Maternity / OB, Pediatrics

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Sample questions from Maternity / OB, Pediatrics

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client at 30 weeks of gestation reports a severe headache and seeing spots. Blood pressure is 168/112 mm Hg, and urine dipstick shows 3+ protein. Which action is the nurse's priority?

   • A.Place the client in a quiet room and reassess in 1 hour
   • B.Notify the obstetric provider and prepare for urgent treatment
   • C.Encourage oral fluids and ambulation
   • D.Document the findings as expected in the third trimester

   Rationale: Severe-range blood pressure with headache, visual symptoms, and proteinuria suggests preeclampsia with severe features and requires urgent evaluation and treatment. Waiting an hour risks progression to eclampsia or stroke, and fluids or ambulation do not treat the underlying danger. These findings are not an expected feature of normal pregnancy.

2. 2.A client at 32 weeks of gestation with preeclampsia is receiving magnesium sulfate. The nurse notes a respiratory rate of 10/min and absent patellar reflexes. What is the priority action?

   • A.Continue the infusion and reassess in 30 minutes
   • B.Stop the infusion and prepare to administer calcium gluconate
   • C.Increase the infusion rate to prevent seizures
   • D.Encourage the client to take slow, deep breaths

   Rationale: Respiratory depression and absent deep tendon reflexes indicate magnesium toxicity, so the infusion should be stopped and the provider notified while calcium gluconate is prepared as the antidote. Continuing or increasing the infusion can worsen respiratory and cardiac depression. Breathing exercises do not reverse magnesium toxicity.

3. 3.An Rh-negative, unsensitized client gives birth to an Rh-positive newborn. Which intervention should the nurse anticipate?

   • A.Administer Rho(D) immune globulin within 72 hours after birth
   • B.Administer Rho(D) immune globulin only if the newborn develops jaundice
   • C.Withhold Rho(D) immune globulin because the client has already delivered
   • D.Administer Rho(D) immune globulin to the newborn

   Rationale: Rho(D) immune globulin is given to an unsensitized Rh-negative client after exposure to Rh-positive fetal blood, usually within 72 hours of birth. Jaundice is not the indication, and delivery does not eliminate the risk of maternal sensitization. The medication is administered to the parent, not the newborn.

4. 4.A client at 28 weeks of gestation reports painless, bright-red vaginal bleeding. The uterus is soft and nontender. Which action should the nurse avoid?

   • A.Assess maternal vital signs
   • B.Initiate fetal monitoring
   • C.Perform a digital vaginal examination
   • D.Notify the obstetric provider

   Answer and rationale are in the full material.

5. 5.A client at 35 weeks of gestation has sudden, severe abdominal pain, a rigid tender uterus, and dark vaginal bleeding. Which complication is most likely?

   • A.Placenta previa
   • B.Placental abruption
   • C.Vasa previa
   • D.Preterm rupture of membranes

   Answer and rationale are in the full material.