A woman at 35 weeks with pre-eclampsia is on the antenatal ward. Which new complaint most strongly suggests impending eclampsia?

Severe headache with blurred vision

Swelling of both ankles in the evening

Frequent passing of small amounts of urine

Two hours after birth, the baby of a mother with poorly controlled gestational diabetes is jittery and feeding poorly. The nurse's priority is to:

Wrap the baby and recheck in an hour

Check the baby's serum bilirubin

Arrange a chest X-ray for the baby

High-risk pregnancy: PIH, eclampsia, diabetes, anaemia

26 AIIMS NORCET (Nursing Officer) practice questions on High-risk pregnancy: PIH, eclampsia, diabetes, anaemia, part of Obstetric and Gynaecological Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
Pre-eclampsia is defined as new-onset hypertension with proteinuria appearing:
1. AOnly during labour
2. BOnly after delivery
3. CAfter 20 weeks of gestation
4. DBefore 12 weeks
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Answer: C · After 20 weeks of gestation
Pre-eclampsia is BP of 140/90 mmHg or more on two readings at least 4 hours apart, first appearing after 20 weeks, with proteinuria or signs of organ involvement. Hypertension present before 20 weeks suggests chronic hypertension. Pre-eclampsia before 20 weeks points to a molar pregnancy. It can also present for the first time after delivery, but its classic onset is in the second half of pregnancy.
- A: It is not limited to labour; most cases appear antenatally.
- B: Postpartum onset happens but is not the defining time.
- D: Hypertension before 20 weeks is usually chronic, not pre-eclampsia.
Question 2 · Easy
In HELLP syndrome, a complication of severe pre-eclampsia, the letters 'LP' stand for:
1. ALiver pain
2. BLow platelets
3. CLeaking placenta
4. DLow protein
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Answer: B · Low platelets
HELLP stands for haemolysis, elevated liver enzymes and low platelets. Platelets often fall below 100,000/µL, and the woman may complain of epigastric or right upper quadrant pain. It can progress quickly to DIC, liver haematoma or rupture. The nurse watches for bleeding gums, oozing from puncture sites and falling urine output.
- A: Pain is a symptom, but the letters refer to the low platelet count.
- C: Abruption may complicate it but is not part of the name.
- D: Low serum protein is not one of the defining features.
Question 3 · Medium
A woman at 35 weeks with pre-eclampsia is on the antenatal ward. Which new complaint most strongly suggests impending eclampsia?
1. ASevere headache with blurred vision
2. BSwelling of both ankles in the evening
3. CFrequent passing of small amounts of urine
4. DMild backache after walking
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Answer: A · Severe headache with blurred vision
Severe frontal headache, blurred vision or flashes, epigastric pain, vomiting and falling urine output are signs that eclampsia may follow. They reflect cerebral oedema, vasospasm and liver involvement. The nurse checks BP, reflexes and urine output and informs the doctor at once; magnesium sulphate is usually started. Ankle oedema alone is common in normal pregnancy.
- B: Evening ankle swelling is common and is no longer a diagnostic sign.
- C: Frequency is a normal late-pregnancy symptom; oliguria would be the warning sign.
- D: Mild backache is a common minor ailment.
Question 4 · Medium
Two hours after birth, the baby of a mother with poorly controlled gestational diabetes is jittery and feeding poorly. The nurse's priority is to:
1. AWrap the baby and recheck in an hour
2. BCheck the baby's serum bilirubin
3. CArrange a chest X-ray for the baby
4. DCheck the baby's blood glucose
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Answer: D · Check the baby's blood glucose
Maternal hyperglycaemia makes the fetal pancreas secrete extra insulin. After the cord is cut the glucose supply stops but insulin stays high, so hypoglycaemia is common in the first hours. Jitteriness, poor feeding, lethargy or apnoea need an immediate blood glucose check and early feeding or IV dextrose. Untreated hypoglycaemia can cause brain injury.
