Exam 2 - NUR 2633 / NUR2633
Maternal Child Health Nursing
Complete Guide with Questions and Verified Answers
120 Exam-Style Multiple-Choice Questions
Rasmussen University | Latest Update
Covers 7 Sections | 120 Questions | Cognitive Mix: 30% Recall - 50% Application - 20% Analysis
80% Scenario-Based | 20% Direct Recall
Question Distribution:
• SECTION 1: Antepartum Complications and High-Risk Pregnancy - Q1-Q22
• SECTION 2: Intrapartum Care and Fetal Monitoring - Q23-Q44
• SECTION 3: Postpartum Assessment and Complications - Q45-Q62
• SECTION 4: Newborn Transition and Assessment - Q63-Q80
• SECTION 5: High-Risk Newborn Conditions - Q81-Q94
• SECTION 6: Pediatric Growth, Development, and Nutrition - Q95-Q106
• SECTION 7: Pediatric Respiratory, Infectious, and Fluid/Electrolyte Disorders - Q107-Q120
Guideline Alignment:
ACOG | AWHONN | AAP | CDC | NRP | AAP Bright Futures
Format: Each question features 4 options (A-D) with one correct answer clearly marked, followed
by a detailed rationale integrating maternal/fetal physiology, nursing priorities, pediatric
considerations, developmental expectations, and evidence-based practice standards. Includes fetal
heart rate strip interpretation, labor stage prioritization, postpartum complication recognition,
newborn APGAR/resuscitation scenarios, pediatric developmental milestone identification, pediatric
medication calculation (mg/kg, mL/dose), and commonly confused condition differentiations
(Previa vs. Abruptio, Physiologic vs. pathologic jaundice, RDS vs. TTN, Croup vs. Epiglottitis, Baby
blues vs. postpartum depression).
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 1
,Table of Contents
Section Topic Question Range
SECTION 1 Antepartum Complications and High-Risk Pregnancy Q1 - Q22
SECTION 2 Intrapartum Care and Fetal Monitoring Q23 - Q44
SECTION 3 Postpartum Assessment and Complications Q45 - Q62
SECTION 4 Newborn Transition and Assessment Q63 - Q80
SECTION 5 High-Risk Newborn Conditions Q81 - Q94
SECTION 6 Pediatric Growth, Development, and Nutrition Q95 - Q106
SECTION 7 Pediatric Respiratory, Infectious, and Fluid/Electrolyte Disorders Q107 - Q120
How to Use This Guide
This NUR 2633 Exam 2 preparation guide is designed for Rasmussen University maternal child
health nursing students preparing for high-acuity maternal, newborn, and pediatric content. Each
question includes four answer options with the correct answer marked [CORRECT] in green. A
detailed rationale explains the maternal child health nursing clinical reasoning behind the correct
answer and identifies why the distractors are incorrect, integrating maternal/fetal physiology,
nursing priorities, pediatric considerations, developmental expectations, and evidence-based
practice standards.
Recommended study approach: complete each section, then review rationales for both correct and
incorrect answers. Pay particular attention to fetal monitoring strip category classification and
intrauterine resuscitation priorities, postpartum hemorrhage '4 T's' differentiation, newborn APGAR
scoring and resuscitation criteria, developmental milestone age identification, pediatric medication
weight-based calculations, and commonly confused conditions (Previa vs. Abruptio, Physiologic vs.
pathologic jaundice, RDS vs. TTN, Croup vs. Epiglottitis, Baby blues vs. postpartum depression).
The cognitive level distribution (30% recall, 50% application, 20% analysis) mirrors the NUR 2633
final exam blueprint.
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 2
,SECTION 1: Antepartum Complications and High-Risk
Pregnancy
Hyperemesis - GDM - Preeclampsia - Previa - Abruptio - PPROM | Q1-22
Q1: A client at 9 weeks gestation presents with persistent vomiting, weight loss of 8 lbs,
ketonuria, and dehydration. The nurse identifies these findings as most consistent with
which condition?
A. Normal morning sickness that resolves with crackers and small meals
B. Hyperemesis gravidarum requiring IV fluids, antiemetics, and electrolyte correction
[CORRECT]
C. Gastroenteritis requiring oral rehydration only
D. Food poisoning requiring outpatient management
Correct Answer: B
Rationale: Hyperemesis gravidarum is distinguished from normal nausea/vomiting of pregnancy by
persistent vomiting, weight loss >=5% of prepregnancy weight, ketonuria, dehydration, and electrolyte
imbalance. Treatment includes IV fluids with multivitamins (thiamine before glucose to prevent
Wernicke), antiemetics (pyridoxine, doxylamine, ondansetron), and serial electrolytes. Morning sickness
does not cause significant weight loss or ketonuria.
