NSG 3500 MATERNAL HEALTH
NURSING COMPREHENSIVE EXAM
GUIDE QUESTIONS AND ANSWERS
1. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding should the nurse prioritize as a sign of magnesium toxicity?
A. Respiratory rate of 10 breaths per minute
B. Presence of 2+ deep tendon reflexes
C. Urinary output of 40 mL per hour
D. Blood pressure of 150/90 mmHg
Answer: A
Conceptual Explanation: Magnesium sulfate is a CNS depressant. Toxicity is indicated by a
respiratory rate below 12, absent deep tendon reflexes, and decreased urinary output. A
rate of 10 is critically low.
2. A laboring client’s fetal monitor strip shows late decelerations. Which action should the
nurse take first?
A. Assist the client into a side-lying position
,B. Increase the IV oxytocin infusion rate
C. Prepare the client for an immediate amniotomy
D. Administer oxygen at 2 L/min via nasal cannula
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation by turning the client to their side, followed by stopping
oxytocin and increasing IV fluids.
3. A client presents with painless, bright red vaginal bleeding at 32 weeks gestation. Which
condition should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Placenta previa
D. Preterm labor
Answer: C
Conceptual Explanation: Placenta previa is characterized by painless, bright red bleeding.
Placental abruption typically involves painful, dark red bleeding and a board-like abdomen.
4. Which finding is a definitive sign that a client is in true labor?
A. Contractions occurring every 5 minutes
B. Progressive cervical dilation and effacement
, C. Rupture of membranes
D. Loss of the mucus plug
Answer: B
Conceptual Explanation: True labor is defined by progressive changes in the cervix
(dilation and effacement). Other signs like contractions or ROM can occur without cervical
change (false labor).
5. A postpartum client is experiencing heavy vaginal bleeding and a boggy uterus. What is the
priority nursing intervention?
A. Administer methylergonovine IM
B. Massage the uterine fundus until firm
C. Notify the healthcare provider
D. Catheterize the client to empty the bladder
Answer: B
Conceptual Explanation: The most common cause of postpartum hemorrhage is uterine
atony. Massaging the fundus is the immediate action to stimulate contraction and stop
bleeding.
6. Calculate the estimated date of delivery (EDD) using Naegele’s rule for a client whose last
menstrual period began on May 10.
A. February 17
NURSING COMPREHENSIVE EXAM
GUIDE QUESTIONS AND ANSWERS
1. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding should the nurse prioritize as a sign of magnesium toxicity?
A. Respiratory rate of 10 breaths per minute
B. Presence of 2+ deep tendon reflexes
C. Urinary output of 40 mL per hour
D. Blood pressure of 150/90 mmHg
Answer: A
Conceptual Explanation: Magnesium sulfate is a CNS depressant. Toxicity is indicated by a
respiratory rate below 12, absent deep tendon reflexes, and decreased urinary output. A
rate of 10 is critically low.
2. A laboring client’s fetal monitor strip shows late decelerations. Which action should the
nurse take first?
A. Assist the client into a side-lying position
,B. Increase the IV oxytocin infusion rate
C. Prepare the client for an immediate amniotomy
D. Administer oxygen at 2 L/min via nasal cannula
Answer: A
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation by turning the client to their side, followed by stopping
oxytocin and increasing IV fluids.
3. A client presents with painless, bright red vaginal bleeding at 32 weeks gestation. Which
condition should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Placenta previa
D. Preterm labor
Answer: C
Conceptual Explanation: Placenta previa is characterized by painless, bright red bleeding.
Placental abruption typically involves painful, dark red bleeding and a board-like abdomen.
4. Which finding is a definitive sign that a client is in true labor?
A. Contractions occurring every 5 minutes
B. Progressive cervical dilation and effacement
, C. Rupture of membranes
D. Loss of the mucus plug
Answer: B
Conceptual Explanation: True labor is defined by progressive changes in the cervix
(dilation and effacement). Other signs like contractions or ROM can occur without cervical
change (false labor).
5. A postpartum client is experiencing heavy vaginal bleeding and a boggy uterus. What is the
priority nursing intervention?
A. Administer methylergonovine IM
B. Massage the uterine fundus until firm
C. Notify the healthcare provider
D. Catheterize the client to empty the bladder
Answer: B
Conceptual Explanation: The most common cause of postpartum hemorrhage is uterine
atony. Massaging the fundus is the immediate action to stimulate contraction and stop
bleeding.
6. Calculate the estimated date of delivery (EDD) using Naegele’s rule for a client whose last
menstrual period began on May 10.
A. February 17
