GALEN NUR 231 MATERNAL NURSING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is calculating the GTPAL for a client who is currently 10 weeks pregnant. She has a
5-year-old child born at 39 weeks, 3-year-old twins born at 34 weeks, and had a spontaneous
abortion at 8 weeks. What is the correct GTPAL?
A. G3 T1 P2 A1 L3
B. G4 T2 P1 A1 L3
C. G4 T1 P1 A1 L3
D. G4 T1 P2 A1 L2
Answer: C
Conceptual Explanation: Gravida is 4 (current pregnancy, 5-year-old, twins, and
abortion). Term is 1 (the 5-year-old). Preterm is 1 (the twins count as one delivery event).
Abortion is 1. Living is 3 (5-year-old + twins).
2. A client at 34 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse report to the provider immediately?
A. Deep tendon reflexes of 2+
,B. Respiratory rate of 14 breaths/min
C. Urinary output of 20 mL/hr
D. Feeling of warmth and flushing
Answer: C
Conceptual Explanation: Magnesium is excreted by the kidneys. Urinary output less than
30 mL/hr indicates potential toxicity due to renal insufficiency, requiring immediate
intervention.
3. The nurse observes late decelerations on the fetal heart rate monitor. What is the priority
nursing action?
A. Perform a vaginal exam to check for cord prolapse
B. Assist the mother into a supine position
C. Reposition the client to the left side and administer oxygen via non-rebreather
D. Increase the rate of the oxytocin infusion
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation to the fetus by repositioning the mother, providing O2,
and discontinuing oxytocin if applicable.
, 4. Which medication is contraindicated for a client experiencing postpartum hemorrhage who
has a history of asthma?
A. Oxytocin
B. Methylergonovine
C. Misoprostol
D. Carboprost Tromethamine
Answer: D
Conceptual Explanation: Carboprost (Hemabate) can cause severe bronchoconstriction
and is contraindicated in patients with asthma.
5. A client is in the transition phase of the first stage of labor. Which clinical manifestation
should the nurse expect?
A. The client is talkative and excited
B. The client is experiencing mild, infrequent contractions
C. The cervix is dilated 4 to 7 cm
D. The client feels an urge to push and is highly irritable
Answer: D
Conceptual Explanation: Transition phase (8-10 cm) is characterized by intense
contractions, irritability, nausea, and the urge to push.
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is calculating the GTPAL for a client who is currently 10 weeks pregnant. She has a
5-year-old child born at 39 weeks, 3-year-old twins born at 34 weeks, and had a spontaneous
abortion at 8 weeks. What is the correct GTPAL?
A. G3 T1 P2 A1 L3
B. G4 T2 P1 A1 L3
C. G4 T1 P1 A1 L3
D. G4 T1 P2 A1 L2
Answer: C
Conceptual Explanation: Gravida is 4 (current pregnancy, 5-year-old, twins, and
abortion). Term is 1 (the 5-year-old). Preterm is 1 (the twins count as one delivery event).
Abortion is 1. Living is 3 (5-year-old + twins).
2. A client at 34 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse report to the provider immediately?
A. Deep tendon reflexes of 2+
,B. Respiratory rate of 14 breaths/min
C. Urinary output of 20 mL/hr
D. Feeling of warmth and flushing
Answer: C
Conceptual Explanation: Magnesium is excreted by the kidneys. Urinary output less than
30 mL/hr indicates potential toxicity due to renal insufficiency, requiring immediate
intervention.
3. The nurse observes late decelerations on the fetal heart rate monitor. What is the priority
nursing action?
A. Perform a vaginal exam to check for cord prolapse
B. Assist the mother into a supine position
C. Reposition the client to the left side and administer oxygen via non-rebreather
D. Increase the rate of the oxytocin infusion
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation to the fetus by repositioning the mother, providing O2,
and discontinuing oxytocin if applicable.
, 4. Which medication is contraindicated for a client experiencing postpartum hemorrhage who
has a history of asthma?
A. Oxytocin
B. Methylergonovine
C. Misoprostol
D. Carboprost Tromethamine
Answer: D
Conceptual Explanation: Carboprost (Hemabate) can cause severe bronchoconstriction
and is contraindicated in patients with asthma.
5. A client is in the transition phase of the first stage of labor. Which clinical manifestation
should the nurse expect?
A. The client is talkative and excited
B. The client is experiencing mild, infrequent contractions
C. The cervix is dilated 4 to 7 cm
D. The client feels an urge to push and is highly irritable
Answer: D
Conceptual Explanation: Transition phase (8-10 cm) is characterized by intense
contractions, irritability, nausea, and the urge to push.
