OBSTETRIC NURSING

1. The woman about 2 months pregnant complaints of nocturia. In addition to advising her decrease fluid
intake after 6 p.m., teaching includes sleeping in a:
a. supine position b. semifowlers position
c. chair sitting position d. side-lying position
2. !uring pregnanc" there is an increase possibilit" of weakness of the walls of certain blood vessels, what
common complication does this cause#
a. weak abdominal muscles b. varicose veins
c. h"pertension d. urinar" fre$uenc"
%. & pregnant patient complains of nausea and vomiting in the morning. 'hich patient teaching will help
remed" this condition#
a. coke b. crackers c. butter toast d. whole milk
(. 'hat are the blood vessels in the umbilical cord that provide for fetal circulation#
a. )ne arter" and two veins b. one arter" and one vein
c. Two arteries and two veins d. to arteries and one vein
*. The woman who has +ust completed her 1%
th
week of pregnanc" comes in for monthl" period of visit. ,he
has gained 12 lbs. since her initial visit two months ago. The nurse e-presses concern regarding the weight
gain. The patient asks, .'ell, how much weight should I have gained b" now/#
a. about 10 lbs. b. not more than 10 lbs
c. not !ore t"an #-$ lbs d. no weight gain is e-pected is e-pected this soon
6. The pregnant patient asks .'hen does the heart and brain of the bab" form#/ The nurse answers:
a. t"e %irst !ont" b. the second month
c. the third month d. the first trimester
1. The pregnant patient in her third month when she makes her second prenatal visit. ,he asks the nurse
.'hat is happening right now in the development of the bab"#/ The nurse answers:
a. the heart is beginning to pump blood
b. the brain is dividing into sections
c. lanugo and verni- caseosa are forming to protect embr"o
d. t"e e!bryo is beco!ing %et&s and se' deter!ined
2. & new patient states .I must be about ( months pregnant/ I cant remember e-actl" m" last menstrual
period, but I have been feeling the bab" kicking for % or ( weeks now .3pon auscultation the nurse hears
fetal heart sounds. The nurse states that this assessment indicates:
a. "ou are not $uite four months b. yo& are in yo&r %i%t" !ont"s
c. "ou ma"be si- months along d. "ou are probabl" seven months pregnant
4. The patient in her fifth month asks the nurse. 5ow much does m" bab" weight at this point in the
pregnanc"# 6ased on averages, the nurse answers, "our bab" weighs appro-imatel":
a. () o*. b. 2 lbs. c. % lbs. d. ( lbs.
10. The pregnant woman has two daughters and with pregnanc" she wants a son. ,he asks the nurse, It is
m" fault if dont have a son# The nurse answers.
a. $uite possibl", "es
b. $uite possibl", but I dont think so
c. no+ beca&se t"e !ale se' deter!ine se'
d. no, because no one can determine that
11. !uring labor and deliver" the fetus goes through a series of maneuvers in preparation for deliver".
'hat is the normal se$uence#
a. fle-ion, descent, e-tension and internal and e-ternal rotation
b. descent, e-tension, fle-ion, internal and e-ternal rotation
c. descent, fle-ion, e-tension, internal rotation and e-ternal rotation
d. descent+ %le'ion+ internal rotation+ e'tension and e'ternal rotation
12. The woman in transitional phase of labor is h"perventilating. The nurse has not been able to get her to
show down her respiration and begins to monitor for respirator" alkalosis. 'hat sign and s"mptoms are
evident of this condition#
a. nausea and vomiting b. sudden increase in temperature
c. di**iness and circ&!oral n&!bness d. fruit" odor of breath and di77iness
1%. To counteract the s"mptoms of respirator" alkalosis, the nurse offers the patient:
a. ice chips b. paper bag c. o-"gen b" mask d. ice cold water
1(. The woman who is pregnant for the first time comes to the hospital in labor. 'hich of the following
s"mptoms is inactive of true labor#
a. pain in back b. irregular contractions
c. walking doesnt increase pain d. no change in intensit" of contractions
1*. The woman who is dilated at 1 cm is beginning to bear down and push. The nurse discourages pushing at
this point in the labor process because.
