Maternal Newborn Nursing Test Maternity Nursing: Antepartum 2 — Questions and Answers
Question 1: A pregnant client at 28 weeks gestation is prescribed the Rh immunoglobulin (RhoGAM) injection. The nurse knows this is indicated because the client is:
- Rh-positive with an Rh-negative fetus
- Rh-negative with an Rh-positive fetus (Correct answer)
- Rh-positive with an Rh-positive fetus
- Rh-negative with an Rh-negative fetus
Correct answer: Rh-negative with an Rh-positive fetus
RhoGAM is given to Rh-negative mothers who may be carrying an Rh-positive fetus to prevent isoimmunization.
Question 2: Which laboratory finding is most concerning in a client at 34 weeks gestation with suspected preeclampsia?
- Hemoglobin of 11.5 g/dL
- Platelet count of 85,000/mm³ (Correct answer)
- Serum creatinine of 0.8 mg/dL
- BUN of 12 mg/dL
Correct answer: Platelet count of 85,000/mm³
A platelet count below 100,000/mm³ suggests HELLP syndrome, a severe complication of preeclampsia requiring immediate intervention.
Question 3: A client at 20 weeks gestation reports painful leg cramps at night. The nurse's best recommendation is to:
- Restrict fluid intake after dinner
- Dorsiflex the foot during the cramp (Correct answer)
- Apply heat and massage the calf vigorously
- Increase sodium intake to prevent muscle spasms
Correct answer: Dorsiflex the foot during the cramp
Dorsiflexing the foot stretches the gastrocnemius muscle and relieves the cramp; plantarflexion worsens it.
Question 4: A client with gestational diabetes is being taught about diet management. Which meal plan choice is MOST appropriate?
- Consume three large meals daily with no snacks
- Eat a high-carbohydrate diet to meet fetal glucose needs
- Distribute carbohydrates evenly across three meals and two to three snacks (Correct answer)
- Eliminate all carbohydrates from the diet
Correct answer: Distribute carbohydrates evenly across three meals and two to three snacks
Distributing carbohydrates evenly helps maintain stable blood glucose levels and prevents postprandial hyperglycemia.
Question 5: During a routine 16-week prenatal visit, the nurse assesses fundal height. The fundus should be palpable at approximately:
- At the umbilicus
- Halfway between the symphysis pubis and umbilicus (Correct answer)
- At the symphysis pubis
- At the xiphoid process
Correct answer: Halfway between the symphysis pubis and umbilicus
At 16 weeks, the fundus is midway between the symphysis pubis and umbilicus, consistent with McDonald's rule.
Question 6: A nurse is reviewing a client's prenatal labs. Which finding requires immediate follow-up?
- Fasting blood glucose of 88 mg/dL
- Rubella titer non-immune (Correct answer)
- Hemoglobin of 12.8 g/dL
- Blood type A positive
Correct answer: Rubella titer non-immune
A non-immune rubella titer means the client is susceptible to rubella infection, which can cause serious fetal harm; vaccination is scheduled postpartum.
Question 7: A client at 32 weeks gestation reports decreased fetal movement. The nurse instructs her to perform a kick count. Which response indicates a need for further evaluation?
- Ten fetal movements in 60 minutes
- Ten fetal movements in 2 hours
- Fewer than ten movements in 2 hours (Correct answer)
- Five movements in 30 minutes
Correct answer: Fewer than ten movements in 2 hours
Fewer than ten fetal movements in a 2-hour period is a warning sign of fetal compromise requiring further assessment.
