NUR1025 MODULE 4 EAQS HIGH-RISK PREGNANCY,
OBSTETRIC EMERGENCIES & MATERNAL CARE — Q&A WITH
RATIONALES
1. A pregnant patient receiving IV magnesium sulfate develops toxicity. Which
medication should the nurse request from the provider?
Answer: Calcium gluconate.
Rationale: Calcium gluconate is the antidote for magnesium toxicity and reverses
respiratory depression, cardiac arrhythmias, and loss of reflexes.
2. A pregnant patient at >20 weeks reports painless, bright red vaginal bleeding
with stable vital signs. What condition is suspected?
Answer: Placenta previa.
Rationale: Painless bleeding in the second or third trimester strongly suggests
placenta previa, where the placenta covers or partially covers the cervical os.
3. What nursing intervention optimizes fetal oxygenation during maternal surgery?
Answer: Position the patient with a lateral tilt.
Rationale: Tilting the uterus off the vena cava prevents supine hypotension,
improving maternal and fetal circulation.
4. A patient recovering from dehydration in early pregnancy says she’ll eat small
frequent amounts of light foods like crackers and baked potato. Does this reflect
correct teaching?
Answer: Yes, this shows understanding of recommended dietary modifications.
Rationale: Small, bland, frequent meals reduce nausea and help maintain hydration
during early pregnancy discomforts.
,5. A patient in early pregnancy has excessive vomiting, weight loss, and ketonuria.
What condition is suspected?
Answer: Hyperemesis gravidarum.
Rationale: Ketonuria indicates fat breakdown resulting from prolonged vomiting
and inadequate nutrition.
6. A patient has an incomplete miscarriage with heavy bleeding. What is the
priority nursing action?
Answer: Prepare the patient for dilation and curettage (D&C).
Rationale: A D&C removes retained products of conception to prevent hemorrhage
and infection.
7. A patient with severe preeclampsia is receiving magnesium sulfate. What
indicates successful treatment?
Answer: Absence of seizures.
Rationale: Magnesium sulfate is administered primarily to prevent eclamptic
seizures.
8. What is the priority nursing intervention for a patient with hyperemesis
gravidarum?
Answer: Initiate IV fluid therapy.
Rationale: Rehydration corrects fluid imbalance, electrolyte loss, and prevents
ketone production.
9. A nursing student describes treatment for cervical insufficiency. Which
statement shows correct learning?
, Answer: “A prophylactic cerclage is placed to tighten the internal cervical
opening.”
Rationale: Cerclage reinforces the cervix and helps prevent pregnancy loss related
to cervical incompetence.
10. A baby born at 38 weeks weighs 6 lb 2 oz and has a 5-minute Apgar of 8. The
mother had hyperemesis gravidarum. How should this outcome be evaluated?
Answer: Normal for gestational age and Apgar expectations.
Rationale: Infant weight and Apgar score fall within normal limits despite maternal
complications.
11. A pregnant patient has RLQ pain, nausea, and vomiting with no UTI and a
normal chest x-ray. What condition is suspected?
Answer: Appendicitis.
Rationale: Appendix pain can present in the right lower quadrant during pregnancy
as the uterus shifts abdominal organs.
12. A 37-week pregnant trauma patient arrives with abdominal impact injuries.
What is the priority?
Answer: Assess vital signs, evaluate pain, and initiate continuous fetal heart
monitoring.
Rationale: Trauma in late pregnancy can threaten both maternal and fetal stability;
fetal monitoring is essential.
OBSTETRIC EMERGENCIES & MATERNAL CARE — Q&A WITH
RATIONALES
1. A pregnant patient receiving IV magnesium sulfate develops toxicity. Which
medication should the nurse request from the provider?
Answer: Calcium gluconate.
Rationale: Calcium gluconate is the antidote for magnesium toxicity and reverses
respiratory depression, cardiac arrhythmias, and loss of reflexes.
2. A pregnant patient at >20 weeks reports painless, bright red vaginal bleeding
with stable vital signs. What condition is suspected?
Answer: Placenta previa.
Rationale: Painless bleeding in the second or third trimester strongly suggests
placenta previa, where the placenta covers or partially covers the cervical os.
3. What nursing intervention optimizes fetal oxygenation during maternal surgery?
Answer: Position the patient with a lateral tilt.
Rationale: Tilting the uterus off the vena cava prevents supine hypotension,
improving maternal and fetal circulation.
4. A patient recovering from dehydration in early pregnancy says she’ll eat small
frequent amounts of light foods like crackers and baked potato. Does this reflect
correct teaching?
Answer: Yes, this shows understanding of recommended dietary modifications.
Rationale: Small, bland, frequent meals reduce nausea and help maintain hydration
during early pregnancy discomforts.
,5. A patient in early pregnancy has excessive vomiting, weight loss, and ketonuria.
What condition is suspected?
Answer: Hyperemesis gravidarum.
Rationale: Ketonuria indicates fat breakdown resulting from prolonged vomiting
and inadequate nutrition.
6. A patient has an incomplete miscarriage with heavy bleeding. What is the
priority nursing action?
Answer: Prepare the patient for dilation and curettage (D&C).
Rationale: A D&C removes retained products of conception to prevent hemorrhage
and infection.
7. A patient with severe preeclampsia is receiving magnesium sulfate. What
indicates successful treatment?
Answer: Absence of seizures.
Rationale: Magnesium sulfate is administered primarily to prevent eclamptic
seizures.
8. What is the priority nursing intervention for a patient with hyperemesis
gravidarum?
Answer: Initiate IV fluid therapy.
Rationale: Rehydration corrects fluid imbalance, electrolyte loss, and prevents
ketone production.
9. A nursing student describes treatment for cervical insufficiency. Which
statement shows correct learning?
, Answer: “A prophylactic cerclage is placed to tighten the internal cervical
opening.”
Rationale: Cerclage reinforces the cervix and helps prevent pregnancy loss related
to cervical incompetence.
10. A baby born at 38 weeks weighs 6 lb 2 oz and has a 5-minute Apgar of 8. The
mother had hyperemesis gravidarum. How should this outcome be evaluated?
Answer: Normal for gestational age and Apgar expectations.
Rationale: Infant weight and Apgar score fall within normal limits despite maternal
complications.
11. A pregnant patient has RLQ pain, nausea, and vomiting with no UTI and a
normal chest x-ray. What condition is suspected?
Answer: Appendicitis.
Rationale: Appendix pain can present in the right lower quadrant during pregnancy
as the uterus shifts abdominal organs.
12. A 37-week pregnant trauma patient arrives with abdominal impact injuries.
What is the priority?
Answer: Assess vital signs, evaluate pain, and initiate continuous fetal heart
monitoring.
Rationale: Trauma in late pregnancy can threaten both maternal and fetal stability;
fetal monitoring is essential.