a. pushing does not aid in the deliver"
b. pushing should alwa"s be avoided
c. p&s"ing s"o&ld begin at %&ll dilatation
d. pushing should begin at 2 cm dilatation
16. 'hat instruction should the nurse give the mother when she begins to breastfed her infant for the
first time#
a. stroke her ear on the side that is ne-t to the breast
b. stroke the sole of her feet
c. stroke t"e c"eek t"at is ne't to t"e breast
d. gentl" turn her head toward the breast
11. The new mother asks the nurse how long should I breastfed m" bab" each time. The nurse recommends.
a. # !in&tes at eac" nipple b. * minutes at each nipple
c. 10 minutes at each nipple d. 1* minutes at each nipple
12. The pregnant patient asks the nurse when she should start breastfeeding. The nurse replies.
a. when "our milk comes down
b. as soon as possible a%ter delivery
c. in 2 or % da"s when "ou are feeling better
d. I do not recommend breastfeeding
14. The new mother who is breastfeeding complains that the bab" keep falling sleep. The nurse teaches the
mother to:
a. +ust wake the bab" b. let the bab" sleep
c. postpone feeding for one hour d. r&b t"e soles o% t"e %eet gently
20. The nurse is doing an initial assessment with the pregnant patient who states that she is a strict
vegetarian. 'hat vitamin supplement should be recommended#
a. & b. 8 c. ! d. B(#
21. The pregnant woman states that she has never heard a folic acid before and asks, what food should I
be eating# The nurse responses, "ou should be eating:
a. &n abundance of animal products b. lots o% green+ lea%y vegetables
c. mainl" fruits and wheat germ d. citrus fruits, nuts and grained
22. The patient states that folic acid is a strange name for a vitamin. 'h" do I need it# The nurse states
that this 6 vitamin is especiall" needed during pregnanc" because it:
a. aids in maternal circulation
b. assist in growth of bones and teeth
c. aids in coagulation of red blood cells
d. is essential %or cell and RB %or!ation
2%. The nurse is teaching the pregnant woman about specific needs during pregnanc" and lactation.
9egarding grain products, how man" servings are re$uired dail"#
a. Two b. three c. %o&r d. si-
2(. !uring the first si- months of lactation, the nurse instructs the mother who is breastfeeding that she
needs additional calories. 'hat is the 9!& during lactation#
a. 100 more calories b. %00 more calories c. a total o% #+,)) calories d. a total of %,*00
2*. The nurse states that an iron supplement is recommended during pregnanc" because:
a. not man" foods contain iron
b. supplements are better than food
c. foods containing iron cause nausea
d. R-. %or iron do&bles d&ring pregnancy
26. The pregnant woman in her first trimester asks, should I be eating for two# :ust how much should I be
eating# The nurse responses:
a. "ou should +ust double "our intake
b. "oure not reall" eating for two
c. yo&r calories s"o&ld not increase in t"e %irst tri!ester+ b&t yo& s"o&ld add $)) calories
daily d&ring t"e second and t"ird tri!ester
d. "our calories should +ust sta" the same, but "ou need to add some foods that will suppl" other
essential nutrients re$uired for growth.
21. The pregnant patient is complaining of flatulence and re$uest advice regarding relief measures. The
nurse should teach her:
a. to decrease intake o% seet b. to take prescribed medication
c. to increase fluid intake d. to take fre$uent walks
22. & pregnant woman is practicing pica. 'hat does this mean#
a. S"e is eating non-%ood t"ings
b. she is refusing an" medication
c. she is avoiding all dair" products
d. she is planning natural child birth
24. & pregnant patient has her urine glucose tested. The glucose is negative but the acetone is positive.
