NUR 231 MATERNAL NURSING
COMPREHENSIVE FINAL EXAM
QUESTIONS AND ANSWERS
1. A patient at 32 weeks gestation presents with sudden, sharp abdominal pain and a rigid,
board-like abdomen. The nurse notes dark red vaginal bleeding. What is the priority nursing
intervention?
A. Perform a vaginal exam to check for dilation
B. Monitor fetal heart rate for the next 30 minutes
C. Administer oxygen via non-rebreather mask and notify the provider
D. Encourage the patient to ambulate to relieve pain
Answer: C
Conceptual Explanation: These symptoms indicate Abruptio Placentae. Vaginal exams are
contraindicated. Immediate oxygenation and notification of the provider are critical as this
is a medical emergency.
2. A nurse is caring for a client receiving Magnesium Sulfate for preeclampsia. The nurse
notes absent deep tendon reflexes and a respiratory rate of 10 breaths/min. Which
medication should the nurse prepare?
A. Naloxone
,B. Terbutaline
C. Hydralazine
D. Calcium Gluconate
Answer: D
Conceptual Explanation: Calcium Gluconate is the antidote for Magnesium Sulfate
toxicity, which is manifested by respiratory depression and loss of DTRs.
3. A pregnant client’s LMP was February 10th. Using Naegele’s Rule, what is the Estimated
Date of Delivery (EDD)?
A. November 3rd
B. November 17th
C. May 17th
D. November 24th
Answer: B
Conceptual Explanation: Naegele’s Rule: Subtract 3 months from the LMP, add 7 days, and
add 1 year (Feb 10 - 3 months = Nov 10 + 7 days = Nov 17).
4. Which fetal heart rate pattern is most indicative of uteroplacental insufficiency?
A. Early decelerations
B. Late decelerations
, C. Variable decelerations
D. Accelerations
Answer: B
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency
and require immediate intervention to improve fetal oxygenation.
5. A client is in the transition phase of the first stage of labor. Which behavior is the nurse
most likely to observe?
A. The client is talkative and excited
B. The client is irritable, nauseated, and feels a loss of control
C. The client is focused, serious, and using breathing techniques
D. The client is sleeping between contractions
Answer: B
Conceptual Explanation: The transition phase (8-10 cm) is characterized by intensity,
irritability, nausea, and an urge to push.
6. When assessing a newborn with a suspected Cephalohematoma, which finding
distinguishes it from Caput Succedaneum?
A. It crosses the suture lines
B. It resolves within 24 hours
C. It is present at the time of birth
COMPREHENSIVE FINAL EXAM
QUESTIONS AND ANSWERS
1. A patient at 32 weeks gestation presents with sudden, sharp abdominal pain and a rigid,
board-like abdomen. The nurse notes dark red vaginal bleeding. What is the priority nursing
intervention?
A. Perform a vaginal exam to check for dilation
B. Monitor fetal heart rate for the next 30 minutes
C. Administer oxygen via non-rebreather mask and notify the provider
D. Encourage the patient to ambulate to relieve pain
Answer: C
Conceptual Explanation: These symptoms indicate Abruptio Placentae. Vaginal exams are
contraindicated. Immediate oxygenation and notification of the provider are critical as this
is a medical emergency.
2. A nurse is caring for a client receiving Magnesium Sulfate for preeclampsia. The nurse
notes absent deep tendon reflexes and a respiratory rate of 10 breaths/min. Which
medication should the nurse prepare?
A. Naloxone
,B. Terbutaline
C. Hydralazine
D. Calcium Gluconate
Answer: D
Conceptual Explanation: Calcium Gluconate is the antidote for Magnesium Sulfate
toxicity, which is manifested by respiratory depression and loss of DTRs.
3. A pregnant client’s LMP was February 10th. Using Naegele’s Rule, what is the Estimated
Date of Delivery (EDD)?
A. November 3rd
B. November 17th
C. May 17th
D. November 24th
Answer: B
Conceptual Explanation: Naegele’s Rule: Subtract 3 months from the LMP, add 7 days, and
add 1 year (Feb 10 - 3 months = Nov 10 + 7 days = Nov 17).
4. Which fetal heart rate pattern is most indicative of uteroplacental insufficiency?
A. Early decelerations
B. Late decelerations
, C. Variable decelerations
D. Accelerations
Answer: B
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency
and require immediate intervention to improve fetal oxygenation.
5. A client is in the transition phase of the first stage of labor. Which behavior is the nurse
most likely to observe?
A. The client is talkative and excited
B. The client is irritable, nauseated, and feels a loss of control
C. The client is focused, serious, and using breathing techniques
D. The client is sleeping between contractions
Answer: B
Conceptual Explanation: The transition phase (8-10 cm) is characterized by intensity,
irritability, nausea, and an urge to push.
6. When assessing a newborn with a suspected Cephalohematoma, which finding
distinguishes it from Caput Succedaneum?
A. It crosses the suture lines
B. It resolves within 24 hours
C. It is present at the time of birth
