NUR 2513 / NUR2513 Final Exam: Maternal Child Nursing
Latest Update 2026/2027 | Rasmussen College | 100%
Correct | Grade A
Verified Questions & Answers with Rationales
Section 1: Antepartum and High-Risk Pregnancy
Q1: A pregnant patient at 28 weeks gestation presents to the clinic with a blood pressure of 150/95
mmHg, proteinuria of 2+, and severe facial edema. Which pathophysiological mechanism is the primary
cause of this patient's symptoms?
A. Hyperactivity of the parasympathetic nervous system causing vasodilation
B. Abnormal trophoblast invasion leading to widespread endothelial dysfunction and vasospasm.
[CORRECT]
C. Excessive renin release from the maternal kidneys causing fluid retention only
D. Fetal chromosomal abnormalities triggering an immune-mediated maternal rash
Correct Answer: B
Rationale: Preeclampsia is caused by poor placental perfusion due to abnormal trophoblast invasion of
the spiral arteries during early pregnancy. This ischemia releases anti-angiogenic factors into the maternal
circulation, causing widespread systemic endothelial dysfunction, intense vasospasm, and capillary leak,
which manifest as hypertension, proteinuria, and edema. Options A, C, and D do not describe the
fundamental placental-endothelial pathophysiology of preeclampsia.
Q2: A pregnant patient at 10 weeks gestation is experiencing severe, persistent nausea and vomiting. She
has lost 5 lbs since her last visit and reports dark, concentrated urine. Which nursing intervention is the
priority?
A. Advise the patient to eat only dry crackers for the next 48 hours.
B. Schedule an immediate ultrasound to check for a molar pregnancy.
C. Assess for signs of dehydration and electrolyte imbalances. [CORRECT]
D. Prescribe promethazine (Phenergan) 25 mg orally every 6 hours.
Correct Answer: C
,Rationale: The patient is exhibiting signs of hyperemesis gravidarum, which differs from typical morning
sickness by its severity, resulting in weight loss, dehydration, and electrolyte imbalances. The priority
nursing action is to assess the severity of fluid and electrolyte deficits (e.g., checking skin turgor, urine
output, and serum electrolytes) to determine if IV fluid replacement is required. Option A is insufficient
for severe dehydration, and Option D requires a provider's order, which cannot be done withou t an
assessment. Option B is premature without further assessment.
Q3: A patient at 8 weeks gestation presents with sharp, unilateral lower quadrant pain and light vaginal
spotting. Which triad of symptoms is most classically associated with an ectopic pregnancy?
A. Amenorrhea, lower quadrant pain, and vaginal spotting. [CORRECT]
B. Uterine cramping, heavy vaginal bleeding, and passage of tissue.
C. Elevated blood pressure, proteinuria, and severe headache.
D. Fever, foul-smelling lochia, and uterine tenderness.
Correct Answer: A
Rationale: The classic triad for an ectopic pregnancy is amenorrhea (missed period), unilateral lower
quadrant pain (due to fallopian tube distension or rupture), and abnormal vaginal spotting. Option B
describes a spontaneous abortion (miscarriage). Option C describes preeclampsia. Option D describes
postpartum or post-abortal infection.
Q4: A patient with pregestational type 2 diabetes is at 32 weeks gestation. The nurse is educating the
patient on the risks of poorly controlled blood glucose during the third trimester. Which complication
should the nurse prioritize in the teaching?
A. Placenta previa
B. Fetal macrosomia and shoulder dystocia. [CORRECT]
C. Neonatal hyperglycemia
D. Maternal placenta accreta
Correct Answer: B
Rationale: Poorly controlled maternal hyperglycemia crosses the placenta, stimulating the fetal pancreas
to produce excess insulin. This insulin acts as a growth hormone, leading to excessive fetal growth
(macrosomia), which significantly increases the risk of shou lder dystocia and birth trauma during
delivery. Option A and D are related to prior uterine surgeries or scarring, not diabetes. Option C is
incorrect because infants of diabetic mothers are at risk for hypoglycemia after birth when the maternal
glucose supply is cut off, not hyperglycemia.
, Q5: [Analysis] A patient at 35 weeks gestation arrives at the labor and delivery unit reporting sudden,
severe, unrelenting abdominal pain and a rigid, board-like abdomen. Vaginal bleeding is scant. What is
the most likely diagnosis, and which mechanism is occurring?
