NURS 306/ NURS306 Final Exam – OB | WCU
(Latest 2026/ 2027 Update) 100% Verified
Questions & Answers | Grade A
Question 1: A pregnant woman at 28 weeks gestation reports persistent headaches and visual
changes. Her blood pressure is 160/110 mmHg. The nurse's priority action is to:
A) Document the findings and continue monitoring
B) Place the patient on bedrest in left lateral position
C) Notify the healthcare provider immediately
D) Administer prescribed antihypertensive medication
Correct Answer: C) Notify the healthcare provider immediately
Explanation: These are classic signs of preeclampsia, a potentially life-threatening condition.
Immediate provider notification is essential for timely intervention to prevent maternal and fetal
complications including seizures, placental abruption, and fetal distress.
Question 2: During active labor, the fetal heart rate shows late decelerations. The nurse should
first:
A) Administer oxygen via face mask
B) Increase IV fluid rate
C) Reposition the patient
D) Stop Pitocin if infusing
Correct Answer: D) Stop Pitocin if infusing
Explanation: Late decelerations indicate uteroplacental insufficiency. Stopping Pitocin (which
causes uterine contractions) is the priority to reduce uterine activity and improve placental
perfusion before implementing other interventions.
Question 3: A postpartum patient reports sudden chest pain and difficulty breathing. Her vitals
show tachycardia and decreased oxygen saturation. The nurse suspects:
,A) Postpartum depression
B) Pulmonary embolism
C) Mastitis
D) Uterine atony
Correct Answer: B) Pulmonary embolism
Explanation: These are classic signs of pulmonary embolism, a leading cause of maternal mortality
in the postpartum period. Pregnancy-induced hypercoagulability increases clot risk, especially after
cesarean delivery or prolonged immobility.
Question 4: A patient at 32 weeks gestation presents with vaginal bleeding and abdominal pain.
The nurse should anticipate preparing for:
A) Emergency cesarean section
B) Tocolysis administration
C) Ultrasound examination
D) Amniocentesis
Correct Answer: C) Ultrasound examination
Explanation: Vaginal bleeding with abdominal pain requires immediate ultrasound to differentiate
placental abruption from placenta previa before any interventions, as management differs
significantly between these conditions.
Question 5: During newborn assessment, the nurse notes a heart rate of 180 beats per minute.
This is considered:
A) Normal for newborn
B) Slightly elevated
C) Moderately elevated
D) Severely elevated
Correct Answer: C) Moderately elevated
Explanation: Normal newborn heart rate is 120-160 bpm. 180 bpm represents moderate elevation
requiring assessment for causes such as fever, dehydration, pain, or cardiac compromise.
,Question 6: A breastfeeding mother reports cracked, bleeding nipples. The nurse should first
assess:
A) Infant's latch
B) Frequency of feeding
C) Maternal nutrition
D) Use of pump
Correct Answer: A) Infant's latch
Explanation: Poor latch is the most common cause of nipple trauma. Proper latch assessment and
correction can prevent further damage and maintain successful breastfeeding relationship.
Question 7: A patient at 20 weeks gestation asks when she will feel fetal movements. The nurse
should respond:
A) 16-20 weeks
B) 20-24 weeks
C) 24-28 weeks
D) 28-32 weeks
Correct Answer: A) 16-20 weeks
Explanation: Nulliparous women typically feel quickening between 16-20 weeks gestation, while
multiparous women may feel movements as early as 14-16 weeks due to previous experience
recognizing fetal movements.
Question 8: During transition phase of labor, the patient expresses feeling out of control and states
she can't do this anymore. The nurse recognizes this as:
A) Need for immediate intervention
B) Normal transition behavior
C) Sign of complications
D) Request for pain medication
Correct Answer: B) Normal transition behavior
, Explanation: Transition phase (8-10 cm dilation) commonly causes feelings of loss of control,
irritability, and statements of giving up. This indicates imminent pushing phase and requires
emotional support rather than medical intervention.
Question 9: A patient receiving magnesium sulfate for preeclampsia develops absent deep tendon
reflexes. The nurse should:
A) Continue monitoring per protocol
B) Stop the infusion immediately
C) Decrease the infusion rate
D) Administer calcium gluconate
Correct Answer: B) Stop the infusion immediately
Explanation: Absent reflexes indicate magnesium toxicity requiring immediate cessation of infusion.
This precedes more serious complications like respiratory depression and cardiac arrest.
Question 10: A newborn's blood glucose is 35 mg/dL. The nurse should first:
A) Notify the provider
B) Initiate breastfeeding
C) Prepare for IV glucose
D) Recheck in 30 minutes
Correct Answer: B) Initiate breastfeeding
Explanation: Asymptomatic hypoglycemia >30 mg/dL responds to feeding. Early breastfeeding
provides glucose and stimulates glucose production. IV therapy reserved for symptomatic or
severe hypoglycemia.
