NSG 3500 EXAM 4 (GALEN) NEWEST 2026
TEST BANK| NSG3500 MATERNITY EXAM 4
REVIEW
1. A 34-week gestation patient presents with a blood pressure of 158/102
mmHg, 3+ proteinuria, and reports a severe headache and epigastric pain.
Which laboratory value would the nurse expect to be elevated in this patient?
A) Platelet count
B) Serum albumin
C) Liver transaminases (AST/ALT)
D) Serum calcium
Correct Answer: C)
Rationale: Epigastric/RUQ pain, headache, and elevated BP with proteinuria
suggest HELLP syndrome or severe preeclampsia. HELLP involves Hemolysis,
Elevated Liver enzymes, and Low Platelets. AST/ALT would be elevated due to
hepatic ischemia. Platelets would be decreased, not elevated.
2. A nurse is administering Magnesium Sulfate IV to a patient with severe
preeclampsia. Which assessment finding indicates magnesium toxicity requiring
immediate intervention?
A) Urinary output of 35 mL/hr
B) Deep tendon reflexes 2+
C) Respiratory rate of 10 breaths/min
D) Fetal heart rate of 140 bpm
Correct Answer: C)
Rationale: Magnesium toxicity depresses the central nervous system and
respiratory muscles. A respiratory rate < 12/min is a critical sign of toxicity. Urine
output > 30 mL/hr is acceptable. DTRs of 2+ are normal (loss of DTRs is the first
sign of toxicity).
,3. The antidote for Magnesium Sulfate toxicity is:
A) Naloxone
B) Protamine sulfate
C) Calcium gluconate
D) Vitamin K
Correct Answer: C)
Rationale: Calcium gluconate 10% is the specific antidote for magnesium toxicity.
It antagonizes the effects of magnesium at the neuromuscular junction. Naloxone
is for opioids, protamine for heparin, and Vitamin K for warfarin.
4. A patient with preeclampsia is on seizure precautions. Which of the following
nursing interventions is the priority?
A) Restrict oral fluids to 1000 mL/day
B) Keep the bed in the lowest position with padded side rails
C) Perform vaginal exams every 2 hours
D) Encourage high-sodium foods to increase blood volume
Correct Answer: B)
Rationale: Seizure precautions (padded side rails, low bed, airway/suction at
bedside) are vital to prevent injury during an eclamptic seizure. Vaginal exams are
contraindicated if bleeding is present and not done routinely. Fluids are monitored
strictly, but not typically restricted to 1000 mL unless pulmonary edema is
present. Sodium is restricted, not encouraged.
5. A patient at 28 weeks gestation has a 1-hour glucose challenge test result of
155 mg/dL. What is the nurse's next action?
A) Diagnose the patient with Gestational Diabetes
B) Instruct the patient to begin a 1200-calorie diabetic diet
C) Schedule a 3-hour oral glucose tolerance test (OGTT)
D) Administer a dose of insulin glargine
,Correct Answer: C)
Rationale: A 1-hour glucose challenge result > 130-140 mg/dL is abnormal and
requires a 3-hour OGTT for definitive diagnosis. A single elevated screen is not
diagnostic.
6. A patient with Gestational Diabetes is checking her blood glucose. Which of
the following values indicates successful glycemic control?
A) Fasting: 102 mg/dL
B) 1-hour postprandial: 135 mg/dL
C) 2-hour postprandial: 145 mg/dL
D) Random: 180 mg/dL
Correct Answer: B)
Rationale: Target goals for GDM are: Fasting < 95 mg/dL, 1-hour post-meal < 140
mg/dL, and 2-hour post-meal < 120 mg/dL. 135 mg/dL is within the 1-hour goal.
7. A nurse is caring for a patient at 36 weeks with placenta previa. The patient
suddenly complains of abdominal pain and the nurse notes a rigid, board-like
abdomen. The fetal heart rate shows severe variable decelerations. The nurse
should prepare for which emergency?
A) Administration of Magnesium Sulfate
B) Immediate cesarean section
C) Insertion of a Foley catheter for induction
D) Nitrazine test to check for rupture
Correct Answer: B)
Rationale: Placenta previa is classically painless bleeding. If this patient now
has pain and a rigid abdomen, she likely has a concealed placental abruption
(which can happen with previa). This is an obstetric emergency requiring
immediate delivery via C-section.
, 8. A patient at 32 weeks gestation is admitted with preterm labor. The provider
orders Betamethasone. The nurse understands the purpose of this medication is
to:
A) Stop uterine contractions
B) Accelerate fetal lung maturity
C) Decrease maternal blood pressure
D) Treat a maternal infection
Correct Answer: B)
Rationale: Betamethasone is a corticosteroid given to stimulate fetal surfactant
production, accelerating lung maturity and reducing the risk of Respiratory
Distress Syndrome (RDS). It does not stop contractions (tocolytics do that).
9. A patient is receiving Nifedipine for preterm labor. The nurse should monitor
the patient for which adverse effect?
A) Hypertension
B) Tachycardia
C) Hypotension
D) Hyperglycemia
Correct Answer: C)
Rationale: Nifedipine is a calcium channel blocker that causes vasodilation. The
primary adverse effect is maternal hypotension, which can reduce uteroplacental
perfusion. Terbutaline causes tachycardia/hyperglycemia.
10. The nurse notes a "turtle sign" during a delivery. Which maneuver should
the nurse anticipate assisting with?
