ALL Q&A of OB.
Chapter 7: High-Risk Antepartum Nursing Care
Multiple Choice
1. A client on 2 gm/hr of magnesium sulfate has decreased deep tendon reflexes. Identify the priority
nursing assessment to ensure client safety.
a. Assess uterine contractions continuously.
b. Assess fetal heart rate continuously.
c. Assess urinary output.
d. Assess respiratory
rate.
2. A pregnant client with a history of multiple sexual partners is at highest risk for which of the
following complications:
a. Premature rupture of membranes
b. Gestational diabetes
c. Ectopic pregnancy
d. Pregnancy-induced hypertension
3. Identify the hallmark of placenta previa that differentiates it from abruptio
placenta. a. Sudden onset of painless vaginal bleeding
b. Board-like abdomen with severe pain
c. Sudden onset of bright red vaginal bleeding
d. Severe vaginal pain with bright red bleeding
4. Which of the following assessments would indicate instability in the client hospitalized for
placenta previa?
a. BP <90/60 mm/Hg, Pulse <60 BPM or >120 BPM
b. FHR moderate variability without accelerations
c. Dark brown vaginal discharge when voiding
d. Oral temperature of 99.9F
5. During pregnancy, poorly controlled asthma can place the fetus at risk for:
a. Hyperglycemia
b. IUGR
c. Hypoglycemia
d. Macrosomia
6. Which of the following nursing diagnoses is of highest priority for a client with an ectopic pregnancy
who has developed disseminated intravascular coagulation (DIC)?
a. Risk for deficient fluid volume
b. Risk for family process interrupted
c. Risk for disturbed identity
d. High risk for injury
,ALL Q&A of OB.
7. Which of the following laboratory values is most concerning in a client with pregnancy-induced
hypertension?
a. Total urine protein of 200 mg/dL
b. Total platelet count of 40,000
mm
c. Uric acid level of 8 mg/dL
d. Blood urea nitrogen 24 mg/dL
8. Which of the following medications administered to the pregnant client with GDM and experiencing
preterm labor requires close monitoring of the client’s blood glucose levels?
a. Nifedipine
b. Betamethasone
c. Magnesium sulfate
d. Indomethacin
9. While educating the client with class II cardiac disease, at 28 weeks’ gestation, the nurse instructs the
client to notify the physician if she experiences which of the following conditions?
a. Emotional stress at work
b. Increased dyspnea while resting
c. Mild pedal and ankle edema
d. Weight gain of 1 pound in 1 week
10. The nurse working in a prenatal clinic is providing care to three primigravida patients. Which of
the patient findings would the nurse highlight for the physician?
a. 15 weeks, denies feeling fetal movement
b. 20 weeks, fundal height at the umbilicus
c. 25 weeks, complains of excess salivation
d. 30 weeks, states that her vision is blurry
11. The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks’ gestation in her first
pregnancy. She is worried about having her baby “too soon,” and she is experiencing uterine
contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal
examination performed by the health-care provider reveals that the cervix is closed, long, and
posterior. The most likely diagnosis would be:
a. Preterm labor
b. Term labor
c. Back labor
d. Braxton-Hicks contractions
12. The perinatal nurse knows that the term to describe a woman at 26 weeks’ gestation with a history of
elevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is:
a. Preeclampsia
b. Chronic hypertension
c. Gestational hypertension
d. Chronic hypertension with superimposed preeclampsia
,ALL Q&A of OB.
13. A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the
attending physician immediately of which of the following findings?
a. Patellar and biceps reflexes of +4
b. Urinary output of 50 mL/hr
c. Respiratory rate of 10 rpm
d. Serum magnesium level of 5 mg/dL
14. A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor. Which of
the following common medication effects would the nurse expect to see in the mother?
a. Serum potassium level increases
b. Diarrhea
c. Urticaria
d. Complaints of nervousness
15. Which of the following signs or symptoms would the nurse expect to see in a woman with
concealed abruptio placentae?
a. Increasing abdominal girth measurements
b. Profuse vaginal bleeding
c. Bradycardia with an aortic thrill
d. Hypothermia with chills
16. A woman who has had no prenatal care was assessed and found to have hydramnios on admission to
the labor unit and has since delivered a baby weighing 4500 grams. Which of the following
complications of pregnancy likely contributed to these findings?
a. Pyelonephritis
b. Pregnancy-induced hypertension
c. Gestational diabetes
d. Abruptio placentae
17. For the patient with which of the following medical problems should the nurse question a
physician’s order for beta agonist tocolytics?
a. Type 1 diabetes mellitus
b. Cerebral palsy
c. Myelomeningocele
d. Positive group B streptococci culture
18. The nurse is caring for two laboring women. Which of the patients should be monitored
most carefully for signs of placental abruption?
