OB NURSING PRELIM POST TEST

Question 1
A woman who’s 36 weeks pregnant comes into the labor room with mild contractions.
Which of the following complications should the nurse watch for when the client informs
her that she has placenta previa?
Select one:
a. sudden rupture of membrane
b. vaginal bleeding
c. emesis
d. fever

Question 2
Which of the following findings would be expected when assessing the postpartum client?
Select one:
a. fundus 1 cm above the umbilicus 1 hour postpartum
b. fundus 1 cm above the umbilicus on postpartum day 3
c. fundus palpable in the abdomen at 2 weeks postpartum
d. fundus slightly to right; 2 cm above umbilicus on postpartum day 2

Question 3
A 30 year old multiparous client admitted to the labor and delivery unit hasn’t received
prenatal care for this pregnancy. Which of the following data is most relevant to the nursing
assessment?
Select one:
a. date of last menstrual period
b. family history of STD
c. name of insurance provider
d. Number of siblings.

Question 4
A client is admitted to the labor and delivery unit in labor, with blood flowing down her legs.
Which of the following nursing interventions would be most appropriate?
Select one:
a. place an indwelling catheter
b. assess fetal heart tones
c. perform a vaginal examination
d. prepare the client for cesarean delivery
Question 5
Which of the following conditions is the most common cause of anemia in pregnancy?
Select one:
a. alpha thalassemia
b. beta thalassemia
c. Iron deficiency anemia
d. Sickle cell anemia
Question 6
Which of the following answers best describes the stage of pregnancy in which maternal
and fetal blood are exchanged?
Select one:
a. conception
b. 9 weeks gestation, when the fetal heart is well developed
c. 32-34 weeks’ gestation (3rd trimester)
d. Maternal and fetal bloods are never exchanged.

Question 7
The antagonist for magnesium sulfate should be readily available to any client receiving IV
magnesium. Which of the following drugs is the antidote for magnesium toxicity?
Select one:
a. calcium gluconate (Kalcinate)
b. hydralazine (apresoline)
c. naloxone (Narcan)
d. Rh0 (D) immune globulin (RhoGAM)

Question 8
Magnesium sulfate is given to pregnant clients w/ preeclampsia to prevent which of the
following conditions?
Select one:
a. hemorrhage
b. hypertension
c. hypomagnesemia
d. seizures

Question 9
To diagnose as having placenta previa, which of the following procedures is usually
performed?
Select one:
a. Amniocentesis
b. Digital or speculum examination
c. External fetal monitoring
d. Ultrasound

Question 10
Which of the following types of placenta previa is it when the placental edge reaches the
internal os?
Select one:
a. low lying placenta previa
b. marginal placenta previa
c. partial placenta previa
d. total placenta previa

Question 11
Which of the following factors would contribute to a high risk pregnancy?
Select one:
a. blood type O positive
b. first pregnancy at age 33 years
c. history of allergy to flowers
d. history of insulin-independent diabetes mellitus

Question 12
A 21-year-old client, 6 weeks pregnant, is diagnosed with hyperemesis gravidarum. This
excessive vomiting during pregnancy will often result in which of the following conditions?
Select one:
a. bowel perforation
b. electrolyte imbalance
c. Miscarriage
d. Pregnancy-induced hypertension.

Question 13
A client a term arrives in the labor unit experiencing contractions every minute. After a brief
assessment, she’s admitted and an electronic fetal monitor is applied. Which of the
following observations would alert the nurse to an increased potential for fetal distress?
Select one:
a. total weight gain of 30lb (13.6kg)
b. maternal age of 32 years
c. BP of 146/90 mmHg
d. Treatment for syphilis at 15 weeks’ gestation.

Question 14
Before the placenta functions, the corpus luteum is the primary source for synthesis of
which of the following hormones?
Select one:
a. cortisol and thyroxine
b. estrogen and progesterone
c. Luteinizing hormone and follicle stimulating hormone
d. Thyroxine (T4) and triiodothyronine (T3)

Question 15
Which of the following symptoms isn’t usually observed in laboring clients with pregnancy-
induced hypertension (PIH)?
Select one:
a. elevated blood pressure
b. polyuria
c. facial and hand edema
d. epigastric discomfort

Question 16
The phrase Gravida 4, para 2 indicates which of the following prenatal histories?
Select one:
a. a client has been pregnant four times and had twin delivery
b. a client has been pregnant four times and had two live-born children
c. a client has been pregnant four times and has two cesarean deliveries
d. a client has been pregnant four times and had two spontaneous abortions

Question 17
During which of the following stages does crowning take place?
Select one:
a. first
b. second
c. third
d. fourth

Question 18
A client is complaining of painful contraction, or after pains, on postpartum day 2. Which of
the following conditions would increase the severity of afterpains?
Select one:
a. breastfeeding
b. diabetes
c. multiple gestation
d. primiparity

Question 19
A pregnant client is concerned about lack of fetal movement. What instructions would the
nurse give that might offer reassurance?
Select one:
a. start taking two prenatal vitamins
b. take a warm bath to facilitate fetal movement
c. Eat foods that contain a high sugar content to enhance fetal movement.
d. Lie down once a day and count the number of fetal movements for 15 to 30 minutes.

