NURS 316L | NURS316L Final Exam: OB Clinical -
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. Which of the
following is the primary purpose of the first maneuver?
A. To identify the fetal part located in the fundus.
B. To determine the location of the fetal back.
C. To identify the presenting part at the pelvic inlet.
D. To assess the descent of the fetal head into the pelvis.
Correct Answer: A
Rationale: The first Leopold maneuver involves palpating the upper abdomen to
determine which fetal part occupies the fundus. This step helps the nurse distinguish
between the head and the breech. A head feels hard and round, while a breech feels soft
and irregular. Identifying the contents of the fundus is essential for determining fetal lie.
This systematic approach ensures accurate assessment of the fetal position before
monitoring begins.
2. A nurse is monitoring a client in labor who has a late deceleration on the electronic fetal
monitor. Which action should the nurse take first?
A. Turn the client onto her left side.
B. Apply oxygen at 10 L/min via nonrebreather face mask.
C. Increase the rate of the maintenance IV fluids.
D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: Late decelerations are indicative of uteroplacental insufficiency and require
immediate nursing intervention. The first action is to reposition the client, typically to a
lateral position, to improve blood flow to the placenta. This change in position relieves
pressure on the vena cava and enhances cardiac output. After repositioning, the nurse
should then apply oxygen and increase IV fluids as prescribed. Immediate intervention is
critical to prevent fetal hypoxia and ensure neonatal well-being.
3. A nurse is assessing a newborn 1 hour after birth. Which of the following findings should
the nurse report to the provider?
A. A respiratory rate of 48 breaths per minute.
B. Nasal flaring and chest retractions.
,C. A heart rate of 145 beats per minute.
D. Acrocyanosis of the hands and feet.
Correct Answer: B
Rationale: Nasal flaring and chest retractions are clinical signs of respiratory distress in a
newborn. Normal newborn respiratory rates range from 30 to 60 breaths per minute
without signs of effort. Acrocyanosis is a normal finding in the first 24 to 48 hours as the
peripheral circulation stabilizes. A heart rate of 140 to 160 is considered within the
expected range for a healthy neonate. Respiratory distress requires immediate evaluation
and potentially supplementary oxygen or respiratory support.
4. A client at 32 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
finding indicates magnesium toxicity?
A. Respiratory rate of 10 breaths per minute.
B. Deep tendon reflexes of 2+.
C. Urine output of 40 mL per hour.
D. Blood pressure of 150/95 mmHg.
Correct Answer: A
Rationale: Magnesium sulfate is a central nervous system depressant used to prevent
seizures in preeclamptic patients. A respiratory rate below 12 breaths per minute is a
hallmark sign of magnesium toxicity. Other signs include loss of deep tendon reflexes and
decreased urinary output. If toxicity is suspected, the nurse must immediately stop the
infusion and prepare calcium gluconate. Close monitoring of vital signs and reflexes is
mandatory during the administration of this high-alert medication.
5. A nurse is caring for a client who is in the third stage of labor. Which of the following is an
expected finding?
A. The cervix reaches 10 cm dilation.
B. The placenta is delivered.
C. The fetus is expelled from the birth canal.
D. The client experiences strong urge to push.
Correct Answer: B
Rationale: The third stage of labor begins after the delivery of the infant and ends with the
delivery of the placenta. During this stage, the nurse monitors for signs of placental
separation such as a gush of blood. The second stage of labor is when the fetus is actually
expelled from the mother. Dilating to 10 cm marks the end of the first stage of labor.
Understanding these stages allows the nurse to provide appropriate care and anticipate
complications like hemorrhage.
, 6. A nurse is teaching a client who is breastfeeding about common concerns. Which
statement by the client indicates an understanding of mastitis?
A. I should stop breastfeeding on the affected side.
B. I can only treat this with cold compresses.
C. Mastitis usually affects both breasts at the same time.
D. I will likely have a fever and flu-like symptoms.
Correct Answer: D
Rationale: Mastitis is an infection of the breast tissue that typically presents with fever,
chills, and localized pain. It usually occurs unilaterally and requires antibiotic treatment
alongside continued milk expression. Clients should be encouraged to continue
breastfeeding or pumping to prevent further stasis of milk. Frequent emptying of the
breast is essential to the healing process and preventing abscess formation. Education on
proper latch techniques can significantly reduce the risk of nipple trauma and subsequent
infection.
7. Which of the following interventions should the nurse perform for a client with a boggy
uterus 2 hours postpartum?
A. Administer an analgesic for pain.
B. Place the client in a Trendelenburg position.
C. Perform fundal massage until firm.
D. Prepare the client for an immediate D&C.
Correct Answer: C
Rationale: A boggy uterus indicates uterine atony, which is the leading cause of
postpartum hemorrhage. The primary nursing intervention is to perform fundal massage
to stimulate uterine contractions and firm up the muscle. If the uterus does not firm up, the
nurse should assess for a full bladder, which can displace the uterus. Oxytocic medications
may be required if massage alone is ineffective. Continuous assessment of lochia flow is
also necessary to monitor the severity of bleeding.
8. A nurse is assessing a client for preeclampsia at 36 weeks gestation. Which of the following
findings is a diagnostic criterion?
A. Blood pressure of 130/85 mmHg.
B. Proteinuria of 1+ on a dipstick.
C. Weight gain of 1 lb in one week.
D. Platelet count of 250,000/mm3.
Correct Answer: B
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. Which of the
following is the primary purpose of the first maneuver?
