Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
NUR 5461 – CHAPTERS 28, 29, 31 & 32 | EXAM QUESTIONS
AND CORRECT ANSWERS | LATEST 2026/2027
Nur 5461 Ch 28, 29, 31 & 32
SCHOOL OF NURSING
MATERNAL-NEWBORN NURSING: HIGH-RISK PREGNANCY, LABOR AND
POSTPARTUM COMPLICATIONS
1. A primigravida at 33 weeks has a blood pressure of 150/96 mm Hg
on two readings taken 4 hours apart. She had normal pressures at her
first prenatal visit, and a urine dipstick shows 2+ protein. Which
condition is most consistent with these findings?
A. Chronic hypertension
B. Chronic hypertension with superimposed preeclampsia
C. Gestational hypertension
D. Preeclampsia
ANSWER : D. Preeclampsia
New-onset hypertension after 20 weeks with proteinuria in a woman
who was normotensive before meets the definition of preeclampsia.
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,Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
2. Which finding in a client with preeclampsia indicates that the disease
now has severe features?
A. Weight gain of 0.5 kg in one week
B. Urine protein of 1+ on dipstick
C. Trace pedal edema at the end of the day
D. Blood pressure of 164/112 mm Hg
ANSWER : D. Blood pressure of 164/112 mm Hg
A systolic pressure of 160 or higher or a diastolic of 110 or higher is one
of the defining severe features.
3. The nurse is starting a magnesium sulfate infusion for a client with
severe preeclampsia. The client asks why she needs this drug. The
nurse explains that its main purpose is to:
A. Mature the baby's lungs
B. Prevent seizure activity
C. Stop the uterus from contracting
D. Lower her blood pressure quickly
ANSWER : B. Prevent seizure activity
Magnesium sulfate is a CNS depressant given to prevent eclamptic
seizures; it is not a reliable antihypertensive.
4. During a magnesium sulfate infusion, which assessment finding is
usually the earliest sign that the serum level is becoming toxic?
A. Feeling warm and flushed
B. Respiratory rate of 16 per minute
C. Absent patellar reflexes
D. Urine output of 45 mL per hour
ANSWER : C. Absent patellar reflexes
Loss of deep tendon reflexes appears at levels below those that cause
respiratory depression, so it serves as the early warning sign.
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,Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
5. Which medication should be immediately available at the bedside of
any client receiving IV magnesium sulfate?
A. Protamine sulfate
B. Naloxone
C. Vitamin K
D. Calcium gluconate
ANSWER : D. Calcium gluconate
Calcium gluconate 10% given slowly IV reverses the effects of
magnesium toxicity.
6. The therapeutic serum magnesium range the nurse expects for
seizure prophylaxis in preeclampsia is:
A. 8 to 10 mEq/L
B. 1.5 to 2.5 mEq/L
C. 4 to 7 mEq/L
D. 10 to 12 mEq/L
ANSWER : C. 4 to 7 mEq/L
A level of roughly 4 to 7 mEq/L prevents seizures; reflexes disappear
near 10 and respiratory depression follows above that.
7. A client on magnesium sulfate has a respiratory rate of 10 per
minute, 1+ reflexes, and urine output of 35 mL/hr. What is the nurse's
first action?
A. Stop the infusion and notify the provider
B. Recheck the respirations in one hour
C. Increase the IV rate to improve circulation
D. Turn the client to her right side
ANSWER : A. Stop the infusion and notify the provider
A respiratory rate below 12 signals magnesium toxicity, so the infusion
is stopped first and the provider notified.
Page 3 of 63
, Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
8. HELLP syndrome is a variant of preeclampsia characterized by:
A. Hemolysis, elevated liver enzymes, and low platelets
B. Hyperglycemia, elevated lipids, and low potassium
C. Hemorrhage, elevated leukocytes, and low fibrinogen
D. Hypertension, edema, and low protein
ANSWER : A. Hemolysis, elevated liver enzymes, and low platelets
The acronym stands for hemolysis, elevated liver enzymes, and a low
platelet count.
9. A client at 35 weeks reports nausea, malaise, and pain under the
right ribs. Her BP is 148/94 mm Hg. Which laboratory result would
most concern the nurse?
A. Serum creatinine of 0.6 mg/dL
B. White blood cell count of 12,000/mm3
C. Platelet count of 85,000/mm3
D. Hemoglobin of 11.2 g/dL
ANSWER : C. Platelet count of 85,000/mm3
Right upper quadrant pain with hypertension suggests HELLP, and
thrombocytopenia under 100,000 supports that diagnosis.
10. Which antihypertensive is commonly used for acute-onset severe
hypertension in a pregnant client?
A. IV furosemide
B. Oral lisinopril
C. Oral losartan
D. IV labetalol
ANSWER : D. IV labetalol
IV labetalol, IV hydralazine, and oral immediate-release nifedipine are
first-line; ACE inhibitors and ARBs harm the fetal kidneys.
