,GCN|NU171/NU 171 Maternal Child Nursing
Exam 3 | Galen | 2026–2027 Edition (PDF)
1. Which laboratory abnormality is characteristic of HELLP syndrome?
A) Hemoconcentration, elevated BUN, and low creatinine
B) Hyperglycemia, elevated lipase, and low potassium
C) Hemolysis, elevated liver enzymes, and low platelets
D) Hypernatremia, elevated bilirubin, and low calcium
Correct Answer: C) Hemolysis, elevated liver enzymes, and low platelets
Rationale: HELLP syndrome is a severe variant of preeclampsia involving hemolysis (H), elevated liver
enzymes (EL), and low platelets (LP). Immediate recognition is critical as it can progress rapidly to
maternal and fetal complications. The other options describe laboratory patterns not characteristic of
this syndrome.
2. A patient with severe preeclampsia is receiving a magnesium sulfate infusion. Which assessment
finding indicates magnesium toxicity?
A) Blood pressure 140/90 mm Hg
B) Loss of deep tendon reflexes
C) Urine output 45 mL/hr
D) Respiratory rate 18 breaths/min
Correct Answer: B) Loss of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is the earliest sign of magnesium toxicity, followed by
respiratory depression and cardiac arrest. The therapeutic range for magnesium is 4-7 mEq/L; toxicity
occurs at levels above 8-10 mEq/L. Calcium gluconate is the antidote.
3. A client at 28 weeks' gestation is admitted with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
,A) Placental abruption
B) Preterm labor
C) Placenta previa
D) Vasa previa
Correct Answer: C) Placenta previa
Rationale: Painless, bright red vaginal bleeding in the second or third trimester is the classic
presentation of placenta previa, where the placenta partially or completely covers the cervical os.
Placental abruption typically presents with painful, dark red bleeding and a rigid abdomen.
4. Which assessment finding is most indicative of uterine atony in the postpartum period?
A) Firm fundus at the umbilicus
B) Boggy fundus with heavy lochia
C) Foul-smelling lochia and fever
D) Fundus displaced to the left
Correct Answer: B) Boggy fundus with heavy lochia
Rationale: Uterine atony is the most common cause of postpartum hemorrhage. A boggy uterus fails
to contract effectively, allowing continued bleeding from the placental site. A firm fundus indicates
good uterine tone; foul-smelling lochia suggests infection.
5. A newborn of a mother with gestational diabetes is at highest risk for which complication in the
first hour after birth?
A) Hyperbilirubinemia
B) Respiratory distress syndrome
C) Hypoglycemia
D) Polycythemia
, Correct Answer: C) Hypoglycemia
Rationale: Infants of diabetic mothers experience hyperinsulinism in response to maternal
hyperglycemia, leading to rebound hypoglycemia after birth when the maternal glucose supply is
removed. Close monitoring of blood glucose is essential in the first hours of life.
6. A nurse is assessing a 2-year-old child with fever, irritability, and tugging at the right ear. Which
finding is most consistent with acute otitis media?
A) Clear drainage from the ear
B) Erythema and bulging of the tympanic membrane
C) Normal tympanic membrane appearance
D) Absence of fever
Correct Answer: B) Erythema and bulging of the tympanic membrane
Rationale: Acute otitis media is characterized by inflammation and infection of the middle ear,
resulting in erythema, bulging, and decreased mobility of the tympanic membrane. Clear drainage
suggests a ruptured tympanic membrane or otitis externa, not acute otitis media.
7. A preschool-age child is diagnosed with acute glomerulonephritis. The nurse understands that this
condition is most commonly associated with a prior:
A) Viral upper respiratory infection
B) Streptococcal infection
C) Parasitic infection
D) Fungal infection
Correct Answer: B) Streptococcal infection
Rationale: Acute post-streptococcal glomerulonephritis typically occurs 1-2 weeks after a
streptococcal infection, such as strep throat or impetigo. Immune complexes deposit in the glomeruli,
leading to inflammation and symptoms including hematuria, proteinuria, and edema.
