NUR 2513 MATERNAL-CHILD NURSING FINAL EXAM
2026/2027 | Questions and Verified Answers | Graded A |
Rasmussen | Pass Guaranteed
Domain 1: Reproductive Health & Prenatal Care (12 Questions)
Q1: A 28-year-old primigravida at 10 weeks gestation presents for her first prenatal visit.
Her BMI is 31 kg/m², and she reports consuming 1-2 glasses of wine weekly before
pregnancy but has stopped since her positive pregnancy test. Which nursing
intervention takes priority for this patient?
A. Calculate total weight gain goal of 25-35 pounds for the entire pregnancy
B. Provide counseling about complete alcohol abstinence throughout pregnancy
C. Assess for gestational diabetes risk factors and schedule early glucose screening
D. Recommend increasing caloric intake by 500 calories daily starting immediately
Correct Answer: B [CORRECT]
Rationale: While all options address relevant prenatal concerns, complete alcohol
abstinence counseling takes priority because there is no established safe level of
alcohol consumption during pregnancy, and fetal alcohol spectrum disorders (FASDs)
can occur with even minimal exposure, particularly during the first trimester when
organogenesis is occurring.
● Option A is incorrect because the recommended weight gain for a patient with
pre-pregnancy BMI of 31 (obese class I) is 11-20 pounds total, not 25-35 pounds.
The 25-35 pound recommendation applies to normal BMI (18.5-24.9).
, ● Option C is incorrect because while obesity is a risk factor for gestational
diabetes, early glucose screening (before 24-28 weeks) is only indicated for
patients with additional high-risk factors such as previous GDM, glycosuria, or
strong family history. This patient requires standard screening at 24-28 weeks
unless additional risk factors emerge.
● Option D is incorrect because caloric increase recommendations are
trimester-specific: no additional calories in first trimester, +340 calories/day in
second trimester, and +452 calories/day in third trimester. Immediate 500-calorie
increase would promote excessive weight gain.
Q2: A nurse is reviewing laboratory results for a 16-week pregnant patient. Which finding
requires immediate follow-up and possible intervention?
A. Hemoglobin 11.2 g/dL, Hematocrit 33%
B. Rubella titer: non-immune (IgG negative)
C. 1-hour glucose challenge test: 145 mg/dL
D. Blood type: O negative with antibody screen negative
Correct Answer: C [CORRECT]
Rationale: A 1-hour glucose challenge test result of 145 mg/dL requires immediate
follow-up because it exceeds the standard screening threshold of 130-140 mg/dL
(depending on institutional protocol) and necessitates a diagnostic 3-hour oral glucose
tolerance test (OGTT) to rule out gestational diabetes mellitus (GDM). Untreated GDM
significantly increases risks for macrosomia, birth trauma, neonatal hypoglycemia, and
long-term metabolic complications for both mother and child.
● Option A is incorrect because hemoglobin of 11.2 g/dL and hematocrit of 33%
represent physiologic anemia of pregnancy due to plasma volume expansion
exceeding red blood cell production. These values are within expected range for
second trimester (normal: Hgb ≥11.0 g/dL, Hct ≥33% in 2nd trimester; Hgb ≥11.0
g/dL, Hct ≥33% in 3rd trimester per CDC criteria).
, ● Option B is incorrect because while rubella non-immunity requires counseling
about avoiding exposure and postpartum vaccination, it does not require
immediate intervention during pregnancy since live attenuated vaccines are
contraindicated in pregnancy.
● Option D is incorrect because O negative blood type with negative antibody
screen requires only standard Rh immune globulin (RhoGAM) administration at
28 weeks and postpartum, which is routine rather than urgent.
Q3: A pregnant patient at 32 weeks gestation calls the clinic reporting decreased fetal
movement over the past 24 hours. She typically feels 10 movements within 2 hours but
has only felt 3 movements in the past 12 hours. What is the nurse's priority action?
