MATERNAL-CHILD NURSING
COMPREHENSIVE EXAM QUESTIONS
ND ANSWERS
1. A nurse is reviewing the electronic fetal monitoring (EFM) strip of a client in active labor.
The nurse notes repetitive late decelerations. Which of the following is the priority nursing
intervention?
A. Increase the rate of the intravenous oxytocin infusion.
B. Apply oxygen at 8-10 L/min via non-rebreather mask.
C. Encourage the client to take deep breaths and push.
D. Perform a vaginal exam to assess for cord prolapse.
Answer: B
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve fetal oxygenation by repositioning the mother, increasing IV fluids,
and applying oxygen. Oxytocin should be discontinued, not increased.
2. A 26-year-old client is currently 32 weeks pregnant. Her obstetric history includes a
miscarriage at 10 weeks, a daughter born at 39 weeks, and twin boys born at 34 weeks. All
children are living. What is her GTPAL?
A. G3, T1, P2, A1, L2
,B. G4, T2, P1, A1, L3
C. G4, T1, P1, A1, L3
D. G4, T1, P2, A1, L3
Answer: C
Conceptual Explanation: Gravida (G) = 4 (current, miscarriage, daughter, twins). Term (T)
= 1 (daughter at 39w). Preterm (P) = 1 (twins at 34w - twins count as one birth event).
Abortion (A) = 1 (miscarriage). Living (L) = 3 (daughter + twins).
3. A nurse is monitoring a client with preeclampsia who is receiving intravenous magnesium
sulfate. Which finding would indicate magnesium toxicity?
A. Hyperactive deep tendon reflexes (4+)
B. Urine output of 40 mL per hour
C. Respiratory rate of 10 breaths per minute
D. Blood pressure of 150/95 mmHg
Answer: C
Conceptual Explanation: Magnesium sulfate is a CNS depressant. Toxicity is indicated by
loss of deep tendon reflexes, respiratory depression (<12/min), and decreased urine
output (<30 mL/hr).
, 4. A client at 38 weeks gestation presents with sudden-onset, sharp abdominal pain and a
board-like, tender abdomen. Fetal heart rate is 100 bpm. Which condition should the nurse
suspect?
A. Placenta Previa
B. Abruptio Placentae
C. Uterine Atony
D. Cervical Dilation
Answer: B
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
(though bleeding can be concealed), abdominal pain, and uterine tenderness or rigidity
(board-like abdomen). Placenta previa is typically painless.
5. During a postpartum assessment, the nurse finds the client’s fundus to be boggy and
displaced to the right of the midline. Which action should the nurse take first?
A. Massage the fundus until firm.
B. Assist the client to the bathroom to void.
C. Administer oxytocin as ordered.
D. Notify the healthcare provider immediately.
Answer: B
COMPREHENSIVE EXAM QUESTIONS
ND ANSWERS
1. A nurse is reviewing the electronic fetal monitoring (EFM) strip of a client in active labor.
The nurse notes repetitive late decelerations. Which of the following is the priority nursing
intervention?
A. Increase the rate of the intravenous oxytocin infusion.
B. Apply oxygen at 8-10 L/min via non-rebreather mask.
C. Encourage the client to take deep breaths and push.
D. Perform a vaginal exam to assess for cord prolapse.
Answer: B
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve fetal oxygenation by repositioning the mother, increasing IV fluids,
and applying oxygen. Oxytocin should be discontinued, not increased.
2. A 26-year-old client is currently 32 weeks pregnant. Her obstetric history includes a
miscarriage at 10 weeks, a daughter born at 39 weeks, and twin boys born at 34 weeks. All
children are living. What is her GTPAL?
A. G3, T1, P2, A1, L2
,B. G4, T2, P1, A1, L3
C. G4, T1, P1, A1, L3
D. G4, T1, P2, A1, L3
Answer: C
Conceptual Explanation: Gravida (G) = 4 (current, miscarriage, daughter, twins). Term (T)
= 1 (daughter at 39w). Preterm (P) = 1 (twins at 34w - twins count as one birth event).
Abortion (A) = 1 (miscarriage). Living (L) = 3 (daughter + twins).
3. A nurse is monitoring a client with preeclampsia who is receiving intravenous magnesium
sulfate. Which finding would indicate magnesium toxicity?
A. Hyperactive deep tendon reflexes (4+)
B. Urine output of 40 mL per hour
C. Respiratory rate of 10 breaths per minute
D. Blood pressure of 150/95 mmHg
Answer: C
Conceptual Explanation: Magnesium sulfate is a CNS depressant. Toxicity is indicated by
loss of deep tendon reflexes, respiratory depression (<12/min), and decreased urine
output (<30 mL/hr).
, 4. A client at 38 weeks gestation presents with sudden-onset, sharp abdominal pain and a
board-like, tender abdomen. Fetal heart rate is 100 bpm. Which condition should the nurse
suspect?
A. Placenta Previa
B. Abruptio Placentae
C. Uterine Atony
D. Cervical Dilation
Answer: B
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
(though bleeding can be concealed), abdominal pain, and uterine tenderness or rigidity
(board-like abdomen). Placenta previa is typically painless.
5. During a postpartum assessment, the nurse finds the client’s fundus to be boggy and
displaced to the right of the midline. Which action should the nurse take first?
A. Massage the fundus until firm.
B. Assist the client to the bathroom to void.
C. Administer oxytocin as ordered.
D. Notify the healthcare provider immediately.
Answer: B
