NURS 2156 REVISION EXAM:
COMPLICATIONS OF CHILDBEARING
NURSING EXAM PRACTICE QUESTIONS
WITH VERIFIED ANSWERS AND DETAILED
RATIONALES |LATEST UPDATE
SECTION 1: HYPERTENSIVE DISORDERS OF PREGNANCY
(Questions 1-75)
1. A nurse is reviewing the medical record of a pregnant client at 22 weeks
gestation. The client's blood pressure has been consistently 148/94 mm Hg
over two separate readings six hours apart. The client has no proteinuria.
Which classification of hypertensive disorder does the nurse anticipate?
A. Chronic hypertension
B. Gestational hypertension
C. Pre-eclampsia
D. Eclampsia
Answer: B
Rationale: Gestational hypertension is defined as blood pressure ≥140/90 mm Hg
appearing after 20 weeks gestation in a previously normotensive woman, without
proteinuria. Chronic hypertension would be diagnosed before 20 weeks or before
pregnancy. Pre-eclampsia requires proteinuria or another end-organ dysfunction.
Eclampsia involves seizures, which are not present here.
,2. A nurse is assessing a client at 36 weeks gestation who presents with blood
pressure 168/112 mm Hg, severe headache, and visual disturbances. Which
condition should the nurse suspect?
A. Gestational hypertension
B. Mild pre-eclampsia
C. Severe pre-eclampsia
D. Chronic hypertension
Answer: C
Rationale: Severe pre-eclampsia is characterized by blood pressure ≥160/110 mm
Hg with signs of end-organ involvement such as severe headache and visual
disturbances. Mild pre-eclampsia typically presents with BP ≥140/90 but <160/110
with mild symptoms. Gestational hypertension lacks these severe features. Chronic
hypertension would have been present before 20 weeks.
3. A nurse is caring for a client with severe pre-eclampsia who is receiving
magnesium sulfate. Which assessment finding indicates magnesium toxicity?
A. Blood pressure 138/88 mm Hg
B. Respiratory rate of 10 breaths per minute
C. Urine output of 50 mL/hour
D. Deep tendon reflexes 2+
Answer: B
Rationale: Magnesium toxicity is indicated by respiratory depression (RR <12
breaths/min), loss of deep tendon reflexes, and oliguria. A respiratory rate of 10 is
dangerously low and indicates toxicity. Blood pressure of 138/88 is acceptable.
Urine output of 50 mL/hour is adequate (minimum 30 mL/hour required). Deep
tendon reflexes of 2+ are normal.
4. The antidote for magnesium sulfate toxicity is:
A. Naloxone
B. Calcium gluconate
,C. Protamine sulfate
D. Vitamin K
Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity.
Naloxone is the antidote for opioid overdose. Protamine sulfate reverses heparin.
Vitamin K reverses warfarin.
5. A nurse is teaching a client with chronic hypertension who is planning to
become pregnant. Which statement by the client indicates understanding?
A. "I should stop taking my blood pressure medication immediately when I find
out I'm pregnant."
B. "I need to maintain my blood pressure below 140/90 mm Hg before
conception."
C. "My blood pressure will naturally decrease during pregnancy, so I won't need
medication."
D. "I should only take medication during the third trimester."
Answer: B
Rationale: Women with chronic hypertension should achieve optimal blood
pressure control before conception, typically below 140/90 mm Hg. Medications
should not be stopped abruptly without medical supervision. While blood pressure
may decrease slightly in the second trimester, medication is often still needed.
Treatment is not limited to the third trimester.
6. Which finding in a client at 34 weeks gestation should the nurse report
immediately as a sign of worsening pre-eclampsia?
A. Blood pressure 142/92 mm Hg
B. 1+ proteinuria
C. Platelet count of 95,000/mm³
D. Mild ankle edema
Answer: C
, Rationale: A platelet count below 100,000/mm³ indicates thrombocytopenia,
which is a sign of HELLP syndrome and worsening pre-eclampsia. Blood pressure
142/92 and 1+ proteinuria are consistent with mild pre-eclampsia. Mild ankle
edema is common in pregnancy.
7. A nurse is assessing a client with pre-eclampsia. Which laboratory value
requires immediate intervention?
A. Hemoglobin 11.5 g/dL
B. Serum creatinine 1.8 mg/dL
C. WBC 12,000/mm³
D. Platelets 180,000/mm³
Answer: B
Rationale: Serum creatinine of 1.8 mg/dL indicates renal impairment, which is a
sign of severe pre-eclampsia with end-organ damage. Normal creatinine in
pregnancy is 0.5-1.0 mg/dL. Hemoglobin 11.5 is within normal limits for
pregnancy. WBC 12,000 is slightly elevated but common in pregnancy. Platelets
180,000 is within normal limits.
8. A client with severe pre-eclampsia is prescribed hydralazine. The nurse
should monitor for which adverse effect?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Hyperkalemia
Answer: C
Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as a
compensatory response to decreased blood pressure. Bradycardia is not typical.
Hypertension would indicate the medication is not working. Hyperkalemia is not
associated with hydralazine.
