NSG 3500 Exams 1-4 Maternal Health Actual 2026/2027 with
Detailed Rationales | Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded(Galen College)
EXAM INFORMATION
Total Questions: 60
Recommended Time: 90 Minutes
Passing Threshold: 78%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Professional Decision-Making Questions
Difficulty Level: Comprehensive
==============================
SECTION 1: Antepartum Care and Maternal Physiology
Question 1
A client at 28 weeks gestation presents to the prenatal clinic with a blood pressure of
152/96 mmHg, 2+ proteinuria, and reports seeing spots in her visual field. Which
nursing intervention is the priority?
A. Administer a bolus of magnesium sulfate and prepare for seizure precautions
B. Place the client in a supine position and initiate continuous fetal monitoring
C. Administer an IV bolus of normal saline and prepare for immediate delivery
D. Obtain a stat urine culture and administer prophylactic antibiotics
Correct Answer: A
Rationale: The client is exhibiting signs of severe preeclampsia with visual disturbances,
hypertension, and proteinuria. Magnesium sulfate is the anticonvulsant of choice to
prevent eclamptic seizures. Seizure precautions are a priority. A supine position is
contraindicated due to uterine compression of the vena cava. Immediate delivery is not
,the first intervention at 28 weeks without stabilization. Antibiotics are not indicated
without evidence of infection.
Question 2
A 32-year-old primigravida at 18 weeks gestation asks the nurse why she needs the
quad screen test. Which response by the nurse is most accurate?
A. The test identifies open neural tube defects and certain chromosomal abnormalities
by measuring specific maternal serum markers
B. The test confirms the presence of Down syndrome and requires amniocentesis if
results are positive
C. The test evaluates placental function and determines if the fetus is receiving
adequate oxygenation
D. The test is mandatory for all pregnant clients and must be completed before 16
weeks gestation
Correct Answer: A
Rationale: The quad screen measures maternal serum alpha-fetoprotein, hCG,
unconjugated estriol, and inhibin-A to assess risk for open neural tube defects and
trisomies. It is a screening test, not diagnostic. It does not confirm Down syndrome,
evaluate placental oxygenation, or is mandatory.
Question 3
A pregnant client at 24 weeks gestation with pregestational diabetes has a fasting
blood glucose of 128 mg/dL and a 2-hour postprandial glucose of 168 mg/dL. Which
nursing action is most appropriate?
A. Collaborate with the provider to adjust insulin dosing and reinforce dietary counseling
B. Advise the client that these values are within normal limits for the second trimester
C. Instruct the client to increase carbohydrate intake to prevent hypoglycemia
,D. Prepare the client for immediate induction of labor due to poor glycemic control
Correct Answer: A
Rationale: For pregestational diabetes, fasting glucose should be less than 95 mg/dL
and 2-hour postprandial less than 120 mg/dL. These elevated values indicate the need
for insulin adjustment and dietary reinforcement. The values are not normal. Increasing
carbohydrates would worsen control. Immediate induction is not indicated at 24 weeks.
Question 4
A client at 10 weeks gestation reports severe nausea and vomiting, has lost 8 pounds in
two weeks, and shows signs of dehydration. Which laboratory finding would the nurse
expect to see?
A. Elevated serum ketones and increased blood urea nitrogen
B. Decreased hematocrit and increased serum potassium
C. Normal liver enzymes and decreased thyroid-stimulating hormone
D. Decreased urine specific gravity and increased serum bicarbonate
Correct Answer: A
Rationale: Hyperemesis gravidarum leads to dehydration, starvation ketosis, and
prerenal azotemia, resulting in elevated ketones and increased BUN. Hematocrit
typically increases with dehydration. Electrolyte imbalances usually show decreased
potassium due to vomiting. Urine specific gravity increases with dehydration, and
metabolic alkalosis may occur, not increased bicarbonate.
Question 5
, A nurse is caring for a client at 34 weeks gestation who was diagnosed with placenta
previa after painless vaginal bleeding. The client asks when she can go home. Which
response by the nurse is most appropriate?
A. You will likely remain hospitalized until delivery because bleeding can recur suddenly
and become hemorrhagic
B. You can go home now as long as you avoid sexual intercourse and strenuous activity
C. You will be discharged after the bleeding stops and you can return to work with light
duty
D. Home care is appropriate if you have a reliable vehicle and live within 30 minutes of
the hospital
Correct Answer: A
Rationale: Placenta previa with bleeding after 34 weeks typically requires hospitalization
until delivery due to the risk of sudden, severe hemorrhage. Complete or partial previa
near term is managed expectantly in a hospital setting. Sexual abstinence is required
but insufficient for safe discharge after active bleeding. Returning to work is
contraindicated.
Question 6
A client at 16 weeks gestation reports regular alcohol consumption of 3-4 drinks per
day. Which potential fetal complication should the nurse prioritize in client education?
