NUR202 / NUR 202 Exam 2 Maternal
Newborn Nursing ACTUAL EXAM
2026/2027 | NUR 202 Maternal Newborn
Exam 2 | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Antepartum Complications (Q1–Q12)
Q1: A patient at 34 weeks gestation with preterm labor is receiving magnesium sulfate for
neuroprotection. The nurse notes a respiratory rate of 10 breaths per minute, absent deep tendon
reflexes, and urine output of 15 mL in the past hour. Which action is the priority?
A. Decrease the magnesium sulfate infusion rate by half.
B. Discontinue the magnesium sulfate infusion immediately and prepare to administer calcium
gluconate. [CORRECT]
C. Administer oxygen via nasal cannula at 4 L/min.
D. Increase IV fluid rate to promote magnesium excretion.
Correct Answer: B
Rationale: Magnesium sulfate toxicity presents with the classic triad of respiratory depression (RR <12
breaths/min), loss of deep tendon reflexes, and oliguria (<30 mL/hr or <100 mL/4hr). Magnesium is
excreted renally; impaired renal function or overdose causes progressive neuromuscular blockade
leading to respiratory arrest and cardiac arrest. The antidote is calcium gluconate 1 g IV push, which
antagonizes magnesium at the neuromuscular junction. The nurse must immediately stop the infusion
to prevent further magnesium accumulation, notify the provider, and have calcium gluconate ready for
administration.
Q2: A patient at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM) after a 75g
oral glucose tolerance test. Which nursing instruction is essential for initial management?
,A. "You should avoid all carbohydrates to keep your blood sugar low."
B. "Monitor your blood glucose fasting and 2 hours postprandially, and maintain a carbohydrate-
controlled diet with consistent timing." [CORRECT]
C. "You will need to start insulin immediately regardless of your glucose levels."
D. "Gestational diabetes does not affect your baby, so you only need to monitor your own symptoms."
Correct Answer: B
Rationale: Initial GDM management involves medical nutrition therapy with carbohydrate counting and
consistent meal timing, plus self-monitoring of blood glucose (fasting and postprandial) to assess
glycemic control. Dietary carbohydrates are necessary for fetal brain development and maternal energy;
the goal is controlled distribution rather than elimination. Insulin is initiated only if dietary management
fails to achieve target glucose levels (fasting <95 mg/dL, 1-hour <140 mg/dL, 2-hour <120 mg/dL). GDM
significantly affects fetal outcomes (macrosomia, birth trauma, neonatal hypoglycemia, stillbirth risk),
making maternal glucose monitoring critical for both mother and fetus.
Q3: A patient at 32 weeks gestation presents with sudden-onset severe headache, visual disturbances
(scotomata), epigastric pain, and blood pressure of 168/110 mmHg. Urine protein is 3+. Which condition
should the nurse recognize?
A. Mild preeclampsia
B. Severe preeclampsia [CORRECT]
C. Chronic hypertension
D. Gestational hypertension
Correct Answer: B
Rationale: Severe preeclampsia is diagnosed when a patient with preeclampsia (hypertension +
proteinuria after 20 weeks) develops any of the following: systolic BP ≥160 or diastolic ≥110 on two
occasions 4 hours apart; cerebral or visual symptoms (headache, scotomata); epigastric or right upper
quadrant pain (hepatic involvement); thrombocytopenia (<100,000/μL); impaired liver function; renal
insufficiency (creatinine >1.1 mg/dL); pulmonary edema; or fetal growth restriction. This patient has
severe features (headache, visual changes, epigastric pain, severe range BP), requiring immediate
magnesium sulfate for seizure prophylaxis, antihypertensive therapy, and delivery planning.
Q4: A patient at 36 weeks gestation reports painless, bright red vaginal bleeding. The fetal heart rate is
140 bpm with moderate variability. The uterus is soft and nontender. Which condition should the nurse
suspect?
A. Abruptio placentae
B. Placenta previa [CORRECT]
, C. Preterm labor
D. Cervical laceration
Correct Answer: B
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester
as the lower uterine segment effaces and dilates, shearing the placental attachment over the cervical os.