a. The patient with placenta previa
b. The patient whose vagina is colonized with group B streptococci
c. The patient who is hepatitis B surface antigen positive
d. The patient with eclampsia
19. The nurse is caring for a woman at 28 weeks’ gestation with a history of preterm delivery. Which
of the following laboratory data should the nurse carefully assess in relation to this diagnosis?
a. Human relaxin levels
, ALL Q&A of OB.
b. Amniotic fluid levels
c. Alpha-fetoprotein levels
d. Fetal fibronectin levels
20. Which of the following statements is most appropriate for the nurse to say to a patient with a
complete placenta previa?
a. “During the second stage of labor you will need to bear down.”
b. “You should ambulate in the halls at least twice each day.”
c. “The doctor will likely induce your labor with oxytocin.”
d. “Please promptly report if you experience any bleeding or feel any back discomfort.”
21. A woman at 32 weeks’ gestation is diagnosed with severe preeclampsia with HELLP syndrome.
The nurse will identify which of the following as a positive patient care outcome?
a. Rise in serum creatinine
b. Drop in serum protein
c. Resolution of thrombocytopenia
d. Resolution of polycythemia
22. A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse
must closely monitor the woman for which of the following?
a. High leukocyte count
b. Explosive diarrhea
c. Fractured pelvis
d. Low platelet count
23. A woman at 10 weeks’ gestation is diagnosed with gestational trophoblastic disease (hydatiform
mole). Which of the following findings would the nurse expect to see?
a. Platelet count of 550,000/ mm3
b. Dark brown vaginal bleeding
c. White blood cell count 17,000/ mm3
d. Macular papular rash
24. After an education class, the nurse overhears an adolescent woman discussing safe sex practices.
Which of the following comments by the young woman indicates that additional teaching about sexually
transmitted infection (STI) control issues is needed?
a. “I could get an STI even if I just have oral sex.”
b. “Girls over 16 are less likely to get STDs than younger girls.”
c. “The best way to prevent an STI is to use a diaphragm.”
d. “Girls get human immunodeficiency virus (HIV) easier than boys do.”
25. A woman who is admitted to labor and delivery at 30 weeks’ gestation, is 1 cm dilated, and is
contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the
following maternal vital signs is most important for the nurse to assess each hour?
a. Temperature
Chapter 7: High-Risk Antepartum Nursing Care
Multiple Choice
1. A client on 2 gm/hr of magnesium sulfate has decreased deep tendon reflexes. Identify the priority
nursing assessment to ensure client safety.
a. Assess uterine contractions continuously.
b. Assess fetal heart rate continuously.
c. Assess urinary output.
d. Assess respiratory
rate.
2. A pregnant client with a history of multiple sexual partners is at highest risk for which of the
following complications:
a. Premature rupture of membranes
b. Gestational diabetes
c. Ectopic pregnancy
d. Pregnancy-induced hypertension
3. Identify the hallmark of placenta previa that differentiates it from abruptio
placenta. a. Sudden onset of painless vaginal bleeding
b. Board-like abdomen with severe pain
c. Sudden onset of bright red vaginal bleeding
d. Severe vaginal pain with bright red bleeding
4. Which of the following assessments would indicate instability in the client hospitalized for
placenta previa?
a. BP <90/60 mm/Hg, Pulse <60 BPM or >120 BPM
b. FHR moderate variability without accelerations
c. Dark brown vaginal discharge when voiding
d. Oral temperature of 99.9F
5. During pregnancy, poorly controlled asthma can place the fetus at risk for:
a. Hyperglycemia
b. IUGR
c. Hypoglycemia
d. Macrosomia
6. Which of the following nursing diagnoses is of highest priority for a client with an ectopic pregnancy
who has developed disseminated intravascular coagulation (DIC)?
a. Risk for deficient fluid volume
b. Risk for family process interrupted
c. Risk for disturbed identity
d. High risk for injury
,ALL Q&A of OB.