The nurse should ask the patient about.
a. her e-ercise b. /er diet
c. bladder infection d. possibilit" of pica
%0. 'hat is the etiolog" of leg cramps in pregnanc"#
a. calci&!-p"osp"oro&s i!balance b. too much calcium in the blood
c. ;ack of proper e-ercise d. electrol"te imbalance
%1. The nurse is teaching newl" pregnant woman about eating properl". 'hich of this food is highest in
calcium#
a. apricots b. prunes c. nuts d. broccoli
%2. & pregnant woman eats 2 eggs with toast to facilitate her iron intake. The nurse teaches that iron is
absorbed poorl", and absorption will be enhanced b":
a. taking a vitamin pill &8 b. eating a banana at breakfast
c. not drinking coffee with meals d. drink orange 0&ice it" t"is !eal
%%. 'hich food high in iron would be recommended to the pregnant patient#
a. apricots and pr&nes b. eggs and bacon
c. cottage cheese and fruit d. milk and ice cream
%(. The pregnant woman is prescribed a diet high in protein. The nurse recommends which of the following
combinations:
a. rice and vegetables b. peas and carrots
c. fruits and vegetables d. beans and rice
%*. The pregnant patient is advised to take ferrous sulfate. 'hat instruction that the nurse give the
patient about taking this medication#
a. take with milk to increase absorption
b. take it" %ood to increase absorption
c. mi- with +uice to disguise taste
d. take with water earl" in the morning
%6. 'h" is iron prescribed during pregnanc"#
a. to prevent drop in the 968
b. to prevent shock during deliver"
c. to prevent drop in t"e "e!atocrit
d. to provide iron storage in placenta
%1. The nurse is assessing a woman who thinks she is pregnant. 'hich of the following is a positive sign of
pregnanc"#
a. $uickening b. %etal "eart tones c. positive 58< d. chadwicks sign
%2. !uring an initial assessment, 2( "ear old woman tells the nurse she is pregnant because she feels the
bab" moving or fluttering around. The nurse recogni7es this is a:
a. pres&!ptive sign b. probable sign
c. positive sign d. possible sign
%4. =etal heart sounds is one of the four positive signs of pregnanc", the nurse anticipates assessing the
heartbeat b" stethoscope at:
a. about 6 weeks b. about 12 weeks
c. appro-imatel" 16 weeks d. appro'i!ately #) eeks

(0. The pregnant woman is somewhat distressed about developing mudd" brown blotches on the face. The
nurse e-plains this:
a. indicates potential complications
b. signal hormonal shifts
c. is a nor!al condition called c"loas!a
d. is a highl" abnormal condition
(1. !uring an initial vaginal e-am, the nurse assesses a dark blue discoloration of the vaginal mucous
membrane. This presumptive sign is:
a. ballotment b. $uickening c. c"adick1s sign d. kernigs sign
(2. The woman 20 week pregnant is in her monthl" checkup. 5er blood pressure has highl" been increase
on the last two visits. The nurse is aware that the brachial pressure is highest when the patient is:
a. supine b. sitting c. l"ing on right side d. l"ing on left side
(%. )n her second visit, the woman eight weeks pregnant is surprise that her blood pressure is lower than
it was before she became pregnant. The nurse e-plains blood pressure drops slightl" during the first
trimester because:
a. the heart becomes enlarge b. peripheral vessels constrict
c. perip"eral vessels dilate d. the bod" is in the resting state
((. The postpartum patients circulator" status is carefull" monitored because blood has an enhanced
tendenc" to coagulate. This natural phenomenon puts the patient at a higher risk for:
a. hemorrhage b. menopause c. t"ro!b&s d. placental clots
(*. & patient %6 weeks gestation, comes to the hospital e-periencing false labor and escalating an-iet",
respiration are %2>min. The electrol"te imbalance that the nurse must be alert for is:
a. respirator" acidosis b. respiratory alkalosis
c. metabolic acidosis d. metabolic alkalosis
(6. The nurse tells the patient with swelling in the legs that she is e-periencing ph"siologic edema. The
patient asks, what do I do# The nurse answers:
a. sta" off "our feet
b. strict bed rest is re$uired
c. the doctor will prescribed something
d. no treat!ent is re2&ired at t"is ti!e
(1. The pregnant patient with edema in the ankles states that her friend told her to cut down on salt. ,he
asks the nurse, how much salt I should have, the appropriate is response is:
a. as little as possible
b. +ust dont add salt at the table
c. +ust dont add salt when cooking
d. yo& need at least $ gra!s per day
(2. This patient has difficult" understanding how much % grams of sodium per da" is. In e-plaining this, the
nurse suggests:
a. eat a regular diet without limiting a salt
b. yo& can eat anyt"ing yo& ant in !oderation
c. "ou must be ver" careful about adding salt
d. +ust dont eat potato chips or salt" snack foods
(4. The nurse is preparing to administer ?itocin. 'hat is the priorit" assessment before administration#
a. fundus b. blood press&re c. urine output d. pulse rate
*0. )-"tocin is being administered at 2 m3> min. It has +ust been increased from 1 m3> min. suddenl" the
nurse notes an irregular faster fetal heart rate. The priorit" intervention is:
a. cut I@ back to 1 m3> min b. increase to % m3> min
c. monitor heartbeat closel" d. discontin&e o'ytocin in%&sion
*1. The nursing assessment of a patient in labor is contractions lasting 60 seconds four minutes apart.
