NUR2513 MATERNAL-CHILD NURSING
ADVANCED EXAM QUESTIONS AND
ANSWERS
1. A nurse is reviewing the obstetric history of a client who is currently at 12 weeks gestation.
The client has a 5-year-old child born at 39 weeks, a 3-year-old born at 34 weeks, and had a
spontaneous abortion at 8 weeks. How should the nurse document her GTPAL?
A. G3 T1 P1 A1 L2
B. G4 T1 P1 A1 L2
C. G4 T2 P0 A1 L2
D. G3 T2 P1 A0 L2
Answer: B
Conceptual Explanation: G (Gravida) is 4 (current pregnancy, 39-weeker, 34-weeker, and
abortion). T (Term) is 1 (39-weeker). P (Preterm) is 1 (34-weeker). A (Abortion) is 1 (8-
week miscarriage). L (Living) is 2.
,2. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on October 15?
A. July 8
B. August 15
C. July 22
D. June 22
Answer: C
Conceptual Explanation: Naegele’s rule involves subtracting 3 months and adding 7 days
and 1 year to the LMP. October minus 3 months is July; 15 plus 7 days is 22.
3. A client at 32 weeks gestation is admitted with a diagnosis of severe preeclampsia. Which
laboratory finding should the nurse prioritize reporting to the provider?
A. Platelet count 95,000/mm3
B. Hemoglobin 11.5 g/dL
C. Creatinine 0.8 mg/dL
D. Uric acid 5.2 mg/dL
Answer: A
Conceptual Explanation: A platelet count below 100,000/mm3 indicates
thrombocytopenia, a sign of worsening preeclampsia or HELLP syndrome.
, 4. A nurse is monitoring a client receiving magnesium sulfate for preeclampsia. Which finding
indicates magnesium toxicity?
A. Blood pressure 150/95 mmHg
B. Urinary output of 40 mL/hr
C. Absent deep tendon reflexes
D. Respiratory rate of 16/min
Answer: C
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity. Other signs include respiratory depression (<12/min) and oliguria.
5. What is the primary purpose of administering Rho(D) immune globulin (RhoGAM) to an Rh-
negative mother at 28 weeks gestation?
A. To treat fetal hemolytic disease
B. To stimulate fetal red blood cell production
C. To prevent the mother from forming antibodies against Rh-positive fetal blood
D. To prevent ABO incompatibility
Answer: C
Conceptual Explanation: RhoGAM prevents the Rh-negative mother’s immune system
from recognizing Rh-positive fetal blood cells and developing antibodies that could attack
future pregnancies.
ADVANCED EXAM QUESTIONS AND
ANSWERS
1. A nurse is reviewing the obstetric history of a client who is currently at 12 weeks gestation.
The client has a 5-year-old child born at 39 weeks, a 3-year-old born at 34 weeks, and had a
spontaneous abortion at 8 weeks. How should the nurse document her GTPAL?
A. G3 T1 P1 A1 L2
B. G4 T1 P1 A1 L2
C. G4 T2 P0 A1 L2
D. G3 T2 P1 A0 L2
Answer: B
Conceptual Explanation: G (Gravida) is 4 (current pregnancy, 39-weeker, 34-weeker, and
abortion). T (Term) is 1 (39-weeker). P (Preterm) is 1 (34-weeker). A (Abortion) is 1 (8-
week miscarriage). L (Living) is 2.
,2. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on October 15?
A. July 8
B. August 15
C. July 22
D. June 22
Answer: C
Conceptual Explanation: Naegele’s rule involves subtracting 3 months and adding 7 days
and 1 year to the LMP. October minus 3 months is July; 15 plus 7 days is 22.
3. A client at 32 weeks gestation is admitted with a diagnosis of severe preeclampsia. Which
laboratory finding should the nurse prioritize reporting to the provider?
A. Platelet count 95,000/mm3
B. Hemoglobin 11.5 g/dL
C. Creatinine 0.8 mg/dL
D. Uric acid 5.2 mg/dL
Answer: A
Conceptual Explanation: A platelet count below 100,000/mm3 indicates
thrombocytopenia, a sign of worsening preeclampsia or HELLP syndrome.
, 4. A nurse is monitoring a client receiving magnesium sulfate for preeclampsia. Which finding
indicates magnesium toxicity?
A. Blood pressure 150/95 mmHg
B. Urinary output of 40 mL/hr
C. Absent deep tendon reflexes
D. Respiratory rate of 16/min
Answer: C
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity. Other signs include respiratory depression (<12/min) and oliguria.
5. What is the primary purpose of administering Rho(D) immune globulin (RhoGAM) to an Rh-
negative mother at 28 weeks gestation?
A. To treat fetal hemolytic disease
B. To stimulate fetal red blood cell production
C. To prevent the mother from forming antibodies against Rh-positive fetal blood
D. To prevent ABO incompatibility
Answer: C
Conceptual Explanation: RhoGAM prevents the Rh-negative mother’s immune system
from recognizing Rh-positive fetal blood cells and developing antibodies that could attack
future pregnancies.
