UWorld Maternity Practice Questions
A 14-year-old client confides to the school nurse that she is pregnant, likely in the second
trimester, and has not had prenatal care. Which of the following topics should the nurse
discuss with the client at this time? SATA
--desire for adoption planning services
--emotional response to the pregnancy
--family/social support systems
--nutritional habits and substance abuse
-plan for finishing high school - ANS---emotional response to pregnancy
--family/social support systems
--nutritional habits and substance abuse
--address adoption planning at a different time with a social worker. Education planning may
be approached during later encounters, but is not a priority
\A 37 weeks pregnant woman comes to the ED with a fractured ankle. Which assessment
finding is MOST concerning and requires the nurse to follow up?
--fetal heart rate remains 206/min
--fetus kicked 4 times in the past hour
--mother reports feeling 2 contractions every hour
--mother's hemoglobin is 11 g/dl - ANS-fetal heart rate remains 206/min
\A client at 20 weeks gestation reports "running to the bathroom all the time", pain with
urination, and foul-smelling urine. Which question is MOST important for the nurse to ask
when assessing the client?
--"Are you having any pain in your lower back or flank area?"
--"Do you wipe front to back after urinating?"
--"Have you found that you urinate more frequently since becoming pregnant?"
--"Have you had a urinary tract infection in the past?" - ANS-"Are you having any pain in your
lower back or flank area?"
---UTI is common during pregnancy. If the client reports signs and symptoms of cystitis, the
nurse's priority is to rule out ascending infection, which would require hospitalization and IV
antibiotics.
\A client at 20 weeks gestation states that she started consuming an increased amount of
cornstarch about 3 weeks ago. Based on this assessment,the nurse should anticipate that
the healthcare provider will order which laboratory test(s)?
--hemoglobin and hematocrit levels
--humanchorionic gonadotropin level
--serum folate level
--white blood cell count - ANS-hemoglobin and hematocrit level
--client has Pica (abnormal, compulsive craving for and consumption of substances that may
occur in pregnancy). Pica is often associated with iron deficiency anemia. Checking the
,hemoglobin and hematocrit levels are useful in assessing anemia. Folate levels are
associated with assessing neural tube defects.
\A client at 34 weeks gestation reports constipation. The client has been taking 325 mg
ferrous sulfate tid for anemia since the last appointment 4 weeks ago. Which
recommendations should the nurse make for this client? SATA
--decreased daily dairy intake
--increased fruit and vegetable intake
--moderate-intensity regular exercise
--one laxative twice daily for a week
--two cups of hot coffee each morning - ANS---increased fruit and vegetable intake
--moderate-intensity regular exercise
---calcium is essential for fetal bone development. Laxatives increase risk for dehydration
and electrolyte imbalances, which can lead to uterine cramping and contractions. Caffeine
consumption should be limited to 200-300 mg/day.
\A client at 35 weeks gestation is admitted to the labor and delivery unit for severe
preeclampsia. She is started on IV magnesium sulfate for seizure prophylaxis. Which of the
following signs indicate that the client has developed magnesium sulfate toxicity? SATA
--0/4 patellar reflex
--blood pressure of 156/84 mm Hg
--client voiding 600mL in 8 hours
--respirations of 10/min
--serum magnesium level of 8.0 mEq/l - ANS---0/4 patellar reflex
--respirations of 10/min
--serum magnesium level of 8.0 mEq/L
---the therapeutic level of magnesium for preeclampsia/eclampsia treatment is 4-7 mEq/l.
Calcium gluconate should be readily available in the event of cardiorespiratory compromise
\A client at 38 weeks gestation is brought to the emergency department after a motor vehicle
crash. She reports severe, continuous abdominal pain. The nurse notes frequent uterine
contractions and mild, dark vaginal bleeding. What actions should the nurse take? SATA
--anticipate emergency cesarean section
--apply continuous external fetal monitoring
--assess routine vital signs every 4 hours
--draw blood for type and crossmatch
--initiate IV access with a 22-gauge catheter - ANS---anticipate emergent cesarean birth
--apply continuous external fetal monitoring
--draw blood for type and crossmatch
---patient is showing signs of placental abruption. Main concern for this condition are
maternal blood loss resulting in hypotension/shock and fetal compromise. Vital signs will be
assessed more than every 4 hours. While an IV will be placed, it will be 16 or 18-gauge
\A client at 38 weeks gestation is in latent labor with ruptured membranes and is receiving an
oxytocin infusion for labor augmentation. The client is requesting IV pain medication. When
administering an IV narcotic during labor, which nursing action is appropriate?
