NURS 354 COMPREHENSIVE REVIEW
(QUIZZES 1-5) QUESTIONS AND
ANSWERS 2026
1. A pregnant client at 32 weeks gestation presents with painless, bright red vaginal bleeding.
Which nursing intervention is contraindicated?
A. Administering intravenous fluids
B. Monitoring fetal heart rate patterns
C. Assessing maternal blood pressure
D. Performing a sterile vaginal examination
Answer: D
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa. A
vaginal exam can cause further placental separation and life-threatening hemorrhage.
2. Using Naegele’s rule, calculate the estimated date of delivery (EDD) for a client whose last
menstrual period began on March 15.
A. December 15
B. January 15
C. January 22
,D. December 22
Answer: D
Conceptual Explanation: Naegele’s rule: Subtract 3 months and add 7 days to the first day
of the last menstrual period (March 15 - 3 months = Dec 15; + 7 days = Dec 22).
3. A client is in the active phase of labor. The nurse notes a fetal heart rate (FHR) deceleration
that begins after the peak of the contraction and returns to baseline after the contraction
ends. What is the priority action?
A. Reposition the client to a side-lying position
B. Perform a scalp stimulation test
C. Increase the rate of the oxytocin infusion
D. Document this as a normal finding
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. Priority
interventions include repositioning, oxygen, and stopping oxytocin.
4. Which GTPAL notation correctly describes a client who is currently pregnant, had a
miscarriage at 10 weeks, and has one child born at 39 weeks?
A. G2, T1, P0, A1, L1
B. G3, T1, P0, A1, L1
C. G3, T0, P1, A1, L1
, D. G2, T0, P0, A1, L1
Answer: B
Conceptual Explanation: G=3 (current, miscarriage, full-term), T=1 (39 weeks), P=0, A=1
(miscarriage < 20 weeks), L=1.
5. A client with preeclampsia is receiving Magnesium Sulfate. The nurse notes a respiratory
rate of 10 breaths/min and absent deep tendon reflexes. What is the immediate action?
A. Decrease the infusion rate by half
B. Call for a STAT Magnesium level
C. Check the client’s blood pressure
D. Administer Calcium Gluconate
Answer: D
Conceptual Explanation: Absent reflexes and respiratory depression are signs of
Magnesium toxicity. Calcium Gluconate is the specific antidote.
6. During a postpartum assessment 4 hours after delivery, the nurse finds the fundus to be
boggy and displaced to the right. What is the most likely cause?
A. Uterine atony
B. Retained placental fragments
C. Cervical laceration
D. Bladder distension
(QUIZZES 1-5) QUESTIONS AND
ANSWERS 2026
1. A pregnant client at 32 weeks gestation presents with painless, bright red vaginal bleeding.
Which nursing intervention is contraindicated?
A. Administering intravenous fluids
B. Monitoring fetal heart rate patterns
C. Assessing maternal blood pressure
D. Performing a sterile vaginal examination
Answer: D
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa. A
vaginal exam can cause further placental separation and life-threatening hemorrhage.
2. Using Naegele’s rule, calculate the estimated date of delivery (EDD) for a client whose last
menstrual period began on March 15.
A. December 15
B. January 15
C. January 22
,D. December 22
Answer: D
Conceptual Explanation: Naegele’s rule: Subtract 3 months and add 7 days to the first day
of the last menstrual period (March 15 - 3 months = Dec 15; + 7 days = Dec 22).
3. A client is in the active phase of labor. The nurse notes a fetal heart rate (FHR) deceleration
that begins after the peak of the contraction and returns to baseline after the contraction
ends. What is the priority action?
A. Reposition the client to a side-lying position
B. Perform a scalp stimulation test
C. Increase the rate of the oxytocin infusion
D. Document this as a normal finding
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. Priority
interventions include repositioning, oxygen, and stopping oxytocin.
4. Which GTPAL notation correctly describes a client who is currently pregnant, had a
miscarriage at 10 weeks, and has one child born at 39 weeks?
A. G2, T1, P0, A1, L1
B. G3, T1, P0, A1, L1
C. G3, T0, P1, A1, L1
, D. G2, T0, P0, A1, L1
Answer: B
Conceptual Explanation: G=3 (current, miscarriage, full-term), T=1 (39 weeks), P=0, A=1
(miscarriage < 20 weeks), L=1.
5. A client with preeclampsia is receiving Magnesium Sulfate. The nurse notes a respiratory
rate of 10 breaths/min and absent deep tendon reflexes. What is the immediate action?
A. Decrease the infusion rate by half
B. Call for a STAT Magnesium level
C. Check the client’s blood pressure
D. Administer Calcium Gluconate
Answer: D
Conceptual Explanation: Absent reflexes and respiratory depression are signs of
Magnesium toxicity. Calcium Gluconate is the specific antidote.
6. During a postpartum assessment 4 hours after delivery, the nurse finds the fundus to be
boggy and displaced to the right. What is the most likely cause?
A. Uterine atony
B. Retained placental fragments
C. Cervical laceration
D. Bladder distension
