COMPREHENSIVE MATERNAL-
NEWBORN NURSING EXAM (NUR 230)
QUESTIONS AND ANSWERS
1. A pregnant client with a history of hypertension is diagnosed with HELLP syndrome. Which
laboratory finding should the nurse anticipate?
A. Elevated serum creatinine
B. Increased hemoglobin and hematocrit
C. Low platelet count
D. Decreased liver enzymes
Answer: C
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. A low platelet count (thrombocytopenia) is a hallmark of this condition.
2. A client at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding requires immediate intervention?
A. Deep tendon reflexes 2+
B. Respiration rate of 14 breaths/min
C. Urinary output of 20 mL/hr
,D. Serum magnesium level of 6 mEq/L
Answer: C
Conceptual Explanation: Urinary output less than 30 mL/hr indicates renal impairment
and increases the risk of magnesium toxicity, as magnesium is excreted by the kidneys.
3. Calculate the EDD using Naegele’s rule for a client whose LMP began on November 10.
A. August 3
B. August 17
C. August 10
D. August 24
Answer: B
Conceptual Explanation: Naegele’s rule: Subtract 3 months and add 7 days to the first day
of the LMP. November 10 - 3 months = August 10; August 10 + 7 days = August 17.
4. A client is in the transition phase of the first stage of labor. Which behavior is most
characteristic of this stage?
A. Excitement and talkativeness
B. Increased fatigue and sleeping between contractions
C. Urge to push and bear down
D. Irritability and a feeling of loss of control
, Answer: D
Conceptual Explanation: The transition phase (8-10 cm) is characterized by intense
contractions, irritability, nausea, and a feeling of being overwhelmed.
5. A nurse is monitoring a fetal heart rate (FHR) tracing and notes late decelerations. What is
the priority nursing action?
A. Perform a vaginal exam to check for cord prolapse
B. Place the client in a lateral position
C. Increase the rate of Pitocin infusion
D. Apply a fetal scalp electrode
Answer: B
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation, which starts with repositioning the client to their side.
6. Which medication is contraindicated for a postpartum client with a blood pressure of
150/94 mmHg who is experiencing heavy bleeding?
A. Oxytocin (Pitocin)
B. Carboprost (Hemabate)
C. Misoprostol (Cytotec)
D. Methylergonovine (Methergine)
Answer: D
NEWBORN NURSING EXAM (NUR 230)
QUESTIONS AND ANSWERS
1. A pregnant client with a history of hypertension is diagnosed with HELLP syndrome. Which
laboratory finding should the nurse anticipate?
A. Elevated serum creatinine
B. Increased hemoglobin and hematocrit
C. Low platelet count
D. Decreased liver enzymes
Answer: C
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. A low platelet count (thrombocytopenia) is a hallmark of this condition.
2. A client at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding requires immediate intervention?
A. Deep tendon reflexes 2+
B. Respiration rate of 14 breaths/min
C. Urinary output of 20 mL/hr
,D. Serum magnesium level of 6 mEq/L
Answer: C
Conceptual Explanation: Urinary output less than 30 mL/hr indicates renal impairment
and increases the risk of magnesium toxicity, as magnesium is excreted by the kidneys.
3. Calculate the EDD using Naegele’s rule for a client whose LMP began on November 10.
A. August 3
B. August 17
C. August 10
D. August 24
Answer: B
Conceptual Explanation: Naegele’s rule: Subtract 3 months and add 7 days to the first day
of the LMP. November 10 - 3 months = August 10; August 10 + 7 days = August 17.
4. A client is in the transition phase of the first stage of labor. Which behavior is most
characteristic of this stage?
A. Excitement and talkativeness
B. Increased fatigue and sleeping between contractions
C. Urge to push and bear down
D. Irritability and a feeling of loss of control
, Answer: D
Conceptual Explanation: The transition phase (8-10 cm) is characterized by intense
contractions, irritability, nausea, and a feeling of being overwhelmed.
5. A nurse is monitoring a fetal heart rate (FHR) tracing and notes late decelerations. What is
the priority nursing action?
A. Perform a vaginal exam to check for cord prolapse
B. Place the client in a lateral position
C. Increase the rate of Pitocin infusion
D. Apply a fetal scalp electrode
Answer: B
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation, which starts with repositioning the client to their side.
6. Which medication is contraindicated for a postpartum client with a blood pressure of
150/94 mmHg who is experiencing heavy bleeding?
A. Oxytocin (Pitocin)
B. Carboprost (Hemabate)
C. Misoprostol (Cytotec)
D. Methylergonovine (Methergine)
Answer: D
