Maternity Nursing Questions and Answers for NCLEX

Fundal Height Measurement

• Question: 24 weeks pregnant, normal measurement?
  • Options: 16 cm, 28 cm, 26 cm, 12 cm
  • Answer: 26 cm (C)
  • Key Point: After 20 weeks, fundal height should be weeks pregnant ± 2 cm.
  • Calculation: 24 weeks → 22 to 26 cm

Apgar Score Calculation

• Question: Initial Apgar score with listed observations
  • Observations: HR 140 bpm, strong regular cry, pink body/blue hands, some flexion, moves/cries
  • Answer: 8 (D)
  • Key Point: Apgar measures Appearance, Pulse, Grimace, Activity, Respiration (APGAR).
  • Scoring: Appearance (1), Pulse (2), Grimace (2), Activity (1), Respiration (2).

Early Decelerations

• Question: Cause of early decelerations?
  • Answer: Baby head compression from uterine contractions. (B)
  • Key Point: Early decelerations are expected and caused by vagus nerve stimulation due to head compression.
  • Types: Early, Variable, Late

Fetal Station

• Question: Interpretation of fetal station +2 during labor assessment?
  • Answer: Baby’s presenting part is 2 cm below the ischial spine. (D)
  • Key Point: Fetal station measures presentation in the pelvis; uses ischial spine as a landmark.
  • Negative numbers = above spine, Positive = below spine.

Postpartum Fundal Height

• Question: 48 hours postpartum, expected fundal height?
  • Answer: 2 cm below the belly button. (B)
  • Key Point: Fundal height should decrease by 1 cm per day postpartum.

Glucose Tolerance Test Interpretation

• Question: 27 weeks pregnant, 3-hour glucose tolerance test results?
  • Observations: Fasting (94 mg/dL, normal), 1-hour (210 mg/dL, abnormal), 2-hour (180 mg/dL, abnormal), 3-hour (130 mg/dL, normal)
  • Result: Gestational diabetes (2 or more abnormal results)
  • Key values: Fasting > 95, 1-hour > 180, 2-hour > 155, 3-hour > 140

Gravidity and Parity

• Question: First pregnancy, birth to twins, 38 weeks
  • Answer: Gravida 1, Para 1 (A)
  • Key Point: Gravidity = number of pregnancies, Parity = number of births after 20 weeks, multiples count as 1.

Magnesium Sulfate Antidote

• Question: Preeclampsia patient on magnesium sulfate, necessary medication on standby?
  • Answer: Calcium gluconate (D)
  • Key Point: Magnesium sulfate toxicity: signs include decreased deep tendon reflexes.

Estimated Due Date Calculation (Naegele's Rule)

• Question: Last menstrual period August 15, 2016?
  • Answer: May 22, 2017
  • Key Calculation: Subtract 3 months, add 7 days, add 1 year.

Abruptio Placentae Symptoms

• Question: Signs/symptoms of abruptio placentae?
  • Answer: Hard abdomen, fetal distress, tender uterus (But not decrease in fundal height or abnormal positioning)
  • Key Mnemonic: DETACHED: Dark red bleeding, Extended fundal height, Tender uterus, Abdominal pain, Concealed bleeding, Hard abdomen, Experiencing DIC, Distress baby

Quickening Definition

• Question: 18 weeks pregnant, feeling fluttering (baby moving)
  • Answer: Quickening (B)
  • Key Point: Quickening = feeling fetal movement, starts ~16-20 weeks.

Goodell's Sign Definition

• Question: Softening of the cervix, 6-8 weeks gestation
  • Answer: Goodell's sign (softening of the cervix, C)
  • Key Points: Hegar's sign (softening of lower uterine segment), Chadwick's sign (bluish tint), Palmer's sign (uterine contractions on bimanual exam).

Routine Post-Delivery Assessment

• Question: Uterus soft and displaced to the left
  • Answer: Perform fundal massage and have the patient go to the bathroom (A)
  • Key Point: Soft/displaced uterus indicates full bladder; fundal massage helps contraction.

True Labor Indications

• Question: Symptoms indicating true labor?
  • Signs: Regular contractions, no relief from position/activity, cervical changes (effacement and dilation)
  • Key Mnemonic for True Labor: TRUE (Timing regular, Radiating pain, Unrelieved by activity, Exam changes)
  • Key Mnemonic for False Labor: FAKE (Fails to change cervix, Activity diminishes contractions, Keeps above belly button, Erratic timing).