NCLEX RN Obstetric Emergencies
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A pregnant client at 34 weeks' gestation presents with painless, bright-red
vaginal bleeding. Which condition should the nurse suspect first?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Answer: Placenta previa
Rationale: Placenta previa classically presents with sudden, painless, bright-
red vaginal bleeding in the second or third trimester. Digital vaginal
examination should be avoided until placenta previa is excluded.
2. A client with suspected placenta previa has vaginal bleeding. Which
nursing action is the priority?
A. Perform a digital vaginal examination
B. Encourage ambulation
C. Apply continuous fetal monitoring
D. Administer oxytocin immediately
Answer: Apply continuous fetal monitoring
Rationale: Continuous fetal monitoring helps identify fetal compromise
associated with maternal bleeding. Digital vaginal examination can provoke
severe hemorrhage and should be avoided with suspected placenta previa.
,3. A client at 36 weeks' gestation reports severe abdominal pain, dark vaginal
bleeding, and uterine tenderness. Which complication is most likely?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Answer: Abruptio placentae
Rationale: Placental abruption commonly causes painful vaginal bleeding,
uterine tenderness, abdominal pain, and a firm or rigid uterus.
4. Which finding is most concerning in a client with suspected placental
abruption?
A. Mild nausea
B. Soft, nontender uterus
C. Rigid, tender uterus
D. Increased appetite
Answer: Rigid, tender uterus
Rationale: A rigid, tender uterus is characteristic of placental abruption and
indicates significant uterine irritation and possible concealed hemorrhage.
5. A pregnant client develops a sudden seizure and has severe hypertension.
Which medication should the nurse anticipate administering to prevent
recurrent seizures?
A. Oxytocin
B. Magnesium sulfate
C. Terbutaline
D. Methylergonovine
Answer: Magnesium sulfate
,Rationale: Magnesium sulfate is the medication of choice for seizure
prevention and treatment in clients with preeclampsia and eclampsia.
6. A client receiving magnesium sulfate has absent deep tendon reflexes,
respiratory rate of 8/min, and urine output of 15 mL/hr. What is the nurse's
priority action?
A. Increase the magnesium infusion
B. Continue monitoring
C. Stop the magnesium infusion
D. Administer oxytocin
Answer: Stop the magnesium infusion
Rationale: Absent reflexes, respiratory depression, and oliguria are signs of
magnesium toxicity. The infusion should be stopped and the provider notified;
calcium gluconate may be prescribed as the antidote.
7. Which medication should be readily available when administering
magnesium sulfate?
A. Calcium gluconate
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: Calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity
and should be readily available during therapy.
8. A client with severe preeclampsia suddenly reports severe right-upper-
quadrant pain. Which complication should the nurse suspect?
A. Appendicitis
B. HELLP syndrome
, C. Placenta previa
D. Hyperemesis gravidarum
Answer: HELLP syndrome
Rationale: Right-upper-quadrant or epigastric pain may indicate hepatic
involvement in HELLP syndrome, which consists of hemolysis, elevated liver
enzymes, and low platelet count.
9. Which laboratory finding is associated with HELLP syndrome?
A. Increased platelet count
B. Decreased liver enzymes
C. Low platelet count
D. Increased serum calcium
Answer: Low platelet count
Rationale: Thrombocytopenia is a major feature of HELLP syndrome and
increases the risk of severe bleeding.
10. A pregnant client with eclampsia is actively seizing. What should the
nurse do first?
A. Insert an oral airway
B. Restrain the client's arms and legs
C. Protect the client from injury and maintain the airway
D. Obtain a urine specimen
Answer: Protect the client from injury and maintain the airway
Rationale: During an eclamptic seizure, the immediate priorities are airway
protection, oxygenation, and prevention of injury. The client should not be
restrained or have objects placed in the mouth.
11. A client at 39 weeks suddenly experiences a gush of fluid followed by a
fetal heart rate deceleration. What complication should the nurse suspect?