Page 4 of 63
NUR 5461 – CHAPTERS 28, 29, 31 & 32 | EXAM QUESTIONS
AND CORRECT ANSWERS | LATEST 2026/2027
Nur 5461 Ch 28, 29, 31 & 32
SCHOOL OF NURSING
MATERNAL-NEWBORN NURSING: HIGH-RISK PREGNANCY, LABOR AND
POSTPARTUM COMPLICATIONS
1. A primigravida at 33 weeks has a blood pressure of 150/96 mm Hg
on two readings taken 4 hours apart. She had normal pressures at her
first prenatal visit, and a urine dipstick shows 2+ protein. Which
condition is most consistent with these findings?
A. Chronic hypertension
B. Chronic hypertension with superimposed preeclampsia
C. Gestational hypertension
D. Preeclampsia
ANSWER : D. Preeclampsia
New-onset hypertension after 20 weeks with proteinuria in a woman
who was normotensive before meets the definition of preeclampsia.
Page 1 of 63
,Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
2. Which finding in a client with preeclampsia indicates that the disease
now has severe features?
A. Weight gain of 0.5 kg in one week
B. Urine protein of 1+ on dipstick
C. Trace pedal edema at the end of the day
D. Blood pressure of 164/112 mm Hg
ANSWER : D. Blood pressure of 164/112 mm Hg
A systolic pressure of 160 or higher or a diastolic of 110 or higher is one
of the defining severe features.
3. The nurse is starting a magnesium sulfate infusion for a client with
severe preeclampsia. The client asks why she needs this drug. The
nurse explains that its main purpose is to:
A. Mature the baby's lungs
B. Prevent seizure activity
C. Stop the uterus from contracting
D. Lower her blood pressure quickly
ANSWER : B. Prevent seizure activity
Magnesium sulfate is a CNS depressant given to prevent eclamptic
seizures; it is not a reliable antihypertensive.
4. During a magnesium sulfate infusion, which assessment finding is
usually the earliest sign that the serum level is becoming toxic?
A. Feeling warm and flushed
B. Respiratory rate of 16 per minute
C. Absent patellar reflexes
D. Urine output of 45 mL per hour
ANSWER : C. Absent patellar reflexes
Loss of deep tendon reflexes appears at levels below those that cause
respiratory depression, so it serves as the early warning sign.
Page 2 of 63
,Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
5. Which medication should be immediately available at the bedside of
any client receiving IV magnesium sulfate?
A. Protamine sulfate
B. Naloxone
C. Vitamin K
D. Calcium gluconate
ANSWER : D. Calcium gluconate
Calcium gluconate 10% given slowly IV reverses the effects of
magnesium toxicity.
6. The therapeutic serum magnesium range the nurse expects for
seizure prophylaxis in preeclampsia is:
A. 8 to 10 mEq/L
B. 1.5 to 2.5 mEq/L
C. 4 to 7 mEq/L
D. 10 to 12 mEq/L
ANSWER : C. 4 to 7 mEq/L
A level of roughly 4 to 7 mEq/L prevents seizures; reflexes disappear
near 10 and respiratory depression follows above that.
7. A client on magnesium sulfate has a respiratory rate of 10 per
minute, 1+ reflexes, and urine output of 35 mL/hr. What is the nurse's
first action?
A. Stop the infusion and notify the provider
B. Recheck the respirations in one hour
C. Increase the IV rate to improve circulation
D. Turn the client to her right side
ANSWER : A. Stop the infusion and notify the provider
A respiratory rate below 12 signals magnesium toxicity, so the infusion
is stopped first and the provider notified.
Page 3 of 63
, Maternal-Newborn Nursing: High-Risk Pregnancy and Complications
8. HELLP syndrome is a variant of preeclampsia characterized by:
A. Hemolysis, elevated liver enzymes, and low platelets
B. Hyperglycemia, elevated lipids, and low potassium
C. Hemorrhage, elevated leukocytes, and low fibrinogen
D. Hypertension, edema, and low protein
ANSWER : A. Hemolysis, elevated liver enzymes, and low platelets
The acronym stands for hemolysis, elevated liver enzymes, and a low
platelet count.
9. A client at 35 weeks reports nausea, malaise, and pain under the
right ribs. Her BP is 148/94 mm Hg. Which laboratory result would
most concern the nurse?
A. Serum creatinine of 0.6 mg/dL
B. White blood cell count of 12,000/mm3
C. Platelet count of 85,000/mm3
D. Hemoglobin of 11.2 g/dL
ANSWER : C. Platelet count of 85,000/mm3
Right upper quadrant pain with hypertension suggests HELLP, and
thrombocytopenia under 100,000 supports that diagnosis.
10. Which antihypertensive is commonly used for acute-onset severe
hypertension in a pregnant client?
A. IV furosemide
B. Oral lisinopril
C. Oral losartan
D. IV labetalol
ANSWER : D. IV labetalol
IV labetalol, IV hydralazine, and oral immediate-release nifedipine are
first-line; ACE inhibitors and ARBs harm the fetal kidneys.
Page 4 of 63
