3-hour test
rather than a single screening value.
2. A nurse practitioner is assessing a patient at 36 weeks gestation. Which of the following
findings would be considered most concerning and require immediate consultation?
A. Occasional Braxton Hicks contractions
B. New onset of facial and hand edema with a headache
,C. Increased vaginal discharge (leukorrhea)
D. Shortness of breath when lying supine
Correct Answer: B
Facial and hand edema coupled with a headache are classic warning signs of preeclampsia
in the third trimester. While dependent edema is common, facial swelling is more specific
to hypertensive disorders of pregnancy. This presentation necessitates immediate blood
pressure evaluation and urinalysis for protein.
3. During a prenatal visit at 35 weeks, the clinician performs Leopold maneuvers. The first
maneuver reveals a soft, irregular mass in the fundus. The second maneuver identifies a long,
smooth surface on the mother’s left side. Which fetal position does this indicate?
A. Right Occiput Anterior (ROA)
B. Left Occiput Anterior (LOA)
C. Breech presentation
D. Transverse lie
Correct Answer: B
The presence of a soft mass in the fundus suggests the breech (buttocks) is at the top,
meaning the fetus is in a cephalic presentation. Identifying the back on the mother’s left
side and the head (implied) downward points toward a Left Occiput position. This
maneuver helps clinicians determine fetal presentation and lie before labor onset.
, 4. Which of the following patients should receive Rho(D) immune globulin (RhoGAM) at 28
weeks gestation?
A. An Rh-positive mother with an Rh-negative partner
B. An Rh-negative mother with a negative antibody screen
C. An Rh-negative mother with a positive antibody screen
D. An Rh-positive mother with a positive antibody screen
Correct Answer: B
RhoGAM is administered to Rh-negative women who are not yet sensitized (negative
antibody screen) to prevent isoimmunization. If the mother is already sensitized, RhoGAM
is no longer effective. The standard prophylactic dose is given at 28 weeks and again within
72 hours of delivery if the neonate is Rh-positive.
5. A patient at 38 weeks gestation presents to the clinic with concerns about going into labor.
Which of the following signs or symptoms suggest that true labor is approaching or
occurring? (Select All That Apply)
A. Cervical effacement and dilation
B. Contractions that increase in frequency and intensity
C. Rupture of membranes
D. Contractions that stop with rest or hydration
E. Bloody show