Question 20
Which of the following characteristics best describes variable decelerations?
Select one:
a. predictable
b. indicators of fetal well-being
c. indicative of cord compression
d. periodic decreases in fetal heart rate resulting from pressure on the fetal head

Question 21
A woman with a term pregnancy comes into the labor-and-delivery unit in early labor saying
that she thinks her water has broken. Which of the following actions by the nurse would be
most appropriate?
Select one:
a. prepare the woman for delivery
b. Note the color, amount, and odor of the fluid.
c. Immediately contact the physician
d. Collect a sample of the fluid for microbial analysis.

Question 22
Which phrase refers to the degree of flexion that the fetus assumes or the relationship of
the fetal parts to one another?
Select one:
a. fetal attitude
b. fetal position
c. fetal lie
d. fetal presentation

Question 23
The cervix of a 26 year old primigravida in labor is 5 cm dilated and 75% effaced, and the
fetus is at 0 station. The physician prescribes an epidural regional block. Into which of the
following positions should the nurse place the client when an epidural is administered?
Select one:
a. lithotomy
b. supine
c. prone
d. Lateral

Question 24
A 21 year old has just been diagnosed with having a hydatidiform mole. Which of the
following factors is considered a risk factor for developing a hydatidiform mole?
Select one:
a. age in 20s or 30s
b. high socioeconomic status
c. primigravida
d. prior molar gestation

Question 25
Which of the following hormones would be administered for the stimulation of uterine
contractions?
Select one:
a. estrogen
b. fetal cortisol
c. oxytocin
d. progesterone

Question 26
Pregnancy- induced hypertension (PIH) may be diagnosed initially when the client is in
labor. Beside elevated blood pressure, which are classic signs of PIH?
Select one:
a. proteinuria
b. edema and generalized neuralgia
c. headache and edema
d. proteinuria and edema

Question 27
Rh isoimmunization in a pregnant client develops during which of the following conditions?
Select one:
a. Rh-positive maternal blood crosses into fetal blood, stimulating fetal antibodies.
b. Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies.
c. Rh-negative fetal blood crosses into maternal blood stimulating maternal antibodies.
d. Rh-negative maternal blood crosses into fetal blood, stimulating antibodies.

Question 28
During labor a client’s amniotic membranes rupture. Meconium is present in the amniotic
fluid. Meconium in amniotic fluid is a normal finding in which of the following situations?
Select one:
a. preterm labor
b. cephalopelvic disproportion
c. prolonged latent phase
d. breech presentation

Question 29
Which of the following rationales best explains why a pregnant client should lie on her left
side when resting or sleeping in the later stages of pregnancy?
Select one:
a. to facilitate digestion
b. to facilitate bladder emptying
c. To prevent compression of the vena cava.
d. To avoid the development of fetal anomalies

Question 30
A client is being admitted to the antepartum unit for hypovolemia secondary to hyperemesis
gravidarum. Which of the following factors predisposes a client to the development of this
condition?
Select one:
a. trophoblastic disease
b. maternal age older than 35 years old
c. malnourished or underweight clients
d. low levels of human chorionic gonadotropin (HCG)

Question 31
Which of the following drugs is preferred for treating pregnancy-induced hypertension
(PIH)?
Select one:
a. terbutaline (Brethaire)
b. Oxytocin
c. Magnesium sulfate
d. Calcium gluconate

Question 32
While performing a vaginal examination, the nurse feels pulsating tissue against her
fingertips. What would be the most appropriate nursing intervention?
Select one:
a. leave the client and call the physician
b. put the client in a knee chest position
c. Ask the client to push with the next contraction.
d. Leave the fingers in place, and press the nurse call light.

Question 33
On completing a fundal assessment, the nurse notes the fundus is situated on the client’s
left abdomen. Which of the following actions is appropriate?
Select one:
a. Ask the client to empty her bladder.
b. Straight catheterize the client immediately.
c. Call the client’s primary health care giver for direction.
d. Straight catheterize the client for half of her urine volume.
Question 34
When completing the morning postpartum assessment, the nurse notices the client’s
perineal pad is completely saturated with lochia rubra. Which of the following actions
should be the nurse’s first response?
Select one:
a. vigorously massage the fundus
b. Immediately call the primary care provider.
c. Have the charge nurse review the assessment.
d. Ask the client when she last changed her perineal pad.