A. Reassure the patient that fetal movement naturally decreases in late pregnancy due
to limited space
B. Instruct the patient to perform a formal kick count and call back if fewer than 10
movements in 2 hours
C. Advise immediate presentation to labor and delivery for fetal heart rate monitoring
and biophysical profile
D. Schedule a routine follow-up appointment within the next 2-3 days for assessment
Correct Answer: C [CORRECT]
Rationale: Decreased fetal movement (DFM) in the third trimester is a potential sign of
fetal compromise and requires immediate evaluation. Maternal perception of reduced
fetal activity is associated with increased risk of stillbirth, fetal growth restriction,
oligohydramnios, and umbilical cord complications. The patient should be directed to
labor and delivery immediately for non-stress test (NST) and possibly biophysical profile
(BPP) to assess fetal well-being.
● Option A is incorrect because while fetal movement patterns may change in late
pregnancy (more rolling, less kicking), total movement count should not
, significantly decrease. Reassurance without assessment could delay diagnosis
of fetal distress.
● Option B is incorrect because formal kick counts are used for routine screening,
not for evaluating already-reported decreased movement. Once DFM is reported,
immediate professional assessment is required rather than delayed home
monitoring.
● Option D is incorrect because scheduling routine follow-up in 2-3 days creates
dangerous delay. Fetal compromise can progress rapidly, and immediate
assessment is standard of care for DFM after 28 weeks.
Q4: A nurse is teaching a pregnant patient about essential nutrients. Which statement
by the patient indicates understanding of folic acid requirements?
A. "I need to take 400 mcg daily throughout pregnancy to prevent neural tube defects."
B. "I should increase to 600 mcg daily now that I'm pregnant, and continue through the
first trimester."
C. "I need 600 mcg daily throughout pregnancy, and 500 mcg if I breastfeed."
D. "Since I'm past the first trimester, I can stop taking folic acid supplements now."
Correct Answer: C [CORRECT]
Rationale: The correct folic acid requirement is 600 mcg (0.6 mg) daily throughout
pregnancy, increasing to 500 mcg during lactation. Folic acid is essential for DNA
synthesis, cell division, and prevention of neural tube defects (NTDs). While NTD closure
occurs by 4 weeks post-conception (before many women know they're pregnant),
continued folate is necessary for placental development, rapid fetal growth, and
maternal erythropoiesis.
● Option A is incorrect because 400 mcg is the preconception and early pregnancy
recommendation (at least 1 month before conception through first trimester), but
insufficient for second and third trimesters when demands increase.
2026/2027 | Questions and Verified Answers | Graded A |
Rasmussen | Pass Guaranteed
Domain 1: Reproductive Health & Prenatal Care (12 Questions)
Q1: A 28-year-old primigravida at 10 weeks gestation presents for her first prenatal visit.
Her BMI is 31 kg/m², and she reports consuming 1-2 glasses of wine weekly before
pregnancy but has stopped since her positive pregnancy test. Which nursing
intervention takes priority for this patient?
A. Calculate total weight gain goal of 25-35 pounds for the entire pregnancy
B. Provide counseling about complete alcohol abstinence throughout pregnancy
C. Assess for gestational diabetes risk factors and schedule early glucose screening
D. Recommend increasing caloric intake by 500 calories daily starting immediately
Correct Answer: B [CORRECT]
Rationale: While all options address relevant prenatal concerns, complete alcohol
abstinence counseling takes priority because there is no established safe level of
alcohol consumption during pregnancy, and fetal alcohol spectrum disorders (FASDs)
can occur with even minimal exposure, particularly during the first trimester when
organogenesis is occurring.
● Option A is incorrect because the recommended weight gain for a patient with
pre-pregnancy BMI of 31 (obese class I) is 11-20 pounds total, not 25-35 pounds.
The 25-35 pound recommendation applies to normal BMI (18.5-24.9).
, ● Option C is incorrect because while obesity is a risk factor for gestational
diabetes, early glucose screening (before 24-28 weeks) is only indicated for
patients with additional high-risk factors such as previous GDM, glycosuria, or
strong family history. This patient requires standard screening at 24-28 weeks
unless additional risk factors emerge.
● Option D is incorrect because caloric increase recommendations are
trimester-specific: no additional calories in first trimester, +340 calories/day in
second trimester, and +452 calories/day in third trimester. Immediate 500-calorie
increase would promote excessive weight gain.
Q2: A nurse is reviewing laboratory results for a 16-week pregnant patient. Which finding
requires immediate follow-up and possible intervention?
