NR 327 Maternal-Child Nursing Exam 1
Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════
SECTION 1: ANTEPARTUM NURSING Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 28-year-old G1P0 at 10 weeks gestation presents to the prenatal clinic complaining of
nausea and vomiting that has worsened over the past 2 weeks. She reports being unable to
keep any food or fluids down for the past 24 hours and has noticed dark urine and dizziness
when standing. Her vital signs show BP 98/62 mmHg, HR 112 bpm, and she has lost 3 kg
since her last visit. Which intervention should the nurse prioritize?
A. Advise the patient to eat dry crackers before getting out of bed in the morning
B. Recommend ginger supplements and acupressure wristbands for symptom relief
C. Notify the provider immediately to discuss possible IV fluid replacement and antiemetic
therapy ✓ CORRECT
D. Suggest the patient try small, frequent meals consisting of bland carbohydrates
Correct Answer: C
Rationale: Severe nausea with vomiting, weight loss, signs of dehydration, and ketonuria
indicate hyperemesis gravidarum, which requires prompt IV fluid replacement and antiemetic
therapy to prevent electrolyte imbalances and maintain maternal-fetal perfusion. Options
suggesting dietary modifications alone are insufficient for this degree of dehydration and
represent a dangerous delay in care. Chamberlain NR 327 emphasizes that persistent
vomiting with ketonuria and orthostatic changes signals progression beyond morning
sickness requiring medical intervention.
Question 2 of 50
A 34-year-old G2P1 at 18 weeks gestation is seen for a routine prenatal visit. Her medical
history includes type 2 diabetes mellitus diagnosed 3 years ago. Her current fasting blood
glucose is 142 mg/dL, and her HbA1c from last week was 7.8%. The nurse is reviewing her
,care plan. Which statement by the nurse best reflects appropriate management for this
patient?
A. "Your blood sugar control is excellent, so we can continue your current oral hypoglycemic
regimen"
B. "We will likely transition you to insulin therapy to optimize glycemic control and reduce
fetal risks" ✓ CORRECT
C. "Since you are already in your second trimester, medication changes are no longer
necessary"
D. "Your HbA1c indicates we should increase your current oral agent dosage before
considering insulin"
Correct Answer: B
Rationale: During pregnancy, oral hypoglycemic agents are generally contraindicated due to
limited safety data, and insulin is the preferred treatment to achieve glycemic control with a
target fasting glucose below 95 mg/dL and HbA1c below 6.5%. Continuing oral agents or
delaying treatment increases the risk of macrosomia, congenital anomalies, and stillbirth.
The nurse should advocate for insulin therapy and coordinate with the provider to adjust the
regimen throughout pregnancy.
Question 3 of 50
A 22-year-old G1P0 at 28 weeks gestation arrives at the clinic for her scheduled glucose
screening. She is instructed to drink the 50-gram glucose solution and return in one hour for a
blood draw. Two hours later, the laboratory calls with a result of 158 mg/dL. Which action
should the nurse take next?
A. Document the result as normal and continue with routine prenatal care
B. Reassure the patient that one elevated screening does not require any further testing
C. Schedule the patient for a 100-gram oral glucose tolerance test to confirm gestational
diabetes ✓ CORRECT
D. Instruct the patient to begin a diabetic diet and monitor blood glucose four times daily
Correct Answer: C
Rationale: A 50-gram glucose screening result of 158 mg/dL exceeds the typical threshold of
130 to 140 mg/dL, necessitating a diagnostic 100-gram oral glucose tolerance test to confirm
gestational diabetes. Documenting the result as normal or initiating treatment without
confirmation would be premature and potentially harmful. The three-hour test remains the
standard for definitive diagnosis before implementing dietary modifications or glucose
monitoring.
Question 4 of 50
, A 31-year-old G3P2 at 32 weeks gestation is being monitored in the antepartum unit for
preeclampsia with severe features. Her blood pressure is 164/110 mmHg, she has 3+
proteinuria, and reports a severe headache unrelieved by acetaminophen. Her reflexes are 3+
with two beats of clonus. Which medication should the nurse anticipate administering first?
