RASMUSSEN UNIVERSITY | SCHOOL OF NURSING | NUR 2513 / NUR2513
Exam 2 - NUR 2513 / NUR2513 (Latest 2026/2027): Maternal
Child Nursing
Rasmussen University - Course Examination
Course / Institution NUR 2513 Maternal-Child Nursing - Rasmussen University
Examination Exam 2 - Comprehensive Examination (Latest Edition)
Total Questions 120 multiple-choice items (Sections 1-7)
Item Format Four options (A-D), one best answer; answers and rationales included
Cognitive Levels 20% Recall | 50% Application | 30% Analysis / Clinical Reasoning
Standards Alignment NUR 2513 Syllabus - NCLEX-RN Test Plan - QSEN Competencies - AWHONN &
ACOG Standards (2026/2027)
Suggested Time 180 minutes (1.5 minutes per item)
DIRECTIONS: Read each clinical scenario or question carefully and select the single best response from options
A through D. The correct answer is marked *[CORRECT]* beneath each item, followed by an evidence-based
rationale citing NUR 2513 curriculum content, AWHONN standards, and current maternal-child nursing evidence.
Items are sequenced by content section; prioritize using the nursing process (assessment before implementation,
safety first, airway-breathing-circulation) when multiple options appear correct. Use this examination for
summative review, remediation planning, and NCLEX-RN preparation.
SECTION 1 | Section 1: High-Risk Pregnancy & Antepartum Questions 1-20
Complications
Q1: A 26-year-old G2P1 client with no risk factors for diabetes mellitus presents for her 26-week
prenatal visit. The nurse should anticipate screening for gestational diabetes using which method?
A. 100-g oral glucose tolerance test with fasting and hourly blood draws performed today
B. 1-hour 50-g oral glucose challenge test scheduled between 24 and 28 weeks of gestation
*[CORRECT]*
C. Glycosylated hemoglobin (HbA1c) obtained at 32 weeks of gestation
D. Random capillary blood glucose measured at every subsequent prenatal visit
Correct Answer: B
Rationale: NUR 2513 curriculum follows ACOG guidance: universal screening for gestational diabetes with a
50-g oral glucose load occurs at 24-28 weeks, when placental counter-regulatory hormones peak. An abnormal
1-hour result (typically at or above 130-140 mg/dL) is followed by the diagnostic 100-g 3-hour OGTT, which is not
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 1
,Exam 2 - NUR 2513 Maternal-Child Nursing (2026/2027) 120 Questions | 7 Sections
the initial screening step. HbA1c and random glucose do not screen for gestational diabetes because normal
pregnancy lowers fasting glucose and masks postprandial elevations.
Q2: A 34-week G1P0 client presents with a blood pressure of 168/112 mm Hg on two readings 15
minutes apart, 3+ proteinuria, a severe unrelenting headache, epigastric pain, and scotomata. Which
collaborative intervention should the nurse anticipate first?
A. Initiate magnesium sulfate for seizure prophylaxis and prepare for delivery *[CORRECT]*
B. Administer an antihypertensive and discharge home with weekly nonstress tests
C. Encourage strict bed rest at home with daily fetal kick counts
D. Obtain a 24-hour urine collection and reevaluate at the next prenatal visit
Correct Answer: A
Rationale: This client has severe preeclampsia with severe features (severe-range BP, cerebral and epigastric
symptoms) at 34 weeks. Magnesium sulfate prevents eclamptic seizures, antihypertensives control BP, and delivery
is the only cure, so AWHONN and ACOG standards support stabilization and prompt birth. Expectant
management is reserved for stable clients at less than 34 weeks, and sending this client home risks eclampsia,
HELLP, abruption, and fetal death.
Q3: A client receiving a magnesium sulfate infusion for severe preeclampsia has a respiratory rate of
10 breaths/min, absent deep tendon reflexes, and urine output of 20 mL/hr. What is the nurse's first
action?
A. Increase the infusion rate to prevent an eclamptic seizure
B. Draw a serum magnesium level and continue the current infusion
C. Discontinue the magnesium sulfate infusion and prepare to administer calcium gluconate
*[CORRECT]*
D. Apply oxygen at 10 L/min via face mask and reposition the client
Correct Answer: C
Rationale: Respiratory depression below 12 breaths/min, absent patellar reflexes, and oliguria indicate magnesium
sulfate toxicity; the infusion must be stopped immediately and the antidote, calcium gluconate, readied. Raising the
rate or continuing the infusion would worsen respiratory and cardiac depression. Respiratory depression takes
priority over oxygen administration because the problem is hypoventilation from magnesium excess, not simple
hypoxemia.
