NU 170 Exam 2 | NU 170 Maternal-Child Nursing |
Questions and Answers with Rationales
2026/2027 Update
1. Which physiological change occurs in the cardiovascular system during a
normal pregnancy?
A) Cardiac output increases significantly by 30 to 50 percent due to increases in
both stroke volume and heart rate.
B) Systemic vascular resistance increases sharply, causing severe maternal
hypertension throughout all three trimesters.
C) Maternal blood volume decreases by 20 percent to protect the heart from
overworking.
D) The heart shifts to the right and decreases in overall muscular size.
Correct Answer: A
Rationale: Cardiac output rises markedly during pregnancy, peaking in the second
trimester, driven by increases in stroke volume and maternal heart rate to
support uteroplacental perfusion.
2. What is the primary cause of physiological anemia of pregnancy
(pseudoanemia)?
A) Total destruction of bone marrow red blood cell production.
B) Plasma volume increases proportionally much more than red blood cell mass
expansion, leading to hemodilution.
C) Severe iron malabsorption caused by excessive progesterone production.
D) Chronic gastrointestinal bleeding throughout gestation.
Correct Answer: B
,Rationale: Plasma volume increases by nearly 50 percent while red blood cell
mass increases by 20 to 30 percent, creating a dilutional effect that lowers
measured hemoglobin and hematocrit concentrations.
3. Which respiratory system adaptation is expected as the gravid uterus
enlarges and elevates the maternal diaphragm?
A) Shift from abdominal to thoracic breathing, with increased tidal volume and
minute ventilation resulting in mild respiratory alkalosis.
B) Permanent collapse of the functional residual lung capacity.
C) Chronic hypoventilation leading to severe respiratory acidosis.
D) Total cessation of respiratory muscle movement.
Correct Answer: A
Rationale: Elevation of the diaphragm by about 4 cm shifts breathing to a thoracic
pattern, increasing tidal volume and causing mild compensated respiratory
alkalosis to facilitate fetal gas exchange.
4. Which gastrointestinal alteration is commonly reported by pregnant women
due to progesterone-induced smooth muscle relaxation?
A) Accelerated gastric emptying and hyperactive bowel motility.
B) Constipation, heartburn, and delayed gastric emptying.
C) Complete inhibition of hydrochloric acid secretion.
D) Spasm of the pyloric sphincter preventing all reflux.
Correct Answer: B
Rationale: High progesterone levels relax smooth muscle throughout the body,
slowing gastrointestinal motility (causing constipation) and relaxing the lower
esophageal sphincter (causing pyrosis/heartburn).
5. Why are pregnant women at an increased risk for urinary tract infections
(UTIs)?
A) Progesterone causes relaxation and dilation of the ureters and renal pelvis,
resulting in urinary stasis and incomplete bladder emptying.
,B) Complete structural obstruction of the urethra by the placenta.
C) Increased urine acidity that destroys mucosal defense barriers.
D) Excessive daily fluid restriction.
Correct Answer: A
Rationale: Smooth muscle relaxation leads to hydroureter and urinary stasis,
providing an ideal environment for bacterial growth and increasing UTI risk.
6. Which screening test is used between 15 and 20 weeks gestation to detect
open neural tube defects and abdominal wall defects?
A) Maternal serum alpha-fetoprotein (MSAFP)
B) Direct Coombs test
C) Serum creatinine clearance assay
D) 3-hour glucose tolerance test
Correct Answer: A
Rationale: MSAFP measures alpha-fetoprotein levels in maternal blood;
abnormally high levels are associated with open neural tube defects (spina bifida,
anencephaly) and ventral wall defects.
7. Which non-invasive assessment evaluates fetal well-being by combining real-
time ultrasound monitoring of four biophysical variables with a non-stress test?
A) Biophysical profile (BPP)
B) Complete blood count panel
C) Contraction stress test alone
D) Kleihauer-Betke assay
Correct Answer: A
Rationale: The BPP assesses fetal breathing movements, gross body movements,
fetal tone, amniotic fluid volume, and fetal heart rate reactivity via non-stress
test.
, 8. What is the interpretation of a biophysical profile score of 8 out of 10 with
normal amniotic fluid volume?
A) Reassuring, indicating adequate fetal oxygenation and absence of acute
asphyxia.
B) Critical indicator of immediate fetal distress requiring emergency cesarean
delivery.
C) Borderline result requiring immediate maternal blood transfusion.
D) Invalid test requiring repeat evaluation in 24 hours.
Correct Answer: A
Rationale: BPP scores of 8 or 10 are normal and reassuring, reflecting good fetal
central nervous system oxygenation.
9. What does a contraction stress test (CST) evaluate?
A) Fetal heart rate response to the transient hypoxia of uterine contractions to
determine uteroplacental reserve.
B) Maternal uterine muscle strength during second-stage pushing.
C) Maternal antibody titer levels.
D) Fetal chromosomal karyotype makeup.
Correct Answer: A
Rationale: A CST evaluates whether the placenta can maintain adequate
oxygenation for the fetus during the stress of uterine contractions.
10. What constitutes a negative (reassuring) contraction stress test result?
A) Absence of late or significant variable decelerations during contractions.
