Maternity Nursing: Antepartum NCLEX
Practice Questions #6 | 55 Questions
1. 1. Question
A nursing instructor is conducting a lecture and is reviewing the
functions of the female reproductive system. She asks the student
nurse to describe the follicle-stimulating hormone (FSH) and the
luteinizing hormone (LH). The student nurse accurately responds by
stating that:
o A. FSH and LH are released from the anterior pituitary
gland.
o B. FSH and LH are secreted by the corpus luteum of the ovary
o C. FSH and LH are secreted by the adrenal glands
o D. FSH and LH stimulate the formation of milk during pregnancy.
Incorrect
Correct Answer: A. FSH and LH are released from the anterior
pituitary gland.
FSH and LH, when stimulated by the gonadotropin-releasing hormone
from the hypothalamus, are released from the anterior pituitary gland
to stimulate follicular growth and development, the growth of the
Graafian follicle, and production of progesterone.
Option B: The primary hormone produced from the corpus
luteum is progesterone, but it also produces inhibin A and
estradiol. In the absence of fertilization, the corpus luteum will
regress over time.
Option C: Development of the ovarian follicle is largely under
FSH control, and the secretion of estrogen from this follicle is
dependent on FSH and LH. The granulosa cells of the ovary
secrete inhibin, which plays a role in cellular differentiation.
Option D: In women, LH stimulates estrogen and progesterone
production from the ovary. A surge of LH in the mid menstrual
cycle is responsible for ovulation, and continued LH secretion
subsequently stimulates the corpus luteum to produce
progesterone.
,2. 2. Question
A nurse is describing the process of fetal circulation to a client during a
prenatal visit. The nurse accurately tells the client that fetal circulation
consists of:
A. Two umbilical veins and one umbilical artery.
B. Two umbilical arteries and one umbilical vein.
C. Arteries carrying oxygenated blood to the fetus.
D. Veins carrying deoxygenated blood to the fetus.
Incorrect
Correct Answer: B. Two umbilical arteries and one umbilical
vein.
Blood pumped by the embryo’s heart leaves the embryo through two
umbilical arteries. Once oxygenated, the blood then is returned by one
umbilical vein. Arteries carry deoxygenated blood and waste products
from the fetus, and veins carry oxygenated blood and provide oxygen
and nutrients to the fetus.
Option A: The fetal circulation system is distinctly different from
adult circulation. This intricate system allows the fetus to receive
oxygenated blood and nutrients from the placenta. It comprises
the blood vessels in the placenta and the umbilical cord, which
contains two umbilical arteries and one umbilical vein.
Option C: Oxygenated blood from the mother in the placenta
flows through the umbilical vein and into the inferior vena cava
(IVC), bypassing the liver via the ductus venosus. From the IVC,
oxygenated blood travels to the right atrium of the heart. There is
greater pressure in the right atrium compared to the left atrium
in fetal circulation; therefore most of the blood is shunted from
the right atrium to the left atrium through an opening called the
foramen ovale. Once in the left atrium, blood travels through the
left ventricle into the aorta and the systemic circulation.
Option D: The deoxygenated blood travels back to the placenta
via the umbilical arteries to be oxygenated by the mother.
Additionally, some oxygenated blood in the right atrium can also
enter the right ventricle and then the pulmonary artery. Because
there is high resistance to blood flow in the lungs, the blood is
shunted from the pulmonary artery into the aorta via the ductus
, arteriosus, hence bypassing the lungs. Blood then enters the
systemic circulation, and the deoxygenated blood is recycled
back to the mother via the umbilical arteries.
3. 3. Question
During a prenatal visit at 38 weeks, a nurse assesses the fetal heart
rate. The nurse determines that the fetal heart rate is normal if which
of the following is noted?
A. 80 BPM
B. 100 BPM
C. 150 BPM
D. 180 BPM
Incorrect
Correct Answer: C. 150 BPM.
The fetal heart rate depends on gestational age and ranges from 160-
170 BPM in the first trimester but slows with fetal growth to 120-160
BPM near or at term. At or near term, if the fetal heart rate is less than
120 or more than 160 BPM with the uterus at rest, the fetus may be in
distress.
Option A: Data from a recently published study in a different
context (Serra et al., 2009) is compatible with the findings of our
exploratory analysis with a lower limit of 115 or 120 bpm for the
gestational ages. Data for the 97th and 99th percentiles are not
shown in this study. But shifting the lower limit to 120 will
increase the number of false alarms whereas a lower limit of 115
will inevitably increase the risk to misinterpret maternal heart
rates as fetal heart rate.
