NUR 631 EXAM 4: COMPREHENSIVE MATERNAL-FETAL
NURSING EXAM REVIEW AND COMPLETE QUESTIONS WITH
VERIFIED ANSWERS
Question 1
A pregnant patient in her second trimester reports feeling short of
breath and requests an assessment. Which physiological change during
pregnancy explains this finding?
A) Decreased oxygen consumption
B) Upward displacement of the diaphragm
C) Decreased tidal volume
D) Compensatory respiratory acidosis
Correct Answer: B) Upward displacement of the diaphragm
Rationale: As the uterus enlarges, it pushes the diaphragm upward,
reducing functional residual capacity and causing dyspnea. Oxygen
consumption actually increases, tidal volume increases, and pregnancy
is characterized by a compensatory respiratory alkalosis.
Question 2
A nurse is calculating the Estimated Due Date (EDD) for a patient whose
Last Menstrual Period (LMP) began on November 20, 2025. Using
Naegle's Rule, what is the EDD?
A) August 27, 2026
B) August 20, 2026
C) September 27, 2026
D) July 27, 2026
,Correct Answer: A) August 27, 2026
Rationale: Naegle's Rule involves adding 7 days to the first day of the
LMP, subtracting 3 months, and adding 1 year. November 20 + 7 days =
November 27. November 27 minus 3 months = August 27. Adding 1
year results in August 27, 2026.
Question 3
A patient is currently 36 weeks pregnant. She has a history of one full-
term vaginal delivery, one preterm cesarean delivery, and one
spontaneous miscarriage at 8 weeks. She currently has two living
children. What is her GTPAL?
A) G3 T1 P1 A1 L2
B) G4 T1 P1 A1 L2
C) G4 T2 P0 A1 L3
D) G3 T2 P0 A0 L2
Correct Answer: B) G4 T1 P1 A1 L2
Rationale: GTPAL stands for Gravida, Term births, Preterm births,
Abortions/Miscarriages, and Living children. Total pregnancies (G) = 4 (1
term, 1 preterm, 1 miscarriage, 1 current). Term (T) = 1. Preterm (P) = 1.
Abortions (A) = 1. Living (L) = 2 (the term and preterm child).
Question 4
At what gestational age should the Nurse Practitioner expect the
uterine fundus to be palpated at the level of the umbilicus?
A) 12 weeks
B) 16 weeks
C) 20 weeks
D) 36 weeks
Correct Answer: C) 20 weeks
Rationale: The fundal height serves as a landmark for gestational age. At
,12 weeks, the fundus is at the pubic symphysis. At 20 weeks, it reaches
the umbilicus. By 36 weeks, it is near the xiphoid process.
Question 5
A pregnant patient asks the nurse why she needs to increase her dietary
intake of iron. Which physiological change in pregnancy best supports
the need for increased iron?
A) Decreased cardiac output
B) Increased blood volume by 40-50%
C) Decreased glomerular filtration rate
D) Increased systemic vascular resistance
Correct Answer: B) Increased blood volume by 40-50%
Rationale: Blood volume increases by 40-50% during pregnancy to
support the growing fetus and prepare for blood loss during delivery.
This necessitates increased iron intake to support the production of
additional red blood cells and prevent dilutional anemia.
Question 6
A nurse is assessing a pregnant patient who is experiencing
hyperemesis gravidarum. Which laboratory value should the nurse
monitor most closely?
A) Serum potassium
B) Serum calcium
C) Serum magnesium
D) Serum sodium
Correct Answer: A) Serum potassium
Rationale: Hyperemesis gravidarum leads to severe vomiting, resulting
in fluid, electrolyte, and acid-base imbalances. Hypokalemia (decreased
potassium) is a common and dangerous complication due to the loss of
gastric contents.
, Question 7
A patient at 28 weeks gestation is diagnosed with gestational diabetes
mellitus (GDM). Which of the following is the primary risk factor for the
fetus if GDM is poorly controlled?
A) Macrosomia
B) Intrauterine growth restriction (IUGR)
C) Oligohydramnios
D) Microcephaly
Correct Answer: A) Macrosomia
Rationale: Poorly controlled gestational diabetes leads to maternal
hyperglycemia, causing fetal hyperglycemia and increased fetal insulin
production. Insulin acts as a growth factor, resulting in macrosomia
(excessive fetal growth). IUGR is more commonly associated with
preeclampsia or placental insufficiency.
Question 8
A pregnant patient at 32 weeks gestation presents with painless, bright
red vaginal bleeding. Which condition should the nurse suspect?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Vasa previa
Correct Answer: B) Placenta previa
Rationale: Placenta previa is characterized by painless, bright red
vaginal bleeding in the second or third trimester. Placental abruption
typically presents with painful, dark red bleeding and a rigid, tender
uterus.
