Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
TEST BANK
1. Antepartum — Severe preeclampsia
presentation (Single best answer)
A 30-year-old at 35 weeks’ gestation reports a
severe, persistent frontal headache and blurred
vision. BP 168/106 mm Hg, urine protein 3+.
The nurse’s highest priority action is:
A. Administer oral acetaminophen for
headache.
B. Initiate magnesium sulfate per protocol and
prepare antihypertensive therapy.
C. Encourage oral fluids and observe for 6 hours.
D. Send labs for CBC, liver enzymes, and
creatinine and await results.
Answer: B
,Rationale — correct (B): Severe features (BP
≥160/110, neurologic symptoms, proteinuria)
indicate risk for eclampsia and organ injury;
immediate seizure prophylaxis (magnesium sulfate)
and BP control are time-sensitive and take priority
over diagnostic testing. (ACOG guidance supports
magnesium for severe features). ACOG
Why others are incorrect:
A. Symptom relief alone doesn’t prevent seizures or
maternal/fetal compromise.
C. Waiting risks progression; not safe for severe
features.
D. Labs are important but should not delay
emergent stabilization.
2. Antepartum — Gestational diabetes follow-up
(Single best answer)
A 28-week patient has a 1-hour glucose
screening value of 160 mg/dL (screen threshold
140 mg/dL). The next best action is:
A. Start insulin therapy immediately.
, B. Schedule a diagnostic 3-hour OGTT.
C. Tell the patient to restrict carbs and recheck
in 2 weeks.
D. No action — result is acceptable.
Answer: B
Rationale — correct (B): A screening value above
threshold requires confirmatory 3-hour OGTT
before diagnosing GDM or initiating insulin/diet
therapy.
Why others are incorrect: A. Insulin without
diagnosis is premature. C. Dietary advice useful but
diagnostic confirmation is the immediate next step.
D. Result is not acceptable — needs further testing.
3. Fetal monitoring — Deceleration classification
(Single best answer)
Continuous FHR tracing shows gradual
decreases in FHR that begin and end with
contractions and mirror their timing. The nurse
interprets these as:
A. Early decelerations — continue routine care.
, B. Variable decelerations — reposition mother.
C. Late decelerations — prepare for delivery.
D. Prolonged deceleration — start neonatal
team.
Answer: A
Rationale — correct (A): Early decelerations mirror
contractions and indicate fetal head compression—
usually benign and monitored. NCBI
Why others are incorrect: B. Variable decels are
abrupt and cord-related. C. Late decels follow
contraction peak and indicate uteroplacental
insufficiency. D. Prolonged decels last >2 minutes
and need different responses.
4. Intrapartum — Oxytocin and tachysystole
(SATA)
A laboring client on oxytocin shows ≥6
contractions in 10 minutes and recurrent late
decelerations. Immediate nursing actions
include: (select all that apply)
A. Stop oxytocin.
PN® Examination
9th Edition
TEST BANK
1. Antepartum — Severe preeclampsia
presentation (Single best answer)
A 30-year-old at 35 weeks’ gestation reports a
severe, persistent frontal headache and blurred
vision. BP 168/106 mm Hg, urine protein 3+.
The nurse’s highest priority action is:
A. Administer oral acetaminophen for
headache.
B. Initiate magnesium sulfate per protocol and
prepare antihypertensive therapy.
C. Encourage oral fluids and observe for 6 hours.
D. Send labs for CBC, liver enzymes, and
creatinine and await results.
Answer: B
,Rationale — correct (B): Severe features (BP
≥160/110, neurologic symptoms, proteinuria)
indicate risk for eclampsia and organ injury;
immediate seizure prophylaxis (magnesium sulfate)
and BP control are time-sensitive and take priority
over diagnostic testing. (ACOG guidance supports
magnesium for severe features). ACOG
Why others are incorrect:
A. Symptom relief alone doesn’t prevent seizures or
maternal/fetal compromise.
C. Waiting risks progression; not safe for severe
features.
D. Labs are important but should not delay
emergent stabilization.
2. Antepartum — Gestational diabetes follow-up
(Single best answer)
A 28-week patient has a 1-hour glucose
screening value of 160 mg/dL (screen threshold
140 mg/dL). The next best action is:
A. Start insulin therapy immediately.
, B. Schedule a diagnostic 3-hour OGTT.
C. Tell the patient to restrict carbs and recheck
in 2 weeks.
D. No action — result is acceptable.
Answer: B
Rationale — correct (B): A screening value above
threshold requires confirmatory 3-hour OGTT
before diagnosing GDM or initiating insulin/diet
therapy.
Why others are incorrect: A. Insulin without
diagnosis is premature. C. Dietary advice useful but
diagnostic confirmation is the immediate next step.
D. Result is not acceptable — needs further testing.
3. Fetal monitoring — Deceleration classification
(Single best answer)
Continuous FHR tracing shows gradual
decreases in FHR that begin and end with
contractions and mirror their timing. The nurse
interprets these as:
A. Early decelerations — continue routine care.
, B. Variable decelerations — reposition mother.
C. Late decelerations — prepare for delivery.
D. Prolonged deceleration — start neonatal
team.
Answer: A
Rationale — correct (A): Early decelerations mirror
contractions and indicate fetal head compression—
usually benign and monitored. NCBI
Why others are incorrect: B. Variable decels are
abrupt and cord-related. C. Late decels follow
contraction peak and indicate uteroplacental
insufficiency. D. Prolonged decels last >2 minutes
and need different responses.
4. Intrapartum — Oxytocin and tachysystole
(SATA)
A laboring client on oxytocin shows ≥6
contractions in 10 minutes and recurrent late
decelerations. Immediate nursing actions
include: (select all that apply)
A. Stop oxytocin.
