NU 335 EXAM 2 PRACTICE QUESTIONS LATEST 2026
PRACTICE QUESTIONS AND ANSWERS WITH FULL
RATIONALES | INSTANT DOWNLOAD PDF
The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would support the
diagnosis of hyperemesis gravidarum?
a. Hypercalcemia.
b. Hypokalemia.
c. Hyperkalemia.
d. Hypocalcemia. - correct answer -b. Hypokalemia.
Rationale: In severe cases, hyperemesis causes dehydration, which leads to fluid-electrolyte
imbalance. Severe potassium loss can disrupt cardiac functioning. Potassium loss (hypokalemia),
not hyperkalemia, is characteristic of hyperemesis gravidarum. Neither hypercalcemia nor
hypocalcemia (low calcium) is characteristic of hyperemesis gravidarum.
If a client does not respond to standard home treatment for severe hyperemesis gravidarum,
the nurse will anticipate adding which therapy on an outpatient basis?
a. Low-fat soft diet.
b. Complex carbohydrates with limited liquids.
c. IV fluids.
d. Total parenteral nutrition. - correct answer -c. IV fluids.
Rationale: If the woman does not respond to standard approaches to the control of nausea and
vomiting in pregnancy, she might require intravenous (IV) fluids on an outpatient basis. Total
parenteral nutrition would be started only if the client were unresponsive to IV hydration.
Lowfat soft diet and complex carbohydrates with limited liquids are progressive diets after the
client is stabilized for hyperemesis gravidarum.
,A client at 30 weeks' gestation is admitted to the maternity unit with vaginal bleeding. What
should be the nurse's initial nursing action?
a. Count and weigh peripads.
b. Start an intravenous infusion drip.
c. Assess blood pressure and pulse.
d. Observe for pallor, clammy skin, and perspiration. - correct answer -c. Assess blood pressure
and pulse.
Rationale: The nurse's initial action for a client with vaginal bleeding at 30 weeks would be to
assess blood pressure and pulse. Counting and weighing peripads; observing for pallor, clammy
skin, and perspiration; and starting an intravenous infusion drip are all important actions for this
client; they are just not the initial action.
A prenatal client at 16 weeks' gestation presents to the clinic with unexplained bright red
bleeding, cramping, and backache, which she has had for the past two days. A pelvic exam
reveals a closed cervix. What type of abortion does this indicate?
a. Threatened.
b. Incomplete.
c. Missed.
d. Imminent. - correct answer -a. Threatened.
Rationale: A threatened abortion (miscarriage) has symptoms of vaginal bleeding and backache
without cervical dilation. In an imminent abortion, the internal cervical os is dilated. Although
the cervix is closed in a missed abortion, other symptoms would include a regression in breast
changes and a brownish vaginal discharge. Diagnosis is made based on history, pelvic exam, and
a negative pregnancy test. With an incomplete abortion, the embryo has passed out of the
uterus, but the placenta remains, and the internal os is slightly dilated.
The client asks for information about ectopic pregnancy. The nurse correctly responds by saying
ectopic pregnancy is caused by: (Select all that apply.)
a. Pelvic inflammatory disease (PID).
b. Presence of an IUD.
,c. In utero exposure to diethylstilbestrol (DES).
d. Endometriosis. - correct answer -a. Pelvic inflammatory disease (PID).
d. Endometriosis.
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
Rationale: Ectopic pregnancy can be caused by tubal damage from pelvic inflammatory disease
(PID), previous tubal surgery, congenital anomalies of the tube, endometriosis, previous ectopic
pregnancy, presence of an IUD, and in utero exposure to diethylstilbestrol (DES).
A client presents to the physician's office with complaints of right-sided abdominal pain,
dizziness, and vaginal bleeding. A pelvic exam determines adnexal tenderness. What diagnosis
should the nurse suspect?
a. Cholelithiasis.
b. Appendicitis.
c. Threatened abortion.
d. Ectopic pregnancy. - correct answer -d. Ectopic pregnancy.
Rationale: A client with an ectopic pregnancy would present to the physician's office with
complaints of one-sided abdominal pain, dizziness, and vaginal bleeding, and would have
adnexal tenderness on exam. Clients with a threatened abortion would have complaints of
unexplained bleeding, cramping, or backache. A pelvic exam would reveal a closed cervix.