Question 9
Which fetal heart rate pattern indicates a healthy, well-oxygenated
NURSING EXAM REVIEW AND COMPLETE QUESTIONS WITH
VERIFIED ANSWERS
Question 1
A pregnant patient in her second trimester reports feeling short of
breath and requests an assessment. Which physiological change during
pregnancy explains this finding?
A) Decreased oxygen consumption
B) Upward displacement of the diaphragm
C) Decreased tidal volume
D) Compensatory respiratory acidosis
Correct Answer: B) Upward displacement of the diaphragm
Rationale: As the uterus enlarges, it pushes the diaphragm upward,
reducing functional residual capacity and causing dyspnea. Oxygen
consumption actually increases, tidal volume increases, and pregnancy
is characterized by a compensatory respiratory alkalosis.
Question 2
A nurse is calculating the Estimated Due Date (EDD) for a patient whose
Last Menstrual Period (LMP) began on November 20, 2025. Using
Naegle's Rule, what is the EDD?
A) August 27, 2026
B) August 20, 2026
C) September 27, 2026
D) July 27, 2026
,Correct Answer: A) August 27, 2026
Rationale: Naegle's Rule involves adding 7 days to the first day of the
LMP, subtracting 3 months, and adding 1 year. November 20 + 7 days =
November 27. November 27 minus 3 months = August 27. Adding 1
year results in August 27, 2026.
Question 3
A patient is currently 36 weeks pregnant. She has a history of one full-
term vaginal delivery, one preterm cesarean delivery, and one
spontaneous miscarriage at 8 weeks. She currently has two living
children. What is her GTPAL?
A) G3 T1 P1 A1 L2
B) G4 T1 P1 A1 L2
C) G4 T2 P0 A1 L3
D) G3 T2 P0 A0 L2
Correct Answer: B) G4 T1 P1 A1 L2
Rationale: GTPAL stands for Gravida, Term births, Preterm births,
Abortions/Miscarriages, and Living children. Total pregnancies (G) = 4 (1
term, 1 preterm, 1 miscarriage, 1 current). Term (T) = 1. Preterm (P) = 1.
Abortions (A) = 1. Living (L) = 2 (the term and preterm child).
Question 4
At what gestational age should the Nurse Practitioner expect the
uterine fundus to be palpated at the level of the umbilicus?
A) 12 weeks
B) 16 weeks
C) 20 weeks
D) 36 weeks
Correct Answer: C) 20 weeks
Rationale: The fundal height serves as a landmark for gestational age. At
,12 weeks, the fundus is at the pubic symphysis. At 20 weeks, it reaches
the umbilicus. By 36 weeks, it is near the xiphoid process.
Question 5
A pregnant patient asks the nurse why she needs to increase her dietary
intake of iron. Which physiological change in pregnancy best supports
the need for increased iron?
A) Decreased cardiac output
B) Increased blood volume by 40-50%
C) Decreased glomerular filtration rate
D) Increased systemic vascular resistance
Correct Answer: B) Increased blood volume by 40-50%
Rationale: Blood volume increases by 40-50% during pregnancy to
support the growing fetus and prepare for blood loss during delivery.
This necessitates increased iron intake to support the production of
additional red blood cells and prevent dilutional anemia.
Question 6
A nurse is assessing a pregnant patient who is experiencing
hyperemesis gravidarum. Which laboratory value should the nurse
monitor most closely?
A) Serum potassium
B) Serum calcium
C) Serum magnesium
D) Serum sodium
Correct Answer: A) Serum potassium
Rationale: Hyperemesis gravidarum leads to severe vomiting, resulting
in fluid, electrolyte, and acid-base imbalances. Hypokalemia (decreased
potassium) is a common and dangerous complication due to the loss of
gastric contents.
, Question 7
A patient at 28 weeks gestation is diagnosed with gestational diabetes
mellitus (GDM). Which of the following is the primary risk factor for the
fetus if GDM is poorly controlled?
A) Macrosomia
B) Intrauterine growth restriction (IUGR)
C) Oligohydramnios
D) Microcephaly
Correct Answer: A) Macrosomia
Rationale: Poorly controlled gestational diabetes leads to maternal
hyperglycemia, causing fetal hyperglycemia and increased fetal insulin
production. Insulin acts as a growth factor, resulting in macrosomia
(excessive fetal growth). IUGR is more commonly associated with
preeclampsia or placental insufficiency.
Question 8
A pregnant patient at 32 weeks gestation presents with painless, bright
red vaginal bleeding. Which condition should the nurse suspect?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Vasa previa
Correct Answer: B) Placenta previa
Rationale: Placenta previa is characterized by painless, bright red
vaginal bleeding in the second or third trimester. Placental abruption
typically presents with painful, dark red bleeding and a rigid, tender
uterus.
Question 9
Which fetal heart rate pattern indicates a healthy, well-oxygenated
