,NRNP 6553 Advanced Nurse Practice in Obstetric
Health Care Exam Prep — Comprehensive Review +
Practice MCQs — Walden University 2025/2026
1. A 24-year-old G1P0 at 10 weeks gestation presents for her initial prenatal visit. Which finding on history
would be considered a risk factor requiring closer monitoring?
A. Occasional nausea without vomiting
B. Mild fatigue relieved by rest
C. History of untreated hypothyroidism
D. Breast tenderness
Correct Answer: C. History of untreated hypothyroidism
Rationale: Untreated hypothyroidism in pregnancy is associated with increased risk of miscarriage, preterm
birth, and impaired fetal neurodevelopment. Thyroid function should be assessed and treated appropriately.
Nausea, fatigue, and breast tenderness are normal physiologic changes of early pregnancy.
2. A patient at 28 weeks gestation reports occasional palpitations. ECG shows normal sinus rhythm. What is the
most likely explanation?
A. Peripartum cardiomyopathy
B. Physiologic increase in cardiac output
C. Pulmonary embolism
D. Mitral stenosis
,Correct Answer: B. Physiologic increase in cardiac output
Rationale: Cardiac output increases 30–50% during pregnancy, primarily due to increased stroke volume and
heart rate. Palpitations and mild tachycardia are common physiologic findings in the absence of structural
heart disease.
3. Which laboratory finding is expected in a normal pregnancy at 20 weeks?
A. Hemoglobin 9.5 g/dL
B. Platelet count 90,000/mm³
C. Creatinine 1.4 mg/dL
D. Fasting glucose 85 mg/dL
Correct Answer: D. Fasting glucose 85 mg/dL
Rationale: Fasting glucose remains within normal non-pregnant ranges. Hemoglobin dilution occurs, but <10.5
g/dL suggests anemia. Platelets may slightly decrease but <100,000 requires evaluation. Creatinine decreases
due to increased GFR; 1.4 mg/dL is abnormal.
4. A 32-year-old G3P2 at 36 weeks presents with a blood pressure of 158/102 mmHg on two occasions 4 hours
apart. She has no proteinuria or symptoms. What is the most appropriate next step?
A. Reassure and recheck in one week
B. Initiate antihypertensive therapy and monitor closely
C. Immediate delivery
D. Order 24-hour urine protein and discharge
, Correct Answer: B. Initiate antihypertensive therapy and monitor closely
Rationale: Gestational hypertension with BP ≥160/110 requires treatment. Even at 158/102, persistent
elevation warrants antihypertensive initiation and close monitoring for progression to preeclampsia. Delivery is
not immediate without severe features or fetal indication.
5. A patient at 34 weeks with preeclampsia without severe features is being managed expectantly. Which
symptom would indicate progression to severe features?
A. 1+ proteinuria
B. Blood pressure 145/95 mmHg
C. Persistent headache unresponsive to acetaminophen
D. Mild ankle edema
Correct Answer: C. Persistent headache unresponsive to acetaminophen
Rationale: Severe features of preeclampsia include persistent headache, visual disturbances, RUQ pain, BP
≥160/110, platelets <100,000, elevated liver enzymes, renal insufficiency, or pulmonary edema. Mild edema
and 1+ proteinuria are not severe features.
6. A patient receiving magnesium sulfate for preeclampsia demonstrates loss of deep tendon reflexes. What is
the priority nursing action?
A. Increase the infusion rate
B. Discontinue magnesium sulfate and notify the provider
C. Administer calcium gluconate
Health Care Exam Prep — Comprehensive Review +
Practice MCQs — Walden University 2025/2026
1. A 24-year-old G1P0 at 10 weeks gestation presents for her initial prenatal visit. Which finding on history
would be considered a risk factor requiring closer monitoring?
A. Occasional nausea without vomiting
B. Mild fatigue relieved by rest
C. History of untreated hypothyroidism
D. Breast tenderness
Correct Answer: C. History of untreated hypothyroidism
Rationale: Untreated hypothyroidism in pregnancy is associated with increased risk of miscarriage, preterm
birth, and impaired fetal neurodevelopment. Thyroid function should be assessed and treated appropriately.
Nausea, fatigue, and breast tenderness are normal physiologic changes of early pregnancy.
2. A patient at 28 weeks gestation reports occasional palpitations. ECG shows normal sinus rhythm. What is the
most likely explanation?
A. Peripartum cardiomyopathy
B. Physiologic increase in cardiac output
C. Pulmonary embolism
D. Mitral stenosis
,Correct Answer: B. Physiologic increase in cardiac output
Rationale: Cardiac output increases 30–50% during pregnancy, primarily due to increased stroke volume and
heart rate. Palpitations and mild tachycardia are common physiologic findings in the absence of structural
heart disease.
3. Which laboratory finding is expected in a normal pregnancy at 20 weeks?
A. Hemoglobin 9.5 g/dL
B. Platelet count 90,000/mm³
C. Creatinine 1.4 mg/dL
D. Fasting glucose 85 mg/dL
Correct Answer: D. Fasting glucose 85 mg/dL
Rationale: Fasting glucose remains within normal non-pregnant ranges. Hemoglobin dilution occurs, but <10.5
g/dL suggests anemia. Platelets may slightly decrease but <100,000 requires evaluation. Creatinine decreases
due to increased GFR; 1.4 mg/dL is abnormal.
4. A 32-year-old G3P2 at 36 weeks presents with a blood pressure of 158/102 mmHg on two occasions 4 hours
apart. She has no proteinuria or symptoms. What is the most appropriate next step?
A. Reassure and recheck in one week
B. Initiate antihypertensive therapy and monitor closely
C. Immediate delivery
D. Order 24-hour urine protein and discharge
, Correct Answer: B. Initiate antihypertensive therapy and monitor closely
Rationale: Gestational hypertension with BP ≥160/110 requires treatment. Even at 158/102, persistent
elevation warrants antihypertensive initiation and close monitoring for progression to preeclampsia. Delivery is
not immediate without severe features or fetal indication.
5. A patient at 34 weeks with preeclampsia without severe features is being managed expectantly. Which
symptom would indicate progression to severe features?
A. 1+ proteinuria
B. Blood pressure 145/95 mmHg
C. Persistent headache unresponsive to acetaminophen
D. Mild ankle edema
Correct Answer: C. Persistent headache unresponsive to acetaminophen
Rationale: Severe features of preeclampsia include persistent headache, visual disturbances, RUQ pain, BP
≥160/110, platelets <100,000, elevated liver enzymes, renal insufficiency, or pulmonary edema. Mild edema
and 1+ proteinuria are not severe features.
6. A patient receiving magnesium sulfate for preeclampsia demonstrates loss of deep tendon reflexes. What is
the priority nursing action?
A. Increase the infusion rate
B. Discontinue magnesium sulfate and notify the provider
C. Administer calcium gluconate
