NSG 432 Exam 2 V1 | NSG 432 Maternal-
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 2) | Grand
Canyon University
1. A nurse is assessing a client at 34 weeks gestation who has been diagnosed with severe
preeclampsia. Which of the following findings should the nurse report to the provider?
(Select all that apply)
A. Epigastric pain
B. 3+ deep tendon reflexes
C. Urine output of 40 mL/hr
D. Blurred vision
E. Frontal headache
F. 1+ pedal edema
Correct Answer: A, B, D, E
Findings such as epigastric pain, blurred vision, and severe headaches are indicative of
worsening preeclampsia and potential hepatic or cerebral involvement. Hyperreflexia (3+
or 4+) suggests central nervous system irritability and an increased risk for seizures.
Peripheral edema is a common finding in pregnancy and is less specific for the severity of
preeclampsia than the other signs listed.
,2. A client is receiving magnesium sulfate for the treatment of preeclampsia. Which
assessment finding is the most sensitive early indicator of magnesium toxicity?
A. Disappearance of deep tendon reflexes
B. Urinary output of 30 mL/hr
C. Respiratory rate of 12 breaths/minute
D. Cardiac dysrhythmias
Correct Answer: A
The loss of deep tendon reflexes is one of the earliest signs that magnesium levels are
reaching a toxic range. As levels continue to rise, respiratory depression and eventually
cardiac arrest can occur. The nurse must monitor reflexes, respiratory rate, and urinary
output closely during magnesium therapy.
3. A nurse is caring for a client who is receiving magnesium sulfate IV and notes a respiratory
rate of 8/min and absent deep tendon reflexes. Which medication should the nurse prepare
to administer?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Hydralazine
Correct Answer: B
, Calcium gluconate is the specific antidote for magnesium sulfate toxicity and should be
readily available at the bedside. It works by antagonizing the effects of magnesium at the
neuromuscular junction to restore respiratory and muscular function. Administration
should occur slowly to prevent cardiac complications.
4. A client at 30 weeks gestation presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Preterm labor
D. Hydatidiform mole
Correct Answer: B
Painless, bright red vaginal bleeding in the second or third trimester is the classic clinical
manifestation of placenta previa. Unlike abruptio placentae, which is typically associated
with severe abdominal pain and uterine tenderness, placenta previa involves the placenta
covering the cervical os. Vaginal exams are strictly contraindicated in these clients until the
placental location is confirmed by ultrasound.
5. A nurse is reviewing the laboratory results for a client suspected of having HELLP
syndrome. Which findings are consistent with this diagnosis? (Select all that apply)
A. Low platelets
B. Elevated liver enzymes
, C. Elevated hemoglobin
D. Hemolysis
E. Decreased creatinine
Correct Answer: A, B, D
HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets, which
are the hallmark laboratory findings of this severe form of preeclampsia. Hemolysis is often
evidenced by abnormal red blood cell morphology on a smear or elevated bilirubin.
Elevated ALT and AST levels reflect liver damage, while a platelet count below
100,000/mm3 indicates thrombocytopenia.
6. A client at 32 weeks gestation is experiencing preterm labor. The provider prescribes
betamethasone. What is the primary purpose of this medication?
A. To stop uterine contractions
B. To prevent neonatal sepsis
C. To promote fetal lung maturity
D. To treat maternal hypertension
Correct Answer: C
Betamethasone is a corticosteroid administered to the mother to stimulate the production
of surfactant in the fetal lungs. This treatment significantly reduces the risk of respiratory
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 2) | Grand
Canyon University
1. A nurse is assessing a client at 34 weeks gestation who has been diagnosed with severe
preeclampsia. Which of the following findings should the nurse report to the provider?
(Select all that apply)
A. Epigastric pain
B. 3+ deep tendon reflexes
C. Urine output of 40 mL/hr
D. Blurred vision
E. Frontal headache
F. 1+ pedal edema
Correct Answer: A, B, D, E
Findings such as epigastric pain, blurred vision, and severe headaches are indicative of
worsening preeclampsia and potential hepatic or cerebral involvement. Hyperreflexia (3+
or 4+) suggests central nervous system irritability and an increased risk for seizures.
Peripheral edema is a common finding in pregnancy and is less specific for the severity of
preeclampsia than the other signs listed.
,2. A client is receiving magnesium sulfate for the treatment of preeclampsia. Which
assessment finding is the most sensitive early indicator of magnesium toxicity?
A. Disappearance of deep tendon reflexes
B. Urinary output of 30 mL/hr
C. Respiratory rate of 12 breaths/minute
D. Cardiac dysrhythmias
Correct Answer: A
The loss of deep tendon reflexes is one of the earliest signs that magnesium levels are
reaching a toxic range. As levels continue to rise, respiratory depression and eventually
cardiac arrest can occur. The nurse must monitor reflexes, respiratory rate, and urinary
output closely during magnesium therapy.
3. A nurse is caring for a client who is receiving magnesium sulfate IV and notes a respiratory
rate of 8/min and absent deep tendon reflexes. Which medication should the nurse prepare
to administer?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Hydralazine
Correct Answer: B
, Calcium gluconate is the specific antidote for magnesium sulfate toxicity and should be
readily available at the bedside. It works by antagonizing the effects of magnesium at the
neuromuscular junction to restore respiratory and muscular function. Administration
should occur slowly to prevent cardiac complications.
4. A client at 30 weeks gestation presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Preterm labor
D. Hydatidiform mole
Correct Answer: B
Painless, bright red vaginal bleeding in the second or third trimester is the classic clinical
manifestation of placenta previa. Unlike abruptio placentae, which is typically associated
with severe abdominal pain and uterine tenderness, placenta previa involves the placenta
covering the cervical os. Vaginal exams are strictly contraindicated in these clients until the
placental location is confirmed by ultrasound.
5. A nurse is reviewing the laboratory results for a client suspected of having HELLP
syndrome. Which findings are consistent with this diagnosis? (Select all that apply)
A. Low platelets
B. Elevated liver enzymes
, C. Elevated hemoglobin
D. Hemolysis
E. Decreased creatinine
Correct Answer: A, B, D
HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets, which
are the hallmark laboratory findings of this severe form of preeclampsia. Hemolysis is often
evidenced by abnormal red blood cell morphology on a smear or elevated bilirubin.
Elevated ALT and AST levels reflect liver damage, while a platelet count below
100,000/mm3 indicates thrombocytopenia.
6. A client at 32 weeks gestation is experiencing preterm labor. The provider prescribes
betamethasone. What is the primary purpose of this medication?
A. To stop uterine contractions
B. To prevent neonatal sepsis
C. To promote fetal lung maturity
D. To treat maternal hypertension
Correct Answer: C
Betamethasone is a corticosteroid administered to the mother to stimulate the production
of surfactant in the fetal lungs. This treatment significantly reduces the risk of respiratory
