NU 335 EXAM 2 PRACTICE QUESTIONS 2026/2027 – NURSING STUDY GUIDE,
TEST PREP & EXAM REVIEW
The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would support the
diagnosis of hyperemesis gravidarum?
a. Hypercalcemia.
b. Hypokalemia.
c. Hyperkalemia.
d. Hypocalcemia. - correct answer ✔✔b. Hypokalemia.
Rationale: In severe cases, hyperemesis causes dehydration, which leads to fluid-electrolyte imbalance.
Severe potassium loss can disrupt cardiac functioning. Potassium loss (hypokalemia), not hyperkalemia,
is characteristic of hyperemesis gravidarum. Neither hypercalcemia nor hypocalcemia (low calcium) is
characteristic of hyperemesis gravidarum.
If a client does not respond to standard home treatment for severe hyperemesis gravidarum, the nurse
will anticipate adding which therapy on an outpatient basis?
a. Low-fat soft diet.
b. Complex carbohydrates with limited liquids.
c. IV fluids.
d. Total parenteral nutrition. - correct answer ✔✔c. IV fluids.
Rationale: If the woman does not respond to standard approaches to the control of nausea and vomiting
in pregnancy, she might require intravenous (IV) fluids on an outpatient basis. Total parenteral nutrition
would be started only if the client were unresponsive to IV hydration. Lowfat soft diet and complex
carbohydrates with limited liquids are progressive diets after the client is stabilized for hyperemesis
gravidarum.
A client at 30 weeks' gestation is admitted to the maternity unit with vaginal bleeding. What should be
the nurse's initial nursing action?
a. Count and weigh peripads.
b. Start an intravenous infusion drip.
c. Assess blood pressure and pulse.
d. Observe for pallor, clammy skin, and perspiration. - correct answer ✔✔c. Assess blood pressure and
pulse.
Rationale: The nurse's initial action for a client with vaginal bleeding at 30 weeks would be to assess
blood pressure and pulse. Counting and weighing peripads; observing for pallor, clammy skin, and
perspiration; and starting an intravenous infusion drip are all important actions for this client; they are
just not the initial action.
A prenatal client at 16 weeks' gestation presents to the clinic with unexplained bright red bleeding,
cramping, and backache, which she has had for the past two days. A pelvic exam reveals a closed cervix.
What type of abortion does this indicate?
a. Threatened.
b. Incomplete.
c. Missed.
d. Imminent. - correct answer ✔✔a. Threatened.
,Rationale: A threatened abortion (miscarriage) has symptoms of vaginal bleeding and backache without
cervical dilation. In an imminent abortion, the internal cervical os is dilated. Although the cervix is closed
in a missed abortion, other symptoms would include a regression in breast changes and a brownish
vaginal discharge. Diagnosis is made based on history, pelvic exam, and a negative pregnancy test. With
an incomplete abortion, the embryo has passed out of the uterus, but the placenta remains, and the
internal os is slightly dilated.
The client asks for information about ectopic pregnancy. The nurse correctly responds by saying ectopic
pregnancy is caused by: (Select all that apply.)
a. Pelvic inflammatory disease (PID).
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
d. Endometriosis. - correct answer ✔✔a. Pelvic inflammatory disease (PID).
d. Endometriosis.
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
Rationale: Ectopic pregnancy can be caused by tubal damage from pelvic inflammatory disease (PID),
previous tubal surgery, congenital anomalies of the tube, endometriosis, previous ectopic pregnancy,
presence of an IUD, and in utero exposure to diethylstilbestrol (DES).
A client presents to the physician's office with complaints of right-sided abdominal pain, dizziness, and
vaginal bleeding. A pelvic exam determines adnexal tenderness. What diagnosis should the nurse
suspect?
a. Cholelithiasis.
b. Appendicitis.
c. Threatened abortion.
d. Ectopic pregnancy. - correct answer ✔✔d. Ectopic pregnancy.
Rationale: A client with an ectopic pregnancy would present to the physician's office with complaints of
one-sided abdominal pain, dizziness, and vaginal bleeding, and would have adnexal tenderness on exam.
