NSG 3500 Maternal Exam 1 — Realistic Practice Exam Latest 2026
Question And Answers .
1. A patient receiving magnesium sulfate for preeclampsia has a respiratory rate of
10 breaths/min, absent deep tendon reflexes, and urine output of 20 mL/hr. What
is the nurse's first action?
A) Increase the infusion rate to maintain therapeutic levels
B) Stop the magnesium infusion and prepare calcium gluconate
C) Document findings and reassess in 30 minutes
D) Administer a fluid bolus to increase urine output
Answer: B
These findings are the classic triad of magnesium toxicity (respiratory depression, absent
reflexes, oliguria). The infusion must be stopped immediately and the antidote, calcium
gluconate, prepared. Increasing the rate or delaying intervention would worsen the
toxicity.
2. A laboring patient at 41 weeks has a Category II tracing with recurrent late
decelerations. The nurse has already repositioned her laterally, given a 500 mL IV bolus,
and stopped oxytocin. What is the next priority?
A) Prepare for immediate cesarean birth
B) Administer oxygen at 10 L/min via nonrebreather and notify the provider
C) Restart oxytocin at a lower rate
D) Reclassify the tracing as Category I
Answer: B
After lateral positioning, fluid bolus, and stopping oxytocin, the next intrauterine
resuscitation step is maternal oxygen and provider notification. Immediate cesarean is not
automatic for a Category II tracing, and restarting oxytocin would worsen the pattern.
,3. A patient has a confirmed 3 cm unruptured ectopic pregnancy in the right fallopian
tube. She is hemodynamically stable with no fetal cardiac activity. What treatment does
the nurse anticipate?
A) Laparoscopic salpingostomy
B) Methotrexate
C) Immediate laparotomy
D) Expectant management with no follow-up
Answer: B
Methotrexate is the medical treatment for an unruptured ectopic pregnancy meeting
criteria (mass <4 cm, no cardiac activity, stable patient). Surgery is reserved for rupture,
large mass, or failed methotrexate.
4. A patient at 34 weeks reports painless, bright-red vaginal bleeding. Her uterus is soft
and nontender, and the fetal heart rate is normal. What complication does the nurse
suspect?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Vasa previa
Answer: B
Painless bright-red bleeding with a soft, nontender uterus is classic for placenta previa.
Abruption causes painful, dark bleeding with a rigid, board-like uterus. Vaginal exams are
avoided until previa is ruled out.
5. A patient at 28 weeks reports dizziness and lightheadedness when lying on her back.
What is the nurse's priority action?
A) Administer oxygen at 2 L/min
B) Instruct the patient to turn onto her left side
C) Elevate the legs above heart level
D) Place the patient in Trendelenburg position
Answer: B
Supine hypotension occurs when the gravid uterus compresses the inferior vena cava.
,Turning to the left side relieves the compression and restores venous return. Oxygen and
leg elevation do not address the underlying cause.
6. Which hormone is responsible for regulating oogenesis?
A) Estrogen
B) Follicle-stimulating hormone (FSH)
C) Gonadotropin-releasing hormone (GnRH)
D) Progesterone
Answer: B
FSH promotes the growth and maturation of ovarian follicles containing oocytes. It
initiates follicular recruitment and development during the menstrual cycle.
7. Why might a patient in the latent phase of labor be counseled to remain at home
rather than be admitted immediately?
A) Latent phase is defined as 6 cm or greater dilation
B) Early admission increases unnecessary interventions without improving outcomes
C) The latent phase rarely lasts more than 2 hours
D) Fetal descent does not begin until active phase
Answer: B
Early admission in the latent phase is associated with more cesarean births, epidural use,
and oxytocin augmentation without improved outcomes. Latent phase is 0–5 cm and can
last many hours.
8. A patient in active labor had no prenatal care and reports the baby's father has
gonorrhea. She is untreated. What complication is the newborn at highest risk for?
A) Pneumonia
B) Skin lesions
C) Blindness
D) Intellectual disability
, Answer: C
Untreated maternal gonorrhea can cause ophthalmia neonatorum (gonococcal
conjunctivitis) during delivery, which can lead to blindness. Erythromycin ointment is given
prophylactically to all newborns.
9. A patient at 18 weeks with diagnosed cervical insufficiency is stable. What action does
the nurse anticipate?
A) Prepare for immediate delivery
B) Assist with obtaining informed consent for cerclage
C) Administer methotrexate
D) Schedule follow-up in 4 weeks
Answer: B
Cervical insufficiency is treated with cerclage (surgical reinforcement of the cervix) to
prevent preterm birth. Delivery is not indicated at 18 weeks for this condition alone.
10. A client who is Rh-negative and unsensitized is 28 weeks pregnant. When should
she receive Rh immune globulin (RhoGAM) routinely?
A) At 12 weeks
B) At 20 weeks
C) At 28 weeks
D) At 36 weeks
Answer: C
Routine antepartum RhoGAM is given at 28 weeks to prevent sensitization from silent
fetomaternal bleeding. It is repeated within 72 hours after birth if the newborn is Rh-
positive.
11. A postpartum patient is prescribed methylergonovine. Which statement indicates a
need for further teaching?
A) "I will report any severe cramping or headache."
