DIAGNOSTIC EXAM
Nursing Board Review – 200
Questions with Verified Answers
& Rationales
1. Nurse would suspect an ectopic pregnancy if the
client complained of:
A. An adherent painful ovarian mass
B. Lower abdominal cramping for a long period of time.
C. Leukorrhea and dysuria a few days after the first missed
period
D. Sharp lower right or left abdominal pain radiating to the
shoulder.
Answer: D. Sharp lower right or left abdominal pain
radiating to the shoulder.
Rationale: Ectopic pregnancy classically presents with
sharp, unilateral lower abdominal pain that may radiate to
the shoulder (due to diaphragmatic irritation from
hemoperitoneum). This is a classic sign of a ruptured ectopic
pregnancy.
2. A client who has missed two menstrual cycle period
comes to the prenatal clinic complaining of vaginal
bleeding and one-sided lower-quadrant pain. The
nurse suspects that this client has.
A. Abruptio placentae
B. An ectopic pregnancy
C. An incomplete abortion
D. A rupture of a graafian follicle.
Answer: B. An ectopic pregnancy
Rationale: The classic triad of ectopic pregnancy is missed
menstrual period (amenorrhea), vaginal bleeding, and one-
sided lower-quadrant pain. This presentation is highly
suspicious for ectopic pregnancy.
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,3. Variable decelerations indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
Answer: A. cord compression
Rationale: Variable decelerations are characterized by an
abrupt decrease in fetal heart rate that varies in duration
and intensity. They are caused by umbilical cord
compression.
4. Late deceleration indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
Answer: B. placental insufficiency
Rationale: Late decelerations are characterized by a
gradual decrease in fetal heart rate that begins after the
peak of the contraction and returns to baseline after the
contraction ends. They indicate uteroplacental insufficiency.
5. Early deceleration indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
Answer: C. fetal head compression
Rationale: Early decelerations are characterized by a
gradual decrease in fetal heart rate that begins with the
onset of the contraction and returns to baseline by the end
of the contraction. They are caused by fetal head
compression and are considered benign.
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,6. Blood therapeutic level of magnesium So4?
A. 1.3 – 2.1 mEq/L
B. 0.5 – 1 meq/L
C. 1.3 – 5 meq/L
D. 0.5 – 2 meq/L
Answer: A. 1.3 – 2.1 mEq/L
Rationale: The therapeutic serum magnesium level for
magnesium sulfate therapy is 1.3 to 2.1 mEq/L. Levels above
this range indicate toxicity.
7. A client is on Magnesium So4 therapy for severe
preeclampsia. The nurse must be alert for the first
sign of an excessive blood magnesium level which is:
A. Disturbance in sensorium
B. Increased in respiratory rate
C. Development of cardiac dysrhythmia
D. Disappearance of the knee-jerk reflex
Answer: D. Disappearance of the knee-jerk reflex
Rationale: The first sign of magnesium sulfate toxicity is the
disappearance of the knee-jerk (deep tendon) reflex. This is
followed by respiratory depression and cardiac
dysrhythmias.
Situation: Diane is arrived to the labor and delivery
area in labor. She complains of regular uterine
contractions with 8 to 10 minutes interval and states
that her bag of water has been ruptured. The fetus is
in a left occiput anterior position (LOA).
8. The nurse's first action should be to:
A. check the FHR
B. start IV fluid as ordered
C. call the physician
D. place to lying position
Answer: A. check the FHR
Rationale: The first action when a client arrives in labor with
ruptured membranes is to check the fetal heart rate (FHR) to
assess fetal well-being. This is the priority nursing action.
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, 9. Which procedure would best determine if Diane's
BOW has ruptured
A. A complete blood count
B. Nitrazine Paper test
C. Urinalysis
D. Vaginal examination
Answer: B. Nitrazine Paper test
Rationale: The Nitrazine paper test is used to determine if
membranes have ruptured. Amniotic fluid is alkaline (pH 7.0-
7.5) and turns Nitrazine paper blue, while normal vaginal
secretions are acidic.
10. Initial assessment done and revealed the
following FH = 30cm, FHT 145bpm, BP = 110/70
mmHg. IE done by Dr. Mar and revealed 4 cm cervical
dilatation. Diane asked for Demerol. The nurse's best
response is:
A. "Try to wait until you really need it."
B. "It is too early in your labor; medication will retard
progress of uterine contraction."
C. "I know you are in pain. I'll just prepare the medication."
D. "Perhaps a change in position will make you more
comfortable."
Answer: B. "It is too early in your labor; medication
will retard progress of uterine contraction."
Rationale: At 4 cm cervical dilatation, the client is in the
latent phase of labor. Administering Demerol (meperidine) at
this stage may retard the progress of uterine contractions.
The nurse should explain this to the client.
11. The pregnant woman ask "When does the heart
and the brain of the baby form". The best response
made by the nurse is:
A. First month
B. Second month
C. Third month
D. Fourth month
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