NU 661 Exam 4 V3 | NU 661 Primary Care
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 4) | Regis
1. A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 155/96
mmHg and 2+ proteinuria. Which of the following findings would lead the clinician to
categorize this as preeclampsia with severe features? (Select All That Apply)
A. Platelet count less than 100,000/microliter
B. Trace edema in lower extremities
C. Serum creatinine greater than 1.1 mg/dL
D. Cerebral or visual disturbances
E. Hepatic transaminases at least twice the upper limit of normal
F. Fetal heart rate of 140 bpm
Correct Answer: A, C, D, E
Severe features of preeclampsia include thrombocytopenia, renal insufficiency, impaired
liver function, and new-onset neurological symptoms. Trace edema is considered a
common physiological change in pregnancy rather than a diagnostic criterion for severity.
Accurate identification is critical for determining whether immediate delivery or inpatient
stabilization is required for maternal safety.
,2. Which of the following instructions should the nurse practitioner provide to a pregnant
patient regarding the administration of iron supplements?
A. Take the supplement with orange juice to enhance absorption.
B. Take the supplement with a glass of milk to prevent gastric upset.
C. Take the supplement immediately after a large meal.
D. Decrease fiber intake to manage potential side effects.
Correct Answer: A
Vitamin C significantly increases the bioavailability of non-heme iron by facilitating its
absorption in the duodenum. Patients should be advised that calcium and caffeine can
inhibit iron absorption and should be avoided at the time of ingestion. Maintaining high
fiber and fluid intake is necessary to combat the common side effect of constipation
associated with iron therapy.
3. A woman at 28 weeks gestation is Rh-negative and her antibody screen is negative. What is
the standard protocol for Rho(D) immune globulin (RhoGAM) administration?
A. Wait until after delivery to administer RhoGAM.
B. Administer 300 mcg of RhoGAM intramuscularly at 28 weeks gestation.
C. Administer RhoGAM only if the patient experiences trauma.
D. Administer RhoGAM at every prenatal visit starting in the second trimester.
Correct Answer: B
, Standard practice guidelines dictate the administration of RhoGAM at 28 weeks gestation
to prevent isoimmunization in Rh-negative mothers with negative antibody screens. A
second dose is typically administered within 72 hours of delivery if the newborn is
confirmed to be Rh-positive. This intervention is vital in protecting future pregnancies
from hemolytic disease of the newborn.
4. Which clinical finding is most characteristic of a placenta previa rather than an abruptio
placentae?
A. Rigid, board-like abdomen
B. Painless, bright red vaginal bleeding
C. Severe abdominal pain
D. Dark red vaginal bleeding with uterine tenderness
Correct Answer: B
Placenta previa classically presents as painless vaginal bleeding in the second or third
trimester due to the placenta partially or totally covering the internal os. In contrast,
placental abruption involves the premature separation of the placenta and is usually
accompanied by significant pain and uterine rigidity. Digital vaginal exams are strictly
contraindicated until placenta previa is ruled out by ultrasound.
5. According to ACOG guidelines, when should screening for Group B Streptococcus (GBS) be
performed in a low-risk pregnancy?
A. 36 0/7 to 37 6/7 weeks gestation
of Childbearing Woman | Actual Q&A with
Rationale (NU661 Exam 4) | Regis
1. A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 155/96
mmHg and 2+ proteinuria. Which of the following findings would lead the clinician to
categorize this as preeclampsia with severe features? (Select All That Apply)
A. Platelet count less than 100,000/microliter
B. Trace edema in lower extremities
C. Serum creatinine greater than 1.1 mg/dL
D. Cerebral or visual disturbances
E. Hepatic transaminases at least twice the upper limit of normal
F. Fetal heart rate of 140 bpm
Correct Answer: A, C, D, E
Severe features of preeclampsia include thrombocytopenia, renal insufficiency, impaired
liver function, and new-onset neurological symptoms. Trace edema is considered a
common physiological change in pregnancy rather than a diagnostic criterion for severity.
Accurate identification is critical for determining whether immediate delivery or inpatient
stabilization is required for maternal safety.
,2. Which of the following instructions should the nurse practitioner provide to a pregnant
patient regarding the administration of iron supplements?
A. Take the supplement with orange juice to enhance absorption.
B. Take the supplement with a glass of milk to prevent gastric upset.
C. Take the supplement immediately after a large meal.
D. Decrease fiber intake to manage potential side effects.
Correct Answer: A
Vitamin C significantly increases the bioavailability of non-heme iron by facilitating its
absorption in the duodenum. Patients should be advised that calcium and caffeine can
inhibit iron absorption and should be avoided at the time of ingestion. Maintaining high
fiber and fluid intake is necessary to combat the common side effect of constipation
associated with iron therapy.
3. A woman at 28 weeks gestation is Rh-negative and her antibody screen is negative. What is
the standard protocol for Rho(D) immune globulin (RhoGAM) administration?
A. Wait until after delivery to administer RhoGAM.
B. Administer 300 mcg of RhoGAM intramuscularly at 28 weeks gestation.
C. Administer RhoGAM only if the patient experiences trauma.
D. Administer RhoGAM at every prenatal visit starting in the second trimester.
Correct Answer: B
, Standard practice guidelines dictate the administration of RhoGAM at 28 weeks gestation
to prevent isoimmunization in Rh-negative mothers with negative antibody screens. A
second dose is typically administered within 72 hours of delivery if the newborn is
confirmed to be Rh-positive. This intervention is vital in protecting future pregnancies
from hemolytic disease of the newborn.
4. Which clinical finding is most characteristic of a placenta previa rather than an abruptio
placentae?
A. Rigid, board-like abdomen
B. Painless, bright red vaginal bleeding
C. Severe abdominal pain
D. Dark red vaginal bleeding with uterine tenderness
Correct Answer: B
Placenta previa classically presents as painless vaginal bleeding in the second or third
trimester due to the placenta partially or totally covering the internal os. In contrast,
placental abruption involves the premature separation of the placenta and is usually
accompanied by significant pain and uterine rigidity. Digital vaginal exams are strictly
contraindicated until placenta previa is ruled out by ultrasound.
5. According to ACOG guidelines, when should screening for Group B Streptococcus (GBS) be
performed in a low-risk pregnancy?
A. 36 0/7 to 37 6/7 weeks gestation