Option B: A lower limit of 120 bpm leads only near term to more
false alarms since normal FHR decreases further, and is more
appropriate, to avoid misinterpretation of maternal heartbeat as
FHR.
Option D: The upper limit of 160 bpm raised concerns in the
FIGO meeting in 1985, as Saling described abnormal findings in
24% of scalp blood analyses if the baseline was higher than 160
bpm. It could be shown that the current FIGO guidelines based on
computerized analyses of the CTG show a high sensitivity to
, detect fetal acidosis in case of a suspect or pathological
classification of the baseline level.
4. 4. Question
A client arrives at a prenatal clinic for the first prenatal assessment.
The client tells a nurse that the first day of her last menstrual period
was September 19th, 2013. Using Naegele’s rule, the nurse determines
the estimated date of confinement as:
A. July 26, 2013
B. June 12, 2014
C. June 26, 2014
D. July 12, 2014
Incorrect
Correct Answer: C. June 26, 2014.
Accurate use of Naegele’s rule requires that the woman has a regular
28-day menstrual cycle. Add 7 days to the first day of the last
menstrual period, subtract three months, and then add one year to
that date.
Option A: An average pregnancy lasts 280 days from the first
day of the last menstrual period (LMP) or 266 days after
conception. Historically, an accurate LMP is the best estimator to
determine the due date.
Option B: Naegele’s rule, derived from a German obstetrician,
subtracts 3 months and adds 7 days to calculate the estimated
due date (EDD). It is prudent for the obstetrician to get a detailed
menstrual history, including duration, flow, previous menstrual
periods, and hormonal contraceptives. These factors are used to
determine the length of her cycles and ovulation period.
Option D: There are several fallacies with Naegele’s rule. First, a
woman may not accurately recall the first day of her menstrual
cycle. Second, this method assumes a woman’s cycle is exactly
28 days, with ovulation occurring at day 14, however, it does not
consider menstrual cycles with shorter or longer durations. Third,
there are small variations in the duration between fertilization
and blastocyst implantation. Last, this method cannot
differentiate between menstrual bleeding and early pregnancy
bleeding.
Practice Questions #6 | 55 Questions
1. 1. Question
A nursing instructor is conducting a lecture and is reviewing the
functions of the female reproductive system. She asks the student
nurse to describe the follicle-stimulating hormone (FSH) and the
luteinizing hormone (LH). The student nurse accurately responds by
stating that:
o A. FSH and LH are released from the anterior pituitary
gland.
o B. FSH and LH are secreted by the corpus luteum of the ovary
o C. FSH and LH are secreted by the adrenal glands
o D. FSH and LH stimulate the formation of milk during pregnancy.
Incorrect
Correct Answer: A. FSH and LH are released from the anterior
pituitary gland.
FSH and LH, when stimulated by the gonadotropin-releasing hormone
from the hypothalamus, are released from the anterior pituitary gland
to stimulate follicular growth and development, the growth of the
Graafian follicle, and production of progesterone.
Option B: The primary hormone produced from the corpus
luteum is progesterone, but it also produces inhibin A and
estradiol. In the absence of fertilization, the corpus luteum will
regress over time.
Option C: Development of the ovarian follicle is largely under
FSH control, and the secretion of estrogen from this follicle is
dependent on FSH and LH. The granulosa cells of the ovary
secrete inhibin, which plays a role in cellular differentiation.
Option D: In women, LH stimulates estrogen and progesterone
production from the ovary. A surge of LH in the mid menstrual
cycle is responsible for ovulation, and continued LH secretion
subsequently stimulates the corpus luteum to produce
progesterone.
,2. 2. Question
A nurse is describing the process of fetal circulation to a client during a
prenatal visit. The nurse accurately tells the client that fetal circulation
consists of:
A. Two umbilical veins and one umbilical artery.
B. Two umbilical arteries and one umbilical vein.
C. Arteries carrying oxygenated blood to the fetus.
D. Veins carrying deoxygenated blood to the fetus.
Incorrect
Correct Answer: B. Two umbilical arteries and one umbilical
vein.
Blood pumped by the embryo’s heart leaves the embryo through two
umbilical arteries. Once oxygenated, the blood then is returned by one
umbilical vein. Arteries carry deoxygenated blood and waste products
from the fetus, and veins carry oxygenated blood and provide oxygen
and nutrients to the fetus.
