MDC 3 Final Examination ACTUAL EXAM
2026/2027 | Maternal-Child Nursing &
Complex Care | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Antepartum Nursing (Questions 1–15)
Q1: A nurse is caring for a 32-year-old G3P2 patient at 34 weeks gestation who presents with a blood
pressure of 158/94 mmHg and 2+ proteinuria on dipstick. She reports a headache that has not improved
with acetaminophen and mild epigastric pain. Which action should the nurse take first?
A. Administer labetalol 20 mg IV push.
B. Place the patient in left lateral recumbent position.
C. Notify the provider of severe features of preeclampsia. [CORRECT]
D. Obtain a clean catch urine for protein-to-creatinine ratio.
Correct Answer: C
Rationale: The patient has preeclampsia with severe features indicated by persistent headache and
epigastric pain. Immediate provider notification is required for magnesium sulfate initiation and delivery
planning.
Q2: A patient at 28 weeks gestation has a 1-hour glucose challenge test result of 185 mg/dL. Which
follow-up test is indicated?
A. Fasting blood glucose
B. 3-hour oral glucose tolerance test [CORRECT]
C. Hemoglobin A1c
D. Random glucose in 1 week
Correct Answer: B
Rationale: A 1-hour value ≥180 mg/dL is diagnostic of gestational diabetes per Carpenter-Coustan
criteria. Values between 130–180 mg/dL require 3-hour OGTT confirmation.
Q3: A patient at 18 weeks gestation reports painless vaginal bleeding after intercourse. Ultrasound
reveals placenta covering the internal os. Which instruction is most important?
,A. Schedule repeat ultrasound at 32 weeks
B. Advise pelvic rest and report heavy bleeding immediately [CORRECT]
C. Recommend bed rest for remainder of pregnancy
D. Prepare for immediate cesarean delivery
Correct Answer: B
Rationale: Placenta previa requires pelvic rest to prevent bleeding. Most partial previas resolve by third
trimester. Immediate reporting of heavy bleeding is essential for maternal-fetal safety.
Q4: A patient at 10 weeks gestation presents with severe nausea, vomiting 8 times daily, and 5-pound
weight loss. Ketones are present in urine. Which condition is suspected?
A. Normal morning sickness
B. Hyperemesis gravidarum [CORRECT]
C. Gestational diabetes
D. Pyloric stenosis
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by persistent vomiting, weight loss >5 pounds, and
ketonuria requiring IV fluid replacement and antiemetics. Normal morning sickness does not cause
weight loss or dehydration.
Q5: A patient at 35 weeks gestation reports decreased fetal movement. NST reveals no accelerations in
40 minutes. Which intervention is priority?
A. Schedule BPP within 24 hours
B. Perform vibroacoustic stimulation and continue monitoring [CORRECT]
C. Immediate cesarean delivery
D. Discharge with kick count instructions
Correct Answer: B
Rationale: Nonreactive NST requires vibroacoustic stimulation or extended monitoring before
determining need for BPP or delivery. Fetal sleep cycles can cause temporary nonreactivity.
Q6: A patient with O-negative blood delivers an O-positive infant. Which intervention prevents Rh
sensitization?
A. Administer Rho(D) immune globulin within 72 hours postpartum [CORRECT]
B. Type and crossmatch for transfusion
C. Schedule amniocentesis for next pregnancy
D. Administer rubella vaccine immediately
, Correct Answer: A
Rationale: Rho(D) immune globulin prevents antibody formation in Rh-negative mothers exposed to Rh-
positive fetal blood. Must be given within 72 hours postpartum or at 28 weeks gestation.
Q7: A patient at 16 weeks gestation has MSAFP elevated at 3.5 MoM. Which condition is NOT associated
with this finding?
A. Open neural tube defect
B. Down syndrome [CORRECT]
C. Ventral wall defect
D. Multiple gestation
Correct Answer: B
Rationale: Elevated MSAFP is associated with open neural tube defects, ventral wall defects, and
multiple gestations. Down syndrome is associated with LOW MSAFP, low estriol, and high hCG (triple
screen pattern).
Q8: A patient at 30 weeks gestation reports regular contractions every 5 minutes. Cervix is 3 cm dilated,
80% effaced. Which medication promotes fetal lung maturity?
A. Nifedipine
B. Betamethasone [CORRECT]
C. Indomethacin
D. Magnesium sulfate
Correct Answer: B
Rationale: Betamethasone 12 mg IM × 2 doses 24 hours apart accelerates fetal lung maturity when
preterm birth is anticipated between 24–34 weeks. Optimal effect occurs 24 hours to 7 days after first
dose.
Q9: A patient at 20 weeks gestation reports unilateral leg swelling and calf pain. Doppler ultrasound
reveals DVT. Which anticoagulant is preferred in pregnancy?
A. Warfarin
B. Low molecular weight heparin [CORRECT]
C. Rivaroxaban
D. Aspirin
Correct Answer: B
Rationale: LMWH (enoxaparin) does not cross placenta and is safe in pregnancy. Warfarin is teratogenic.
DOACs lack safety data in pregnancy. Treatment continues for minimum 3 months postpartum.