Exam 3 | Galen | 2026–2027 Edition (PDF)
1. Which laboratory abnormality is characteristic of HELLP syndrome?
A) Hemoconcentration, elevated BUN, and low creatinine
B) Hyperglycemia, elevated lipase, and low potassium
C) Hemolysis, elevated liver enzymes, and low platelets
D) Hypernatremia, elevated bilirubin, and low calcium
Correct Answer: C) Hemolysis, elevated liver enzymes, and low platelets
Rationale: HELLP syndrome is a severe variant of preeclampsia involving hemolysis (H), elevated liver
enzymes (EL), and low platelets (LP). Immediate recognition is critical as it can progress rapidly to
maternal and fetal complications. The other options describe laboratory patterns not characteristic of
this syndrome.
2. A patient with severe preeclampsia is receiving a magnesium sulfate infusion. Which assessment
finding indicates magnesium toxicity?
A) Blood pressure 140/90 mm Hg
B) Loss of deep tendon reflexes
C) Urine output 45 mL/hr
D) Respiratory rate 18 breaths/min
Correct Answer: B) Loss of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is the earliest sign of magnesium toxicity, followed by
respiratory depression and cardiac arrest. The therapeutic range for magnesium is 4-7 mEq/L; toxicity
occurs at levels above 8-10 mEq/L. Calcium gluconate is the antidote.
3. A client at 28 weeks' gestation is admitted with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
,A) Placental abruption
B) Preterm labor
C) Placenta previa
D) Vasa previa
Correct Answer: C) Placenta previa
Rationale: Painless, bright red vaginal bleeding in the second or third trimester is the classic
presentation of placenta previa, where the placenta partially or completely covers the cervical os.
Placental abruption typically presents with painful, dark red bleeding and a rigid abdomen.
4. Which assessment finding is most indicative of uterine atony in the postpartum period?
A) Firm fundus at the umbilicus
B) Boggy fundus with heavy lochia
C) Foul-smelling lochia and fever
D) Fundus displaced to the left
Correct Answer: B) Boggy fundus with heavy lochia
Rationale: Uterine atony is the most common cause of postpartum hemorrhage. A boggy uterus fails
to contract effectively, allowing continued bleeding from the placental site. A firm fundus indicates
good uterine tone; foul-smelling lochia suggests infection.
5. A newborn of a mother with gestational diabetes is at highest risk for which complication in the
first hour after birth?
A) Hyperbilirubinemia
B) Respiratory distress syndrome
C) Hypoglycemia
D) Polycythemia
, Correct Answer: C) Hypoglycemia
Rationale: Infants of diabetic mothers experience hyperinsulinism in response to maternal
hyperglycemia, leading to rebound hypoglycemia after birth when the maternal glucose supply is
removed. Close monitoring of blood glucose is essential in the first hours of life.
6. A nurse is assessing a 2-year-old child with fever, irritability, and tugging at the right ear. Which
finding is most consistent with acute otitis media?
A) Clear drainage from the ear
B) Erythema and bulging of the tympanic membrane
C) Normal tympanic membrane appearance
D) Absence of fever
Correct Answer: B) Erythema and bulging of the tympanic membrane
Rationale: Acute otitis media is characterized by inflammation and infection of the middle ear,
resulting in erythema, bulging, and decreased mobility of the tympanic membrane. Clear drainage
suggests a ruptured tympanic membrane or otitis externa, not acute otitis media.
7. A preschool-age child is diagnosed with acute glomerulonephritis. The nurse understands that this
condition is most commonly associated with a prior:
A) Viral upper respiratory infection
B) Streptococcal infection
C) Parasitic infection
D) Fungal infection
Correct Answer: B) Streptococcal infection
Rationale: Acute post-streptococcal glomerulonephritis typically occurs 1-2 weeks after a
streptococcal infection, such as strep throat or impetigo. Immune complexes deposit in the glomeruli,
leading to inflammation and symptoms including hematuria, proteinuria, and edema.