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 2
,Exam 2 - NUR 2513 Maternal-Child Nursing (2026/2027) 120 Questions | 7 Sections
Q4: A 33-week pregnant client reports right upper quadrant pain and nausea. The nurse reviews her
laboratory results: elevated LDH with schistocytes on smear, AST 148 units/L, ALT 162 units/L, and
platelets 86,000/mm3. The nurse recognizes these findings as consistent with which condition?
A. Physiologic anemia of pregnancy
B. Benign gestational thrombocytopenia
C. Intrahepatic cholestasis of pregnancy
D. HELLP syndrome *[CORRECT]*
Correct Answer: D
Rationale: HELLP syndrome - Hemolysis (elevated LDH, schistocytes), Elevated Liver enzymes (AST/ALT), and
Low Platelets below 100,000/mm3 - is a severe variant of preeclampsia that frequently presents with epigastric or
right upper quadrant pain. Physiologic anemia and gestational thrombocytopenia do not produce hepatocellular
injury, and cholestasis presents with pruritus and elevated bile acids rather than hemolysis. HELLP mandates
magnesium sulfate, blood product readiness, and delivery per AWHONN hypertensive disorder standards.
Q5: A 29-week pregnant client arrives with sudden onset of painless, bright-red vaginal bleeding. Her
uterus is soft and nontender, and the fetal heart rate is 140 beats/min with moderate variability. What is
the nurse's priority action?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Prepare the client for ultrasound to determine placental location *[CORRECT]*
C. Insert an indwelling urinary catheter for strict output monitoring
D. Begin oxytocin induction to accelerate delivery
Correct Answer: B
Rationale: Painless, bright-red bleeding with a soft, nontender uterus is the classic presentation of placenta previa,
and location must be confirmed by ultrasound before any digital examination. A digital examination before previa
is excluded can disrupt placental vessels and trigger catastrophic hemorrhage, particularly with coexisting placenta
accreta. Induction is unsafe when the placenta covers the os, and the stable fetal status allows diagnostic imaging
first per NUR 2513 antepartum hemorrhage protocol.
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 3
, Exam 2 - NUR 2513 Maternal-Child Nursing (2026/2027) 120 Questions | 7 Sections
Q6: A 32-week G2P1 presents with sudden dark-red vaginal bleeding, severe constant abdominal pain,
and a rigid, board-like uterus. The fetal heart tracing shows recurrent late decelerations. The nurse
correctly interprets these findings and prepares the client for which outcome?
A. Placental abruption with fetal compromise; prepare for emergent delivery *[CORRECT]*
B. Placenta previa; anticipate expectant management and bed rest
C. Uterine rupture; anticipate tocolysis and cervical cerclage
D. Vasa previa; anticipate expectant monitoring until 36 weeks
Correct Answer: A
Rationale: Painful dark bleeding with a board-like uterus and non-reassuring fetal status indicates placental
abruption with concealed hemorrhage, a leading cause of fetal demise and DIC. Because bleeding may be
concealed behind the placenta, visible blood loss poorly estimates true hemorrhage. Delivery, often by cesarean
birth, is the priority when the fetus is compromised; expectant management is appropriate only when both the fetus
and mother are stable despite a preterm gestation.
Q7: A 28-year-old client at 7 weeks' gestation reports unilateral lower-quadrant pain and light vaginal
spotting. She is hemodynamically stable with a small, soft uterus and minimal hCG elevation without
fetal cardiac activity. If she meets clinical criteria, which management does the nurse anticipate?
A. Immediate laparoscopic salpingectomy
B. Strict bed rest with weekly hCG levels only
C. Intramuscular methotrexate with serial hCG follow-up *[CORRECT]*
D. Oxytocin induction to evacuate the pregnancy
Correct Answer: C
Rationale: An unruptured ectopic pregnancy smaller than about 3.5 cm without fetal cardiac activity can be
treated medically with methotrexate, preserving tubal function when the client is stable and reliable for serial hCG
follow-up. Surgery is reserved for rupture, hemodynamic instability, significant pain, or failure of medical therapy.
Expectant management alone is uncommon once symptoms appear, and oxytocin has no effect on ectopic tissue
because it acts only on uterine myometrium.
