NURS 306/ NURS306 Quiz 4 – OB | WCU
(Latest 2026/ 2027 Update) 100% Verified
Questions & Answers | Grade A
Question 1: A patient at 38 weeks gestation presents with contractions every 3 minutes lasting 60
seconds. Cervical examination reveals 4 cm dilation, 90% effacement, and -1 station. The nurse
documents this as which stage of labor?
A) First stage, latent phase
B) First stage, active phase
C) Second stage
D) Third stage
Correct Answer: B) First stage, active phase
Explanation: Active phase of first stage labor is defined as cervical dilation 4-7 cm with regular
contractions. The patient has progressed beyond latent phase (0-3 cm) but has not yet reached
second stage (complete dilation with pushing).
Question 2: During active labor, the fetal heart rate shows early decelerations beginning with
contractions and returning to baseline by the end. The nurse should:
A) Stop the Pitocin infusion
B) Reposition the patient
C) Document as a normal finding
D) Administer oxygen
Correct Answer: C) Document as a normal finding
Explanation: Early decelerations are benign and physiologic, caused by fetal head compression
during contractions. They mirror the contraction pattern and indicate a well-oxygenated fetus with
normal cardiac reflexes.
,Question 3: A patient receiving magnesium sulfate for preeclampsia develops absent deep tendon
reflexes. The nurse's priority action is to:
A) Decrease the infusion rate
B) Stop the infusion immediately
C) Check the magnesium level
D) Notify the provider after shift
Correct Answer: B) Stop the infusion immediately
Explanation: Absent reflexes indicate magnesium toxicity. Stopping the infusion is the immediate
priority to prevent progression to respiratory depression and cardiac arrest. Calcium gluconate
should be readily available as an antidote.
Question 4: A newborn's temperature is 97.2°F (36.2°C) under the warmer. The nurse should first:
A) Increase warmer temperature
B) Add blankets
C) Assess for drafts
D) Check blood glucose
Correct Answer: A) Increase warmer temperature
Explanation: Newborns are poikilothermic and require environmental temperature regulation. The
priority is adjusting the external heat source to maintain normothermia (97.7-99.5°F) and prevent
cold stress complications.
Question 5: A patient at 34 weeks gestation with gestational diabetes has a fasting blood glucose
of 110 mg/dL. This indicates:
A) Excellent control
B) Good control
C) Suboptimal control
D) Dangerous level
Correct Answer: C) Suboptimal control
Explanation: Target fasting glucose in GDM is <95 mg/dL. 110 mg/dL represents suboptimal control
requiring intervention to prevent macrosomia, polyhydramnios, and other diabetic complications.
,Question 6: During Leopold's maneuvers, the nurse palpates a hard, round mass in the fundus
and a soft, irregular mass in the lower uterus. This indicates:
A) Breech presentation
B) Vertex presentation
C) Transverse lie
D) Face presentation
Correct Answer: B) Vertex presentation
Explanation: Hard, round mass (fetal head) in fundus with soft, irregular mass (buttocks) in lower
uterus confirms vertex presentation, the most common and optimal for vaginal delivery.
Question 7: A postpartum patient has a firm fundus at the umbilicus with moderate lochia rubra.
The priority assessment is:
A) Blood pressure
B) Bladder distension
C) Temperature
D) Pain level
Correct Answer: B) Bladder distension
Explanation: A firm fundus with moderate bleeding suggests adequate uterine contraction.
However, bladder distension can displace the uterus and prevent effective contractions, leading to
increased bleeding.
Question 8: A newborn's respiratory rate is 70 breaths per minute with mild intercostal retractions.
This assessment indicates:
A) Normal newborn respirations
B) Mild respiratory distress
C) Severe respiratory compromise
D) Transient tachypnea
Correct Answer: B) Mild respiratory distress
, Explanation: Normal newborn respiratory rate is 30-60 breaths per minute. 70 bpm with retractions
indicates mild respiratory distress requiring close monitoring for potential deterioration or
improvement.
Question 9: A patient at 28 weeks gestation reports decreased fetal movement. After eating and
lying on her left side, she feels 2 movements in 1 hour. The nurse should:
A) Reassure the patient
B) Continue monitoring for another hour
C) Send for immediate ultrasound
D) Prepare for emergency delivery
Correct Answer: B) Continue monitoring for another hour
Explanation: <10 movements in 2 hours requires further evaluation. Continuing monitoring for the
full 2-hour period provides more accurate assessment before determining next steps in evaluation.
Question 10: During active labor, the fetal heart rate shows late decelerations with minimal
variability. The nurse should first:
A) Stop the Pitocin infusion
B) Reposition the patient
C) Administer oxygen
D) Increase IV fluids
Correct Answer: A) Stop the Pitocin infusion
Explanation: Late decelerations indicate uteroplacental insufficiency. Stopping uterine stimulants is
the priority to reduce uterine activity and improve placental perfusion before implementing other
interventions.
