NURS 203 | NURS 203 Maternity Exam 1 Version 3
Questions with Correct Answers and Expert
Explanation for Each Question
1. A nurse is teaching a pregnant client about physiological changes in the
cardiovascular system. Which statement accurately describes the blood volume
change during pregnancy?
A. Blood volume decreases to prevent fluid overload
B. Blood volume remains constant while heart rate slows down
C. Blood volume increases by 40% to 50% above pre-pregnancy levels
D. Only the red blood cell count increases significantly
Correct Answer: C
Expert Explanation: During pregnancy, the total blood volume increases by
approximately 40% to 50% to meet metabolic demands. This increase supports the
hypertrophy of the vascular system and ensures placental perfusion. Because the
plasma volume increases more than the red cell mass, a condition called physiologic
anemia occurs. Nurses must assess the hemoglobin levels to differentiate between
this normal change and actual iron deficiency. Adequate hydration and nutrition are
essential to support this significant cardiovascular adaptation.
,2. A client at 28 weeks gestation reports feeling dizzy and faint when lying on her
back. What is the nurse’s priority action?
A. Increase the IV fluid rate to boost blood pressure
B. Obtain an immediate 12-lead EKG
C. Advise the client to lie in a left side-lying position
D. Tell the client this is a normal sign of early labor
Correct Answer: C
Expert Explanation: Supine hypotensive syndrome occurs when the heavy uterus
compresses the inferior vena cava while the mother lies flat. This compression
reduces venous return to the heart, leading to decreased cardiac output and
hypotension. The patient may experience lightheadedness, dizziness, and pallor
during these episodes. To correct this, the nurse should immediately assist the
patient into a side-lying position. This intervention relieves the pressure on the vena
cava and restores maternal-fetal circulation.
3. The nurse is providing preconception counseling. To prevent neural tube defects,
what is the recommended daily intake of folic acid for a woman of childbearing age?
A. 100 mcg
B. 200 mcg
C. 1000 mcg
,D. 400 mcg
Correct Answer: D
Expert Explanation: The intake of 400 mcg of folic acid daily is critical for women
planning to become pregnant. Folic acid is essential for the proper closure of the
neural tube in the early weeks of gestation. Many pregnancies are unplanned, so this
recommendation applies to all women of childbearing age. Deficiency in this vitamin
is strongly linked to defects like spina bifida and anencephaly. Nurses should
emphasize that starting supplementation before conception provides the best
protection for the fetus.
4. Where should the nurse expect to find the fundus of the uterus in a woman who is
at 20 weeks of gestation?
A. At the level of the symphysis pubis
B. Halfway between the symphysis pubis and the umbilicus
C. At the level of the xiphoid process
D. At the level of the umbilicus
Correct Answer: D
Expert Explanation: At 20 weeks gestation, the fundus is typically located at the
level of the umbilicus. This measurement serves as a key indicator of normal fetal
growth and development during the second trimester. Fundal height in centimeters
, generally correlates with the number of weeks of gestation between 18 and 32
weeks. Discrepancies in this measurement may indicate issues such as
oligohydramnios or macrosomia. Consistent monitoring allows the healthcare team
to identify potential complications early in the pregnancy.
5. A client notes a bluish-purple discoloration of the cervix and vaginal mucosa during
an exam. The nurse documents this finding as:
A. Goodell’s sign
B. Hegar’s sign
C. Chadwick’s sign
D. Ballottement
Correct Answer: C
Expert Explanation: Chadwick’s sign is the bluish or purplish discoloration of the
vulva, vagina, and cervix due to increased vascularity. This change is considered a
probable sign of pregnancy and can be observed as early as six weeks. The increased
blood flow to the pelvic region is caused by rising levels of estrogen. While it
strongly suggests pregnancy, it is not a definitive positive sign. Nurses must
distinguish between presumptive, probable, and positive signs of pregnancy during
assessment.
Questions with Correct Answers and Expert
Explanation for Each Question
1. A nurse is teaching a pregnant client about physiological changes in the
cardiovascular system. Which statement accurately describes the blood volume
change during pregnancy?
A. Blood volume decreases to prevent fluid overload
B. Blood volume remains constant while heart rate slows down
C. Blood volume increases by 40% to 50% above pre-pregnancy levels
D. Only the red blood cell count increases significantly
Correct Answer: C
Expert Explanation: During pregnancy, the total blood volume increases by
approximately 40% to 50% to meet metabolic demands. This increase supports the
hypertrophy of the vascular system and ensures placental perfusion. Because the
plasma volume increases more than the red cell mass, a condition called physiologic
anemia occurs. Nurses must assess the hemoglobin levels to differentiate between
this normal change and actual iron deficiency. Adequate hydration and nutrition are
essential to support this significant cardiovascular adaptation.
,2. A client at 28 weeks gestation reports feeling dizzy and faint when lying on her
back. What is the nurse’s priority action?
A. Increase the IV fluid rate to boost blood pressure
B. Obtain an immediate 12-lead EKG
C. Advise the client to lie in a left side-lying position
D. Tell the client this is a normal sign of early labor
Correct Answer: C
Expert Explanation: Supine hypotensive syndrome occurs when the heavy uterus
compresses the inferior vena cava while the mother lies flat. This compression
reduces venous return to the heart, leading to decreased cardiac output and
hypotension. The patient may experience lightheadedness, dizziness, and pallor
during these episodes. To correct this, the nurse should immediately assist the
patient into a side-lying position. This intervention relieves the pressure on the vena
cava and restores maternal-fetal circulation.
3. The nurse is providing preconception counseling. To prevent neural tube defects,
what is the recommended daily intake of folic acid for a woman of childbearing age?
A. 100 mcg
B. 200 mcg
C. 1000 mcg
,D. 400 mcg
Correct Answer: D
Expert Explanation: The intake of 400 mcg of folic acid daily is critical for women
planning to become pregnant. Folic acid is essential for the proper closure of the
neural tube in the early weeks of gestation. Many pregnancies are unplanned, so this
recommendation applies to all women of childbearing age. Deficiency in this vitamin
is strongly linked to defects like spina bifida and anencephaly. Nurses should
emphasize that starting supplementation before conception provides the best
protection for the fetus.
4. Where should the nurse expect to find the fundus of the uterus in a woman who is
at 20 weeks of gestation?
A. At the level of the symphysis pubis
B. Halfway between the symphysis pubis and the umbilicus
C. At the level of the xiphoid process
D. At the level of the umbilicus
Correct Answer: D
Expert Explanation: At 20 weeks gestation, the fundus is typically located at the
level of the umbilicus. This measurement serves as a key indicator of normal fetal
growth and development during the second trimester. Fundal height in centimeters
, generally correlates with the number of weeks of gestation between 18 and 32
weeks. Discrepancies in this measurement may indicate issues such as
oligohydramnios or macrosomia. Consistent monitoring allows the healthcare team
to identify potential complications early in the pregnancy.
5. A client notes a bluish-purple discoloration of the cervix and vaginal mucosa during
an exam. The nurse documents this finding as:
A. Goodell’s sign
B. Hegar’s sign
C. Chadwick’s sign
D. Ballottement
Correct Answer: C
Expert Explanation: Chadwick’s sign is the bluish or purplish discoloration of the
vulva, vagina, and cervix due to increased vascularity. This change is considered a
probable sign of pregnancy and can be observed as early as six weeks. The increased
blood flow to the pelvic region is caused by rising levels of estrogen. While it
strongly suggests pregnancy, it is not a definitive positive sign. Nurses must
distinguish between presumptive, probable, and positive signs of pregnancy during
assessment.
