Maternal-Newborn Nursing Exam 3 Actual Exam 2026/2027:
Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Time Allowed: 75 minutes
Total Questions: 50
Format: Multiple Choice, Select All That Apply, Ordered Response, Fill‑in‑the‑Blank
Domain 1: Third Trimester & Antepartal Complications
1.
A nurse is caring for a client at 32 weeks gestation with a blood pressure of 162/104
mmHg and 3+ proteinuria. Which finding indicates progression to severe preeclampsia?
A) Weight gain of 2 lb in one week
B) Reflexes 2+ and clonus absent
C) Platelet count 85,000/mm³ ✓
D) Urine output 40 mL/hr
Correct Answer: C) Platelet count 85,000/mm³
Rationale: Thrombocytopenia (<100,000/mm³) is a severe feature of preeclampsia per
ACOG criteria and indicates HELLP syndrome risk; 2 lb weight gain and 2+ reflexes
without clonus are not severe features, and 40 mL/hr exceeds the oliguria threshold of
<30 mL/hr.
2.
A client at 24 weeks gestation asks about the one-hour glucose challenge test. The
nurse explains that a screening result above which value requires a three-hour oral
glucose tolerance test?
A) 120 mg/dL
B) 130 mg/dL
C) 140 mg/dL ✓
D) 160 mg/dL
Correct Answer: C) 140 mg/dL
,Rationale: A one-hour glucose challenge test result of 140 mg/dL or greater indicates
the need for diagnostic three-hour testing; some providers use 130 mg/dL for high-risk
clients, but 140 mg/dL is the standard screening threshold.
3.
A nurse is teaching a client with mild gestational hypertension about warning signs that
require immediate reporting. Which statements by the client indicate correct
understanding? (Select All That Apply)
A) "I should call if I notice swelling in my ankles at the end of the day."
B) "A severe headache that does not improve with acetaminophen is a concern."
C) "Visual changes like seeing spots mean I need to be seen right away."
D) "Decreased fetal movement after 28 weeks requires evaluation."
E) "Mild upper right quadrant pain that resolves with rest is normal."
Correct Answers: B, C, D
Rationale: Severe headache, visual disturbances, and decreased fetal movement are red
flags for worsening preeclampsia; ankle edema is common in pregnancy, and upper
right quadrant pain suggests liver involvement requiring immediate evaluation.
4.
A client at 34 weeks gestation arrives in the emergency department with sudden onset
of dark red vaginal bleeding and a rigid, tender uterus. The fetal heart rate is 110 bpm
with minimal variability. The nurse should anticipate which diagnosis?
A) Marginal placenta previa with partial separation
B) Placental abruption with concealed hemorrhage ✓
C) Vasa previa with fetal exsanguination
D) Cervical laceration from intercourse
Correct Answer: B) Placental abruption with concealed hemorrhage
Rationale: Painful vaginal bleeding with uterine rigidity and tetany is classic for placental
abruption; placenta previa typically presents with painless bright red bleeding, and vasa
previa causes rapid fetal compromise with minimal maternal symptoms.
5.
, A client receiving magnesium sulfate for preterm labor prophylaxis has a respiratory
rate of 10 breaths per minute and absent deep tendon reflexes. Which action should the
nurse take first?
A) Increase the maintenance infusion rate to prolong tocolysis
B) Administer calcium gluconate and discontinue the infusion ✓
C) Obtain a serum magnesium level and continue monitoring
D) Administer hydralazine to lower the blood pressure
Correct Answer: B) Administer calcium gluconate and discontinue the infusion
Rationale: Respiratory depression and absent reflexes indicate magnesium sulfate
toxicity requiring immediate antidote administration and cessation of the infusion;
waiting for lab results delays life-saving treatment.
6.
A client at 29 weeks gestation is admitted with preterm premature rupture of
membranes. The provider orders betamethasone. The nurse explains that the primary
purpose of this medication is to:
A) Prevent intra-amniotic infection by providing antibiotic coverage
B) Accelerate fetal lung maturation and reduce respiratory distress syndrome ✓
C) Promote uterine relaxation and inhibit preterm labor contractions
D) Stabilize the fetal heart rate and improve placental perfusion
Correct Answer: B) Accelerate fetal lung maturation and reduce respiratory distress
syndrome
Rationale: Betamethasone is a corticosteroid administered to pregnant clients between
24 and 34 weeks to accelerate fetal surfactant production; it does not treat infection,
provide tocolysis, or directly affect fetal heart rate.
7.
A nurse is caring for a client at 36 weeks gestation diagnosed with HELLP syndrome.
Which findings are consistent with this diagnosis? (Select All That Apply)
A) Hemolysis with schistocytes on peripheral smear
B) Elevated liver enzymes (AST >70 IU/L)
C) Low platelet count (<100,000/mm³)
D) Proteinuria of 1+ on dipstick
E) Blood pressure 138/86 mmHg
Correct Answers: A, B, C
Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Time Allowed: 75 minutes
Total Questions: 50
Format: Multiple Choice, Select All That Apply, Ordered Response, Fill‑in‑the‑Blank
Domain 1: Third Trimester & Antepartal Complications
1.