,--discontinue the oxytocin infusion prior to giving the medication
--give the medication slowly during the peak of the next contraction
--hold until contractions are occurring at least every 4 minutes for an hour
--withdraw 5 mL of lactated Ringer from the IV tubing to dilute the medication - ANS-Give the
medication slowly during the peak of the next contraction
--this helps decrease sedation of the fetus and subsequent newborn respiratory depression
at birth. Less medication will cross the placental barrier d/t reduced uteroplacental blood flow
during contraction peaks
\A client at 39 weeks gestation with preeclampsia has a blood pressureof 170/100 mm Hg,
2+ proteinuria, and moderate peripheral edema. Immediately after hospital admission, she
develops seizures and uterine contractions. Magnesium sulfate is prescribed. Which finding
indicates that the drug has achieved the desired therapeutic effect?
--blood pressure <130/80mm Hg
--seizure activity stops
--urine has 1+ protein
--uterine contractions stop - ANS-seizure activity stops
---Magnesium sulfate is prescribed for clients with preeclampsia to prevent seizure activity. A
therapeutic magnesium level of 4-7 mEq/L is necessary to prevent seizures in a
preeclamptic client. Hydralazine, methyldopa, or labetalol are used to lower blood pressure.
Control of hypertension and delivery will reduce protein level. Tocolytic drugs are used to
suppress uterine contractions in preterm labor.
\A client at 41 weeks gestation is admitted to the labor and delivery unit for labor induction.
The nurse is assisting the healthcare provider with an amniotomy. What actions should the
nurse anticipate? SATA
--assessing the fetal heart rate before and after the procedure
--checking the client's temperature every 2 hours
--informing the client she will feel a sharp pain during the procedure
--keeping the client in a supine position after the procedure
--noting the characteristics of the amniotic fluid - ANS---assessing the fetal heart rate before
and after the procedure
--checking the client's temperature every 2 hours
--noting the characteristics of the amniotic fluid
\A client comes to the clinic indicating that a home pregnancy test was positive. The client's
last menstrual period was September 7th. Today is December 7th. Which are true
statements for this client? SATA
--according to Naegele's rule, the expected date of delivery is June 14
--detection of the fetal heart rate via Doppler is possible
--fundal height should be 24 cm above the symphysis pubis
--the client should be feeling fetal movement
--urinary frequency is a common symptom - ANS---according to Naegele's rule, the expected
date of delivery is June 14
--detection of the fetal heart rate via Doppler is possible
--urinary frequency is a common symptom
, ----detection of fetal heart rate is possible using a doppler by 10-12 weeks gestation.
Quickening occurs around 18-20 weeks gestation in primigravidas and 14-16 in
multigravidas
\A client gives birth within an hour of arriving at labor and delivery unit and delivers the
placenta 5 minutes later. During assessment, the nurse notes that the uterus is midline and
boggy. Which action should the nurse take FIRST?
--check for pooled blood under buttocks
--increase IV oxytocin infusion rate
--monitor blood pressure and pulse
--perform firm fundal massage - ANS-perform firm fundal massage
\A client in active labor who is receiving an epidural 20 minutes ago reports feeling
nauseated and lightheaded. Which action should the nurse perform FIRST?
--administer IV ondansetron
--apply oxygen via face mask
--obtain blood pressure
--perform vaginal examination - ANS-obtain blood pressure
--this confirms hypotension caused by inhibition of they sympathetic nervous system. The
nurse should then administer IV fluid bolus and position client in left later position to alleviate
pressure on vena cava
\A client in labor has reached 8 cm dilation, is fully effaced, and feels an urge to push. The
nurse observed thick, blood-tinged mucus during the vaginal examination. What is the
nurse's BEST action?
--administer prescribed IV meperidine for pain relief
--encourage client to bear down with spontaneous urges to push
--place client in the lithotomy position in preparation for birth
--provide encouragement and coaching in breathing techniques - ANS-provide
encouragement and coaching in breathing techniques
--Meperidine is an opioid occasionally used for analgesia during labor. It should be avoided
within 1-4 hours of birth d/t potential for neonatal respiratory depression. Clients may feel the
urge to push (Ferguson reflex) prior to complete dilation, but pushing should be delayed until
complete dilation is achieved to avoid cervical swelling/lacerations. The client has not yet
reached complete dilation and should be allowed to move freely, although lithotomy
positioning may be more convenient for birth attendant
\A client in labor with a hx of a previous C-section has chosen to attempt a vaginal birth.
During labor, which of the following would be MOST concerning to the nurse?
