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NR602 PRIMARY CARE CHILDBEARING CHILDREARING
MIDTERM EXAM 2026/2027 | Grade A 100% Review |
Complete Solutions | Pass Guaranteed - A+ Graded
Section 1: Prenatal Care & Antepartum Management (Questions 1-18)
Q1. According to ACOG guidelines, how frequently should a low-risk primigravid
patient be seen for prenatal visits during the third trimester (28 weeks to delivery)?
A. Every 4 weeks
B. Every 2 weeks until 36 weeks, then weekly
C. Weekly beginning at 28 weeks
D. Every 3 weeks until 36 weeks, then every 2 weeks
B. Every 2 weeks until 36 weeks, then weekly [CORRECT]
Rationale: Standard prenatal visit frequency is every 4 weeks until 28 weeks
gestation, every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until
delivery. This schedule allows for timely detection of third-trimester complications.
Correct Answer: B
Q2. A 28-year-old G1P0 presents for her first prenatal visit at 10 weeks gestation.
Which of the following laboratory tests is routinely recommended at the initial
prenatal visit?
A. Quad marker screen
B. Group B Streptococcus culture
C. Type and screen, CBC, HIV, hepatitis B surface antigen, syphilis (RPR/VDRL), rubella
immunity, and urine culture
D. 1-hour glucose challenge test
,2
C. Type and screen, CBC, HIV, hepatitis B surface antigen, syphilis (RPR/VDRL), rubella
immunity, and urine culture [CORRECT]
Rationale: Initial prenatal labs include blood type and antibody screen, CBC,
infectious disease screening (HIV, hepatitis B, syphilis), rubella immunity, and urine
culture. GBS is screened at 36-37 weeks; GDM screening occurs at 24-28 weeks; quad
screen is a second-trimester aneuploidy screen.
Correct Answer: C
Q3. At what gestational age is the fetal anatomy ultrasound survey optimally
performed to assess fetal structures and detect anomalies?
A. 10-14 weeks
B. 15-17 weeks
C. 18-22 weeks
D. 24-28 weeks
C. 18-22 weeks [CORRECT]
Rationale: The detailed fetal anatomy survey is optimally performed between 18 and
22 weeks gestation when fetal structures are sufficiently developed for visualization
and amniotic fluid volume is adequate.
Correct Answer: C
Q4. A 32-year-old G2P1 at 26 weeks gestation presents for routine gestational
diabetes mellitus (GDM) screening. Using Carpenter-Coustan criteria, which 75g oral
glucose tolerance test value meets the threshold for GDM diagnosis?
A. Fasting 88 mg/dL
B. 1-hour 170 mg/dL
C. 2-hour 155 mg/dL
D. Fasting 95 mg/dL
D. Fasting 95 mg/dL [CORRECT]
,3
Rationale: Carpenter-Coustan diagnostic thresholds for GDM are fasting ≥92 mg/dL,
1-hour ≥180 mg/dL, and 2-hour ≥153 mg/dL. A fasting value of 95 mg/dL exceeds
the 92 mg/dL threshold. The 1-hour and 2-hour values listed are below diagnostic
thresholds.
Correct Answer: D
Q5. At what gestational age should Group B Streptococcus (GBS) rectovaginal
screening be performed in all pregnant patients, and what is the purpose?
A. 24-28 weeks; to prevent neonatal sepsis
B. 32-34 weeks; to determine antibiotic sensitivity
C. 36-37 weeks; to identify colonization and guide intrapartum antibiotic prophylaxis
D. 38-40 weeks; to assess for active infection
C. 36-37 weeks; to identify colonization and guide intrapartum antibiotic prophylaxis
[CORRECT]
Rationale: Universal GBS screening is performed at 36 0/7 to 37 6/7 weeks gestation.
Intrapartum antibiotic prophylaxis (penicillin G) is administered to GBS-positive
patients during labor to prevent early-onset neonatal GBS sepsis.