A nurse is caring for a client at 32 weeks gestation with a blood pressure of 162/104
mmHg and 3+ proteinuria. Which finding indicates progression to severe preeclampsia?
A) Weight gain of 2 lb in one week
B) Reflexes 2+ and clonus absent
C) Platelet count 85,000/mm³ ✓
D) Urine output 40 mL/hr
Correct Answer: C) Platelet count 85,000/mm³
Rationale: Thrombocytopenia (<100,000/mm³) is a severe feature of preeclampsia per
ACOG criteria and indicates HELLP syndrome risk; 2 lb weight gain and 2+ reflexes
without clonus are not severe features, and 40 mL/hr exceeds the oliguria threshold of
<30 mL/hr.
2.
A client at 24 weeks gestation asks about the one-hour glucose challenge test. The
nurse explains that a screening result above which value requires a three-hour oral
glucose tolerance test?
A) 120 mg/dL
B) 130 mg/dL
C) 140 mg/dL ✓
D) 160 mg/dL
Correct Answer: C) 140 mg/dL
,Rationale: A one-hour glucose challenge test result of 140 mg/dL or greater indicates
the need for diagnostic three-hour testing; some providers use 130 mg/dL for high-risk
clients, but 140 mg/dL is the standard screening threshold.
3.
A nurse is teaching a client with mild gestational hypertension about warning signs that
require immediate reporting. Which statements by the client indicate correct
understanding? (Select All That Apply)
A) "I should call if I notice swelling in my ankles at the end of the day."
B) "A severe headache that does not improve with acetaminophen is a concern."
C) "Visual changes like seeing spots mean I need to be seen right away."
D) "Decreased fetal movement after 28 weeks requires evaluation."
E) "Mild upper right quadrant pain that resolves with rest is normal."
Correct Answers: B, C, D
Rationale: Severe headache, visual disturbances, and decreased fetal movement are red
flags for worsening preeclampsia; ankle edema is common in pregnancy, and upper
right quadrant pain suggests liver involvement requiring immediate evaluation.
4.
A client at 34 weeks gestation arrives in the emergency department with sudden onset
of dark red vaginal bleeding and a rigid, tender uterus. The fetal heart rate is 110 bpm
with minimal variability. The nurse should anticipate which diagnosis?
A) Marginal placenta previa with partial separation
B) Placental abruption with concealed hemorrhage ✓
C) Vasa previa with fetal exsanguination
D) Cervical laceration from intercourse
Correct Answer: B) Placental abruption with concealed hemorrhage
Rationale: Painful vaginal bleeding with uterine rigidity and tetany is classic for placental
abruption; placenta previa typically presents with painless bright red bleeding, and vasa
previa causes rapid fetal compromise with minimal maternal symptoms.
5.
, A client receiving magnesium sulfate for preterm labor prophylaxis has a respiratory
rate of 10 breaths per minute and absent deep tendon reflexes. Which action should the
nurse take first?
A) Increase the maintenance infusion rate to prolong tocolysis
B) Administer calcium gluconate and discontinue the infusion ✓
C) Obtain a serum magnesium level and continue monitoring
D) Administer hydralazine to lower the blood pressure
Correct Answer: B) Administer calcium gluconate and discontinue the infusion
Rationale: Respiratory depression and absent reflexes indicate magnesium sulfate
toxicity requiring immediate antidote administration and cessation of the infusion;
waiting for lab results delays life-saving treatment.
6.
A client at 29 weeks gestation is admitted with preterm premature rupture of
membranes. The provider orders betamethasone. The nurse explains that the primary
purpose of this medication is to:
A) Prevent intra-amniotic infection by providing antibiotic coverage
B) Accelerate fetal lung maturation and reduce respiratory distress syndrome ✓
C) Promote uterine relaxation and inhibit preterm labor contractions
D) Stabilize the fetal heart rate and improve placental perfusion
Correct Answer: B) Accelerate fetal lung maturation and reduce respiratory distress
syndrome
Rationale: Betamethasone is a corticosteroid administered to pregnant clients between
24 and 34 weeks to accelerate fetal surfactant production; it does not treat infection,
provide tocolysis, or directly affect fetal heart rate.
7.
A nurse is caring for a client at 36 weeks gestation diagnosed with HELLP syndrome.
Which findings are consistent with this diagnosis? (Select All That Apply)
A) Hemolysis with schistocytes on peripheral smear
B) Elevated liver enzymes (AST >70 IU/L)
C) Low platelet count (<100,000/mm³)
D) Proteinuria of 1+ on dipstick
E) Blood pressure 138/86 mmHg
Correct Answers: A, B, C
