Maternal Newborn Nursing Test Maternity Nursing: Antepartum 3 — Questions and Answers
Question 1: A client at 26 weeks gestation is diagnosed with placenta previa. The nurse should prioritize which assessment?
- Severity of uterine contractions
- Amount and characteristics of vaginal bleeding (Correct answer)
- Degree of cervical dilation
- Frequency of fetal hiccups
Correct answer: Amount and characteristics of vaginal bleeding
Painless, bright-red vaginal bleeding is the hallmark of placenta previa and its amount must be monitored to assess maternal and fetal stability.
Question 2: A nurse is caring for a client with hyperemesis gravidarum at 10 weeks gestation. Which laboratory result is MOST likely to be abnormal?
- Serum potassium 3.8 mEq/L
- Serum sodium 136 mEq/L
- Serum potassium 2.9 mEq/L (Correct answer)
- BUN 14 mg/dL
Correct answer: Serum potassium 2.9 mEq/L
Persistent vomiting in hyperemesis gravidarum causes loss of hydrogen and chloride ions, leading to hypokalemia and metabolic alkalosis.
Question 3: Which assessment finding in a client at 38 weeks gestation is MOST consistent with lightening?
- Increased urinary frequency and easier breathing (Correct answer)
- Decreased urinary frequency and dyspnea
- Onset of regular, painful contractions every 5 minutes
- Rupture of membranes with clear fluid
Correct answer: Increased urinary frequency and easier breathing
Lightening (engagement of the fetal head into the pelvis) relieves diaphragmatic pressure, easing breathing, but increases bladder pressure, causing urinary frequency.
Question 4: A client at 24 weeks gestation with no prior history of diabetes has a 1-hour glucose challenge test result of 152 mg/dL. The nurse explains that the next step is:
- Begin insulin therapy immediately
- Perform a 3-hour oral glucose tolerance test (Correct answer)
- Retest in 4 weeks
- Start a diabetic diet and recheck fasting glucose
Correct answer: Perform a 3-hour oral glucose tolerance test
A 1-hour GCT value ≥140 mg/dL is a positive screen that requires confirmation with a 3-hour 100-g OGTT for gestational diabetes diagnosis.
Question 5: A primigravida at 36 weeks asks the nurse about warning signs to report immediately. Which symptom is MOST urgent?
- Braxton Hicks contractions every 20 minutes
- Mild ankle edema at day's end
- Sudden severe headache and visual disturbances (Correct answer)
- Increased vaginal discharge without odor
Correct answer: Sudden severe headache and visual disturbances
Sudden severe headache and visual changes (scotoma, blurring) are signs of severe preeclampsia or impending eclampsia requiring emergency evaluation.
Question 6: The nurse is reviewing fetal development with a client at 12 weeks gestation. Which statement about fetal status at 12 weeks is ACCURATE?
- Surfactant production is complete
- External genitalia are distinguishable (Correct answer)
- The fetus can survive outside the uterus with intervention
- Myelination of the spinal cord is complete
Correct answer: External genitalia are distinguishable
By 12 weeks gestation, external genitalia differentiate enough to be distinguishable on ultrasound, though fine details may vary.
Question 7: A client at 30 weeks gestation is scheduled for a nonstress test (NST). The nurse explains the test is REACTIVE (normal) when:
- Two or more fetal heart rate accelerations of 15 bpm lasting 15 seconds occur within 20 minutes (Correct answer)
- No fetal movement is detected in 30 minutes
- Fetal heart rate decelerations follow uterine contractions
- Baseline fetal heart rate is 110 bpm with no variability
Correct answer: Two or more fetal heart rate accelerations of 15 bpm lasting 15 seconds occur within 20 minutes
A reactive NST requires at least two FHR accelerations of ≥15 bpm above baseline lasting ≥15 seconds within 20 minutes, indicating fetal well-being.
