NU 170 Exam 4 | NU 170 Maternal-Child Nursing |
Questions and Answers with Rationales
2026/2027 Update
1. Which physiological alteration in the cardiovascular system occurs normally
during a healthy pregnancy?
A) Maternal blood volume increases by approximately 40 to 50 percent above
pre-pregnancy levels to meet metabolic and placental demands.
B) Maternal heart rate decreases by 30 beats per minute throughout gestation.
C) Systolic blood pressure rises significantly into the hypertensive range in the
first trimester.
D) Total red blood cell mass drops to half of baseline values without plasma
changes.
Correct Answer: A
Rationale: Maternal blood volume increases markedly during pregnancy (by 40-
50%) to accommodate the vascular needs of the placenta, provide adequate
perfusion, and compensate for blood loss during delivery.
2. What causes the physiological anemia of pregnancy (pseudoanemia)?
A) Complete destruction of bone marrow stem cells by placental hormones.
B) Plasma volume increases to a much greater extent than red blood cell mass
expansion, resulting in hemodilution.
C) Total cessation of dietary iron absorption by the intestinal mucosa.
D) Rapid destruction of maternal platelets by fetal antigens.
Correct Answer: B
Rationale: Plasma volume increases by nearly 50% while red blood cell mass
increases by only 20-30%, creating hemodilution that lowers measured
hemoglobin and hematocrit values.
,3. Which respiratory system adaptation is normal in a pregnant woman as the
uterus enlarges and elevates the diaphragm?
A) Shift from abdominal breathing to thoracic (costal) breathing, accompanied by
an increase in tidal volume and minute ventilation.
B) Complete collapse of the functional residual capacity of the lungs.
C) Permanent loss of total lung capacity.
D) Severe chronic hypoventilation leading to respiratory acidosis.
Correct Answer: A
Rationale: As the uterus rises, the diaphragm is displaced upward by about 4 cm,
causing the chest cage to flare and changing breathing from abdominal to
thoracic, with increased tidal volume and hyperventilation.
4. Which gastrointestinal change is commonly experienced during pregnancy
due to elevated progesterone levels and smooth muscle relaxation?
A) Accelerated gastric emptying and hyperactive bowel motility.
B) Constipation, heartburn (pyrosis), and delayed gastric emptying.
C) Complete elimination of gastric acid secretion.
D) Hypertrophy of the pyloric sphincter preventing all reflux.
Correct Answer: B
Rationale: High progesterone levels relax smooth muscle throughout the body,
including the gastrointestinal tract, leading to slowed motility, constipation, and
relaxation of the lower esophageal sphincter resulting in heartburn.
5. Why are pregnant women at a significantly higher risk for urinary tract
infections (UTIs) and asymptomatic bacteriuria?
A) Progesterone causes relaxation of the renal pelves and ureters, combined with
urinary stasis and incomplete bladder emptying from uterine compression.
B) Complete obstruction of the urethra by the fetus.
C) Increased acidity of urine destroying normal mucosal flora.
,D) Excessive water intake diluting renal output.
Correct Answer: A
Rationale: Smooth muscle relaxation from progesterone leads to dilation of
ureters and renal pelvis (hydroureter/hydronephrosis) and urinary stasis,
providing an ideal environment for bacterial proliferation.
6. Which screening test is used to detect neural tube defects and abdominal
wall defects by measuring protein levels in maternal blood?
A) Maternal serum alpha-fetoprotein (MSAFP)
B) Direct Coombs test
C) Serum creatinine clearance test
D) GTT glucose challenge test
Correct Answer: A
Rationale: MSAFP screening performed between 15 and 20 weeks gestation
measures alpha-fetoprotein produced by the fetus; elevated levels indicate open
neural tube defects or ventral wall defects.
7. Which fetal assessment technique measures amniotic fluid volume, fetal
breathing movements, body movements, muscle tone, and a non-stress test in a
single session?
A) Biophysical profile (BPP)
B) Complete blood count panel
C) Contraction stress test alone
D) Kleihauer-Betke test
Correct Answer: A
Rationale: The biophysical profile (BPP) combines real-time ultrasound
assessment of four fetal biophysical variables with the non-stress test to
comprehensively evaluate fetal well-being.
, 8. What is the interpretation of a biophysical profile (BPP) score of 8 out of 10
with normal amniotic fluid volume?
A) Highly reassuring, indicating no acute fetal asphyxia.
B) Immediate indicator of severe fetal distress requiring emergency delivery.
C) Borderline score requiring immediate maternal blood transfusion.
D) Invalid test requiring repeat testing in 24 hours.
Correct Answer: A
Rationale: BPP scores of 8 or 10 are normal and reassuring, reflecting adequate
fetal oxygenation and central nervous system integrity.
9. What does a contraction stress test (CST) evaluate when assessing high-risk
pregnancies?
A) The ability of the fetus to tolerate the transient hypoxia of uterine contractions
without exhibiting late decelerations.
B) Maternal uterine muscle strength during pushing.
C) Maternal antibody titer levels.
D) Fetal chromosomal karyotype makeup.
Correct Answer: A
Rationale: A CST evaluates uteroplacental respiratory reserve by observing fetal
heart rate responses to induced or spontaneous uterine contractions.
10. What constitutes a negative (reassuring) contraction stress test result?
A) Absence of late or significant variable decelerations during a 10-minute
window with at least three contractions.
B) Presence of persistent late decelerations with 50 percent of contractions.
C) Fetal baseline heart rate dropping below 100 bpm.
D) Complete absence of uterine contractions.