- A: Waiting an hour may allow serious hypoglycaemia to go untreated.
- B: Jaundice in IDM usually appears after 24 hours, not at 2 hours.
- C: Respiratory distress would prompt an X-ray, but jitteriness at 2 hours points to glucose.
Question 5 · Easy
In the DIPSI single-step test used in India, a pregnant woman is diagnosed with gestational diabetes when her 2-hour plasma glucose after 75 g oral glucose is:
1. A140 mg/dL or more
2. B200 mg/dL or more
3. C126 mg/dL or more
4. D180 mg/dL or more
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Answer: A · 140 mg/dL or more
MoHFW uses the DIPSI test: 75 g glucose is given regardless of the last meal and plasma glucose is checked at 2 hours. A value of 140 mg/dL or more means GDM. A single test suits Indian antenatal clinics because the woman need not come fasting. Capillary readings on a glucometer must be confirmed as per the guideline.
- B: 200 mg/dL is the 2-hour cut-off for overt diabetes.
- C: 126 mg/dL is the fasting cut-off for diabetes outside pregnancy.
- D: 180 mg/dL is the 1-hour value used in some other criteria.
Question 6 · Medium
Which parenteral iron preparation carries the highest risk of anaphylaxis, so a test dose is essential before it is given?
1. AFerric carboxymaltose
2. BFerrous ascorbate
3. CIron sucrose
4. DIron dextran
Answer and explanation in LearnFree account
Question 7 · Medium
A woman with rheumatic mitral stenosis is in the third stage of labour. Which drug should be avoided?
1. AOxytocin
2. BFurosemide
3. CMorphine
4. DMethylergometrine
Answer and explanation in LearnFree account
Question 8 · Hard
At her first antenatal visit at 12 weeks, a woman's DIPSI test (75 g glucose, non-fasting) gives a 2-hour plasma glucose of 132 mg/dL. Under MoHFW guidelines, what should happen next?
1. ANo further glucose test in this pregnancy
2. BStart medical nutrition therapy now
3. CRepeat the test at 24-28 weeks
4. DStart insulin for early-onset GDM
Answer and explanation in LearnFree account
Question 9 · Hard
Two hours after a vaginal delivery, a woman with mitral stenosis becomes breathless, with a pulse of 124/min, SpO2 88% and fine crackles at both lung bases. The nurse's first action is to:
1. AStart a 500 mL normal saline bolus
2. BGive oral paracetamol and reassess
3. CLay her flat and raise the foot end of the bed
4. DSit her upright with legs down and start oxygen
Answer and explanation in LearnFree account
Question 10 · Hard
A woman with severe pre-eclampsia is ordered magnesium sulphate maintenance at 1 g per hour (Zuspan regimen). The infusion bag contains 10 g magnesium sulphate in 250 mL. At what rate should the pump be set?
1. A10 mL/hour
2. B2.5 mL/hour
3. C25 mL/hour
4. D50 mL/hour
Answer and explanation in LearnFree account
Question 11 · Medium
Monochorionic diamniotic twins share one placenta. The complication specific to this type of twinning, which needs close ultrasound watch, is:
1. ASuperfecundation
2. BConjoined twins
3. CLocked twins during delivery
4. DTwin-to-twin transfusion syndrome
Answer and explanation in LearnFree account
Question 12 · Easy
After delivery of an Rh-positive baby, an Rh-negative mother should receive anti-D only if her indirect Coombs test is:
1. ANegative
2. BNot needed at all
3. CClearly positive
4. DRising in titre
Answer and explanation in LearnFree account
Question 13 · Easy
The most common heart lesion seen in pregnant women in India is:
1. ARheumatic mitral stenosis
2. BTetralogy of Fallot
3. CAortic stenosis
4. DAtrial septal defect
Answer and explanation in LearnFree account
Question 14 · Easy
The earliest clinical sign of magnesium toxicity that the nurse checks before each dose is:
1. ACardiac arrest
2. BReduced urine output
3. CRespiratory rate below 12/min
4. DLoss of the patellar reflex
Answer and explanation in LearnFree account
Question 15 · Medium
