NSG 432 Exam 4 V2 | NSG 432 Maternal-
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 4) | Grand
Canyon University
1. A nurse is assessing a client at 32 weeks gestation who is admitted with severe
preeclampsia. Which findings would lead the nurse to suspect the client is developing HELLP
syndrome? (Select all that apply)
A. Low platelets
B. Elevated liver enzymes
C. Hemolysis of red blood cells
D. Epigastric pain
E. Hypoglycemia
F. Decreased creatinine
Correct Answer: A, B, C, D
HELLP syndrome is a severe complication of preeclampsia characterized by hemolysis,
elevated liver enzymes, and low platelet counts. Epigastric pain is a hallmark sign
indicating liver distention or subcapsular hematoma. Early recognition is critical because
this condition significantly increases maternal and fetal morbidity and mortality.
,2. Which medication should the nurse have readily available at the bedside for a client
receiving Magnesium Sulfate for preeclampsia?
A. Calcium gluconate
B. Naloxone
C. Terbutaline
D. Hydralazine
Correct Answer: A
Calcium gluconate is the specific antidote for magnesium sulfate toxicity. The nurse must
monitor for signs of toxicity such as loss of deep tendon reflexes, respiratory depression,
and decreased urine output. Having the antidote available ensures immediate intervention
to reverse life-threatening magnesium levels.
3. A client is experiencing postpartum hemorrhage due to uterine atony. Which of the
following is the nurse’s priority action?
A. Perform fundal massage until firm
B. Catheterize the bladder
C. Administer oxygen via non-rebreather mask
D. Increase the IV fluid rate
Correct Answer: A
, Uterine atony is the leading cause of postpartum hemorrhage, and fundal massage is the
primary intervention to stimulate contractions. Massaging the fundus helps the uterine
muscles constrict the spiral arteries at the placental site. If the uterus remains boggy,
further pharmacological interventions such as oxytocin or methylergonovine may be
required.
4. A newborn is 5 minutes old and presents with a heart rate of 110 bpm, a weak cry, some
flexion of the extremities, grimacing when stimulated, and a pink body with blue extremities.
What is the APGAR score?
A. 5
B. 8
C. 7
D. 6
Correct Answer: D
The APGAR score is calculated as follows: Heart rate >100 (2), weak cry (1), some flexion
(1), grimace (1), and acrocyanosis (1), totaling 6. A score of 6 indicates moderate distress
and may require some resuscitative measures or close observation. Scores are typically
taken at 1 and 5 minutes to assess the newborn’s transition to extrauterine life.
5. A nurse is teaching a pregnant client with Type 1 Diabetes about insulin requirements
during pregnancy. Which statement should be included?
A. Insulin needs decrease significantly in the second trimester.
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 4) | Grand
Canyon University
1. A nurse is assessing a client at 32 weeks gestation who is admitted with severe
preeclampsia. Which findings would lead the nurse to suspect the client is developing HELLP
syndrome? (Select all that apply)
A. Low platelets
B. Elevated liver enzymes
C. Hemolysis of red blood cells
D. Epigastric pain
E. Hypoglycemia
F. Decreased creatinine
Correct Answer: A, B, C, D
HELLP syndrome is a severe complication of preeclampsia characterized by hemolysis,
elevated liver enzymes, and low platelet counts. Epigastric pain is a hallmark sign
indicating liver distention or subcapsular hematoma. Early recognition is critical because
this condition significantly increases maternal and fetal morbidity and mortality.
,2. Which medication should the nurse have readily available at the bedside for a client
receiving Magnesium Sulfate for preeclampsia?
A. Calcium gluconate
B. Naloxone
C. Terbutaline
D. Hydralazine
Correct Answer: A
Calcium gluconate is the specific antidote for magnesium sulfate toxicity. The nurse must
monitor for signs of toxicity such as loss of deep tendon reflexes, respiratory depression,
and decreased urine output. Having the antidote available ensures immediate intervention
to reverse life-threatening magnesium levels.
3. A client is experiencing postpartum hemorrhage due to uterine atony. Which of the
following is the nurse’s priority action?
A. Perform fundal massage until firm
B. Catheterize the bladder
C. Administer oxygen via non-rebreather mask
D. Increase the IV fluid rate
Correct Answer: A
, Uterine atony is the leading cause of postpartum hemorrhage, and fundal massage is the
primary intervention to stimulate contractions. Massaging the fundus helps the uterine
muscles constrict the spiral arteries at the placental site. If the uterus remains boggy,
further pharmacological interventions such as oxytocin or methylergonovine may be
required.
4. A newborn is 5 minutes old and presents with a heart rate of 110 bpm, a weak cry, some
flexion of the extremities, grimacing when stimulated, and a pink body with blue extremities.
What is the APGAR score?
A. 5
B. 8
C. 7
D. 6
Correct Answer: D
The APGAR score is calculated as follows: Heart rate >100 (2), weak cry (1), some flexion
(1), grimace (1), and acrocyanosis (1), totaling 6. A score of 6 indicates moderate distress
and may require some resuscitative measures or close observation. Scores are typically
taken at 1 and 5 minutes to assess the newborn’s transition to extrauterine life.
5. A nurse is teaching a pregnant client with Type 1 Diabetes about insulin requirements
during pregnancy. Which statement should be included?
A. Insulin needs decrease significantly in the second trimester.