Correct Answer: C
Q6. A 24-year-old G1P0 at 32 weeks calls the office reporting sudden onset of severe
headache, visual changes (spots in vision), and right upper quadrant/epigastric pain.
What is the priority nursing action?
A. Schedule routine follow-up in 1 week
B. Advise acetaminophen and rest, then reassess tomorrow
C. Instruct her to proceed immediately to labor and delivery for evaluation for
preeclampsia with severe features
D. Recommend increasing fluid intake and monitoring blood pressure at home
, 4
C. Instruct her to proceed immediately to labor and delivery for evaluation for
preeclampsia with severe features [CORRECT]
Rationale: Headache, visual disturbances, and epigastric/RUQ pain are classic
warning signs of preeclampsia with severe features. These symptoms require
immediate evaluation in labor and delivery to prevent eclampsia, stroke, and HELLP
syndrome.
Correct Answer: C
Q7. A pregnant patient at her first prenatal visit is found to be rubella non-immune
(IgG negative). What is the standard management?
A. Administer MMR vaccine immediately
B. Administer MMR vaccine postpartum and advise avoiding pregnancy for 1 month
C. No intervention is necessary
D. Administer varicella vaccine instead
B. Administer MMR vaccine postpartum and advise avoiding pregnancy for 1 month
[CORRECT]
Rationale: MMR is a live-attenuated vaccine and is contraindicated during pregnancy
due to theoretical teratogenic risk. Non-immune patients receive MMR postpartum
and are counseled to avoid conception for 28 days.
Correct Answer: B
Q8. A 30-year-old G2P1, Rh-negative, presents at 28 weeks gestation. What is the
recommended management regarding Rh sensitization?
A. No intervention needed until delivery
B. Administer Rho(D) immune globulin (RhoGAM) at 28 weeks and within 72 hours
postpartum if the infant is Rh-positive
C. Administer RhoGAM only if the father is Rh-positive
D. Administer RhoGAM at 20 weeks only
NR602 PRIMARY CARE CHILDBEARING CHILDREARING
MIDTERM EXAM 2026/2027 | Grade A 100% Review |
Complete Solutions | Pass Guaranteed - A+ Graded
Section 1: Prenatal Care & Antepartum Management (Questions 1-18)
Q1. According to ACOG guidelines, how frequently should a low-risk primigravid
patient be seen for prenatal visits during the third trimester (28 weeks to delivery)?
A. Every 4 weeks
B. Every 2 weeks until 36 weeks, then weekly
C. Weekly beginning at 28 weeks
D. Every 3 weeks until 36 weeks, then every 2 weeks
B. Every 2 weeks until 36 weeks, then weekly [CORRECT]
Rationale: Standard prenatal visit frequency is every 4 weeks until 28 weeks
gestation, every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until
delivery. This schedule allows for timely detection of third-trimester complications.
Correct Answer: B
Q2. A 28-year-old G1P0 presents for her first prenatal visit at 10 weeks gestation.
Which of the following laboratory tests is routinely recommended at the initial
prenatal visit?
A. Quad marker screen
B. Group B Streptococcus culture
C. Type and screen, CBC, HIV, hepatitis B surface antigen, syphilis (RPR/VDRL), rubella
immunity, and urine culture
D. 1-hour glucose challenge test
,2
C. Type and screen, CBC, HIV, hepatitis B surface antigen, syphilis (RPR/VDRL), rubella
immunity, and urine culture [CORRECT]
Rationale: Initial prenatal labs include blood type and antibody screen, CBC,
infectious disease screening (HIV, hepatitis B, syphilis), rubella immunity, and urine
culture. GBS is screened at 36-37 weeks; GDM screening occurs at 24-28 weeks; quad
screen is a second-trimester aneuploidy screen.
Correct Answer: C
Q3. At what gestational age is the fetal anatomy ultrasound survey optimally
performed to assess fetal structures and detect anomalies?
