NUR 231 Final Exam: Childbearing & Child Caring Family 2026 Galen
1. A nurse is calculating a client’s expected date of delivery using Naegele’s rule.
The client’s last menstrual period began on March 10th. What is the expected
date of delivery?
A. December 17th
B. December 3rd
C. December 7th
D. January 17th
Answer: A
Rationale: Naegele’s rule is calculated by subtracting 3 months from the first day of the
last menstrual period and adding 7 days and 1 year. March 10 minus 3 months is December
10, plus 7 days is December 17.
2. Using the GTPAL system, how would a nurse document a client who is
currently pregnant, has one living child born at 39 weeks, and had one
miscarriage at 12 weeks?
A. G2 T1 P0 A1 L1
B. G3 T1 P0 A1 L1
C. G3 T1 P1 A0 L1
D. G2 T1 P1 A1 L2
Answer: B
Rationale: Gravida (G) is 3 (current, full term, miscarriage). Term (T) is 1 (born at 39
weeks). Preterm (P) is 0. Abortion (A) is 1 (miscarriage). Living (L) is 1.
,3. Which of the following is considered a positive sign of pregnancy?
A. Positive pregnancy test
B. Quickening
C. Amenorrhea
D. Fetal heart tones heard by Doppler
Answer: D
Rationale: Positive signs are objective and can only be attributed to a fetus: fetal heart
tones, visualization by ultrasound, or fetal movement palpated by an examiner. Others are
presumptive or probable.
4. A client at 32 weeks gestation reports feeling dizzy and lightheaded while
lying on her back. Which action should the nurse take first?
A. Notify the healthcare provider
B. Turn the client onto her side
C. Measure the client’s blood pressure
D. Administer oxygen via non-rebreather mask
Answer: B
Rationale: This is supine hypotensive syndrome caused by the uterus compressing the
vena cava. Turning the client to the side relieves the pressure and improves blood flow.
5. Which nutritional supplement is most critical in the first trimester to prevent
neural tube defects?
A. Iron
B. Calcium
C. Folic Acid
D. Vitamin C
Answer: C
Rationale: Folic acid intake is essential before and during early pregnancy to reduce the
risk of neural tube defects like spina bifida.
, 6. A nurse is assessing a client with preeclampsia who is receiving Magnesium
Sulfate. Which finding should the nurse report immediately?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10/min
C. Urine output of 40 mL/hr
D. Feeling of warmth and flushing
Answer: B
Rationale: Magnesium toxicity is characterized by respiratory depression (less than
12/min), loss of deep tendon reflexes, and decreased urine output. Flushing is a common
side effect, not toxicity.
7. Which medication is the antidote for Magnesium Sulfate toxicity?
A. Naloxone
B. Vitamin K
C. Terbutaline
D. Calcium Gluconate
Answer: D
Rationale: Calcium gluconate is the specific antagonist used to reverse the effects of
magnesium sulfate toxicity.
8. A client at 30 weeks gestation presents with painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio Placentae
B. Ectopic Pregnancy
C. Placenta Previa
D. Preterm Labor
Answer: C
Rationale: Placenta previa is characterized by painless, bright red bleeding. Abruptio
placentae usually presents with painful, dark red bleeding and a board-like abdomen.
1. A nurse is calculating a client’s expected date of delivery using Naegele’s rule.
The client’s last menstrual period began on March 10th. What is the expected
date of delivery?
A. December 17th
B. December 3rd
C. December 7th
D. January 17th
Answer: A
Rationale: Naegele’s rule is calculated by subtracting 3 months from the first day of the
last menstrual period and adding 7 days and 1 year. March 10 minus 3 months is December
10, plus 7 days is December 17.
2. Using the GTPAL system, how would a nurse document a client who is
currently pregnant, has one living child born at 39 weeks, and had one
miscarriage at 12 weeks?
A. G2 T1 P0 A1 L1
B. G3 T1 P0 A1 L1
C. G3 T1 P1 A0 L1
D. G2 T1 P1 A1 L2
Answer: B
Rationale: Gravida (G) is 3 (current, full term, miscarriage). Term (T) is 1 (born at 39
weeks). Preterm (P) is 0. Abortion (A) is 1 (miscarriage). Living (L) is 1.
,3. Which of the following is considered a positive sign of pregnancy?
A. Positive pregnancy test
B. Quickening
C. Amenorrhea
D. Fetal heart tones heard by Doppler
Answer: D
Rationale: Positive signs are objective and can only be attributed to a fetus: fetal heart
tones, visualization by ultrasound, or fetal movement palpated by an examiner. Others are
presumptive or probable.
4. A client at 32 weeks gestation reports feeling dizzy and lightheaded while
lying on her back. Which action should the nurse take first?
A. Notify the healthcare provider
B. Turn the client onto her side
C. Measure the client’s blood pressure
D. Administer oxygen via non-rebreather mask
Answer: B
Rationale: This is supine hypotensive syndrome caused by the uterus compressing the
vena cava. Turning the client to the side relieves the pressure and improves blood flow.
5. Which nutritional supplement is most critical in the first trimester to prevent
neural tube defects?
A. Iron
B. Calcium
C. Folic Acid
D. Vitamin C
Answer: C
Rationale: Folic acid intake is essential before and during early pregnancy to reduce the
risk of neural tube defects like spina bifida.
, 6. A nurse is assessing a client with preeclampsia who is receiving Magnesium
Sulfate. Which finding should the nurse report immediately?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10/min
C. Urine output of 40 mL/hr
D. Feeling of warmth and flushing
Answer: B
Rationale: Magnesium toxicity is characterized by respiratory depression (less than
12/min), loss of deep tendon reflexes, and decreased urine output. Flushing is a common
side effect, not toxicity.
7. Which medication is the antidote for Magnesium Sulfate toxicity?
A. Naloxone
B. Vitamin K
C. Terbutaline
D. Calcium Gluconate
Answer: D
Rationale: Calcium gluconate is the specific antagonist used to reverse the effects of
magnesium sulfate toxicity.
8. A client at 30 weeks gestation presents with painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio Placentae
B. Ectopic Pregnancy
C. Placenta Previa
D. Preterm Labor
Answer: C
Rationale: Placenta previa is characterized by painless, bright red bleeding. Abruptio
placentae usually presents with painful, dark red bleeding and a board-like abdomen.