--cessation of contractions and maternal tachycardia
--fetal tachycardia with moderate variability
--increased anxiety and discomfort with contractions
--painful, strong contractions every 3-4 minutes - ANS-Cessation of contractions and
maternal tachycardia
\A client indicates the desire to become pregnant. Which of the following are importnat
preconception education topics for the nurse to provide? SATA
--aim for BMI of 18.5-24.9 kg/m3
--avoid alcohol consumption and tobacco products
--ensure daily intake of 400 mcg of folic acid
--obtain testing for rubella immunity
A 14-year-old client confides to the school nurse that she is pregnant, likely in the second
trimester, and has not had prenatal care. Which of the following topics should the nurse
discuss with the client at this time? SATA
--desire for adoption planning services
--emotional response to the pregnancy
--family/social support systems
--nutritional habits and substance abuse
-plan for finishing high school - ANS---emotional response to pregnancy
--family/social support systems
--nutritional habits and substance abuse
--address adoption planning at a different time with a social worker. Education planning may
be approached during later encounters, but is not a priority
\A 37 weeks pregnant woman comes to the ED with a fractured ankle. Which assessment
finding is MOST concerning and requires the nurse to follow up?
--fetal heart rate remains 206/min
--fetus kicked 4 times in the past hour
--mother reports feeling 2 contractions every hour
--mother's hemoglobin is 11 g/dl - ANS-fetal heart rate remains 206/min
\A client at 20 weeks gestation reports "running to the bathroom all the time", pain with
urination, and foul-smelling urine. Which question is MOST important for the nurse to ask
when assessing the client?
--"Are you having any pain in your lower back or flank area?"
--"Do you wipe front to back after urinating?"
--"Have you found that you urinate more frequently since becoming pregnant?"
--"Have you had a urinary tract infection in the past?" - ANS-"Are you having any pain in your
lower back or flank area?"
---UTI is common during pregnancy. If the client reports signs and symptoms of cystitis, the
nurse's priority is to rule out ascending infection, which would require hospitalization and IV
antibiotics.
\A client at 20 weeks gestation states that she started consuming an increased amount of
cornstarch about 3 weeks ago. Based on this assessment,the nurse should anticipate that
the healthcare provider will order which laboratory test(s)?
--hemoglobin and hematocrit levels
--humanchorionic gonadotropin level
--serum folate level
--white blood cell count - ANS-hemoglobin and hematocrit level
--client has Pica (abnormal, compulsive craving for and consumption of substances that may
occur in pregnancy). Pica is often associated with iron deficiency anemia. Checking the
,hemoglobin and hematocrit levels are useful in assessing anemia. Folate levels are
associated with assessing neural tube defects.
\A client at 34 weeks gestation reports constipation. The client has been taking 325 mg
ferrous sulfate tid for anemia since the last appointment 4 weeks ago. Which
recommendations should the nurse make for this client? SATA
--decreased daily dairy intake
--increased fruit and vegetable intake
--moderate-intensity regular exercise
--one laxative twice daily for a week
--two cups of hot coffee each morning - ANS---increased fruit and vegetable intake
--moderate-intensity regular exercise
---calcium is essential for fetal bone development. Laxatives increase risk for dehydration
and electrolyte imbalances, which can lead to uterine cramping and contractions. Caffeine
consumption should be limited to 200-300 mg/day.
\A client at 35 weeks gestation is admitted to the labor and delivery unit for severe
preeclampsia. She is started on IV magnesium sulfate for seizure prophylaxis. Which of the
following signs indicate that the client has developed magnesium sulfate toxicity? SATA
--0/4 patellar reflex
--blood pressure of 156/84 mm Hg
--client voiding 600mL in 8 hours
--respirations of 10/min
--serum magnesium level of 8.0 mEq/l - ANS---0/4 patellar reflex
--respirations of 10/min
--serum magnesium level of 8.0 mEq/L
---the therapeutic level of magnesium for preeclampsia/eclampsia treatment is 4-7 mEq/l.
Calcium gluconate should be readily available in the event of cardiorespiratory compromise
\A client at 38 weeks gestation is brought to the emergency department after a motor vehicle
crash. She reports severe, continuous abdominal pain. The nurse notes frequent uterine
contractions and mild, dark vaginal bleeding. What actions should the nurse take? SATA
--anticipate emergency cesarean section
--apply continuous external fetal monitoring
--assess routine vital signs every 4 hours
--draw blood for type and crossmatch
--initiate IV access with a 22-gauge catheter - ANS---anticipate emergent cesarean birth
--apply continuous external fetal monitoring
--draw blood for type and crossmatch
---patient is showing signs of placental abruption. Main concern for this condition are
maternal blood loss resulting in hypotension/shock and fetal compromise. Vital signs will be
assessed more than every 4 hours. While an IV will be placed, it will be 16 or 18-gauge
\A client at 38 weeks gestation is in latent labor with ruptured membranes and is receiving an
oxytocin infusion for labor augmentation. The client is requesting IV pain medication. When
administering an IV narcotic during labor, which nursing action is appropriate?
