2026 IATEST UPDATE DOWNLOAD
NUR 254 Exam 4 | Nursing 254
Maternal Exam 4 Exam Questions &
Answers, Explained Solutions 2026
Q1. A patient at 28 weeks’ gestation reports sudden, painless bright red vaginal bleeding. The
priority is to suspect:
A. Placenta abruptio
B. Placenta previa
C. Ectopic pregnancy
D. Gestational trophoblastic disease
Answer: B. Placenta previa
Rationale: Painless bright red bleeding in the third trimester is classic for placenta previa,
especially without pain or contractions.
Q2. True or False: Placenta previa is diagnosed via transvaginal ultrasound.
Answer: True
Rationale: Ultrasound is the safest way to visualize placental placement and confirm diagnosis.
Q3. A prenatal client at 32 weeks with gestational hypertension has a blood pressure of 150/98
mm Hg. First nursing action:
A. Assess deep tendon reflexes
B. Provide reassurance
C. Record in chart and continue care
D. Encourage bedrest at home
Answer: A. Assess deep tendon reflexes
Rationale: Severe hypertension may indicate preeclampsia; hyperreflexia suggests CNS
irritability.
Q4. True or False: One large proteinuria result (>300 mg/24 hrs) helps diagnose preeclampsia.
Answer: True
Rationale: Proteinuria with hypertension after 20 weeks supports preeclampsia diagnosis.
,2026 IATEST UPDATE DOWNLOAD
Q5. A 22-year-old at 10 weeks gestation reports left lower quadrant pain and vaginal spotting.
Nursing priority:
A. Prepare for possible ectopic pregnancy evaluation
B. Reassure as normal
C. Encourage heavy exercise
D. Provide diet counseling only
Answer: A. Prepare for possible ectopic pregnancy evaluation
Rationale: Unilateral pain early in pregnancy with bleeding raises concern for ectopic
pregnancy.
Q6. True or False: Ectopic pregnancy can be life-threatening and requires emergency
intervention.
Answer: True
Rationale: If ruptured, ectopic pregnancy causes hemorrhage and shock.
Fetal Assessment & Monitoring
Q7. The nurse interprets a fetal heart rate of 160 bpm as:
A. Fetal tachycardia
B. Normal
C. Fetal bradycardia
D. Variable deceleration
Answer: A. Fetal tachycardia
Rationale: Normal baseline FHR is 110–160 bpm; anything above is tachycardic.
Q8. True or False: A Category I FHR tracing is normal and requires routine care.
Answer: True
Rationale: Category I is reassuring with no interventions required.
Q9. Early decelerations in FHR are most commonly associated with:
A. Fetal head compression
B. Cord prolapse
C. Uteroplacental insufficiency
D. Maternal hypotension
,2026 IATEST UPDATE DOWNLOAD
Answer: A. Fetal head compression
Rationale: Early decels mirror contractions and are benign.
Q10. True or False: Late decelerations indicate uteroplacental insufficiency and require
intervention.
Answer: True
Rationale: Late decels suggest compromised fetal oxygenation.
Q11. A non-stress test (NST) shows two accelerations within 20 minutes. Interpretation:
A. Reactive NST
B. Non-reactive NST
C. Variable decelerations
D. Fetal bradycardia
Answer: A. Reactive NST
Rationale: Two accelerations indicate fetal well-being.
Q12. True or False: Variable decelerations are usually related to umbilical cord compression.
Answer: True
Rationale: Variable shape and timing decels signal possible cord issues.
Labor & Intrapartum Care
Q13. A mother at 9 cm dilation complains of the urge to bear down. This suggests:
A. Transition phase
B. Early labor
C. False labor
D. Postpartum onset
Answer: A. Transition phase
Rationale: Strong desire to push indicates nearing second stage.
Q14. True or False: Rupture of membranes increases infection risk, especially after 18 hours.
Answer: True
Rationale: Prolonged ROM increases risk for chorioamnionitis.
, 2026 IATEST UPDATE DOWNLOAD
Q15. The nurse hears a sudden change in fetal heart tones during labor with ROM. When should
a sterile vaginal exam be done promptly?
A. Suspected cord prolapse
B. At onset of contractions
C. If maternal blood pressure drops
D. When pushing begins
Answer: A. Suspected cord prolapse
Rationale: Cord prolapse requires immediate assessment and often rapid delivery.
Q16. True or False: In shoulder dystocia, McRoberts maneuver and suprapubic pressure are
recommended.
Answer: True
Rationale: These maneuvers help free the impacted shoulder.
Complications of Labor & Delivery
Q17. A mother with magnesium sulfate infusion shows respiratory depression and absent
reflexes. Priority action:
A. Stop infusion and administer calcium gluconate
B. Give more magnesium
C. Administer oxygen only
D. Reposition
Answer: A. Stop infusion and administer calcium gluconate
Rationale: Magnesium toxicity depresses CNS and respirations; calcium gluconate is antidote.
Q18. True or False: Deep tendon reflexes should be checked frequently during magnesium
sulfate therapy.
Answer: True
Rationale: Hyperreflexia may signal worsening preeclampsia; absent reflexes can indicate
toxicity.
Q19. A pregnant client has severe preeclampsia. Which sign requires immediate action?
