NR 327 Maternal-Newborn (OB) Final Exam
ACTUAL EXAM TEST BANK 230 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
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2026/2027
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and 100% Accurate
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Question
A client at 34 weeks gestation presents with severe headache, visual disturbances, and BP
168/112 mmHg. What is the nurse's priority action?
a. Encourage oral fluids
b. Prepare for immediate delivery
c. Administer acetaminophen
d. Place client in left lateral position
✔️ Correct Answer: D
Rationale: The client is showing signs of severe preeclampsia, which can rapidly progress
,to eclampsia and seizures. The priority nursing action is to improve uteroplacental
perfusion and reduce blood pressure through positional intervention. Left lateral
positioning decreases vena cava compression, improves cardiac output, and enhances
renal perfusion, which helps reduce blood pressure. While delivery (Option B) is the
definitive treatment, stabilization comes first. Acetaminophen does not treat the
underlying condition. Oral fluids are not a priority and may worsen fluid overload.
Immediate maternal stabilization is essential before preparing for delivery unless
emergent deterioration occurs.
Which finding indicates magnesium sulfate toxicity?
a. Respiratory rate 10/min
b. Urine output 50 mL/hr
c. Blood pressure 140/90 mmHg
d. Fetal heart rate 150 bpm
✔️ Correct Answer: A
Rationale: Magnesium sulfate is a CNS depressant used in preeclampsia to prevent
seizures. Toxicity occurs when serum levels rise excessively, with the earliest and most
dangerous sign being respiratory depression. A respiratory rate below 12/min indicates
impending respiratory failure and requires immediate intervention and administration of
calcium gluconate as the antidote. Urine output of 50 mL/hr is adequate for renal
clearance. Blood pressure and fetal heart rate are unrelated to toxicity detection.
Respiratory function is the priority assessment in magnesium therapy.
A client in labor has variable decelerations on the fetal monitor. What is the first nursing
action?
a. Prepare for cesarean delivery
b. Increase oxytocin infusion
c. Reposition the client
d. Apply fetal scalp electrode
✔️ Correct Answer: C
Rationale: Variable decelerations indicate umbilical cord compression. The first-line
,intervention is maternal repositioning to relieve pressure on the cord and restore fetal
oxygenation. This may include lateral positioning or knee-chest position. Cesarean
delivery is not immediately indicated unless decelerations persist. Oxytocin would worsen
uterine contractions and fetal stress. Fetal scalp electrode placement does not address
oxygenation issues. Immediate non-invasive interventions are always priority in fetal
distress.
Which are risk factors for postpartum hemorrhage? (Select all that apply.)
a. Prolonged labor
b. Uterine overdistention
c. High parity
d. Short second stage of labor
e. Retained placenta
✔️ Correct Answer: A, B, C, E
Rationale: Postpartum hemorrhage is commonly caused by uterine atony and structural
abnormalities. Prolonged labor exhausts uterine muscle tone, increasing bleeding risk.
Uterine overdistention from multiple gestation or polyhydramnios prevents effective
contraction. High parity weakens uterine musculature. Retained placental fragments
prevent uterine contraction and lead to continuous bleeding. A short second stage is not
a risk factor; it may actually reduce fatigue-related complications. Understanding uterine
tone and placental separation is essential in preventing hemorrhage.
A newborn has a blood glucose level of 38 mg/dL. What is the priority intervention?
a. Initiate breastfeeding immediately
b. Administer IV insulin
c. Give formula feeding
d. Prepare for phototherapy
✔️ Correct Answer: A
Rationale: Neonatal hypoglycemia occurs when glucose is below 40 mg/dL. The first-line
intervention is early feeding to stabilize blood glucose levels. Breastfeeding provides
immediate glucose and supports metabolic stabilization. IV insulin is contraindicated
, because it would worsen hypoglycemia. Formula feeding is also appropriate but
breastfeeding is preferred if possible. Phototherapy treats jaundice, not hypoglycemia.
Early feeding prevents neurologic damage.
A client receiving oxytocin has uterine hyperstimulation. What should the nurse do first?
a. Increase oxytocin dose
b. Discontinue oxytocin infusion
c. Perform vaginal exam
d. Encourage ambulation
✔️ Correct Answer: B
Rationale: Uterine hyperstimulation reduces fetal oxygenation due to decreased placental
perfusion. The priority intervention is stopping oxytocin immediately to reduce uterine
activity. Increasing the dose would worsen fetal distress. Vaginal exam is not priority and
may increase infection risk. Ambulation is contraindicated in active uterine
overstimulation. Prompt discontinuation prevents fetal hypoxia and uterine rupture.
Which sign is most concerning in a client with placenta previa?
a. Painless bright red vaginal bleeding
b. Abdominal tenderness
c. Severe back pain
d. Fetal tachycardia
✔️ Correct Answer: A
Rationale: Placenta previa is characterized by painless, bright red bleeding due to
placental implantation over the cervical os. This is a medical emergency requiring
immediate evaluation. Abdominal tenderness and back pain are more consistent with
placental abruption. Fetal tachycardia is a late sign of fetal distress. Painless bleeding is
the hallmark distinguishing feature of placenta previa.