Clients with appendicitis would have complaints of lower right-sided tenderness, low-grade
fever, nausea, and often vomiting. Clients with cholelithiasis would have complaints of epigastric
distress, such as fullness, distention, and vague pain in the right upper quadrant of the
abdomen.
A client at 15 weeks' gestation presents to the prenatal clinic with "prune juice"-like vaginal
bleeding. Other assessment data include a hematocrit of 10 and complaints of severe nausea
and vomiting. What diagnosis should the nurse suspect?
a. Prolapsed cord.
b. Hydatidiform mole.
, c. Placenta previa.
d. Abruptio placentae. - correct answer -b. Hydatidiform mole.
Rationale: In hydatidiform mole, vaginal bleeding occurs almost universally. It is often brownish
due to liquefaction of the uterine clot. In addition, because serum hCG levels are higher with
molar pregnancy than with normal pregnancy, the woman might experience hyperemesis
gravidarum. Anemia occurs frequently due to blood loss and poor nutrition secondary to
hyperemesis. Placenta previa symptoms include painless bright red vaginal bleeding, usually in
the third trimester of pregnancy. Prolapsed cord symptoms include a trickle of bright red vaginal
blood and possibly a visible cord at the vaginal opening. Abruptio placentae symptoms include
vaginal bleeding (bright red or dark red), abdominal pain, and uterine tenderness.
A client is being maintained at home with a diagnosis of mild pre-eclampsia. Which of the
following complaints require further evaluation? Select all that apply.
a. Headache.
b. Anxiety.
c. Heartburn.
d. Blurred vision. - correct answer -a. Headache.
d. Blurred vision.
Rationale: Answers (a) and (d) are correct; headache and blurred vision are symptoms
associated with worsening preeclampsia. Answer (c) is incorrect; heartburn is a familiar
sensation and is less intense than the epigastric pain associated with severe preeclampsia.
Answer (b) is incorrect; anxiety is a normal response to a complicated pregnancy.
During a prenatal visit, a client states, "Sometimes my boyfriend hits me, but it is just when he is
stressed at work. I know he loves the baby and me; it's just hard right now. He wouldn't really
hurt me." The nurse's first priority is to:
a. Notify the social worker immediately.
b. Determine the client's immediate safety.
c. Encourage the client to leave her partner as soon as possible for the sake of the baby.
PRACTICE QUESTIONS AND ANSWERS WITH FULL
RATIONALES | INSTANT DOWNLOAD PDF
The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would support the
diagnosis of hyperemesis gravidarum?
a. Hypercalcemia.
b. Hypokalemia.
c. Hyperkalemia.
d. Hypocalcemia. - correct answer -b. Hypokalemia.
Rationale: In severe cases, hyperemesis causes dehydration, which leads to fluid-electrolyte
imbalance. Severe potassium loss can disrupt cardiac functioning. Potassium loss (hypokalemia),
not hyperkalemia, is characteristic of hyperemesis gravidarum. Neither hypercalcemia nor
hypocalcemia (low calcium) is characteristic of hyperemesis gravidarum.
If a client does not respond to standard home treatment for severe hyperemesis gravidarum,
the nurse will anticipate adding which therapy on an outpatient basis?
a. Low-fat soft diet.
b. Complex carbohydrates with limited liquids.
c. IV fluids.
d. Total parenteral nutrition. - correct answer -c. IV fluids.
Rationale: If the woman does not respond to standard approaches to the control of nausea and
vomiting in pregnancy, she might require intravenous (IV) fluids on an outpatient basis. Total
parenteral nutrition would be started only if the client were unresponsive to IV hydration.
Lowfat soft diet and complex carbohydrates with limited liquids are progressive diets after the
client is stabilized for hyperemesis gravidarum.
,A client at 30 weeks' gestation is admitted to the maternity unit with vaginal bleeding. What
should be the nurse's initial nursing action?
a. Count and weigh peripads.
b. Start an intravenous infusion drip.
c. Assess blood pressure and pulse.
d. Observe for pallor, clammy skin, and perspiration. - correct answer -c. Assess blood pressure
and pulse.
Rationale: The nurse's initial action for a client with vaginal bleeding at 30 weeks would be to
assess blood pressure and pulse. Counting and weighing peripads; observing for pallor, clammy
skin, and perspiration; and starting an intravenous infusion drip are all important actions for this
client; they are just not the initial action.
