OB/Maternity Practice Exam Questions & Answers

1. A 30-year old gravida 2, para 1 client is admitted to the hospital at 26-weeks gestation in preterm labor. She is started on an IV solution of terbutaline (Brethine). Which assessment is the highest priority for the nurse to monitor during the administration of this drug? a. Maternal blood pressure and respirations. b. Maternal and fetal heart rates. c. Hourly urinary output. d. Deep tendon reflexes. - ANSWERSB 2. During labor, the nurse determines that a full-term client is demonstrating late decelerations. In which sequence should the nurse implement these nursing actions? (Place the first action on top and last action on the bottom.) a. Reposition the client. b. Call the healthcare provider. c. Increase IV fluid. d. Provide oxygen via face mask. - ANSWERSA, C, D, B 3. A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the nurse implement first? a. Provide oral hydration. b. Have a complete blood count (CBC) drawn. c. Obtain a specimen for urine analysis. d. Place the client on strict bedrest. - ANSWERSC 4. A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when she could use a home pregnancy test to diagnose pregnancy. Which response is appropriate? a. "A home pregnancy test can be used right after your first missed period." b. "These tests are most accurate after you have missed your second period." c. "Home pregnancy tests often give false positives and should not be trusted." d. "The test can provide accurate information when used right after ovulation." - ANSWERSA 5. When evaluating maternal bonding, which of the following maternal behaviors exhibited by the client would the nurse most likely expect to see when a new mother receives her infant for the first time? a. She eagerly reaches for the infant, undresses the infant, and examines the infant completely. b. Her arms and hands receive the infant and she then traces the infant's profile with her fingertips. c. Her arms and hands receive the infant and she then cuddles the infant to her own body. d. She eagerly reaches for the infant and then holds the infant close to her own body. - ANSWERSB 6. The nurse is performing a gestational age assessment on a full-term newborn during the first hour of transition using the Ballard (Dubowitz) scale. Based on this assessment, the nurse determines that the neonate has a maturity rating of 40-weeks. What findings should the nurse identify to determine if the neonate is small for gestational age (SGA)? (Select all that apply.) a. Admission weight of 4 pounds, 15 ounces ( 2244 grams). b. Head to heel length of 17 inches (42.5 cm). c. Frontal occipital circumference of 12.5 inches (31.25 cm). d. Skin smooth with visible veins and abundant vernix. e. Anterior plantar crease and smooth heel surfaces. f. Full flexion of all extremities in resting supine position. - ANSWERSA, B, C 7. When assessing a client who is at 12-weeks gestation, the nurse recommends that she and her husband consider attending childbirth preparation classes. When is the best time for the couple to attend these classes? a. At 16-weeks gestation. b. At 20-weeks gestation. c. At 24-weeks gestation. At 30-weeks gestation. - ANSWERSD 8. A new mother asks the nurse, "How do I know that my daughter is getting enough breast milk?" Which response is best for the nurse provide? "Weigh the baby daily, and if she is gaining weight, she is eating enough." "Your milk is sufficient if the baby is voiding pale straw-colored urine 6 to 10 times a day." "Offer the baby extra bottle milk after her feeding, and see if she is still hungry." "If you're concerned, you might consider bottle feeding so that you can monitor her intake." - ANSWERSB 9. A primigravida at 40-weeks gestation is receiving oxytocin (Pitocin) to augment labor. Which adverse effect should the nurse monitor for during the infusion of Pitocin? a. Dehydration. b. Hyperstimulation. c. Galactorrhea. d. Fetal tachycardia. - ANSWERSB 10. The nurse is teaching a woman how to use her basal body temperature (BBT) pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception? a. Between the time the temperature falls and rises. b. Between 36 and 48 hours after the temperature rises. c. When the temperature falls and remains low for 36 hours. d. Within 72 hours before the temperature falls. - ANSWERSA 11. A new mother who has just had her first baby says to the nurse, "I saw the baby in the recovery room. She sure has a funny looking head." Which response by the nurse is best? a. "This is not an unusual shaped head, especially for a first baby." b. "It may look funny to you, but newborn babies are often born with heads like your baby's." c. "That is normal; the head will return to a round shape within 7 to 10 days." d. "Your pelvis was too small, so the baby's head had to adjust to the birth canal." - ANSWERSC 12. A 42-week gestational client is receiving an intravenous infusion of oxytocin (Pitocin) to augment early labor. Which pattern of contractions should alert the nurse to discontinue the oxytocin infusion? a. Transition labor with contractions every 2 minutes, lasting 90 seconds each. b. Early labor with contractions every 5 minutes, lasting 40 seconds each. c. Active labor with contractions every 31 minutes, lasting 60 seconds each. d. Active labor with contractions every 2 to 3 minutes, lasting 70 to 80 seconds each. - ANSWERSA 13. The nurse is assessing a 3-day old infant with a cephalohematoma in the newborn nursery. Which assessment finding should the nurse report to the healthcare provider? a. Yellowish tinge to the skin. b. Babinski reflex present bilaterally. c. Pink papular rash on the face. d. Moro reflex noted after a loud noise. - ANSWERSA 14. A client who had a miscarriage 6 months ago becomes pregnant. Which instruction is most important for the nurse to provide this client? a. Elevate lower legs