Maternity Nursing: Antepartum
NCLEX Practice Questions #6 | 55
Questions
1. Question
A nursing instructor is conducting a lecture and is reviewing the
functions of the female reproductive system. She asks the
student nurse to describe the follicle-stimulating hormone (FSH)
and the luteinizing hormone (LH). The student nurse accurately
responds by stating that:
o A. FSH and LH are released from the anterior
pituitary gland.
o B. FSH and LH are secreted by the corpus luteum of the
ovary
o C. FSH and LH are secreted by the adrenal glands
o D. FSH and LH stimulate the formation of milk during
pregnancy.
Incorrect
Correct Answer: A. FSH and LH are released from the
anterior pituitary gland.
FSH and LH, when stimulated by the gonadotropin-releasing
hormone from the hypothalamus, are released from the anterior
pituitary gland to stimulate follicular growth and development,
the growth of the Graafian follicle, and production of
progesterone.
Option B: The primary hormone produced from the
corpus luteum is progesterone, but it also produces
inhibin A and estradiol. In the absence of fertilization,
the corpus luteum will regress over time.
Option C: Development of the ovarian follicle is
largely under FSH control, and the secretion of
estrogen from this follicle is dependent on FSH and LH.
The granulosa cells of the ovary secrete inhibin, which
plays a role in cellular differentiation.
, Option D: In women, LH stimulates estrogen and
progesterone production from the ovary. A surge of LH
in the mid menstrual cycle is responsible for ovulation,
and continued LH secretion subsequently stimulates
the corpus luteum to produce progesterone.
2. 2. Question
A nurse is describing the process of fetal circulation to a client
during a prenatal visit. The nurse accurately tells the client that
fetal circulation consists of:
A. Two umbilical veins and one umbilical artery.
B. Two umbilical arteries and one umbilical vein.
C. Arteries carrying oxygenated blood to the fetus.
D. Veins carrying deoxygenated blood to the fetus.
Incorrect
Correct Answer: B. Two umbilical arteries and one
umbilical vein.
Blood pumped by the embryo’s heart leaves the embryo through
two umbilical arteries. Once oxygenated, the blood then is
returned by one umbilical vein. Arteries carry deoxygenated
blood and waste products from the fetus, and veins carry
oxygenated blood and provide oxygen and nutrients to the fetus.
Option A: The fetal circulation system is distinctly
different from adult circulation. This intricate system
allows the fetus to receive oxygenated blood and
nutrients from the placenta. It comprises the blood
vessels in the placenta and the umbilical cord, which
contains two umbilical arteries and one umbilical vein.
Option C: Oxygenated blood from the mother in the
placenta flows through the umbilical vein and into the
inferior vena cava (IVC), bypassing the liver via the
ductus venosus. From the IVC, oxygenated blood
travels to the right atrium of the heart. There is
greater pressure in the right atrium compared to the
left atrium in fetal circulation; therefore most of the
blood is shunted from the right atrium to the left
, atrium through an opening called the foramen ovale.
Once in the left atrium, blood travels through the left
ventricle into the aorta and the systemic circulation.
Option D: The deoxygenated blood travels back to
the placenta via the umbilical arteries to be
oxygenated by the mother. Additionally, some
oxygenated blood in the right atrium can also enter
the right ventricle and then the pulmonary artery.
Because there is high resistance to blood flow in the
lungs, the blood is shunted from the pulmonary artery
into the aorta via the ductus arteriosus, hence
bypassing the lungs. Blood then enters the systemic
circulation, and the deoxygenated blood is recycled
back to the mother via the umbilical arteries.
3. 3. Question
During a prenatal visit at 38 weeks, a nurse assesses the fetal
heart rate. The nurse determines that the fetal heart rate is
normal if which of the following is noted?
A. 80 BPM
B. 100 BPM
C. 150 BPM
D. 180 BPM
Incorrect
Correct Answer: C. 150 BPM.
