Alyssa Kane Maternal newborn simulation
3.0 Questions and ANSWERS 2026\2027
update
1.The nurse is assessing Alyssa Kane, a postpartum patient, and notes
that her fundus is boggy and displaced to the right above the umbilicus.
What is the nurse’s first action?
Answer: Assist the patient to void and then reassess the fundus.
Rationale: A displaced, boggy fundus is most commonly caused by a
distended bladder, which prevents the uterus from contracting firmly.
Assisting the patient to empty her bladder is the first intervention before
initiating fundal massage.
2.Following the intervention for the displaced fundus, the nurse
performs fundal massage and notes that Alyssa is experiencing heavy,
bright red vaginal bleeding with large clots. Which medication should
the nurse anticipate administering first?
Answer: Oxytocin (Pitocin)
Rationale: Oxytocin is the first-line uterotonic agent for the management
of postpartum hemorrhage due to uterine atony. It promotes uterine
contractions to compress bleeding vessels.
3.Despite the administration of Oxytocin, Alyssa’s bleeding continues.
Her blood pressure is now 150/98 mm Hg. Which second-line
medication is contraindicated for this patient?
Answer: Methylergonovine (Methergine)
, Rationale: Methylergonovine is contraindicated in patients with
hypertension because it causes vasoconstriction, which can dangerously
elevate blood pressure and increase the risk of stroke. Carboprost
(Hemabate) or misoprostol (Cytotec) would be safer alternatives.
4.Alyssa Kane is diagnosed with severe preeclampsia with severe
features. The provider prescribes Magnesium Sulfate. What is the
primary therapeutic effect of this medication?
Answer: Prevention of seizures
Rationale: Magnesium sulfate is a central nervous system depressant and
is the gold standard medication used to prevent and treat eclamptic
seizures in patients with severe preeclampsia.
5.While receiving Magnesium Sulfate, the nurse assesses Alyssa and
notes a respiratory rate of 10 breaths per minute, absent deep tendon
reflexes (DTRs), and a decreased level of consciousness. What is the
nurse’s priority action?
Answer: Stop the Magnesium Sulfate infusion immediately.
Rationale: These are signs of Magnesium Sulfate toxicity. The first and
most critical action is to stop the infusion to prevent respiratory arrest.
Calcium gluconate, the antidote, should then be readily available to
administer.
6.Prior to initiating the Magnesium Sulfate infusion, which of the
following must the nurse ensure is at the bedside?
Answer: Calcium gluconate
Rationale: Calcium gluconate is the specific antidote for Magnesium
Sulfate toxicity and must be kept at the bedside whenever a patient is
receiving this medication.
3.0 Questions and ANSWERS 2026\2027
update
1.The nurse is assessing Alyssa Kane, a postpartum patient, and notes
that her fundus is boggy and displaced to the right above the umbilicus.
What is the nurse’s first action?
Answer: Assist the patient to void and then reassess the fundus.
Rationale: A displaced, boggy fundus is most commonly caused by a
distended bladder, which prevents the uterus from contracting firmly.
Assisting the patient to empty her bladder is the first intervention before
initiating fundal massage.
2.Following the intervention for the displaced fundus, the nurse
performs fundal massage and notes that Alyssa is experiencing heavy,
bright red vaginal bleeding with large clots. Which medication should
the nurse anticipate administering first?
Answer: Oxytocin (Pitocin)
Rationale: Oxytocin is the first-line uterotonic agent for the management
of postpartum hemorrhage due to uterine atony. It promotes uterine
contractions to compress bleeding vessels.
3.Despite the administration of Oxytocin, Alyssa’s bleeding continues.
Her blood pressure is now 150/98 mm Hg. Which second-line
medication is contraindicated for this patient?
Answer: Methylergonovine (Methergine)
, Rationale: Methylergonovine is contraindicated in patients with
hypertension because it causes vasoconstriction, which can dangerously
elevate blood pressure and increase the risk of stroke. Carboprost
(Hemabate) or misoprostol (Cytotec) would be safer alternatives.
4.Alyssa Kane is diagnosed with severe preeclampsia with severe
features. The provider prescribes Magnesium Sulfate. What is the
primary therapeutic effect of this medication?
Answer: Prevention of seizures
Rationale: Magnesium sulfate is a central nervous system depressant and
is the gold standard medication used to prevent and treat eclamptic
seizures in patients with severe preeclampsia.
5.While receiving Magnesium Sulfate, the nurse assesses Alyssa and
notes a respiratory rate of 10 breaths per minute, absent deep tendon
reflexes (DTRs), and a decreased level of consciousness. What is the
nurse’s priority action?
Answer: Stop the Magnesium Sulfate infusion immediately.
Rationale: These are signs of Magnesium Sulfate toxicity. The first and
most critical action is to stop the infusion to prevent respiratory arrest.
Calcium gluconate, the antidote, should then be readily available to
administer.
6.Prior to initiating the Magnesium Sulfate infusion, which of the
following must the nurse ensure is at the bedside?
Answer: Calcium gluconate
Rationale: Calcium gluconate is the specific antidote for Magnesium
Sulfate toxicity and must be kept at the bedside whenever a patient is
receiving this medication.