A prenatal client at 16 weeks' gestation presents to the clinic with unexplained bright red
bleeding, cramping, and backache, which she has had for the past two days. A pelvic exam
reveals a closed cervix. What type of abortion does this indicate?
a. Threatened.
b. Incomplete.
c. Missed.
d. Imminent. - correct answer -a. Threatened.
Rationale: A threatened abortion (miscarriage) has symptoms of vaginal bleeding and backache
without cervical dilation. In an imminent abortion, the internal cervical os is dilated. Although
the cervix is closed in a missed abortion, other symptoms would include a regression in breast
changes and a brownish vaginal discharge. Diagnosis is made based on history, pelvic exam, and
a negative pregnancy test. With an incomplete abortion, the embryo has passed out of the
uterus, but the placenta remains, and the internal os is slightly dilated.
The client asks for information about ectopic pregnancy. The nurse correctly responds by saying
ectopic pregnancy is caused by: (Select all that apply.)
a. Pelvic inflammatory disease (PID).
b. Presence of an IUD.
,c. In utero exposure to diethylstilbestrol (DES).
d. Endometriosis. - correct answer -a. Pelvic inflammatory disease (PID).
d. Endometriosis.
b. Presence of an IUD.
c. In utero exposure to diethylstilbestrol (DES).
Rationale: Ectopic pregnancy can be caused by tubal damage from pelvic inflammatory disease
(PID), previous tubal surgery, congenital anomalies of the tube, endometriosis, previous ectopic
pregnancy, presence of an IUD, and in utero exposure to diethylstilbestrol (DES).
A client presents to the physician's office with complaints of right-sided abdominal pain,
dizziness, and vaginal bleeding. A pelvic exam determines adnexal tenderness. What diagnosis
should the nurse suspect?
a. Cholelithiasis.
b. Appendicitis.
c. Threatened abortion.
d. Ectopic pregnancy. - correct answer -d. Ectopic pregnancy.
Rationale: A client with an ectopic pregnancy would present to the physician's office with
complaints of one-sided abdominal pain, dizziness, and vaginal bleeding, and would have
adnexal tenderness on exam. Clients with a threatened abortion would have complaints of
unexplained bleeding, cramping, or backache. A pelvic exam would reveal a closed cervix.
Clients with appendicitis would have complaints of lower right-sided tenderness, low-grade
fever, nausea, and often vomiting. Clients with cholelithiasis would have complaints of epigastric
distress, such as fullness, distention, and vague pain in the right upper quadrant of the
abdomen.
A client at 15 weeks' gestation presents to the prenatal clinic with "prune juice"-like vaginal
bleeding. Other assessment data include a hematocrit of 10 and complaints of severe nausea
and vomiting. What diagnosis should the nurse suspect?
a. Prolapsed cord.
b. Hydatidiform mole.
, c. Placenta previa.
d. Abruptio placentae. - correct answer -b. Hydatidiform mole.
Rationale: In hydatidiform mole, vaginal bleeding occurs almost universally. It is often brownish
due to liquefaction of the uterine clot. In addition, because serum hCG levels are higher with
molar pregnancy than with normal pregnancy, the woman might experience hyperemesis
gravidarum. Anemia occurs frequently due to blood loss and poor nutrition secondary to
hyperemesis. Placenta previa symptoms include painless bright red vaginal bleeding, usually in
the third trimester of pregnancy. Prolapsed cord symptoms include a trickle of bright red vaginal
blood and possibly a visible cord at the vaginal opening. Abruptio placentae symptoms include
vaginal bleeding (bright red or dark red), abdominal pain, and uterine tenderness.
A client is being maintained at home with a diagnosis of mild pre-eclampsia. Which of the
following complaints require further evaluation? Select all that apply.
a. Headache.
b. Anxiety.
c. Heartburn.
d. Blurred vision. - correct answer -a. Headache.
d. Blurred vision.
Rationale: Answers (a) and (d) are correct; headache and blurred vision are symptoms
associated with worsening preeclampsia. Answer (c) is incorrect; heartburn is a familiar
sensation and is less intense than the epigastric pain associated with severe preeclampsia.
Answer (b) is incorrect; anxiety is a normal response to a complicated pregnancy.
During a prenatal visit, a client states, "Sometimes my boyfriend hits me, but it is just when he is
stressed at work. I know he loves the baby and me; it's just hard right now. He wouldn't really
hurt me." The nurse's first priority is to:
a. Notify the social worker immediately.
b. Determine the client's immediate safety.
c. Encourage the client to leave her partner as soon as possible for the sake of the baby.
