NUR 230 Exam 1: OB/Peds - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A client who is 12 weeks pregnant reports experiencing urinary frequency and breast tenderness. These
symptoms are classified as which type of pregnancy signs?
A. Positive signs
B. Objective signs
C. Probable signs
D. Presumptive signs
Correct Answer: D
Rationale: Presumptive signs of pregnancy are subjective changes felt by the woman herself. Common
examples include amenorrhea, fatigue, breast changes, and urinary frequency. These symptoms are not
definitive evidence because they can be caused by conditions other than pregnancy. Probable signs are
objective changes observed by an examiner, while positive signs confirm the presence of a fetus.
Understanding these classifications helps the nurse accurately assess the client’s maternal status.
2. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on October 15?
A. July 22
B. July 8
C. August 15
D. January 22
Correct Answer: A
,Rationale: Naegele’s rule is a standard method for calculating the due date based on the last menstrual
period. The formula involves subtracting three months from the first day of the LMP and adding seven
days. In this specific case, subtracting three months from October results in July. Adding seven days to the
15th brings the date to the 22nd. This calculation provides an approximate date for the expected delivery
of the newborn.
3. A nurse is assessing a woman who is pregnant for the third time. She has one living child born at 39
weeks and had one miscarriage at 10 weeks. What is her GTPAL?
A. G3, T1, P0, A1, L1
B. G2, T1, P1, A0, L1
C. G3, T2, P0, A1, L2
D. G2, T1, P0, A1, L1
Correct Answer: A
Rationale: The GTPAL acronym tracks a client’s obstetric history regarding total pregnancies and
outcomes. Gravida counts all pregnancies, including the current one, which equals three here. Term
births occur after 37 weeks, so the child born at 39 weeks counts as one. Preterm is zero since there were
no births between 20 and 37 weeks, and the miscarriage counts as one abortion. Currently, she has one
living child, completing the assessment of G3, T1, P0, A1, L1.
4. Which nursing intervention is the highest priority for a client receiving Magnesium Sulfate for
preeclampsia who exhibits a respiratory rate of 10 breaths per minute?
A. Continue monitoring the fetal heart rate
B. Decrease the infusion rate immediately
C. Discontinue the infusion and prepare Calcium Gluconate
,D. Notify the provider of the respiratory status
Correct Answer: C
Rationale: Magnesium sulfate is used to prevent seizures in preeclampsia but carries a risk of toxicity. A
respiratory rate below 12 breaths per minute is a major sign of magnesium toxicity. The priority action is
to stop the medication to prevent further central nervous system depression. Calcium gluconate is the
specific antidote that must be kept at the bedside for emergency administration. Ensuring the safety of
the mother and fetus requires immediate cessation of the offending agent.
5. A nurse observes late decelerations on the fetal monitor. What is the primary cause of this heart rate
pattern?
A. Umbilical cord compression
B. Maternal hypotension due to epidural
C. Fetal head compression
D. Uteroplacental insufficiency
Correct Answer: D
Rationale: Late decelerations are characterized by a decrease in fetal heart rate that begins after the
peak of a contraction. This pattern indicates uteroplacental insufficiency, where the fetus is not receiving
adequate oxygen. It is often associated with conditions like placental abruption or maternal
hypertension. Immediate nursing interventions include repositioning the mother and administering
oxygen. Addressing the underlying cause is essential to prevent fetal hypoxia and metabolic acidosis.
6. Which of the following describes the correct technique for assessing the fundal height in a postpartum
patient?
A. Measure from the pubic symphysis to the top of the fundus
, B. Assess the fundus only if the patient reports pain
C. Palpate the fundus while supporting the lower uterine segment
D. Ensure the patient has a full bladder before the assessment
Correct Answer: C
Rationale: Palpating the fundus is a critical part of postpartum care to ensure the uterus is contracting.
The nurse must support the lower uterine segment to prevent potential uterine inversion during the
massage. A firm fundus indicates proper involution and reduces the risk of hemorrhage. The bladder
should be empty before assessment because a full bladder can displace the uterus. This procedure allows
the nurse to monitor the height and consistency of the uterine tissue.
7. A newborn has a heart rate of 90, slow/irregular respirations, some flexion of extremities, a grimace
when stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 4
B. 5
C. 6
D. 7
Correct Answer: B
Rationale: The APGAR score is calculated based on five categories worth zero to two points each. The
infant receives 1 point for a heart rate under 100 and 1 point for irregular respirations. Flexion of
extremities earns 1 point, and the grimace response earns another 1 point. Acrocyanosis (pink body with
blue hands/feet) results in only 1 point for appearance. Summing these values gives a total APGAR score
of 5, indicating a need for intervention.
