NR 602 Primary Care of Women & Child Health Midterm
Exam ACTUAL EXAM 2026: Comprehensive Questions &
Verified Answers (Detailed & Elaborated) 100% SOLVED
2026 | Grade A Guaranteed
Subject: Primary Care of Women & Child Health – Presumptive/Probable/Positive Signs of Pregnancy;
Naegele's Rule; Fundal Height; Breastfeeding; Vaccinations in Pregnancy; Contraception (COCs,
Progestin-Only, Emergency Contraception, Depo-Provera); Amenorrhea, Dysmenorrhea (Primary &
Secondary), Abnormal Uterine Bleeding (PALM-COEIN); Benign Breast Masses, Galactorrhea, Breast
Cancer Screening; Ectopic Pregnancy; STIs (Bacterial Vaginosis, Vulvovaginal Candidiasis, Chlamydia,
Gonorrhea, HSV, HPV, Syphilis, Chancroid); PID; Cervical Cancer Screening; Neonatal & Infant
Development (Birth-12 Months, Growth & Development Milestones, Red Flags, Teething, Tanner
Stages); Pediatric Dentistry; Infertility Risk Factors; Contraceptive Failure Rates.
Source: NR 602 Midterm Exam 2026, ACOG, CDC STI Guidelines, USPSTF, Bright Futures/AAP.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
What are presumptive signs of pregnancy?
Correct Answer: Amenorrhea, nausea/vomiting, breast engorgement/darkening of areola, breast
tenderness, fatigue, urinary frequency.
1. Presumptive signs are subjective findings that could be caused by other conditions (e.g.,
pseudocyesis, hormonal imbalance). Not diagnostic but suggestive.
2. These symptoms arise from hormonal changes (hCG, estrogen, progesterone). Often appear in first
trimester.
What are probable signs of pregnancy?
Correct Answer: Goodell sign (cervical softening), Chadwick sign (bluish coloration of
cervix/vagina), enlarged uterus, positive UPT (urine pregnancy test).
1. Probable signs are objective findings detected by examiner but can be caused by other conditions
(e.g., uterine fibroids).
2. Positive pregnancy test → detects hCG (also in molar pregnancy, choriocarcinoma).
What is Goodell sign?
Correct Answer: Cervical softening that happens around 4 weeks of pregnancy (due to increased
vascularity and edema).
1. Caused by hyperemia and hypertrophy of cervical glands. Assessed during bimanual exam.
2. Differentiate from other cervical changes (e.g., inflammatory softening).
, What is Chadwick sign?
Correct Answer: Bluish coloration of the vagina and cervix at 6-8 weeks during pregnancy
(increased vascularity).
1. Visible as early as 6 weeks. Caused by venous congestion from increased pelvic blood flow.
2. Also seen in estrogen excess states (e.g., oral contraceptives).
What are positive signs of pregnancy?
Correct Answer: Palpation of fetus by healthcare provider, ultrasound and visualization of fetus,
fetal heart tones auscultated by healthcare provider (Doppler or fetoscope).
1. Positive signs are definitive (cannot be caused by other conditions). Fetal heartbeat detectable by
Doppler at 10-12 weeks.
2. Ultrasound confirms intrauterine pregnancy, detects cardiac activity by 6 weeks transvaginally.
Where is the fundus at 12 weeks gestation?
Correct Answer: At the level of the symphysis pubis (just palpable above pubic bone).
1. Uterus rises out of pelvis between 12-14 weeks. Fundal height measurement in cm approximates
weeks of gestation (18-32 weeks).
2. Deviations (too high or too low) suggest dates miscalculated, multiple gestation, polyhydramnios, or
IUGR.
Where is the fundus at 16 weeks gestation?
Correct Answer: Between symphysis pubis and umbilicus (approximately halfway).
1. Fundal height ~14-16 cm. Fetal heart tones audible with Doppler.
Where is the fundus at 20 weeks gestation?
Correct Answer: The same height as the umbilicus (approximately 20 cm).
1. Fundus at umbilicus marks the halfway point. Fetal movements (quickening) typically felt by
primigravida at 18-20 weeks, multigravida 16-18 weeks.
What is Naegele's rule?
Correct Answer: Begin on the first day of the last menstrual period, subtract three months, add
seven days, then add one year (adjust year).
1. Assumes regular 28-day cycle with conception on day 14. Examples: LMP June 5, 2023 → June 5 -3
months = March 5 +7 days = March 12, 2024.
2. Most accurate for dating; ultrasound dating if cycles irregular.
Breast-fed baby should receive what vitamin?
Correct Answer: Vitamin D (400 IU daily starting within days of birth).
1. Breastmilk insufficient vitamin D (10-80 IU/L). Rickets risk in exclusively breastfed infants without
supplementation.
