ANTEPARTUM CARE UNFOLDING REASONING ACTUAL FINAL PRACTICE EXAM
PREP WITH ALL POSSIBLE COMPLETE DETAILED AND MOST TESTED PRACTICE
QUESTIONS AND 100% CORRECT VERIFIED ANSWERS FULLY SOLVED WITH
CERTIFIED RATIONALES PLUS RELIABLE ANSWER KEY (100% COMPLETE SOL)
SECTION 1: UNFOLDING CASE STUDY — JESSICA TAYLOR
Jessica Taylor, a 17-year-old G1P0, presents to the prenatal clinic at 9 weeks gestation by LMP. She is
accompanied by her 19-year-old boyfriend. She lives with her grandmother and two younger siblings.
She dropped out of high school in 11th grade and works part-time at a retail store.
1. Which factor in Jessica's history places her at the HIGHEST risk for adverse pregnancy outcomes?
A. Her age alone (17 years)
B. Her lack of a high school diploma and limited financial resources
C. Her gravidity/parity status (G1P0)
D. Her living situation with extended family
B. Her lack of a high school diploma and limited financial resources
Rationale: While adolescent age increases risks (preterm birth, low birthweight, preeclampsia, anemia),
social determinants of health—particularly low educational attainment, limited financial resources, and
food insecurity—are the strongest predictors of adverse outcomes in teen pregnancies. These factors
compound physiologic risks by creating barriers to consistent prenatal care, nutrition, and stress
management. Option A is a risk factor but not the highest. Option C is normal for a first pregnancy.
Option D (living with family) can actually be protective if supportive.
2. Jessica asks the nurse about the probable signs of pregnancy. Which of the following is considered a
probable sign of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones auscultated
,C. Chadwick's sign
D. Fetal movement felt by the examiner
C. Chadwick's sign
Rationale: Chadwick's sign (bluish discoloration of the cervix, vagina, and labia) is a probable sign of
pregnancy. A positive pregnancy test, fetal heart tones, and fetal movement felt by the examiner are
positive signs of pregnancy.
3. At 27 weeks gestation, Jessica presents with headaches and bilateral lower extremity edema. Her
blood pressure is 152/96 mmHg. Which condition is most concerning?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Migraine headache
B. Preeclampsia
Rationale: Jessica has new-onset hypertension after 20 weeks gestation, along with headaches and
edema, which are classic signs of preeclampsia. Gestational hypertension is elevated BP without
proteinuria or other end-organ dysfunction. Chronic hypertension predates pregnancy. Migraine would
not explain the hypertension and edema.
4. The nurse is assessing Jessica for preeclampsia. Which laboratory test is most important to obtain?
A. Complete blood count
B. Urinalysis for protein
C. Blood glucose
D. Thyroid function tests
B. Urinalysis for protein
,Rationale: Proteinuria is a key diagnostic criterion for preeclampsia. A 24-hour urine collection or
protein-to-creatinine ratio is used to quantify protein. CBC, glucose, and thyroid tests are not diagnostic
for preeclampsia.
5. Jessica's blood pressure remains elevated. The provider orders magnesium sulfate. What is the
priority nursing assessment during magnesium sulfate administration?
A. Assess deep tendon reflexes
B. Monitor blood glucose
C. Assess for constipation
D. Monitor for hypertension
A. Assess deep tendon reflexes
Rationale: Magnesium sulfate toxicity can cause loss of deep tendon reflexes (DTRs), respiratory
depression, and cardiac arrest. DTRs should be assessed hourly. Blood glucose and constipation are not
priority assessments. Magnesium sulfate is used to prevent seizures, not to treat hypertension.
6. Jessica asks the nurse about the purpose of magnesium sulfate. What is the best response?
A. "It will lower your blood pressure."
B. "It will prevent seizures."
C. "It will help your baby's lungs mature."
D. "It will prevent preterm labor."
B. "It will prevent seizures."
Rationale: Magnesium sulfate is primarily administered to prevent seizures (eclampsia) in patients with
preeclampsia. While it can cause some vasodilation, its main purpose is seizure prophylaxis. It does not
mature fetal lungs (corticosteroids do) and is not a tocolytic for preterm labor.
7. Jessica's last menstrual period (LMP) was March 5, 2026. Using Naegle's rule, what is her estimated
date of delivery (EDD)?
, A. December 12, 2026
B. December 5, 2026
C. December 19, 2026
D. December 26, 2026
A. December 12, 2026
Rationale: Naegle's rule: EDD = LMP + 1 year - 3 months + 7 days. March 5, 2026 + 1 year = March 5,
2027. Minus 3 months = December 5, 2026. Plus 7 days = December 12, 2026.
8. Jessica is 17 years old and presents without a parent. She requests that her pregnancy information
not be shared with her grandmother. What is the nurse's most appropriate action?
A. Inform Jessica that her grandmother must be notified because she is a minor
B. Respect Jessica's confidentiality and provide care without parental notification
C. Contact child protective services to report the pregnancy
D. Ask Jessica to sign a consent form allowing her grandmother to be informed
B. Respect Jessica's confidentiality and provide care without parental notification
Rationale: Minors can consent to prenatal care in most states, and confidentiality is protected. The
nurse should respect Jessica's autonomy and provide care. Informing her grandmother without consent
would violate confidentiality. Child protective services do not need to be involved solely because of the
pregnancy.
9. The nurse is reviewing Jessica's prenatal labs. Which finding would be most concerning for
preeclampsia?