Question 11: A patient at 36 weeks gestation with gestational diabetes has a fasting blood glucose
of 110 mg/dL. The nurse should:
A) Document as normal
B) Notify provider immediately
C) Recheck in 2 hours
D) Give insulin per protocol
Correct Answer: B) Notify provider immediately
(Latest 2026/ 2027 Update) 100% Verified
Questions & Answers | Grade A
Question 1: A pregnant woman at 28 weeks gestation reports persistent headaches and visual
changes. Her blood pressure is 160/110 mmHg. The nurse's priority action is to:
A) Document the findings and continue monitoring
B) Place the patient on bedrest in left lateral position
C) Notify the healthcare provider immediately
D) Administer prescribed antihypertensive medication
Correct Answer: C) Notify the healthcare provider immediately
Explanation: These are classic signs of preeclampsia, a potentially life-threatening condition.
Immediate provider notification is essential for timely intervention to prevent maternal and fetal
complications including seizures, placental abruption, and fetal distress.
Question 2: During active labor, the fetal heart rate shows late decelerations. The nurse should
first:
A) Administer oxygen via face mask
B) Increase IV fluid rate
C) Reposition the patient
D) Stop Pitocin if infusing
Correct Answer: D) Stop Pitocin if infusing
Explanation: Late decelerations indicate uteroplacental insufficiency. Stopping Pitocin (which
causes uterine contractions) is the priority to reduce uterine activity and improve placental
perfusion before implementing other interventions.
Question 3: A postpartum patient reports sudden chest pain and difficulty breathing. Her vitals
show tachycardia and decreased oxygen saturation. The nurse suspects:
,A) Postpartum depression
B) Pulmonary embolism
C) Mastitis
D) Uterine atony
Correct Answer: B) Pulmonary embolism
Explanation: These are classic signs of pulmonary embolism, a leading cause of maternal mortality
in the postpartum period. Pregnancy-induced hypercoagulability increases clot risk, especially after
cesarean delivery or prolonged immobility.
Question 4: A patient at 32 weeks gestation presents with vaginal bleeding and abdominal pain.
The nurse should anticipate preparing for:
A) Emergency cesarean section
B) Tocolysis administration
C) Ultrasound examination
D) Amniocentesis
Correct Answer: C) Ultrasound examination
Explanation: Vaginal bleeding with abdominal pain requires immediate ultrasound to differentiate
placental abruption from placenta previa before any interventions, as management differs
significantly between these conditions.
Question 5: During newborn assessment, the nurse notes a heart rate of 180 beats per minute.
This is considered:
A) Normal for newborn
B) Slightly elevated
C) Moderately elevated
D) Severely elevated
Correct Answer: C) Moderately elevated
Explanation: Normal newborn heart rate is 120-160 bpm. 180 bpm represents moderate elevation
requiring assessment for causes such as fever, dehydration, pain, or cardiac compromise.
,Question 6: A breastfeeding mother reports cracked, bleeding nipples. The nurse should first
assess:
A) Infant's latch
B) Frequency of feeding
C) Maternal nutrition
D) Use of pump
Correct Answer: A) Infant's latch
Explanation: Poor latch is the most common cause of nipple trauma. Proper latch assessment and
correction can prevent further damage and maintain successful breastfeeding relationship.
Question 7: A patient at 20 weeks gestation asks when she will feel fetal movements. The nurse
should respond:
A) 16-20 weeks
B) 20-24 weeks
C) 24-28 weeks
D) 28-32 weeks
Correct Answer: A) 16-20 weeks
Explanation: Nulliparous women typically feel quickening between 16-20 weeks gestation, while
multiparous women may feel movements as early as 14-16 weeks due to previous experience
recognizing fetal movements.
Question 8: During transition phase of labor, the patient expresses feeling out of control and states
she can't do this anymore. The nurse recognizes this as:
A) Need for immediate intervention
B) Normal transition behavior
C) Sign of complications
D) Request for pain medication
Correct Answer: B) Normal transition behavior
, Explanation: Transition phase (8-10 cm dilation) commonly causes feelings of loss of control,
irritability, and statements of giving up. This indicates imminent pushing phase and requires
emotional support rather than medical intervention.
Question 9: A patient receiving magnesium sulfate for preeclampsia develops absent deep tendon
reflexes. The nurse should:
A) Continue monitoring per protocol
B) Stop the infusion immediately
C) Decrease the infusion rate
D) Administer calcium gluconate
Correct Answer: B) Stop the infusion immediately
Explanation: Absent reflexes indicate magnesium toxicity requiring immediate cessation of infusion.
This precedes more serious complications like respiratory depression and cardiac arrest.
Question 10: A newborn's blood glucose is 35 mg/dL. The nurse should first:
A) Notify the provider
B) Initiate breastfeeding
C) Prepare for IV glucose
D) Recheck in 30 minutes
Correct Answer: B) Initiate breastfeeding
Explanation: Asymptomatic hypoglycemia >30 mg/dL responds to feeding. Early breastfeeding
provides glucose and stimulates glucose production. IV therapy reserved for symptomatic or
severe hypoglycemia.
Question 11: A patient at 36 weeks gestation with gestational diabetes has a fasting blood glucose
of 110 mg/dL. The nurse should:
A) Document as normal
B) Notify provider immediately
C) Recheck in 2 hours
D) Give insulin per protocol
Correct Answer: B) Notify provider immediately
