NUR 231 MATERNAL-NEWBORN
NURSING EXAM 2 QUESTIONS &
VERIFIED ANSWERS | ILLINOIS STATE
UNIVERSITY (A+ GUARANTEE)
1. A patient at 34 weeks gestation presents with sudden, dark red vaginal bleeding and a
board-like, tender abdomen. Which condition should the nurse suspect?
A. Placenta previa
B. Cervical insufficiency
C. Hydatidiform mole
D. Abruptio placentae
Answer: D
Conceptual Explanation: Abruptio placentae is characterized by painful, dark red
bleeding and uterine tenderness or rigidity (board-like abdomen). Placenta previa is
typically painless and bright red.
2. Which of the following findings in a client receiving Magnesium Sulfate for preeclampsia
indicates toxicity?
A. Blood pressure of 140/90 mmHg
B. Urinary output of 40 mL/hr
,C. Respiratory rate of 10 breaths/min
D. Presence of deep tendon reflexes (2+)
Answer: C
Conceptual Explanation: Signs of magnesium toxicity include respiratory depression (less
than 12/min), loss of deep tendon reflexes, and decreased urinary output (less than 30
mL/hr).
3. A nurse observes late decelerations on the fetal monitor strip. Which action should the
nurse take first?
A. Reposition the patient to a side-lying position
B. Administer oxygen via face mask at 8-10 L/min
C. Increase the IV infusion rate of Oxytocin
D. Prepare for immediate forceps delivery
Answer: A
Conceptual Explanation: The first action for late decelerations (uteroplacental
insufficiency) is to reposition the patient to maximize blood flow. Oxygen and discontinuing
oxytocin would follow.
4. A laboring patient is in the transition phase of the first stage of labor. Which behavior is the
nurse most likely to observe?
A. The patient is chatty and excited
, B. The patient is calm and follows directions easily
C. The patient is experiencing a ‘second wind’ of energy
D. The patient is irritable, frustrated, and may feel the urge to push
Answer: D
Conceptual Explanation: The transition phase (8-10 cm dilation) is marked by increased
irritability, nausea, and the primary urge to push or bear down.
5. What is the primary purpose of administering Betamethasone to a patient in preterm labor
at 30 weeks?
A. To stop uterine contractions
B. To prevent maternal infection
C. To increase maternal blood glucose
D. To promote fetal lung maturity
Answer: D
Conceptual Explanation: Betamethasone is a corticosteroid given to stimulate the
production of surfactant in the fetal lungs, reducing the risk of Respiratory Distress
Syndrome.
6. A newborn has a heart rate of 90 bpm, a weak cry, some flexion of extremities, grimace
with suctioning, and a pink body with blue extremities. What is the APGAR score?
A. 4
NURSING EXAM 2 QUESTIONS &
VERIFIED ANSWERS | ILLINOIS STATE
UNIVERSITY (A+ GUARANTEE)
1. A patient at 34 weeks gestation presents with sudden, dark red vaginal bleeding and a
board-like, tender abdomen. Which condition should the nurse suspect?
A. Placenta previa
B. Cervical insufficiency
C. Hydatidiform mole
D. Abruptio placentae
Answer: D
Conceptual Explanation: Abruptio placentae is characterized by painful, dark red
bleeding and uterine tenderness or rigidity (board-like abdomen). Placenta previa is
typically painless and bright red.
2. Which of the following findings in a client receiving Magnesium Sulfate for preeclampsia
indicates toxicity?
A. Blood pressure of 140/90 mmHg
B. Urinary output of 40 mL/hr
,C. Respiratory rate of 10 breaths/min
D. Presence of deep tendon reflexes (2+)
Answer: C
Conceptual Explanation: Signs of magnesium toxicity include respiratory depression (less
than 12/min), loss of deep tendon reflexes, and decreased urinary output (less than 30
mL/hr).
3. A nurse observes late decelerations on the fetal monitor strip. Which action should the
nurse take first?
A. Reposition the patient to a side-lying position
B. Administer oxygen via face mask at 8-10 L/min
C. Increase the IV infusion rate of Oxytocin
D. Prepare for immediate forceps delivery
Answer: A
Conceptual Explanation: The first action for late decelerations (uteroplacental
insufficiency) is to reposition the patient to maximize blood flow. Oxygen and discontinuing
oxytocin would follow.
4. A laboring patient is in the transition phase of the first stage of labor. Which behavior is the
nurse most likely to observe?
A. The patient is chatty and excited
, B. The patient is calm and follows directions easily
C. The patient is experiencing a ‘second wind’ of energy
D. The patient is irritable, frustrated, and may feel the urge to push
Answer: D
Conceptual Explanation: The transition phase (8-10 cm dilation) is marked by increased
irritability, nausea, and the primary urge to push or bear down.
5. What is the primary purpose of administering Betamethasone to a patient in preterm labor
at 30 weeks?
A. To stop uterine contractions
B. To prevent maternal infection
C. To increase maternal blood glucose
D. To promote fetal lung maturity
Answer: D
Conceptual Explanation: Betamethasone is a corticosteroid given to stimulate the
production of surfactant in the fetal lungs, reducing the risk of Respiratory Distress
Syndrome.
6. A newborn has a heart rate of 90 bpm, a weak cry, some flexion of extremities, grimace
with suctioning, and a pink body with blue extremities. What is the APGAR score?
A. 4
