NR 327 Obstetric Complications Practice Pack 2026/2027 Chamberlain
College
1. Which assessment finding is a classic sign of placenta previa?
A. Rigid, board-like abdomen
B. Frequent uterine contractions with low back pain
C. Severe abdominal pain and uterine tenderness
D. Painless, bright red vaginal bleeding
Answer: D
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding during
the second or third trimester. A rigid abdomen and pain are more indicative of placental
abruption.
2. A patient is receiving magnesium sulfate for preeclampsia. Which finding
should the nurse report to the provider immediately?
A. Respiratory rate of 10 breaths per minute
B. Deep tendon reflexes of +2
C. Feeling of warmth and flushing
D. Urine output of 40 mL per hour
Answer: A
Rationale: A respiratory rate below 12 per minute is a sign of magnesium toxicity. +2
reflexes and 40mL/hr urine output are normal, while flushing is a common side effect, not
toxicity.
,3. Which of the following laboratory results is characteristic of HELLP syndrome?
A. Elevated hemoglobin and hematocrit
B. Elevated liver enzymes (AST and ALT)
C. High platelet count above 400,000
D. Decreased serum creatinine
Answer: B
Rationale: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelets.
Elevated AST and ALT indicate liver involvement common in this severe form of
preeclampsia.
4. What is the primary pathophysiology behind the development of
preeclampsia?
A. Increased peripheral vasodilation
B. Chronic renal failure prior to pregnancy
C. Generalized vasospasm and endothelial cell damage
D. Excessive blood volume expansion
Answer: C
Rationale: Preeclampsia is caused by generalized vasospasm, which leads to reduced
perfusion to all organs and endothelial damage.
5. Which risk factor is most significantly associated with placental abruption?
A. Maternal hypertension
B. First-time pregnancy (nulliparity)
C. Gestational diabetes
D. Placenta previa in a previous pregnancy
Answer: A
Rationale: Hypertension (chronic or gestational) is the most common and significant risk
factor for placental abruption due to the pressure on the placental vessels.
, 6. A nurse is caring for a patient with severe preeclampsia. Which medication
should be readily available as an antidote for magnesium sulfate toxicity?
A. Naloxone
B. Calcium gluconate
C. Vitamin K
D. Hydralazine
Answer: B
Rationale: Calcium gluconate is the specific antidote to reverse the effects of magnesium
sulfate toxicity (respiratory depression/cardiac arrest).
7. A patient at 32 weeks gestation presents with dark red vaginal bleeding and a
board-like, tender abdomen. What should the nurse suspect?
A. Placenta previa
B. Preterm labor
C. Abruptio placentae
D. Cervical insufficiency
Answer: C
Rationale: Abruptio placentae typically presents with dark red bleeding, uterine
tenderness, and a firm or board-like abdomen due to concealed or overt hemorrhage.
8. What is the diagnostic threshold for proteinuria in a 24-hour urine collection
to confirm preeclampsia?
A. Greater than 100 mg
B. Greater than 300 mg
C. Greater than 500 mg
D. Greater than 1000 mg
Answer: B
Rationale: Proteinuria is defined as 300 mg or more of protein in a 24-hour urine
specimen for the diagnosis of preeclampsia.
College
1. Which assessment finding is a classic sign of placenta previa?
A. Rigid, board-like abdomen
B. Frequent uterine contractions with low back pain
C. Severe abdominal pain and uterine tenderness
D. Painless, bright red vaginal bleeding
Answer: D
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding during
the second or third trimester. A rigid abdomen and pain are more indicative of placental
abruption.
2. A patient is receiving magnesium sulfate for preeclampsia. Which finding
should the nurse report to the provider immediately?
A. Respiratory rate of 10 breaths per minute
B. Deep tendon reflexes of +2
C. Feeling of warmth and flushing
D. Urine output of 40 mL per hour
Answer: A
Rationale: A respiratory rate below 12 per minute is a sign of magnesium toxicity. +2
reflexes and 40mL/hr urine output are normal, while flushing is a common side effect, not
toxicity.
,3. Which of the following laboratory results is characteristic of HELLP syndrome?
A. Elevated hemoglobin and hematocrit
B. Elevated liver enzymes (AST and ALT)
C. High platelet count above 400,000
D. Decreased serum creatinine
Answer: B
Rationale: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelets.
Elevated AST and ALT indicate liver involvement common in this severe form of
preeclampsia.
4. What is the primary pathophysiology behind the development of
preeclampsia?
A. Increased peripheral vasodilation
B. Chronic renal failure prior to pregnancy
C. Generalized vasospasm and endothelial cell damage
D. Excessive blood volume expansion
Answer: C
Rationale: Preeclampsia is caused by generalized vasospasm, which leads to reduced
perfusion to all organs and endothelial damage.
5. Which risk factor is most significantly associated with placental abruption?
A. Maternal hypertension
B. First-time pregnancy (nulliparity)
C. Gestational diabetes
D. Placenta previa in a previous pregnancy
Answer: A
Rationale: Hypertension (chronic or gestational) is the most common and significant risk
factor for placental abruption due to the pressure on the placental vessels.
, 6. A nurse is caring for a patient with severe preeclampsia. Which medication
should be readily available as an antidote for magnesium sulfate toxicity?
A. Naloxone
B. Calcium gluconate
C. Vitamin K
D. Hydralazine
Answer: B
Rationale: Calcium gluconate is the specific antidote to reverse the effects of magnesium
sulfate toxicity (respiratory depression/cardiac arrest).
7. A patient at 32 weeks gestation presents with dark red vaginal bleeding and a
board-like, tender abdomen. What should the nurse suspect?
A. Placenta previa
B. Preterm labor
C. Abruptio placentae
D. Cervical insufficiency
Answer: C
Rationale: Abruptio placentae typically presents with dark red bleeding, uterine
tenderness, and a firm or board-like abdomen due to concealed or overt hemorrhage.
8. What is the diagnostic threshold for proteinuria in a 24-hour urine collection
to confirm preeclampsia?
A. Greater than 100 mg
B. Greater than 300 mg
C. Greater than 500 mg
D. Greater than 1000 mg
Answer: B
Rationale: Proteinuria is defined as 300 mg or more of protein in a 24-hour urine
specimen for the diagnosis of preeclampsia.
