NSG 432 Maternal-Newborn Nursing Exam 1: (Latest 2026/2027 Update)
Comprehensive Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Maternal-Newborn Nursing / OB/GYN (NSG 432)
Source: Exam 1 Blueprint & Evidence-Based Clinical Guidelines (2026/2027 Update)
Format: Q&A Guide with Rationale – Antepartum, Intrapartum, Genetics, STIs, Reproductive Health
Verified: 100% Correct Answers | Grade A Guaranteed
1: A client gave birth to twin boys at 37 weeks, had a miscarriage at eight weeks, and is currently
pregnant. What is her GTPAL score?
Correct Answer: G3, T1, P0, A1, L2
1. GTPAL: Gravida (total pregnancies) = 3, Term births (≥37 weeks) = 1 (twins count as one term
delivery), Preterm (20-36.6 weeks) = 0, Abortions/miscarriages = 1, Living children = 2.
2. Twins are counted as one pregnancy event but L (living) counts each infant.
3. A common error is counting twins as separate preterm births; only the delivery event matters
for T/P/A.
2: Which medication is used for treatment of herpes during pregnancy?
Correct Answer: Acyclovir
1. Acyclovir is an antiviral that suppresses HSV outbreaks and reduces viral shedding.
2. It is pregnancy category B and considered safe to reduce risk of neonatal herpes transmission.
3. Valacyclovir and famciclovir are alternatives; acyclovir remains first-line for acute treatment.
3: What fluid discharge comes out of the nipple during early pregnancy at around 18 weeks?
Correct Answer: Colostrum
1. Colostrum is the first milk, rich in antibodies and nutrients, produced as early as 16-20 weeks.
2. It is thick, yellowish, and may leak from nipples due to hormonal changes (prolactin, estrogen).
3. Mature milk does not appear until 2-5 days postpartum; colostrum is the correct early
secretion.
4: What is the most common cause of anemia during pregnancy?
Correct Answer: Hemodilution (physiologic anemia from increased plasma volume)
1. Plasma volume increases 40-50%, while RBC mass increases only 20-30%, causing dilutional
hemoglobin drop.
2. This hemodilution is normal and peaks at 28-36 weeks; iron deficiency is also common but not
most prevalent cause.
3. A common wrong answer is "iron deficiency" – while important, hemodilution is the primary
physiologic cause.
,5: At what gestational age should testing for gestational diabetes be performed?
Correct Answer: 24-28 weeks
1. Placental hormones (hPL, cortisol) peak between 24-28 weeks, causing insulin resistance.
2. Screening typically uses 1-hour 50g glucose challenge; diagnostic 3-hour 100g OGTT if
positive.
3. Early testing (first trimester) may be done for high-risk patients, but standard window is 24-28
weeks.
6: Select the three categories of pregnancy signs: presumptive, probable, and ______.
Correct Answer: Positive
1. Presumptive = subjective (amenorrhea, nausea), probable = objective by examiner (Chadwick,
Goodell, positive pregnancy test), positive = definitive (fetal heart tones, ultrasound, fetal
movement felt by examiner).
2. Positive signs confirm pregnancy without doubt.
3. Errors often confuse probable (pregnancy test) as positive – but test can have false positives.
7: Which findings are considered positive signs of pregnancy (Select All That Apply)?
Correct Answer: Fetal heart rate, ultrasound visualization of fetus, fetal movement felt by examiner
1. Positive signs include auscultation of fetal heart tones, ultrasound confirmation, and palpation
of fetal parts/movements by examiner.
2. Patient-reported movement (quickening) is presumptive, not positive.
3. Hearing fetal heart with Doppler (10-12 weeks) is a positive sign after 10 weeks.
8: Which probable sign of pregnancy causes a purple/bluish discoloration of the cervix?
Correct Answer: Chadwick sign
1. Chadwick sign results from increased vascular congestion and estrogen, causing bluish-purple
cervix/vagina at 6-8 weeks.
2. It is a probable sign because it is objective but not definitive (can occur with other pelvic
congestion).
3. Goodell sign (softening of cervix) and Hegar sign (softening of uterine isthmus) are different
probable signs.
9: Which description matches Chadwick sign (probable sign of pregnancy)?
Correct Answer: Purple/bluish vaginal lining and cervix appearing at 6-8 weeks due to hyperemia
1. Chadwick sign is visible on speculum exam as violet/blue discoloration of cervix and vaginal
mucosa.
2. It occurs due to increased pelvic blood flow and estrogen effects.
3. The sign appears around 6-8 weeks gestation and is a probable, not positive, sign.
, 10: Which contraceptive method should be used with a water-soluble lubricant?