,--discontinue the oxytocin infusion prior to giving the medication
--give the medication slowly during the peak of the next contraction
--hold until contractions are occurring at least every 4 minutes for an hour
--withdraw 5 mL of lactated Ringer from the IV tubing to dilute the medication - ANS-Give the
medication slowly during the peak of the next contraction
--this helps decrease sedation of the fetus and subsequent newborn respiratory depression
at birth. Less medication will cross the placental barrier d/t reduced uteroplacental blood flow
during contraction peaks
\A client at 39 weeks gestation with preeclampsia has a blood pressureof 170/100 mm Hg,
2+ proteinuria, and moderate peripheral edema. Immediately after hospital admission, she
develops seizures and uterine contractions. Magnesium sulfate is prescribed. Which finding
indicates that the drug has achieved the desired therapeutic effect?
--blood pressure <130/80mm Hg
--seizure activity stops
--urine has 1+ protein
--uterine contractions stop - ANS-seizure activity stops
---Magnesium sulfate is prescribed for clients with preeclampsia to prevent seizure activity. A
therapeutic magnesium level of 4-7 mEq/L is necessary to prevent seizures in a
preeclamptic client. Hydralazine, methyldopa, or labetalol are used to lower blood pressure.
Control of hypertension and delivery will reduce protein level. Tocolytic drugs are used to
suppress uterine contractions in preterm labor.
\A client at 41 weeks gestation is admitted to the labor and delivery unit for labor induction.
The nurse is assisting the healthcare provider with an amniotomy. What actions should the
nurse anticipate? SATA
--assessing the fetal heart rate before and after the procedure
--checking the client's temperature every 2 hours
--informing the client she will feel a sharp pain during the procedure
--keeping the client in a supine position after the procedure
--noting the characteristics of the amniotic fluid - ANS---assessing the fetal heart rate before
and after the procedure
--checking the client's temperature every 2 hours
--noting the characteristics of the amniotic fluid
\A client comes to the clinic indicating that a home pregnancy test was positive. The client's
last menstrual period was September 7th. Today is December 7th. Which are true
statements for this client? SATA
--according to Naegele's rule, the expected date of delivery is June 14
--detection of the fetal heart rate via Doppler is possible
--fundal height should be 24 cm above the symphysis pubis
--the client should be feeling fetal movement
--urinary frequency is a common symptom - ANS---according to Naegele's rule, the expected
date of delivery is June 14
--detection of the fetal heart rate via Doppler is possible
--urinary frequency is a common symptom
, ----detection of fetal heart rate is possible using a doppler by 10-12 weeks gestation.
Quickening occurs around 18-20 weeks gestation in primigravidas and 14-16 in
multigravidas
\A client gives birth within an hour of arriving at labor and delivery unit and delivers the
placenta 5 minutes later. During assessment, the nurse notes that the uterus is midline and
boggy. Which action should the nurse take FIRST?
--check for pooled blood under buttocks
--increase IV oxytocin infusion rate
--monitor blood pressure and pulse
--perform firm fundal massage - ANS-perform firm fundal massage
\A client in active labor who is receiving an epidural 20 minutes ago reports feeling
nauseated and lightheaded. Which action should the nurse perform FIRST?
--administer IV ondansetron
--apply oxygen via face mask
--obtain blood pressure
--perform vaginal examination - ANS-obtain blood pressure
--this confirms hypotension caused by inhibition of they sympathetic nervous system. The
nurse should then administer IV fluid bolus and position client in left later position to alleviate
pressure on vena cava
\A client in labor has reached 8 cm dilation, is fully effaced, and feels an urge to push. The
nurse observed thick, blood-tinged mucus during the vaginal examination. What is the
nurse's BEST action?
--administer prescribed IV meperidine for pain relief
--encourage client to bear down with spontaneous urges to push
--place client in the lithotomy position in preparation for birth
--provide encouragement and coaching in breathing techniques - ANS-provide
encouragement and coaching in breathing techniques
--Meperidine is an opioid occasionally used for analgesia during labor. It should be avoided
within 1-4 hours of birth d/t potential for neonatal respiratory depression. Clients may feel the
urge to push (Ferguson reflex) prior to complete dilation, but pushing should be delayed until
complete dilation is achieved to avoid cervical swelling/lacerations. The client has not yet
reached complete dilation and should be allowed to move freely, although lithotomy
positioning may be more convenient for birth attendant
\A client in labor with a hx of a previous C-section has chosen to attempt a vaginal birth.
During labor, which of the following would be MOST concerning to the nurse?
--cessation of contractions and maternal tachycardia
--fetal tachycardia with moderate variability
--increased anxiety and discomfort with contractions
--painful, strong contractions every 3-4 minutes - ANS-Cessation of contractions and
maternal tachycardia
\A client indicates the desire to become pregnant. Which of the following are importnat
preconception education topics for the nurse to provide? SATA
--aim for BMI of 18.5-24.9 kg/m3
--avoid alcohol consumption and tobacco products
--ensure daily intake of 400 mcg of folic acid
--obtain testing for rubella immunity
