MATERNITY EXAM 4 PRACTICE QUESTIONS AND
VERIFIED SOLUTIONS | LATEST UPDATED .
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would
yield more detailed information about the fetus?
A. Biophysical profile
B. Ultrasound for structural amomalies of the fetus
C. Percutaneous umbilical blood sampling
D. Maternal serum alpha-fetoprotein screening - Correct Answer -A. Biophysical profile
Rationale: Real-time ultrasound permits detailed assessment of the physical and physiologic
characteristics of the developing fetus and cataloging of normal and abnormal biophysical responses
to stimuli. The BPP is a noninvasive, dynamic assessment of a fetus that is based on acute and chronic
markers of fetal disease.
A client asks her nurse, " My doctor told me that he is concerned with the age of my placenta because
I am overdue. What does that mean?" The best response by the nurse is:
A. Don't worry about it. Everything is fine."
B. "Your placenta isn't working properly, and your baby is in danger."
C. "This means that we will need to perform an amniocentesis to detect if you have any placental
damage."
D. Your placenta ages and changes as your pregnancy progresses, and it is given a score that indicates
a number of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that
is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby." -
Correct Answer -D. Your placenta ages and changes as your pregnancy progresses, and it is given a
score that indicates a number of calcium deposits it has. The more calcium deposits, the higher the
grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be
delivered to your baby."
When nurses help their expectant mothers assess the daily fetal movement counts (Kick counts) they
should be aware that:
A. Obese mothers familiar with their bodies can assess fetal movement as well as average-sized
women.
B. "Kick counts" should be taken every half hour and averaged every 6 hours, with every other 6-hour
stretch off.
1
,C. Alcohol or cigarette smoke can irritate the fetus into greater activity.
D. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. - Correct
Answer -D. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.
Rationale: No movement in a 12-hour period is cause for investigation and possibly intervention.
A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should
indicate that more investigation needs to be done regarding the patient and her preeclampsia?
A. Weight gain of 0.5 kg during the past 2 weeks
B. Pitting pedal edema at the end of the day
C. Blood pressure increase to 138/86 mm Hg
D. A dipstick value of 3+ for protein in her urine - Correct Answer -D. A dipstick value of 3+ for
protein in her urine
Rationale: Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement. A
dipstick value of 3+ should alert the nurse that additional testing or assessment should be made.
The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin
infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a low platelet
count of 90,000, an elevated aspartate transaminase (AST) level (liver enzymes), and a falling
hematocrit. The nurse notifies the physician because the lab results are indicative of:
A. Eclampsia
B. Disseminated intravascular coagulation
C. Idiopathic thrombocytopenia
D. HELLP syndrome - Correct Answer -D. HELLP syndrome
Rationale: HELLP syndrome is a laboratory diagnosis for a variant of severe preeclampsia that
involves hepatic dysfunction characterized by hemolysis (H), elevated liver enzymes (EL), and low
platelets (LP).
A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe
preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature of
37.3° C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure of 148/90 mm
Hg, absent deep tendon reflexes, and no ankle clonus. The client complains, "I'm so thirsty and
warm." The nurse:
A. Calls for a stat magnesium sulfate level
B. Administers oxygen
C. Prepares to administer hydralazine
2
, D. Discontinues the magnesium sulfate infusion and notifies the provider. - Correct Answer -D.
Discontinues the magnesium sulfate infusion and notifies the provider.
Rationale: The client is displaying clinical signs and symptoms of magnesium toxicity. Magnesium
should be discontinued immediately. Additionally, calcium gluconate, the antidote for magnesium,
may be administered.
A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes
concerned after assessment when the woman exhibits:
A. Absent ankle clonus
B. A respiratory rate of 10 breaths/min
C. A sleepy, sedated affect
D. Deep tendon reflexes of 2 - Correct Answer -B. A respiratory rate of 10 breaths/min
Rationale: A respiratory rate of 10 breaths/min indicates that the client is experiencing respiratory
depression from magnesium toxicity.
Your client has been on magnesium sulfate for 20 hours for treatment of preeclampsia. She just
delivered a viable infant girl 30 minutes ago. What uterine findings would you anticipate to
observe/assess in this client?
A. A fundus firm below the level of the umbilicus
B. A boggy uterus with heavy lochia flow
C. Absence of uterine bleeding in the postpartum period
D. Scant lochia flow - Correct Answer -B. A boggy uterus with heavy lochia flow
Rationale: Because of the tocolytic effects of magnesium sulfate, this client most likely would have a
boggy uterus with increased amounts of bleeding.
The nurse caring for pregnant women must be aware that the most common medical complication of
pregnancy is:
A. Hyperemesis gravidarum
B. Infections
C. Hemorrhagic complications
D. Hypertensive Disorders of Pregnancy - Correct Answer -D. Hypertensive Disorders of Pregnancy
Rationale: Preeclampsia and eclampsia are two noted, deadly forms of hypertension.