Clients with a threatened abortion would have complaints of unexplained bleeding, cramping, or
backache. A pelvic exam would reveal a closed cervix. Clients with appendicitis would have complaints of
lower right-sided tenderness, low-grade fever, nausea, and often vomiting. Clients with cholelithiasis
would have complaints of epigastric distress, such as fullness, distention, and vague pain in the right
upper quadrant of the abdomen.
A client at 15 weeks' gestation presents to the prenatal clinic with "prune juice"-like vaginal bleeding.
Other assessment data include a hematocrit of 10 and complaints of severe nausea and vomiting. What
diagnosis should the nurse suspect?
a. Prolapsed cord.
b. Hydatidiform mole.
c. Placenta previa.
d. Abruptio placentae. - correct answer ✔✔b. Hydatidiform mole.
Rationale: In hydatidiform mole, vaginal bleeding occurs almost universally. It is often brownish due to
liquefaction of the uterine clot. In addition, because serum hCG levels are higher with molar pregnancy
than with normal pregnancy, the woman might experience hyperemesis gravidarum. Anemia occurs
frequently due to blood loss and poor nutrition secondary to hyperemesis. Placenta previa symptoms
include painless bright red vaginal bleeding, usually in the third trimester of pregnancy. Prolapsed cord
symptoms include a trickle of bright red vaginal blood and possibly a visible cord at the vaginal opening.
, Abruptio placentae symptoms include vaginal bleeding (bright red or dark red), abdominal pain, and
uterine tenderness.
A client is being maintained at home with a diagnosis of mild pre-eclampsia. Which of the following
complaints require further evaluation? Select all that apply.
a. Headache.
b. Anxiety.
c. Heartburn.
d. Blurred vision. - correct answer ✔✔a. Headache.
d. Blurred vision.
Rationale: Answers (a) and (d) are correct; headache and blurred vision are symptoms associated with
worsening preeclampsia. Answer (c) is incorrect; heartburn is a familiar sensation and is less intense than
the epigastric pain associated with severe preeclampsia. Answer (b) is incorrect; anxiety is a normal
response to a complicated pregnancy.
During a prenatal visit, a client states, "Sometimes my boyfriend hits me, but it is just when he is stressed
at work. I know he loves the baby and me; it's just hard right now. He wouldn't really hurt me." The
nurse's first priority is to:
a. Notify the social worker immediately.
b. Determine the client's immediate safety.
c. Encourage the client to leave her partner as soon as possible for the sake of the baby.
d. Give the client pamphlets with the contact information for local shelters. - correct answer ✔✔b.
Determine the client's immediate safety.
Rationale: Answer (b) is correct; when working with clients who are victims of physical abuse, the
priority is always to determine the client's immediate safety. Answer (a) is incorrect; notifying a social
worker is an appropriate action but it is not the immediate priority. Answer (c) is incorrect; giving
information to victims of abuse must be discreet; if the abuser feels the client may leave, the violence
may escalate. Answer (d) is incorrect; there are numerous factors associated with deciding to leave an
abusive relationship; it is seldom a rapid or easy process. The nurse's role is to support the client in
developing the best safety plan.
Which of the following client statements indicate a need for additional education regarding avoidance of
perinatal infection? Select all that apply.
a. "If I have beta strep in labor, I will most likely need a C-section."
b. "I need to buy a good pair of gloves for when I am working in the garden."
c. "After receiving my rubella immunization, I will avoid getting pregnant for 1 month."
d. "I will not let the cat sleep in our bed now that I am pregnant." - correct answer ✔✔a. "If I have beta
strep in labor, I will most likely need a C-section."
d. "I will not let the cat sleep in our bed now that I am pregnant."
Rationale: GBS requires antibiotic prophylaxis during labor, but a vaginal delivery is not contraindicated.
Toxoplasmosis can be transferred in cat feces; clients should be instructed to avoid handling litter boxes.
The client should avoid pregnancy for 1 month after receiving the rubella immunization and gardening
gloves should be worn during pregnancy to avoid contact with soil organisms. These statements indicate
client understanding.
A client at 28 weeks' gestation is admitted to the labor and birth unit. Which test would most likely be
used to assess the client's comprehensive fetal status?
a. Amniocentesis.
