NURS 306 Quiz 5 OB 2026 [Latest Update] |
WCU | 100% Verified Questions & Answers
| Grade A
Question 1: A nurse is caring for a client at 32 weeks gestation with suspected preterm labor.
Which finding would confirm the diagnosis?
A) Contractions every 15 minutes for 1 hour with cervical change
B) Braxton Hicks contractions every 10 minutes
C) Pelvic pressure without contractions
D) Cervical dilation of 2 cm without contractions
Correct Answer: A) Contractions every 15 minutes for 1 hour with cervical change
Explanation: Preterm labor is defined as regular contractions (every 10-15 minutes) for more than
1 hour with cervical change (dilation, effacement, or station) occurring between 20-37 weeks
gestation.
Question 2: A client at 28 weeks gestation presents with PPROM. Which nursing intervention is
priority?
A) Perform sterile vaginal examination
B) Administer tocolytic medications
C) Monitor for signs of infection
D) Encourage ambulation
Correct Answer: C) Monitor for signs of infection
Explanation: With PPROM, the priority is monitoring for infection (chorioamnionitis) since the
amniotic sac is open. Avoid vaginal exams to reduce infection risk, monitor temperature, WBC
count, and fetal heart rate patterns.
Question 3: A client receiving magnesium sulfate for preterm labor develops flushing, drowsiness,
and absent deep tendon reflexes. What is the priority nursing action?
,A) Stop the infusion immediately
B) Increase the infusion rate
C) Administer calcium gluconate
D) Monitor blood pressure more frequently
Correct Answer: A) Stop the infusion immediately
Explanation: These are signs of magnesium sulfate toxicity. The priority is to stop the infusion
immediately. Calcium gluconate is the antidote but stopping the infusion comes first to prevent
further toxicity.
Question 4: A client at 34 weeks gestation is receiving betamethasone. What is the purpose of this
medication?
A) Stop preterm contractions
B) Accelerate fetal lung maturity
C) Prevent infection
D) Reduce blood pressure
Correct Answer: B) Accelerate fetal lung maturity
Explanation: Betamethasone is a corticosteroid given to accelerate fetal lung maturity when
preterm birth is anticipated between 24-34 weeks gestation, reducing the risk of respiratory
distress syndrome.
Question 5: A client presents with cervical insufficiency at 20 weeks gestation. Which finding would
the nurse expect?
A) Regular painful contractions
B) Vaginal bleeding with clots
C) Painless cervical dilation
D) Ruptured membranes
Correct Answer: C) Painless cervical dilation
Explanation: Cervical insufficiency is characterized by painless cervical dilation in the second
trimester without contractions, often presenting as pelvic pressure, backache, or increased vaginal
discharge.
,Question 6: A client at 30 weeks gestation with twins is experiencing preterm labor. Which tocolytic
medication is contraindicated?
A) Nifedipine
B) Magnesium sulfate
C) Terbutaline
D) Indomethacin
Correct Answer: C) Terbutaline
Explanation: Terbutaline is contraindicated in multiple gestations due to increased risk of maternal
pulmonary edema and cardiac complications from the beta-agonist effects.
Question 7: A client with severe preeclampsia has a blood pressure of 170/110 mmHg. Which
antihypertensive medication is most appropriate?
A) Hydralazine
B) Labetalol
C) Nifedipine
D) Methyldopa
Correct Answer: B) Labetalol
Explanation: Labetalol is the first-line antihypertensive for severe preeclampsia as it effectively
lowers blood pressure without adverse fetal effects and can be given IV for rapid control.
Question 8: A client at 35 weeks gestation presents with bright red vaginal bleeding and abdominal
pain. Which condition should the nurse suspect?
A) Placenta previa
B) Placental abruption
C) Normal bloody show
D) Vasa previa
Correct Answer: B) Placental abruption
Explanation: Placental abruption presents with bright red vaginal bleeding (may be concealed),
abdominal pain, uterine tenderness, and possibly fetal heart rate abnormalities. Placenta previa
typically presents with painless bleeding.
, Question 9: A client with gestational diabetes has a 1-hour glucose challenge test result of 145
mg/dL. What is the next step?
A) Diagnose gestational diabetes
B) Repeat the test in 1 week
C) Proceed to 3-hour glucose tolerance test
D) Start insulin therapy
Correct Answer: C) Proceed to 3-hour glucose tolerance test
Explanation: A 1-hour glucose challenge >140 mg/dL requires a 3-hour glucose tolerance test for
definitive diagnosis of gestational diabetes. Values >200 mg/dL may indicate pregestational
diabetes.
Question 10: A client at 28 weeks gestation presents with BP 160/110, proteinuria 3+, and
epigastric pain. What is the priority nursing action?
A) Monitor blood pressure every 4 hours
B) Prepare for immediate delivery
C) Administer oral antihypertensives
D) Encourage bed rest
Correct Answer: B) Prepare for immediate delivery
Explanation: This represents severe preeclampsia with impending eclampsia. Immediate delivery is
indicated after 34 weeks gestation or with severe features regardless of gestational age to prevent
maternal complications.
Question 11: A client with shoulder dystocia delivers successfully after McRoberts maneuver and
suprapubic pressure. Which complication should the nurse assess for in the neonate?