Q2: A client with hyperemesis gravidarum is receiving IV fluids. The nurse knows to
administer thiamine BEFORE glucose-containing IV fluids to prevent:
A. Wernicke encephalopathy from thiamine depletion precipitated by glucose [CORRECT]
B. Hypoglycemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: A
Rationale: Wernicke encephalopathy is a rare but serious complication of hyperemesis caused by
thiamine deficiency. Administering glucose without thiamine first precipitates or worsens Wernicke
encephalopathy (triad: ataxia, confusion, ophthalmoplegia). Always give thiamine 100 mg IV before any
dextrose-containing solution.
Q3: A client at 24 weeks gestation has a 1-hour glucose challenge test result of 145 mg/dL.
The nurse anticipates the next step:
A. Diagnosis of gestational diabetes; begin insulin therapy immediately
B. Schedule a 3-hour oral glucose tolerance test (OGTT) to confirm gestational diabetes
[CORRECT]
C. Repeat the 1-hour test in 4 weeks
D. No further action needed; value is normal
Correct Answer: B
Rationale: Per ACOG, a 1-hour GCT of 140 mg/dL or higher requires a 3-hour 100-g OGTT for
confirmation. Diagnosis of GDM requires 2 or more abnormal values on the 3-hour OGTT (fasting >=95,
1-hour >=180, 2-hour >=155, 3-hour >=140 mg/dL). Initial treatment is nutrition therapy and exercise;
insulin or metformin if targets not met.
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 3
, Q4: A client with gestational diabetes is taught to self-monitor blood glucose. Which
finding indicates the need to adjust her treatment plan?
A. Fasting blood glucose of 88 mg/dL
B. 1-hour postprandial blood glucose of 140 mg/dL
C. Fasting blood glucose of 105 mg/dL on two separate occasions [CORRECT]
D. Bedtime glucose of 110 mg/dL
Correct Answer: C
Rationale: Target values in GDM: fasting <95 mg/dL, 1-hour postprandial <140 mg/dL, 2-hour
postprandial <120 mg/dL. Two fasting values >=95 mg/dL indicate need for pharmacologic therapy
(insulin or metformin). A single elevated value warrants diet review; persistently elevated values require
medication.
Q5: A client at 32 weeks gestation presents with BP 158/108, headache, blurred vision,
and epigastric pain. Laboratory: platelets 95,000, AST 95, LDH 600. The nurse recognizes
these findings as:
A. Gestational hypertension
B. Preeclampsia with severe features requiring immediate delivery consideration
[CORRECT]
C. Chronic hypertension
D. Mild preeclampsia manageable with outpatient monitoring
Correct Answer: B
Rationale: Preeclampsia with severe features: BP >=160 systolic or >=110 diastolic on two occasions,
OR end-organ dysfunction (thrombocytopenia <100,000, transaminases >2x normal, renal insufficiency,
pulmonary edema, new-onset headache unresponsive to medication, or visual disturbances). At 32
weeks with severe features, IV magnesium sulfate for seizure prophylaxis and delivery decision (often
delivery if >=34 weeks, expectant management in select cases if <34 weeks at tertiary center).
Q6: A client with preeclampsia with severe features is started on IV magnesium sulfate.
The nurse understands the therapeutic serum level is:
A. 2 to 4 mEq/L
B. 4 to 7 mEq/L (therapeutic); >10 mEq/L reflects toxicity [CORRECT]
C. 8 to 10 mEq/L
D. 1 to 2 mEq/L
Correct Answer: B
Rationale: Therapeutic magnesium sulfate level for seizure prophylaxis is 4-7 mEq/L. Signs of toxicity:
loss of deep tendon reflexes (8-10 mEq/L), respiratory depression (10-12 mEq/L), cardiac arrest (15+
mEq/L). Antidote is calcium gluconate 10% (10 mL IV over 3 min). Assess DTRs, respirations (>=12/min),
and urine output (>=25 mL/hr) q1h.
Q7: A client on magnesium sulfate has respirations of 10/min and absent deep tendon
reflexes. Which action should the nurse take FIRST?
A. Continue the infusion and notify the provider
B. Stop the magnesium sulfate infusion, administer oxygen, prepare calcium gluconate
[CORRECT]
C. Increase the infusion rate
D. Administer a fluid bolus
Correct Answer: B
Rationale: Respirations <12/min and absent DTRs indicate magnesium toxicity. Stop infusion
immediately, administer oxygen, maintain airway, and administer calcium gluconate (antidote) per
provider order. Notify provider. Continuing or escalating the infusion worsens toxicity.
