Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
TEST BANK
Item 1 — Preeclampsia with severe features (MCQ)
A 30-year-old primigravida at 37 weeks reports
severe headache and visual spots. BP 162/104 mm
Hg, 3+ protein on dipstick. Which nursing action is
highest priority?
A. Encourage oral fluids and recheck BP in 30
minutes.
B. Prepare for immediate administration of
magnesium sulfate and place client in left lateral
position.
C. Start a 24-hour urine collection for protein.
D. Obtain a pelvic ultrasound.
Correct answer: B
Rationale (correct): Severe features (BP ≥160/110
or neurologic symptoms with proteinuria) place the
,mother at high risk for eclampsia. Immediate
priorities are maternal stabilization and seizure
prophylaxis — left lateral position improves
uteroplacental perfusion and magnesium sulfate is
instituted for seizure prevention.
Rationale (incorrect):
A — Waiting delays urgent seizure prophylaxis.
C — Diagnostic measures are secondary to
immediate maternal stabilization.
D — Ultrasound does not address acute seizure risk.
Source: ACOG practice guidance supports
magnesium sulfate for severe preeclampsia as
seizure prophylaxis. Preeclampsia Foundation+1
Item 2 — Hyperemesis gravidarum (SATA)
A woman at 10 weeks has persistent vomiting,
ketonuria, and 6% weight loss. Which should the
nurse implement? (Select all that apply.)
A. Initiate IV fluids and correct electrolytes.
B. Recommend three large meals daily.
C. Administer pyridoxine (vitamin B6) ± doxylamine
,as ordered.
D. Obtain baseline serum electrolytes and ketones.
E. Schedule immediate induction of labor.
Correct answers: A, C, D
Rationale (correct): Replace fluids/electrolytes to
treat dehydration and metabolic imbalance;
pyridoxine (± doxylamine) is first-line medication for
severe pregnancy nausea; baseline labs guide
therapy.
Rationale (incorrect):
B — Small, frequent bland meals are recommended.
E — Induction is irrelevant in first trimester and
unsafe. (No citation needed; standard antepartum
care.)
Item 3 — Gestational diabetes screening follow-up
(MCQ)
A 28-year-old at 28 weeks has a 1-hour 50 g glucose
challenge result of 165 mg/dL. What is the nurse’s
best next action?
A. Reassure and continue routine prenatal care.
, B. Schedule a diagnostic 3-hour 100 g oral glucose
tolerance test.
C. Begin insulin therapy immediately.
D. Restrict carbohydrates to under 30 g/day.
Correct answer: B
Rationale (correct): A screening value above
commonly used cutoffs (often 130–140 mg/dL)
requires diagnostic 3-hour testing per standard
obstetric protocols before initiating treatment.
Rationale (incorrect):
A — Screening result is elevated and needs
diagnostic confirmation.
C — Insulin is not started until diagnosis and
individualized plan.
D — Extreme carbohydrate restriction is unsafe
without dietitian/provider guidance.
Item 4 — Oxytocin infusion: uterine tachysystole
(MCQ)
During oxytocin augmentation the nurse documents
more than 6 contractions in 10 minutes and late
PN® Examination
9th Edition
TEST BANK
Item 1 — Preeclampsia with severe features (MCQ)
A 30-year-old primigravida at 37 weeks reports
severe headache and visual spots. BP 162/104 mm
Hg, 3+ protein on dipstick. Which nursing action is
highest priority?
A. Encourage oral fluids and recheck BP in 30
minutes.
B. Prepare for immediate administration of
magnesium sulfate and place client in left lateral
position.
C. Start a 24-hour urine collection for protein.
D. Obtain a pelvic ultrasound.
Correct answer: B
Rationale (correct): Severe features (BP ≥160/110
or neurologic symptoms with proteinuria) place the
,mother at high risk for eclampsia. Immediate
priorities are maternal stabilization and seizure
prophylaxis — left lateral position improves
uteroplacental perfusion and magnesium sulfate is
instituted for seizure prevention.
Rationale (incorrect):
A — Waiting delays urgent seizure prophylaxis.
C — Diagnostic measures are secondary to
immediate maternal stabilization.
D — Ultrasound does not address acute seizure risk.
Source: ACOG practice guidance supports
magnesium sulfate for severe preeclampsia as
seizure prophylaxis. Preeclampsia Foundation+1
Item 2 — Hyperemesis gravidarum (SATA)
A woman at 10 weeks has persistent vomiting,
ketonuria, and 6% weight loss. Which should the
nurse implement? (Select all that apply.)
A. Initiate IV fluids and correct electrolytes.
B. Recommend three large meals daily.
C. Administer pyridoxine (vitamin B6) ± doxylamine
,as ordered.
D. Obtain baseline serum electrolytes and ketones.
E. Schedule immediate induction of labor.
Correct answers: A, C, D
Rationale (correct): Replace fluids/electrolytes to
treat dehydration and metabolic imbalance;
pyridoxine (± doxylamine) is first-line medication for
severe pregnancy nausea; baseline labs guide
therapy.
Rationale (incorrect):
B — Small, frequent bland meals are recommended.
E — Induction is irrelevant in first trimester and
unsafe. (No citation needed; standard antepartum
care.)
Item 3 — Gestational diabetes screening follow-up
(MCQ)
A 28-year-old at 28 weeks has a 1-hour 50 g glucose
challenge result of 165 mg/dL. What is the nurse’s
best next action?
A. Reassure and continue routine prenatal care.
, B. Schedule a diagnostic 3-hour 100 g oral glucose
tolerance test.
C. Begin insulin therapy immediately.
D. Restrict carbohydrates to under 30 g/day.
Correct answer: B
Rationale (correct): A screening value above
commonly used cutoffs (often 130–140 mg/dL)
requires diagnostic 3-hour testing per standard
obstetric protocols before initiating treatment.
Rationale (incorrect):
A — Screening result is elevated and needs
diagnostic confirmation.
C — Insulin is not started until diagnosis and
individualized plan.
D — Extreme carbohydrate restriction is unsafe
without dietitian/provider guidance.
Item 4 — Oxytocin infusion: uterine tachysystole
(MCQ)
During oxytocin augmentation the nurse documents
more than 6 contractions in 10 minutes and late
