1|Page
NSG 3500 Exam 4 — Maternity Nursing
Questions With Verified Answers And
Rationales
1. A client at 38 weeks gestation is admitted in active labor. Which assessment
finding requires immediate nursing intervention?
A. Contractions every 3 minutes lasting 50 seconds
B. Fetal heart rate baseline of 140 bpm with moderate variability
C. Prolonged deceleration lasting 3 minutes
D. Maternal request for epidural analgesia
Correct Answer: C
Rationale: A prolonged deceleration lasting 2 minutes or longer is a Category II or
III finding requiring immediate intrauterine resuscitation and provider
notification. It may indicate cord compression, placental insufficiency, or
impending fetal acidosis.
2. A nurse is assessing a client receiving oxytocin for labor induction. Which
finding requires immediate discontinuation of the infusion?
A. Contractions every 3 minutes lasting 60 seconds
,2|Page
B. Fetal heart rate baseline of 150 bpm
C. Contractions every 90 seconds lasting 90 seconds with fetal decelerations
D. Maternal blood pressure of 120/80 mmHg
Correct Answer: C
Rationale: Uterine hyperstimulation (tachysystole) with fetal decelerations
requires immediate discontinuation of oxytocin, repositioning, oxygen
administration, and IV fluid bolus. Continued hyperstimulation can cause fetal
hypoxia.
3. A client at 36 weeks gestation presents with painless, bright red vaginal
bleeding. Which diagnosis should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Correct Answer: B
Rationale: Placenta previa classically presents with painless, bright red vaginal
bleeding in the second or third trimester. Placental abruption typically presents
with painful bleeding and a tense, tender uterus.
,3|Page
4. A client with placenta previa is admitted for observation. Which intervention is
contraindicated?
A. Bed rest
B. Vaginal examination
C. Continuous fetal monitoring
D. IV access
Correct Answer: B
Rationale: Vaginal examination is contraindicated in placenta previa because it
can cause severe hemorrhage. The diagnosis is confirmed by ultrasound.
5. A client with preeclampsia is receiving magnesium sulfate. Which assessment
finding indicates magnesium toxicity requiring immediate intervention?
A. Respiratory rate of 16 breaths per minute
B. Deep tendon reflexes 2+
C. Urine output of 25 mL/hour
D. Loss of deep tendon reflexes
Correct Answer: D
Rationale: Magnesium sulfate toxicity progresses from loss of deep tendon
, 4|Page
reflexes to respiratory depression to cardiac arrest. Loss of DTRs is an early sign
requiring immediate intervention. The antidote is calcium gluconate.
6. A client with severe preeclampsia is prescribed hydralazine. Which finding
indicates a therapeutic response?
A. Blood pressure decreases from 180/110 to 150/95 mmHg
B. Blood pressure decreases from 180/110 to 90/50 mmHg
C. Heart rate increases to 140 bpm
D. Urine output decreases
Correct Answer: A
Rationale: Hydralazine is used to lower blood pressure gradually in severe
preeclampsia. A decrease from 180/110 to 150/95 mmHg indicates a therapeutic
response. Rapid drops in blood pressure can compromise placental perfusion.
7. A client at 34 weeks gestation is diagnosed with preterm premature rupture of
membranes (PPROM). Which intervention is appropriate?
A. Immediate delivery regardless of gestational age
B. Administration of antenatal corticosteroids
NSG 3500 Exam 4 — Maternity Nursing
Questions With Verified Answers And
Rationales
1. A client at 38 weeks gestation is admitted in active labor. Which assessment
finding requires immediate nursing intervention?
A. Contractions every 3 minutes lasting 50 seconds
B. Fetal heart rate baseline of 140 bpm with moderate variability
C. Prolonged deceleration lasting 3 minutes
D. Maternal request for epidural analgesia
Correct Answer: C
Rationale: A prolonged deceleration lasting 2 minutes or longer is a Category II or
III finding requiring immediate intrauterine resuscitation and provider
notification. It may indicate cord compression, placental insufficiency, or
impending fetal acidosis.
2. A nurse is assessing a client receiving oxytocin for labor induction. Which
finding requires immediate discontinuation of the infusion?
A. Contractions every 3 minutes lasting 60 seconds
,2|Page
B. Fetal heart rate baseline of 150 bpm
C. Contractions every 90 seconds lasting 90 seconds with fetal decelerations
D. Maternal blood pressure of 120/80 mmHg
Correct Answer: C
Rationale: Uterine hyperstimulation (tachysystole) with fetal decelerations
requires immediate discontinuation of oxytocin, repositioning, oxygen
administration, and IV fluid bolus. Continued hyperstimulation can cause fetal
hypoxia.
3. A client at 36 weeks gestation presents with painless, bright red vaginal
bleeding. Which diagnosis should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Correct Answer: B
Rationale: Placenta previa classically presents with painless, bright red vaginal
bleeding in the second or third trimester. Placental abruption typically presents
with painful bleeding and a tense, tender uterus.
,3|Page
4. A client with placenta previa is admitted for observation. Which intervention is
contraindicated?
A. Bed rest
B. Vaginal examination
C. Continuous fetal monitoring
D. IV access
Correct Answer: B
Rationale: Vaginal examination is contraindicated in placenta previa because it
can cause severe hemorrhage. The diagnosis is confirmed by ultrasound.
5. A client with preeclampsia is receiving magnesium sulfate. Which assessment
finding indicates magnesium toxicity requiring immediate intervention?
A. Respiratory rate of 16 breaths per minute
B. Deep tendon reflexes 2+
C. Urine output of 25 mL/hour
D. Loss of deep tendon reflexes
Correct Answer: D
Rationale: Magnesium sulfate toxicity progresses from loss of deep tendon
, 4|Page
reflexes to respiratory depression to cardiac arrest. Loss of DTRs is an early sign
requiring immediate intervention. The antidote is calcium gluconate.
6. A client with severe preeclampsia is prescribed hydralazine. Which finding
indicates a therapeutic response?
A. Blood pressure decreases from 180/110 to 150/95 mmHg
B. Blood pressure decreases from 180/110 to 90/50 mmHg
C. Heart rate increases to 140 bpm
D. Urine output decreases
Correct Answer: A
Rationale: Hydralazine is used to lower blood pressure gradually in severe
preeclampsia. A decrease from 180/110 to 150/95 mmHg indicates a therapeutic
response. Rapid drops in blood pressure can compromise placental perfusion.
7. A client at 34 weeks gestation is diagnosed with preterm premature rupture of
membranes (PPROM). Which intervention is appropriate?
A. Immediate delivery regardless of gestational age
B. Administration of antenatal corticosteroids
