NUR 231 MATERNAL NURSING
COMPREHENSIVE MASTERY EXAM
QUESTIONS AND ANSWERS
1. A client at 34 weeks gestation presents with sudden-onset, severe abdominal pain and a
board-like abdomen. The nurse notes dark red vaginal bleeding. Which condition should the
nurse suspect?
A. Placenta Previa
B. Abruptio Placentae
C. Hydatidiform Mole
D. Ectopic Pregnancy
Answer: B
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
and uterine rigidity (board-like abdomen). Placenta previa is usually painless.
2. A patient is receiving Magnesium Sulfate for preeclampsia. The nurse notes a respiratory
rate of 10 breaths/minute and absent deep tendon reflexes (DTRs). What is the priority
action?
A. Increase the IV fluid rate
,B. Administer Naloxone
C. Stop the Magnesium Sulfate infusion
D. Place the patient in Trendelenburg position
Answer: C
Conceptual Explanation: Respiratory depression and absent DTRs are signs of
Magnesium toxicity. The priority is to stop the medication before administering the
antagonist, Calcium Gluconate.
3. During a non-stress test (NST), the nurse observes two fetal heart rate accelerations of 15
beats/min lasting 15 seconds within a 20-minute period. How should this be documented?
A. Reactive
B. Non-reactive
C. Positive
D. Negative
Answer: A
Conceptual Explanation: A reactive NST is defined by at least two accelerations of 15 bpm
above baseline for at least 15 seconds within a 20-minute window.
4. Which laboratory finding is indicative of HELLP syndrome in a patient with severe
preeclampsia?
A. Low Platelets
, B. Low Serum Creatinine
C. Elevated Hemoglobin
D. Decreased Liver Enzymes
Answer: A
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. Platelet counts below 100,000/mm3 are a hallmark sign.
5. A nurse is caring for a client in the first stage of labor. The fetal heart rate monitor shows
late decelerations. Which action should the nurse take first?
A. Perform a vaginal exam
B. Increase the Oxytocin rate
C. Turn the client to the left side
D. Prepare for immediate delivery
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation by turning the client to the side, increasing IV fluids, and
applying oxygen.
6. Which medication is typically administered to a newborn within 1 hour of birth to prevent
ophthalmia neonatorum?
A. Vitamin K
COMPREHENSIVE MASTERY EXAM
QUESTIONS AND ANSWERS
1. A client at 34 weeks gestation presents with sudden-onset, severe abdominal pain and a
board-like abdomen. The nurse notes dark red vaginal bleeding. Which condition should the
nurse suspect?
A. Placenta Previa
B. Abruptio Placentae
C. Hydatidiform Mole
D. Ectopic Pregnancy
Answer: B
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
and uterine rigidity (board-like abdomen). Placenta previa is usually painless.
2. A patient is receiving Magnesium Sulfate for preeclampsia. The nurse notes a respiratory
rate of 10 breaths/minute and absent deep tendon reflexes (DTRs). What is the priority
action?
A. Increase the IV fluid rate
,B. Administer Naloxone
C. Stop the Magnesium Sulfate infusion
D. Place the patient in Trendelenburg position
Answer: C
Conceptual Explanation: Respiratory depression and absent DTRs are signs of
Magnesium toxicity. The priority is to stop the medication before administering the
antagonist, Calcium Gluconate.
3. During a non-stress test (NST), the nurse observes two fetal heart rate accelerations of 15
beats/min lasting 15 seconds within a 20-minute period. How should this be documented?
A. Reactive
B. Non-reactive
C. Positive
D. Negative
Answer: A
Conceptual Explanation: A reactive NST is defined by at least two accelerations of 15 bpm
above baseline for at least 15 seconds within a 20-minute window.
4. Which laboratory finding is indicative of HELLP syndrome in a patient with severe
preeclampsia?
A. Low Platelets
, B. Low Serum Creatinine
C. Elevated Hemoglobin
D. Decreased Liver Enzymes
Answer: A
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. Platelet counts below 100,000/mm3 are a hallmark sign.
5. A nurse is caring for a client in the first stage of labor. The fetal heart rate monitor shows
late decelerations. Which action should the nurse take first?
A. Perform a vaginal exam
B. Increase the Oxytocin rate
C. Turn the client to the left side
D. Prepare for immediate delivery
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation by turning the client to the side, increasing IV fluids, and
applying oxygen.
6. Which medication is typically administered to a newborn within 1 hour of birth to prevent
ophthalmia neonatorum?
A. Vitamin K