A. To identify the fetal part located in the fundus.
B. To determine the location of the fetal back.
C. To identify the presenting part at the pelvic inlet.
D. To assess the descent of the fetal head into the pelvis.
Correct Answer: A
Rationale: The first Leopold maneuver involves palpating the upper abdomen to
determine which fetal part occupies the fundus. This step helps the nurse distinguish
between the head and the breech. A head feels hard and round, while a breech feels soft
and irregular. Identifying the contents of the fundus is essential for determining fetal lie.
This systematic approach ensures accurate assessment of the fetal position before
monitoring begins.
2. A nurse is monitoring a client in labor who has a late deceleration on the electronic fetal
monitor. Which action should the nurse take first?
A. Turn the client onto her left side.
B. Apply oxygen at 10 L/min via nonrebreather face mask.
C. Increase the rate of the maintenance IV fluids.
D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: Late decelerations are indicative of uteroplacental insufficiency and require
immediate nursing intervention. The first action is to reposition the client, typically to a
lateral position, to improve blood flow to the placenta. This change in position relieves
pressure on the vena cava and enhances cardiac output. After repositioning, the nurse
should then apply oxygen and increase IV fluids as prescribed. Immediate intervention is
critical to prevent fetal hypoxia and ensure neonatal well-being.
3. A nurse is assessing a newborn 1 hour after birth. Which of the following findings should
the nurse report to the provider?
A. A respiratory rate of 48 breaths per minute.
B. Nasal flaring and chest retractions.
,C. A heart rate of 145 beats per minute.
D. Acrocyanosis of the hands and feet.
Correct Answer: B
Rationale: Nasal flaring and chest retractions are clinical signs of respiratory distress in a
newborn. Normal newborn respiratory rates range from 30 to 60 breaths per minute
without signs of effort. Acrocyanosis is a normal finding in the first 24 to 48 hours as the
peripheral circulation stabilizes. A heart rate of 140 to 160 is considered within the
expected range for a healthy neonate. Respiratory distress requires immediate evaluation
and potentially supplementary oxygen or respiratory support.
4. A client at 32 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
finding indicates magnesium toxicity?
A. Respiratory rate of 10 breaths per minute.
B. Deep tendon reflexes of 2+.
C. Urine output of 40 mL per hour.
D. Blood pressure of 150/95 mmHg.
Correct Answer: A
Rationale: Magnesium sulfate is a central nervous system depressant used to prevent
seizures in preeclamptic patients. A respiratory rate below 12 breaths per minute is a
hallmark sign of magnesium toxicity. Other signs include loss of deep tendon reflexes and
decreased urinary output. If toxicity is suspected, the nurse must immediately stop the
infusion and prepare calcium gluconate. Close monitoring of vital signs and reflexes is
mandatory during the administration of this high-alert medication.
5. A nurse is caring for a client who is in the third stage of labor. Which of the following is an
expected finding?
A. The cervix reaches 10 cm dilation.
B. The placenta is delivered.
C. The fetus is expelled from the birth canal.
D. The client experiences strong urge to push.
Correct Answer: B
Rationale: The third stage of labor begins after the delivery of the infant and ends with the
delivery of the placenta. During this stage, the nurse monitors for signs of placental
separation such as a gush of blood. The second stage of labor is when the fetus is actually
expelled from the mother. Dilating to 10 cm marks the end of the first stage of labor.
Understanding these stages allows the nurse to provide appropriate care and anticipate
complications like hemorrhage.
, 6. A nurse is teaching a client who is breastfeeding about common concerns. Which
statement by the client indicates an understanding of mastitis?
A. I should stop breastfeeding on the affected side.
B. I can only treat this with cold compresses.
C. Mastitis usually affects both breasts at the same time.
D. I will likely have a fever and flu-like symptoms.
Correct Answer: D
Rationale: Mastitis is an infection of the breast tissue that typically presents with fever,
chills, and localized pain. It usually occurs unilaterally and requires antibiotic treatment
alongside continued milk expression. Clients should be encouraged to continue
breastfeeding or pumping to prevent further stasis of milk. Frequent emptying of the
breast is essential to the healing process and preventing abscess formation. Education on
proper latch techniques can significantly reduce the risk of nipple trauma and subsequent
infection.
7. Which of the following interventions should the nurse perform for a client with a boggy
uterus 2 hours postpartum?
A. Administer an analgesic for pain.
B. Place the client in a Trendelenburg position.
C. Perform fundal massage until firm.
D. Prepare the client for an immediate D&C.
Correct Answer: C
Rationale: A boggy uterus indicates uterine atony, which is the leading cause of
postpartum hemorrhage. The primary nursing intervention is to perform fundal massage
to stimulate uterine contractions and firm up the muscle. If the uterus does not firm up, the
nurse should assess for a full bladder, which can displace the uterus. Oxytocic medications
may be required if massage alone is ineffective. Continuous assessment of lochia flow is
also necessary to monitor the severity of bleeding.
8. A nurse is assessing a client for preeclampsia at 36 weeks gestation. Which of the following
findings is a diagnostic criterion?
A. Blood pressure of 130/85 mmHg.
B. Proteinuria of 1+ on a dipstick.
C. Weight gain of 1 lb in one week.
D. Platelet count of 250,000/mm3.
Correct Answer: B