A) Clavicular fracture
B) Facial paralysis
C) Caput succedaneum
D) Cephalohematoma
Correct Answer: A) Clavicular fracture
WCU | 100% Verified Questions & Answers
| Grade A
Question 1: A nurse is caring for a client at 32 weeks gestation with suspected preterm labor.
Which finding would confirm the diagnosis?
A) Contractions every 15 minutes for 1 hour with cervical change
B) Braxton Hicks contractions every 10 minutes
C) Pelvic pressure without contractions
D) Cervical dilation of 2 cm without contractions
Correct Answer: A) Contractions every 15 minutes for 1 hour with cervical change
Explanation: Preterm labor is defined as regular contractions (every 10-15 minutes) for more than
1 hour with cervical change (dilation, effacement, or station) occurring between 20-37 weeks
gestation.
Question 2: A client at 28 weeks gestation presents with PPROM. Which nursing intervention is
priority?
A) Perform sterile vaginal examination
B) Administer tocolytic medications
C) Monitor for signs of infection
D) Encourage ambulation
Correct Answer: C) Monitor for signs of infection
Explanation: With PPROM, the priority is monitoring for infection (chorioamnionitis) since the
amniotic sac is open. Avoid vaginal exams to reduce infection risk, monitor temperature, WBC
count, and fetal heart rate patterns.
Question 3: A client receiving magnesium sulfate for preterm labor develops flushing, drowsiness,
and absent deep tendon reflexes. What is the priority nursing action?
,A) Stop the infusion immediately
B) Increase the infusion rate
C) Administer calcium gluconate
D) Monitor blood pressure more frequently
Correct Answer: A) Stop the infusion immediately
Explanation: These are signs of magnesium sulfate toxicity. The priority is to stop the infusion
immediately. Calcium gluconate is the antidote but stopping the infusion comes first to prevent
further toxicity.
Question 4: A client at 34 weeks gestation is receiving betamethasone. What is the purpose of this
medication?
A) Stop preterm contractions
B) Accelerate fetal lung maturity
C) Prevent infection
D) Reduce blood pressure
Correct Answer: B) Accelerate fetal lung maturity
Explanation: Betamethasone is a corticosteroid given to accelerate fetal lung maturity when
preterm birth is anticipated between 24-34 weeks gestation, reducing the risk of respiratory
distress syndrome.
Question 5: A client presents with cervical insufficiency at 20 weeks gestation. Which finding would
the nurse expect?
A) Regular painful contractions
B) Vaginal bleeding with clots
C) Painless cervical dilation
D) Ruptured membranes
Correct Answer: C) Painless cervical dilation
Explanation: Cervical insufficiency is characterized by painless cervical dilation in the second
trimester without contractions, often presenting as pelvic pressure, backache, or increased vaginal
discharge.
,Question 6: A client at 30 weeks gestation with twins is experiencing preterm labor. Which tocolytic
medication is contraindicated?
A) Nifedipine
B) Magnesium sulfate
C) Terbutaline
D) Indomethacin
Correct Answer: C) Terbutaline
Explanation: Terbutaline is contraindicated in multiple gestations due to increased risk of maternal
pulmonary edema and cardiac complications from the beta-agonist effects.
Question 7: A client with severe preeclampsia has a blood pressure of 170/110 mmHg. Which
antihypertensive medication is most appropriate?
A) Hydralazine
B) Labetalol
C) Nifedipine
D) Methyldopa
Correct Answer: B) Labetalol
Explanation: Labetalol is the first-line antihypertensive for severe preeclampsia as it effectively
lowers blood pressure without adverse fetal effects and can be given IV for rapid control.
Question 8: A client at 35 weeks gestation presents with bright red vaginal bleeding and abdominal
pain. Which condition should the nurse suspect?
A) Placenta previa
B) Placental abruption
C) Normal bloody show
D) Vasa previa
Correct Answer: B) Placental abruption
Explanation: Placental abruption presents with bright red vaginal bleeding (may be concealed),
abdominal pain, uterine tenderness, and possibly fetal heart rate abnormalities. Placenta previa
typically presents with painless bleeding.
, Question 9: A client with gestational diabetes has a 1-hour glucose challenge test result of 145
mg/dL. What is the next step?
A) Diagnose gestational diabetes
B) Repeat the test in 1 week
C) Proceed to 3-hour glucose tolerance test
D) Start insulin therapy
Correct Answer: C) Proceed to 3-hour glucose tolerance test
Explanation: A 1-hour glucose challenge >140 mg/dL requires a 3-hour glucose tolerance test for
definitive diagnosis of gestational diabetes. Values >200 mg/dL may indicate pregestational
diabetes.
Question 10: A client at 28 weeks gestation presents with BP 160/110, proteinuria 3+, and
epigastric pain. What is the priority nursing action?
A) Monitor blood pressure every 4 hours
B) Prepare for immediate delivery
C) Administer oral antihypertensives
D) Encourage bed rest
Correct Answer: B) Prepare for immediate delivery
Explanation: This represents severe preeclampsia with impending eclampsia. Immediate delivery is
indicated after 34 weeks gestation or with severe features regardless of gestational age to prevent
maternal complications.
Question 11: A client with shoulder dystocia delivers successfully after McRoberts maneuver and
suprapubic pressure. Which complication should the nurse assess for in the neonate?
A) Clavicular fracture
B) Facial paralysis
C) Caput succedaneum
D) Cephalohematoma
Correct Answer: A) Clavicular fracture