8ervi- is 6 cm. dilated. 'hat stage of labor is this#
a. active p"ase II b. earl" phase I c. transition phase III d. false labor
*%. 'hen a patient is admitted to the unit in active labor. 'hat is the action the nurse should take#
a. assess for ruptured membrane b. take vital signs and c"eck 3/T
c. perform ;eopold maneuver d. catheteri7e for urine specimen
*(. Aursing assessment active labor, breech presentation, ruptured membranes, a change in location of
fetal heart sounds. The nurse evaluates this as:
a. a fetus in distress b. abnor!al assess!ent
c. a sign labor is progressing d. indicative of cesarean section
**. & gravida III ?ara II is in labor and is progressing rapidl". 'hen she should be move into deliver"
room#
a. cervi- is dilated 2( cm. b. cervi' is dilated ,-4 c!.
c. cervi- is full" dilated d. at the onset of the labor
*6. 'hat does it mean during labor when the nurse assesses the fetal presenting part at .plus one#/
a. one inch above ischial spines b. one inch below the ischial spines
c. One cm. above ischial spines d. one c! belo t"e isc"ial spines
*1. 6efore performing leopolds maneuver, the nurse e-plains to the pregnant patient, what she will
be doing. The nurse states that the primar" purpose of these assessment is to:
a. determined the length of the fetus b. deter!ined t"e position o% t"e %et&s
c. locate the head of the fetus d. estimate the length of labor
*2. The nurse is to perform ;eopolds maneuver on a permanent patient. 'hat instruction does the
nurse give the patient +ust before the assessment#
a. take slow, deep breaths to relieve pain b. do not eat the night before the procedure
c. remain on strict bed rest prior to procedure d. &rinate 0&st prior to proced&re
*4. &fter the membranes rupture what is the priorit" nursing intervention#
a. blood pressure b. presentation c. ;B, d. %etal "eart rate
60. The nurse is timing contractions in a patient who is 1 cm dilated. 5ow is contraction fre$uenc"
measured#
a. from the beginning of a contraction to the end
b. %ro! t"e beginning o% t"e contraction or t"e beginning o% t"e ne't
c. from the end of the contraction to the beginning of the ne-t
d. from the end of the contraction to the end of the ne-t
61. The patient is dilated 10 cm. and the head is emerging. The ph"sician has been called but has not
arrived. 'hat is the initial action the nurse must take after the head emerges#
a. ?age doctor to deliver" room ,T&T
b. deliver the shoulder b" turning the presenting part to an internal rotation position
c. p&s" don on t"e %&nd&s to "elp e'pel t"e in%ant
d. ,upport head while bod" is spontaneousl" deliver
62. If labor is progressing satisfactor", when would it be appropriate to administer pain medication
such as !emerol.
a. cervical dilatation of % cm. b. cervical dilatation of % cm.
c. cervical dilatation of * cm. d. cervical dilatation o% , c!.
