Maternal Newborn Nursing Test Maternal Complications 2 — Questions and Answers
Question 1: A patient develops eclampsia and begins seizing during labor. What is the nurse's FIRST priority action?
- Administer magnesium sulfate IV bolus
- Turn the patient to her side and protect her from injury (Correct answer)
- Call for emergency assistance immediately
- Time and document the seizure
Correct answer: Turn the patient to her side and protect her from injury
The first priority during an eclamptic seizure is patient safety — turning her to the side prevents aspiration and maintains a patent airway while protecting her from self-injury.
Question 2: A patient is admitted with hyperemesis gravidarum. Which nursing intervention is the highest priority?
- Encourage small frequent oral meals immediately
- Assess hydration status and initiate IV fluid replacement (Correct answer)
- Administer antiemetics before assessing dehydration
- Teach relaxation techniques to manage nausea
Correct answer: Assess hydration status and initiate IV fluid replacement
Hyperemesis gravidarum causes severe dehydration and electrolyte imbalances; assessment of hydration status and IV fluid/electrolyte replacement is the immediate priority.
Question 3: A patient at 20 weeks gestation is diagnosed with an incompetent cervix and undergoes cervical cerclage. Which discharge instruction should the nurse provide?
- Resume all normal activities including sexual intercourse
- Report any uterine contractions, bleeding, or ruptured membranes immediately (Correct answer)
- Expect some cervical bleeding for 4–6 weeks
- Avoid all prenatal vitamins after the procedure
Correct answer: Report any uterine contractions, bleeding, or ruptured membranes immediately
After cerclage placement, patients must be educated to report contractions, bleeding, or membrane rupture immediately as these may indicate cerclage failure or preterm labor.
Question 4: A patient at 36 weeks has been diagnosed with obstetric cholestasis (intrahepatic cholestasis of pregnancy). Which symptom is most characteristic?
- Nausea and vomiting in the morning
- Intense generalized pruritus, worst on the palms and soles (Correct answer)
- Painless jaundice with dark urine
- Upper right quadrant pain with fever
Correct answer: Intense generalized pruritus, worst on the palms and soles
The hallmark symptom of intrahepatic cholestasis of pregnancy is intense pruritus, especially on the palms and soles, caused by bile salt accumulation under the skin.
Question 5: A pregnant patient has a hemoglobin of 9.2 g/dL and is diagnosed with iron-deficiency anemia. Which instruction about iron supplementation is most important?
- Take iron with milk to enhance absorption
- Take iron with orange juice or vitamin C to enhance absorption (Correct answer)
- Take iron with calcium supplements to improve tolerance
- Take iron with meals only to prevent nausea
Correct answer: Take iron with orange juice or vitamin C to enhance absorption
Vitamin C (ascorbic acid) enhances the absorption of non-heme iron by converting ferric iron to the more absorbable ferrous form; dairy products and calcium decrease iron absorption.
Question 6: A patient with gestational diabetes is at 38 weeks gestation. Her fasting glucose readings have been 95–105 mg/dL on dietary management alone. What intervention is indicated?
- Continue dietary management and recheck at 40 weeks
- Initiate insulin therapy as dietary control has failed (Correct answer)
- Switch to oral hypoglycemic agents such as glyburide
- Schedule immediate induction of labor
Correct answer: Initiate insulin therapy as dietary control has failed
Fasting glucose levels above 95 mg/dL despite dietary management indicate inadequate blood glucose control, and insulin therapy should be initiated to protect fetal outcomes.