The soft, nontender uterus and reassuring fetal heart rate pattern distinguish it from abruptio
placentae, which presents with painful bleeding, a firm/tender uterus (Couvelaire uterus), and often
fetal distress. Placenta previa requires pelvic rest (no vaginal exams), continuous fetal monitoring,
Rhogam if Rh-negative, and delivery by cesarean if complete previa persists.
Q5: A patient at 30 weeks gestation with preeclampsia is receiving magnesium sulfate. The nurse is
monitoring for therapeutic effectiveness. Which finding indicates the magnesium sulfate is at a
therapeutic level?
A. Respiratory rate of 8 breaths per minute
B. Patellar reflexes 2+ and present, urine output 35 mL/hr [CORRECT]
C. Absent deep tendon reflexes
D. Decreased level of consciousness
Correct Answer: B
Rationale: Therapeutic magnesium sulfate levels for preeclampsia/eclampsia seizure prophylaxis are 4–
8 mEq/L (or 4.8–9.6 mg/dL). Clinical indicators of therapeutic levels include present but slightly
depressed deep tendon reflexes (1+ to 2+), adequate urine output (>25–30 mL/hr ensuring renal
excretion), and normal respiratory rate (≥12 breaths/min). Patellar reflexes 2+ and urine output 35
mL/hr indicate the patient is within the therapeutic window without toxicity. Absent reflexes,
respiratory depression, and altered consciousness are signs of toxicity requiring immediate intervention.
Q6: A patient at 18 weeks gestation has been vomiting 8–10 times daily for 3 weeks, has lost 8 lb, and
shows signs of dehydration. Ketones are present in urine. Which condition does this represent?
A. Normal morning sickness
B. Hyperemesis gravidarum [CORRECT]
C. Gastroenteritis
D. Peptic ulcer disease
Correct Answer: B
Rationale: Hyperemesis gravidarum is severe nausea and vomiting in pregnancy leading to weight loss
(>5% of pre-pregnancy weight), dehydration, electrolyte imbalance, and ketonuria. It typically begins
Newborn Nursing ACTUAL EXAM
2026/2027 | NUR 202 Maternal Newborn
Exam 2 | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Antepartum Complications (Q1–Q12)
Q1: A patient at 34 weeks gestation with preterm labor is receiving magnesium sulfate for
neuroprotection. The nurse notes a respiratory rate of 10 breaths per minute, absent deep tendon
reflexes, and urine output of 15 mL in the past hour. Which action is the priority?
A. Decrease the magnesium sulfate infusion rate by half.
B. Discontinue the magnesium sulfate infusion immediately and prepare to administer calcium
gluconate. [CORRECT]
C. Administer oxygen via nasal cannula at 4 L/min.
D. Increase IV fluid rate to promote magnesium excretion.
Correct Answer: B
Rationale: Magnesium sulfate toxicity presents with the classic triad of respiratory depression (RR <12
breaths/min), loss of deep tendon reflexes, and oliguria (<30 mL/hr or <100 mL/4hr). Magnesium is
excreted renally; impaired renal function or overdose causes progressive neuromuscular blockade
leading to respiratory arrest and cardiac arrest. The antidote is calcium gluconate 1 g IV push, which
antagonizes magnesium at the neuromuscular junction. The nurse must immediately stop the infusion
to prevent further magnesium accumulation, notify the provider, and have calcium gluconate ready for
administration.
Q2: A patient at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM) after a 75g
oral glucose tolerance test. Which nursing instruction is essential for initial management?
,A. "You should avoid all carbohydrates to keep your blood sugar low."