6%. The placenta should be delivered within what period of time following the deliver"#
a. 12 minutes b. $-() !in&tes c. 1*20 minutes d. 121* minutes
6(. Ten minutes after the deliver", the placenta is still intact. 'hat action should the nurse take#
a. gentl" pull on cord to initiate separation
b. call the ph"sician back to the deliver" room
c. push gentl", but firml" in the fundus
d. allo in%ant to s&ck on t"e breast
6*. & multigravida is admitted to the emergenc" room in active labor. ,he is "elling, .hurr", 5urr"#
Its coming# 'hat is the initial nursing action indicated#
a. time the contraction interval
b. do a $uick leopolds maneuver
c. check the fetal heart tone
d. deter!ine t"e presenting part
66. &fter the placenta is delivered, the nurse adds a medication to the I@ solution. 'hich
medication is ordered#
a. penicillin b. o'ytocin c. astropines d. catapres
61. The nurse is assessing between false labor and true labor. 'hat does she asks the patient to
do:
a. bear down b. alk aro&nd c. time contractions d. do breathing e-ercises
62. Two da"s after deliver", the nurse assesses a heav" amount of lochia rubra containing four
blood clots about the si7e of $uarters. This assessment is:
a. normal for two da"s post deliver"
b. normal for four da"s post deliver"
c. abnormal because it is rubra serosa
d. a sign o% co!plication or "e!orr"age
64. The patient who is si- da"s postpartum calls and asks the nurse about the discharge she is
e-periencing she states it has a foul odor. The nurse further assesses for signs of:
a. cleanliness b. hemorrhage c. in%ection d. knowledge deficit
10. In e-plaining the pattern of discharge following deliver", the nurse e-plains that lochia will be
heavier:
a. in t"e !orning b. at night c. as the lochia cessation nears d. toward the end of lactation
11. & patient has been in postpartum % C da"s when she begins complaining of foul smelling lochia. 'hen
nursing intervention is indicated#
a. c"eck te!perat&re and %&nd&s b. check bladder distention
c. tell her this is normal d. check color of lochia
12. The nurse assesses a patient who delivered one hour ago. The fundus is firm and two finger breaths
below umbilicus and the lochia is bright red. The patient complains of having chills. The nurse should be
aware that this assessment is indicative of:
a. a nor!al postpart&! response b. the onset of hemorrhage
c. onset of h"povolemic shock d. an inverted uterus
1%. 'hen is postpartum blues or depression most likel" to occur#
a. first (2 hours b. first 12 hours
c. 3o&rt" or %i%t" day d. during the second week
1(. The postpartum patient states, I feel so let down and sad. I dont know what to do, the appropriate
nursing response is:
a. o%%er e!pat"y and s&pport b. offer referral to a ps"chiatrist
c. tell her to be happ" to have a new bab" d. tell her to call doctor for medications
1*. In the newborn, flatless, or allow displacement of the upper earlobes, is indicative of what ph"sical
condition#
a. liver anomal" b. kidney ano!aly c. heart anomal" d. lung anomal"
16. 'hat diagnosis in the newborn is confirmed when a flash light is held close to the scrotum and
transparenc" is noted#
a. h"drocete b. undescented testes c. enlarged scrotum d. h"pospadias
11. Dongolian spots are blueblack discoloration in the sacral area on an infant that:
a. are indicative of child abuse b. ill disappear in a year
c. are indicative of internal problems d. are something like a birth mark
12. & bab" weighs 1 lbs., ( o7 at birth. Three da"s later the infant weighs 6 lbs., 4 o7. The nurse tells the
mother that this weight loss is:
a. nor!al b. abnormal c. probabl" a mistake d. a warning sign
14. 'hat is the best techni$ue for assessing +aundice in a newborn#
a. interpretation of lab data b. blanc"ing skin on %ore"ead
c. testing capillar" refill d. assessing skin on bottom of feet
20. & newborn is assessed at a gestational age of %6 weeks. 'hat signs does the nurse assess#
a. feeling cracked skin b. lanugo over entire bod"
c. flat ears d. !oro re%le'
21. 'hich of the following are signs of a postpartum newborn#
a. long, brittle hair b. creases in soles of feet
c. well developed e"ebrows d. long+ brittle %ingernails
22. 'hich of the following signs would indicate the newborn is at a gestation age of %4(0 weeks>
a. pinkish, wrinkled skin b. creases in soles o% %eet
c. lanugo over the bod" d. laid back ears
2%. & newborn has strabismus, and the mother states she is worried about it. The nurse tells the mother
that this condition is:
a. nor!al b. permanent c. re$uires surger" d. re$uires medication
2(. In assessing the breechbirth newborn the nurse looks for what particular complication of birth#
a. h"drocephalus b. cerebral palsy c. broken hip d. c"anosis
2*. 'hich of the following are signs of postmature newborn#
a. long brittle hair b. creases in soles of feet c. welldeveloped e"ebrows d. long brittle %ingernails
26. ?itocin should be administered rapidl" I@ to the patient who is hemorrhaging as a result of uterine atom".