Updated and Latest Questions and Correct Answers with
Rationale
1. A client who is 12 weeks pregnant reports experiencing urinary frequency and breast tenderness. These
symptoms are classified as which type of pregnancy signs?
A. Positive signs
B. Objective signs
C. Probable signs
D. Presumptive signs
Correct Answer: D
Rationale: Presumptive signs of pregnancy are subjective changes felt by the woman herself. Common
examples include amenorrhea, fatigue, breast changes, and urinary frequency. These symptoms are not
definitive evidence because they can be caused by conditions other than pregnancy. Probable signs are
objective changes observed by an examiner, while positive signs confirm the presence of a fetus.
Understanding these classifications helps the nurse accurately assess the client’s maternal status.
2. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on October 15?
A. July 22
B. July 8
C. August 15
D. January 22
Correct Answer: A
,Rationale: Naegele’s rule is a standard method for calculating the due date based on the last menstrual
period. The formula involves subtracting three months from the first day of the LMP and adding seven
days. In this specific case, subtracting three months from October results in July. Adding seven days to the
15th brings the date to the 22nd. This calculation provides an approximate date for the expected delivery
of the newborn.
3. A nurse is assessing a woman who is pregnant for the third time. She has one living child born at 39
weeks and had one miscarriage at 10 weeks. What is her GTPAL?
A. G3, T1, P0, A1, L1
B. G2, T1, P1, A0, L1
C. G3, T2, P0, A1, L2
D. G2, T1, P0, A1, L1
Correct Answer: A
Rationale: The GTPAL acronym tracks a client’s obstetric history regarding total pregnancies and
outcomes. Gravida counts all pregnancies, including the current one, which equals three here. Term
births occur after 37 weeks, so the child born at 39 weeks counts as one. Preterm is zero since there were
no births between 20 and 37 weeks, and the miscarriage counts as one abortion. Currently, she has one
living child, completing the assessment of G3, T1, P0, A1, L1.
4. Which nursing intervention is the highest priority for a client receiving Magnesium Sulfate for
preeclampsia who exhibits a respiratory rate of 10 breaths per minute?
A. Continue monitoring the fetal heart rate
B. Decrease the infusion rate immediately
C. Discontinue the infusion and prepare Calcium Gluconate
,D. Notify the provider of the respiratory status
Correct Answer: C
Rationale: Magnesium sulfate is used to prevent seizures in preeclampsia but carries a risk of toxicity. A
respiratory rate below 12 breaths per minute is a major sign of magnesium toxicity. The priority action is
to stop the medication to prevent further central nervous system depression. Calcium gluconate is the
specific antidote that must be kept at the bedside for emergency administration. Ensuring the safety of
the mother and fetus requires immediate cessation of the offending agent.
5. A nurse observes late decelerations on the fetal monitor. What is the primary cause of this heart rate
pattern?
A. Umbilical cord compression
B. Maternal hypotension due to epidural
C. Fetal head compression
D. Uteroplacental insufficiency
Correct Answer: D
Rationale: Late decelerations are characterized by a decrease in fetal heart rate that begins after the
peak of a contraction. This pattern indicates uteroplacental insufficiency, where the fetus is not receiving
adequate oxygen. It is often associated with conditions like placental abruption or maternal
hypertension. Immediate nursing interventions include repositioning the mother and administering
oxygen. Addressing the underlying cause is essential to prevent fetal hypoxia and metabolic acidosis.
6. Which of the following describes the correct technique for assessing the fundal height in a postpartum
patient?
A. Measure from the pubic symphysis to the top of the fundus
, B. Assess the fundus only if the patient reports pain
C. Palpate the fundus while supporting the lower uterine segment
D. Ensure the patient has a full bladder before the assessment
Correct Answer: C
Rationale: Palpating the fundus is a critical part of postpartum care to ensure the uterus is contracting.
The nurse must support the lower uterine segment to prevent potential uterine inversion during the
massage. A firm fundus indicates proper involution and reduces the risk of hemorrhage. The bladder
should be empty before assessment because a full bladder can displace the uterus. This procedure allows
the nurse to monitor the height and consistency of the uterine tissue.
7. A newborn has a heart rate of 90, slow/irregular respirations, some flexion of extremities, a grimace
when stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 4
B. 5
C. 6
D. 7
Correct Answer: B
Rationale: The APGAR score is calculated based on five categories worth zero to two points each. The
infant receives 1 point for a heart rate under 100 and 1 point for irregular respirations. Flexion of
extremities earns 1 point, and the grimace response earns another 1 point. Acrocyanosis (pink body with
blue hands/feet) results in only 1 point for appearance. Summing these values gives a total APGAR score
of 5, indicating a need for intervention.
