Maternity CJE Exam | Latest Update 2026/2027 | 200 Practice
Questions and Verified Answers | Complete Q&A Guide | A+
Graded
1. A client at 10 weeks' gestation reports severe nausea and vomiting, weight loss, and ketones in the
urine. Which prescription should the nurse question?
A) NPO with IV lactated Ringer's
B) Ondansetron IV as prescribed
C) Promethazine IM as prescribed
D) Discharge home with oral fluids and crackers
Answer: D
Explanation: Discharge home with oral fluids is inappropriate for a client with hyperemesis gravidarum
who has ketones and weight loss. IV fluids and antiemetics are necessary. Discharging her with oral
fluids could lead to continued dehydration and electrolyte imbalance.
2. A client at 38 weeks' gestation reports a sudden gush of fluid from the vagina. What is the priority
nursing action?
A) Check fetal heart rate
B) Test fluid with nitrazine paper
C) Inspect perineum for crowning
D) Ask when she last voided
Answer: A
,Explanation: Priority is to assess fetal wellbeing. A sudden gush of fluid may be accompanied by
umbilical cord prolapse, which compromises fetal oxygenation. FHR assessment must be done
immediately.
3. A client at 32 weeks' gestation has painless, bright red vaginal bleeding. Which condition does the
nurse suspect?
A) Placenta previa
B) Abruptio placentae
C) Threatened abortion
D) Ectopic pregnancy
Answer: A
Explanation: Painless bright red bleeding in the third trimester is the classic presentation of placenta
previa. Abruptio placentae typically presents with painful dark bleeding.
4. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding
would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendon reflexes 2+
D) Difficulty in arousing
Answer: C
,Explanation: With magnesium sulfate, deep tendon reflexes of 2+ are normal and indicate a therapeutic
level. Urinary output <30 mL/hr, respiratory rate <12, and diminished arousal indicate magnesium
toxicity.
5. A nurse is assessing a client at 34 weeks' gestation with a BP of 152/96 mmHg. Which additional
finding is the priority to report?
A) Trace proteinuria
B) 2+ pedal edema
C) Frontal headache and blurred vision
D) Weight gain of 1 lb in a week
Answer: C
Explanation: Frontal headache and blurred vision are signs of severe preeclampsia and possible
impending eclampsia. These neurologic symptoms indicate worsening disease and require immediate
reporting and intervention.
6. Which laboratory result is the most significant indicator of HELLP syndrome?
A) Elevated blood glucose
B) Decreased serum creatinine
C) Low platelet count (<100,000/mm³)
D) Increased hemoglobin
Answer: C
Explanation: HELLP syndrome is characterized by Hemolysis, Elevated Liver enzymes, and Low Platelet
count. A platelet count below 100,000/mm³ is a key diagnostic finding.
, 7. Using Nägele's rule, if a client's LMP was August 19, 2025, what is the EDB?
A) May 12, 2026
B) May 26, 2026
C) May 19, 2026
D) June 2, 2026
Answer: B
Explanation: Nägele's rule: Subtract 3 months from the first day of the LMP and add 7 days. August 19 3
months = May 19; May 19 + 7 days = May 26, 2026.
8. A nurse is monitoring a FHR tracing and notes late decelerations. What is the priority intervention?
A) Turn the mother to the left side and increase IV fluids
B) Administer oxygen via nasal cannula at 2 L/min
C) Prepare for immediate forceps delivery
D) Continue to monitor for 15 minutes
Answer: A
Explanation: Late decelerations indicate uteroplacental insufficiency. The priority interventions are to
position the mother on her left side to improve placental perfusion and increase IV fluids. Oxygen should
be administered at 810 L/min via nonrebreather mask, not 2 L/min nasal cannula.
Questions and Verified Answers | Complete Q&A Guide | A+
Graded
1. A client at 10 weeks' gestation reports severe nausea and vomiting, weight loss, and ketones in the
urine. Which prescription should the nurse question?
A) NPO with IV lactated Ringer's
B) Ondansetron IV as prescribed
C) Promethazine IM as prescribed
D) Discharge home with oral fluids and crackers
Answer: D
Explanation: Discharge home with oral fluids is inappropriate for a client with hyperemesis gravidarum
who has ketones and weight loss. IV fluids and antiemetics are necessary. Discharging her with oral
fluids could lead to continued dehydration and electrolyte imbalance.
2. A client at 38 weeks' gestation reports a sudden gush of fluid from the vagina. What is the priority
nursing action?
A) Check fetal heart rate
B) Test fluid with nitrazine paper
C) Inspect perineum for crowning
D) Ask when she last voided
Answer: A
,Explanation: Priority is to assess fetal wellbeing. A sudden gush of fluid may be accompanied by
umbilical cord prolapse, which compromises fetal oxygenation. FHR assessment must be done
immediately.
3. A client at 32 weeks' gestation has painless, bright red vaginal bleeding. Which condition does the
nurse suspect?
A) Placenta previa
B) Abruptio placentae
C) Threatened abortion
D) Ectopic pregnancy
Answer: A
Explanation: Painless bright red bleeding in the third trimester is the classic presentation of placenta
previa. Abruptio placentae typically presents with painful dark bleeding.
4. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding
would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendon reflexes 2+
D) Difficulty in arousing
Answer: C
,Explanation: With magnesium sulfate, deep tendon reflexes of 2+ are normal and indicate a therapeutic
level. Urinary output <30 mL/hr, respiratory rate <12, and diminished arousal indicate magnesium
toxicity.
5. A nurse is assessing a client at 34 weeks' gestation with a BP of 152/96 mmHg. Which additional
finding is the priority to report?
A) Trace proteinuria
B) 2+ pedal edema
C) Frontal headache and blurred vision
D) Weight gain of 1 lb in a week
Answer: C
Explanation: Frontal headache and blurred vision are signs of severe preeclampsia and possible
impending eclampsia. These neurologic symptoms indicate worsening disease and require immediate
reporting and intervention.
6. Which laboratory result is the most significant indicator of HELLP syndrome?
A) Elevated blood glucose
B) Decreased serum creatinine
C) Low platelet count (<100,000/mm³)
D) Increased hemoglobin
Answer: C
Explanation: HELLP syndrome is characterized by Hemolysis, Elevated Liver enzymes, and Low Platelet
count. A platelet count below 100,000/mm³ is a key diagnostic finding.
, 7. Using Nägele's rule, if a client's LMP was August 19, 2025, what is the EDB?
A) May 12, 2026
B) May 26, 2026
C) May 19, 2026
D) June 2, 2026
Answer: B
Explanation: Nägele's rule: Subtract 3 months from the first day of the LMP and add 7 days. August 19 3
months = May 19; May 19 + 7 days = May 26, 2026.
8. A nurse is monitoring a FHR tracing and notes late decelerations. What is the priority intervention?
A) Turn the mother to the left side and increase IV fluids
B) Administer oxygen via nasal cannula at 2 L/min
C) Prepare for immediate forceps delivery
D) Continue to monitor for 15 minutes
Answer: A
Explanation: Late decelerations indicate uteroplacental insufficiency. The priority interventions are to
position the mother on her left side to improve placental perfusion and increase IV fluids. Oxygen should
be administered at 810 L/min via nonrebreather mask, not 2 L/min nasal cannula.
