NR-327 – Maternal-Child Nursing Examines
nursing care during pregnancy, childbirth,
postpartum recovery, newborn development,
and pediatric health promotion activities.
1. A nurse is calculating a patient's estimated date of delivery (EDD) using
Naegele's rule. The patient's last menstrual period (LMP) began on May 10.
What is the EDD?
• A) February 3
• B) February 17
• C) March 3
• D) March 17
Answer: B
Rationale: Naegele's rule: LMP (May 10) → subtract 3 months (February 10) →
add 7 days = February 17. Assumes a 28-day cycle. This is the standard EDD
calculation.
2. A patient at 12 weeks gestation reports frequent urination. The nurse
explains this is due to:
• A) Urinary tract infection
• B) Enlarging uterus pressing on the bladder
• C) Decreased renal blood flow
• D) Gestational diabetes
Answer: B
Rationale: In the first trimester, the enlarging uterus (still within the
pelvis) compresses the bladder, causing urinary frequency. By second trimester,
the uterus rises into the abdomen, relieving frequency temporarily.
,3. A nurse is assessing a patient at 16 weeks gestation. Which finding is
considered a positive sign of pregnancy?
• A) Amenorrhea
• B) Chadwick's sign (bluish discoloration of cervix/vagina)
• C) Fetal heartbeat on Doppler
• D) Nausea and vomiting
Answer: C
Rationale: Positive signs of pregnancy are those directly attributable to the fetus:
fetal heart tones, fetal movement felt by examiner, and ultrasound visualization of
fetus. Amenorrhea, Chadwick's sign, and nausea are probable/presumptive signs.
4. A patient at 28 weeks gestation has a positive glucose screening test (1-hour
GTT = 155 mg/dL). The nurse anticipates:
• A) Diagnosis of gestational diabetes
• B) A 3-hour oral glucose tolerance test (OGTT)
• C) Immediate insulin therapy
• D) Repeat 1-hour test in 4 weeks
Answer: B
Rationale: A 1-hour glucose challenge test (GCT) ≥140 mg/dL (or ≥135-140
depending on guidelines) requires a 3-hour OGTT for definitive diagnosis of
gestational diabetes. Do not diagnose from screening alone.
5. A nurse is teaching about Rh incompatibility. An Rh-negative pregnant
patient who is not sensitized should receive RhoGAM at which times?
• A) Only after delivery if the baby is Rh-positive
• B) At 28 weeks gestation and within 72 hours after delivery if baby is Rh-
positive
• C) Only at the first prenatal visit
, • D) At 12 weeks and again at 36 weeks
Answer: B
Rationale: RhoGAM (Rh immune globulin) is given at 28 weeks
gestation (prophylaxis) and within 72 hours after delivery if the newborn is Rh-
positive. Also given after miscarriage, abortion, or invasive procedures.
6. A pregnant patient reports a sudden gush of fluid from the vagina. The
nurse notes the fluid is clear and tests positive for ferning. The nurse should:
• A) Send the patient home on bed rest
• B) Administer tocolytics immediately
• C) Notify the provider; suspect rupture of membranes
• D) Check cervical dilation
Answer: C
Rationale: Positive ferning (microscopic crystallization of amniotic fluid on a
slide) confirms rupture of membranes (ROM). Patient needs immediate evaluation
for infection (chorioamnionitis), cord prolapse, and gestational age.
7. A patient at 32 weeks gestation reports headache, blurred vision, and
epigastric pain. Blood pressure is 168/104 mm Hg. Urine protein is 3+. The
nurse suspects:
• A) Gestational hypertension
• B) Eclampsia
• C) Severe preeclampsia
• D) HELLP syndrome
Answer: C
Rationale: Severe preeclampsia = BP ≥160/110 + proteinuria + symptoms
(headache, visual changes, epigastric pain). Eclampsia = seizures. HELLP is a
variant with hemolysis, elevated liver enzymes, low platelets.
, 8. A patient at 38 weeks gestation has contractions every 3-5 minutes, cervix 4
cm dilated, 80% effaced. The nurse classifies this as:
• A) False labor (Braxton-Hicks)
• B) Latent phase (early) of first stage of labor
• C) Active phase of first stage of labor
• D) Transition phase
Answer: C
Rationale: Active phase of first stage of labor: cervical dilation 4-7 cm, regular
contractions, progressive effacement. Latent phase is 0-3 cm. Transition is 8-10
cm.
9. A nurse is administering the hepatitis B vaccine to a newborn. The nurse
should administer it:
• A) Within 12 hours of birth
• B) Within 24 hours of birth (after parental consent)
• C) At the 2-month well-child visit
• D) Only if the mother is HBsAg positive
Answer: B
Rationale: CDC recommends hepatitis B vaccine within 24 hours of birth for all
medically stable newborns weighing ≥2000 g, after parental consent. If mother is
HBsAg positive, also give HBIG within 12 hours.
10. A patient at 10 weeks gestation has hyperemesis gravidarum. Which
finding indicates a complication requiring hospitalization?
• A) Weight loss of 3% of pre-pregnancy weight
• B) Ketones in urine and inability to keep down fluids
• C) Nausea only in the morning
• D) Mild fatigue
nursing care during pregnancy, childbirth,
postpartum recovery, newborn development,
and pediatric health promotion activities.
