(2026) Actual Q&A PDF
1. The nurse is reviewing the lab results of a patient with severe preeclampsia. The platelet count is
90,000/mm³. The nurse understands this finding indicates:
A) Normal pregnancy adaptation
B) Risk for bleeding and possible HELLP syndrome
C) Gestational diabetes
D) Anemia of pregnancy
Correct Answer: Risk for bleeding and possible HELLP syndrome
Rationale: Thrombocytopenia (<100,000/mm³) is a sign of severe preeclampsia and is part of HELLP
syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets). It increases bleeding risk and requires
close monitoring. Delivery is the definitive treatment. Normal platelet count is 150,000‑450,000/mm³.
2. A patient at 30 weeks gestation is receiving magnesium sulfate for severe preeclampsia. Which
finding indicates magnesium toxicity?
A) Deep tendon reflexes 2+
B) Respiratory rate of 10 breaths per minute
C) Urine output of 50 mL/hr
D) Blood pressure 150/100 mm Hg
Correct Answer: Respiratory rate of 10 breaths per minute
Rationale: Respiratory depression (<12 breaths/min) is a sign of magnesium toxicity, along with
absent deep tendon reflexes and oliguria. The nurse must stop the infusion, administer calcium
gluconate, and notify the provider. DTRs 2+ and urine output 50 mL/hr are reassuring.
3. The nurse is assessing a patient with hyperemesis gravidarum. Which laboratory finding is most
consistent with this condition?
,A) Hypokalemia and metabolic alkalosis
B) Hyperkalemia and metabolic acidosis
C) Hyponatremia and respiratory acidosis
D) Hypernatremia and respiratory alkalosis
Correct Answer: Hypokalemia and metabolic alkalosis
Rationale: Severe vomiting causes loss of hydrochloric acid and potassium, leading to hypochloremic
metabolic alkalosis and hypokalemia. The patient requires IV fluids, electrolyte replacement, and
thiamine before glucose to prevent Wernicke encephalopathy.
4. The nurse is teaching a patient about the glucose challenge test for gestational diabetes screening.
The test is typically performed at:
A) 12 weeks
B) 20 weeks
C) 24 to 28 weeks
D) 36 weeks
Correct Answer: 24 to 28 weeks
Rationale: The 1‑hour glucose challenge test is routinely performed between 24 and 28 weeks
gestation to screen for gestational diabetes. If abnormal, a 3‑hour glucose tolerance test is performed
for diagnosis. Screening earlier may occur if risk factors are present.
5. A patient with gestational diabetes asks why her newborn is at risk for hypoglycemia. The nurse
explains that:
A) The baby’s pancreas is underdeveloped
B) Maternal hyperglycemia causes fetal hyperinsulinemia, leading to hypoglycemia after birth
C) The baby is not receiving enough glucose in utero
D) Insulin crosses the placenta and lowers the baby’s glucose
, Correct Answer: Maternal hyperglycemia causes fetal hyperinsulinemia, leading to hypoglycemia after
birth
Rationale: In GDM, maternal glucose crosses the placenta, stimulating the fetal pancreas to produce
excess insulin. After delivery, glucose supply is cut off, but the high insulin levels persist, causing
hypoglycemia. Early feeding is the best prevention.
6. An Rh‑negative mother who is not sensitized delivers an Rh‑positive infant. The nurse should
administer Rho(D) immune globulin (RhoGAM) within what time frame?
A) 24 hours
B) 48 hours
C) 72 hours
D) 1 week
Correct Answer: 72 hours
Rationale: RhoGAM should be administered within 72 hours of delivery to prevent maternal
sensitization to Rh‑positive fetal red blood cells that may have entered the maternal circulation. It is
also given at 28 weeks antenatally.
7. A patient at 32 weeks gestation with preterm labor is prescribed betamethasone. The nurse
explains that the purpose of this medication is to:
A) Stop uterine contractions
B) Prevent maternal infection
C) Accelerate fetal lung maturity
D) Lower maternal blood pressure
Correct Answer: Accelerate fetal lung maturity
Rationale: Betamethasone is a corticosteroid that accelerates fetal lung maturation by stimulating
surfactant production, reducing the risk and severity of respiratory distress syndrome. It does not stop
contractions or lower blood pressure.