2026/2027 | Maternal-Child Nursing &
Complex Care | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Antepartum Nursing (Questions 1–15)
Q1: A nurse is caring for a 32-year-old G3P2 patient at 34 weeks gestation who presents with a blood
pressure of 158/94 mmHg and 2+ proteinuria on dipstick. She reports a headache that has not improved
with acetaminophen and mild epigastric pain. Which action should the nurse take first?
A. Administer labetalol 20 mg IV push.
B. Place the patient in left lateral recumbent position.
C. Notify the provider of severe features of preeclampsia. [CORRECT]
D. Obtain a clean catch urine for protein-to-creatinine ratio.
Correct Answer: C
Rationale: The patient has preeclampsia with severe features indicated by persistent headache and
epigastric pain. Immediate provider notification is required for magnesium sulfate initiation and delivery
planning.
Q2: A patient at 28 weeks gestation has a 1-hour glucose challenge test result of 185 mg/dL. Which
follow-up test is indicated?
A. Fasting blood glucose
B. 3-hour oral glucose tolerance test [CORRECT]
C. Hemoglobin A1c
D. Random glucose in 1 week
Correct Answer: B
Rationale: A 1-hour value ≥180 mg/dL is diagnostic of gestational diabetes per Carpenter-Coustan
criteria. Values between 130–180 mg/dL require 3-hour OGTT confirmation.
Q3: A patient at 18 weeks gestation reports painless vaginal bleeding after intercourse. Ultrasound
reveals placenta covering the internal os. Which instruction is most important?
,A. Schedule repeat ultrasound at 32 weeks
B. Advise pelvic rest and report heavy bleeding immediately [CORRECT]
C. Recommend bed rest for remainder of pregnancy
D. Prepare for immediate cesarean delivery
Correct Answer: B
Rationale: Placenta previa requires pelvic rest to prevent bleeding. Most partial previas resolve by third
trimester. Immediate reporting of heavy bleeding is essential for maternal-fetal safety.
Q4: A patient at 10 weeks gestation presents with severe nausea, vomiting 8 times daily, and 5-pound
weight loss. Ketones are present in urine. Which condition is suspected?
A. Normal morning sickness
B. Hyperemesis gravidarum [CORRECT]
C. Gestational diabetes
D. Pyloric stenosis
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by persistent vomiting, weight loss >5 pounds, and
ketonuria requiring IV fluid replacement and antiemetics. Normal morning sickness does not cause
weight loss or dehydration.
Q5: A patient at 35 weeks gestation reports decreased fetal movement. NST reveals no accelerations in
40 minutes. Which intervention is priority?
A. Schedule BPP within 24 hours
B. Perform vibroacoustic stimulation and continue monitoring [CORRECT]
C. Immediate cesarean delivery
D. Discharge with kick count instructions
Correct Answer: B
Rationale: Nonreactive NST requires vibroacoustic stimulation or extended monitoring before
determining need for BPP or delivery. Fetal sleep cycles can cause temporary nonreactivity.
Q6: A patient with O-negative blood delivers an O-positive infant. Which intervention prevents Rh
sensitization?
A. Administer Rho(D) immune globulin within 72 hours postpartum [CORRECT]
B. Type and crossmatch for transfusion
C. Schedule amniocentesis for next pregnancy
D. Administer rubella vaccine immediately
, Correct Answer: A
Rationale: Rho(D) immune globulin prevents antibody formation in Rh-negative mothers exposed to Rh-
positive fetal blood. Must be given within 72 hours postpartum or at 28 weeks gestation.
Q7: A patient at 16 weeks gestation has MSAFP elevated at 3.5 MoM. Which condition is NOT associated
with this finding?
A. Open neural tube defect
B. Down syndrome [CORRECT]
C. Ventral wall defect
D. Multiple gestation
Correct Answer: B
Rationale: Elevated MSAFP is associated with open neural tube defects, ventral wall defects, and
multiple gestations. Down syndrome is associated with LOW MSAFP, low estriol, and high hCG (triple
screen pattern).
Q8: A patient at 30 weeks gestation reports regular contractions every 5 minutes. Cervix is 3 cm dilated,
80% effaced. Which medication promotes fetal lung maturity?
A. Nifedipine
B. Betamethasone [CORRECT]
C. Indomethacin
D. Magnesium sulfate
Correct Answer: B
Rationale: Betamethasone 12 mg IM × 2 doses 24 hours apart accelerates fetal lung maturity when
preterm birth is anticipated between 24–34 weeks. Optimal effect occurs 24 hours to 7 days after first
dose.
Q9: A patient at 20 weeks gestation reports unilateral leg swelling and calf pain. Doppler ultrasound
reveals DVT. Which anticoagulant is preferred in pregnancy?
A. Warfarin
B. Low molecular weight heparin [CORRECT]
C. Rivaroxaban
D. Aspirin
Correct Answer: B
Rationale: LMWH (enoxaparin) does not cross placenta and is safe in pregnancy. Warfarin is teratogenic.
DOACs lack safety data in pregnancy. Treatment continues for minimum 3 months postpartum.