A. Labetalol 20 mg IV push to lower the blood pressure
B. Hydralazine 5 mg IV to achieve rapid antihypertensive control
C. Nifedipine 10 mg orally for sustained blood pressure management
D. Magnesium sulfate IV loading dose for seizure prophylaxis ✓ CORRECT
Correct Answer: D
Rationale: Magnesium sulfate is the anticonvulsant of choice for seizure prophylaxis in
preeclampsia with severe features, including headache, hyperreflexia, and clonus, and should
be administered before antihypertensives in most protocols. While labetalol and hydralazine
are appropriate for blood pressure control, they do not prevent eclampsia seizures. The nurse
must prioritize magnesium sulfate administration and prepare for potential side effects
including respiratory depression and loss of deep tendon reflexes.
Question 5 of 50
A 26-year-old G1P0 at 16 weeks gestation asks the nurse about recommended weight gain
during her pregnancy. Her pre-pregnancy BMI was 19.2 kg/m². Which response by the nurse is
most accurate?
A. "For your BMI category, the recommended total weight gain is 25 to 35 pounds" ✓
CORRECT
B. "You should aim to gain approximately 15 to 25 pounds throughout this pregnancy"
C. "A weight gain of 11 to 20 pounds is appropriate for your current body mass index"
D. "We recommend limiting your weight gain to no more than 10 pounds to reduce
complications"
Correct Answer: A
Rationale: A pre-pregnancy BMI of 19.2 kg/m² falls within the normal weight category, for
which the Institute of Medicine recommends a total gestational weight gain of 25 to 35
pounds to support fetal growth and maternal tissue expansion. Recommendations for
overweight or obese categories would be inappropriate and could lead to inadequate fetal
nutrition. The nurse should individualize counseling based on BMI and gestational weight gain
patterns throughout pregnancy.
Question 6 of 50
A 29-year-old G2P1 at 20 weeks gestation presents with vaginal bleeding after intercourse.
Ultrasound confirms placenta previa with the placenta covering the internal os. The patient is
Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════
SECTION 1: ANTEPARTUM NURSING Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 28-year-old G1P0 at 10 weeks gestation presents to the prenatal clinic complaining of
nausea and vomiting that has worsened over the past 2 weeks. She reports being unable to
keep any food or fluids down for the past 24 hours and has noticed dark urine and dizziness
when standing. Her vital signs show BP 98/62 mmHg, HR 112 bpm, and she has lost 3 kg
since her last visit. Which intervention should the nurse prioritize?
A. Advise the patient to eat dry crackers before getting out of bed in the morning
B. Recommend ginger supplements and acupressure wristbands for symptom relief
C. Notify the provider immediately to discuss possible IV fluid replacement and antiemetic
therapy ✓ CORRECT
D. Suggest the patient try small, frequent meals consisting of bland carbohydrates
Correct Answer: C
Rationale: Severe nausea with vomiting, weight loss, signs of dehydration, and ketonuria
indicate hyperemesis gravidarum, which requires prompt IV fluid replacement and antiemetic
therapy to prevent electrolyte imbalances and maintain maternal-fetal perfusion. Options
suggesting dietary modifications alone are insufficient for this degree of dehydration and
represent a dangerous delay in care. Chamberlain NR 327 emphasizes that persistent
vomiting with ketonuria and orthostatic changes signals progression beyond morning
sickness requiring medical intervention.
Question 2 of 50
A 34-year-old G2P1 at 18 weeks gestation is seen for a routine prenatal visit. Her medical
history includes type 2 diabetes mellitus diagnosed 3 years ago. Her current fasting blood
glucose is 142 mg/dL, and her HbA1c from last week was 7.8%. The nurse is reviewing her
,care plan. Which statement by the nurse best reflects appropriate management for this
patient?