Correct Answer: Male condom (latex condom with water-soluble lubricant)
1. Oil-based lubricants degrade latex, increasing risk of breakage and STI/pregnancy.
2. Water-soluble lubricants are safe with latex condoms and do not compromise integrity.
3. Common wrong answer: using petroleum jelly – oil-based products cause latex deterioration.
11: Define "multipara" in obstetrics.
Correct Answer: A woman who has had two or more pregnancies that reached 20+ weeks gestation
1. Para counts deliveries after 20 weeks regardless of number of fetuses.
2. Multipara = ≥2 pregnancies reaching viability (20 weeks).
3. Primipara = 1; nullipara = 0. Often confused with gravida (any pregnancy).
12: What pregnancy outcome are adolescents more likely to experience compared to older mothers?
Correct Answer: Preterm birth
1. Adolescent pregnancy is associated with increased risk of preterm labor, low birth weight,
preeclampsia.
2. Biologic immaturity and inadequate prenatal care contribute.
3. They also have higher rates of anemia and STIs.
13: Parents are seeking infertility testing. The nurse explains that the first step in the evaluation
process is:
Correct Answer: Test the male partner first (semen analysis) because it is non-invasive
1. Semen analysis is inexpensive, non-invasive, and provides immediate information.
2. Female evaluation is more invasive (hysterosalpingogram, laparoscopy).
3. Standard infertility workup: male partner first, then female ovulatory/structural assessment.
14: What should the nurse tell parents who are considering infertility testing regarding time and
cost?
Correct Answer: It costs a lot and can take months to complete the full workup and treatment cycles.
1. Infertility evaluation may take 3-6 months; treatments like IVF are expensive and often not
fully covered by insurance.
2. Many couples require multiple cycles.
3. Set realistic expectations early to reduce frustration.
15: A patient states, "Dizygotic twins always have the same sex." Which statement indicates that
further teaching is required?
Correct Answer: "Dizygotic means they will always have the same sex." (This is false – dizygotic are
fraternal and can be same or opposite sex.)
1. Dizygotic twins result from two separate eggs fertilized by two sperm; they share ~50% DNA
like any siblings, can be same or different sex.
2. Monozygotic (identical) share same sex because they originate from one zygote.
3. The patient requires clarification about dizygotic genetics.
Comprehensive Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Maternal-Newborn Nursing / OB/GYN (NSG 432)
Source: Exam 1 Blueprint & Evidence-Based Clinical Guidelines (2026/2027 Update)
Format: Q&A Guide with Rationale – Antepartum, Intrapartum, Genetics, STIs, Reproductive Health
Verified: 100% Correct Answers | Grade A Guaranteed
1: A client gave birth to twin boys at 37 weeks, had a miscarriage at eight weeks, and is currently
pregnant. What is her GTPAL score?
Correct Answer: G3, T1, P0, A1, L2
1. GTPAL: Gravida (total pregnancies) = 3, Term births (≥37 weeks) = 1 (twins count as one term
delivery), Preterm (20-36.6 weeks) = 0, Abortions/miscarriages = 1, Living children = 2.
2. Twins are counted as one pregnancy event but L (living) counts each infant.
3. A common error is counting twins as separate preterm births; only the delivery event matters
for T/P/A.
2: Which medication is used for treatment of herpes during pregnancy?
Correct Answer: Acyclovir
1. Acyclovir is an antiviral that suppresses HSV outbreaks and reduces viral shedding.
2. It is pregnancy category B and considered safe to reduce risk of neonatal herpes transmission.
3. Valacyclovir and famciclovir are alternatives; acyclovir remains first-line for acute treatment.
3: What fluid discharge comes out of the nipple during early pregnancy at around 18 weeks?
Correct Answer: Colostrum
1. Colostrum is the first milk, rich in antibodies and nutrients, produced as early as 16-20 weeks.
2. It is thick, yellowish, and may leak from nipples due to hormonal changes (prolactin, estrogen).
3. Mature milk does not appear until 2-5 days postpartum; colostrum is the correct early
secretion.
4: What is the most common cause of anemia during pregnancy?
Correct Answer: Hemodilution (physiologic anemia from increased plasma volume)
1. Plasma volume increases 40-50%, while RBC mass increases only 20-30%, causing dilutional
hemoglobin drop.
2. This hemodilution is normal and peaks at 28-36 weeks; iron deficiency is also common but not
most prevalent cause.
3. A common wrong answer is "iron deficiency" – while important, hemodilution is the primary
physiologic cause.