Question 11: A breastfeeding mother reports her baby feeds every 2 hours for 45 minutes. The
infant has 6 wet diapers daily and appropriate weight gain. The nurse should:
A) Recommend supplementation
B) Suggest spacing feedings
C) Reassure about normalcy
D) Limit feeding duration
Correct Answer: C) Reassure about normalcy
(Latest 2026/ 2027 Update) 100% Verified
Questions & Answers | Grade A
Question 1: A patient at 38 weeks gestation presents with contractions every 3 minutes lasting 60
seconds. Cervical examination reveals 4 cm dilation, 90% effacement, and -1 station. The nurse
documents this as which stage of labor?
A) First stage, latent phase
B) First stage, active phase
C) Second stage
D) Third stage
Correct Answer: B) First stage, active phase
Explanation: Active phase of first stage labor is defined as cervical dilation 4-7 cm with regular
contractions. The patient has progressed beyond latent phase (0-3 cm) but has not yet reached
second stage (complete dilation with pushing).
Question 2: During active labor, the fetal heart rate shows early decelerations beginning with
contractions and returning to baseline by the end. The nurse should:
A) Stop the Pitocin infusion
B) Reposition the patient
C) Document as a normal finding
D) Administer oxygen
Correct Answer: C) Document as a normal finding
Explanation: Early decelerations are benign and physiologic, caused by fetal head compression
during contractions. They mirror the contraction pattern and indicate a well-oxygenated fetus with
normal cardiac reflexes.
,Question 3: A patient receiving magnesium sulfate for preeclampsia develops absent deep tendon
reflexes. The nurse's priority action is to:
A) Decrease the infusion rate
B) Stop the infusion immediately
C) Check the magnesium level
D) Notify the provider after shift
Correct Answer: B) Stop the infusion immediately
Explanation: Absent reflexes indicate magnesium toxicity. Stopping the infusion is the immediate
priority to prevent progression to respiratory depression and cardiac arrest. Calcium gluconate
should be readily available as an antidote.
Question 4: A newborn's temperature is 97.2°F (36.2°C) under the warmer. The nurse should first:
A) Increase warmer temperature
B) Add blankets
C) Assess for drafts
D) Check blood glucose
Correct Answer: A) Increase warmer temperature
Explanation: Newborns are poikilothermic and require environmental temperature regulation. The
priority is adjusting the external heat source to maintain normothermia (97.7-99.5°F) and prevent
cold stress complications.
Question 5: A patient at 34 weeks gestation with gestational diabetes has a fasting blood glucose
of 110 mg/dL. This indicates:
A) Excellent control
B) Good control
C) Suboptimal control
D) Dangerous level
Correct Answer: C) Suboptimal control
Explanation: Target fasting glucose in GDM is <95 mg/dL. 110 mg/dL represents suboptimal control
requiring intervention to prevent macrosomia, polyhydramnios, and other diabetic complications.
,Question 6: During Leopold's maneuvers, the nurse palpates a hard, round mass in the fundus
and a soft, irregular mass in the lower uterus. This indicates:
A) Breech presentation
B) Vertex presentation
C) Transverse lie
D) Face presentation
Correct Answer: B) Vertex presentation
Explanation: Hard, round mass (fetal head) in fundus with soft, irregular mass (buttocks) in lower
uterus confirms vertex presentation, the most common and optimal for vaginal delivery.
Question 7: A postpartum patient has a firm fundus at the umbilicus with moderate lochia rubra.
The priority assessment is:
A) Blood pressure
B) Bladder distension
C) Temperature
D) Pain level
Correct Answer: B) Bladder distension
Explanation: A firm fundus with moderate bleeding suggests adequate uterine contraction.
However, bladder distension can displace the uterus and prevent effective contractions, leading to
increased bleeding.
Question 8: A newborn's respiratory rate is 70 breaths per minute with mild intercostal retractions.
This assessment indicates:
A) Normal newborn respirations
B) Mild respiratory distress
C) Severe respiratory compromise
D) Transient tachypnea
Correct Answer: B) Mild respiratory distress
, Explanation: Normal newborn respiratory rate is 30-60 breaths per minute. 70 bpm with retractions
indicates mild respiratory distress requiring close monitoring for potential deterioration or
improvement.
Question 9: A patient at 28 weeks gestation reports decreased fetal movement. After eating and
lying on her left side, she feels 2 movements in 1 hour. The nurse should:
A) Reassure the patient
B) Continue monitoring for another hour
C) Send for immediate ultrasound
D) Prepare for emergency delivery
Correct Answer: B) Continue monitoring for another hour
Explanation: <10 movements in 2 hours requires further evaluation. Continuing monitoring for the
full 2-hour period provides more accurate assessment before determining next steps in evaluation.
Question 10: During active labor, the fetal heart rate shows late decelerations with minimal
variability. The nurse should first:
A) Stop the Pitocin infusion
B) Reposition the patient
C) Administer oxygen
D) Increase IV fluids
Correct Answer: A) Stop the Pitocin infusion
Explanation: Late decelerations indicate uteroplacental insufficiency. Stopping uterine stimulants is
the priority to reduce uterine activity and improve placental perfusion before implementing other
interventions.
Question 11: A breastfeeding mother reports her baby feeds every 2 hours for 45 minutes. The
infant has 6 wet diapers daily and appropriate weight gain. The nurse should:
A) Recommend supplementation
B) Suggest spacing feedings
C) Reassure about normalcy
D) Limit feeding duration
Correct Answer: C) Reassure about normalcy