B) "I should avoid breastfeeding while taking this."
Question And Answers .
1. A patient receiving magnesium sulfate for preeclampsia has a respiratory rate of
10 breaths/min, absent deep tendon reflexes, and urine output of 20 mL/hr. What
is the nurse's first action?
A) Increase the infusion rate to maintain therapeutic levels
B) Stop the magnesium infusion and prepare calcium gluconate
C) Document findings and reassess in 30 minutes
D) Administer a fluid bolus to increase urine output
Answer: B
These findings are the classic triad of magnesium toxicity (respiratory depression, absent
reflexes, oliguria). The infusion must be stopped immediately and the antidote, calcium
gluconate, prepared. Increasing the rate or delaying intervention would worsen the
toxicity.
2. A laboring patient at 41 weeks has a Category II tracing with recurrent late
decelerations. The nurse has already repositioned her laterally, given a 500 mL IV bolus,
and stopped oxytocin. What is the next priority?
A) Prepare for immediate cesarean birth
B) Administer oxygen at 10 L/min via nonrebreather and notify the provider
C) Restart oxytocin at a lower rate
D) Reclassify the tracing as Category I
Answer: B
After lateral positioning, fluid bolus, and stopping oxytocin, the next intrauterine
resuscitation step is maternal oxygen and provider notification. Immediate cesarean is not
automatic for a Category II tracing, and restarting oxytocin would worsen the pattern.
,3. A patient has a confirmed 3 cm unruptured ectopic pregnancy in the right fallopian
tube. She is hemodynamically stable with no fetal cardiac activity. What treatment does
the nurse anticipate?
A) Laparoscopic salpingostomy
B) Methotrexate
C) Immediate laparotomy
D) Expectant management with no follow-up
Answer: B
Methotrexate is the medical treatment for an unruptured ectopic pregnancy meeting
criteria (mass <4 cm, no cardiac activity, stable patient). Surgery is reserved for rupture,
large mass, or failed methotrexate.
4. A patient at 34 weeks reports painless, bright-red vaginal bleeding. Her uterus is soft
and nontender, and the fetal heart rate is normal. What complication does the nurse
suspect?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Vasa previa
Answer: B
Painless bright-red bleeding with a soft, nontender uterus is classic for placenta previa.
Abruption causes painful, dark bleeding with a rigid, board-like uterus. Vaginal exams are
avoided until previa is ruled out.
5. A patient at 28 weeks reports dizziness and lightheadedness when lying on her back.
What is the nurse's priority action?
A) Administer oxygen at 2 L/min
B) Instruct the patient to turn onto her left side
C) Elevate the legs above heart level
D) Place the patient in Trendelenburg position
Answer: B
Supine hypotension occurs when the gravid uterus compresses the inferior vena cava.
,Turning to the left side relieves the compression and restores venous return. Oxygen and
leg elevation do not address the underlying cause.
6. Which hormone is responsible for regulating oogenesis?
A) Estrogen
B) Follicle-stimulating hormone (FSH)
C) Gonadotropin-releasing hormone (GnRH)
D) Progesterone
Answer: B
FSH promotes the growth and maturation of ovarian follicles containing oocytes. It
initiates follicular recruitment and development during the menstrual cycle.
7. Why might a patient in the latent phase of labor be counseled to remain at home
rather than be admitted immediately?
A) Latent phase is defined as 6 cm or greater dilation
B) Early admission increases unnecessary interventions without improving outcomes
C) The latent phase rarely lasts more than 2 hours
D) Fetal descent does not begin until active phase
Answer: B
Early admission in the latent phase is associated with more cesarean births, epidural use,
and oxytocin augmentation without improved outcomes. Latent phase is 0–5 cm and can
last many hours.
8. A patient in active labor had no prenatal care and reports the baby's father has
gonorrhea. She is untreated. What complication is the newborn at highest risk for?
A) Pneumonia
B) Skin lesions
C) Blindness
D) Intellectual disability
, Answer: C
Untreated maternal gonorrhea can cause ophthalmia neonatorum (gonococcal
conjunctivitis) during delivery, which can lead to blindness. Erythromycin ointment is given
prophylactically to all newborns.
9. A patient at 18 weeks with diagnosed cervical insufficiency is stable. What action does
the nurse anticipate?
A) Prepare for immediate delivery
B) Assist with obtaining informed consent for cerclage
C) Administer methotrexate
D) Schedule follow-up in 4 weeks
Answer: B
Cervical insufficiency is treated with cerclage (surgical reinforcement of the cervix) to
prevent preterm birth. Delivery is not indicated at 18 weeks for this condition alone.
10. A client who is Rh-negative and unsensitized is 28 weeks pregnant. When should
she receive Rh immune globulin (RhoGAM) routinely?
A) At 12 weeks
B) At 20 weeks
C) At 28 weeks
D) At 36 weeks
Answer: C
Routine antepartum RhoGAM is given at 28 weeks to prevent sensitization from silent
fetomaternal bleeding. It is repeated within 72 hours after birth if the newborn is Rh-
positive.
11. A postpartum patient is prescribed methylergonovine. Which statement indicates a
need for further teaching?
A) "I will report any severe cramping or headache."
B) "I should avoid breastfeeding while taking this."