& bolus of ?itocin is not administered because it can cause:
a. h"pertension b. "ypotension c. shock d. palpitation
21. & %2"earold woman whose parit" is si- has +ust delivered an 2 lb., * o7 bab". 'hat complication should
the nurse monitor during the fourth stage of labor#
a. uterine shock b. &terine atony c. cardiogenic shock d. inverted fetus
22. & patient 6 hours postpartum is hemorrhaging following abrupt deliver" of a 4 lb. 6 o7 infant. The nurse
has changed her pad ever" 10 minutes and each pad weighs about 10 grams, she estimates blood loss per hour
as:
a. 10 ml>hr b. 20 ml>hr c. 5) !l6"r d. 100 ml>hr
24. The nurse assesses a prolapsed cord, in what position should the nurse placed the patient#
a. lithotom" b. knee-c"est c. sidel"ing d. lowfowlers
40. The nurse assesses a pulsating cord protruding from the vagina. The patient is placed in the ,ims
position, the pelvis elevated on pillows and:
a. no further action is re$uired
b. et+ saline sol&tion co!press applied
c. push cord back into vagina
d. attempt to deliver fetus
41. 'hich of the following nursing interventions is most important in monitoring a patient 9itodrine#
a. patient Ritodrine7 6. monitor brad"cardia
c. monitor h"pertension d. monitor for h"pogl"cemia
42. The nurse is monitoring primigravida who is carr"ing twins. ,he is on the %%
rd
week of gestation and the
members have +ust ruptured. The nurse hears onl" one heartbeat. 'hat action should be taken#
a. nothing this is not common b. move twins to more accessible position
c. noti%y t"e p"ysician i!!ediately d. monitor the heartbeats more fre$uentl"
4%. 'hen the patient receiving 9etrodine becomes h"potensive, what medication should the nurse prepare to
administer#
a. catapres b. inderal c. atropine d. vasodilan
4(. The pregnant patient goes into labor prematurel" and is admitted to the unit. 'hich medication would the
nurse prepare to administer#
a. valium to decrease an-iet" b. ?itocin to strengthen contractions
c. Rotrodrine "ydroc"loride to "alt labor d. !emerol to relieve pain
4*. In caring for a premature infant, which measure is priorit"#
a. putting infant in an o-"gen tent
b. putting infant under light to prevent +aundice
c. providing in%ant it" ar! environ!ent
d. providing infant with plent" of h"dration
46. The twins were too premature to develop their sucking refle-es and will be fed via gavages. 5ow will the
nurse determine the location of the catheter after it has been started#
a. In+ect a table spoon of formula, observe response
b. ?ull back on tube to withdraw gastric contents
c. In0ect ( !l o% air t"ro&g" cat"eter and listen it" stet"oscope over t"e abdo!en
d. In+ect 1 ml of water and listen with stethoscope for gurgling sound over abdomen
41. The nurse might suspect earl" preeclampsia if the patient complains
a. I am bleeding ver" heavil"
b. I got di77" and had to lie down
c. I get ver" depressed and cr" easil"
d. I can1t ear !y edding ring any!ore