Introduction to
Maternity and Pediatric
Nursing
SECTION 1: REPRODUCTIVE ANATOMY & PHYSIOLOGY (Questions 1–10)
Q1. Where does fertilization of the ovum typically occur?
A) Ovary
B) Uterus
C) Fallopian tube (ampulla)
D) Cervix
Answer: C. Fallopian tube (ampulla)
Rationale: Fertilization typically occurs in the ampulla (outer third) of the fallopian tube. The ovum is
viable for about 24 hours after ovulation, and sperm can survive up to 5 days in the female reproductive
tract.
Q2. Which hormone is responsible for maintaining the endometrial lining during the first trimester of
pregnancy?
A) Estrogen
B) Progesterone
C) Follicle-stimulating hormone (FSH)
D) Human chorionic gonadotropin (hCG)
Answer: B. Progesterone
Rationale: Progesterone, produced first by the corpus luteum and then by the placenta, maintains the
endometrial lining (decidua) to support the implanted embryo. hCG maintains the corpus luteum in
early pregnancy.
Q3. Which structure produces amniotic fluid?
,A) Placenta
B) Fetal kidneys
C) Amniotic membranes
D) Both B and C
Answer: D. Both B and C (Fetal kidneys and amniotic membranes)
Rationale: Amniotic fluid is produced by:
Amnion (membrane) in early pregnancy
Fetal urine (kidneys) after 16-20 weeks gestation
Abnormal fluid levels indicate potential fetal anomalies (oligohydramnios = renal issues;
polyhydramnios = GI or neural tube defects).
Q4. What is the normal location of the placenta in a healthy pregnancy?
A) Covering the internal cervical os
B) Attached to the lower uterine segment
C) Attached to the fundus (upper portion) of the uterus
D) Implanted into the myometrium
Answer: C. Attached to the fundus (upper portion) of the uterus
Rationale: The placenta normally implants in the fundus or upper uterine wall, which has the richest
blood supply. Placenta previa occurs when the placenta covers the cervical os. Placenta accreta occurs
when it invades the myometrium.
Q5. Which fetal structure allows blood to bypass the non-functioning lungs in utero?
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical vein
Answer: B. Foramen ovale
Rationale: The foramen ovale is an opening between the right and left atria that allows blood to bypass
the pulmonary circulation. At birth, increased left atrial pressure closes it. Other shunts: ductus
arteriosus (bypasses lungs) and ductus venosus (bypasses liver).
Q6. Which of the following is a normal finding in a term newborn's umbilical cord?
A) One artery and two veins
B) Two arteries and one vein
,C) One artery and one vein
D) Two arteries and two veins
Answer: B. Two arteries and one vein
Rationale: A normal umbilical cord contains two umbilical arteries (carry deoxygenated blood from
fetus to placenta) and one umbilical vein (carries oxygenated blood from placenta to fetus). A single
umbilical artery (SUA) may be associated with congenital anomalies.
Q7. At what gestational age is a fetus considered "term" by current ACOG definitions?
A) 37 0/7 to 38 6/7 weeks
B) 37 0/7 to 40 6/7 weeks
C) 39 0/7 to 40 6/7 weeks
D) 37 0/7 to 38 6/7 weeks for early term; 39 0/7 to 40 6/7 for full term
Answer: D. 37 0/7 to 38 6/7 = early term; 39 0/7 to 40 6/7 = full term
Rationale: ACOG (2013) updated definitions:
Early term: 37 0/7 – 38 6/7 weeks
Full term: 39 0/7 – 40 6/7 weeks
Late term: 41 0/7 – 41 6/7 weeks
Postterm: 42 0/7 weeks and beyond
Elective deliveries before 39 weeks are discouraged unless medically indicated.
Q8. What is the function of the mucous plug (operculum) during pregnancy?