A. Placenta previa; the placenta is implanted over the cervical os, blocking the exit of blood.
B. Placental abruption; the placenta has prematurely detached from the uterine wall, causing
concealed hemorrhage and uterine irritability. [CORRECT]
C. Uterine rupture; the myometrium has torn, allowing the fetus to enter the abdominal cavity.
D. Vasa previa; fetal blood vessels crossing the cervix have ruptured.
Correct Answer: B
Rationale: Sudden, severe pain with a rigid, board-like abdomen and scant (or concealed) bleeding is the
hallmark of placental abruption, where the placenta prematurely separates. The blood can be trapped
behind the placenta (concealed abruption), causing intense uterine irritation and rigidity. Placenta previa
(Option A) typically presents with painless, bright red bleeding and a soft, relaxed uterus. Uterine rupture
(Option C) usually occurs during labor in a scarred uterus and often leads to loss of fetal station . Vasa
previa (Option D) presents with painless bleeding at membrane rupture.
Q6: [Select-All-That-Apply] Which of the following conditions are considered risk factors for the
development of preeclampsia? (Select all that apply)
A. Chronic hypertension. [CORRECT]
B. Multifetal gestation (e.g., twins). [CORRECT]
C. Maternal age under 18. [CORRECT]
D. Being a primigravida. [CORRECT]
E. Smoking during pregnancy.
Correct Answer: A, B, C, D
Rationale: Risk factors for preeclampsia include preexisting vascular conditions like chronic
hypertension, large placentas (multifetal gestation), extremes of maternal age (under 18 or over 35), and
first pregnancy (primigravida). Interestingly, smoking is generally associated with a decreased risk of
developing preeclampsia, although it carries many other severe risks to the pregnancy.
Q7: [Ordered Response] A patient at 32 weeks gestation is diagnosed with severe preeclampsia with
severe features. Place the following nursing interventions in the correct priority sequence:
Initiate a magnesium sulfate infusion.
Assess deep tendon reflexes (DTRs) and respiratory rate.
Draw blood for a complete blood count (CBC) and liver enzymes.
Latest Update 2026/2027 | Rasmussen College | 100%
Correct | Grade A
Verified Questions & Answers with Rationales
Section 1: Antepartum and High-Risk Pregnancy
Q1: A pregnant patient at 28 weeks gestation presents to the clinic with a blood pressure of 150/95
mmHg, proteinuria of 2+, and severe facial edema. Which pathophysiological mechanism is the primary
cause of this patient's symptoms?
A. Hyperactivity of the parasympathetic nervous system causing vasodilation
B. Abnormal trophoblast invasion leading to widespread endothelial dysfunction and vasospasm.
[CORRECT]
C. Excessive renin release from the maternal kidneys causing fluid retention only
D. Fetal chromosomal abnormalities triggering an immune-mediated maternal rash
Correct Answer: B
Rationale: Preeclampsia is caused by poor placental perfusion due to abnormal trophoblast invasion of
the spiral arteries during early pregnancy. This ischemia releases anti-angiogenic factors into the maternal
circulation, causing widespread systemic endothelial dysfunction, intense vasospasm, and capillary leak,
which manifest as hypertension, proteinuria, and edema. Options A, C, and D do not describe the
fundamental placental-endothelial pathophysiology of preeclampsia.
Q2: A pregnant patient at 10 weeks gestation is experiencing severe, persistent nausea and vomiting. She
has lost 5 lbs since her last visit and reports dark, concentrated urine. Which nursing intervention is the
priority?
A. Advise the patient to eat only dry crackers for the next 48 hours.
B. Schedule an immediate ultrasound to check for a molar pregnancy.
C. Assess for signs of dehydration and electrolyte imbalances. [CORRECT]
D. Prescribe promethazine (Phenergan) 25 mg orally every 6 hours.
Correct Answer: C
,Rationale: The patient is exhibiting signs of hyperemesis gravidarum, which differs from typical morning
sickness by its severity, resulting in weight loss, dehydration, and electrolyte imbalances. The priority
nursing action is to assess the severity of fluid and electrolyte deficits (e.g., checking skin turgor, urine
output, and serum electrolytes) to determine if IV fluid replacement is required. Option A is insufficient
for severe dehydration, and Option D requires a provider's order, which cannot be done withou t an
assessment. Option B is premature without further assessment.