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 4
Maternal Child Health Nursing
Complete Guide with Questions and Verified Answers
120 Exam-Style Multiple-Choice Questions
Rasmussen University | Latest Update
Covers 7 Sections | 120 Questions | Cognitive Mix: 30% Recall - 50% Application - 20% Analysis
80% Scenario-Based | 20% Direct Recall
Question Distribution:
• SECTION 1: Antepartum Complications and High-Risk Pregnancy - Q1-Q22
• SECTION 2: Intrapartum Care and Fetal Monitoring - Q23-Q44
• SECTION 3: Postpartum Assessment and Complications - Q45-Q62
• SECTION 4: Newborn Transition and Assessment - Q63-Q80
• SECTION 5: High-Risk Newborn Conditions - Q81-Q94
• SECTION 6: Pediatric Growth, Development, and Nutrition - Q95-Q106
• SECTION 7: Pediatric Respiratory, Infectious, and Fluid/Electrolyte Disorders - Q107-Q120
Guideline Alignment:
ACOG | AWHONN | AAP | CDC | NRP | AAP Bright Futures
Format: Each question features 4 options (A-D) with one correct answer clearly marked, followed
by a detailed rationale integrating maternal/fetal physiology, nursing priorities, pediatric
considerations, developmental expectations, and evidence-based practice standards. Includes fetal
heart rate strip interpretation, labor stage prioritization, postpartum complication recognition,
newborn APGAR/resuscitation scenarios, pediatric developmental milestone identification, pediatric
medication calculation (mg/kg, mL/dose), and commonly confused condition differentiations
(Previa vs. Abruptio, Physiologic vs. pathologic jaundice, RDS vs. TTN, Croup vs. Epiglottitis, Baby
blues vs. postpartum depression).
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 1
,Table of Contents
Section Topic Question Range
SECTION 1 Antepartum Complications and High-Risk Pregnancy Q1 - Q22
SECTION 2 Intrapartum Care and Fetal Monitoring Q23 - Q44
SECTION 3 Postpartum Assessment and Complications Q45 - Q62
SECTION 4 Newborn Transition and Assessment Q63 - Q80
SECTION 5 High-Risk Newborn Conditions Q81 - Q94
SECTION 6 Pediatric Growth, Development, and Nutrition Q95 - Q106
SECTION 7 Pediatric Respiratory, Infectious, and Fluid/Electrolyte Disorders Q107 - Q120
How to Use This Guide
This NUR 2633 Exam 2 preparation guide is designed for Rasmussen University maternal child
health nursing students preparing for high-acuity maternal, newborn, and pediatric content. Each
question includes four answer options with the correct answer marked [CORRECT] in green. A
detailed rationale explains the maternal child health nursing clinical reasoning behind the correct
answer and identifies why the distractors are incorrect, integrating maternal/fetal physiology,
nursing priorities, pediatric considerations, developmental expectations, and evidence-based
practice standards.
Recommended study approach: complete each section, then review rationales for both correct and
incorrect answers. Pay particular attention to fetal monitoring strip category classification and
intrauterine resuscitation priorities, postpartum hemorrhage '4 T's' differentiation, newborn APGAR
scoring and resuscitation criteria, developmental milestone age identification, pediatric medication
weight-based calculations, and commonly confused conditions (Previa vs. Abruptio, Physiologic vs.
pathologic jaundice, RDS vs. TTN, Croup vs. Epiglottitis, Baby blues vs. postpartum depression).
The cognitive level distribution (30% recall, 50% application, 20% analysis) mirrors the NUR 2633
final exam blueprint.
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 2
,SECTION 1: Antepartum Complications and High-Risk
Pregnancy
Hyperemesis - GDM - Preeclampsia - Previa - Abruptio - PPROM | Q1-22
Q1: A client at 9 weeks gestation presents with persistent vomiting, weight loss of 8 lbs,
ketonuria, and dehydration. The nurse identifies these findings as most consistent with
which condition?
A. Normal morning sickness that resolves with crackers and small meals
B. Hyperemesis gravidarum requiring IV fluids, antiemetics, and electrolyte correction
[CORRECT]
C. Gastroenteritis requiring oral rehydration only
D. Food poisoning requiring outpatient management
Correct Answer: B
Rationale: Hyperemesis gravidarum is distinguished from normal nausea/vomiting of pregnancy by
persistent vomiting, weight loss >=5% of prepregnancy weight, ketonuria, dehydration, and electrolyte
imbalance. Treatment includes IV fluids with multivitamins (thiamine before glucose to prevent
Wernicke), antiemetics (pyridoxine, doxylamine, ondansetron), and serial electrolytes. Morning sickness
does not cause significant weight loss or ketonuria.