The fetal heart rate depends on gestational age and ranges from
160-170 BPM in the first trimester but slows with fetal growth to
120-160 BPM near or at term. At or near term, if the fetal heart
rate is less than 120 or more than 160 BPM with the uterus at
rest, the fetus may be in distress.
Option A: Data from a recently published study in a
different context (Serra et al., 2009) is compatible with
the findings of our exploratory analysis with a lower
limit of 115 or 120 bpm for the gestational ages. Data
for the 97th and 99th percentiles are not shown in this
study. But shifting the lower limit to 120 will increase
, the number of false alarms whereas a lower limit of
115 will inevitably increase the risk to misinterpret
maternal heart rates as fetal heart rate.
Option B: A lower limit of 120 bpm leads only near
term to more false alarms since normal FHR decreases
further, and is more appropriate, to avoid
misinterpretation of maternal heartbeat as FHR.
Option D: The upper limit of 160 bpm raised concerns
in the FIGO meeting in 1985, as Saling described
abnormal findings in 24% of scalp blood analyses if
the baseline was higher than 160 bpm. It could be
shown that the current FIGO guidelines based on
computerized analyses of the CTG show a high
sensitivity to detect fetal acidosis in case of a suspect
or pathological classification of the baseline level.
4. 4. Question
A client arrives at a prenatal clinic for the first prenatal
assessment. The client tells a nurse that the first day of her last
menstrual period was September 19th, 2013. Using Naegele’s
rule, the nurse determines the estimated date of confinement as:
A. July 26, 2013
B. June 12, 2014
C. June 26, 2014
D. July 12, 2014
Incorrect
Correct Answer: C. June 26, 2014.
Accurate use of Naegele’s rule requires that the woman has a
regular 28-day menstrual cycle. Add 7 days to the first day of the
last menstrual period, subtract three months, and then add one
year to that date.
Option A: An average pregnancy lasts 280 days from
the first day of the last menstrual period (LMP) or 266
days after conception. Historically, an accurate LMP is
the best estimator to determine the due date.
NCLEX Practice Questions #6 | 55
Questions
1. Question
A nursing instructor is conducting a lecture and is reviewing the
functions of the female reproductive system. She asks the
student nurse to describe the follicle-stimulating hormone (FSH)
and the luteinizing hormone (LH). The student nurse accurately
responds by stating that:
o A. FSH and LH are released from the anterior
pituitary gland.
o B. FSH and LH are secreted by the corpus luteum of the
ovary
o C. FSH and LH are secreted by the adrenal glands
o D. FSH and LH stimulate the formation of milk during
pregnancy.
Incorrect
Correct Answer: A. FSH and LH are released from the
anterior pituitary gland.
FSH and LH, when stimulated by the gonadotropin-releasing
hormone from the hypothalamus, are released from the anterior
pituitary gland to stimulate follicular growth and development,
the growth of the Graafian follicle, and production of
progesterone.
Option B: The primary hormone produced from the
corpus luteum is progesterone, but it also produces
inhibin A and estradiol. In the absence of fertilization,
the corpus luteum will regress over time.
Option C: Development of the ovarian follicle is
largely under FSH control, and the secretion of
estrogen from this follicle is dependent on FSH and LH.
The granulosa cells of the ovary secrete inhibin, which
plays a role in cellular differentiation.
, Option D: In women, LH stimulates estrogen and
progesterone production from the ovary. A surge of LH
in the mid menstrual cycle is responsible for ovulation,
and continued LH secretion subsequently stimulates
the corpus luteum to produce progesterone.
2. 2. Question
A nurse is describing the process of fetal circulation to a client
during a prenatal visit. The nurse accurately tells the client that
fetal circulation consists of:
A. Two umbilical veins and one umbilical artery.
B. Two umbilical arteries and one umbilical vein.
C. Arteries carrying oxygenated blood to the fetus.
D. Veins carrying deoxygenated blood to the fetus.
Incorrect
Correct Answer: B. Two umbilical arteries and one
umbilical vein.
