NSG 3500 Final Exam V1 | NSG 3500
Maternal Health Review | Actual Q&A with
Rationale (NSG3500 Final Exam) | Galen
College of Nursing
1. A nurse is reviewing the GTPAL of a client who is currently pregnant. The client has one
child born at 39 weeks, twins born at 34 weeks, and had one spontaneous abortion at 10
weeks. What is the correct GTPAL?
A. G4, T2, P1, A1, L2
B. G3, T1, P2, A1, L3
C. G4, T1, P1, A1, L3
D. G4, T1, P2, A1, L3
Answer: C
Rationale: The client is currently pregnant, which makes G=4. The term birth at 39 weeks
is T=1, and the twins born at 34 weeks count as one preterm event (P=1) but two living
children (L=3). The miscarriage at 10 weeks is A=1, resulting in G4T1P1A1L3.
2. A client’s last menstrual period began on May 10th. Using Naegele’s rule, what is the
estimated date of delivery (EDD)?
A. February 10th
B. August 17th
,C. February 17th
D. February 3rd
Answer: C
Rationale: Naegele’s rule calculates the EDD by subtracting three months and adding
seven days to the first day of the last menstrual period. May 10 minus three months is
February 10, plus seven days equals February 17. This calculation assumes a standard 28-
day menstrual cycle.
3. A nurse is assessing a client at 34 weeks gestation who reports a sudden onset of severe
abdominal pain and vaginal bleeding. The abdomen is board-like and tender. Which condition
should the nurse suspect?
A. Abruptio placentae
B. Vasa previa
C. Placenta previa
D. Uterine inversion
Answer: A
Rationale: Abruptio placentae is characterized by the premature separation of the
placenta from the uterine wall, leading to painful bleeding and a rigid abdomen. In contrast,
placenta previa typically presents with painless, bright red bleeding. This is a medical
emergency that requires immediate intervention to ensure fetal and maternal safety.
, 4. Which medication is the primary antidote for magnesium sulfate toxicity in a preeclamptic
client?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Hydralazine
Answer: B
Rationale: Calcium gluconate is the specific antagonist used to reverse the effects of
magnesium sulfate toxicity. Signs of toxicity include respiratory depression, loss of deep
tendon reflexes, and decreased urinary output. The nurse must keep this medication
readily available at the bedside whenever a magnesium drip is infusing.
5. A nurse observes late decelerations on the fetal heart rate monitor. Which action should
the nurse take first?
A. Increase the rate of the IV Pitocin infusion
B. Administer oxygen via non-rebreather mask at 10 L/min
C. Perform a vaginal exam to check for cord prolapse
D. Assist the client into a supine position
Answer: B
Maternal Health Review | Actual Q&A with
Rationale (NSG3500 Final Exam) | Galen
College of Nursing
1. A nurse is reviewing the GTPAL of a client who is currently pregnant. The client has one
child born at 39 weeks, twins born at 34 weeks, and had one spontaneous abortion at 10
weeks. What is the correct GTPAL?
A. G4, T2, P1, A1, L2
B. G3, T1, P2, A1, L3
C. G4, T1, P1, A1, L3
D. G4, T1, P2, A1, L3
Answer: C
Rationale: The client is currently pregnant, which makes G=4. The term birth at 39 weeks
is T=1, and the twins born at 34 weeks count as one preterm event (P=1) but two living
children (L=3). The miscarriage at 10 weeks is A=1, resulting in G4T1P1A1L3.
2. A client’s last menstrual period began on May 10th. Using Naegele’s rule, what is the
estimated date of delivery (EDD)?
A. February 10th
B. August 17th
,C. February 17th
D. February 3rd
Answer: C
Rationale: Naegele’s rule calculates the EDD by subtracting three months and adding
seven days to the first day of the last menstrual period. May 10 minus three months is
February 10, plus seven days equals February 17. This calculation assumes a standard 28-
day menstrual cycle.
3. A nurse is assessing a client at 34 weeks gestation who reports a sudden onset of severe
abdominal pain and vaginal bleeding. The abdomen is board-like and tender. Which condition
should the nurse suspect?
A. Abruptio placentae
B. Vasa previa
C. Placenta previa
D. Uterine inversion
Answer: A
Rationale: Abruptio placentae is characterized by the premature separation of the
placenta from the uterine wall, leading to painful bleeding and a rigid abdomen. In contrast,
placenta previa typically presents with painless, bright red bleeding. This is a medical
emergency that requires immediate intervention to ensure fetal and maternal safety.
, 4. Which medication is the primary antidote for magnesium sulfate toxicity in a preeclamptic
client?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Hydralazine
Answer: B
Rationale: Calcium gluconate is the specific antagonist used to reverse the effects of
magnesium sulfate toxicity. Signs of toxicity include respiratory depression, loss of deep
tendon reflexes, and decreased urinary output. The nurse must keep this medication
readily available at the bedside whenever a magnesium drip is infusing.
5. A nurse observes late decelerations on the fetal heart rate monitor. Which action should
the nurse take first?
A. Increase the rate of the IV Pitocin infusion
B. Administer oxygen via non-rebreather mask at 10 L/min
C. Perform a vaginal exam to check for cord prolapse
D. Assist the client into a supine position
Answer: B