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 4
Exam 2 - NUR 2513 / NUR2513 (Latest 2026/2027): Maternal
Child Nursing
Rasmussen University - Course Examination
Course / Institution NUR 2513 Maternal-Child Nursing - Rasmussen University
Examination Exam 2 - Comprehensive Examination (Latest Edition)
Total Questions 120 multiple-choice items (Sections 1-7)
Item Format Four options (A-D), one best answer; answers and rationales included
Cognitive Levels 20% Recall | 50% Application | 30% Analysis / Clinical Reasoning
Standards Alignment NUR 2513 Syllabus - NCLEX-RN Test Plan - QSEN Competencies - AWHONN &
ACOG Standards (2026/2027)
Suggested Time 180 minutes (1.5 minutes per item)
DIRECTIONS: Read each clinical scenario or question carefully and select the single best response from options
A through D. The correct answer is marked *[CORRECT]* beneath each item, followed by an evidence-based
rationale citing NUR 2513 curriculum content, AWHONN standards, and current maternal-child nursing evidence.
Items are sequenced by content section; prioritize using the nursing process (assessment before implementation,
safety first, airway-breathing-circulation) when multiple options appear correct. Use this examination for
summative review, remediation planning, and NCLEX-RN preparation.
SECTION 1 | Section 1: High-Risk Pregnancy & Antepartum Questions 1-20
Complications
Q1: A 26-year-old G2P1 client with no risk factors for diabetes mellitus presents for her 26-week
prenatal visit. The nurse should anticipate screening for gestational diabetes using which method?
A. 100-g oral glucose tolerance test with fasting and hourly blood draws performed today
B. 1-hour 50-g oral glucose challenge test scheduled between 24 and 28 weeks of gestation
*[CORRECT]*
C. Glycosylated hemoglobin (HbA1c) obtained at 32 weeks of gestation
D. Random capillary blood glucose measured at every subsequent prenatal visit
Correct Answer: B
Rationale: NUR 2513 curriculum follows ACOG guidance: universal screening for gestational diabetes with a
50-g oral glucose load occurs at 24-28 weeks, when placental counter-regulatory hormones peak. An abnormal
1-hour result (typically at or above 130-140 mg/dL) is followed by the diagnostic 100-g 3-hour OGTT, which is not
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 1
,Exam 2 - NUR 2513 Maternal-Child Nursing (2026/2027) 120 Questions | 7 Sections
the initial screening step. HbA1c and random glucose do not screen for gestational diabetes because normal
pregnancy lowers fasting glucose and masks postprandial elevations.
Q2: A 34-week G1P0 client presents with a blood pressure of 168/112 mm Hg on two readings 15
minutes apart, 3+ proteinuria, a severe unrelenting headache, epigastric pain, and scotomata. Which
collaborative intervention should the nurse anticipate first?
A. Initiate magnesium sulfate for seizure prophylaxis and prepare for delivery *[CORRECT]*
B. Administer an antihypertensive and discharge home with weekly nonstress tests
C. Encourage strict bed rest at home with daily fetal kick counts
D. Obtain a 24-hour urine collection and reevaluate at the next prenatal visit
Correct Answer: A
Rationale: This client has severe preeclampsia with severe features (severe-range BP, cerebral and epigastric
symptoms) at 34 weeks. Magnesium sulfate prevents eclamptic seizures, antihypertensives control BP, and delivery
is the only cure, so AWHONN and ACOG standards support stabilization and prompt birth. Expectant
management is reserved for stable clients at less than 34 weeks, and sending this client home risks eclampsia,
HELLP, abruption, and fetal death.
Q3: A client receiving a magnesium sulfate infusion for severe preeclampsia has a respiratory rate of
10 breaths/min, absent deep tendon reflexes, and urine output of 20 mL/hr. What is the nurse's first
action?
A. Increase the infusion rate to prevent an eclamptic seizure
B. Draw a serum magnesium level and continue the current infusion
C. Discontinue the magnesium sulfate infusion and prepare to administer calcium gluconate
*[CORRECT]*
D. Apply oxygen at 10 L/min via face mask and reposition the client
Correct Answer: C
Rationale: Respiratory depression below 12 breaths/min, absent patellar reflexes, and oliguria indicate magnesium
sulfate toxicity; the infusion must be stopped immediately and the antidote, calcium gluconate, readied. Raising the
rate or continuing the infusion would worsen respiratory and cardiac depression. Respiratory depression takes
priority over oxygen administration because the problem is hypoventilation from magnesium excess, not simple
hypoxemia.
