NR327/NR 327 Exam 3 V1 | Maternal Child
Nursing Q&A with Rationale | Chamberlain
University
1. A nurse is monitoring a client who is receiving magnesium sulfate for the treatment of
preeclampsia. Which of the following findings should the nurse prioritize as a sign of
magnesium toxicity?
A. Absent deep tendon reflexes (DTRs)
B. Blood pressure of 150/100 mmHg
C. Increased urinary output
D. Fetal heart rate of 140 bpm
Correct Answer: A
Rationale: The loss of deep tendon reflexes is a primary indicator of magnesium toxicity.
Magnesium sulfate acts as a central nervous system depressant, and its therapeutic
window is narrow. The nurse must also monitor for a respiratory rate below 12 breaths
per minute and decreased urinary output to prevent respiratory arrest.
2. A client at 32 weeks of gestation is admitted for preterm labor. Which medication should
the nurse anticipate administering to promote fetal lung maturity?
A. Terbutaline
B. Indomethacin
,C. Nifedipine
D. Betamethasone
Correct Answer: D
Rationale: Betamethasone is a corticosteroid specifically administered to women in
preterm labor to stimulate the production of fetal surfactant. This intervention significantly
reduces the risk of respiratory distress syndrome in the neonate. It is typically given in two
doses, 24 hours apart, during the antepartum period.
3. A nurse is assessing a postpartum client 2 hours after delivery and notes a boggy uterus
that is displaced to the right. Which action should the nurse take first?
A. Massage the uterine fundus
B. Notify the healthcare provider
C. Administer oxytocin
D. Assist the client to void
Correct Answer: D
Rationale: A displaced uterus to the right usually indicates a distended bladder, which
prevents the uterus from contracting effectively. Assisting the client to empty their bladder
will allow the uterus to return to the midline and firm up. If the uterus remains boggy after
voiding, fundal massage would be the next appropriate intervention to prevent
hemorrhage.
, 4. Which clinical manifestation differentiates placenta previa from abruptio placentae?
A. Increase in fundal height
B. Dark red vaginal bleeding with abdominal pain
C. Rigid, board-like abdomen
D. Bright red, painless vaginal bleeding
Correct Answer: D
Rationale: Placenta previa is characterized by the sudden onset of painless, bright red
vaginal bleeding in the second or third trimester. In contrast, abruptio placentae typically
involves severe abdominal pain and a rigid uterus. Accurate assessment of the quality and
associated pain of bleeding is critical for determining the correct obstetric emergency
protocol.
5. A nurse is caring for a client with gestational diabetes. Which of the following is the
primary goal of nutritional therapy for this client?
A. Complete elimination of carbohydrates
B. Restricting calories to induce weight loss
C. Maintaining euglycemia to prevent fetal macrosomia
D. Providing high levels of dietary fiber only
Correct Answer: C
Nursing Q&A with Rationale | Chamberlain
University
1. A nurse is monitoring a client who is receiving magnesium sulfate for the treatment of
preeclampsia. Which of the following findings should the nurse prioritize as a sign of
magnesium toxicity?
A. Absent deep tendon reflexes (DTRs)
B. Blood pressure of 150/100 mmHg
C. Increased urinary output
D. Fetal heart rate of 140 bpm
Correct Answer: A
Rationale: The loss of deep tendon reflexes is a primary indicator of magnesium toxicity.
Magnesium sulfate acts as a central nervous system depressant, and its therapeutic
window is narrow. The nurse must also monitor for a respiratory rate below 12 breaths
per minute and decreased urinary output to prevent respiratory arrest.
2. A client at 32 weeks of gestation is admitted for preterm labor. Which medication should
the nurse anticipate administering to promote fetal lung maturity?
A. Terbutaline
B. Indomethacin
,C. Nifedipine
D. Betamethasone
Correct Answer: D
Rationale: Betamethasone is a corticosteroid specifically administered to women in
preterm labor to stimulate the production of fetal surfactant. This intervention significantly
reduces the risk of respiratory distress syndrome in the neonate. It is typically given in two
doses, 24 hours apart, during the antepartum period.
3. A nurse is assessing a postpartum client 2 hours after delivery and notes a boggy uterus
that is displaced to the right. Which action should the nurse take first?
A. Massage the uterine fundus
B. Notify the healthcare provider
C. Administer oxytocin
D. Assist the client to void
Correct Answer: D
Rationale: A displaced uterus to the right usually indicates a distended bladder, which
prevents the uterus from contracting effectively. Assisting the client to empty their bladder
will allow the uterus to return to the midline and firm up. If the uterus remains boggy after
voiding, fundal massage would be the next appropriate intervention to prevent
hemorrhage.
, 4. Which clinical manifestation differentiates placenta previa from abruptio placentae?
A. Increase in fundal height
B. Dark red vaginal bleeding with abdominal pain
C. Rigid, board-like abdomen
D. Bright red, painless vaginal bleeding
Correct Answer: D
Rationale: Placenta previa is characterized by the sudden onset of painless, bright red
vaginal bleeding in the second or third trimester. In contrast, abruptio placentae typically
involves severe abdominal pain and a rigid uterus. Accurate assessment of the quality and
associated pain of bleeding is critical for determining the correct obstetric emergency
protocol.
5. A nurse is caring for a client with gestational diabetes. Which of the following is the
primary goal of nutritional therapy for this client?
A. Complete elimination of carbohydrates
B. Restricting calories to induce weight loss
C. Maintaining euglycemia to prevent fetal macrosomia
D. Providing high levels of dietary fiber only
Correct Answer: C