Nurses should be aware that HELLP syndrome:
A. Is a mild form of preeclampsia
3
VERIFIED SOLUTIONS | LATEST UPDATED .
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would
yield more detailed information about the fetus?
A. Biophysical profile
B. Ultrasound for structural amomalies of the fetus
C. Percutaneous umbilical blood sampling
D. Maternal serum alpha-fetoprotein screening - Correct Answer -A. Biophysical profile
Rationale: Real-time ultrasound permits detailed assessment of the physical and physiologic
characteristics of the developing fetus and cataloging of normal and abnormal biophysical responses
to stimuli. The BPP is a noninvasive, dynamic assessment of a fetus that is based on acute and chronic
markers of fetal disease.
A client asks her nurse, " My doctor told me that he is concerned with the age of my placenta because
I am overdue. What does that mean?" The best response by the nurse is:
A. Don't worry about it. Everything is fine."
B. "Your placenta isn't working properly, and your baby is in danger."
C. "This means that we will need to perform an amniocentesis to detect if you have any placental
damage."
D. Your placenta ages and changes as your pregnancy progresses, and it is given a score that indicates
a number of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that
is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby." -
Correct Answer -D. Your placenta ages and changes as your pregnancy progresses, and it is given a
score that indicates a number of calcium deposits it has. The more calcium deposits, the higher the
grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be
delivered to your baby."
When nurses help their expectant mothers assess the daily fetal movement counts (Kick counts) they
should be aware that:
A. Obese mothers familiar with their bodies can assess fetal movement as well as average-sized
women.
B. "Kick counts" should be taken every half hour and averaged every 6 hours, with every other 6-hour
stretch off.
1
,C. Alcohol or cigarette smoke can irritate the fetus into greater activity.
D. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. - Correct
Answer -D. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.
Rationale: No movement in a 12-hour period is cause for investigation and possibly intervention.
A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should
indicate that more investigation needs to be done regarding the patient and her preeclampsia?
A. Weight gain of 0.5 kg during the past 2 weeks
B. Pitting pedal edema at the end of the day
C. Blood pressure increase to 138/86 mm Hg
D. A dipstick value of 3+ for protein in her urine - Correct Answer -D. A dipstick value of 3+ for
protein in her urine
Rationale: Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement. A
dipstick value of 3+ should alert the nurse that additional testing or assessment should be made.
The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin
infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a low platelet
count of 90,000, an elevated aspartate transaminase (AST) level (liver enzymes), and a falling
hematocrit. The nurse notifies the physician because the lab results are indicative of:
A. Eclampsia
B. Disseminated intravascular coagulation
C. Idiopathic thrombocytopenia
D. HELLP syndrome - Correct Answer -D. HELLP syndrome
Rationale: HELLP syndrome is a laboratory diagnosis for a variant of severe preeclampsia that
involves hepatic dysfunction characterized by hemolysis (H), elevated liver enzymes (EL), and low
platelets (LP).
A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe
preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature of
37.3° C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure of 148/90 mm
Hg, absent deep tendon reflexes, and no ankle clonus. The client complains, "I'm so thirsty and
warm." The nurse:
A. Calls for a stat magnesium sulfate level
B. Administers oxygen
C. Prepares to administer hydralazine
2
, D. Discontinues the magnesium sulfate infusion and notifies the provider. - Correct Answer -D.
Discontinues the magnesium sulfate infusion and notifies the provider.
Rationale: The client is displaying clinical signs and symptoms of magnesium toxicity. Magnesium
should be discontinued immediately. Additionally, calcium gluconate, the antidote for magnesium,
may be administered.
A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes
concerned after assessment when the woman exhibits:
A. Absent ankle clonus
B. A respiratory rate of 10 breaths/min
C. A sleepy, sedated affect
D. Deep tendon reflexes of 2 - Correct Answer -B. A respiratory rate of 10 breaths/min
Rationale: A respiratory rate of 10 breaths/min indicates that the client is experiencing respiratory
depression from magnesium toxicity.
Your client has been on magnesium sulfate for 20 hours for treatment of preeclampsia. She just
delivered a viable infant girl 30 minutes ago. What uterine findings would you anticipate to
observe/assess in this client?
A. A fundus firm below the level of the umbilicus
B. A boggy uterus with heavy lochia flow
C. Absence of uterine bleeding in the postpartum period
D. Scant lochia flow - Correct Answer -B. A boggy uterus with heavy lochia flow
Rationale: Because of the tocolytic effects of magnesium sulfate, this client most likely would have a
boggy uterus with increased amounts of bleeding.
The nurse caring for pregnant women must be aware that the most common medical complication of
pregnancy is:
A. Hyperemesis gravidarum
B. Infections
C. Hemorrhagic complications
D. Hypertensive Disorders of Pregnancy - Correct Answer -D. Hypertensive Disorders of Pregnancy
Rationale: Preeclampsia and eclampsia are two noted, deadly forms of hypertension.
Nurses should be aware that HELLP syndrome:
A. Is a mild form of preeclampsia
3