A. "Your blood sugar control is excellent, so we can continue your current oral hypoglycemic
regimen"
B. "We will likely transition you to insulin therapy to optimize glycemic control and reduce
fetal risks" ✓ CORRECT
C. "Since you are already in your second trimester, medication changes are no longer
necessary"
D. "Your HbA1c indicates we should increase your current oral agent dosage before
considering insulin"
Correct Answer: B
Rationale: During pregnancy, oral hypoglycemic agents are generally contraindicated due to
limited safety data, and insulin is the preferred treatment to achieve glycemic control with a
target fasting glucose below 95 mg/dL and HbA1c below 6.5%. Continuing oral agents or
delaying treatment increases the risk of macrosomia, congenital anomalies, and stillbirth.
The nurse should advocate for insulin therapy and coordinate with the provider to adjust the
regimen throughout pregnancy.
Question 3 of 50
A 22-year-old G1P0 at 28 weeks gestation arrives at the clinic for her scheduled glucose
screening. She is instructed to drink the 50-gram glucose solution and return in one hour for a
blood draw. Two hours later, the laboratory calls with a result of 158 mg/dL. Which action
should the nurse take next?
A. Document the result as normal and continue with routine prenatal care
B. Reassure the patient that one elevated screening does not require any further testing
C. Schedule the patient for a 100-gram oral glucose tolerance test to confirm gestational
diabetes ✓ CORRECT
D. Instruct the patient to begin a diabetic diet and monitor blood glucose four times daily
Correct Answer: C
Rationale: A 50-gram glucose screening result of 158 mg/dL exceeds the typical threshold of
130 to 140 mg/dL, necessitating a diagnostic 100-gram oral glucose tolerance test to confirm
gestational diabetes. Documenting the result as normal or initiating treatment without
confirmation would be premature and potentially harmful. The three-hour test remains the
standard for definitive diagnosis before implementing dietary modifications or glucose
monitoring.
Question 4 of 50
, A 31-year-old G3P2 at 32 weeks gestation is being monitored in the antepartum unit for
preeclampsia with severe features. Her blood pressure is 164/110 mmHg, she has 3+
proteinuria, and reports a severe headache unrelieved by acetaminophen. Her reflexes are 3+
with two beats of clonus. Which medication should the nurse anticipate administering first?
A. Labetalol 20 mg IV push to lower the blood pressure
B. Hydralazine 5 mg IV to achieve rapid antihypertensive control
C. Nifedipine 10 mg orally for sustained blood pressure management
D. Magnesium sulfate IV loading dose for seizure prophylaxis ✓ CORRECT
Correct Answer: D
Rationale: Magnesium sulfate is the anticonvulsant of choice for seizure prophylaxis in
preeclampsia with severe features, including headache, hyperreflexia, and clonus, and should
be administered before antihypertensives in most protocols. While labetalol and hydralazine
are appropriate for blood pressure control, they do not prevent eclampsia seizures. The nurse
must prioritize magnesium sulfate administration and prepare for potential side effects
including respiratory depression and loss of deep tendon reflexes.
Question 5 of 50
A 26-year-old G1P0 at 16 weeks gestation asks the nurse about recommended weight gain
during her pregnancy. Her pre-pregnancy BMI was 19.2 kg/m². Which response by the nurse is
most accurate?
A. "For your BMI category, the recommended total weight gain is 25 to 35 pounds" ✓
CORRECT
B. "You should aim to gain approximately 15 to 25 pounds throughout this pregnancy"
C. "A weight gain of 11 to 20 pounds is appropriate for your current body mass index"
D. "We recommend limiting your weight gain to no more than 10 pounds to reduce
complications"
Correct Answer: A
Rationale: A pre-pregnancy BMI of 19.2 kg/m² falls within the normal weight category, for
which the Institute of Medicine recommends a total gestational weight gain of 25 to 35
pounds to support fetal growth and maternal tissue expansion. Recommendations for
overweight or obese categories would be inappropriate and could lead to inadequate fetal
nutrition. The nurse should individualize counseling based on BMI and gestational weight gain
patterns throughout pregnancy.
Question 6 of 50
A 29-year-old G2P1 at 20 weeks gestation presents with vaginal bleeding after intercourse.
Ultrasound confirms placenta previa with the placenta covering the internal os. The patient is