1. A nurse is calculating a patient's estimated date of delivery (EDD) using
Naegele's rule. The patient's last menstrual period (LMP) began on May 10.
What is the EDD?
• A) February 3
• B) February 17
• C) March 3
• D) March 17
Answer: B
Rationale: Naegele's rule: LMP (May 10) → subtract 3 months (February 10) →
add 7 days = February 17. Assumes a 28-day cycle. This is the standard EDD
calculation.
2. A patient at 12 weeks gestation reports frequent urination. The nurse
explains this is due to:
• A) Urinary tract infection
• B) Enlarging uterus pressing on the bladder
• C) Decreased renal blood flow
• D) Gestational diabetes
Answer: B
Rationale: In the first trimester, the enlarging uterus (still within the
pelvis) compresses the bladder, causing urinary frequency. By second trimester,
the uterus rises into the abdomen, relieving frequency temporarily.
,3. A nurse is assessing a patient at 16 weeks gestation. Which finding is
considered a positive sign of pregnancy?
• A) Amenorrhea
• B) Chadwick's sign (bluish discoloration of cervix/vagina)
• C) Fetal heartbeat on Doppler
• D) Nausea and vomiting
Answer: C
Rationale: Positive signs of pregnancy are those directly attributable to the fetus:
fetal heart tones, fetal movement felt by examiner, and ultrasound visualization of
fetus. Amenorrhea, Chadwick's sign, and nausea are probable/presumptive signs.
4. A patient at 28 weeks gestation has a positive glucose screening test (1-hour
GTT = 155 mg/dL). The nurse anticipates:
• A) Diagnosis of gestational diabetes
• B) A 3-hour oral glucose tolerance test (OGTT)
• C) Immediate insulin therapy
• D) Repeat 1-hour test in 4 weeks
Answer: B
Rationale: A 1-hour glucose challenge test (GCT) ≥140 mg/dL (or ≥135-140
depending on guidelines) requires a 3-hour OGTT for definitive diagnosis of
gestational diabetes. Do not diagnose from screening alone.
5. A nurse is teaching about Rh incompatibility. An Rh-negative pregnant
patient who is not sensitized should receive RhoGAM at which times?
• A) Only after delivery if the baby is Rh-positive
• B) At 28 weeks gestation and within 72 hours after delivery if baby is Rh-
positive
• C) Only at the first prenatal visit
, • D) At 12 weeks and again at 36 weeks
Answer: B
Rationale: RhoGAM (Rh immune globulin) is given at 28 weeks
gestation (prophylaxis) and within 72 hours after delivery if the newborn is Rh-
positive. Also given after miscarriage, abortion, or invasive procedures.
6. A pregnant patient reports a sudden gush of fluid from the vagina. The
nurse notes the fluid is clear and tests positive for ferning. The nurse should:
• A) Send the patient home on bed rest
• B) Administer tocolytics immediately
• C) Notify the provider; suspect rupture of membranes
• D) Check cervical dilation
Answer: C
Rationale: Positive ferning (microscopic crystallization of amniotic fluid on a
slide) confirms rupture of membranes (ROM). Patient needs immediate evaluation
for infection (chorioamnionitis), cord prolapse, and gestational age.
7. A patient at 32 weeks gestation reports headache, blurred vision, and
epigastric pain. Blood pressure is 168/104 mm Hg. Urine protein is 3+. The
nurse suspects:
• A) Gestational hypertension
• B) Eclampsia
• C) Severe preeclampsia
• D) HELLP syndrome
Answer: C
Rationale: Severe preeclampsia = BP ≥160/110 + proteinuria + symptoms
(headache, visual changes, epigastric pain). Eclampsia = seizures. HELLP is a
variant with hemolysis, elevated liver enzymes, low platelets.
, 8. A patient at 38 weeks gestation has contractions every 3-5 minutes, cervix 4
cm dilated, 80% effaced. The nurse classifies this as:
• A) False labor (Braxton-Hicks)
• B) Latent phase (early) of first stage of labor
• C) Active phase of first stage of labor
• D) Transition phase
Answer: C
Rationale: Active phase of first stage of labor: cervical dilation 4-7 cm, regular
contractions, progressive effacement. Latent phase is 0-3 cm. Transition is 8-10
cm.
9. A nurse is administering the hepatitis B vaccine to a newborn. The nurse
should administer it:
• A) Within 12 hours of birth
• B) Within 24 hours of birth (after parental consent)
• C) At the 2-month well-child visit
• D) Only if the mother is HBsAg positive
Answer: B
Rationale: CDC recommends hepatitis B vaccine within 24 hours of birth for all
medically stable newborns weighing ≥2000 g, after parental consent. If mother is
HBsAg positive, also give HBIG within 12 hours.
10. A patient at 10 weeks gestation has hyperemesis gravidarum. Which
finding indicates a complication requiring hospitalization?
• A) Weight loss of 3% of pre-pregnancy weight
• B) Ketones in urine and inability to keep down fluids
• C) Nausea only in the morning
• D) Mild fatigue
