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WorksheetsObstetric Nursing -Fetal Development and Physiology
Total questions: 40
Worksheet time: 20mins
A pregnant client at 8 weeks tells the nurse she is worried because she was exposed to a strong chemical cleaner at work several times this week. Based on fetal development, the nurse knows this exposure is most concerning because this time period is:
A less critical fetal stage with minimal organ development
The most critical time for organ development
When fetal fat and muscle are primarily forming
When only growth in size occurs, not structure
The nurse is reviewing a client’s chart and notes that implantation occurred 7 days after conception. The nurse correctly interprets this as:
Earlier than expected
Later than expected
Within the normal implantation window
Outside the normal range, requiring follow-up
A client asks where fertilization usually occurs. Which response by the nurse is most accurate?
“In the uterus”
“In the cervix”
“In the outer third of the fallopian tube”
“In the inner third of the fallopian tube”
A pregnant client’s ultrasound shows amniotic fluid volume of 200 mL in the third trimester. The nurse recognizes this finding as:
Normal
Polyhydramnios
Oligohydramnios
An expected change close to term
The nurse is caring for a client with polyhydramnios. Which amniotic fluid volume would the nurse expect to see documented?
100 mL
250 mL
1000 mL
More than 2 liters
During a childbirth class, a parent asks about the umbilical cord. Which statement by a participant shows correct understanding?
“The cord usually has one artery and two veins.”
“The cord has two arteries and one vein.”
“The cord has a single large vessel for both blood directions.”
“The number of cord vessels changes throughout pregnancy.”
The nurse explains that Wharton’s jelly protects the fetus by:
Preventing the umbilical cord from twisting
Surrounding the vessels to prevent compression
Thickening the amniotic membrane
Helping the placenta attach to the uterus
A pregnant client asks about the placenta. Which statement by the nurse best describes a key factor needed for optimal placental function?
“It functions the same regardless of your blood pressure.”
“It only depends on fetal blood flow.”
“It depends heavily on your maternal blood pressure to function well.”
“It functions independently of your circulation.”
A nurse is teaching a student about placental hormones. The student demonstrates correct understanding by stating which hormone is the earliest biochemical marker for pregnancy?
Progesterone
Human chorionic gonadotropin (hCG)
Human chorionic somatomammotropin (hCS)
Estriol
The nurse reviews fetal circulation with a client. Which structure is correctly paired with its function?
Ductus arteriosus – carries blood between right atrium and left atrium
Ductus venosus – allows most oxygenated blood to bypass the liver
Foramen ovale – connects the pulmonary artery to the aorta
Umbilical vein – carries deoxygenated blood to the fetus
The nurse explains why the fetus can obtain enough oxygen from the mother. Which statement is most accurate?
Fetal hemoglobin carries less oxygen than maternal hemoglobin.
Fetal hemoglobin carries 20% to 30% more oxygen than maternal hemoglobin.
Maternal hemoglobin has a higher affinity for oxygen than fetal hemoglobin.
Fetal hemoglobin and maternal hemoglobin carry equal amounts of oxygen.
A client at 32 weeks asks why the provider ordered an L/S ratio test. The nurse’s best response is:
“It measures your iron stores.”
“It helps determine if your baby’s lungs are mature.”
“It evaluates how well the placenta is working.”
“It checks how much amniotic fluid you have.”
The nurse is discussing fetal development. Which finding would the nurse expect at week 9 of gestation?
Kidneys are formed and beginning to function
Liver fully mature and functioning
Pancreas producing adult levels of insulin
Fetal senses of taste and sound fully developed
A pregnant client asks when her baby will begin to respond to sound. The nurse knows fetal response to sound typically occurs around:
16 weeks of gestation
20 weeks of gestation
24 weeks of gestation
30 weeks of gestation
The nurse is explaining fetal immunity to a client. Which statement demonstrates correct understanding?
Your baby receives IgG antibodies through the placenta.
Your baby only produces IgG and does not receive any from you.
IgM crosses the placenta to protect your baby.
No antibodies cross the placenta before birth.
A pregnant client is concerned about teratogens. The nurse is teaching about the time of highest risk. Which statements should the nurse include? Select all that apply.
The greatest risk is during the embryonic period.
This period is roughly from days 15 to 60.
This is when most structural development occurs.
Teratogens have the least impact during this time.
You don’t need to worry about teratogens until the third trimester.
A client is currently 20 weeks pregnant and is carrying twins. Which teaching point should the nurse prioritize based on this multifetal pregnancy?
You are less likely to deliver early.
Multifetal pregnancies have a higher chance of prematurity.
Your risk of preterm labor is lower than with one baby.
Spontaneous rupture of membranes before term is rare.
A client at 10 weeks asks how long pregnancy typically lasts. Which response is most accurate?
About 36 weeks from conception.
About 280 days from the first day of your last menstrual period.
About 260 days from the last day of your last period.
About 42 weeks from when you first missed your period.
A nurse is helping a client calculate the EDD (estimated date of delivery) using Nägele’s rule. The client’s LMP was April 10, 2025. Which EDD should the nurse expect to document?
January 10, 2026
January 17, 2026
January 24, 2026
February 17, 2026
A client tells the nurse she has missed her period, feels very tired, and her breasts are tender. These findings are classified as:
Presumptive signs of pregnancy
Probable signs of pregnancy
Positive signs of pregnancy
Diagnostic signs unrelated to pregnancy
The nurse assesses a patient and documents a Goodell sign. Which finding supports this documentation?