7. Which of the following laboratory values is most concerning in a client with pregnancy-induced
hypertension?
a. Total urine protein of 200 mg/dL
b. Total platelet count of 40,000
mm
c. Uric acid level of 8 mg/dL
d. Blood urea nitrogen 24 mg/dL
8. Which of the following medications administered to the pregnant client with GDM and experiencing
preterm labor requires close monitoring of the client’s blood glucose levels?
a. Nifedipine
b. Betamethasone
c. Magnesium sulfate
d. Indomethacin
9. While educating the client with class II cardiac disease, at 28 weeks’ gestation, the nurse instructs the
client to notify the physician if she experiences which of the following conditions?
a. Emotional stress at work
b. Increased dyspnea while resting
c. Mild pedal and ankle edema
d. Weight gain of 1 pound in 1 week
10. The nurse working in a prenatal clinic is providing care to three primigravida patients. Which of
the patient findings would the nurse highlight for the physician?
a. 15 weeks, denies feeling fetal movement
b. 20 weeks, fundal height at the umbilicus
c. 25 weeks, complains of excess salivation
d. 30 weeks, states that her vision is blurry
11. The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks’ gestation in her first
pregnancy. She is worried about having her baby “too soon,” and she is experiencing uterine
contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal
examination performed by the health-care provider reveals that the cervix is closed, long, and
posterior. The most likely diagnosis would be:
a. Preterm labor
b. Term labor
c. Back labor
d. Braxton-Hicks contractions
12. The perinatal nurse knows that the term to describe a woman at 26 weeks’ gestation with a history of
elevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is:
a. Preeclampsia
b. Chronic hypertension
c. Gestational hypertension
d. Chronic hypertension with superimposed preeclampsia
,ALL Q&A of OB.
13. A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the
attending physician immediately of which of the following findings?
a. Patellar and biceps reflexes of +4
b. Urinary output of 50 mL/hr
c. Respiratory rate of 10 rpm
d. Serum magnesium level of 5 mg/dL
14. A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor. Which of
the following common medication effects would the nurse expect to see in the mother?
a. Serum potassium level increases
b. Diarrhea
c. Urticaria
d. Complaints of nervousness
15. Which of the following signs or symptoms would the nurse expect to see in a woman with
concealed abruptio placentae?
a. Increasing abdominal girth measurements
b. Profuse vaginal bleeding
c. Bradycardia with an aortic thrill
d. Hypothermia with chills
16. A woman who has had no prenatal care was assessed and found to have hydramnios on admission to
the labor unit and has since delivered a baby weighing 4500 grams. Which of the following
complications of pregnancy likely contributed to these findings?
a. Pyelonephritis
b. Pregnancy-induced hypertension
c. Gestational diabetes
d. Abruptio placentae
17. For the patient with which of the following medical problems should the nurse question a
physician’s order for beta agonist tocolytics?
a. Type 1 diabetes mellitus
b. Cerebral palsy
c. Myelomeningocele
d. Positive group B streptococci culture
18. The nurse is caring for two laboring women. Which of the patients should be monitored
most carefully for signs of placental abruption?
a. The patient with placenta previa
b. The patient whose vagina is colonized with group B streptococci
c. The patient who is hepatitis B surface antigen positive
d. The patient with eclampsia
19. The nurse is caring for a woman at 28 weeks’ gestation with a history of preterm delivery. Which
of the following laboratory data should the nurse carefully assess in relation to this diagnosis?
a. Human relaxin levels
, ALL Q&A of OB.
b. Amniotic fluid levels
c. Alpha-fetoprotein levels
d. Fetal fibronectin levels
20. Which of the following statements is most appropriate for the nurse to say to a patient with a
complete placenta previa?
a. “During the second stage of labor you will need to bear down.”
b. “You should ambulate in the halls at least twice each day.”
c. “The doctor will likely induce your labor with oxytocin.”
d. “Please promptly report if you experience any bleeding or feel any back discomfort.”
21. A woman at 32 weeks’ gestation is diagnosed with severe preeclampsia with HELLP syndrome.
The nurse will identify which of the following as a positive patient care outcome?
a. Rise in serum creatinine
b. Drop in serum protein
c. Resolution of thrombocytopenia
d. Resolution of polycythemia
22. A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse
must closely monitor the woman for which of the following?
a. High leukocyte count
b. Explosive diarrhea
c. Fractured pelvis
d. Low platelet count
23. A woman at 10 weeks’ gestation is diagnosed with gestational trophoblastic disease (hydatiform
mole). Which of the following findings would the nurse expect to see?
a. Platelet count of 550,000/ mm3
b. Dark brown vaginal bleeding
c. White blood cell count 17,000/ mm3
d. Macular papular rash
24. After an education class, the nurse overhears an adolescent woman discussing safe sex practices.
Which of the following comments by the young woman indicates that additional teaching about sexually
transmitted infection (STI) control issues is needed?
a. “I could get an STI even if I just have oral sex.”
b. “Girls over 16 are less likely to get STDs than younger girls.”
c. “The best way to prevent an STI is to use a diaphragm.”
d. “Girls get human immunodeficiency virus (HIV) easier than boys do.”
25. A woman who is admitted to labor and delivery at 30 weeks’ gestation, is 1 cm dilated, and is
contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the
following maternal vital signs is most important for the nurse to assess each hour?
a. Temperature