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A pregnant client at 34 weeks' gestation presents with painless, bright-red
vaginal bleeding. Which condition should the nurse suspect first?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Answer: Placenta previa
Rationale: Placenta previa classically presents with sudden, painless, bright-
red vaginal bleeding in the second or third trimester. Digital vaginal
examination should be avoided until placenta previa is excluded.
2. A client with suspected placenta previa has vaginal bleeding. Which
nursing action is the priority?
A. Perform a digital vaginal examination
B. Encourage ambulation
C. Apply continuous fetal monitoring
D. Administer oxytocin immediately
Answer: Apply continuous fetal monitoring
Rationale: Continuous fetal monitoring helps identify fetal compromise
associated with maternal bleeding. Digital vaginal examination can provoke
severe hemorrhage and should be avoided with suspected placenta previa.
,3. A client at 36 weeks' gestation reports severe abdominal pain, dark vaginal
bleeding, and uterine tenderness. Which complication is most likely?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Answer: Abruptio placentae
Rationale: Placental abruption commonly causes painful vaginal bleeding,
uterine tenderness, abdominal pain, and a firm or rigid uterus.
4. Which finding is most concerning in a client with suspected placental
abruption?
A. Mild nausea
B. Soft, nontender uterus
C. Rigid, tender uterus
D. Increased appetite
Answer: Rigid, tender uterus
Rationale: A rigid, tender uterus is characteristic of placental abruption and
indicates significant uterine irritation and possible concealed hemorrhage.
5. A pregnant client develops a sudden seizure and has severe hypertension.
Which medication should the nurse anticipate administering to prevent
recurrent seizures?
A. Oxytocin
B. Magnesium sulfate
C. Terbutaline
D. Methylergonovine
Answer: Magnesium sulfate
,Rationale: Magnesium sulfate is the medication of choice for seizure
prevention and treatment in clients with preeclampsia and eclampsia.
6. A client receiving magnesium sulfate has absent deep tendon reflexes,
respiratory rate of 8/min, and urine output of 15 mL/hr. What is the nurse's
priority action?
A. Increase the magnesium infusion
B. Continue monitoring
C. Stop the magnesium infusion
D. Administer oxytocin
Answer: Stop the magnesium infusion
Rationale: Absent reflexes, respiratory depression, and oliguria are signs of
magnesium toxicity. The infusion should be stopped and the provider notified;
calcium gluconate may be prescribed as the antidote.
7. Which medication should be readily available when administering
magnesium sulfate?
A. Calcium gluconate
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: Calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity
and should be readily available during therapy.
8. A client with severe preeclampsia suddenly reports severe right-upper-
quadrant pain. Which complication should the nurse suspect?
A. Appendicitis
B. HELLP syndrome
, C. Placenta previa
D. Hyperemesis gravidarum
Answer: HELLP syndrome
Rationale: Right-upper-quadrant or epigastric pain may indicate hepatic
involvement in HELLP syndrome, which consists of hemolysis, elevated liver
enzymes, and low platelet count.
9. Which laboratory finding is associated with HELLP syndrome?
A. Increased platelet count
B. Decreased liver enzymes
C. Low platelet count
D. Increased serum calcium
Answer: Low platelet count
Rationale: Thrombocytopenia is a major feature of HELLP syndrome and
increases the risk of severe bleeding.
10. A pregnant client with eclampsia is actively seizing. What should the
nurse do first?
A. Insert an oral airway
B. Restrain the client's arms and legs
C. Protect the client from injury and maintain the airway
D. Obtain a urine specimen
Answer: Protect the client from injury and maintain the airway
Rationale: During an eclamptic seizure, the immediate priorities are airway
protection, oxygenation, and prevention of injury. The client should not be
restrained or have objects placed in the mouth.
11. A client at 39 weeks suddenly experiences a gush of fluid followed by a
fetal heart rate deceleration. What complication should the nurse suspect?