B. "Monitor your blood glucose fasting and 2 hours postprandially, and maintain a carbohydrate-
controlled diet with consistent timing." [CORRECT]
C. "You will need to start insulin immediately regardless of your glucose levels."
D. "Gestational diabetes does not affect your baby, so you only need to monitor your own symptoms."
Correct Answer: B
Rationale: Initial GDM management involves medical nutrition therapy with carbohydrate counting and
consistent meal timing, plus self-monitoring of blood glucose (fasting and postprandial) to assess
glycemic control. Dietary carbohydrates are necessary for fetal brain development and maternal energy;
the goal is controlled distribution rather than elimination. Insulin is initiated only if dietary management
fails to achieve target glucose levels (fasting <95 mg/dL, 1-hour <140 mg/dL, 2-hour <120 mg/dL). GDM
significantly affects fetal outcomes (macrosomia, birth trauma, neonatal hypoglycemia, stillbirth risk),
making maternal glucose monitoring critical for both mother and fetus.
Q3: A patient at 32 weeks gestation presents with sudden-onset severe headache, visual disturbances
(scotomata), epigastric pain, and blood pressure of 168/110 mmHg. Urine protein is 3+. Which condition
should the nurse recognize?
A. Mild preeclampsia
B. Severe preeclampsia [CORRECT]
C. Chronic hypertension
D. Gestational hypertension
Correct Answer: B
Rationale: Severe preeclampsia is diagnosed when a patient with preeclampsia (hypertension +
proteinuria after 20 weeks) develops any of the following: systolic BP ≥160 or diastolic ≥110 on two
occasions 4 hours apart; cerebral or visual symptoms (headache, scotomata); epigastric or right upper
quadrant pain (hepatic involvement); thrombocytopenia (<100,000/μL); impaired liver function; renal
insufficiency (creatinine >1.1 mg/dL); pulmonary edema; or fetal growth restriction. This patient has
severe features (headache, visual changes, epigastric pain, severe range BP), requiring immediate
magnesium sulfate for seizure prophylaxis, antihypertensive therapy, and delivery planning.
Q4: A patient at 36 weeks gestation reports painless, bright red vaginal bleeding. The fetal heart rate is
140 bpm with moderate variability. The uterus is soft and nontender. Which condition should the nurse
suspect?
A. Abruptio placentae
B. Placenta previa [CORRECT]
, C. Preterm labor
D. Cervical laceration
Correct Answer: B
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester
as the lower uterine segment effaces and dilates, shearing the placental attachment over the cervical os.
The soft, nontender uterus and reassuring fetal heart rate pattern distinguish it from abruptio
placentae, which presents with painful bleeding, a firm/tender uterus (Couvelaire uterus), and often
fetal distress. Placenta previa requires pelvic rest (no vaginal exams), continuous fetal monitoring,
Rhogam if Rh-negative, and delivery by cesarean if complete previa persists.
Q5: A patient at 30 weeks gestation with preeclampsia is receiving magnesium sulfate. The nurse is
monitoring for therapeutic effectiveness. Which finding indicates the magnesium sulfate is at a
therapeutic level?
A. Respiratory rate of 8 breaths per minute
B. Patellar reflexes 2+ and present, urine output 35 mL/hr [CORRECT]
C. Absent deep tendon reflexes
D. Decreased level of consciousness
Correct Answer: B
Rationale: Therapeutic magnesium sulfate levels for preeclampsia/eclampsia seizure prophylaxis are 4–
8 mEq/L (or 4.8–9.6 mg/dL). Clinical indicators of therapeutic levels include present but slightly
depressed deep tendon reflexes (1+ to 2+), adequate urine output (>25–30 mL/hr ensuring renal
excretion), and normal respiratory rate (≥12 breaths/min). Patellar reflexes 2+ and urine output 35
mL/hr indicate the patient is within the therapeutic window without toxicity. Absent reflexes,
respiratory depression, and altered consciousness are signs of toxicity requiring immediate intervention.
Q6: A patient at 18 weeks gestation has been vomiting 8–10 times daily for 3 weeks, has lost 8 lb, and
shows signs of dehydration. Ketones are present in urine. Which condition does this represent?
A. Normal morning sickness
B. Hyperemesis gravidarum [CORRECT]
C. Gastroenteritis
D. Peptic ulcer disease
Correct Answer: B
Rationale: Hyperemesis gravidarum is severe nausea and vomiting in pregnancy leading to weight loss
(>5% of pre-pregnancy weight), dehydration, electrolyte imbalance, and ketonuria. It typically begins
