COMPREHENSIVE EXAMINATION
1. The nurse is caring for a client, 37 weeks’ gestation, who was just told that she is
group B strep _ (positive). The client states, “How could that happen? I only have
sex with my husband. Will my baby be OK?” Based on this information, which of
the following should the nurse communicate to the client?
1. The client’s partner must have acquired the bacteria during a sexual encounter.
2. The bacteria do not injure babies, but they could cause the client to have a bad
sore throat.
3. The client is high risk for developing pelvic inflammatory disease from the
bacteria.
4. Antibiotics will be administered during labor to prevent vertical transmission of
the bacteria.
2. The nurse is caring for a client in labor and delivery with the following history:
G2P1000, 39 weeks’ gestation in transition phase, FH 135 with early decelerations.
The client states, “I’m so scared. Please make sure the baby is ok!” Which of the
following responses by the nurse is appropriate?
1. “There is absolutely nothing to worry about.”
2. “The fetal heart rate is within normal limits.”
3. “How did your first baby die?”
4. “Was your first baby preterm?”
3. A certified nursing assistant (CNA) is working with a registered nurse (RN) in the
neonatal nursery. It would be appropriate for the nurse to delegate which of the following
actions to the assistant?
1. Admission assessment on a newly delivered baby.
2. Patient teaching of a neonatal sponge bath.
3. Placement of a bag on a baby for urine collection.
4. Hourly neonatal blood glucose assessments.
4. A fetus is in the LOA position in utero. Which of the following findings would the
nurse observe when doing Leopold’s maneuvers?
1. Hard round object in the fundal region.
2. Flat object above the symphysis pubis.
3. Soft round object on the left side of the uterus.
4. Small objects on the right side of the uterus.
5. A woman is being interviewed by a triage nurse at a medical doctor’s office. Which
of the following signs/symptoms by the client would warrant the nurse to suggest
that a pregnancy test be done? Select all that apply.
1. Amenorrhea.
2. Fever.
3. Fatigue.
4. Nausea.
5. Dysuria.
6. A woman is seeking counseling regarding tubal ligation. Which of the following
should the nurse include in her discussion?
1. The woman will no longer menstruate.
2. The surgery should be done when the woman is ovulating.
3. The surgery is easily reversible.
4. The woman will be under anesthesia during the procedure.
7. A woman is admitted to the labor and delivery unit with active tuberculosis. She has
not been under a physician’s care and is not on medication. Which of the following
actions should the nursery nurse perform when the neonate is delivered?
1. Isolate the baby from the other babies in a special care nursery.
2. Keep the baby in the regular care nursery but separated from the mother.
3. Isolate the baby with the mother in the mother’s room.
4. Obtain an order from the doctor for antituberculosis medications for the baby.
, 8. A client has just received synthetic prostaglandins for the induction of labor. The
nurse plans to monitor the client for which of the following side effects?
1. Nausea and uterine tetany.
2. Hypertension and vaginal bleeding.
3. Urinary retention and severe headache.
4. Bradycardia and hypothermia.
9. The triage nurse in an obstetric clinic received the following four messages during
the lunch hour. Which of the women should the nurse telephone first?
1. “My section incision from last week is leaking a whitish yellow discharge and
I have a fever. What should I do?”
2. “I am 39 weeks pregnant with my first baby. I am having contractions about
every ten minutes.”
3. “My boyfriend and I had intercourse this morning and our condom broke.
What should we do?”
4. “I started my period yesterday. I need some medicine for these terrible menstrual
cramps.”
10. A patient is placed on bed rest at home for mild preeclampsia at 38 weeks’ gestation.
Which of the following must the nurse teach the patient regarding her condition?
1. Eat a sodium-restricted diet.
2. Check her temperature 4 times daily.
3. Report swollen hands and face.
4. Limit fluids to 1 liter per day.
11. The health care practitioner caring for a pregnant client diagnosed with gonorrhea
writes the following order: ceftriaxone 250 mg IM _ one dose. The medication is
available in 1-gram vials. The nurse adds 8 mL of normal saline to the vial. How
many mL of the medication should the nurse administer?
_2ml mL.
12. A 42-week-gestation neonate is being assessed. Which of the following findings
would the nurse expect to see?
1. Folded and flat pinnae.
2. Smooth plantar surfaces.
3. Loose and peeling skin.
4. Short pliable fingernails.
13. A 39-week-gestation client is admitted to the labor and delivery unit for a scheduled
cesarean delivery. The nurse should inform the surgeon regarding which of
the following admission laboratory findings?
1. Potassium 4.9 mEq/L.
2. Sodium 136 mEq/L.
3. Platelet count 75,000 cells/mm3.
4. White blood cell count 15,000 cells/mm3
14. A mother questions the nurse about when the newborn screening tests for inborn
diseases will be performed. Which of the following is an appropriate response by
the nurse?
1. The doctor took blood from the baby’s umbilical cord at birth.
2. A sample of the baby’s first urine and first stool were sent for testing.
3. A vial of blood was drawn and sent when the baby was admitted to the nursery.
4. Blood from the baby’s heel was sent after the baby had been fed a few times.
15. On vaginal exam it is noted that the fetus is in the LSA position and _2 station.
Place an “X” on the diagram in the quadrant where the fetal heart would best be
assessed. left upper quadrant
16. The nurse would be concerned that a 26-week-gravid client is carrying an unwanted
pregnancy when the client makes which of the following statements?
1. “The baby hasn’t started to move yet.”