ACTUAL EXAM TEST BANK 230 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||NEWEST VERSION 2026/2027
2026/2027
Frequently Most
Tested Questions
and 100% Accurate
From Past papers |
Graded A+ ,
Reviewed and
Updated | 100%
Guarantee Pass |
Latest Exam and
Newest Version!!!
Question
A client at 34 weeks gestation presents with severe headache, visual disturbances, and BP
168/112 mmHg. What is the nurse's priority action?
a. Encourage oral fluids
b. Prepare for immediate delivery
c. Administer acetaminophen
d. Place client in left lateral position
✔️ Correct Answer: D
Rationale: The client is showing signs of severe preeclampsia, which can rapidly progress
,to eclampsia and seizures. The priority nursing action is to improve uteroplacental
perfusion and reduce blood pressure through positional intervention. Left lateral
positioning decreases vena cava compression, improves cardiac output, and enhances
renal perfusion, which helps reduce blood pressure. While delivery (Option B) is the
definitive treatment, stabilization comes first. Acetaminophen does not treat the
underlying condition. Oral fluids are not a priority and may worsen fluid overload.
Immediate maternal stabilization is essential before preparing for delivery unless
emergent deterioration occurs.
Which finding indicates magnesium sulfate toxicity?
a. Respiratory rate 10/min
b. Urine output 50 mL/hr
c. Blood pressure 140/90 mmHg
d. Fetal heart rate 150 bpm
✔️ Correct Answer: A
Rationale: Magnesium sulfate is a CNS depressant used in preeclampsia to prevent
seizures. Toxicity occurs when serum levels rise excessively, with the earliest and most
dangerous sign being respiratory depression. A respiratory rate below 12/min indicates
impending respiratory failure and requires immediate intervention and administration of
calcium gluconate as the antidote. Urine output of 50 mL/hr is adequate for renal
clearance. Blood pressure and fetal heart rate are unrelated to toxicity detection.
Respiratory function is the priority assessment in magnesium therapy.
A client in labor has variable decelerations on the fetal monitor. What is the first nursing
action?
a. Prepare for cesarean delivery
b. Increase oxytocin infusion
c. Reposition the client
d. Apply fetal scalp electrode
✔️ Correct Answer: C
Rationale: Variable decelerations indicate umbilical cord compression. The first-line
,intervention is maternal repositioning to relieve pressure on the cord and restore fetal
oxygenation. This may include lateral positioning or knee-chest position. Cesarean
delivery is not immediately indicated unless decelerations persist. Oxytocin would worsen
uterine contractions and fetal stress. Fetal scalp electrode placement does not address
oxygenation issues. Immediate non-invasive interventions are always priority in fetal
distress.
Which are risk factors for postpartum hemorrhage? (Select all that apply.)
a. Prolonged labor
b. Uterine overdistention
c. High parity
d. Short second stage of labor
e. Retained placenta
✔️ Correct Answer: A, B, C, E
Rationale: Postpartum hemorrhage is commonly caused by uterine atony and structural
abnormalities. Prolonged labor exhausts uterine muscle tone, increasing bleeding risk.
Uterine overdistention from multiple gestation or polyhydramnios prevents effective
contraction. High parity weakens uterine musculature. Retained placental fragments
prevent uterine contraction and lead to continuous bleeding. A short second stage is not
a risk factor; it may actually reduce fatigue-related complications. Understanding uterine
tone and placental separation is essential in preventing hemorrhage.
A newborn has a blood glucose level of 38 mg/dL. What is the priority intervention?
a. Initiate breastfeeding immediately
b. Administer IV insulin
c. Give formula feeding
d. Prepare for phototherapy
✔️ Correct Answer: A
Rationale: Neonatal hypoglycemia occurs when glucose is below 40 mg/dL. The first-line
intervention is early feeding to stabilize blood glucose levels. Breastfeeding provides
immediate glucose and supports metabolic stabilization. IV insulin is contraindicated
, because it would worsen hypoglycemia. Formula feeding is also appropriate but
breastfeeding is preferred if possible. Phototherapy treats jaundice, not hypoglycemia.
Early feeding prevents neurologic damage.
A client receiving oxytocin has uterine hyperstimulation. What should the nurse do first?
a. Increase oxytocin dose
b. Discontinue oxytocin infusion
c. Perform vaginal exam
d. Encourage ambulation
✔️ Correct Answer: B
Rationale: Uterine hyperstimulation reduces fetal oxygenation due to decreased placental
perfusion. The priority intervention is stopping oxytocin immediately to reduce uterine
activity. Increasing the dose would worsen fetal distress. Vaginal exam is not priority and
may increase infection risk. Ambulation is contraindicated in active uterine
overstimulation. Prompt discontinuation prevents fetal hypoxia and uterine rupture.
Which sign is most concerning in a client with placenta previa?
a. Painless bright red vaginal bleeding
b. Abdominal tenderness
c. Severe back pain
d. Fetal tachycardia
✔️ Correct Answer: A
Rationale: Placenta previa is characterized by painless, bright red bleeding due to
placental implantation over the cervical os. This is a medical emergency requiring
immediate evaluation. Abdominal tenderness and back pain are more consistent with
placental abruption. Fetal tachycardia is a late sign of fetal distress. Painless bleeding is
the hallmark distinguishing feature of placenta previa.