TEST PREP & EXAM REVIEW
The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would support the
diagnosis of hyperemesis gravidarum?
a. Hypercalcemia.
b. Hypokalemia.
c. Hyperkalemia.
d. Hypocalcemia. - correct answer ✔✔b. Hypokalemia.
Rationale: In severe cases, hyperemesis causes dehydration, which leads to fluid-electrolyte imbalance.
Severe potassium loss can disrupt cardiac functioning. Potassium loss (hypokalemia), not hyperkalemia,
is characteristic of hyperemesis gravidarum. Neither hypercalcemia nor hypocalcemia (low calcium) is
characteristic of hyperemesis gravidarum.
If a client does not respond to standard home treatment for severe hyperemesis gravidarum, the nurse
will anticipate adding which therapy on an outpatient basis?
a. Low-fat soft diet.
b. Complex carbohydrates with limited liquids.
c. IV fluids.
d. Total parenteral nutrition. - correct answer ✔✔c. IV fluids.
Rationale: If the woman does not respond to standard approaches to the control of nausea and vomiting
in pregnancy, she might require intravenous (IV) fluids on an outpatient basis. Total parenteral nutrition
would be started only if the client were unresponsive to IV hydration. Lowfat soft diet and complex
carbohydrates with limited liquids are progressive diets after the client is stabilized for hyperemesis
gravidarum.
A client at 30 weeks' gestation is admitted to the maternity unit with vaginal bleeding. What should be
the nurse's initial nursing action?
a. Count and weigh peripads.
b. Start an intravenous infusion drip.
c. Assess blood pressure and pulse.
d. Observe for pallor, clammy skin, and perspiration. - correct answer ✔✔c. Assess blood pressure and
pulse.
Rationale: The nurse's initial action for a client with vaginal bleeding at 30 weeks would be to assess
blood pressure and pulse. Counting and weighing peripads; observing for pallor, clammy skin, and
perspiration; and starting an intravenous infusion drip are all important actions for this client; they are
just not the initial action.
A prenatal client at 16 weeks' gestation presents to the clinic with unexplained bright red bleeding,
cramping, and backache, which she has had for the past two days. A pelvic exam reveals a closed cervix.
What type of abortion does this indicate?
a. Threatened.
b. Incomplete.
c. Missed.
d. Imminent. - correct answer ✔✔a. Threatened.
,Rationale: A threatened abortion (miscarriage) has symptoms of vaginal bleeding and backache without
cervical dilation. In an imminent abortion, the internal cervical os is dilated. Although the cervix is closed
in a missed abortion, other symptoms would include a regression in breast changes and a brownish
vaginal discharge. Diagnosis is made based on history, pelvic exam, and a negative pregnancy test. With
an incomplete abortion, the embryo has passed out of the uterus, but the placenta remains, and the
internal os is slightly dilated.
The client asks for information about ectopic pregnancy. The nurse correctly responds by saying ectopic
pregnancy is caused by: (Select all that apply.)
a. Pelvic inflammatory disease (PID).
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
d. Endometriosis. - correct answer ✔✔a. Pelvic inflammatory disease (PID).
d. Endometriosis.
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
Rationale: Ectopic pregnancy can be caused by tubal damage from pelvic inflammatory disease (PID),
previous tubal surgery, congenital anomalies of the tube, endometriosis, previous ectopic pregnancy,
presence of an IUD, and in utero exposure to diethylstilbestrol (DES).
A client presents to the physician's office with complaints of right-sided abdominal pain, dizziness, and
vaginal bleeding. A pelvic exam determines adnexal tenderness. What diagnosis should the nurse
suspect?
a. Cholelithiasis.
b. Appendicitis.
c. Threatened abortion.
d. Ectopic pregnancy. - correct answer ✔✔d. Ectopic pregnancy.
Rationale: A client with an ectopic pregnancy would present to the physician's office with complaints of
one-sided abdominal pain, dizziness, and vaginal bleeding, and would have adnexal tenderness on exam.
