NSG 3500 MATERNAL HEALTH
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A client at 34 weeks gestation presents with a sudden onset of severe abdominal pain,
uterine tenderness, and a firm, board-like abdomen. The nurse suspects which complication?
A. Placenta previa
B. Uterine rupture
C. Abruptio placentae
D. Ectopic pregnancy
Answer: C
Conceptual Explanation: Abruptio placentae is characterized by premature separation of
the placenta, causing severe pain and a board-like abdomen due to concealed or overt
bleeding. Placenta previa is typically painless.
2. A nurse is monitoring a patient on Magnesium Sulfate for preeclampsia. Which assessment
finding indicates Magnesium toxicity?
A. Urine output of 20 mL/hr over 2 hours
,B. Presence of deep tendon reflexes (2+)
C. Respiratory rate of 14 breaths/min
D. Blood pressure of 150/90 mmHg
Answer: A
Conceptual Explanation: Magnesium is excreted by the kidneys. Low urine output (<30
mL/hr) can lead to toxic accumulation. Other signs include loss of DTRs and respiratory
depression.
3. Which medication should the nurse have readily available as an antidote for Magnesium
Sulfate toxicity?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Oxytocin
Answer: B
Conceptual Explanation: Calcium gluconate is the specific antagonist for magnesium
toxicity to reverse respiratory depression and cardiac effects.
4. A client with HELLP syndrome is being managed in the L&D unit. The nurse monitors
laboratory values closely for which definitive criteria?
A. High Hemoglobin, Elevated Liver enzymes, Low Platelets
, B. Hemolysis, Elevated Liver enzymes, Low Platelets
C. Hemolysis, Elevated Lipids, Low Platelets
D. Hyperglycemia, Elevated Liver enzymes, Low Platelets
Answer: B
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets, representing a severe variant of preeclampsia.
5. A nurse is caring for a client with gestational diabetes. Which statement regarding insulin
needs during pregnancy is accurate?
A. Insulin needs decrease during the second and third trimesters.
B. Insulin needs increase during the second and third trimesters due to placental
hormones.
C. Insulin needs increase significantly during the first trimester.
D. Insulin needs remain constant throughout the entire pregnancy.
Answer: B
Conceptual Explanation: Placental hormones (like hPL) act as insulin antagonists,
increasing insulin resistance and therefore increasing insulin requirements as the
pregnancy progresses.
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A client at 34 weeks gestation presents with a sudden onset of severe abdominal pain,
uterine tenderness, and a firm, board-like abdomen. The nurse suspects which complication?
A. Placenta previa
B. Uterine rupture
C. Abruptio placentae
D. Ectopic pregnancy
Answer: C
Conceptual Explanation: Abruptio placentae is characterized by premature separation of
the placenta, causing severe pain and a board-like abdomen due to concealed or overt
bleeding. Placenta previa is typically painless.
2. A nurse is monitoring a patient on Magnesium Sulfate for preeclampsia. Which assessment
finding indicates Magnesium toxicity?
A. Urine output of 20 mL/hr over 2 hours
,B. Presence of deep tendon reflexes (2+)
C. Respiratory rate of 14 breaths/min
D. Blood pressure of 150/90 mmHg
Answer: A
Conceptual Explanation: Magnesium is excreted by the kidneys. Low urine output (<30
mL/hr) can lead to toxic accumulation. Other signs include loss of DTRs and respiratory
depression.
3. Which medication should the nurse have readily available as an antidote for Magnesium
Sulfate toxicity?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Oxytocin
Answer: B
Conceptual Explanation: Calcium gluconate is the specific antagonist for magnesium
toxicity to reverse respiratory depression and cardiac effects.
4. A client with HELLP syndrome is being managed in the L&D unit. The nurse monitors
laboratory values closely for which definitive criteria?
A. High Hemoglobin, Elevated Liver enzymes, Low Platelets
, B. Hemolysis, Elevated Liver enzymes, Low Platelets
C. Hemolysis, Elevated Lipids, Low Platelets
D. Hyperglycemia, Elevated Liver enzymes, Low Platelets
Answer: B
Conceptual Explanation: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets, representing a severe variant of preeclampsia.
5. A nurse is caring for a client with gestational diabetes. Which statement regarding insulin
needs during pregnancy is accurate?
A. Insulin needs decrease during the second and third trimesters.
B. Insulin needs increase during the second and third trimesters due to placental
hormones.
C. Insulin needs increase significantly during the first trimester.
D. Insulin needs remain constant throughout the entire pregnancy.
Answer: B
Conceptual Explanation: Placental hormones (like hPL) act as insulin antagonists,
increasing insulin resistance and therefore increasing insulin requirements as the
pregnancy progresses.