A. Fetal alcohol spectrum disorders including growth restriction and
neurodevelopmental abnormalities
B. Congenital heart defects specifically related to septal wall malformations
C. Renal agenesis caused by direct alcohol toxicity to the metanephric kidney
D. Skeletal dysplasia resulting from impaired calcium metabolism
Correct Answer: A
Detailed Rationales | Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded(Galen College)
EXAM INFORMATION
Total Questions: 60
Recommended Time: 90 Minutes
Passing Threshold: 78%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Professional Decision-Making Questions
Difficulty Level: Comprehensive
==============================
SECTION 1: Antepartum Care and Maternal Physiology
Question 1
A client at 28 weeks gestation presents to the prenatal clinic with a blood pressure of
152/96 mmHg, 2+ proteinuria, and reports seeing spots in her visual field. Which
nursing intervention is the priority?
A. Administer a bolus of magnesium sulfate and prepare for seizure precautions
B. Place the client in a supine position and initiate continuous fetal monitoring
C. Administer an IV bolus of normal saline and prepare for immediate delivery
D. Obtain a stat urine culture and administer prophylactic antibiotics
Correct Answer: A
Rationale: The client is exhibiting signs of severe preeclampsia with visual disturbances,
hypertension, and proteinuria. Magnesium sulfate is the anticonvulsant of choice to
prevent eclamptic seizures. Seizure precautions are a priority. A supine position is
contraindicated due to uterine compression of the vena cava. Immediate delivery is not
,the first intervention at 28 weeks without stabilization. Antibiotics are not indicated
without evidence of infection.
Question 2
A 32-year-old primigravida at 18 weeks gestation asks the nurse why she needs the
quad screen test. Which response by the nurse is most accurate?
A. The test identifies open neural tube defects and certain chromosomal abnormalities
by measuring specific maternal serum markers
B. The test confirms the presence of Down syndrome and requires amniocentesis if
results are positive
C. The test evaluates placental function and determines if the fetus is receiving
adequate oxygenation
D. The test is mandatory for all pregnant clients and must be completed before 16
weeks gestation
Correct Answer: A
Rationale: The quad screen measures maternal serum alpha-fetoprotein, hCG,
unconjugated estriol, and inhibin-A to assess risk for open neural tube defects and
trisomies. It is a screening test, not diagnostic. It does not confirm Down syndrome,
evaluate placental oxygenation, or is mandatory.
Question 3
A pregnant client at 24 weeks gestation with pregestational diabetes has a fasting
blood glucose of 128 mg/dL and a 2-hour postprandial glucose of 168 mg/dL. Which
nursing action is most appropriate?
A. Collaborate with the provider to adjust insulin dosing and reinforce dietary counseling
B. Advise the client that these values are within normal limits for the second trimester
C. Instruct the client to increase carbohydrate intake to prevent hypoglycemia
,D. Prepare the client for immediate induction of labor due to poor glycemic control
Correct Answer: A
Rationale: For pregestational diabetes, fasting glucose should be less than 95 mg/dL
and 2-hour postprandial less than 120 mg/dL. These elevated values indicate the need
for insulin adjustment and dietary reinforcement. The values are not normal. Increasing
carbohydrates would worsen control. Immediate induction is not indicated at 24 weeks.
Question 4
A client at 10 weeks gestation reports severe nausea and vomiting, has lost 8 pounds in
two weeks, and shows signs of dehydration. Which laboratory finding would the nurse
expect to see?
A. Elevated serum ketones and increased blood urea nitrogen
B. Decreased hematocrit and increased serum potassium
C. Normal liver enzymes and decreased thyroid-stimulating hormone
D. Decreased urine specific gravity and increased serum bicarbonate
Correct Answer: A
Rationale: Hyperemesis gravidarum leads to dehydration, starvation ketosis, and
prerenal azotemia, resulting in elevated ketones and increased BUN. Hematocrit
typically increases with dehydration. Electrolyte imbalances usually show decreased
potassium due to vomiting. Urine specific gravity increases with dehydration, and
metabolic alkalosis may occur, not increased bicarbonate.
Question 5
, A nurse is caring for a client at 34 weeks gestation who was diagnosed with placenta
previa after painless vaginal bleeding. The client asks when she can go home. Which
response by the nurse is most appropriate?
A. You will likely remain hospitalized until delivery because bleeding can recur suddenly
and become hemorrhagic
B. You can go home now as long as you avoid sexual intercourse and strenuous activity
C. You will be discharged after the bleeding stops and you can return to work with light
duty
D. Home care is appropriate if you have a reliable vehicle and live within 30 minutes of
the hospital
Correct Answer: A
Rationale: Placenta previa with bleeding after 34 weeks typically requires hospitalization
until delivery due to the risk of sudden, severe hemorrhage. Complete or partial previa
near term is managed expectantly in a hospital setting. Sexual abstinence is required
but insufficient for safe discharge after active bleeding. Returning to work is
contraindicated.
Question 6
A client at 16 weeks gestation reports regular alcohol consumption of 3-4 drinks per
day. Which potential fetal complication should the nurse prioritize in client education?
A. Fetal alcohol spectrum disorders including growth restriction and
neurodevelopmental abnormalities
B. Congenital heart defects specifically related to septal wall malformations
C. Renal agenesis caused by direct alcohol toxicity to the metanephric kidney
D. Skeletal dysplasia resulting from impaired calcium metabolism
Correct Answer: A
