,NU 171/NU171 Exam 3 | Maternal Child Nursing (2026)
Q&A | Galen College
1. Which finding most reliably indicates that a client is in true labor?
A) Contractions that stop when the client walks
B) Progressive cervical dilation and effacement
C) Irregular abdominal tightening
D) Increased urinary frequency
Correct Answer: Progressive cervical dilation and effacement
Rationale: True labor is confirmed by progressive cervical change, which does not
occur in false labor. Contractions that stop with walking, irregular tightening, and
urinary frequency can occur in false labor or early pregnancy and are not definitive.
Cervical dila tion and effacement are objective, measurable indicators that labor is
true and progressing.
2. What is the priority nursing action for a client at 32 weeks' gestation reporting
contractions every 5 minutes with cervical dilation of 2 cm?
A) Prepare immediately for cesarean birth
B) Assess maternal and fetal status
C) Encourage the client to push
D) Discharge the client home
Correct Answer: Assess maternal and fetal status
Rationale: The initial management of suspected preterm labor begins with a
comprehensive assessment of maternal condition, fetal well - being, contraction
pattern, and cervical change. This assessment guides subsequent interventions.
Preparing for cesarean birth, enco uraging pushing, and discharging the client are
not appropriate initial actions.
,3. A client at 28 weeks' gestation is admitted with painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A) Placental abruption
B) Preterm labor
C) Placenta previa
D) Vasa previa
Correct Answer: Placenta previa
Rationale: Placenta previa classically presents with painless, bright red vaginal
bleeding in the second or third trimester. A digital cervical examination is
contraindicated because it can cause severe hemorrhage. Abruptio placentae
presents with painful, dark red bleeding and a rigid uterus. Preterm labor presents
with contractions, not painless bleeding.
4. Which laboratory abnormality is characteristic of HELLP syndrome?
A) Hemolysis, elevated liver enzymes, and low platelets
B) Hyperglycemia, elevated lipase, and low potassium
C) Hemoconcentration, elevated BUN, and low creatinine
D) Hypernatremia, elevated bilirubin, and low calcium
Correct Answer: Hemolysis, elevated liver enzymes, and low platelets
Rationale: HELLP syndrome is a severe variant of preeclampsia characterized by
hemolysis, elevated liver enzymes, and low platelets. It requires immediate
recognition and delivery. The other options do not describe the classic HELLP triad.
Early recognition improves maternal and fetal outcomes.
5. A patient with severe preeclampsia is receiving magnesium sulfate. Which finding
indicates magnesium toxicity?
A) Blood pressure 140/90 mm Hg
B) Loss of deep tendon reflexes
C) Urine output 45 mL/hr
, D) Respiratory rate 18 breaths/min
Correct Answer: Loss of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is the earliest sign of magnesium toxicity,
followed by respiratory depression and cardiac arrest. Calcium gluconate is the
antidote. Urine output of 45 mL/hr is adequate, and a respiratory rate of 18 is
normal. Blood pressure of 140/90 mm Hg is not a sign of magnesium toxicity.
6. Which medication is administered to accelerate fetal lung maturity in a client at
30 weeks' gestation in preterm labor?
A) Magnesium sulfate
B) Betamethasone
C) Oxytocin
D) RhoGAM
Correct Answer: Betamethasone
Rationale: Betamethasone is a corticosteroid given between 24 and 34 weeks'
gestation to accelerate fetal lung maturity and reduce the risk of respiratory
distress syndrome. It requires two doses intramuscularly 24 hours apart.
Magnesium sulfate is used for seizure prophylaxis. Oxytocin induces labor. RhoGAM
prevents Rh sensitization.
7. A Rh - negative mother delivers an Rh - positive infant. When should RhoGAM be
administered?