Question 35
Which of the following conditions is common in pregnant clients in the second trimester of
pregnancy?
Select one:
a. Mastitis
b. metabolic alkalosis
c. physiologic anemia
d. respiratory acidosis

Question 36
Clients with placenta previa are at increased risk for the placenta to form attachment to the
uterine wall, known as placenta accreta. Which of the following statements best describes
these abnormal attachments?
Select one:
a. The placenta invades the myometrium
b. The placenta covers the cervical os
c. The placenta penetrates the myometrium
d. The placenta attaches to the myometrium

Question 37
Which of the following symptoms occurs with a hydatidiform mole?
Select one:
a. Heavy, bright red bleeding every 21 days.
b. Fetal cardiac tumors found in the smooth muscle of the uterus .
c. Benign tumors found in the smooth muscles of the uterus.
d. “Snowstorm” pattern on UTZ w/ no fetus or gestational sac.

Question 38
Which of the following interventions would be helpful to a breast-feeding mother who is
experiencing engorged breasts?
Select one:
a. applying ice
b. applying a breast binder
c. teaching her how to express her breasts in a warm shower
d. administering bromocriptine (Parlodel)

Question 39
A pregnancy causes multiple body changes that are normal but can cause discomfort.
Which change does not normally occur during the first trimester?
Select one:
a. hemorrhoids
b. increased vaginal discharge
c. breast tenderness
d. fatigue

Question 40
Rea is being provided with instructions regarding measures that will assist in alleviating
heartburns. Which statement is made by Rea indicates an understanding of these
measures?
Select one:
a. “I should lie down for an hour after eating.”
b. “I should avoid between-meal snacks.”
c. “I should substitute spices for cooking rather than using salt.”
d. ‘I should avoid eating gas-producing foods or fatty foods.”

Question 41
When giving a postpartum client self-care instructions, the nurse instructs her to report
heavy or excessive bleeding. Which of the following would indicate heavy bleeding?
Select one:
a. saturating a pad in 15 minutes
b. saturating a pad in 1 hour
c. saturating a pad in 4-6 hours
d. saturating a pad in 8 hours

Question 42
Which of the following descriptions best fits Braxton Hicks contractions?
Select one:
a. contractions beginning irregularly, becoming regular and predictable
b. contractions causing cervical effacement and dilation
c. Contractions felt initially in the lower back and radiating to the abdomen in wavelike
motion.
d. Contractions that begin and remain irregular.

Question 43
As the fetus passes through the birth canal, it makes various positional changes, called
cardinal movements of labor. Which is the first cardinal movement?
Select one:
a. descent
b. flexion
c. extension
d. internal rotation

Question 44
Which of the following interventions would the nurse recommend to a client having severe
heartburn during her pregnancy?
Select one:
a. Eat several small meals daily.
b. Eat crackers on waking every a.m.
c. Drink a preparation of salt and vinegar
d. Drink orange juice frequently during the day

Question 45
In performing an assessment of a postpartum client 2 hours after delivery, the nurse
notices heavy bleeding with large clots. Which of the following responses is most
appropriate initially?
Select one:
a. massaging the fundus firmly
b. performing bimanual compressions
c. administering ergonovine
d. notifying the primary health care provider

Question 46
What would be the most appropriate recommendation to a pregnant client who complains
of swelling in her feet and ankles?
Select one:
a. limit fluid intake
b. buy walking shoes
c. sit and elevate the feet twice daily
d. start taking diuretics as needed daily

Question 47
55. A client had spontaneous vaginal delivery after 18 hours of labor. Her excessive vaginal
bleeding has now become a postpartum hemorrhage. Immediate nursing care of this client
should include which of the following interventions?
Select one:
a. avoiding massaging the uterus
b. monitoring vital signs every hour
c. placing the client in Trendelenburg’s position
d. Elevating the head of the bed to increase blood flow.
Question 48
Which of the following assessment of the mother should be made in the immediate
postpartum period (First 2 hours)
Select one:
a. Blood glucose level
b. Electrocardiogram (ECG)
c. Height of fundus
d. Stool test for occult blood

Question 49
Which of the following maternal complications is associated with obesity in pregnancy?
Select one:
a. mastitis
b. placenta previa
c. preeclampsia
d. Rh isoimmunization

Question 50
A client is diagnosed with preterm labor at 28 weeks’ gestation. Later, she comes to the
emergency department saying, “I think I’m in labor.” The nurse would expect her physical
examination to show which of the following conditions?
Select one:
a. painful contractions with no cervical dilation
b. Regular uterine contractions with cervical dilation.
c. Irregular uterine contractions with cervical dilations
d. Irregular uterine contractions with cervical effacement.