Correct Answer: A
Questions and Answers with Rationales
2026/2027 Update
1. Which physiological alteration in the cardiovascular system occurs normally
during a healthy pregnancy?
A) Maternal blood volume increases by approximately 40 to 50 percent above
pre-pregnancy levels to meet metabolic and placental demands.
B) Maternal heart rate decreases by 30 beats per minute throughout gestation.
C) Systolic blood pressure rises significantly into the hypertensive range in the
first trimester.
D) Total red blood cell mass drops to half of baseline values without plasma
changes.
Correct Answer: A
Rationale: Maternal blood volume increases markedly during pregnancy (by 40-
50%) to accommodate the vascular needs of the placenta, provide adequate
perfusion, and compensate for blood loss during delivery.
2. What causes the physiological anemia of pregnancy (pseudoanemia)?
A) Complete destruction of bone marrow stem cells by placental hormones.
B) Plasma volume increases to a much greater extent than red blood cell mass
expansion, resulting in hemodilution.
C) Total cessation of dietary iron absorption by the intestinal mucosa.
D) Rapid destruction of maternal platelets by fetal antigens.
Correct Answer: B
Rationale: Plasma volume increases by nearly 50% while red blood cell mass
increases by only 20-30%, creating hemodilution that lowers measured
hemoglobin and hematocrit values.
,3. Which respiratory system adaptation is normal in a pregnant woman as the
uterus enlarges and elevates the diaphragm?
A) Shift from abdominal breathing to thoracic (costal) breathing, accompanied by
an increase in tidal volume and minute ventilation.
B) Complete collapse of the functional residual capacity of the lungs.
C) Permanent loss of total lung capacity.
D) Severe chronic hypoventilation leading to respiratory acidosis.
Correct Answer: A
Rationale: As the uterus rises, the diaphragm is displaced upward by about 4 cm,
causing the chest cage to flare and changing breathing from abdominal to
thoracic, with increased tidal volume and hyperventilation.
4. Which gastrointestinal change is commonly experienced during pregnancy
due to elevated progesterone levels and smooth muscle relaxation?
A) Accelerated gastric emptying and hyperactive bowel motility.
B) Constipation, heartburn (pyrosis), and delayed gastric emptying.
C) Complete elimination of gastric acid secretion.
D) Hypertrophy of the pyloric sphincter preventing all reflux.
Correct Answer: B
Rationale: High progesterone levels relax smooth muscle throughout the body,
including the gastrointestinal tract, leading to slowed motility, constipation, and
relaxation of the lower esophageal sphincter resulting in heartburn.
5. Why are pregnant women at a significantly higher risk for urinary tract
infections (UTIs) and asymptomatic bacteriuria?
A) Progesterone causes relaxation of the renal pelves and ureters, combined with
urinary stasis and incomplete bladder emptying from uterine compression.
B) Complete obstruction of the urethra by the fetus.
C) Increased acidity of urine destroying normal mucosal flora.
,D) Excessive water intake diluting renal output.
Correct Answer: A
Rationale: Smooth muscle relaxation from progesterone leads to dilation of
ureters and renal pelvis (hydroureter/hydronephrosis) and urinary stasis,
providing an ideal environment for bacterial proliferation.
6. Which screening test is used to detect neural tube defects and abdominal
wall defects by measuring protein levels in maternal blood?
A) Maternal serum alpha-fetoprotein (MSAFP)
B) Direct Coombs test
C) Serum creatinine clearance test
D) GTT glucose challenge test
Correct Answer: A
Rationale: MSAFP screening performed between 15 and 20 weeks gestation
measures alpha-fetoprotein produced by the fetus; elevated levels indicate open
neural tube defects or ventral wall defects.
7. Which fetal assessment technique measures amniotic fluid volume, fetal
breathing movements, body movements, muscle tone, and a non-stress test in a
single session?
A) Biophysical profile (BPP)
B) Complete blood count panel
C) Contraction stress test alone
D) Kleihauer-Betke test
Correct Answer: A
Rationale: The biophysical profile (BPP) combines real-time ultrasound
assessment of four fetal biophysical variables with the non-stress test to
comprehensively evaluate fetal well-being.
, 8. What is the interpretation of a biophysical profile (BPP) score of 8 out of 10
with normal amniotic fluid volume?
A) Highly reassuring, indicating no acute fetal asphyxia.
B) Immediate indicator of severe fetal distress requiring emergency delivery.
C) Borderline score requiring immediate maternal blood transfusion.
D) Invalid test requiring repeat testing in 24 hours.
Correct Answer: A
Rationale: BPP scores of 8 or 10 are normal and reassuring, reflecting adequate
fetal oxygenation and central nervous system integrity.
9. What does a contraction stress test (CST) evaluate when assessing high-risk
pregnancies?
A) The ability of the fetus to tolerate the transient hypoxia of uterine contractions
without exhibiting late decelerations.
B) Maternal uterine muscle strength during pushing.
C) Maternal antibody titer levels.
D) Fetal chromosomal karyotype makeup.
Correct Answer: A
Rationale: A CST evaluates uteroplacental respiratory reserve by observing fetal
heart rate responses to induced or spontaneous uterine contractions.
10. What constitutes a negative (reassuring) contraction stress test result?
A) Absence of late or significant variable decelerations during a 10-minute
window with at least three contractions.
B) Presence of persistent late decelerations with 50 percent of contractions.
C) Fetal baseline heart rate dropping below 100 bpm.
D) Complete absence of uterine contractions.
Correct Answer: A