A. 10-14 weeks
B. 15-17 weeks
C. 18-22 weeks
D. 24-28 weeks
C. 18-22 weeks [CORRECT]
Rationale: The detailed fetal anatomy survey is optimally performed between 18 and
22 weeks gestation when fetal structures are sufficiently developed for visualization
and amniotic fluid volume is adequate.
Correct Answer: C
Q4. A 32-year-old G2P1 at 26 weeks gestation presents for routine gestational
diabetes mellitus (GDM) screening. Using Carpenter-Coustan criteria, which 75g oral
glucose tolerance test value meets the threshold for GDM diagnosis?
A. Fasting 88 mg/dL
B. 1-hour 170 mg/dL
C. 2-hour 155 mg/dL
D. Fasting 95 mg/dL
D. Fasting 95 mg/dL [CORRECT]
,3
Rationale: Carpenter-Coustan diagnostic thresholds for GDM are fasting ≥92 mg/dL,
1-hour ≥180 mg/dL, and 2-hour ≥153 mg/dL. A fasting value of 95 mg/dL exceeds
the 92 mg/dL threshold. The 1-hour and 2-hour values listed are below diagnostic
thresholds.
Correct Answer: D
Q5. At what gestational age should Group B Streptococcus (GBS) rectovaginal
screening be performed in all pregnant patients, and what is the purpose?
A. 24-28 weeks; to prevent neonatal sepsis
B. 32-34 weeks; to determine antibiotic sensitivity
C. 36-37 weeks; to identify colonization and guide intrapartum antibiotic prophylaxis
D. 38-40 weeks; to assess for active infection
C. 36-37 weeks; to identify colonization and guide intrapartum antibiotic prophylaxis
[CORRECT]
Rationale: Universal GBS screening is performed at 36 0/7 to 37 6/7 weeks gestation.
Intrapartum antibiotic prophylaxis (penicillin G) is administered to GBS-positive
patients during labor to prevent early-onset neonatal GBS sepsis.
Correct Answer: C
Q6. A 24-year-old G1P0 at 32 weeks calls the office reporting sudden onset of severe
headache, visual changes (spots in vision), and right upper quadrant/epigastric pain.
What is the priority nursing action?
A. Schedule routine follow-up in 1 week
B. Advise acetaminophen and rest, then reassess tomorrow
C. Instruct her to proceed immediately to labor and delivery for evaluation for
preeclampsia with severe features
D. Recommend increasing fluid intake and monitoring blood pressure at home
, 4
C. Instruct her to proceed immediately to labor and delivery for evaluation for
preeclampsia with severe features [CORRECT]
Rationale: Headache, visual disturbances, and epigastric/RUQ pain are classic
warning signs of preeclampsia with severe features. These symptoms require
immediate evaluation in labor and delivery to prevent eclampsia, stroke, and HELLP
syndrome.
Correct Answer: C
Q7. A pregnant patient at her first prenatal visit is found to be rubella non-immune
(IgG negative). What is the standard management?
A. Administer MMR vaccine immediately
B. Administer MMR vaccine postpartum and advise avoiding pregnancy for 1 month
C. No intervention is necessary
D. Administer varicella vaccine instead
B. Administer MMR vaccine postpartum and advise avoiding pregnancy for 1 month
[CORRECT]
Rationale: MMR is a live-attenuated vaccine and is contraindicated during pregnancy
due to theoretical teratogenic risk. Non-immune patients receive MMR postpartum
and are counseled to avoid conception for 28 days.
Correct Answer: B
Q8. A 30-year-old G2P1, Rh-negative, presents at 28 weeks gestation. What is the
recommended management regarding Rh sensitization?
A. No intervention needed until delivery
B. Administer Rho(D) immune globulin (RhoGAM) at 28 weeks and within 72 hours
postpartum if the infant is Rh-positive
C. Administer RhoGAM only if the father is Rh-positive
D. Administer RhoGAM at 20 weeks only
