NSG 3500 MATERNAL HEALTH EXAM 3
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS
1. A nurse is assessing a client in labor and observes late decelerations on the fetal monitor.
What is the priority nursing action?
A. Place the client in a Trendelenburg position
B. Increase the rate of the maintenance IV fluid
C. Reposition the client to a side-looking position
D. Administer oxygen via a non-rebreather mask at 10 L/min
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority action is to improve placental perfusion, starting with repositioning the client to
the side. Oxygen and IV fluids follow if repositioning is insufficient.
2. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding requires immediate notification of the provider?
A. Report of a warm, flushed feeling throughout the body
,B. Urinary output of 40 mL per hour
C. Absence of patellar deep tendon reflexes
D. Respiratory rate of 14 breaths per minute
Answer: C
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
toxicity. Urinary output below 30mL/hr or RR below 12 are also signs, but absence of
reflexes usually precedes respiratory depression.
3. Following a precipitous delivery, the nurse notes the client is experiencing heavy vaginal
bleeding and a boggy fundus. Which medication should the nurse anticipate administering
first?
A. Methylergonovine
B. Carboprost tromethamine
C. Oxytocin
D. Misoprostol
Answer: C
Conceptual Explanation: Oxytocin is the first-line medication for managing uterine atony
and postpartum hemorrhage due to its rapid effect and lack of hypertensive side effects.
4. Which of the following signs distinguishes abruptio placentae from placenta previa?
A. Painless bright red vaginal bleeding
, B. Soft, non-tender abdomen
C. Increase in fetal heart rate accelerations
D. Rigid, board-like abdomen with severe pain
Answer: D
Conceptual Explanation: Abruptio placentae involves premature separation of the
placenta and is characterized by a rigid, painful abdomen, whereas placenta previa is
typically painless bleeding.
5. A newborn has a heart rate of 90 bpm, a weak cry, some flexion of extremities, grimace
when stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 4
B. 6
C. 5
D. 7
Answer: C
Conceptual Explanation: Heart rate <100 (1), weak cry (1), some flexion (1), grimace (1),
and acrocyanosis (1) equals a total score of 5.
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS
1. A nurse is assessing a client in labor and observes late decelerations on the fetal monitor.
What is the priority nursing action?
A. Place the client in a Trendelenburg position
B. Increase the rate of the maintenance IV fluid
C. Reposition the client to a side-looking position
D. Administer oxygen via a non-rebreather mask at 10 L/min
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority action is to improve placental perfusion, starting with repositioning the client to
the side. Oxygen and IV fluids follow if repositioning is insufficient.
2. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding requires immediate notification of the provider?
A. Report of a warm, flushed feeling throughout the body
,B. Urinary output of 40 mL per hour
C. Absence of patellar deep tendon reflexes
D. Respiratory rate of 14 breaths per minute
Answer: C
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
toxicity. Urinary output below 30mL/hr or RR below 12 are also signs, but absence of
reflexes usually precedes respiratory depression.
3. Following a precipitous delivery, the nurse notes the client is experiencing heavy vaginal
bleeding and a boggy fundus. Which medication should the nurse anticipate administering
first?
A. Methylergonovine
B. Carboprost tromethamine
C. Oxytocin
D. Misoprostol
Answer: C
Conceptual Explanation: Oxytocin is the first-line medication for managing uterine atony
and postpartum hemorrhage due to its rapid effect and lack of hypertensive side effects.
4. Which of the following signs distinguishes abruptio placentae from placenta previa?
A. Painless bright red vaginal bleeding
, B. Soft, non-tender abdomen
C. Increase in fetal heart rate accelerations
D. Rigid, board-like abdomen with severe pain
Answer: D
Conceptual Explanation: Abruptio placentae involves premature separation of the
placenta and is characterized by a rigid, painful abdomen, whereas placenta previa is
typically painless bleeding.
5. A newborn has a heart rate of 90 bpm, a weak cry, some flexion of extremities, grimace
when stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 4
B. 6
C. 5
D. 7
Answer: C
Conceptual Explanation: Heart rate <100 (1), weak cry (1), some flexion (1), grimace (1),
and acrocyanosis (1) equals a total score of 5.