COMPLICATIONS OF CHILDBEARING
NURSING EXAM PRACTICE QUESTIONS
WITH VERIFIED ANSWERS AND DETAILED
RATIONALES |LATEST UPDATE
SECTION 1: HYPERTENSIVE DISORDERS OF PREGNANCY
(Questions 1-75)
1. A nurse is reviewing the medical record of a pregnant client at 22 weeks
gestation. The client's blood pressure has been consistently 148/94 mm Hg
over two separate readings six hours apart. The client has no proteinuria.
Which classification of hypertensive disorder does the nurse anticipate?
A. Chronic hypertension
B. Gestational hypertension
C. Pre-eclampsia
D. Eclampsia
Answer: B
Rationale: Gestational hypertension is defined as blood pressure ≥140/90 mm Hg
appearing after 20 weeks gestation in a previously normotensive woman, without
proteinuria. Chronic hypertension would be diagnosed before 20 weeks or before
pregnancy. Pre-eclampsia requires proteinuria or another end-organ dysfunction.
Eclampsia involves seizures, which are not present here.
,2. A nurse is assessing a client at 36 weeks gestation who presents with blood
pressure 168/112 mm Hg, severe headache, and visual disturbances. Which
condition should the nurse suspect?
A. Gestational hypertension
B. Mild pre-eclampsia
C. Severe pre-eclampsia
D. Chronic hypertension
Answer: C
Rationale: Severe pre-eclampsia is characterized by blood pressure ≥160/110 mm
Hg with signs of end-organ involvement such as severe headache and visual
disturbances. Mild pre-eclampsia typically presents with BP ≥140/90 but <160/110
with mild symptoms. Gestational hypertension lacks these severe features. Chronic
hypertension would have been present before 20 weeks.
3. A nurse is caring for a client with severe pre-eclampsia who is receiving
magnesium sulfate. Which assessment finding indicates magnesium toxicity?
A. Blood pressure 138/88 mm Hg
B. Respiratory rate of 10 breaths per minute
C. Urine output of 50 mL/hour
D. Deep tendon reflexes 2+
Answer: B
Rationale: Magnesium toxicity is indicated by respiratory depression (RR <12
breaths/min), loss of deep tendon reflexes, and oliguria. A respiratory rate of 10 is
dangerously low and indicates toxicity. Blood pressure of 138/88 is acceptable.
Urine output of 50 mL/hour is adequate (minimum 30 mL/hour required). Deep
tendon reflexes of 2+ are normal.
4. The antidote for magnesium sulfate toxicity is:
A. Naloxone
B. Calcium gluconate
,C. Protamine sulfate
D. Vitamin K
Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity.
Naloxone is the antidote for opioid overdose. Protamine sulfate reverses heparin.
Vitamin K reverses warfarin.
5. A nurse is teaching a client with chronic hypertension who is planning to
become pregnant. Which statement by the client indicates understanding?
A. "I should stop taking my blood pressure medication immediately when I find
out I'm pregnant."
B. "I need to maintain my blood pressure below 140/90 mm Hg before
conception."
C. "My blood pressure will naturally decrease during pregnancy, so I won't need
medication."
D. "I should only take medication during the third trimester."
Answer: B
Rationale: Women with chronic hypertension should achieve optimal blood
pressure control before conception, typically below 140/90 mm Hg. Medications
should not be stopped abruptly without medical supervision. While blood pressure
may decrease slightly in the second trimester, medication is often still needed.
Treatment is not limited to the third trimester.
6. Which finding in a client at 34 weeks gestation should the nurse report
immediately as a sign of worsening pre-eclampsia?
A. Blood pressure 142/92 mm Hg
B. 1+ proteinuria
C. Platelet count of 95,000/mm³
D. Mild ankle edema
Answer: C
, Rationale: A platelet count below 100,000/mm³ indicates thrombocytopenia,
which is a sign of HELLP syndrome and worsening pre-eclampsia. Blood pressure
142/92 and 1+ proteinuria are consistent with mild pre-eclampsia. Mild ankle
edema is common in pregnancy.
7. A nurse is assessing a client with pre-eclampsia. Which laboratory value
requires immediate intervention?
A. Hemoglobin 11.5 g/dL
B. Serum creatinine 1.8 mg/dL
C. WBC 12,000/mm³
D. Platelets 180,000/mm³
Answer: B
Rationale: Serum creatinine of 1.8 mg/dL indicates renal impairment, which is a
sign of severe pre-eclampsia with end-organ damage. Normal creatinine in
pregnancy is 0.5-1.0 mg/dL. Hemoglobin 11.5 is within normal limits for
pregnancy. WBC 12,000 is slightly elevated but common in pregnancy. Platelets
180,000 is within normal limits.
8. A client with severe pre-eclampsia is prescribed hydralazine. The nurse
should monitor for which adverse effect?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Hyperkalemia
Answer: C
Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as a
compensatory response to decreased blood pressure. Bradycardia is not typical.
Hypertension would indicate the medication is not working. Hyperkalemia is not
associated with hydralazine.