A) Leopold's maneuvers
B) McRoberts' maneuver
C) Fundal pressure
D) Kristeller maneuver
TEST BANK| NSG3500 MATERNITY EXAM 4
REVIEW
1. A 34-week gestation patient presents with a blood pressure of 158/102
mmHg, 3+ proteinuria, and reports a severe headache and epigastric pain.
Which laboratory value would the nurse expect to be elevated in this patient?
A) Platelet count
B) Serum albumin
C) Liver transaminases (AST/ALT)
D) Serum calcium
Correct Answer: C)
Rationale: Epigastric/RUQ pain, headache, and elevated BP with proteinuria
suggest HELLP syndrome or severe preeclampsia. HELLP involves Hemolysis,
Elevated Liver enzymes, and Low Platelets. AST/ALT would be elevated due to
hepatic ischemia. Platelets would be decreased, not elevated.
2. A nurse is administering Magnesium Sulfate IV to a patient with severe
preeclampsia. Which assessment finding indicates magnesium toxicity requiring
immediate intervention?
A) Urinary output of 35 mL/hr
B) Deep tendon reflexes 2+
C) Respiratory rate of 10 breaths/min
D) Fetal heart rate of 140 bpm
Correct Answer: C)
Rationale: Magnesium toxicity depresses the central nervous system and
respiratory muscles. A respiratory rate < 12/min is a critical sign of toxicity. Urine
output > 30 mL/hr is acceptable. DTRs of 2+ are normal (loss of DTRs is the first
sign of toxicity).
,3. The antidote for Magnesium Sulfate toxicity is:
A) Naloxone
B) Protamine sulfate
C) Calcium gluconate
D) Vitamin K
Correct Answer: C)
Rationale: Calcium gluconate 10% is the specific antidote for magnesium toxicity.
It antagonizes the effects of magnesium at the neuromuscular junction. Naloxone
is for opioids, protamine for heparin, and Vitamin K for warfarin.
4. A patient with preeclampsia is on seizure precautions. Which of the following
nursing interventions is the priority?
A) Restrict oral fluids to 1000 mL/day
B) Keep the bed in the lowest position with padded side rails
C) Perform vaginal exams every 2 hours
D) Encourage high-sodium foods to increase blood volume
Correct Answer: B)
Rationale: Seizure precautions (padded side rails, low bed, airway/suction at
bedside) are vital to prevent injury during an eclamptic seizure. Vaginal exams are
contraindicated if bleeding is present and not done routinely. Fluids are monitored
strictly, but not typically restricted to 1000 mL unless pulmonary edema is
present. Sodium is restricted, not encouraged.
5. A patient at 28 weeks gestation has a 1-hour glucose challenge test result of
155 mg/dL. What is the nurse's next action?
A) Diagnose the patient with Gestational Diabetes
B) Instruct the patient to begin a 1200-calorie diabetic diet
C) Schedule a 3-hour oral glucose tolerance test (OGTT)
D) Administer a dose of insulin glargine
,Correct Answer: C)
Rationale: A 1-hour glucose challenge result > 130-140 mg/dL is abnormal and
requires a 3-hour OGTT for definitive diagnosis. A single elevated screen is not
diagnostic.
6. A patient with Gestational Diabetes is checking her blood glucose. Which of
the following values indicates successful glycemic control?
A) Fasting: 102 mg/dL
B) 1-hour postprandial: 135 mg/dL
C) 2-hour postprandial: 145 mg/dL
D) Random: 180 mg/dL
Correct Answer: B)
Rationale: Target goals for GDM are: Fasting < 95 mg/dL, 1-hour post-meal < 140
mg/dL, and 2-hour post-meal < 120 mg/dL. 135 mg/dL is within the 1-hour goal.
7. A nurse is caring for a patient at 36 weeks with placenta previa. The patient
suddenly complains of abdominal pain and the nurse notes a rigid, board-like
abdomen. The fetal heart rate shows severe variable decelerations. The nurse
should prepare for which emergency?
A) Administration of Magnesium Sulfate
B) Immediate cesarean section
C) Insertion of a Foley catheter for induction
D) Nitrazine test to check for rupture
Correct Answer: B)
Rationale: Placenta previa is classically painless bleeding. If this patient now
has pain and a rigid abdomen, she likely has a concealed placental abruption
(which can happen with previa). This is an obstetric emergency requiring
immediate delivery via C-section.
, 8. A patient at 32 weeks gestation is admitted with preterm labor. The provider
orders Betamethasone. The nurse understands the purpose of this medication is
to:
A) Stop uterine contractions
B) Accelerate fetal lung maturity
C) Decrease maternal blood pressure
D) Treat a maternal infection
Correct Answer: B)
Rationale: Betamethasone is a corticosteroid given to stimulate fetal surfactant
production, accelerating lung maturity and reducing the risk of Respiratory
Distress Syndrome (RDS). It does not stop contractions (tocolytics do that).
9. A patient is receiving Nifedipine for preterm labor. The nurse should monitor
the patient for which adverse effect?
A) Hypertension
B) Tachycardia
C) Hypotension
D) Hyperglycemia
Correct Answer: C)
Rationale: Nifedipine is a calcium channel blocker that causes vasodilation. The
primary adverse effect is maternal hypotension, which can reduce uteroplacental
perfusion. Terbutaline causes tachycardia/hyperglycemia.
10. The nurse notes a "turtle sign" during a delivery. Which maneuver should
the nurse anticipate assisting with?
A) Leopold's maneuvers
B) McRoberts' maneuver
C) Fundal pressure
D) Kristeller maneuver