A. Visual disturbances
NUR 254 Exam 4 | Nursing 254
Maternal Exam 4 Exam Questions &
Answers, Explained Solutions 2026
Q1. A patient at 28 weeks’ gestation reports sudden, painless bright red vaginal bleeding. The
priority is to suspect:
A. Placenta abruptio
B. Placenta previa
C. Ectopic pregnancy
D. Gestational trophoblastic disease
Answer: B. Placenta previa
Rationale: Painless bright red bleeding in the third trimester is classic for placenta previa,
especially without pain or contractions.
Q2. True or False: Placenta previa is diagnosed via transvaginal ultrasound.
Answer: True
Rationale: Ultrasound is the safest way to visualize placental placement and confirm diagnosis.
Q3. A prenatal client at 32 weeks with gestational hypertension has a blood pressure of 150/98
mm Hg. First nursing action:
A. Assess deep tendon reflexes
B. Provide reassurance
C. Record in chart and continue care
D. Encourage bedrest at home
Answer: A. Assess deep tendon reflexes
Rationale: Severe hypertension may indicate preeclampsia; hyperreflexia suggests CNS
irritability.
Q4. True or False: One large proteinuria result (>300 mg/24 hrs) helps diagnose preeclampsia.
Answer: True
Rationale: Proteinuria with hypertension after 20 weeks supports preeclampsia diagnosis.
,2026 IATEST UPDATE DOWNLOAD
Q5. A 22-year-old at 10 weeks gestation reports left lower quadrant pain and vaginal spotting.
Nursing priority:
A. Prepare for possible ectopic pregnancy evaluation
B. Reassure as normal
C. Encourage heavy exercise
D. Provide diet counseling only
Answer: A. Prepare for possible ectopic pregnancy evaluation
Rationale: Unilateral pain early in pregnancy with bleeding raises concern for ectopic
pregnancy.
Q6. True or False: Ectopic pregnancy can be life-threatening and requires emergency
intervention.
Answer: True
Rationale: If ruptured, ectopic pregnancy causes hemorrhage and shock.
Fetal Assessment & Monitoring
Q7. The nurse interprets a fetal heart rate of 160 bpm as:
A. Fetal tachycardia
B. Normal
C. Fetal bradycardia
D. Variable deceleration
Answer: A. Fetal tachycardia
Rationale: Normal baseline FHR is 110–160 bpm; anything above is tachycardic.
Q8. True or False: A Category I FHR tracing is normal and requires routine care.
Answer: True
Rationale: Category I is reassuring with no interventions required.
Q9. Early decelerations in FHR are most commonly associated with:
A. Fetal head compression
B. Cord prolapse
C. Uteroplacental insufficiency
D. Maternal hypotension
,2026 IATEST UPDATE DOWNLOAD
Answer: A. Fetal head compression
Rationale: Early decels mirror contractions and are benign.
Q10. True or False: Late decelerations indicate uteroplacental insufficiency and require
intervention.
Answer: True
Rationale: Late decels suggest compromised fetal oxygenation.
Q11. A non-stress test (NST) shows two accelerations within 20 minutes. Interpretation:
A. Reactive NST
B. Non-reactive NST
C. Variable decelerations
D. Fetal bradycardia
Answer: A. Reactive NST
Rationale: Two accelerations indicate fetal well-being.
Q12. True or False: Variable decelerations are usually related to umbilical cord compression.
Answer: True
Rationale: Variable shape and timing decels signal possible cord issues.
Labor & Intrapartum Care
Q13. A mother at 9 cm dilation complains of the urge to bear down. This suggests:
A. Transition phase
B. Early labor
C. False labor
D. Postpartum onset
Answer: A. Transition phase
Rationale: Strong desire to push indicates nearing second stage.
Q14. True or False: Rupture of membranes increases infection risk, especially after 18 hours.
Answer: True
Rationale: Prolonged ROM increases risk for chorioamnionitis.
, 2026 IATEST UPDATE DOWNLOAD
Q15. The nurse hears a sudden change in fetal heart tones during labor with ROM. When should
a sterile vaginal exam be done promptly?
A. Suspected cord prolapse
B. At onset of contractions
C. If maternal blood pressure drops
D. When pushing begins
Answer: A. Suspected cord prolapse
Rationale: Cord prolapse requires immediate assessment and often rapid delivery.
Q16. True or False: In shoulder dystocia, McRoberts maneuver and suprapubic pressure are
recommended.
Answer: True
Rationale: These maneuvers help free the impacted shoulder.
Complications of Labor & Delivery
Q17. A mother with magnesium sulfate infusion shows respiratory depression and absent
reflexes. Priority action:
A. Stop infusion and administer calcium gluconate
B. Give more magnesium
C. Administer oxygen only
D. Reposition
Answer: A. Stop infusion and administer calcium gluconate
Rationale: Magnesium toxicity depresses CNS and respirations; calcium gluconate is antidote.
Q18. True or False: Deep tendon reflexes should be checked frequently during magnesium
sulfate therapy.
Answer: True
Rationale: Hyperreflexia may signal worsening preeclampsia; absent reflexes can indicate
toxicity.
Q19. A pregnant client has severe preeclampsia. Which sign requires immediate action?
A. Visual disturbances
