NUR 230 MATERNAL NURSING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient at 32 weeks gestation presents with sudden-onset, painless bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Preterm labor
D. Placenta previa
Answer: D
Conceptual Explanation: Placenta previa is characterized by painless, bright red vaginal
bleeding in the second or third trimester. Placental abruption usually involves painful, dark
red bleeding.
2. A nurse is monitoring a patient receiving Magnesium Sulfate for preeclampsia. The
patient’s respiratory rate is 10/min and deep tendon reflexes are absent. What is the priority
action?
A. Increase the IV fluid rate
,B. Prepare for immediate delivery
C. Place the patient in Trendelenburg position
D. Stop the infusion and administer Calcium Gluconate
Answer: D
Conceptual Explanation: Respiratory depression and loss of deep tendon reflexes are
signs of Magnesium toxicity. Calcium Gluconate is the antidote.
3. Calculate the GTPAL for a patient: currently pregnant, had a miscarriage at 10 weeks, gave
birth to twins at 35 weeks, and a singleton at 39 weeks. All children are alive.
A. G3, T1, P2, A1, L3
B. G3, T2, P1, A0, L3
C. G4, T2, P1, A1, L2
D. G4, T1, P1, A1, L3
Answer: D
Conceptual Explanation: G=4 (current, miscarriage, twins, singleton); T=1 (singleton at
39w); P=1 (twins at 35w count as one parity event); A=1 (miscarriage); L=3 (twins +
singleton).
4. Which fetal heart rate pattern indicates 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 are non-reassuring. Early decelerations are caused by head compression.
5. A newborn has a heart rate of 110, a weak cry, some flexion of extremities, grimace when
stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 5
B. 7
C. 6
D. 8
Answer: C
Conceptual Explanation: Heart rate (2), Cry (1), Muscle tone (1), Reflex (1), Color (1) = 6.
6. What is the primary purpose of administering Betamethasone to a patient in preterm labor
at 30 weeks?
A. To stop uterine contractions
B. To promote fetal lung maturity
C. To prevent maternal infection
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient at 32 weeks gestation presents with sudden-onset, painless bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Preterm labor
D. Placenta previa
Answer: D
Conceptual Explanation: Placenta previa is characterized by painless, bright red vaginal
bleeding in the second or third trimester. Placental abruption usually involves painful, dark
red bleeding.
2. A nurse is monitoring a patient receiving Magnesium Sulfate for preeclampsia. The
patient’s respiratory rate is 10/min and deep tendon reflexes are absent. What is the priority
action?
A. Increase the IV fluid rate
,B. Prepare for immediate delivery
C. Place the patient in Trendelenburg position
D. Stop the infusion and administer Calcium Gluconate
Answer: D
Conceptual Explanation: Respiratory depression and loss of deep tendon reflexes are
signs of Magnesium toxicity. Calcium Gluconate is the antidote.
3. Calculate the GTPAL for a patient: currently pregnant, had a miscarriage at 10 weeks, gave
birth to twins at 35 weeks, and a singleton at 39 weeks. All children are alive.
A. G3, T1, P2, A1, L3
B. G3, T2, P1, A0, L3
C. G4, T2, P1, A1, L2
D. G4, T1, P1, A1, L3
Answer: D
Conceptual Explanation: G=4 (current, miscarriage, twins, singleton); T=1 (singleton at
39w); P=1 (twins at 35w count as one parity event); A=1 (miscarriage); L=3 (twins +
singleton).
4. Which fetal heart rate pattern indicates 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 are non-reassuring. Early decelerations are caused by head compression.
5. A newborn has a heart rate of 110, a weak cry, some flexion of extremities, grimace when
stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 5
B. 7
C. 6
D. 8
Answer: C
Conceptual Explanation: Heart rate (2), Cry (1), Muscle tone (1), Reflex (1), Color (1) = 6.
6. What is the primary purpose of administering Betamethasone to a patient in preterm labor
at 30 weeks?
A. To stop uterine contractions
B. To promote fetal lung maturity
C. To prevent maternal infection