B) Presence of persistent late decelerations with over 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 change occurs in the cardiovascular system during a
normal pregnancy?
A) Cardiac output increases significantly by 30 to 50 percent due to increases in
both stroke volume and heart rate.
B) Systemic vascular resistance increases sharply, causing severe maternal
hypertension throughout all three trimesters.
C) Maternal blood volume decreases by 20 percent to protect the heart from
overworking.
D) The heart shifts to the right and decreases in overall muscular size.
Correct Answer: A
Rationale: Cardiac output rises markedly during pregnancy, peaking in the second
trimester, driven by increases in stroke volume and maternal heart rate to
support uteroplacental perfusion.
2. What is the primary cause of physiological anemia of pregnancy
(pseudoanemia)?
A) Total destruction of bone marrow red blood cell production.
B) Plasma volume increases proportionally much more than red blood cell mass
expansion, leading to hemodilution.
C) Severe iron malabsorption caused by excessive progesterone production.
D) Chronic gastrointestinal bleeding throughout gestation.
Correct Answer: B
,Rationale: Plasma volume increases by nearly 50 percent while red blood cell
mass increases by 20 to 30 percent, creating a dilutional effect that lowers
measured hemoglobin and hematocrit concentrations.
3. Which respiratory system adaptation is expected as the gravid uterus
enlarges and elevates the maternal diaphragm?
A) Shift from abdominal to thoracic breathing, with increased tidal volume and
minute ventilation resulting in mild respiratory alkalosis.
B) Permanent collapse of the functional residual lung capacity.
C) Chronic hypoventilation leading to severe respiratory acidosis.
D) Total cessation of respiratory muscle movement.
Correct Answer: A
Rationale: Elevation of the diaphragm by about 4 cm shifts breathing to a thoracic
pattern, increasing tidal volume and causing mild compensated respiratory
alkalosis to facilitate fetal gas exchange.
4. Which gastrointestinal alteration is commonly reported by pregnant women
due to progesterone-induced smooth muscle relaxation?
A) Accelerated gastric emptying and hyperactive bowel motility.
B) Constipation, heartburn, and delayed gastric emptying.
C) Complete inhibition of hydrochloric acid secretion.
D) Spasm of the pyloric sphincter preventing all reflux.
Correct Answer: B
Rationale: High progesterone levels relax smooth muscle throughout the body,
slowing gastrointestinal motility (causing constipation) and relaxing the lower
esophageal sphincter (causing pyrosis/heartburn).
5. Why are pregnant women at an increased risk for urinary tract infections
(UTIs)?
A) Progesterone causes relaxation and dilation of the ureters and renal pelvis,
resulting in urinary stasis and incomplete bladder emptying.
,B) Complete structural obstruction of the urethra by the placenta.
C) Increased urine acidity that destroys mucosal defense barriers.
D) Excessive daily fluid restriction.
Correct Answer: A
Rationale: Smooth muscle relaxation leads to hydroureter and urinary stasis,
providing an ideal environment for bacterial growth and increasing UTI risk.
6. Which screening test is used between 15 and 20 weeks gestation to detect
open neural tube defects and abdominal wall defects?
A) Maternal serum alpha-fetoprotein (MSAFP)
B) Direct Coombs test
C) Serum creatinine clearance assay
D) 3-hour glucose tolerance test
Correct Answer: A
Rationale: MSAFP measures alpha-fetoprotein levels in maternal blood;
abnormally high levels are associated with open neural tube defects (spina bifida,
anencephaly) and ventral wall defects.
7. Which non-invasive assessment evaluates fetal well-being by combining real-
time ultrasound monitoring of four biophysical variables with a non-stress test?
A) Biophysical profile (BPP)
B) Complete blood count panel
C) Contraction stress test alone
D) Kleihauer-Betke assay
Correct Answer: A
Rationale: The BPP assesses fetal breathing movements, gross body movements,
fetal tone, amniotic fluid volume, and fetal heart rate reactivity via non-stress
test.
, 8. What is the interpretation of a biophysical profile score of 8 out of 10 with
normal amniotic fluid volume?
A) Reassuring, indicating adequate fetal oxygenation and absence of acute
asphyxia.
B) Critical indicator of immediate fetal distress requiring emergency cesarean
delivery.
C) Borderline result requiring immediate maternal blood transfusion.
D) Invalid test requiring repeat evaluation in 24 hours.
Correct Answer: A
Rationale: BPP scores of 8 or 10 are normal and reassuring, reflecting good fetal
central nervous system oxygenation.
9. What does a contraction stress test (CST) evaluate?
A) Fetal heart rate response to the transient hypoxia of uterine contractions to
determine uteroplacental reserve.
B) Maternal uterine muscle strength during second-stage pushing.
C) Maternal antibody titer levels.
D) Fetal chromosomal karyotype makeup.
Correct Answer: A
Rationale: A CST evaluates whether the placenta can maintain adequate
oxygenation for the fetus during the stress of uterine contractions.
10. What constitutes a negative (reassuring) contraction stress test result?
A) Absence of late or significant variable decelerations during contractions.
B) Presence of persistent late decelerations with over 50 percent of contractions.
C) Fetal baseline heart rate dropping below 100 bpm.
D) Complete absence of uterine contractions.
Correct Answer: A