2. AAP recommends all breastfed infants receive 400 IU/day vitamin D starting first few days of life.
Exam ACTUAL EXAM 2026: Comprehensive Questions &
Verified Answers (Detailed & Elaborated) 100% SOLVED
2026 | Grade A Guaranteed
Subject: Primary Care of Women & Child Health – Presumptive/Probable/Positive Signs of Pregnancy;
Naegele's Rule; Fundal Height; Breastfeeding; Vaccinations in Pregnancy; Contraception (COCs,
Progestin-Only, Emergency Contraception, Depo-Provera); Amenorrhea, Dysmenorrhea (Primary &
Secondary), Abnormal Uterine Bleeding (PALM-COEIN); Benign Breast Masses, Galactorrhea, Breast
Cancer Screening; Ectopic Pregnancy; STIs (Bacterial Vaginosis, Vulvovaginal Candidiasis, Chlamydia,
Gonorrhea, HSV, HPV, Syphilis, Chancroid); PID; Cervical Cancer Screening; Neonatal & Infant
Development (Birth-12 Months, Growth & Development Milestones, Red Flags, Teething, Tanner
Stages); Pediatric Dentistry; Infertility Risk Factors; Contraceptive Failure Rates.
Source: NR 602 Midterm Exam 2026, ACOG, CDC STI Guidelines, USPSTF, Bright Futures/AAP.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
What are presumptive signs of pregnancy?
Correct Answer: Amenorrhea, nausea/vomiting, breast engorgement/darkening of areola, breast
tenderness, fatigue, urinary frequency.
1. Presumptive signs are subjective findings that could be caused by other conditions (e.g.,
pseudocyesis, hormonal imbalance). Not diagnostic but suggestive.
2. These symptoms arise from hormonal changes (hCG, estrogen, progesterone). Often appear in first
trimester.
What are probable signs of pregnancy?
Correct Answer: Goodell sign (cervical softening), Chadwick sign (bluish coloration of
cervix/vagina), enlarged uterus, positive UPT (urine pregnancy test).
1. Probable signs are objective findings detected by examiner but can be caused by other conditions
(e.g., uterine fibroids).
2. Positive pregnancy test → detects hCG (also in molar pregnancy, choriocarcinoma).
What is Goodell sign?
Correct Answer: Cervical softening that happens around 4 weeks of pregnancy (due to increased
vascularity and edema).
1. Caused by hyperemia and hypertrophy of cervical glands. Assessed during bimanual exam.
2. Differentiate from other cervical changes (e.g., inflammatory softening).
, What is Chadwick sign?
Correct Answer: Bluish coloration of the vagina and cervix at 6-8 weeks during pregnancy
(increased vascularity).
1. Visible as early as 6 weeks. Caused by venous congestion from increased pelvic blood flow.
2. Also seen in estrogen excess states (e.g., oral contraceptives).
What are positive signs of pregnancy?
Correct Answer: Palpation of fetus by healthcare provider, ultrasound and visualization of fetus,
fetal heart tones auscultated by healthcare provider (Doppler or fetoscope).
1. Positive signs are definitive (cannot be caused by other conditions). Fetal heartbeat detectable by
Doppler at 10-12 weeks.
2. Ultrasound confirms intrauterine pregnancy, detects cardiac activity by 6 weeks transvaginally.
Where is the fundus at 12 weeks gestation?
Correct Answer: At the level of the symphysis pubis (just palpable above pubic bone).
1. Uterus rises out of pelvis between 12-14 weeks. Fundal height measurement in cm approximates
weeks of gestation (18-32 weeks).
2. Deviations (too high or too low) suggest dates miscalculated, multiple gestation, polyhydramnios, or
IUGR.
Where is the fundus at 16 weeks gestation?
Correct Answer: Between symphysis pubis and umbilicus (approximately halfway).
1. Fundal height ~14-16 cm. Fetal heart tones audible with Doppler.
Where is the fundus at 20 weeks gestation?
Correct Answer: The same height as the umbilicus (approximately 20 cm).
1. Fundus at umbilicus marks the halfway point. Fetal movements (quickening) typically felt by
primigravida at 18-20 weeks, multigravida 16-18 weeks.
What is Naegele's rule?
Correct Answer: Begin on the first day of the last menstrual period, subtract three months, add
seven days, then add one year (adjust year).
1. Assumes regular 28-day cycle with conception on day 14. Examples: LMP June 5, 2023 → June 5 -3
months = March 5 +7 days = March 12, 2024.
2. Most accurate for dating; ultrasound dating if cycles irregular.
Breast-fed baby should receive what vitamin?
Correct Answer: Vitamin D (400 IU daily starting within days of birth).
1. Breastmilk insufficient vitamin D (10-80 IU/L). Rickets risk in exclusively breastfed infants without
supplementation.
2. AAP recommends all breastfed infants receive 400 IU/day vitamin D starting first few days of life.