while resting. b. Increase caloric intake by 200 to 300 calories per day. c. Increase water intake to 8 full glasses per day. d. Take prescribed multivitamin and mineral supplements. - ANSWERSD 15. A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the nurse to ask this client? a. "Which symptom did you experience first?" b. "Are you eating large amounts of salty foods?" c. "Have you visited a foreign country recently?" d. "Do you have a history of rheumatic fever?" - ANSWERSD 16. One hour after giving birth to an 8-pound infant, a client's lochia rubra has increased from small to large and her fundus is boggy despite massage. The client's pulse is 84 beats/minute and blood pressure is 156/96. The healthcare provider prescribes Methergine 0.2 mg IM X 1. What action should the nurse take immediately? a. Give the medication as prescribed and monitor for efficacy. b. Encourage the client to breastfeed rather than bottle feed. c. Have the client empty her bladder and massage the fundus. d. Call the healthcare provider to question the prescription. - ANSWERSD 17. Which assessment finding should the nursery nurse report to the pediatric healthcare provider? a. Blood glucose level of 45 mg/dl. b. Blood pressure of 82/45 mmHg. c. Non-bulging anterior fontanel. d. Central cyanosis when crying. - ANSWERSD 18. A client at 28-weeks gestation calls the antepartal clinic and states that she is experiencing a small amount of vaginal bleeding which she describes as bright red. She further states that she is not experiencing any uterine contractions or abdominal pain. What instruction should the nurse provide? a. Come to the clinic today for an ultrasound. b. Go immediately to the emergency room. c. Lie on your left side for about one hour and see if the bleeding stops. d. Bring a urine specimen to the lab tomorrow to determine if you have a urinary tract infection. - ANSWERSA 19. The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to complain of tingling fingers and dizziness. What action should the nurse take? a. Administer oxygen by face mask. b. Notify the healthcare provider of the client's symptoms. c. Have the client breathe into her cupped hands. d. Check the client's blood pressure and fetal heart rate. - ANSWERSC 20. The nurse is assessing the umbilical cord of a newborn. Which finding constitutes a normal finding? a. Two vessels: one artery and one vein. b. Two vessels: two arteries and no veins. c. Three vessels: two arteries and one vein. d. Three vessels: two veins and one artery. - ANSWERSC 21. A client who gave birth to a healthy 8 pound infant 3 hours ago is admitted to the postpartum unit. Which nursing plan is best in assisting this mother to bond with her newborn infant? a. Encourage the mother to provide total care for her infant. b. Provide privacy so the mother can develop a relationship with the infant. c. Encourage the father to provide most of the infant's care during hospitalization. d. Meet the mother's physical needs and demonstrate warmth toward the infant. - ANSWERSD 22. While breastfeeding, a new mother strokes the top of her baby's head and asks the nurse about the baby's swollen scalp. The nurse responds that the swelling is caput succedaneum. Which additional information should the nurse provide this new mother? a. The infant should be positioned to reduce the swelling. b. The swelling is a subperiosteal collection of blood. c. The pediatrician will aspirate the blood if it gets larger. d. The scalp edema will subside in a few days after birth. - ANSWERSD 23. A 40-week gestation primigravida client is being induced with an oxytocin (Pitocin) secondary infusion and complains of pain in her lower back. Which intervention should the nurse implement? a. Discontinue the oxytocin (Pitocin) infusion. b. Place the client in a semi-Fowler's position. c. Inform the healthcare provider. d. Apply firm pressure to sacral area. - ANSWERSD 24. A pregnant client tells the nurse that the first day of her last menstrual period was August 2, 2016. Based on Naegele's rule, what is the estimated date of delivery? a. April 25, 2017. b. May 9, 2017. c. May 29, 2017. d. June 2, 2017. - ANSWERSB 25. Immediately after birth a newborn infant is suctioned, dried, and placed under a radiant warmer. The infant has spontaneous respirations and the nurse assesses an apical heart rate of 80 beats/minute and respirations of 20 breaths/minute. What action should the nurse perform next? a. Initiate positive pressure ventilation. b. Intervene after the one minute Apgar is assessed. c. Initiate CPR on the infant. d. Assess the infant's blood glucose level. - ANSWERSA 26. A multigravida client at 41-weeks gestation presents in the labor and delivery unit after a non-stress test indicated that the fetus is experiencing some difficulties in utero. Which diagnostic test should the nurse prepare the client for additional information about fetal status? a. Biophysical profile (BPP). b. Ultrasound for fetal anomalies. c. Maternal serum alpha-fetoprotein (AF) screening. d. Percutaneous umbilical blood sampling (PUBS). - ANSWERSA 27. A woman with Type 2 diabetes mellitus becomes pregnant, and her oral hypoglycemic agents are discontinued. Which intervention is most important for the nurse to implement? a. Describe diet changes that can improve the management of her diabetes. b. Inform the client that oral hypoglycemic agents are teratogenic during pregnancy. c. Demonstrate self-administration of insulin. d. Evaluate the client's ability to do glucose monitoring. - ANSWERSA 28. The nurse is preparing a client with a term pregnancy who is in active labor for an amniotomy. What equipment should the nurse have available at the client's bedside? (Select all that apply.) a. Litmus paper. b. Fetal scalp electrode. c. A sterile glove. d. An amnihook. e. Sterile vaginal speculum. f. Lubricant. - ANSWERSC, D, F