Option A: The fetal circulation system is distinctly different from
adult circulation. This intricate system allows the fetus to receive
oxygenated blood and nutrients from the placenta. It comprises
the blood vessels in the placenta and the umbilical cord, which
contains two umbilical arteries and one umbilical vein.
Option C: Oxygenated blood from the mother in the placenta
flows through the umbilical vein and into the inferior vena cava
(IVC), bypassing the liver via the ductus venosus. From the IVC,
oxygenated blood travels to the right atrium of the heart. There is
greater pressure in the right atrium compared to the left atrium
in fetal circulation; therefore most of the blood is shunted from
the right atrium to the left atrium through an opening called the
foramen ovale. Once in the left atrium, blood travels through the
left ventricle into the aorta and the systemic circulation.
Option D: The deoxygenated blood travels back to the placenta
via the umbilical arteries to be oxygenated by the mother.
Additionally, some oxygenated blood in the right atrium can also
enter the right ventricle and then the pulmonary artery. Because
there is high resistance to blood flow in the lungs, the blood is
shunted from the pulmonary artery into the aorta via the ductus
, arteriosus, hence bypassing the lungs. Blood then enters the
systemic circulation, and the deoxygenated blood is recycled
back to the mother via the umbilical arteries.
3. 3. Question
During a prenatal visit at 38 weeks, a nurse assesses the fetal heart
rate. The nurse determines that the fetal heart rate is normal if which
of the following is noted?
A. 80 BPM
B. 100 BPM
C. 150 BPM
D. 180 BPM
Incorrect
Correct Answer: C. 150 BPM.
The fetal heart rate depends on gestational age and ranges from 160-
170 BPM in the first trimester but slows with fetal growth to 120-160
BPM near or at term. At or near term, if the fetal heart rate is less than
120 or more than 160 BPM with the uterus at rest, the fetus may be in
distress.
Option A: Data from a recently published study in a different
context (Serra et al., 2009) is compatible with the findings of our
exploratory analysis with a lower limit of 115 or 120 bpm for the
gestational ages. Data for the 97th and 99th percentiles are not
shown in this study. But shifting the lower limit to 120 will
increase the number of false alarms whereas a lower limit of 115
will inevitably increase the risk to misinterpret maternal heart
rates as fetal heart rate.
Option B: A lower limit of 120 bpm leads only near term to more
false alarms since normal FHR decreases further, and is more
appropriate, to avoid misinterpretation of maternal heartbeat as
FHR.
Option D: The upper limit of 160 bpm raised concerns in the
FIGO meeting in 1985, as Saling described abnormal findings in
24% of scalp blood analyses if the baseline was higher than 160
bpm. It could be shown that the current FIGO guidelines based on
computerized analyses of the CTG show a high sensitivity to
, detect fetal acidosis in case of a suspect or pathological
classification of the baseline level.
4. 4. Question
A client arrives at a prenatal clinic for the first prenatal assessment.
The client tells a nurse that the first day of her last menstrual period
was September 19th, 2013. Using Naegele’s rule, the nurse determines
the estimated date of confinement as:
A. July 26, 2013
B. June 12, 2014
C. June 26, 2014
D. July 12, 2014
Incorrect
Correct Answer: C. June 26, 2014.
Accurate use of Naegele’s rule requires that the woman has a regular
28-day menstrual cycle. Add 7 days to the first day of the last
menstrual period, subtract three months, and then add one year to
that date.
Option A: An average pregnancy lasts 280 days from the first
day of the last menstrual period (LMP) or 266 days after
conception. Historically, an accurate LMP is the best estimator to
determine the due date.
Option B: Naegele’s rule, derived from a German obstetrician,
subtracts 3 months and adds 7 days to calculate the estimated
due date (EDD). It is prudent for the obstetrician to get a detailed
menstrual history, including duration, flow, previous menstrual
periods, and hormonal contraceptives. These factors are used to
determine the length of her cycles and ovulation period.
Option D: There are several fallacies with Naegele’s rule. First, a
woman may not accurately recall the first day of her menstrual
cycle. Second, this method assumes a woman’s cycle is exactly
28 days, with ovulation occurring at day 14, however, it does not
consider menstrual cycles with shorter or longer durations. Third,
there are small variations in the duration between fertilization
and blastocyst implantation. Last, this method cannot
differentiate between menstrual bleeding and early pregnancy
bleeding.