Blood pumped by the embryo’s heart leaves the embryo through
two umbilical arteries. Once oxygenated, the blood then is
returned by one umbilical vein. Arteries carry deoxygenated
blood and waste products from the fetus, and veins carry
oxygenated blood and provide oxygen and nutrients to the fetus.
Option A: The fetal circulation system is distinctly
different from adult circulation. This intricate system
allows the fetus to receive oxygenated blood and
nutrients from the placenta. It comprises the blood
vessels in the placenta and the umbilical cord, which
contains two umbilical arteries and one umbilical vein.
Option C: Oxygenated blood from the mother in the
placenta flows through the umbilical vein and into the
inferior vena cava (IVC), bypassing the liver via the
ductus venosus. From the IVC, oxygenated blood
travels to the right atrium of the heart. There is
greater pressure in the right atrium compared to the
left atrium in fetal circulation; therefore most of the
blood is shunted from the right atrium to the left
, atrium through an opening called the foramen ovale.
Once in the left atrium, blood travels through the left
ventricle into the aorta and the systemic circulation.
Option D: The deoxygenated blood travels back to
the placenta via the umbilical arteries to be
oxygenated by the mother. Additionally, some
oxygenated blood in the right atrium can also enter
the right ventricle and then the pulmonary artery.
Because there is high resistance to blood flow in the
lungs, the blood is shunted from the pulmonary artery
into the aorta via the ductus arteriosus, hence
bypassing the lungs. Blood then enters the systemic
circulation, and the deoxygenated blood is recycled
back to the mother via the umbilical arteries.
3. 3. Question
During a prenatal visit at 38 weeks, a nurse assesses the fetal
heart rate. The nurse determines that the fetal heart rate is
normal if which of the following is noted?
A. 80 BPM
B. 100 BPM
C. 150 BPM
D. 180 BPM
Incorrect
Correct Answer: C. 150 BPM.
The fetal heart rate depends on gestational age and ranges from
160-170 BPM in the first trimester but slows with fetal growth to
120-160 BPM near or at term. At or near term, if the fetal heart
rate is less than 120 or more than 160 BPM with the uterus at
rest, the fetus may be in distress.
Option A: Data from a recently published study in a
different context (Serra et al., 2009) is compatible with
the findings of our exploratory analysis with a lower
limit of 115 or 120 bpm for the gestational ages. Data
for the 97th and 99th percentiles are not shown in this
study. But shifting the lower limit to 120 will increase
, the number of false alarms whereas a lower limit of
115 will inevitably increase the risk to misinterpret
maternal heart rates as fetal heart rate.
Option B: A lower limit of 120 bpm leads only near
term to more false alarms since normal FHR decreases
further, and is more appropriate, to avoid
misinterpretation of maternal heartbeat as FHR.
Option D: The upper limit of 160 bpm raised concerns
in the FIGO meeting in 1985, as Saling described
abnormal findings in 24% of scalp blood analyses if
the baseline was higher than 160 bpm. It could be
shown that the current FIGO guidelines based on
computerized analyses of the CTG show a high
sensitivity to detect fetal acidosis in case of a suspect
or pathological classification of the baseline level.
4. 4. Question
A client arrives at a prenatal clinic for the first prenatal
assessment. The client tells a nurse that the first day of her last
menstrual period was September 19th, 2013. Using Naegele’s
rule, the nurse determines the estimated date of confinement as:
A. July 26, 2013
B. June 12, 2014
C. June 26, 2014
D. July 12, 2014
Incorrect
Correct Answer: C. June 26, 2014.
Accurate use of Naegele’s rule requires that the woman has a
regular 28-day menstrual cycle. Add 7 days to the first day of the
last menstrual period, subtract three months, and then add one
year to that date.
Option A: An average pregnancy lasts 280 days from
the first day of the last menstrual period (LMP) or 266
days after conception. Historically, an accurate LMP is
the best estimator to determine the due date.