A. Hemoglobin 11.2 g/dL, Hematocrit 33%
B. Rubella titer: non-immune (IgG negative)
C. 1-hour glucose challenge test: 145 mg/dL
D. Blood type: O negative with antibody screen negative
Correct Answer: C [CORRECT]
Rationale: A 1-hour glucose challenge test result of 145 mg/dL requires immediate
follow-up because it exceeds the standard screening threshold of 130-140 mg/dL
(depending on institutional protocol) and necessitates a diagnostic 3-hour oral glucose
tolerance test (OGTT) to rule out gestational diabetes mellitus (GDM). Untreated GDM
significantly increases risks for macrosomia, birth trauma, neonatal hypoglycemia, and
long-term metabolic complications for both mother and child.
● Option A is incorrect because hemoglobin of 11.2 g/dL and hematocrit of 33%
represent physiologic anemia of pregnancy due to plasma volume expansion
exceeding red blood cell production. These values are within expected range for
second trimester (normal: Hgb ≥11.0 g/dL, Hct ≥33% in 2nd trimester; Hgb ≥11.0
g/dL, Hct ≥33% in 3rd trimester per CDC criteria).
, ● Option B is incorrect because while rubella non-immunity requires counseling
about avoiding exposure and postpartum vaccination, it does not require
immediate intervention during pregnancy since live attenuated vaccines are
contraindicated in pregnancy.
● Option D is incorrect because O negative blood type with negative antibody
screen requires only standard Rh immune globulin (RhoGAM) administration at
28 weeks and postpartum, which is routine rather than urgent.
Q3: A pregnant patient at 32 weeks gestation calls the clinic reporting decreased fetal
movement over the past 24 hours. She typically feels 10 movements within 2 hours but
has only felt 3 movements in the past 12 hours. What is the nurse's priority action?
A. Reassure the patient that fetal movement naturally decreases in late pregnancy due
to limited space
B. Instruct the patient to perform a formal kick count and call back if fewer than 10
movements in 2 hours
C. Advise immediate presentation to labor and delivery for fetal heart rate monitoring
and biophysical profile
D. Schedule a routine follow-up appointment within the next 2-3 days for assessment
Correct Answer: C [CORRECT]
Rationale: Decreased fetal movement (DFM) in the third trimester is a potential sign of
fetal compromise and requires immediate evaluation. Maternal perception of reduced
fetal activity is associated with increased risk of stillbirth, fetal growth restriction,
oligohydramnios, and umbilical cord complications. The patient should be directed to
labor and delivery immediately for non-stress test (NST) and possibly biophysical profile
(BPP) to assess fetal well-being.
● Option A is incorrect because while fetal movement patterns may change in late
pregnancy (more rolling, less kicking), total movement count should not
, significantly decrease. Reassurance without assessment could delay diagnosis
of fetal distress.
● Option B is incorrect because formal kick counts are used for routine screening,
not for evaluating already-reported decreased movement. Once DFM is reported,
immediate professional assessment is required rather than delayed home
monitoring.
● Option D is incorrect because scheduling routine follow-up in 2-3 days creates
dangerous delay. Fetal compromise can progress rapidly, and immediate
assessment is standard of care for DFM after 28 weeks.
Q4: A nurse is teaching a pregnant patient about essential nutrients. Which statement
by the patient indicates understanding of folic acid requirements?
A. "I need to take 400 mcg daily throughout pregnancy to prevent neural tube defects."
B. "I should increase to 600 mcg daily now that I'm pregnant, and continue through the
first trimester."
C. "I need 600 mcg daily throughout pregnancy, and 500 mcg if I breastfeed."
D. "Since I'm past the first trimester, I can stop taking folic acid supplements now."
Correct Answer: C [CORRECT]
Rationale: The correct folic acid requirement is 600 mcg (0.6 mg) daily throughout
pregnancy, increasing to 500 mcg during lactation. Folic acid is essential for DNA
synthesis, cell division, and prevention of neural tube defects (NTDs). While NTD closure
occurs by 4 weeks post-conception (before many women know they're pregnant),
continued folate is necessary for placental development, rapid fetal growth, and
maternal erythropoiesis.
● Option A is incorrect because 400 mcg is the preconception and early pregnancy
recommendation (at least 1 month before conception through first trimester), but
insufficient for second and third trimesters when demands increase.