Bluish discoloration of the cervix
Softening of the cervix
Softening of the uterine isthmus
Presence of fetal movement felt by the examiner
A nurse notes a Chadwick sign during a pelvic exam. Which description fits this finding?
Softening of the cervix
Softening of the uterus
Bluish color of the vaginal mucosa and cervix
Thin, white vaginal discharge
A client at 18 weeks reports feeling her baby move for the first time. The nurse correctly documents this as:
Ballottement
Quickening
Lightening
Engagement
During a routine prenatal visit, a patient in her second trimester is noted to have increasing blood volume and a slightly decreased blood pressure. Which statement by the nurse best explains this finding?
This is abnormal and indicates severe hypertension.
In pregnancy, blood volume increases and blood pressure may decrease slightly.
Blood volume usually decreases in the second trimester.
Blood pressure always rises significantly during pregnancy.
The nurse counsels a pregnant client who complains of feeling lightheaded when lying flat on her back. Which teaching is most appropriate?
This is unrelated to pregnancy.
Always lie flat to improve uterine blood flow.
This could be supine hypotensive syndrome; try lying on your side instead.
You should sit upright at all times.
A third-trimester client reports shortness of breath when lying down. The nurse understands this is most likely related to:
Decreasing uterine size
The diaphragm rising and rib cage widening at the base
A drop in cardiac output
Severe respiratory depression
A first-trimester client reports nausea and vomiting that’s worse in the morning. The nurse knows this is common because of:
Decreased uterine size
Hormonal changes, low blood sugar, and slowed peristalsis
Very high blood pressure
Fetal movements irritating the stomach
A pregnant client reports constipation. Based on physiologic changes, which factor is most likely contributing?
Decreased progesterone levels
Increased peristalsis
Smooth muscle relaxation and reduced peristalsis
Dehydration from increased urination alone
The nurse notes glucosuria in a pregnant client’s urine sample. Which best explains this finding?
It always indicates preexisting diabetes.
It is expected because tubular reabsorption of glucose is impaired during pregnancy.
It means the kidneys are failing.
It is a positive sign of preeclampsia.
The nurse prepares teaching materials on common skin changes in pregnancy. Which findings should be included as pregnancy-related hyperpigmentation or vascular changes? Select all that apply.
Melasma (chloasma)
Linea nigra
Striae gravidarum
Angiomatas
Palmar erythema
A pregnant client complains of back pain and numbness/tingling in her hands. The nurse recognizes these complaints may be related to:
Decreased spinal curvature and improved posture
Center of gravity shifting forward and carpal tunnel syndrome
Increased abdominal strength
Decreased breast size
The nurse is reviewing endocrine changes in pregnancy with a student nurse. Which statement requires correction?
“Insulin needs increase during pregnancy.”
“The thyroid gland enlarges during pregnancy.”
“The pituitary gland enlarges during pregnancy.”
“Pregnancy does not require any endocrine adaptations.”
A client at 10 weeks asks what changes are common in the first trimester. The nurse should include which expected finding?
Quickening begins around 10 weeks.
Blood volume peaks in the first trimester.
Serum hCG becomes positive and nausea is common.
Colostrum production ends by 10 weeks.
A pregnant client at 19 weeks reports feeling regular fetal movements and notes her abdomen is visibly growing. Which trimester-specific education would be most appropriate?
Focus on recognizing signs of labor and preparing a birth plan.
Discuss increased caloric needs, iron and calcium, sleep, and prenatal classes.
Emphasize managing nausea, fatigue, and breast tenderness.
Teach about postpartum depression and newborn care only.
A primigravida at 39 weeks asks if her pregnancy is considered “full term.” Which response is most accurate according to ACOG definitions?
“Yes, 39 weeks is considered full term.”
“No, full term starts at 41 weeks.”
“No, full term ends at 38 weeks.”
“No, 39 weeks is late term.”
The nurse is preparing a client for her initial prenatal visit. Which components should the nurse expect to be included? Select all that apply.
Comprehensive health history
Nutritional history
Screening for intimate partner violence
Physical examination
Laboratory tests such as urine, cervical, and blood samples
A nurse is reviewing laboratory tests commonly ordered during pregnancy. Which result would not typically be part of the standard prenatal lab panel?
Rubella immunity
Hepatitis B surface antigen
Syphilis screening
Cardiac troponin level
A provider orders a non-stress test (NST) for a pregnant client. When the client asks what this test does, which explanation should the nurse give?
“It measures your blood pressure changes during pregnancy.”
“It monitors your baby’s heart rate in response to movements and contractions.”
“It checks your baby’s genetic makeup.”
“It measures how much amniotic fluid you have.”
Select the statements about IPV that are true.
IPV can include physical violence.
IPV can include sexual violence.
IPV can include stalking.
IPV can include psychological aggression.
IPV only occurs after pregnancy, not during.
The nurse is teaching a group of pregnant clients about respiratory changes in pregnancy. Which statement should the nurse include?
“Pregnancy is a state of chronic mild hyperventilation and respiratory alkalosis.”
“Breathing becomes more abdominal and less chest-based.”
“Your oxygen consumption decreases by 20% to 40%.”
“Your tidal volume decreases as your pregnancy advances.”