Q2: A client with hyperemesis gravidarum is receiving IV fluids. The nurse knows to
administer thiamine BEFORE glucose-containing IV fluids to prevent:
A. Wernicke encephalopathy from thiamine depletion precipitated by glucose [CORRECT]
B. Hypoglycemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: A
Rationale: Wernicke encephalopathy is a rare but serious complication of hyperemesis caused by
thiamine deficiency. Administering glucose without thiamine first precipitates or worsens Wernicke
encephalopathy (triad: ataxia, confusion, ophthalmoplegia). Always give thiamine 100 mg IV before any
dextrose-containing solution.
Q3: A client at 24 weeks gestation has a 1-hour glucose challenge test result of 145 mg/dL.
The nurse anticipates the next step:
A. Diagnosis of gestational diabetes; begin insulin therapy immediately
B. Schedule a 3-hour oral glucose tolerance test (OGTT) to confirm gestational diabetes
[CORRECT]
C. Repeat the 1-hour test in 4 weeks
D. No further action needed; value is normal
Correct Answer: B
Rationale: Per ACOG, a 1-hour GCT of 140 mg/dL or higher requires a 3-hour 100-g OGTT for
confirmation. Diagnosis of GDM requires 2 or more abnormal values on the 3-hour OGTT (fasting >=95,
1-hour >=180, 2-hour >=155, 3-hour >=140 mg/dL). Initial treatment is nutrition therapy and exercise;
insulin or metformin if targets not met.
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 3
, Q4: A client with gestational diabetes is taught to self-monitor blood glucose. Which
finding indicates the need to adjust her treatment plan?
A. Fasting blood glucose of 88 mg/dL
B. 1-hour postprandial blood glucose of 140 mg/dL
C. Fasting blood glucose of 105 mg/dL on two separate occasions [CORRECT]
D. Bedtime glucose of 110 mg/dL
Correct Answer: C
Rationale: Target values in GDM: fasting <95 mg/dL, 1-hour postprandial <140 mg/dL, 2-hour
postprandial <120 mg/dL. Two fasting values >=95 mg/dL indicate need for pharmacologic therapy
(insulin or metformin). A single elevated value warrants diet review; persistently elevated values require
medication.
Q5: A client at 32 weeks gestation presents with BP 158/108, headache, blurred vision,
and epigastric pain. Laboratory: platelets 95,000, AST 95, LDH 600. The nurse recognizes
these findings as:
A. Gestational hypertension
B. Preeclampsia with severe features requiring immediate delivery consideration
[CORRECT]
C. Chronic hypertension
D. Mild preeclampsia manageable with outpatient monitoring
Correct Answer: B
Rationale: Preeclampsia with severe features: BP >=160 systolic or >=110 diastolic on two occasions,
OR end-organ dysfunction (thrombocytopenia <100,000, transaminases >2x normal, renal insufficiency,
pulmonary edema, new-onset headache unresponsive to medication, or visual disturbances). At 32
weeks with severe features, IV magnesium sulfate for seizure prophylaxis and delivery decision (often
delivery if >=34 weeks, expectant management in select cases if <34 weeks at tertiary center).
Q6: A client with preeclampsia with severe features is started on IV magnesium sulfate.
The nurse understands the therapeutic serum level is:
A. 2 to 4 mEq/L
B. 4 to 7 mEq/L (therapeutic); >10 mEq/L reflects toxicity [CORRECT]
C. 8 to 10 mEq/L
D. 1 to 2 mEq/L
Correct Answer: B
Rationale: Therapeutic magnesium sulfate level for seizure prophylaxis is 4-7 mEq/L. Signs of toxicity:
loss of deep tendon reflexes (8-10 mEq/L), respiratory depression (10-12 mEq/L), cardiac arrest (15+
mEq/L). Antidote is calcium gluconate 10% (10 mL IV over 3 min). Assess DTRs, respirations (>=12/min),
and urine output (>=25 mL/hr) q1h.
Q7: A client on magnesium sulfate has respirations of 10/min and absent deep tendon
reflexes. Which action should the nurse take FIRST?
A. Continue the infusion and notify the provider
B. Stop the magnesium sulfate infusion, administer oxygen, prepare calcium gluconate
[CORRECT]
C. Increase the infusion rate
D. Administer a fluid bolus
Correct Answer: B
Rationale: Respirations <12/min and absent DTRs indicate magnesium toxicity. Stop infusion
immediately, administer oxygen, maintain airway, and administer calcium gluconate (antidote) per
provider order. Notify provider. Continuing or escalating the infusion worsens toxicity.
NUR 2633 Exam 2 - Maternal Child Health Nursing (Rasmussen) | Page 4