A) Within 24 hours of delivery
B) Within 72 hours of delivery
C) At the first postpartum visit
D) Only if the infant develops jaundice
Correct Answer: Within 72 hours of delivery
Q&A | Galen College
1. Which finding most reliably indicates that a client is in true labor?
A) Contractions that stop when the client walks
B) Progressive cervical dilation and effacement
C) Irregular abdominal tightening
D) Increased urinary frequency
Correct Answer: Progressive cervical dilation and effacement
Rationale: True labor is confirmed by progressive cervical change, which does not
occur in false labor. Contractions that stop with walking, irregular tightening, and
urinary frequency can occur in false labor or early pregnancy and are not definitive.
Cervical dila tion and effacement are objective, measurable indicators that labor is
true and progressing.
2. What is the priority nursing action for a client at 32 weeks' gestation reporting
contractions every 5 minutes with cervical dilation of 2 cm?
A) Prepare immediately for cesarean birth
B) Assess maternal and fetal status
C) Encourage the client to push
D) Discharge the client home
Correct Answer: Assess maternal and fetal status
Rationale: The initial management of suspected preterm labor begins with a
comprehensive assessment of maternal condition, fetal well - being, contraction
pattern, and cervical change. This assessment guides subsequent interventions.
Preparing for cesarean birth, enco uraging pushing, and discharging the client are
not appropriate initial actions.
,3. A client at 28 weeks' gestation is admitted with painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A) Placental abruption
B) Preterm labor
C) Placenta previa
D) Vasa previa
Correct Answer: Placenta previa
Rationale: Placenta previa classically presents with painless, bright red vaginal
bleeding in the second or third trimester. A digital cervical examination is
contraindicated because it can cause severe hemorrhage. Abruptio placentae
presents with painful, dark red bleeding and a rigid uterus. Preterm labor presents
with contractions, not painless bleeding.
4. Which laboratory abnormality is characteristic of HELLP syndrome?
A) Hemolysis, elevated liver enzymes, and low platelets
B) Hyperglycemia, elevated lipase, and low potassium
C) Hemoconcentration, elevated BUN, and low creatinine
D) Hypernatremia, elevated bilirubin, and low calcium
Correct Answer: Hemolysis, elevated liver enzymes, and low platelets
Rationale: HELLP syndrome is a severe variant of preeclampsia characterized by
hemolysis, elevated liver enzymes, and low platelets. It requires immediate
recognition and delivery. The other options do not describe the classic HELLP triad.
Early recognition improves maternal and fetal outcomes.
5. A patient with severe preeclampsia is receiving magnesium sulfate. Which finding
indicates magnesium toxicity?
A) Blood pressure 140/90 mm Hg
B) Loss of deep tendon reflexes
C) Urine output 45 mL/hr
, D) Respiratory rate 18 breaths/min
Correct Answer: Loss of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is the earliest sign of magnesium toxicity,
followed by respiratory depression and cardiac arrest. Calcium gluconate is the
antidote. Urine output of 45 mL/hr is adequate, and a respiratory rate of 18 is
normal. Blood pressure of 140/90 mm Hg is not a sign of magnesium toxicity.
6. Which medication is administered to accelerate fetal lung maturity in a client at
30 weeks' gestation in preterm labor?
A) Magnesium sulfate
B) Betamethasone
C) Oxytocin
D) RhoGAM
Correct Answer: Betamethasone
Rationale: Betamethasone is a corticosteroid given between 24 and 34 weeks'
gestation to accelerate fetal lung maturity and reduce the risk of respiratory
distress syndrome. It requires two doses intramuscularly 24 hours apart.
Magnesium sulfate is used for seizure prophylaxis. Oxytocin induces labor. RhoGAM
prevents Rh sensitization.
7. A Rh - negative mother delivers an Rh - positive infant. When should RhoGAM be
administered?
A) Within 24 hours of delivery
B) Within 72 hours of delivery
C) At the first postpartum visit
D) Only if the infant develops jaundice
Correct Answer: Within 72 hours of delivery
