NUR2513 Maternal-Child Nursing EXAM 2
PRACTICE BANK - Rasmussen College 2026/2027
Curriculum | High-Risk Focus | Complications &
Interventions
(75 Questions)
Module 4: High-Risk Pregnancy & Complications (Q1-25)
Q1: A client at 32 weeks gestation with preeclampsia is receiving IV magnesium sulfate.
The nurse notes the client’s respiratory rate is 10/min, deep-tendon reflexes are absent,
and urine output for the last hour was 20 mL. What is the nurse’s immediate priority
action?
A. Administer the next scheduled dose of labetalol
B. Slow the magnesium sulfate infusion rate
C. Prepare to administer calcium gluconate
D. Increase the IV fluid rate to improve urine output
Verified Answer: C
Rationale (Graded A): Respiratory depression (≤ 12) + absent reflexes + oliguria =
magnesium toxicity; calcium gluconate 1 g IV is the antidote and must be given before
respiratory arrest occurs. Slowing the infusion (B) is correct but not sufficient for these
severe signs; calcium is life-saving.
,Q2: A G2P1 at 29 weeks reports sudden, painless vaginal bleeding that stopped after 10
minutes. FHR is 140 bpm, toco shows no contractions. The most likely diagnosis is:
A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Vasa previa
Verified Answer: B
Rationale: Painless bleeding in third trimester = classic placenta previa; abruption (A)
presents with pain and hypertonus.
Q3: A client with gestational diabetes at 35 weeks has fasting glucose 105 mg/dL on
diet therapy. The nurse anticipates:
A. Starting bedtime insulin
B. Induction at 37 weeks
C. Immediate cesarean
D. Oral metformin increase
Verified Answer: A
Rationale: 2026 ACOG threshold fasting ≥ 95 mg/dL on diet → insulin; insulin is first-line
in pregnancy. Induction (B) considered at 39 weeks if well-controlled.
Q4: Which finding indicates impending eclampsia?
,A. BP 140/90 mmHg
B. Proteinuria 1+
C. Headache unrelieved by acetaminophen + visual disturbances
D. Generalized edema
Verified Answer: C
Rationale: Severe-feature headache + visual changes signals cerebral vasospasm →
imminent seizure; other choices are preeclampsia without severe features.
Q5: A client at 24 weeks with preterm premature rupture of membranes (PPROM) is
admitted. The nurse should:
A. Perform a sterile speculum exam immediately
B. Avoid digital cervical exams unless delivery imminent
C. Encourage tub baths for comfort
D. Start oral antibiotics
Verified Answer: B
Rationale: Digital exam ↑ infection risk; limit to one exam if delivery likely within 48 h.
Sterile speculum (A) is acceptable once for visualization.
Q6: The nurse calculates MgSO₄ loading dose: 4 g in 100 mL NS over 20 minutes. Pump
rate is:
A. 200 mL/h
, B. 250 mL/h
C. 300 mL/h
D. 400 mL/h
Verified Answer: C
Rationale: 100 mL ÷ (20 min ÷ 60) = 300 mL/h.
Q7: A client at 18 weeks has a serum α-fetoprotein 2.8 MOM. Next step:
A. Offer amniocentesis
B. Repeat test in 2 weeks
C. Schedule detailed ultrasound
D. Start heparin
Verified Answer: C
Rationale: Elevated MS-AFP → neural-tube or abdominal-wall defect; detailed U/S first to
confirm dates and look for anomalies.
Q8: Select ALL that apply. Risk factors for placental abruption include:
A. Chronic hypertension
B. Cocaine use
C. Advanced maternal age
D. Multiparity
PRACTICE BANK - Rasmussen College 2026/2027
Curriculum | High-Risk Focus | Complications &
Interventions
(75 Questions)
Module 4: High-Risk Pregnancy & Complications (Q1-25)
Q1: A client at 32 weeks gestation with preeclampsia is receiving IV magnesium sulfate.
The nurse notes the client’s respiratory rate is 10/min, deep-tendon reflexes are absent,
and urine output for the last hour was 20 mL. What is the nurse’s immediate priority
action?
A. Administer the next scheduled dose of labetalol
B. Slow the magnesium sulfate infusion rate
C. Prepare to administer calcium gluconate
D. Increase the IV fluid rate to improve urine output
Verified Answer: C
Rationale (Graded A): Respiratory depression (≤ 12) + absent reflexes + oliguria =
magnesium toxicity; calcium gluconate 1 g IV is the antidote and must be given before
respiratory arrest occurs. Slowing the infusion (B) is correct but not sufficient for these
severe signs; calcium is life-saving.
,Q2: A G2P1 at 29 weeks reports sudden, painless vaginal bleeding that stopped after 10
minutes. FHR is 140 bpm, toco shows no contractions. The most likely diagnosis is:
A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Vasa previa
Verified Answer: B
Rationale: Painless bleeding in third trimester = classic placenta previa; abruption (A)
presents with pain and hypertonus.
Q3: A client with gestational diabetes at 35 weeks has fasting glucose 105 mg/dL on
diet therapy. The nurse anticipates:
A. Starting bedtime insulin
B. Induction at 37 weeks
C. Immediate cesarean
D. Oral metformin increase
Verified Answer: A
Rationale: 2026 ACOG threshold fasting ≥ 95 mg/dL on diet → insulin; insulin is first-line
in pregnancy. Induction (B) considered at 39 weeks if well-controlled.
Q4: Which finding indicates impending eclampsia?
,A. BP 140/90 mmHg
B. Proteinuria 1+
C. Headache unrelieved by acetaminophen + visual disturbances
D. Generalized edema
Verified Answer: C
Rationale: Severe-feature headache + visual changes signals cerebral vasospasm →
imminent seizure; other choices are preeclampsia without severe features.
Q5: A client at 24 weeks with preterm premature rupture of membranes (PPROM) is
admitted. The nurse should:
A. Perform a sterile speculum exam immediately
B. Avoid digital cervical exams unless delivery imminent
C. Encourage tub baths for comfort
D. Start oral antibiotics
Verified Answer: B
Rationale: Digital exam ↑ infection risk; limit to one exam if delivery likely within 48 h.
Sterile speculum (A) is acceptable once for visualization.
Q6: The nurse calculates MgSO₄ loading dose: 4 g in 100 mL NS over 20 minutes. Pump
rate is:
A. 200 mL/h
, B. 250 mL/h
C. 300 mL/h
D. 400 mL/h
Verified Answer: C
Rationale: 100 mL ÷ (20 min ÷ 60) = 300 mL/h.
Q7: A client at 18 weeks has a serum α-fetoprotein 2.8 MOM. Next step:
A. Offer amniocentesis
B. Repeat test in 2 weeks
C. Schedule detailed ultrasound
D. Start heparin
Verified Answer: C
Rationale: Elevated MS-AFP → neural-tube or abdominal-wall defect; detailed U/S first to
confirm dates and look for anomalies.
Q8: Select ALL that apply. Risk factors for placental abruption include:
A. Chronic hypertension
B. Cocaine use
C. Advanced maternal age
D. Multiparity