A woman with gestational diabetes is on medical nutrition therapy. Under MoHFW guidelines, her targets are:
1. AFasting 70 mg/dL or less; 2-hour post-meal 100 mg/dL or less
2. BFasting 95 mg/dL or less; 2-hour post-meal 120 mg/dL or less
3. CFasting 110 mg/dL or less; 2-hour post-meal 160 mg/dL or less
4. DFasting 126 mg/dL or less; 2-hour post-meal 200 mg/dL or less
Answer and explanation in LearnFree account
Question 16 · Medium
In the Pritchard regimen of magnesium sulphate, the maintenance dose is:
1. A5 g of 50% solution IM every 4 hours, alternate buttocks
2. B1 g per hour by continuous IV infusion
3. C10 g of 50% solution IM every 6 hours
4. D4 g of 20% solution IV every 4 hours
Answer and explanation in LearnFree account
Question 17 · Medium
An Rh-negative, unsensitised woman has a complete miscarriage at 9 weeks. The recommended anti-D dose for her is:
1. A300 µg IM within 72 hours
2. B50 µg IM within 72 hours
3. C50 µg IM at 28 weeks next pregnancy
4. DNo anti-D, as the fetus was too small
Answer and explanation in LearnFree account
Question 18 · Hard
An Rh-negative woman at 30 weeks has a rising anti-D titre. Her CTG shows a smooth, regular wave-like pattern of about 3-5 cycles per minute, with no variability and no accelerations. This pattern most likely indicates:
1. AMaternal fever
2. BSevere fetal anaemia
3. CUmbilical cord compression
4. DFetal sleep cycle
Answer and explanation in LearnFree account
Question 19 · Medium
A woman at 24 weeks with iron-deficiency anaemia starts oral iron. The earliest laboratory sign that she is responding is:
1. AA rise in reticulocyte count after 7-10 days
2. BA rise in haemoglobin of 3 g/dL within a week
3. CA normal serum ferritin after 2 weeks
4. DReturn of MCV to normal within 3 days
Answer and explanation in LearnFree account
Question 20 · Medium
The baby of an Rh-negative mother is born pale. Which test on cord blood shows that the baby's red cells are coated with maternal antibody?
1. ADirect Coombs test
2. BKleihauer-Betke test
3. COsmotic fragility test
4. DIndirect Coombs test
Answer and explanation in LearnFree account
Question 21 · Hard
A woman on magnesium sulphate for severe pre-eclampsia is drowsy, her respiratory rate is 9/min and her knee jerks are absent. The infusion has been stopped and help called. Which drug order should the nurse expect next?
1. A1 g of calcium gluconate orally with water
2. B10 mL of 10% calcium gluconate IM in each buttock
3. C100 mL of 10% calcium gluconate as a rapid bolus
4. D10 mL of 10% calcium gluconate IV over 10 minutes
Answer and explanation in LearnFree account
Question 22 · Easy
For a woman at high risk of pre-eclampsia, such as one with pre-eclampsia in her last pregnancy, low-dose aspirin is best started:
1. ABetween 12 and 16 weeks
2. BAfter 28 weeks
3. COnly once BP starts rising
4. DAt the onset of labour
Answer and explanation in LearnFree account
Question 23 · Easy
A woman at 28 weeks has a haemoglobin of 6.5 g/dL. By WHO grading of anaemia in pregnancy, she has:
1. AMild anaemia
2. BPhysiological haemodilution
3. CModerate anaemia
4. DSevere anaemia
Answer and explanation in LearnFree account
Question 24 · Hard
Before the next 4-hourly Pritchard dose, a woman with eclampsia has a respiratory rate of 18/min, knee jerks present and 70 mL of urine in the last 4 hours. The unit protocol requires RR 16/min or more, knee jerks present and urine at least 100 mL in 4 hours. What should the nurse do?
1. AWithhold the dose and inform the doctor
2. BGive the dose, as two criteria are met
3. CGive the dose with an IV fluid bolus
4. DGive half the dose and recheck in 2 hours
Answer and explanation in LearnFree account
Question 25 · Medium
A woman at 36 weeks with pre-eclampsia starts a generalised convulsion in the ward. What is the nurse's first action?
1. ALeave her to fetch the magnesium sulphate tray
2. BForce a padded tongue blade between her teeth
3. CTurn her onto her left side and keep the airway clear
4. DHold her arms and legs firmly to stop the jerks
Answer and explanation in LearnFree account

