EXAMS 1, 2, 3 & 4 MATERNAL AND PEDIATRIC
NURSING TEST BANK | GALEN COLLEGE OF NURSING
Question 1
A nurse is assessing a pregnant client at 12 weeks of gestation who reports mild
vaginal bleeding and mild lower abdominal cramping. Upon pelvic
examination, the cervix is found to be closed. Which type of spontaneous
abortion is this client experiencing?
,A) Inevitable abortion
B) Threatened abortion
C) Missed abortion
D) Incomplete abortion
Verified Answer: B) Threatened abortion
Explanation: A threatened abortion is characterized by vaginal bleeding and
mild cramping early in pregnancy, but the cervical os remains tightly closed.
If the cervical os were open, it would progress to an inevitable or incomplete
abortion.
Question 2
A client at 34 weeks of gestation presents to the triage unit with a sudden onset
of severe, continuous abdominal pain, dark red vaginal bleeding, and a rigid,
board-like abdomen. The nurse suspects which of the following obstetric
emergencies?
A) Placenta previa
B) Abruptio placentae
C) Uterine rupture
D) Cervical insufficiency
Verified Answer: B) Abruptio placentae
Explanation: Abruptio placentae involves the premature separation of a
normally implanted placenta from the uterine wall. Classic signs include
painful vaginal bleeding, continuous uterine tenderness, and a characteristic
rigid, board-like abdomen due to concealed or overt hemorrhage. Placenta
previa is typically painless, bright red bleeding.
,Question 3
During a routine prenatal visit at 28 weeks of gestation, a client's blood pressure
is measured at 144/92 mmHg. A urinalysis reveals a protein reading of 2+. The
client has no prior history of hypertension. The nurse should identify these
findings as indicative of:
A) Gestational hypertension
B) Chronic hypertension
C) Preeclampsia
D) Eclampsia
Verified Answer: C) Preeclampsia
Explanation: Preeclampsia is defined as an elevated blood pressure (≥140/90
mmHg) developing after 20 weeks of gestation in a previously normotensive
woman, accompanied by significant proteinuria (≥1+ on dipstick or ≥300 mg
in a 24-hour collection). Gestational hypertension does not present with
significant proteinuria.
Question 4
A nurse is teaching a pregnant client about maternal serum alpha-fetoprotein
(MSAFP) screening. The nurse explains that this blood test is ideally performed
between 15 and 20 weeks of gestation primarily to screen for which conditions?
A) Gestational diabetes mellitus
B) Neural tube defects and chromosomal abnormalities
C) Fetal hemolytic disease
D) Group B Streptococcus colonization
, Verified Answer: B) Neural tube defects and chromosomal abnormalities
Explanation: MSAFP is a maternal screening tool utilized between 15 and 20
weeks to identify structural abnormalities. Elevated levels are strongly
correlated with open neural tube defects (e.g., spina bifida, anencephaly),
whereas low levels can point toward chromosomal anomalies such as Down
syndrome (Trisomy 21).
Question 5
A pregnant client with a pre-pregnancy body mass index (BMI) of 22.0 asks the
nurse about the recommended weight gain during her pregnancy. Based on
current guidelines, the nurse should advise the client to gain a total of:
A) 11 to 20 pounds
B) 15 to 25 pounds
C) 25 to 35 pounds
C) 28 to 40 pounds
Verified Answer: C) 25 to 35 pounds
Explanation: For a woman with a normal pre-pregnancy BMI (18.5 to 24.9),
the recommended total weight gain throughout a singleton pregnancy is 25 to
35 pounds (11.5 to 16 kg). Underweight individuals require more gain, while
overweight and obese individuals require less.
Exam 2 Focus: Intrapartum, Labor Stages, and Electronic Fetal
Monitoring