,5: At what gestational age should testing for gestational diabetes be performed?
Correct Answer: 24-28 weeks
1. Placental hormones (hPL, cortisol) peak between 24-28 weeks, causing insulin resistance.
2. Screening typically uses 1-hour 50g glucose challenge; diagnostic 3-hour 100g OGTT if
positive.
3. Early testing (first trimester) may be done for high-risk patients, but standard window is 24-28
weeks.
6: Select the three categories of pregnancy signs: presumptive, probable, and ______.
Correct Answer: Positive
1. Presumptive = subjective (amenorrhea, nausea), probable = objective by examiner (Chadwick,
Goodell, positive pregnancy test), positive = definitive (fetal heart tones, ultrasound, fetal
movement felt by examiner).
2. Positive signs confirm pregnancy without doubt.
3. Errors often confuse probable (pregnancy test) as positive – but test can have false positives.
7: Which findings are considered positive signs of pregnancy (Select All That Apply)?
Correct Answer: Fetal heart rate, ultrasound visualization of fetus, fetal movement felt by examiner
1. Positive signs include auscultation of fetal heart tones, ultrasound confirmation, and palpation
of fetal parts/movements by examiner.
2. Patient-reported movement (quickening) is presumptive, not positive.
3. Hearing fetal heart with Doppler (10-12 weeks) is a positive sign after 10 weeks.
8: Which probable sign of pregnancy causes a purple/bluish discoloration of the cervix?
Correct Answer: Chadwick sign
1. Chadwick sign results from increased vascular congestion and estrogen, causing bluish-purple
cervix/vagina at 6-8 weeks.
2. It is a probable sign because it is objective but not definitive (can occur with other pelvic
congestion).
3. Goodell sign (softening of cervix) and Hegar sign (softening of uterine isthmus) are different
probable signs.
9: Which description matches Chadwick sign (probable sign of pregnancy)?
Correct Answer: Purple/bluish vaginal lining and cervix appearing at 6-8 weeks due to hyperemia
1. Chadwick sign is visible on speculum exam as violet/blue discoloration of cervix and vaginal
mucosa.
2. It occurs due to increased pelvic blood flow and estrogen effects.
3. The sign appears around 6-8 weeks gestation and is a probable, not positive, sign.
, 10: Which contraceptive method should be used with a water-soluble lubricant?
Correct Answer: Male condom (latex condom with water-soluble lubricant)
1. Oil-based lubricants degrade latex, increasing risk of breakage and STI/pregnancy.
2. Water-soluble lubricants are safe with latex condoms and do not compromise integrity.
3. Common wrong answer: using petroleum jelly – oil-based products cause latex deterioration.
11: Define "multipara" in obstetrics.
Correct Answer: A woman who has had two or more pregnancies that reached 20+ weeks gestation
1. Para counts deliveries after 20 weeks regardless of number of fetuses.
2. Multipara = ≥2 pregnancies reaching viability (20 weeks).
3. Primipara = 1; nullipara = 0. Often confused with gravida (any pregnancy).
12: What pregnancy outcome are adolescents more likely to experience compared to older mothers?
Correct Answer: Preterm birth
1. Adolescent pregnancy is associated with increased risk of preterm labor, low birth weight,
preeclampsia.
2. Biologic immaturity and inadequate prenatal care contribute.
3. They also have higher rates of anemia and STIs.
13: Parents are seeking infertility testing. The nurse explains that the first step in the evaluation
process is:
Correct Answer: Test the male partner first (semen analysis) because it is non-invasive
1. Semen analysis is inexpensive, non-invasive, and provides immediate information.
2. Female evaluation is more invasive (hysterosalpingogram, laparoscopy).
3. Standard infertility workup: male partner first, then female ovulatory/structural assessment.
14: What should the nurse tell parents who are considering infertility testing regarding time and
cost?
Correct Answer: It costs a lot and can take months to complete the full workup and treatment cycles.
1. Infertility evaluation may take 3-6 months; treatments like IVF are expensive and often not
fully covered by insurance.
2. Many couples require multiple cycles.
3. Set realistic expectations early to reduce frustration.
15: A patient states, "Dizygotic twins always have the same sex." Which statement indicates that
further teaching is required?
Correct Answer: "Dizygotic means they will always have the same sex." (This is false – dizygotic are
fraternal and can be same or opposite sex.)
1. Dizygotic twins result from two separate eggs fertilized by two sperm; they share ~50% DNA
like any siblings, can be same or different sex.
2. Monozygotic (identical) share same sex because they originate from one zygote.
3. The patient requires clarification about dizygotic genetics.