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Study Obstetric and Gynaecological Nursing

High-risk pregnancy: PIH, eclampsia, diabetes, anaemia

Pre-eclampsia is defined as new-onset hypertension with proteinuria appearing:

In HELLP syndrome, a complication of severe pre-eclampsia, the letters 'LP' stand for:

A woman at 35 weeks with pre-eclampsia is on the antenatal ward. Which new complaint most strongly suggests impending eclampsia?

Two hours after birth, the baby of a mother with poorly controlled gestational diabetes is jittery and feeding poorly. The nurse's priority is to:

In the DIPSI single-step test used in India, a pregnant woman is diagnosed with gestational diabetes when her 2-hour plasma glucose after 75 g oral glucose is:

Which parenteral iron preparation carries the highest risk of anaphylaxis, so a test dose is essential before it is given?

A woman with rheumatic mitral stenosis is in the third stage of labour. Which drug should be avoided?

At her first antenatal visit at 12 weeks, a woman's DIPSI test (75 g glucose, non-fasting) gives a 2-hour plasma glucose of 132 mg/dL. Under MoHFW guidelines, what should happen next?

Two hours after a vaginal delivery, a woman with mitral stenosis becomes breathless, with a pulse of 124/min, SpO2 88% and fine crackles at both lung bases. The nurse's first action is to:

A woman with severe pre-eclampsia is ordered magnesium sulphate maintenance at 1 g per hour (Zuspan regimen). The infusion bag contains 10 g magnesium sulphate in 250 mL. At what rate should the pump be set?

Monochorionic diamniotic twins share one placenta. The complication specific to this type of twinning, which needs close ultrasound watch, is:

After delivery of an Rh-positive baby, an Rh-negative mother should receive anti-D only if her indirect Coombs test is:

The most common heart lesion seen in pregnant women in India is:

The earliest clinical sign of magnesium toxicity that the nurse checks before each dose is:

A woman with gestational diabetes is on medical nutrition therapy. Under MoHFW guidelines, her targets are:

In the Pritchard regimen of magnesium sulphate, the maintenance dose is:

An Rh-negative, unsensitised woman has a complete miscarriage at 9 weeks. The recommended anti-D dose for her is:

An Rh-negative woman at 30 weeks has a rising anti-D titre. Her CTG shows a smooth, regular wave-like pattern of about 3-5 cycles per minute, with no variability and no accelerations. This pattern most likely indicates:

A woman at 24 weeks with iron-deficiency anaemia starts oral iron. The earliest laboratory sign that she is responding is:

The baby of an Rh-negative mother is born pale. Which test on cord blood shows that the baby's red cells are coated with maternal antibody?

A woman on magnesium sulphate for severe pre-eclampsia is drowsy, her respiratory rate is 9/min and her knee jerks are absent. The infusion has been stopped and help called. Which drug order should the nurse expect next?

For a woman at high risk of pre-eclampsia, such as one with pre-eclampsia in her last pregnancy, low-dose aspirin is best started:

A woman at 28 weeks has a haemoglobin of 6.5 g/dL. By WHO grading of anaemia in pregnancy, she has:

Before the next 4-hourly Pritchard dose, a woman with eclampsia has a respiratory rate of 18/min, knee jerks present and 70 mL of urine in the last 4 hours. The unit protocol requires RR 16/min or more, knee jerks present and urine at least 100 mL in 4 hours. What should the nurse do?

A woman at 36 weeks with pre-eclampsia starts a generalised convulsion in the ward. What is the nurse's first action?