Q3: A patient at 8 weeks gestation presents with sharp, unilateral lower quadrant pain and light vaginal
spotting. Which triad of symptoms is most classically associated with an ectopic pregnancy?
A. Amenorrhea, lower quadrant pain, and vaginal spotting. [CORRECT]
B. Uterine cramping, heavy vaginal bleeding, and passage of tissue.
C. Elevated blood pressure, proteinuria, and severe headache.
D. Fever, foul-smelling lochia, and uterine tenderness.
Correct Answer: A
Rationale: The classic triad for an ectopic pregnancy is amenorrhea (missed period), unilateral lower
quadrant pain (due to fallopian tube distension or rupture), and abnormal vaginal spotting. Option B
describes a spontaneous abortion (miscarriage). Option C describes preeclampsia. Option D describes
postpartum or post-abortal infection.
Q4: A patient with pregestational type 2 diabetes is at 32 weeks gestation. The nurse is educating the
patient on the risks of poorly controlled blood glucose during the third trimester. Which complication
should the nurse prioritize in the teaching?
A. Placenta previa
B. Fetal macrosomia and shoulder dystocia. [CORRECT]
C. Neonatal hyperglycemia
D. Maternal placenta accreta
Correct Answer: B
Rationale: Poorly controlled maternal hyperglycemia crosses the placenta, stimulating the fetal pancreas
to produce excess insulin. This insulin acts as a growth hormone, leading to excessive fetal growth
(macrosomia), which significantly increases the risk of shou lder dystocia and birth trauma during
delivery. Option A and D are related to prior uterine surgeries or scarring, not diabetes. Option C is
incorrect because infants of diabetic mothers are at risk for hypoglycemia after birth when the maternal
glucose supply is cut off, not hyperglycemia.
, Q5: [Analysis] A patient at 35 weeks gestation arrives at the labor and delivery unit reporting sudden,
severe, unrelenting abdominal pain and a rigid, board-like abdomen. Vaginal bleeding is scant. What is
the most likely diagnosis, and which mechanism is occurring?
A. Placenta previa; the placenta is implanted over the cervical os, blocking the exit of blood.
B. Placental abruption; the placenta has prematurely detached from the uterine wall, causing
concealed hemorrhage and uterine irritability. [CORRECT]
C. Uterine rupture; the myometrium has torn, allowing the fetus to enter the abdominal cavity.
D. Vasa previa; fetal blood vessels crossing the cervix have ruptured.
Correct Answer: B
Rationale: Sudden, severe pain with a rigid, board-like abdomen and scant (or concealed) bleeding is the
hallmark of placental abruption, where the placenta prematurely separates. The blood can be trapped
behind the placenta (concealed abruption), causing intense uterine irritation and rigidity. Placenta previa
(Option A) typically presents with painless, bright red bleeding and a soft, relaxed uterus. Uterine rupture
(Option C) usually occurs during labor in a scarred uterus and often leads to loss of fetal station . Vasa
previa (Option D) presents with painless bleeding at membrane rupture.
Q6: [Select-All-That-Apply] Which of the following conditions are considered risk factors for the
development of preeclampsia? (Select all that apply)
A. Chronic hypertension. [CORRECT]
B. Multifetal gestation (e.g., twins). [CORRECT]
C. Maternal age under 18. [CORRECT]
D. Being a primigravida. [CORRECT]
E. Smoking during pregnancy.
Correct Answer: A, B, C, D
Rationale: Risk factors for preeclampsia include preexisting vascular conditions like chronic
hypertension, large placentas (multifetal gestation), extremes of maternal age (under 18 or over 35), and
first pregnancy (primigravida). Interestingly, smoking is generally associated with a decreased risk of
developing preeclampsia, although it carries many other severe risks to the pregnancy.
Q7: [Ordered Response] A patient at 32 weeks gestation is diagnosed with severe preeclampsia with
severe features. Place the following nursing interventions in the correct priority sequence:
Initiate a magnesium sulfate infusion.
Assess deep tendon reflexes (DTRs) and respiratory rate.
Draw blood for a complete blood count (CBC) and liver enzymes.