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 2
,Exam 2 - NUR 2513 Maternal-Child Nursing (2026/2027) 120 Questions | 7 Sections
Q4: A 33-week pregnant client reports right upper quadrant pain and nausea. The nurse reviews her
laboratory results: elevated LDH with schistocytes on smear, AST 148 units/L, ALT 162 units/L, and
platelets 86,000/mm3. The nurse recognizes these findings as consistent with which condition?
A. Physiologic anemia of pregnancy
B. Benign gestational thrombocytopenia
C. Intrahepatic cholestasis of pregnancy
D. HELLP syndrome *[CORRECT]*
Correct Answer: D
Rationale: HELLP syndrome - Hemolysis (elevated LDH, schistocytes), Elevated Liver enzymes (AST/ALT), and
Low Platelets below 100,000/mm3 - is a severe variant of preeclampsia that frequently presents with epigastric or
right upper quadrant pain. Physiologic anemia and gestational thrombocytopenia do not produce hepatocellular
injury, and cholestasis presents with pruritus and elevated bile acids rather than hemolysis. HELLP mandates
magnesium sulfate, blood product readiness, and delivery per AWHONN hypertensive disorder standards.
Q5: A 29-week pregnant client arrives with sudden onset of painless, bright-red vaginal bleeding. Her
uterus is soft and nontender, and the fetal heart rate is 140 beats/min with moderate variability. What is
the nurse's priority action?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Prepare the client for ultrasound to determine placental location *[CORRECT]*
C. Insert an indwelling urinary catheter for strict output monitoring
D. Begin oxytocin induction to accelerate delivery
Correct Answer: B
Rationale: Painless, bright-red bleeding with a soft, nontender uterus is the classic presentation of placenta previa,
and location must be confirmed by ultrasound before any digital examination. A digital examination before previa
is excluded can disrupt placental vessels and trigger catastrophic hemorrhage, particularly with coexisting placenta
accreta. Induction is unsafe when the placenta covers the os, and the stable fetal status allows diagnostic imaging
first per NUR 2513 antepartum hemorrhage protocol.
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 3
, Exam 2 - NUR 2513 Maternal-Child Nursing (2026/2027) 120 Questions | 7 Sections
Q6: A 32-week G2P1 presents with sudden dark-red vaginal bleeding, severe constant abdominal pain,
and a rigid, board-like uterus. The fetal heart tracing shows recurrent late decelerations. The nurse
correctly interprets these findings and prepares the client for which outcome?
A. Placental abruption with fetal compromise; prepare for emergent delivery *[CORRECT]*
B. Placenta previa; anticipate expectant management and bed rest
C. Uterine rupture; anticipate tocolysis and cervical cerclage
D. Vasa previa; anticipate expectant monitoring until 36 weeks
Correct Answer: A
Rationale: Painful dark bleeding with a board-like uterus and non-reassuring fetal status indicates placental
abruption with concealed hemorrhage, a leading cause of fetal demise and DIC. Because bleeding may be
concealed behind the placenta, visible blood loss poorly estimates true hemorrhage. Delivery, often by cesarean
birth, is the priority when the fetus is compromised; expectant management is appropriate only when both the fetus
and mother are stable despite a preterm gestation.
Q7: A 28-year-old client at 7 weeks' gestation reports unilateral lower-quadrant pain and light vaginal
spotting. She is hemodynamically stable with a small, soft uterus and minimal hCG elevation without
fetal cardiac activity. If she meets clinical criteria, which management does the nurse anticipate?
A. Immediate laparoscopic salpingectomy
B. Strict bed rest with weekly hCG levels only
C. Intramuscular methotrexate with serial hCG follow-up *[CORRECT]*
D. Oxytocin induction to evacuate the pregnancy
Correct Answer: C
Rationale: An unruptured ectopic pregnancy smaller than about 3.5 cm without fetal cardiac activity can be
treated medically with methotrexate, preserving tubal function when the client is stable and reliable for serial hCG
follow-up. Surgery is reserved for rupture, hemodynamic instability, significant pain, or failure of medical therapy.
Expectant management alone is uncommon once symptoms appear, and oxytocin has no effect on ectopic tissue
because it acts only on uterine myometrium.
NUR 2513 Maternal-Child Nursing - Comprehensive Examination 2 4