A. Hemoglobin 11.5 g/dL
B. Platelet count 95,000/mm³
C. White blood cell count 9,000/mm³
D. Hematocrit 34%
PREP WITH ALL POSSIBLE COMPLETE DETAILED AND MOST TESTED PRACTICE
QUESTIONS AND 100% CORRECT VERIFIED ANSWERS FULLY SOLVED WITH
CERTIFIED RATIONALES PLUS RELIABLE ANSWER KEY (100% COMPLETE SOL)
SECTION 1: UNFOLDING CASE STUDY — JESSICA TAYLOR
Jessica Taylor, a 17-year-old G1P0, presents to the prenatal clinic at 9 weeks gestation by LMP. She is
accompanied by her 19-year-old boyfriend. She lives with her grandmother and two younger siblings.
She dropped out of high school in 11th grade and works part-time at a retail store.
1. Which factor in Jessica's history places her at the HIGHEST risk for adverse pregnancy outcomes?
A. Her age alone (17 years)
B. Her lack of a high school diploma and limited financial resources
C. Her gravidity/parity status (G1P0)
D. Her living situation with extended family
B. Her lack of a high school diploma and limited financial resources
Rationale: While adolescent age increases risks (preterm birth, low birthweight, preeclampsia, anemia),
social determinants of health—particularly low educational attainment, limited financial resources, and
food insecurity—are the strongest predictors of adverse outcomes in teen pregnancies. These factors
compound physiologic risks by creating barriers to consistent prenatal care, nutrition, and stress
management. Option A is a risk factor but not the highest. Option C is normal for a first pregnancy.
Option D (living with family) can actually be protective if supportive.
2. Jessica asks the nurse about the probable signs of pregnancy. Which of the following is considered a
probable sign of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones auscultated
,C. Chadwick's sign
D. Fetal movement felt by the examiner
C. Chadwick's sign
Rationale: Chadwick's sign (bluish discoloration of the cervix, vagina, and labia) is a probable sign of
pregnancy. A positive pregnancy test, fetal heart tones, and fetal movement felt by the examiner are
positive signs of pregnancy.
3. At 27 weeks gestation, Jessica presents with headaches and bilateral lower extremity edema. Her
blood pressure is 152/96 mmHg. Which condition is most concerning?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Migraine headache
B. Preeclampsia
Rationale: Jessica has new-onset hypertension after 20 weeks gestation, along with headaches and
edema, which are classic signs of preeclampsia. Gestational hypertension is elevated BP without
proteinuria or other end-organ dysfunction. Chronic hypertension predates pregnancy. Migraine would
not explain the hypertension and edema.
4. The nurse is assessing Jessica for preeclampsia. Which laboratory test is most important to obtain?
A. Complete blood count
B. Urinalysis for protein
C. Blood glucose
D. Thyroid function tests
B. Urinalysis for protein
,Rationale: Proteinuria is a key diagnostic criterion for preeclampsia. A 24-hour urine collection or
protein-to-creatinine ratio is used to quantify protein. CBC, glucose, and thyroid tests are not diagnostic
for preeclampsia.
5. Jessica's blood pressure remains elevated. The provider orders magnesium sulfate. What is the
priority nursing assessment during magnesium sulfate administration?
A. Assess deep tendon reflexes
B. Monitor blood glucose
C. Assess for constipation
D. Monitor for hypertension
A. Assess deep tendon reflexes
Rationale: Magnesium sulfate toxicity can cause loss of deep tendon reflexes (DTRs), respiratory
depression, and cardiac arrest. DTRs should be assessed hourly. Blood glucose and constipation are not
priority assessments. Magnesium sulfate is used to prevent seizures, not to treat hypertension.
6. Jessica asks the nurse about the purpose of magnesium sulfate. What is the best response?
A. "It will lower your blood pressure."
B. "It will prevent seizures."
C. "It will help your baby's lungs mature."
D. "It will prevent preterm labor."
B. "It will prevent seizures."
Rationale: Magnesium sulfate is primarily administered to prevent seizures (eclampsia) in patients with
preeclampsia. While it can cause some vasodilation, its main purpose is seizure prophylaxis. It does not
mature fetal lungs (corticosteroids do) and is not a tocolytic for preterm labor.
7. Jessica's last menstrual period (LMP) was March 5, 2026. Using Naegle's rule, what is her estimated
date of delivery (EDD)?
, A. December 12, 2026
B. December 5, 2026
C. December 19, 2026
D. December 26, 2026
A. December 12, 2026
Rationale: Naegle's rule: EDD = LMP + 1 year - 3 months + 7 days. March 5, 2026 + 1 year = March 5,
2027. Minus 3 months = December 5, 2026. Plus 7 days = December 12, 2026.
8. Jessica is 17 years old and presents without a parent. She requests that her pregnancy information
not be shared with her grandmother. What is the nurse's most appropriate action?
A. Inform Jessica that her grandmother must be notified because she is a minor
B. Respect Jessica's confidentiality and provide care without parental notification
C. Contact child protective services to report the pregnancy
D. Ask Jessica to sign a consent form allowing her grandmother to be informed
B. Respect Jessica's confidentiality and provide care without parental notification
Rationale: Minors can consent to prenatal care in most states, and confidentiality is protected. The
nurse should respect Jessica's autonomy and provide care. Informing her grandmother without consent
would violate confidentiality. Child protective services do not need to be involved solely because of the
pregnancy.
9. The nurse is reviewing Jessica's prenatal labs. Which finding would be most concerning for
preeclampsia?
A. Hemoglobin 11.5 g/dL
B. Platelet count 95,000/mm³
C. White blood cell count 9,000/mm³
D. Hematocrit 34%