Clients with a threatened abortion would have complaints of unexplained bleeding, cramping, or
backache. A pelvic exam would reveal a closed cervix. Clients with appendicitis would have complaints of
lower right-sided tenderness, low-grade fever, nausea, and often vomiting. Clients with cholelithiasis
would have complaints of epigastric distress, such as fullness, distention, and vague pain in the right
upper quadrant of the abdomen.
A client at 15 weeks' gestation presents to the prenatal clinic with "prune juice"-like vaginal bleeding.
Other assessment data include a hematocrit of 10 and complaints of severe nausea and vomiting. What
diagnosis should the nurse suspect?
a. Prolapsed cord.
b. Hydatidiform mole.
c. Placenta previa.
d. Abruptio placentae. - correct answer ✔✔b. Hydatidiform mole.
Rationale: In hydatidiform mole, vaginal bleeding occurs almost universally. It is often brownish due to
liquefaction of the uterine clot. In addition, because serum hCG levels are higher with molar pregnancy
than with normal pregnancy, the woman might experience hyperemesis gravidarum. Anemia occurs
frequently due to blood loss and poor nutrition secondary to hyperemesis. Placenta previa symptoms
include painless bright red vaginal bleeding, usually in the third trimester of pregnancy. Prolapsed cord
symptoms include a trickle of bright red vaginal blood and possibly a visible cord at the vaginal opening.
, Abruptio placentae symptoms include vaginal bleeding (bright red or dark red), abdominal pain, and
uterine tenderness.
A client is being maintained at home with a diagnosis of mild pre-eclampsia. Which of the following
complaints require further evaluation? Select all that apply.
a. Headache.
b. Anxiety.
c. Heartburn.
d. Blurred vision. - correct answer ✔✔a. Headache.
d. Blurred vision.
Rationale: Answers (a) and (d) are correct; headache and blurred vision are symptoms associated with
worsening preeclampsia. Answer (c) is incorrect; heartburn is a familiar sensation and is less intense than
the epigastric pain associated with severe preeclampsia. Answer (b) is incorrect; anxiety is a normal
response to a complicated pregnancy.
During a prenatal visit, a client states, "Sometimes my boyfriend hits me, but it is just when he is stressed
at work. I know he loves the baby and me; it's just hard right now. He wouldn't really hurt me." The
nurse's first priority is to:
a. Notify the social worker immediately.
b. Determine the client's immediate safety.
c. Encourage the client to leave her partner as soon as possible for the sake of the baby.
d. Give the client pamphlets with the contact information for local shelters. - correct answer ✔✔b.
Determine the client's immediate safety.
Rationale: Answer (b) is correct; when working with clients who are victims of physical abuse, the
priority is always to determine the client's immediate safety. Answer (a) is incorrect; notifying a social
worker is an appropriate action but it is not the immediate priority. Answer (c) is incorrect; giving
information to victims of abuse must be discreet; if the abuser feels the client may leave, the violence
may escalate. Answer (d) is incorrect; there are numerous factors associated with deciding to leave an
abusive relationship; it is seldom a rapid or easy process. The nurse's role is to support the client in
developing the best safety plan.
Which of the following client statements indicate a need for additional education regarding avoidance of
perinatal infection? Select all that apply.
a. "If I have beta strep in labor, I will most likely need a C-section."
b. "I need to buy a good pair of gloves for when I am working in the garden."
c. "After receiving my rubella immunization, I will avoid getting pregnant for 1 month."
d. "I will not let the cat sleep in our bed now that I am pregnant." - correct answer ✔✔a. "If I have beta
strep in labor, I will most likely need a C-section."
d. "I will not let the cat sleep in our bed now that I am pregnant."
Rationale: GBS requires antibiotic prophylaxis during labor, but a vaginal delivery is not contraindicated.
Toxoplasmosis can be transferred in cat feces; clients should be instructed to avoid handling litter boxes.
The client should avoid pregnancy for 1 month after receiving the rubella immunization and gardening
gloves should be worn during pregnancy to avoid contact with soil organisms. These statements indicate
client understanding.
A client at 28 weeks' gestation is admitted to the labor and birth unit. Which test would most likely be
used to assess the client's comprehensive fetal status?
a. Amniocentesis.
