Obstetric Nurse Test Obstetric Nurse Antepartum Complications 2 — Questions and Answers
Question 1: A pregnant patient at 32 weeks has a blood pressure of 158/105 mmHg on two readings 4 hours apart with proteinuria. Which additional finding would indicate severe features of preeclampsia?
- Serum creatinine of 0.8 mg/dL
- Platelet count of 85,000/μL (Correct answer)
- Urine protein of 300 mg/24h
- Ankle edema 2+
Correct answer: Platelet count of 85,000/μL
A platelet count below 100,000/μL is one of the criteria for severe features of preeclampsia per ACOG guidelines.
Question 2: A patient at 28 weeks gestation presents with painful, firm uterine contractions and dark vaginal bleeding. Fetal heart tones are present but show late decelerations. Which condition is most likely?
- Placenta previa
- Placental abruption (Correct answer)
- Bloody show
- Uterine rupture
Correct answer: Placental abruption
Placental abruption classically presents with painful uterine contractions, dark vaginal bleeding, and uterine rigidity with associated fetal distress.
Question 3: Which laboratory finding is most consistent with HELLP syndrome in a preeclamptic patient?
- Elevated serum albumin
- Elevated LDH and AST with thrombocytopenia (Correct answer)
- Decreased serum bilirubin
- Leukocytosis above 15,000/μL
Correct answer: Elevated LDH and AST with thrombocytopenia
HELLP syndrome is defined by hemolysis (elevated LDH), elevated liver enzymes (AST/ALT), and low platelets.
Question 4: A primigravida at 36 weeks reports headache, visual disturbances, and RUQ pain. BP is 162/110 mmHg. After stabilization, what is the definitive treatment?
- Corticosteroids for fetal lung maturity
- Antihypertensive therapy and close monitoring
- Delivery of the fetus (Correct answer)
- Magnesium sulfate indefinitely
Correct answer: Delivery of the fetus
Delivery is the only definitive treatment for preeclampsia with severe features, regardless of gestational age when the mother is unstable.
Question 5: A patient at 24 weeks is diagnosed with an incompetent cervix. She is asymptomatic with cervical dilation of 2 cm. Which intervention is most appropriate?
- Immediate cesarean delivery
- Cerclage placement (Correct answer)
- Induction of labor
- Bed rest with pelvic rest only
Correct answer: Cerclage placement
Cerclage (cervical stitch) is the standard surgical intervention for cervical incompetence to prevent preterm delivery.
Question 6: A patient at 30 weeks with known placenta previa presents with painless, bright red vaginal bleeding. Which nursing action takes highest priority?
- Prepare for digital cervical exam
- Initiate IV access and continuous fetal monitoring (Correct answer)
- Administer misoprostol for cervical ripening
- Position patient in Trendelenburg
Correct answer: Initiate IV access and continuous fetal monitoring
Establishing IV access for fluid resuscitation and continuous fetal monitoring are the immediate priorities; digital exams are strictly contraindicated with previa.
Question 7: Which type of placenta previa carries the highest risk of maternal hemorrhage at delivery?
- Low-lying placenta
- Marginal previa
- Partial previa
- Complete previa (Correct answer)
Correct answer: Complete previa
Complete placenta previa, in which the placenta fully covers the internal cervical os, poses the greatest risk of severe hemorrhage.
Obstetric Nurse Test Obstetric Nurse Antepartum Complications 2
A pregnant patient at 32 weeks has a blood pressure of 158/105 mmHg on two readings 4 hours apart with proteinuria.
Which additional finding would indicate severe features of preeclampsia?