A) Prevents infection from ascending into the uterus
B) Produces estrogen and progesterone
C) Facilitates fetal movement
D) Prevents preterm labor
Answer: A. Prevents infection from ascending into the uterus
Rationale: The mucous plug forms in the cervical canal and acts as a physical and immunological barrier
against bacteria ascending from the vagina. Loss of the mucous plug (bloody show) often precedes labor
by hours to days.
Q9. Which hormone triggers the let-down reflex (milk ejection) during breastfeeding?
A) Prolactin
B) Estrogen
, C) Oxytocin
D) Progesterone
Answer: C. Oxytocin
Rationale:
Oxytocin causes contraction of myoepithelial cells around alveoli, ejecting milk
Prolactin stimulates milk production
Oxytocin also stimulates uterine contractions, which helps postpartum involution
Q10. What is the normal fetal heart rate (FHR) range at term?
A) 80–100 beats per minute
B) 100–120 beats per minute
C) 110–160 beats per minute
D) 140–180 beats per minute
Answer: C. 110–160 beats per minute
Rationale: The normal baseline FHR for a term fetus is 110–160 bpm. Before 28 weeks, the baseline may
be slightly higher (up to 170 bpm). Bradycardia (<110) or tachycardia (>160) may indicate fetal distress,
infection, or maternal conditions.
SECTION 2: ANTEPARTUM (PRENATAL) CARE (Questions 11–25)
Q11. A pregnant woman at 12 weeks gestation asks when she will first feel fetal movement. What is
the nurse's best response?
A) "You should have felt movement by now."
B) "First-time mothers usually feel movement between 18-22 weeks."
C) "You won't feel movement until the third trimester."
D) "Movement is felt at 12 weeks in all pregnancies."
Answer: B. "First-time mothers usually feel movement between 18-22 weeks."
Rationale: Quickening (first fetal movement) typically occurs:
Primigravidas (first pregnancy): 18–22 weeks
Multigravidas (previous pregnancies): 16–20 weeks
Absence of movement by 24 weeks warrants evaluation.
Q12. Which of the following is a positive sign of pregnancy?
Maternity and Pediatric
Nursing
SECTION 1: REPRODUCTIVE ANATOMY & PHYSIOLOGY (Questions 1–10)
Q1. Where does fertilization of the ovum typically occur?
A) Ovary
B) Uterus
C) Fallopian tube (ampulla)
D) Cervix
Answer: C. Fallopian tube (ampulla)
Rationale: Fertilization typically occurs in the ampulla (outer third) of the fallopian tube. The ovum is
viable for about 24 hours after ovulation, and sperm can survive up to 5 days in the female reproductive
tract.
Q2. Which hormone is responsible for maintaining the endometrial lining during the first trimester of
pregnancy?
A) Estrogen
B) Progesterone
C) Follicle-stimulating hormone (FSH)
D) Human chorionic gonadotropin (hCG)
Answer: B. Progesterone
Rationale: Progesterone, produced first by the corpus luteum and then by the placenta, maintains the
endometrial lining (decidua) to support the implanted embryo. hCG maintains the corpus luteum in
early pregnancy.
Q3. Which structure produces amniotic fluid?
,A) Placenta
B) Fetal kidneys
C) Amniotic membranes
D) Both B and C
Answer: D. Both B and C (Fetal kidneys and amniotic membranes)
Rationale: Amniotic fluid is produced by:
Amnion (membrane) in early pregnancy
Fetal urine (kidneys) after 16-20 weeks gestation
Abnormal fluid levels indicate potential fetal anomalies (oligohydramnios = renal issues;
polyhydramnios = GI or neural tube defects).
Q4. What is the normal location of the placenta in a healthy pregnancy?
A) Covering the internal cervical os
B) Attached to the lower uterine segment
C) Attached to the fundus (upper portion) of the uterus
D) Implanted into the myometrium
Answer: C. Attached to the fundus (upper portion) of the uterus
Rationale: The placenta normally implants in the fundus or upper uterine wall, which has the richest
blood supply. Placenta previa occurs when the placenta covers the cervical os. Placenta accreta occurs
when it invades the myometrium.
