NR 602 Final Exam: Childbearing Care 2026 Chamberlain College
1. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a
patient whose last menstrual period began on March 15?
A. December 22
B. December 15
C. January 22
D. December 8
Answer: A
Rationale: Naegele’s rule involves subtracting 3 months and adding 7 days to the first day
of the last menstrual period (March 15 - 3 months = Dec 15; Dec 15 + 7 days = Dec 22).
2. A woman is pregnant for the third time. She has one child born at 38 weeks
and had one miscarriage at 10 weeks. What is her GTPAL?
A. G3, T1, P1, A1, L1
B. G3, T2, P0, A1, L1
C. G2, T1, P1, A0, L1
D. G3, T1, P0, A1, L1
Answer: D
Rationale: Gravida (3 pregnancies), Term (1 birth at 38 weeks), Preterm (0), Abortion (1
miscarriage), Living (1 child).
,3. Which of the following is considered a positive sign of pregnancy?
A. Amenorrhea
B. Fetal heart tones heard by Doppler
C. Positive pregnancy test
D. Chadwick’s sign
Answer: B
Rationale: Positive signs are objective and can only be attributed to a fetus, such as
ultrasound visualization, fetal movement felt by a provider, or fetal heart tones.
4. At how many weeks of gestation is the fundus typically at the level of the
umbilicus?
A. 12 weeks
B. 16 weeks
C. 20 weeks
D. 24 weeks
Answer: C
Rationale: The fundus reaches the umbilicus at approximately 20 weeks of gestation.
5. What is the primary reason for the ‘physiological anemia’ of pregnancy?
A. Iron deficiency due to fetal demands
B. Decreased production of erythrocytes
C. Increase in plasma volume exceeds increase in red blood cell mass
D. Blood loss during the first trimester
Answer: C
Rationale: Plasma volume increases by 40-50% while RBC mass increases by 20-30%,
leading to hemodilution.
, 6. When is Rho(D) immune globulin (RhoGAM) typically administered to an Rh-
negative unsensitized mother?
A. 12 weeks gestation and 72 hours post-delivery
B. 28 weeks gestation and 72 hours post-delivery
C. Only after delivery if the baby is Rh-positive
D. At every prenatal visit
Answer: B
Rationale: RhoGAM is given at 28 weeks and within 72 hours after birth if the infant is Rh-
positive to prevent sensitization.
7. An elevated Alpha-Fetoprotein (AFP) level in maternal serum is associated
with which condition?
A. Down Syndrome
B. Gestational Diabetes
C. Neural Tube Defects
D. Fetal growth restriction
Answer: C
Rationale: High AFP levels are linked to neural tube defects like spina bifida; low levels are
associated with Down Syndrome.
8. What is the recommended screening window for Group B Streptococcus
(GBS) in pregnancy?
A. 24-28 weeks
B. 28-32 weeks
C. 35-37 weeks
D. At the first prenatal visit
Answer: C
Rationale: GBS screening is performed via vaginal/rectal swab at 35 to 37 weeks
gestation.
1. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a
patient whose last menstrual period began on March 15?
A. December 22
B. December 15
C. January 22
D. December 8
Answer: A
Rationale: Naegele’s rule involves subtracting 3 months and adding 7 days to the first day
of the last menstrual period (March 15 - 3 months = Dec 15; Dec 15 + 7 days = Dec 22).
2. A woman is pregnant for the third time. She has one child born at 38 weeks
and had one miscarriage at 10 weeks. What is her GTPAL?
A. G3, T1, P1, A1, L1
B. G3, T2, P0, A1, L1
C. G2, T1, P1, A0, L1
D. G3, T1, P0, A1, L1
Answer: D
Rationale: Gravida (3 pregnancies), Term (1 birth at 38 weeks), Preterm (0), Abortion (1
miscarriage), Living (1 child).
,3. Which of the following is considered a positive sign of pregnancy?
A. Amenorrhea
B. Fetal heart tones heard by Doppler
C. Positive pregnancy test
D. Chadwick’s sign
Answer: B
Rationale: Positive signs are objective and can only be attributed to a fetus, such as
ultrasound visualization, fetal movement felt by a provider, or fetal heart tones.
4. At how many weeks of gestation is the fundus typically at the level of the
umbilicus?
A. 12 weeks
B. 16 weeks
C. 20 weeks
D. 24 weeks
Answer: C
Rationale: The fundus reaches the umbilicus at approximately 20 weeks of gestation.
5. What is the primary reason for the ‘physiological anemia’ of pregnancy?
A. Iron deficiency due to fetal demands
B. Decreased production of erythrocytes
C. Increase in plasma volume exceeds increase in red blood cell mass
D. Blood loss during the first trimester
Answer: C
Rationale: Plasma volume increases by 40-50% while RBC mass increases by 20-30%,
leading to hemodilution.
, 6. When is Rho(D) immune globulin (RhoGAM) typically administered to an Rh-
negative unsensitized mother?
A. 12 weeks gestation and 72 hours post-delivery
B. 28 weeks gestation and 72 hours post-delivery
C. Only after delivery if the baby is Rh-positive
D. At every prenatal visit
Answer: B
Rationale: RhoGAM is given at 28 weeks and within 72 hours after birth if the infant is Rh-
positive to prevent sensitization.
7. An elevated Alpha-Fetoprotein (AFP) level in maternal serum is associated
with which condition?
A. Down Syndrome
B. Gestational Diabetes
C. Neural Tube Defects
D. Fetal growth restriction
Answer: C
Rationale: High AFP levels are linked to neural tube defects like spina bifida; low levels are
associated with Down Syndrome.
8. What is the recommended screening window for Group B Streptococcus
(GBS) in pregnancy?
A. 24-28 weeks
B. 28-32 weeks
C. 35-37 weeks
D. At the first prenatal visit
Answer: C
Rationale: GBS screening is performed via vaginal/rectal swab at 35 to 37 weeks
gestation.
