Nursing Exam
Preperation Updated
NCC-Aligned Questions
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(Questions and Answers)
2026
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,Fetal Development Sequence Fertilization of egg by sperm -> blastocyst -> uterine implantation -> embryonic
stage -> fetal stage
Naegele rule - method of determining due date (EDD) of pregnancy
- date of onset of last period + 7 days - 3 months
Prenatal Screening : - lab & U/S exams
- screening of down syndrome, neural tube defects, and other genetic conditions
based on family HX
- invasive screenings: angiocentesis, CVS, PUBS
- maternal blood work for gender
- mothers who are RH - should receive 300 mg of Rhogam prior to any procedure
Recommended invasive prenatal dx test should be done - when one or both parents are carriers for specific genetic condition
when: - fetal anomaly visualized on U/S
- thicken nuchal transluceny of >3mm
chorionic villus sampling (CVS) -Prenatal diagnostic technique that involves taking a sample of tissue from the
chorion (transcervical or transabdominal)
- usually occurs at 10-13 weeks
- u/s prior and during procedure
-may slightly increase risk of misscarriage
-less common d/t alternative less invasive
- downs, cystic fibrosis, and sickle cell
Contradictions to a CVS procedure - Maternal RH sensitization
- active vag or cervical infection
- HX of vag bleeding in the last 2 weeks
-fibroids
-retroverted or retroflexed cervix
Cordocentesis (PUBS) - aka percutaneus umbilical blood sampling (PUBS)
- Performed after 17 weeks
- used to detect fetal blood disorders, chromosomal abnormalities, fetal infections
-umbilical vein preferred
- complications of bleeding at cord puncture site
Signs of pregnancy 1. hegar sign: lower uterine softening, starts at 4 weeks - 12 weeks, not useful for
multips
2. Chadwick sign: change in labia, cervix, vaginal color from pink to bluish violet.
Noted as early as 6 weeks
3. Goodell sign: cervical softening due to increased vascularization
First Trimester Characteristics First Trimester:
Defined as the time from fertilization to the end of the 12th week of pregnancy
Includes embryonic stage (weeks 3–8)
Major occurrences:
Implantation
Major organ development
Bone and tooth bud development
Sexual organs distinguishable
Nail beds form.
Spontaneous fetal movements begin.
Heartbeat audible via Doppler in 12th week
Some reflexes may be present (e.g., Babinski).
First Trimester Watch For Ectopic pregnancy, hyperemesis gravidarum, spontaneous abortion.
First Trimester Diet Small frequent meals if necessary; adequate calories, protein, iron, and folate.
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, What is the time frame for the second trimester? The second trimester is defined as the 13th week after conception to the end of
week 26.
What is the second trimester often referred to as? The 'honeymoon' period.
What major development occurs in the second trimester Bone formation.
related to bones?
What occurs in the second trimester regarding urine? Urine excretion into the amniotic fluid.
What major development occurs in the fetal brain during Fetal brain/CNS development.
the second trimester?
What significant lung development happens in the second Fetal lung/alveolar development.
trimester?
What reflex becomes present in the fetus during the Fetal startle reflex.
second trimester?
What sensory organs develop during the second Development of eyes and ears.
trimester?
What physical action can the fetus exhibit in the second Apparent sucking motions.
trimester?
What accumulates in the fetus during the second Subcutaneous fat.
trimester?
What pattern becomes noticeable in the fetus during the Noticeable sleep/wake pattern.
second trimester?
What late developments occur in the second trimester? Swallowing, hair patterns, lanugo, vernix caseosa, surfactant, and fingerprints.
Multiple Marker Screening - Quad Screen is used to identify open spina bifida defects, Down syndrome, or
trisomy 18, obtained between weeks 15 and 22.
- Positive tests may be followed up with an amniocentesis to confirm.
- Inhibin-A increases the likelihood of identifying Down syndrome and decreases
risk of false-positives.
Quad Screen Markers Alpha-fetoprotein (AFP) produced by fetus
Human chorionic gonadotropin (hCG) produced by placenta,
Estriol, unconjugated produced by fetus and placenta, and
Dimeric inhibin-A produced by placenta and ovaries.
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