Q5. Which fetal structure allows blood to bypass the non-functioning lungs in utero?
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical vein
Answer: B. Foramen ovale
Rationale: The foramen ovale is an opening between the right and left atria that allows blood to bypass
the pulmonary circulation. At birth, increased left atrial pressure closes it. Other shunts: ductus
arteriosus (bypasses lungs) and ductus venosus (bypasses liver).
Q6. Which of the following is a normal finding in a term newborn's umbilical cord?
A) One artery and two veins
B) Two arteries and one vein
,C) One artery and one vein
D) Two arteries and two veins
Answer: B. Two arteries and one vein
Rationale: A normal umbilical cord contains two umbilical arteries (carry deoxygenated blood from
fetus to placenta) and one umbilical vein (carries oxygenated blood from placenta to fetus). A single
umbilical artery (SUA) may be associated with congenital anomalies.
Q7. At what gestational age is a fetus considered "term" by current ACOG definitions?
A) 37 0/7 to 38 6/7 weeks
B) 37 0/7 to 40 6/7 weeks
C) 39 0/7 to 40 6/7 weeks
D) 37 0/7 to 38 6/7 weeks for early term; 39 0/7 to 40 6/7 for full term
Answer: D. 37 0/7 to 38 6/7 = early term; 39 0/7 to 40 6/7 = full term
Rationale: ACOG (2013) updated definitions:
Early term: 37 0/7 – 38 6/7 weeks
Full term: 39 0/7 – 40 6/7 weeks
Late term: 41 0/7 – 41 6/7 weeks
Postterm: 42 0/7 weeks and beyond
Elective deliveries before 39 weeks are discouraged unless medically indicated.
Q8. What is the function of the mucous plug (operculum) during pregnancy?
A) Prevents infection from ascending into the uterus
B) Produces estrogen and progesterone
C) Facilitates fetal movement
D) Prevents preterm labor
Answer: A. Prevents infection from ascending into the uterus
Rationale: The mucous plug forms in the cervical canal and acts as a physical and immunological barrier
against bacteria ascending from the vagina. Loss of the mucous plug (bloody show) often precedes labor
by hours to days.
Q9. Which hormone triggers the let-down reflex (milk ejection) during breastfeeding?
A) Prolactin
B) Estrogen
, C) Oxytocin
D) Progesterone
Answer: C. Oxytocin
Rationale:
Oxytocin causes contraction of myoepithelial cells around alveoli, ejecting milk
Prolactin stimulates milk production
Oxytocin also stimulates uterine contractions, which helps postpartum involution
Q10. What is the normal fetal heart rate (FHR) range at term?
A) 80–100 beats per minute
B) 100–120 beats per minute
C) 110–160 beats per minute
D) 140–180 beats per minute
Answer: C. 110–160 beats per minute
Rationale: The normal baseline FHR for a term fetus is 110–160 bpm. Before 28 weeks, the baseline may
be slightly higher (up to 170 bpm). Bradycardia (<110) or tachycardia (>160) may indicate fetal distress,
infection, or maternal conditions.
SECTION 2: ANTEPARTUM (PRENATAL) CARE (Questions 11–25)
Q11. A pregnant woman at 12 weeks gestation asks when she will first feel fetal movement. What is
the nurse's best response?
A) "You should have felt movement by now."
B) "First-time mothers usually feel movement between 18-22 weeks."
C) "You won't feel movement until the third trimester."
D) "Movement is felt at 12 weeks in all pregnancies."
Answer: B. "First-time mothers usually feel movement between 18-22 weeks."
Rationale: Quickening (first fetal movement) typically occurs:
Primigravidas (first pregnancy): 18–22 weeks
Multigravidas (previous pregnancies): 16–20 weeks
Absence of movement by 24 weeks warrants evaluation.
Q12. Which of the following is a positive sign of pregnancy?
