Case Study:
A 28-year-old pregnant woman, at 32 weeks gestation, presents to the clinic for her routine
prenatal checkup. She has no significant medical history. She reports feeling fatigued,
experiencing shortness of breath, and noticing swelling in her feet. Her blood pressure is 140/88
mm Hg, and her weight has increased by 6 kg (13 lbs) in the past month. The patient’s urine
dipstick test shows 1+ protein.
MCQs with Answers and Rationale
1. Which condition should the nurse suspect based on the client's blood pressure and
proteinuria?
a) Preeclampsia
b) Gestational hypertension
c) Chronic hypertension
d) Eclampsia
Answer: a) Preeclampsia
Rationale: Preeclampsia is characterized by elevated blood pressure and the presence of
proteinuria after 20 weeks of gestation. The patient's blood pressure (140/88 mm Hg) and
1+ proteinuria are suggestive of this condition.
2. Which action is the nurse’s priority when caring for a pregnant client with
suspected preeclampsia?
a) Assessing fetal heart tones
b) Monitoring blood pressure regularly
c) Administering magnesium sulfate
d) Encouraging bed rest
Answer: b) Monitoring blood pressure regularly
Rationale: Monitoring blood pressure regularly is critical in assessing the progression of
preeclampsia and preventing complications like seizures and stroke.
3. What is the most common complication associated with preeclampsia?
a) Placental abruption
b) Maternal hemorrhage
c) Fetal growth restriction
d) Gestational diabetes
, Answer: a) Placental abruption
Rationale: Placental abruption is a potential complication of preeclampsia, leading to
premature delivery, fetal distress, and maternal bleeding.
4. Which of the following lab results would most likely indicate worsening
preeclampsia?
a) Normal liver enzymes
b) Low platelet count
c) High serum glucose levels
d) Negative urine protein
Answer: b) Low platelet count
Rationale: A low platelet count (thrombocytopenia) is a sign of worsening preeclampsia
and may indicate the development of HELLP syndrome (hemolysis, elevated liver
enzymes, and low platelets).
5. What is the best position for a woman with preeclampsia to prevent hypotension
and improve fetal oxygenation?
a) Supine
b) Left lateral recumbent
c) Right lateral recumbent
d) Sitting upright
Answer: b) Left lateral recumbent
Rationale: The left lateral recumbent position improves venous return and enhances
uteroplacental blood flow, which is beneficial for both maternal and fetal health.
6. What is the recommended next step in the management of preeclampsia for this
patient?
a) Perform a nonstress test
b) Administer corticosteroids
c) Start magnesium sulfate therapy
d) Prepare for immediate cesarean section
Answer: a) Perform a nonstress test
Rationale: A nonstress test (NST) is performed to monitor fetal well-being in cases of
preeclampsia. It helps assess fetal heart rate patterns and detect signs of fetal distress.
7. Which of the following is a sign that magnesium sulfate toxicity may be developing?
a) Increased deep tendon reflexes
b) Respiratory depression
A 28-year-old pregnant woman, at 32 weeks gestation, presents to the clinic for her routine
prenatal checkup. She has no significant medical history. She reports feeling fatigued,
experiencing shortness of breath, and noticing swelling in her feet. Her blood pressure is 140/88
mm Hg, and her weight has increased by 6 kg (13 lbs) in the past month. The patient’s urine
dipstick test shows 1+ protein.
MCQs with Answers and Rationale
1. Which condition should the nurse suspect based on the client's blood pressure and
proteinuria?
a) Preeclampsia
b) Gestational hypertension
c) Chronic hypertension
d) Eclampsia
Answer: a) Preeclampsia
Rationale: Preeclampsia is characterized by elevated blood pressure and the presence of
proteinuria after 20 weeks of gestation. The patient's blood pressure (140/88 mm Hg) and
1+ proteinuria are suggestive of this condition.
2. Which action is the nurse’s priority when caring for a pregnant client with
suspected preeclampsia?
a) Assessing fetal heart tones
b) Monitoring blood pressure regularly
c) Administering magnesium sulfate
d) Encouraging bed rest
Answer: b) Monitoring blood pressure regularly
Rationale: Monitoring blood pressure regularly is critical in assessing the progression of
preeclampsia and preventing complications like seizures and stroke.
3. What is the most common complication associated with preeclampsia?
a) Placental abruption
b) Maternal hemorrhage
c) Fetal growth restriction
d) Gestational diabetes
, Answer: a) Placental abruption
Rationale: Placental abruption is a potential complication of preeclampsia, leading to
premature delivery, fetal distress, and maternal bleeding.
4. Which of the following lab results would most likely indicate worsening
preeclampsia?
a) Normal liver enzymes
b) Low platelet count
c) High serum glucose levels
d) Negative urine protein
Answer: b) Low platelet count
Rationale: A low platelet count (thrombocytopenia) is a sign of worsening preeclampsia
and may indicate the development of HELLP syndrome (hemolysis, elevated liver
enzymes, and low platelets).
5. What is the best position for a woman with preeclampsia to prevent hypotension
and improve fetal oxygenation?
a) Supine
b) Left lateral recumbent
c) Right lateral recumbent
d) Sitting upright
Answer: b) Left lateral recumbent
Rationale: The left lateral recumbent position improves venous return and enhances
uteroplacental blood flow, which is beneficial for both maternal and fetal health.
6. What is the recommended next step in the management of preeclampsia for this
patient?
a) Perform a nonstress test
b) Administer corticosteroids
c) Start magnesium sulfate therapy
d) Prepare for immediate cesarean section
Answer: a) Perform a nonstress test
Rationale: A nonstress test (NST) is performed to monitor fetal well-being in cases of
preeclampsia. It helps assess fetal heart rate patterns and detect signs of fetal distress.
7. Which of the following is a sign that magnesium sulfate toxicity may be developing?
a) Increased deep tendon reflexes
b) Respiratory depression