1. The nurse is caring for a client, 37 weeks’ gestation, who was just told that she is
group B strep _ (positive). The client states, “How could that happen? I only have
sex with my husband. Will my baby be OK?” Based on this information, which of
the following should the nurse communicate to the client?
1. The client’s partner must have acquired the bacteria during a sexual encounter.
2. The bacteria do not injure babies, but they could cause the client to have a bad
sore throat.
3. The client is high risk for developing pelvic inflammatory disease from the
bacteria.
4. Antibiotics will be administered during labor to prevent vertical transmission of
the bacteria.
2. The nurse is caring for a client in labor and delivery with the following history:
G2P1000, 39 weeks’ gestation in transition phase, FH 135 with early decelerations.
The client states, “I’m so scared. Please make sure the baby is ok!” Which of the
following responses by the nurse is appropriate?
1. “There is absolutely nothing to worry about.”
2. “The fetal heart rate is within normal limits.”
3. “How did your first baby die?”
4. “Was your first baby preterm?”
3. A certified nursing assistant (CNA) is working with a registered nurse (RN) in the
neonatal nursery. It would be appropriate for the nurse to delegate which of the following
actions to the assistant?
1. Admission assessment on a newly delivered baby.
2. Patient teaching of a neonatal sponge bath.
3. Placement of a bag on a baby for urine collection.
4. Hourly neonatal blood glucose assessments.
4. A fetus is in the LOA position in utero. Which of the following findings would the
nurse observe when doing Leopold’s maneuvers?
1. Hard round object in the fundal region.
2. Flat object above the symphysis pubis.
3. Soft round object on the left side of the uterus.
4. Small objects on the right side of the uterus.
5. A woman is being interviewed by a triage nurse at a medical doctor’s office. Which
of the following signs/symptoms by the client would warrant the nurse to suggest
that a pregnancy test be done? Select all that apply.
1. Amenorrhea.
2. Fever.
3. Fatigue.
4. Nausea.
5. Dysuria.
6. A woman is seeking counseling regarding tubal ligation. Which of the following
should the nurse include in her discussion?
1. The woman will no longer menstruate.
2. The surgery should be done when the woman is ovulating.
3. The surgery is easily reversible.
4. The woman will be under anesthesia during the procedure.
7. A woman is admitted to the labor and delivery unit with active tuberculosis. She has
not been under a physician’s care and is not on medication. Which of the following
actions should the nursery nurse perform when the neonate is delivered?
1. Isolate the baby from the other babies in a special care nursery.
2. Keep the baby in the regular care nursery but separated from the mother.
3. Isolate the baby with the mother in the mother’s room.
4. Obtain an order from the doctor for antituberculosis medications for the baby.
, 8. A client has just received synthetic prostaglandins for the induction of labor. The
nurse plans to monitor the client for which of the following side effects?
1. Nausea and uterine tetany.
2. Hypertension and vaginal bleeding.
3. Urinary retention and severe headache.
4. Bradycardia and hypothermia.
9. The triage nurse in an obstetric clinic received the following four messages during
the lunch hour. Which of the women should the nurse telephone first?
1. “My section incision from last week is leaking a whitish yellow discharge and
I have a fever. What should I do?”
2. “I am 39 weeks pregnant with my first baby. I am having contractions about
every ten minutes.”
3. “My boyfriend and I had intercourse this morning and our condom broke.
What should we do?”
4. “I started my period yesterday. I need some medicine for these terrible menstrual
cramps.”
10. A patient is placed on bed rest at home for mild preeclampsia at 38 weeks’ gestation.
Which of the following must the nurse teach the patient regarding her condition?
1. Eat a sodium-restricted diet.
2. Check her temperature 4 times daily.
3. Report swollen hands and face.
4. Limit fluids to 1 liter per day.
11. The health care practitioner caring for a pregnant client diagnosed with gonorrhea
writes the following order: ceftriaxone 250 mg IM _ one dose. The medication is
available in 1-gram vials. The nurse adds 8 mL of normal saline to the vial. How
many mL of the medication should the nurse administer?
_2ml mL.
12. A 42-week-gestation neonate is being assessed. Which of the following findings
would the nurse expect to see?
1. Folded and flat pinnae.
2. Smooth plantar surfaces.
3. Loose and peeling skin.
4. Short pliable fingernails.
13. A 39-week-gestation client is admitted to the labor and delivery unit for a scheduled
cesarean delivery. The nurse should inform the surgeon regarding which of
the following admission laboratory findings?
1. Potassium 4.9 mEq/L.
2. Sodium 136 mEq/L.
3. Platelet count 75,000 cells/mm3.
4. White blood cell count 15,000 cells/mm3
14. A mother questions the nurse about when the newborn screening tests for inborn
diseases will be performed. Which of the following is an appropriate response by
the nurse?
1. The doctor took blood from the baby’s umbilical cord at birth.
2. A sample of the baby’s first urine and first stool were sent for testing.
3. A vial of blood was drawn and sent when the baby was admitted to the nursery.
4. Blood from the baby’s heel was sent after the baby had been fed a few times.
15. On vaginal exam it is noted that the fetus is in the LSA position and _2 station.
Place an “X” on the diagram in the quadrant where the fetal heart would best be
assessed. left upper quadrant
16. The nurse would be concerned that a 26-week-gravid client is carrying an unwanted
pregnancy when the client makes which of the following statements?
1. “The baby hasn’t started to move yet.”
